The Open Diabetes Journal




ISSN: 1876-5246 ― Volume 9, 2019
CLINICAL TRIAL STUDY

Type 2 Diabetes Study, Introduction and Perspective



Da-Yong Lu1, *, Jin-Yu Che1, Nagendra Sastry Yarla2, Hong Zhu3, Ting-Ren Lu1, Bin Xu4, Swathi Putta5
1 Shanghai University, Shanghai 200444, P. R. China
2 Divisions of Biochemistry & Chemistry, City University of New York School of Medicine, 160 Convent Avenue, New York, NY 10031, USA
3 College of Pharmaceutical Science, Zhejiang University, Hangzhou, P. R. China
4 Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, P. R. China
5 College of Pharmaceutical Science, Andhra University, Visakhapatnam, AP, India

Abstract

Background:

The prevalence of Type 2 Diabetes Mellitus (T2DM) continues to rise globally. The T2DM prevalence is not only in developing countries, but also in developed countries now. Correspondingly, the therapeutics of T2DM calls for a change (higher efficiency) due to growing number of patients and increasing economic burdens globally. Entering into this millennium, both piecemeal pathways (idea driven) and exponential growth of human genomic study are developing quickly. Genetypic-phenotypic translation, modern diagnostics, pharmacology, drug developments, traditional Chinese medicine, personalized medicine and so on are promising disciplines for this change. The clinical anti-diabetic therapeutics, pathogenesis, drug development pipelines are especially highlighted.

Conclusion:

In summary, a general landscape and principle of T2DM is provided.

Keywords: Anti-diabetic therapy, Insulin-derivatives, Natural chemotherapeutic drugs, Diabetes-induced complication, Traditional Chinese Medicine, Diabetic pathology, Herbal medicine.


Article Information


Identifiers and Pagination:

Year: 2018
Volume: 8
First Page: 13
Last Page: 21
Publisher Id: TODIAJ-8-13
DOI: 10.2174/1876524601808010013

Article History:

Received Date: 25/5/2018
Revision Received Date: 5/7/2018
Acceptance Date: 16/7/2018
Electronic publication date: 31/07/2018
Collection year: 2018

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© 2018 Lu et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Shanghai University, Shanghai 200444, P. R. China, E-mail; ludayong@shu.edu.cn




1. INTRODUCTION

The prevalence of Type 2 Diabetes Mellitus (T2DM) continues to rise globally. The T2DM prevalence is not only in developing countries, but also in developed countries now [1Lu DY, Che JY, Yarla NS, et al. Types 2 diabetes prevention, treatments and new drug developments. Clin Immunol Endocr Metab Drugs 2018; 5.-4Ahmad S, Ed. An Old Disease, A New Insights 2013.]. Correspondingly, the therapeutics of T2DM calls for a change (higher efficiency) due to growing number of patients and increasing economic burdens globally. Entering into this millennium, both piecemeal pathways (idea driven) and exponential growth of human genomic study are developing quickly. Genetypic-phenotypic translation, modern diagnostics, pharmacology, drug developments, traditional Chinese medicine, personalized medicine and so on are promising disciplines for this change. The clinical anti-diabetic therapeutics, pathogenesis, drug development pipelines are especially highlighted.

2. A COMMON BIOLOGICAL PROCESS FOR T2DM

In order to increase the efficiency of T2DM therapeutics, the basic knowledge of T2DM may be better understood.

Fig. (1)
The most frequent pathway for T2DM induction.


In the long-course of T2DM induction and progress (Fig. 1), it is shown that a great number of risk-factors can totally play critical roles of disease progress.

Generally speaking, it was found that many other factors (chemical, biological or environmental influence) could induce the T2DM occurrence in animal model establishment [4Ahmad S, Ed. An Old Disease, A New Insights 2013.-6Lu DY, Che JY, Yarla NS, et al. Type 2 diabetes, medical knowledge and pharmaceutical innovations. J Diabetol 2017; 1(1): 1-3.] (Table 1). A line of chemical, genetic, cellular, physiological and pathological evidence, especially genetic and environmental aspects is tabulated in Table 1.

2.1. Importance of Early Diagnostics

Development of Type 2 Diabetes Mellitus (T2DM) involves a lengthy and complex process from disease onset into symptom/complication manifesting in susceptible human beings. As a result, the cascade characters must be noticed at the earliest in patients.

In the early stage, many preventive measures (regular exercises, non-smoking and so on) or diet control can slow down the pace of the ongoing stages. Some far-reaching medical education systems for diabetes should be introduced to human beings in order to get medical intervention as early as possible [1Lu DY, Che JY, Yarla NS, et al. Types 2 diabetes prevention, treatments and new drug developments. Clin Immunol Endocr Metab Drugs 2018; 5.]. Due to the asymptomic characteristics in early stages of metabolic syndromes, early technical diagnostics is inevitable yet imperfect now. People should be aware that high calorie food consumption is not the only factor to induce T2DM, some other unfavorable risk factors, such as habitually heavy drinking, somatic mutations, toxic compounds or sleep problems etc. [4Ahmad S, Ed. An Old Disease, A New Insights 2013.-6Lu DY, Che JY, Yarla NS, et al. Type 2 diabetes, medical knowledge and pharmaceutical innovations. J Diabetol 2017; 1(1): 1-3.]. can also trigger the incidence of T2DM. Thus, medical check-up for blood glucose concentration and levels should be carried out for people more than 40 years old every year.

Table 1
Possible categories for T2DM initiations and causality.


2.2. Therapeutic Ideas in General

Regular patho-therapeutic ideas and current drug targets are enlisted as following pathways;

  1. What is the therapeutic outcome and differences between patients with T2DM of various origins?
  2. What are genetic-molecular relationships between blood glucose increase and disease complications?
  3. May a known variety of T2DM origins relevant to different individuals?
  4. Can we successfully predict what kinds of diabetic-induced complications will emerge under specific conditions of patients?

3. GENETIC AND MOLECULAR ASPECT OF T2DM

In order to update therapeutics, questions of whether genetic, molecular, physiological, behavioral and environmental aspects of disease-association pathways might be answered and observed;

  1. By taking account individual variability in genetics, environmental and life-style, might some effective medications be separately validated?
  2. What is the core of different anti-diabetic therapeutics?
  3. Can curable therapeutics be widely achieved by patients with T2DM?

Without fully understanding the patho-therapeutic relation, we will not be able to retard diabetic-induced complications as early as possible. These avenues are inevitable for type 2 diabetes study. Several topics are described in this respect.

3.1. Human Genomic Study

T2DM is generated from genetic factors interaction with environmental influence. Personalized anti-Diabetic Therapy (PDT) may be a modern possibility that enables us to offer better therapeutics by integration of different technology and drugs. Pharmacogenetics (PG) [19Corrêa-Giannella ML, Machado UF. SLC2A4gene: A promising target for pharmacogenomics of insulin resistance. Pharmacogenomics 2013; 14(8): 847-50.[http://dx.doi.org/10.2217/pgs.13.45] [PMID: 23746177] ], the widest utility of PDT has a great potentiality for drug selecting and dosing. To accomplish PG for T2DM treatments, human genetic/pathologic information must be known before therapeutics. With the advent and maturation of genomic sequencing technology [20Lander ES. Initial impact of the sequencing of the human genome. Nature 2011; 470(7333): 187-97.[http://dx.doi.org/10.1038/nature09792] [PMID: 21307931] ], this kind of human genomic study might become practical to all patients and get information exponentially [20Lander ES. Initial impact of the sequencing of the human genome. Nature 2011; 470(7333): 187-97.[http://dx.doi.org/10.1038/nature09792] [PMID: 21307931] , 21van der Klaauw AA, Farooqi IS. The hunger genes: Pathways to obesity. Cell 2015; 161(1): 119-32.[http://dx.doi.org/10.1016/j.cell.2015.03.008] [PMID: 25815990] ]. But, who has the right to use human genomic information without regulation [22Rahimzadeh V, Bartlett G. Policies and practices of data-intensive primary care in the precision-medicine era. Intern Med Rev 2017; 3(9): 1-14.[http://dx.doi.org/10.18103/imr.v3i9.558] ]. It is an ethical question that needs long-term debates between patients and healthcare providers. Currently, the “loss-of-function” by genetic mutation, such as leptin, insulin and their receptors or down-stream molecules is widely observed [21van der Klaauw AA, Farooqi IS. The hunger genes: Pathways to obesity. Cell 2015; 161(1): 119-32.[http://dx.doi.org/10.1016/j.cell.2015.03.008] [PMID: 25815990] ].

At this stage of technical capability, PG study for diabetes widely encompasses drug dosing (pharmacodynamics or pharmacokinetics issue) by genotypes of human metabolic enzymes. Due to the unpredictable nature of overall disease-related molecular alterations and metabolic abnormality, PG for various diabetic profiling is the important information different from metabolic enzymes (Fig. 2). Fig. (2) represents the outlook of PDT applications and promotion in the clinic. This type of PDT may be utilized in anti-diabetic treatments in the future [19Corrêa-Giannella ML, Machado UF. SLC2A4gene: A promising target for pharmacogenomics of insulin resistance. Pharmacogenomics 2013; 14(8): 847-50.[http://dx.doi.org/10.2217/pgs.13.45] [PMID: 23746177] -21van der Klaauw AA, Farooqi IS. The hunger genes: Pathways to obesity. Cell 2015; 161(1): 119-32.[http://dx.doi.org/10.1016/j.cell.2015.03.008] [PMID: 25815990] ].

Fig. (2)
Proposed diagram of personalized anti-diabetic therapy.


3.2. Molecular and Physiologic Pathways and Influences

Molecular and physiologic pathways and influences for T2DM are exemplified as the following parts;

Neural activity and circuits that control the appetite of patients is now located onto brain hypothalamic-pituitary area [17Steculorum SM, Paeger L, Bremser S, et al. Hypothalamic UDP increases in obesity and promotes feeding via P2Y6-dependent activation of AgRP neurons. Cell 2015; 162(6): 1404-17.[http://dx.doi.org/10.1016/j.cell.2015.08.032] [PMID: 26359991] ]. These kinds of brain activities are very important for human obesity and T2DM.

Abnormal metabolic conditions in human adipose tissues; their dysfunctional characteristics are based on adipose tissues, livers and other human organs [18Lee YS, Kim JW, Osborne O, et al. Increased adipocyte O2 consumption triggers HIF-1α, causing inflammation and insulin resistance in obesity. Cell 2014; 157(6): 1339-52.[http://dx.doi.org/10.1016/j.cell.2014.05.012] [PMID: 24906151] ].

Hormonal synthesis, secretion and resistance, such as insulin, leptin and others play key roles for patients’ obesity and diabetes [4Ahmad S, Ed. An Old Disease, A New Insights 2013.-18Lee YS, Kim JW, Osborne O, et al. Increased adipocyte O2 consumption triggers HIF-1α, causing inflammation and insulin resistance in obesity. Cell 2014; 157(6): 1339-52.[http://dx.doi.org/10.1016/j.cell.2014.05.012] [PMID: 24906151] ]. Their synthesis, secretions and functional resistance are useful for individualized treatments of T2DM.

Energy homeostasis; a lot of patients with obesity and T2DM requires food control and heightened exercise activities [15Lu DY, Che JY, Wu HY, et al. An overview of obesity. Metabolomics 2018; 8(2): 200., 16Lu DY, Che JY, Wu HY, et al. Obesity, risks and managements. Metabolomics 2018; 8(1): e156.]. Human energy balance will decide human body weight gain or loss and further affect blood glucose levels. This energy issue is crucial for T2DM progress and managements [21van der Klaauw AA, Farooqi IS. The hunger genes: Pathways to obesity. Cell 2015; 161(1): 119-32.[http://dx.doi.org/10.1016/j.cell.2015.03.008] [PMID: 25815990] ].

Apart from these disease-induced pathways, other genetic and molecular issues may also involve [1Lu DY, Che JY, Yarla NS, et al. Types 2 diabetes prevention, treatments and new drug developments. Clin Immunol Endocr Metab Drugs 2018; 5.-4Ahmad S, Ed. An Old Disease, A New Insights 2013.]. With the growth of T2DM therapeutic study, higher efficiency of disease controls may be expected.

4. PHARMACEUTICAL AND PHARMACOLOGIC STUDIES

4.1. Herbal Drugs and Traditional Chinese Medicine (TCM)

A great variety of herbs (>500 species) have been reported to be associated with T2DM [10Singh A, Srivastav R, Randey AK. Protective role of Terminalia Chebula in streptozotocin-induced diabetic mice for wound healing activity. Br J Med Med Res 2017; 22(2): 1-8.[http://dx.doi.org/10.9734/BJMMR/2017/33137] ]. A lot of articles reported their functionality and therapeutic activity in experimental settings. Nonetheless, only a few of these herbal drugs have been commercialized and widely utilized for T2DM prevention and treatments. Likewise, herbal therapy is one of the major avenues of diabetes mellitus therapeutic study and clinical development in the future [1Lu DY, Che JY, Yarla NS, et al. Types 2 diabetes prevention, treatments and new drug developments. Clin Immunol Endocr Metab Drugs 2018; 5., 23Li GQ, Kam A, Wong KH, et al. Herbal medicines for the management of diabetes. An old disease, A new insights. In: Ahmad S, Ed. 2013; 396-413.].

Most therapeutic data from anti-diabetic herbs are commonly based on multitude biochemical pathways, such as antioxidant activity, insulin synthesis, secretion and sensitivity, glucose uptake assistance, reduced glucose production from hepatocytes, anti-inflammatory activity and so on [22Rahimzadeh V, Bartlett G. Policies and practices of data-intensive primary care in the precision-medicine era. Intern Med Rev 2017; 3(9): 1-14.[http://dx.doi.org/10.18103/imr.v3i9.558] ]. However, except a small number of countries, such as China, India and Germany, herbal drugs are not allowed for therapeutic purpose worldwide because of the requisite of high-quality and complexity of drug prescription in the clinic. From pharmacological perspective, the therapeutic study for herbal medicines should aim at specific drug targets and whole body regulation in clinical trials. Many animal diabetic models might not be the best vehicle for direct translations in the clinic.

To better utility of herbal drugs or recipes, some principle of TCM for diabetes might be properly established in the future [1Lu DY, Che JY, Yarla NS, et al. Types 2 diabetes prevention, treatments and new drug developments. Clin Immunol Endocr Metab Drugs 2018; 5.]. Combinations of anti-diabetic therapy of modern medicine (chemical or biological therapy) and traditional (TCM) might be useful in the clinic.

4.2. Pharmaceutical Study

Insulin-based therapy needs to improve for clinical feasibility. It commonly needs syringes and human-body injections, which lead to treatment inconvenience. Overall, some small-molecular chemicals having the insulin-configurations or insulin receptors binding activity might be potential oral anti-diabetic drugs for improving insulin-based therapy in the clinic [13Lu DY, Che JY, Wu HY, Lu TR. The pathogenesis and treatments of diabetes, questions and answers. Cell Dev Biol 2014; 3(3): e126., 14Lu DY, Che JY, Wu HY, Lu TR. The pathogenesis and treatments of diabetes, a new insight. Adv Tech Biol Med 2014; 2: e102.].

More recently, some capsules containing biological form of insulin were invented for patients needing insulin therapy [1Lu DY, Che JY, Yarla NS, et al. Types 2 diabetes prevention, treatments and new drug developments. Clin Immunol Endocr Metab Drugs 2018; 5.]. This pharmaceutical innovation can provide greater feasibility for diabetic treatments in the future.

4.3. Therapeutic Applications Nowadays

Approximately ten drugs have been widely used for T2DM worldwide. Table 2 outlines parts of these therapeutic drugs and potential applications in the clinic. Despite wide-ranges of drug developments, clinical T2DM treatments are commonly not curable [1Lu DY, Che JY, Yarla NS, et al. Types 2 diabetes prevention, treatments and new drug developments. Clin Immunol Endocr Metab Drugs 2018; 5., 23Li GQ, Kam A, Wong KH, et al. Herbal medicines for the management of diabetes. An old disease, A new insights. In: Ahmad S, Ed. 2013; 396-413.]. To most of these therapeutic options, drug treatments will be life-long for high-proportion of T2DM patients. After all, we need to know more about patho-therapeutic relations for curable therapy for patients with T2DM in the future.

Table 2
The recommended therapeutic options in clinical diabetic treatments.


Apart from herbal drugs, some insect products (Propolis) [25Lu DY, Che JY. Rethink of diabetes treatment and drug development. Cell Dev Biol 2014; 3(2): e125., 26Wagh VD. Propolis: A wonder bees product and its pharmacological potentials. Adv Pharmacol Sci 2013; 2013: 308249.[http://dx.doi.org/10.1155/2013/308249] [PMID: 24382957] ] and fermented soybean (Natto) [4Ahmad S, Ed. An Old Disease, A New Insights 2013., 5Lu DY, Che JY, Yarla NS, et al. Diabetes prevention and treatments, a specific topic for modern medicines. J Metab Syndr 2017; 8(3): 231.] were also applicable in China and Japan for T2DM-related symptom control.

4.4. Therapeutic Combination in Clinical Trials

In the past, life-style adjustment is an effective way for the reductions of blood glucose and complication events for patient’s notification [27Thepwongsa I, Kirby C, Schattner P, Shaw J, Piterman L. Type 2 diabetes continuing medical education for general practitioners: What works? A systematic review. Diabet Med 2014; 31(12): 1488-97.[http://dx.doi.org/10.1111/dme.12552] [PMID: 25047877] -29Wens J, Vermeire E, Hearnshaw H, Lindenmeyer A, Biot Y, Van Royen P. Educational interventions aiming at improving adherence to treatment recommendations in type 2 diabetes: A sub-analysis of a systematic review of randomised controlled trials. Diabetes Res Clin Pract 2008; 79(3): 377-88.[http://dx.doi.org/10.1016/j.diabres.2007.06.006] [PMID: 17643546] ]. As usual, combination of life-style adjustment and meltformin is widely recommended by both American Diabetes Association (ADA) and European Association for Study of Diabetes (EAST). Table 2 shows a great number of therapeutic options chosen for anti-diabetic treatments. Certainly, we commonly use more than one therapeutic option in clinical trials. Generally, drug combination is more welcome for refractory chronic disease, like cancer and HIV/AIDS treatments comparing with mono-therapy [30Lu DY, Lu TR, Cao S. Drug combinations in cancer treatment. Clin Exp Pharmacol 2013; 3: 134.-34Lu DY, Lu TR, Yarla NS, et al. Drug combination in clinical cancer treatment. Rev Recent Clin Trials 2017; 12(3): 202-11.[http://dx.doi.org/10.2174/1574887112666170803145955] [PMID: 28782482] ]. It is a new concept of whether a systematic approach could be helpful from therapeutic combination.

5. ROAD MAP IN THE FUTURE

5.1. Pathological Issues

Expanding pathological knowledge will be introduced to broader ranges of people for noticing and treating patients on disease onset. Genome Wide Association Study (GWAS) between patients and normal people may be breakthroughs for T2DM pathogenesis and treatments - the exponentially explosion of human genomic data.

5.2. Therapeutic Issues

Genetic or molecular study of disease progression, drug pharmacology, mechanisms of action for drug activity/toxicity. Establish personalized anti-diabetic therapy in the clinic. Develop higher therapeutic-index drugs, such as natural chemotherapeutic anti-diabetic drugs [35Lu DY, Lu TR, Lu Y, Sastry N, Wu HY. Discover natural chemical drugs in modern medicines. Metabolomics 2016; 6(3): 181., 36Alam F, Islam MA, Kamal MA, Gan SH. Updates on managing type 2 diabetes mellitus with natural products. Towards antidiabetic drug developments. Curr Med Chem 2016; 23(29): 1-37.[http://dx.doi.org/10.2174/0929867323666160813222436] [PMID: 27528060] ]. Pharmaceutically improves insulin-based treatments from needle to oral. Budget control in drug developments and cost-effective in clinical treatment selections will be more optimized [37Asche C, LaFleur J, Conner C. A review of diabetes treatment adherence and the association with clinical and economic outcomes. Clin Ther 2011; 33(1): 74-109.[http://dx.doi.org/10.1016/j.clinthera.2011.01.019] [PMID: 21397776] ].

5.3. Regulatory Issue

Global cooperation is inevitable, especially invitation of mathematical majored students and scholar in this medical campaign [38Lu DY, Lu TR, Lu Y, Wu HY, Yarla NS. The acquisition of mathematical language in biomedical articles. J Cell Developmental Biol 2017; 1(1): 8.-40Lu DY, Wu HY, Lu TR, Che JY, Lu Y. Updating biomedical studies by recruiting more mathematics or physics-majored talents. Metabolomics 2016; 6(2): e148.]. Mathematical solution of disease risks and occurrence is given in Equation 1 [41Gentle JE. Elements of Computational Statistics 2002.].

(1)

where, T: incidence and risks of T2DM in random human population

CONCLUSION

Despite a lot of discoveries, current therapeutic agents (such as insulin and other drugs) are economic burden to patients due to long-term of drug utility (generally >400 USD per year). Rapid development of higher efficiency anti-diabetic drugs, especially for diabetic-induced complications, is a high priority and of great medical significance [42Turpin SM, Hoy AJ, Brown RD, et al. Adipose triacylglycerol lipase is a major regulator of hepatic lipid metabolism but not insulin sensitivity in mice. Diabetologia 2011; 54(1): 146-56.[http://dx.doi.org/10.1007/s00125-010-1895-5] [PMID: 20842343] -46 Metabolex Inc. N-linked heterocyclic receptor agonists for the treatment of diabetes and metabolic disorders. US20120322804A1 (2012).]. A step closer should be a marvelous thing.

Given too much molecular components and pathways can be involved in T2DM origins, growing volumes of financial supports must be allocated in both developing countries and developed countries. To sum up, win-win situation between developed countries and developed countries can decide how long we can go through in this medical campaign. After global cooperation, both extremes of human populations can be provided with high quality of anti-diabetic medications. In the future, new perspectives and scientific investigations will be introduced for changing the landscape of current anti-diabetic therapeutics if possible. A lot of therapeutic options need to be better served for complicated situations of diabetes in the clinic.

ETHICAL APPROVAL AND CONSENT TO PARTICIPATE

Not applicable.

HUMAN AND ANIMAL RIGHTS

No Animals/Humans were used for studies that are bases of this research.

CONSENT FOR PUBLICATION

Not applicable.

CONFLICT OF INTEREST

The authors declare no conflict of interest, financial or otherwise.

ACKNOWLEDGEMENTS

This work was funded by Shanghai Science and Technology Foundation of High Educations 97A49.

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Endorsements



"Open access will revolutionize 21st century knowledge work and accelerate the diffusion of ideas and evidence that support just in time learning and the evolution of thinking in a number of disciplines."


Daniel Pesut
(Indiana University School of Nursing, USA)

"It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. This is exactly what Open Access Journals provide and this is the reason why I support this endeavor."


Jacques Descotes
(Centre Antipoison-Centre de Pharmacovigilance, France)

"Publishing research articles is the key for future scientific progress. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community."


Patrice Talaga
(UCB S.A., Belgium)

"Open access journals are a novel concept in the medical literature. They offer accessible information to a wide variety of individuals, including physicians, medical students, clinical investigators, and the general public. They are an outstanding source of medical and scientific information."


Jeffrey M. Weinberg
(St. Luke's-Roosevelt Hospital Center, USA)

"Open access journals are extremely useful for graduate students, investigators and all other interested persons to read important scientific articles and subscribe scientific journals. Indeed, the research articles span a wide range of area and of high quality. This is specially a must for researchers belonging to institutions with limited library facility and funding to subscribe scientific journals."


Debomoy K. Lahiri
(Indiana University School of Medicine, USA)

"Open access journals represent a major break-through in publishing. They provide easy access to the latest research on a wide variety of issues. Relevant and timely articles are made available in a fraction of the time taken by more conventional publishers. Articles are of uniformly high quality and written by the world's leading authorities."


Robert Looney
(Naval Postgraduate School, USA)

"Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets."


Richard Reithinger
(Westat, USA)

"Not only do open access journals greatly improve the access to high quality information for scientists in the developing world, it also provides extra exposure for our papers."


J. Ferwerda
(University of Oxford, UK)

"Open Access 'Chemistry' Journals allow the dissemination of knowledge at your finger tips without paying for the scientific content."


Sean L. Kitson
(Almac Sciences, Northern Ireland)

"In principle, all scientific journals should have open access, as should be science itself. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. The articles are high standard and cover a wide area."


Hubert Wolterbeek
(Delft University of Technology, The Netherlands)

"The widest possible diffusion of information is critical for the advancement of science. In this perspective, open access journals are instrumental in fostering researches and achievements."


Alessandro Laviano
(Sapienza - University of Rome, Italy)

"Open access journals are very useful for all scientists as they can have quick information in the different fields of science."


Philippe Hernigou
(Paris University, France)

"There are many scientists who can not afford the rather expensive subscriptions to scientific journals. Open access journals offer a good alternative for free access to good quality scientific information."


Fidel Toldrá
(Instituto de Agroquimica y Tecnologia de Alimentos, Spain)

"Open access journals have become a fundamental tool for students, researchers, patients and the general public. Many people from institutions which do not have library or cannot afford to subscribe scientific journals benefit of them on a daily basis. The articles are among the best and cover most scientific areas."


M. Bendandi
(University Clinic of Navarre, Spain)

"These journals provide researchers with a platform for rapid, open access scientific communication. The articles are of high quality and broad scope."


Peter Chiba
(University of Vienna, Austria)

"Open access journals are probably one of the most important contributions to promote and diffuse science worldwide."


Jaime Sampaio
(University of Trás-os-Montes e Alto Douro, Portugal)

"Open access journals make up a new and rather revolutionary way to scientific publication. This option opens several quite interesting possibilities to disseminate openly and freely new knowledge and even to facilitate interpersonal communication among scientists."


Eduardo A. Castro
(INIFTA, Argentina)

"Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use. The articles published in the open access journals are high quality and cover a wide range of fields."


Kenji Hashimoto
(Chiba University, Japan)

"Open Access journals offer an innovative and efficient way of publication for academics and professionals in a wide range of disciplines. The papers published are of high quality after rigorous peer review and they are Indexed in: major international databases. I read Open Access journals to keep abreast of the recent development in my field of study."


Daniel Shek
(Chinese University of Hong Kong, Hong Kong)

"It is a modern trend for publishers to establish open access journals. Researchers, faculty members, and students will be greatly benefited by the new journals of Bentham Science Publishers Ltd. in this category."


Jih Ru Hwu
(National Central University, Taiwan)


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