Recent Developments

1 It has recently been shown that only two weeks of smoking cessation can ameliorate the enhanced platelet aggregability and intraplatelet redox imbalance in long-term smokers, largely by a reduction in oxidative stress.

2 Data have emerged to suggest that smoking is independently associated with the insulin resistance syndrome and this association may represent a major mechanistic link between cigarette smoking and cardiovascular disease. Smokers have been shown to be more insulin resistant and dyslipidaemic, and have evidence of endothelial dysfunction compared with non-smokers. Recent epidemiologic data have suggested that cardiovascular disease in smokers is primarily seen in those individuals who also have the characteristic findings of insulin resistance. This raises the intriguing possibility of treating the cardiovascular risk associated with smoking with an insulin sensitizer.

3 The role of gamma-aminobutyric acid (GABA) and metabotropic glutamate receptors as potential targets of pharmacotherapies for smoking cessation has recently been investigated. This is based on previous work which indicated a role for GABA and glutamate in the reinforcing effects of drugs of abuse. In an experimental study, compounds that increase GABAergic neurotransmission and antagonists at glutamate receptors have potential anti-smoking properties for humans.

4 Research examining the role of allelic variation in different genes which may influence smoking behaviour and nicotine dependency is also being actively pursued.6 Dopamine receptor genes, transporter genes (serotonin and dopamine) and other genes related to metabolism of nicotine are plausible functional candidate genes.

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