title: Dual blockade of Renin Angiotensin system in reducing the early changes of diabetic retinopathy and nephropathy in a diabetic rat model.
abstract: BACKGROUND
  Diabetes mellitus is a real pandemic of the modern world and the incidence of the disease is increasing at a tremendous rate with a number of complications involving major systems of the human body. The renin angiotensin system (RAS) is considered to be involved in most of the pathological processes that result in diabetic nephropathy and retinopathy.
  
  
  OBJECTIVE
  The study was designed to evaluate and compare effects of ramipril (angiotensin-converting enzyme inhibitor-ACEI) and telmisartan (angiotensin II receptor blocker - ARBs) combinations on the progression of retinopathy and nephropathy in the streptozotocin (STZ) induced diabetic model.
  
  
  METHODS
  Diabetic state in rats was induced by chemical method using STZ 55 mg/kg intraperitoneally. Diabetic renal tubulopathy and interstitial inflammatory changes were done. Diabetic retinopathy manifested in the form of vacuolar changes in the inner plexiform and the ganglionic layers of the retina was observed.
  
  
  RESULTS
  Treatments with ACEI and ARBs reduced the incidence of the occurrence of cataract. The effect of combinational drugs of ACEI (ramipril) and AT1 receptor blocker (Telmisartan) was evaluated. The drugs used in combinations showed improvement in the histopathological and biochemical changes of the diabetic animals, both for the retina and kidney.
  
  
  CONCLUSIONS
  The efficacy of the drugs suggests a pivotal role of the local RAS system in the pathogenesis of tubulopathy in the kidney and neuronal damage in the retina of the diabetic animals.
authors.affiliation: Department of Clinical/Laboratory division, Central Leprosy Teaching and Research Institute, Chengalpattu, India.
authors.forename: Pugazhenthan
authors.initials: P
authors.lastname: Thangaraju
authors.affiliation: Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Amitava
authors.initials: A
authors.lastname: Chakrabarti
authors.affiliation: Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Dibyajyoti
authors.initials: D
authors.lastname: Banerjee
authors.affiliation: Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, India.
authors.forename: Debasish
authors.initials: D
authors.lastname: Hota
authors.affiliation: Department of Computer Science Engineering, SKP Engineering College, Tamil Nadu, India.
authors.lastname: Tamilselvan
authors.affiliation: Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Alka
authors.initials: A
authors.lastname: Bhatia
authors.affiliation: Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Amod
authors.initials: A
authors.lastname: Gupta
keywords: Diabetes; Diabetic nephropathy; Dual block; Nephropathy; Ramipril; Renin angiotensin system; Retinopathy; STZ; Telmisartan