Autophagy in diabetes pathophysiology: Oxidative damage screening as potential for therapeutic management by clinical laboratory methods

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Autophagy or auto-phagocytosis is self-phagocytosis of tissues and cellular materials i.e., “self maintenance.” While phagocytosis normally refers to the innate immune process of white blood cells engulfing foreign bodies such as infectious materials, autophagy is a regulatory phenomenon of dysfunctional cellular components being removed (Kobayashi, 2015). Autophagy is inseparable
from inflammation and oxidative stress phenomena (Turkmen, 2017); which are intricately involved in pathophysiology of diabetes mellitus (DM) (Muriach et al., 2014). The relationships between phenomena is shown in Figure 1.
Autophagy in association with oxidative stress is involved in pathophysiology. For instance, in the non-modifiable aging process, autophagy is involved in the associated oxidative stress and this can be assessed by glycation end-products as well as indices of lipid oxidation such as malondialdehyde (Moldogazieva et al., 2019). What is yet to be articulated for clinical translation in terms of laboratory assessment of autophagy is the concept of oxidative stress screening. A recent review highlights cell culture and electron microscopy methods (Yoshii and Mizushima, 2017) but not blood tests for oxidative stress indices. Thus, the gap between knowledge and practice are the apparent lack of acknowledgment of oxidative damage interplay between autophagy and metabolic diseases.
The objective of this paper is to bring to the fore the way in which clinical laboratory tests for oxidative stress panel can be used to assess autophagy in metabolic syndrome, especially the relevance of tests from different thematic sub-panels to establish cellular damage in metabolic syndrome. In this objective, cognizance is taken that metabolic syndrome is a constellation of diabetes and its cardiovascular complications including dyslipidaemia factor. For instance,
abnormal cholesterol can exacerbate oxidative stress to increase autophagy in diabetes.
This opinion paper is organized in four sections. First three sections cover “causes, consequences, and therapeutic challenges” in terms of oxidative stress, effects on vascular physiology, and implications for management by laboratory methods, respectively. A brief fourth section is on availability of clinical laboratory tests for oxidative stress panel and how to interpret
the results in terms of autophagy-inflammation interplay.
Original languageEnglish
Article number651776
Pages (from-to)1-7
Number of pages7
JournalFrontiers in Cell and Developmental Biology
Publication statusPublished - 27 Apr 2021


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