Welcome Physicians/Health care specialists

Dear Doctor,

On behalf of CMID Inc. laboratory director, scientific committee and our entire laboratory staff members, we would like to extend to you and your patients our greatings  for  the  New  Year.

Please take a moment and join us in welcoming our progress in the field of Laboratory Medicine.  Here, I wanted to update you that we are exclusively offering the Inflammatory Array Panel as esoteric test  panel that is Health Canada approved,  Ministry  of  Health (Ontario) and CAP licenced. This  Panel test  has (12) inflammatory mediators (Cytokines and Chemokines) that are so important screening tool for monitoring the level of inflammation, drug efficacy and toxicity levels. On the other hand, our laboratory has implemented (IL-6 and CRP) as two individual tests that are conducted separately for clinical research using an ELISA platform from a blood sample. Also our laboratory can measure any protein of interest using the same ELISA platform as a technique.

Our focus for 2025  is “building relationships”. We look forward to strengthening and enhancing our current relationships and also look to building new collaboration opportunities.

2025   is promising to be a year of great change for us at the CMID. The laboratory profession is constantly changing, and this is an exciting time to ensure that we at CMID are providing the best services to our patients and physicians.

I look forward to connecting with you and seeing how we can continue to build an  affiliation that is mutually beneficial.

On behalf of the staff, we would like to wish you all the best.

Stay safe.

Respectfully yours,

Dr. Rafik Ragheb
CMID INC. CEO/ Laboratory Director
Canada Metabolic Inflammation Diagnostics Inc.

108-4040 Finch Avenue East-Scarborough, Ontario, M1S 4V5

dr.ragheb@cmidinc.ca

www.cmidinc.ca

For more information:

Tel.: 1-647- 401- 3185

Email: info@cmidinc.ca

January 2025

The cytokine array panel test/profile is a group of inflammatory mediators, 12 proteins known as cytokines and chemokines are measured from one blood sample and other body fluids and tissues.. There are a strong body of literature as scientific evidences to suggest that the inflammation process and its early link for the prediction and intervention of Type II diabetes is a good example for chronic disease managements. The good thing is we have a group of proteins that are working and linked together that can be measured and closely monitored over a specific period of time through a simple methodology. This is considered as a very important tool to reveal the whole picture for different diseases. Insulin resistance is one of the features of the metabolic syndrome associated with obesity (1). Obesity promotes millions of cases of type 2 diabetes worldwide and is considered as a major cause of blindness, kidney failure, cardiovascular diseases as well as other severe diseases. Elevation of plasma FFA has been shown to impair insulin action, and to be a risk factor for the development of type-2 diabetes (2). The insulin signaling system is complex (3-13) and the common mechanism to explain the occurrence of acute and chronic insulin resistance is difficult to identify. There is a strong correlation between insulin resistance and the increased lipid availability in the tissue (14). A reduced capacity for insulin to elicit increases in glucose uptake and metabolism in skeletal muscle and adipose cell, and increase in hepatic glucose production in liver cell are common features of obesity and diabetes (15). Ragheb et. al. have demonstrated that fatty acids induce insulin resistance in muscle and liver through different mechanisms such as protein kinase C (PKC), NFkB and stress kinases ( 16-26). Many prospective studies in different human populations have identified proinflamatory cytokines, acute phase proteins and several indirect markers of inflammation as predictors of type 2 diabetes and glucose disorders in relation to FFA elevation (27). Interestingly, interleukin-6 (IL-6) levels have been reported to be elevated in subjects with type 2 diabetes (28) and correlate with the direct and indirect measures of insulin resistance (28, 29 ).

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2. Paolisso, G., Tataranni, P. A., Foley, J. E., Bogardus, C., Howard, B. V., and Ravussin, E. (1995). A high concentration of fasting plasma non-esterified fatty acids is a risk factor for the development of NIDDM. Diabetologia 38, 1213-1217
3. Holman GD, K.M., (1997) From receptor to transporter: insulin signaling to glucose transport. Diabetologia,. 9(40): 991-1003.
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8. Alessi DR, A.M., Caudwell B, Cron P, Morrice N, Cohen P, Hemmings BA, Mechanism of activation of protein kinase B by insulin and IGF-1. EMBO J, 1996. 23(15): 6541-51.
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11. J., D., (1998) Mechanisms and consequences of activation of rotein kinase B/Akt. Curr. Opin. Cel Biol., (10): 262-267.
12. Griffin ME, M.M., Cline GW, Bell K, Barucci N, Lee D, Goodyear LJ, Kraegen EW, White MF, Shulman GI, (1999) Free fatty acid-induced insulin resistance is associated with activation of protein kinase C theta and alterations in the insulin signaling cascade. Diabetes,. 6(48): p. 1270-4.
13. McGarry, J.D., (1992) What If Minkowski Had Been Ageusic? An Alternative Angle on Diabetes. Science, 258: 766-770.
14. Schmitz-Peiffer, C., D. L. Craig, and T. J. Biden. (1999):Ceramide generation is sufficient to account for the inhibition of the insulin-stimulated PKB pathway in C2C12 skeletal muscle cells pretreated with palmitate. J.Biol.Chem. 274.34 24202-10.
15. Schmitz-Peiffer, C. (1997):et al. Alterations in the expression and cellular localization of protein kinase C isozymes epsilon and theta are associated with insulin resistance in skeletal muscle of the high-fat-fed rat. Diabetes 46.2 169-78.
16. Rafik Ragheb, Gamila M L Shanab, Amina M Medhat, Dina M Seoudi, K Adeli, G I Fantus ( 2009) Free fatty Acids - induced muscle insulin resistance and glucose uptake dysfunction: Evidence for PKC activation and oxidative stress activated signaling pathways. Biochem Biophys Res Commun. November, 389 (2), 211-216.
17. Rafik Ragheb, Amina M Medhat, Gamila M L Shanab, Dina M Seoudi, I G Fantus. (2009) Prolonged Treatment with free fatty acids has post receptor effect in hepatic insulin resistance: Evidence that free fatty acids, oleate and palmitate have insignificant effect on the insulin receptor beta in vivo and ex vivo primary hepatocytes. Biochemistry Insights. June (2): 29-36.
18. Rafik Ragheb, Amina M Medhat, Gamila M L Shanab, Dina M Seoudi, I G Fantus (2008) .Links between enhanced Fatty Acid Flux, Protein Kinase C and NFkB Activation, and ApoB-Lipoprotein Production in the Fructose Fed Hamster Model of Insulin Resistance. Biochem Biophys Res Commun. May 23; 370(1):134-9.
19. Rafik Ragheb, et.al.., (7th Annual World Congress on the Insulin Resistance Syndrome, San Francisco 2009 - USA) Diabetes & Vascular Disease Research. Volume 4 Issue 3, 2009UK (Abstract)
20. Rafik Ragheb, et.al.., Prolonged treatment with free fatty acids (FFA) has post receptor effect in hepatic insulin resistance: evidence that fatty acids, oleate and palmitate have no effect on the insulin receptor beta (IR-β) in vivo and ex vivo primary hepatocytes (6th Annual World Congress on the Insulin Resistance Syndrome, Los Angles 2008 - USA) - Diabetes & Vascular Disease Research. Volume 4 Issue 3, 2008UK (Abstract)
21. Rafik Ragheb, et.al.., Different Free fatty acids (FFAs) – induced serine 307 phosphorylation of IRS-1 as a novel mechanism for skeletal muscle insulin resistance.(5th Annual World Congress on Insulin Resistance Syndrome, Boston, USA-2007 - Diabetes & Vascular Disease Research. Volume 4 Issue 3, 2007UK (Abstract)
22. Rafik Ragheb, et. al..,Free fatty acids - induced PKC and NFkB activation as a mechanism for both insulin resistance and dyslipidemia in the fructose fed hamster model of insulin resistance.(5th Annual World Congress on Insulin Resistance Syndrome, Boston, USA-2007)- Diabetes & Vascular Disease Research. Volume 4 Issue 3, 2007UK (Abstract)
23. Rafik Ragheb, Amina M. Medhat, Gamila M. Shanab, Dina, M. Seoudi, Fantus, I.G., Adeli K. Free fatty acids (FFAs) – induced PKC and NFkB activation, two key events in two different models for insulin resistance, the skeletal muscle and liver. (4th Annual World Congress on Insulin Resistance Syndrome, Nevada, USA)-Diabetes & VascularDiseaseResearch.Volume3Issue2,2006UK (Abstract) (http://www.insulinresistance.us/view.php/ItemID=222).
24. Rafik Ragheb, Khosrow Adeli and George Fantus. Evidence for fatty acid-induced insulin resistance in a cultured muscle cell line, C2C12: Differential effects of fatty acid species on insulin signaling pathways (International Congress of Biochemistry and Molecular Biology). Molecular & Cellular Proteomics 2:642-670, 2003(Abstract) – Montreal.
25. Ragheb, R., Chong, T.M., Naples, M., Fantus I.G., Adeli K. (2003) Tissue-specific Effect of Fatty Acids on Insulin Sensitivity: Evidence that fatty acids, oleate and palmitate, induce muscle insulin resistance but have no effect on hepatic insulin sensitivity. University Health Network and Hospital for Sick Children, University of Toronto. Canadian Lipoprotein Conference, (Abstract), Toronto, Canada.
26. Rafik Ragheb, Khosrow Adeli and George Fantus. Mechanisms of Fatty Acid – (2003) Induced Insulin Resistant In a Cultured Muscle Cell Line, C2C12: Evidence For Differential Effect Of Oleate And Palmitate On insulin Signaling Pathway. XIX International American Congress of Cardiology/ XIX l'InterAmerican Congress of Cardiology October 24-29, 2003, Toronto, Ontario / 24-29 October 2003, Toronto, Ontario. Cardiovascular Pathology, May 2004 (Vol. 13, Issue3 (Supplement) (Abstract).
27. Wilding JP (2007). The importance of free fatty acids in the development of Type 2 diabetes Diabetic Medicine  (24), 9,  934-45.
28. José-Manuel Fernandez-Real, Montserrat Vayreda, Cristobal Richart, Cristina Gutierrez, Montserrat Broch, Joan Vendrell and Wifredo Ricart .(2001) Circulating Interleukin 6 Levels, Blood Pressure, and Insulin Sensitivity in Apparently Healthy Men and Women. J Clin Endocrinology & Met. 86: 1154-1159.
29. Ragheb R, Medhat AM Mechanisms of Fatty Acid-Induced Insulin Resistance in Muscle and Liver. JDiabetes Metab. 2011. 2:127. doi:10.4172/2155-6156.1000127
    

Abstracts:

1. Rafik Ragheb: The Pro-Inflammatory and Anti-Inflammatory Cytokines as Key Tool for Infertility Linked PCOS Diagnosis and Treatment Efficac Diabetes and Obesity International Journal ISSN: 2574-7770 (2019)
2. Rafik Ragheb: The cytokine panel testing (Biochip) as an excellent diagnostic tool for screening, early intervention and disease monitoring for diabetic patients- Metabolomics Summit-2018, Miami, USA (July 15-17th, 2018)