Conventional diuretic agents are very effective agents in relieving volume overload and congestive symptoms in chronic heart failure (CHF). However, they are associated with activation of the renin-angiotensin system (RAS) and the sympathetic nervous system and a reduction in glomerular filtration rate, all of which have been associated with adverse outcomes in CHF. Therefore, there is an increasing interest in drugs that target the natriuretic system without neurohormonal activation and deterioration of renal function. In this review, we will discuss the underlying rationale and evidence behind currently pursued strategies that target the natriuretic system. This includes the administration of natriuretic peptides (NPs) and strategies that potentiate the NP system, such as neutral endopeptidase inhibition. We will also highlight some potentially important interactions of these strategies with drugs that target the RAS.
Adiponectin is one of the most bioactive substances secreted by adipose tissue and is involved in the protection against metabolic syndrome, artherosclerosis and type II diabetes. Research into the use of adiponectin as a promising drug for metabolic syndromes requires production of this hormone in high quantities considering its molecular isoforms. The objective of this study is to produce recombinant human adiponectin by Pichia pastoris (P-ADP) as a cheap and convenient eukaryotic expression system for potential application in pharmaceutical therapy. For comparison, adiponectin was also expressed using the Escherichia coli (E-ADP) expression system. Adiponectin was constructed by overlap-extension PCR, and cloned in standard cloning vector and hosts. Recombinant expression vectors were cloned in the P. pastoris and E. coli host strains, respectively. SDS-PAGE and western blotting were used to detect and analyse expressed recombinant protein in both systems. Adiponectin was purified by affinity chromatography and quantified using the Bradford Assay. The results of this study indicated that P-ADP quantity (0.111 mg/mL) was higher than that of E-ADP (0.04 mg/mL) and both were produced in soluble form. However, P-ADP was able to form high molecular weights of adiponectin molecules, whilst E-ADP was not able to form isoforms higher than trimer. In addition, P-ADP was more active in lowering blood glucose compared with E-ADP. The two types of proteins were equally efficient and significantly decreased blood triglyceride and increased high density lipoprotein. We conclude that P. pastoris is able to produce high quantity of bioactive adiponectin for potential use in treatment of metabolic syndromes.
The objective of this study was to determine the prevalence of men's violence against pregnant women and whether it is influenced by women's attitude. A cross-sectional study was carried out in a hospital in northern state of Peninsular Malaysia. A total of 1,200 postnatal women aged 18 years and above who had been admitted to the hospital were recruited in the study. Universal sampling was performed, and participants were interviewed face-to-face by using a validated Malay version of WHO Women's Health and Life Experiences Questionnaire. The main outcome measures in the study were emotional, physical or sexual violence. The study results showed that more than one third of women (35.9%; confidence interval [CI] = [0.33, 0.39]) had experienced any type of violence during pregnancy with the commonest was psychological violence (29.8%; CI = [0.27, 0.32]) followed by physical (12.9%; CI = [0.11, 0.15]) and sexual violence (9.8%; CI = [0.08, 0.12]). Women who were drug users, had an exposure to violence during childhood, had higher parity, and had inadequate antenatal care were at greater risk. Agree that husband is justified to hit his wife in certain conditions and agree that women has a right to refuse sex in certain conditions were among violence-supporting attitudes. It can be concluded that men's violence against pregnant women is extremely prevalent. Sensitive assessment, attitude modification, and intervention (primary, secondary, and tertiary) are of great value in combating men's violence against pregnant women.