BASEL RAMLAWI, MD
...This study shed new light by demonstrating that diabetic patients are qualitatively and quantitatively different at the gene expression level," Basel Ramlawi, MD, a fellow in cardiovascular surgery, Harvard Medical School and Beth Israel Deaconess Medical Center said.
The study found that muscle from non-diabetic patients exhibited 626 upregulated and 348 downregulated genes after cardiac surgery.In contrast, muscle from diabetic patients exhibited a different set of 420 upregulated genes and 473 downregulated genes.In particular, diabetic patients had lower levels of the TR3 gene (a receptor that mediates the function of cells that line the blood vessels), which was associated with postoperative weight gain."This endothelial function gene, which is differentially expressed in diabetic patients, may play a role in the way blood vessels release fluid into the surrounding tissue.In that way, the difference in gene expression may be related to the propensity of diabetic patients to gain weight and retain water after surgery, which in turn causes complications, such as edema [excessive fluid buildup] or changes in the permeability of blood vessels in the periphery," Dr. Ramlawi
said."The study is at the preliminary stages of investigation, and only gives us a clue in terms of the difference in response to heart surgery and the heart-lung machine, in particular, among diabetic patients," he
Other than the need for insulin among diabetic patients, both groups of patients were similar in every other respect, Dr. Ramlawi
In future experiments, Dr. Ramlawi
colleagues will seek to confirm the relationship between genetic expression and complications in diabetic patients."The first step is to find out with certainty which genes are differentially expressed using laboratory technique and try to modify gene expression that is particular and specific to diabetic patients," he
said."The next step would be to tailor treatment to prevent the complications that are specific to diabetic patients.By identifying genes which are differentially expressed in diabetics and non-diabetics, we may come up with new therapeutic solutions that would tailor treatment to diabetic status and improve and affect the activity of particular genes," Dr. Ramlawi