Multi-mechanistic effects of bisphenol A on testicular dysfunction and endocrine disruption in adult male Labeo bata: oxidative stress, inflammation, and dysregulated energy sensors

Leaching of BPA, a potent endocrine disruptor, from microplastics in aquatic environments has garnered renewed interest in its impact on male reproduction. However, the mechanisms underlying BPA modulation of testicular metabolic, endocrine, and autocrine-paracrine axes in teleost remained relatively unexplored, prompting us to examine BPA-induced testicular dysfunction in adult male Labeo bata. Present results demonstrate that congruent with reduced gonadosomatic index (GSI), chronic BPA treatment at environmentally relevant concentrations enhanced ROS synthesis, oxidative stress, and testicular histopathology characterized by reduced diameter of seminiferous tubules, a sharp decline in spermatozoa, and elevated fibrosis during the spawning season. Elevated NO levels, pro-inflammatory cytokines and NLRP3-inflammasome activation correlated with cleaved caspase -8, -9, -3 activation, altered Bax/Bcl-2 ratio, heightened caspase -3 immunolocalization and TUNEL staining, suggesting DNA damage and apoptosis in BPA-treated testis. Besides, BPA attenuation of cyclin B synthesis and p-p34cdc2 (Thr161) phosphorylation (activation), markers associated with altered meiotic cell cycle progression, corresponded with heightened apoptosis and loss of spermatogenic cells. Importantly, disrupted estrogen and membrane progestin receptor (ERα, ERβ, mPRα-PGRMC1) homeostasis, alteration in gonadotropin receptor (LHCGR) and steroidogenic markers and elevated P450 aromatase immunolocalization indicate endocrine disruption and heightened estrogenic influence of BPA, inducing testicular dysfunction. Congruently, BPA modulation of cellular energy sensors (SIRT1/p-AMPKα/PGC-1α), factors influencing testicular endocrine, paracrine and prostaglandin signalling, and MAPK modulation might indicate pleiotropic regulation by BPA triggering reproductive toxicity. While Pearson's correlation and elevated multi-biomarker IBR indices support testicular dysfunction, present findings highlight the need for further research initiatives and strict regimens to combat ecological risks posed by BPA contamination.

Proteomic evaluation of borosilicate hybrid sol-gel coatings with osteogenic, immunomodulatory and antibacterial properties

Silica hybrid sol-gel coatings represent an interesting approach to bioactivate dental implants. Boron is known for its osteogenic, angiogenic and antibacterial functions in biomedical applications. This study describes the synthesis of a novel borosilicate hybrid sol-gel coating using a mixture of methyltrimethoxysilane, tetraethyl orthosilicate and trimethyl borate (TMB). Coatings with different amounts of boron were obtained, and their physiochemical properties were examined; in vitro tests with human osteoblasts and macrophages (THP-1) were carried out. The effects of these materials on bacteria viability were evaluated using Escherichia coli and Staphylococcus aureus. The human serum proteins adsorbed onto the coatings were analysed employing proteomic techniques. To synthesise the new materials, the appropriate sol-gel reactions were developed; boron was integrated into the silica network, and well-adhering coatings were obtained. These borosilicate coatings were non-cytotoxic, displayed osteogenic potential, and upregulated adsorption of proteins related to bone regeneration (IGF2, ALS and APOE). Boron upregulated the expression of TNF-α, INFg and TGF-β and increased the TNF-α and TGF-β cytokine production in THP-1. Moreover, the addition of boron caused downregulation of NOX2 expression. Proteomic analysis revealed that boron-doping reduced the adsorption of immunoglobulins and complement system proteins. It also caused an increase in the levels of apolipoproteins, antioxidant proteins and serum amyloid A proteins, which was in agreement with in vitro results. The coatings with 10 and 20 % TMB displayed antibacterial effect against S. aureus. The results of this study will enhance our comprehension of interactions between boron-containing biomaterials and biological systems.

Vitamin D testing in pharmacies: Results of a federal screening campaign

Introduction

The convenient accessibility of pharmacies positions them as optimal venues for screening initiatives. There is growing public concern regarding vitamin D levels, particularly during the winter months in middle-and northern latitudes. This study aimed to assess vitamin D levels in early spring and to evaluate the feasibility of implementing a large-scale screening campaign within pharmacies.

Methods

This investigation was structured as a cross-sectional multicenter survey conducted in a routine care setting. Data collection was performed in a fully anonymized manner. An automatic fluorescent immunoassay system was utilized for point-of-care-testing, and both patient and provider questionnaires were developed. Quantitative data were analyzed descriptively. Both parametric- and nonparametric statistical tests were performed to analyze the data, ensuring robust results across different assumptions. A resulting maturity matrix for implementation was conceptualized.

Results

Over a two-week campaign, 62 community pharmacies conducted a total of 2770 vitamin D tests. All participants completed the questionnaire, and 45 pharmacists participated in a retrospective survey. Vitamin D deficiency was identified in 56.2 % of participants, while 25.2 % exhibited levels of insufficiency. A higher BMI was associated with lower vitamin D levels, whereas daily supplementation correlated with higher levels compared to intermittent or weekly dosing regimens. The vast majority of patients expressed high satisfaction with the services provided. Pharmacists valued the positive feedback from patients and expressed enthusiasm for further testing and the advancement of clinical pharmacy services. The resulting maturity matrix facilitates corporate implementation.

Conclusion

The implementation of a large-scale federal vitamin D screening campaign proved to be feasible and resulted in high levels of satisfaction among both patients and providers. The findings indicated significantly low vitamin D levels among participants. Pharmacists expressed a desire for an expansion of clinical pharmacy services in the future.Vitamin D testing in pharmacies: results of a federal screening campaign.

Treatment response variations to a single large bolus of enteral cholecalciferol in vitamin D deficient critically Ill children: Metabolomic insights for precision nutrition

Vitamin D deficiency (VDD) is prevalent globally and in pediatric intensive care units, where it represents a modifiable risk factor that may impact patient recovery during hospitalization. Herein, we performed a retrospective analysis of serum samples from a phase-II randomized placebo-controlled trial involving a single large bolus of 10,000 IU/kg vitamin D3 ingested by critically ill children with VDD (25-OH-D < 50 nmol/L). Targeted and untargeted methods were used to comprehensively measure 6 vitamin D metabolites, 239 lipids, 68 polar metabolites, and 4 electrolytes using a multi-step data workflow for compound authentication. Complementary statistical methods classified circulating metabolites/lipids associated with vitamin D repletion following high-dose vitamin D3 intake (n = 20) versus placebo (n = 11) comprising an optional standard of care maintenance dose (< 1000 IU/day). There was a striking increase in median serum concentrations of 25-OH-D3 (4.7-fold), 3-epi-25-OH-D3 (24-fold) and their C3-epimer ratio (6.7-fold) in treated patients on day 3, whereas serum vitamin D3 peaked on day 1 (128-fold) unlike placebo. Treatment response differences were attributed to D3 bioavailability and C3-epimerase activity without evidence of hypercalcemia. For the first time, we report the detection of circulating 3-epi-D3 that was strongly correlated with vitamin D3 uptake (r = 0.898). Metabolomic studies revealed that vitamin D sufficiency (serum 25-OH-D >75 nmol/L) coincided with lower circulating levels of 3-methylhistidine, cystine, S-methylcysteine, uric acid, and two lysophosphatidylcholines 7 days after treatment. Rapid correction of VDD was associated with indicators of lower oxidative stress, inflammation, and muscle protein turn-over that may contribute clinical benefits in high-risk critically ill children.

Antipsychotic-induced hyperprolactinemia: Toxicologic mechanism and the increased breast cancer risk

Antipsychotic drugs are effective at improving both the positive and negative symptoms of schizophrenia as well as the manic phase of bipolar disorder. Whether an antipsychotic is termed typical or atypical is related to the xenobiotic's propensity to cause extrapyramidal side effects. However, with a few exceptions, drugs of both classes of antipsychotics are known to cause hyperprolactinemia. As many breast cancers are responsive to prolactin concentrations, the persistent increase in prolactin of the antipsychotics has implications for public health and carcinogenesis. The objective of this study was to review the extant literature on hyperprolactinemia due to antipsychotics, and to determine the risk imposed by those drugs on human breast cancer. A summary risk of breast cancer with use of any antipsychotic was found to be 1.19 (95 % confidence interval 1.10-1.30). When limiting usage of antipsychotics to 5 or more years, the summary risk increased to 1.26 (95 % confidence interval 1.12-1.43). And when limited to those studies who evaluated only those medications with the greatest increase in prolactin, the risk increased to 1.59 (95 % confidence interval 1.37-1.85). Given this increased risk of breast cancer, stronger warnings about this increased risk are warranted, and regular monitoring of prolactin levels and breast cancer screening should be part of the management plan for these patients.

Case Series of Patients With FGFR1-Related Pheochromocytoma and Paraganglioma With a Focus on Biochemical, Imaging Signatures and Treatment Options

Pheochromocytoma and paraganglioma (together PPGL) are tumours with a high degree of heritability. Genetic landscape is divided into three clusters, cluster 1 (Krebs/pseudohypoxia signalling pathway), cluster 2 (kinase signalling pathway) and cluster 3 (Wnt signalling pathway). With increasing knowledge in the field of genetics, cluster-specific tumour characteristics, biochemical phenotype and imaging signatures are established in commonly found genes. The association of FGFR1 pathogenic mutations with PPGL have been recently described although its features are not yet well established. Here, we present four patients with PPGL who were found to have somatic FGFR1 pathogenic mutations. We discuss their clinical presentations, biochemical phenotypes, imaging signatures and treatment options that will be relevant for practicing physicians in managing these patients effectively.

The prevalence of metabolically healthy obesity and healthy status and related risk factors among Iranian adults: a cohort-based cross-sectional study

Objectives

this study aims to determine the prevalence and determinants of metabolically healthy obesity (MHO) and metabolically healthy status (MHS) within a large Iranian population.

Methods

This cross-sectional study involved 10,134 participants from the Fasa Adult Cohort Study (FACS) in southern Iran. Following the extraction of metabolic, demographic, and socioeconomic variables, prevalence rates were estimated. Logistic regression analysis was conducted using SPSS 22 to examine the relationship between risk factors.

Results

Among all participants, 19.9% (32.7% in men) exhibited metabolically healthy status (MHS), while 31.4% (37.5% in men) were classified as metabolically healthy obese (MHO). The likelihood of MHO was found to be 18% higher in illiterate individuals compared to their literate counterparts. Additionally, for each 1 cm increase in waist circumference, the probability of MHO increased by 5%, while a 1-year increase in age raised the probability by 1.7%, and a 1 MET increase in physical activity reduced the probability by 1.3%. Furthermore, the likelihood of having MHS was 2.4 times greater in women than in men. Employed individuals had a 17% lower probability of MHS compared to unemployed individuals. For every 1 MET increase in physical activity, the probability of MHS decreased by 0.9%, whereas a 1-year increase in age and a 1 cm increase in waist circumference increased the probability by 1.7% and 12%, respectively.

Conclusions

It seems that MHS and MHO is relatively high in studied population and although their multifactorial nature was determined, at the same time, in order to evaluate the changes, it is necessary to pay serious attention to longitudinal monitoring.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-024-01555-8.

Development of a BMU-on-a-chip model based on spatiotemporal regulation of cellular interactions in the bone remodeling cycle

Bone remodeling is essential for maintaining bone homeostasis throughout life by replacing old bone with new tissue. This dynamic process occurs continuously within basic multicellular unit (BMU) through well-coordinated interactions among osteocytes, osteoblasts, and osteoclasts. However, a precise in vitro model that accurately replicates this mechanism has not yet been developed. In this study, we created a human in vitro BMU-modeling chip platform by tri-culturing cells within a chip unit integrated into a tissue culture well plate, enabling high-throughput three-dimensional (3D) cell culture. To establish the tri-culture, human osteoblasts were isolated from human surgical bone samples and differentiated into osteocytes within collagen gel inside the chip unit. Subsequently, osteoblasts and peripheral blood mononuclear cells (PBMCs) containing osteoclast precursors were added to the chip unit. To simulate each phase of the bone remodeling cycle, we optimized the tri-culture process by adjusting the timing and using two types of osteoblasts at different stages of differentiation. The completed tri-culture model successfully mimicked the bone formation phase. When receptor activators of nuclear factor kappa-Β (RANKL) and macrophage colony-stimulating factor (M-CSF) were introduced, the cells exhibited characteristics of the reversal phase, where osteogenic and osteoclastogenic environments coexist. Additionally, using more differentiated osteoblasts within the tri-culture platform induced osteoclast differentiation, resembling the bone resorption phase. Overall, our model effectively replicates each phase of the bone remodeling cycle in BMUs, both spatially and temporally. This advancement not only facilitates the study of the intricate mechanisms of bone remodeling and cellular function but also aids drug development by providing a robust bone model for testing target drugs.

Klotho senses mechanical stimuli and modulates tension-induced osteogenesis

Delicate external mechanosensing, efficient intracellular mechanotransduction and effective alveolar bone remodeling lay the foundation of orthodontic tooth movement (OTM). Periodontal ligament stem cells (PDLSCs) are thought to be the primary cells that withstand mechanical stimuli and respond to biomechanical signals during orthodontic treatment. Nevertheless, the cellular and molecular mechanisms of orthodontic force-induced mechanosignaling and osteogenesis in PDLSCs still remain unclear. In the present study, we hypothesize that the ageing suppressor, Klotho, is correlated with orthodontic force-triggered mechanical signaling cascades, further contributing to alveolar bone remodeling. This study reveals that Klotho expression is notably upregulated via cytoskeletal-nuclei-mediated epigenetic modifications, consistent with osteogenic differentiation on the tension side during OTM. Additionally, Klotho deficiency undermines tensile force-induced new bone formation in NFκB- and PI3K/Akt-dependent manners. Notably, RNA sequencing (RNA-seq) results and targeted force application experiments unveil that Klotho not only functions as a downstream effector of external stress but also acts as an upstream regulator in mechanical signaling for the first time. In summary, we identify the indispensable role of Klotho in mechanotransduction and alveolar bone formation, which provide a latent target of linking cell senescence to mechanical force in future studies and offer novel insights into orthodontic force-induced tooth movement and bone remodeling.

Transcriptome analysis reveals the mechanism of cortisol through GR regulating the expression of inflammatory cytokines in Siberian sturgeon (Acipenser baerii) after LPS treatment in vitro

Cortisol can impact the transcription of downstream inflammation and immune-related genes via the glucocorticoid receptor (GR), thereby influencing the immune response and maintaining the homeostatic balance of the host. However, there is a lack of research on the mechanisms by which cortisol affects the immune response of Siberian sturgeon (Acipenser baerii) through GR. In this study, an anti-inflammatory state of Siberian sturgeon was established by the combined treatment of head kidney (HK) leukocytes with LPS + cortisol. Subsequently, the inflammation-related genes of the AbGR antagonistic group (LPS + cortisol + RU-486) and the AbGR non-antagonistic group (LPS + cortisol) were compared by qRT-PCR and high-throughput sequencing methods. Furthermore, an AP-1 agonist ASLAN003 was used to detect the regulatory effect of the AP-1 gene on inflammatory cytokines. The results showed that cortisol downregulated the expressions of il-1β, il-6, il-8, tnf-α, and il-17c that were induced by LPS, while simultaneously promoting the expressions of tgf-β1. Moreover, this pattern was reversed by adding RU486. When analyzing the differentially expressed genes in the transcriptome sequencing of HK leukocytes in AbGR antagonistic group, 261 significantly down-regulated genes and 194 significantly up-regulated genes were annotated. Furthermore, 26 differentially expressed genes related to inflammation in AbGR antagonistic group were enriched, and the key nuclear transcription factor AP-1 for regulating inflammation function of AbGR was selected based on the enrichment factor and p-value for subsequent research. In the HK leukocytes after cortisol + ASLAN003 treatment, the expressions of fosl1 and jund that were induced by ASLAN003 were significantly down-regulated after cortisol treatment. In this situation, the expression of tgf-β1 was significantly increased, and the expression of tnf-α was significantly decreased after cortisol treatment. Therefore, this study demonstrated that cortisol inhibits the expression of AP-1 through GR in Siberian sturgeon, and then regulates the generation of the inflammatory response.

Unsaturated fatty acids enhance mitochondrial function and PGC1-α expression in brown adipose tissue of obese mice on a low-carbohydrate diet

Brown adipose tissue (BAT) exhibits greater resilience against inflammation compared to white adipose tissue. However, chronic consumption of a high-fat diet can render brown adipocytes vulnerable to proinflammatory conditions, leading to a decline in their thermogenic capacity and subsequent dysfunction. The analysis of the effects of type fatty acids intake must be important in the context of the dietary pattern and obesity. This study aims to investigate the impact of a low-carbohydrate/high-fat diet, enriched with different types of fatty acids, on mitochondrial activity on brown adipose tissue in obese mice. Male mice were allocated into different dietary groups: a control diet (CTL), and a high-fat diet (HFD) for a duration of 10 weeks to induce obesity. Subsequently, the HFD group was subdivided into the following categories for an additional 6 weeks: HFD with a low carbohydrate content enriched with saturated fatty acids; HFD with a low carbohydrate content enriched with fish oil; HFD with a low carbohydrate content enriched with soybean oil; and HFD with a low carbohydrate content enriched with olive oil. The findings indicated that in comparison to a low-carbohydrate diet rich in saturated fats, diets rich in unsaturated fatty acids-particularly omega-6 (n-6) and omega-9 (n-9)-resulted in elevated expression of UCP1, a marker of BAT activity. Moreover, there was an increase in the expression of PGC1-α, a protein involved in mitochondrial biogenesis, and enhanced functionality of the oxidative phosphorylation system within BAT mitochondria. These results suggest that n-6 and n-9 fatty acids may confer greater benefits to BAT functionality than saturated fats within the context of a low-carbohydrate diet. Therefore, this study revealed some molecular components that mediate BAT mitochondria function influenced by different fatty acids in a low carbohydrate diet, making it an important therapeutic target in obesity.

Add-on effect of curcumin to dienogest in patients with endometriosis: a randomized, double-blind, controlled trial

BACKGROUND

Endometriosis is a chronic gynecological disorder characterized by significant pain and reduced quality of life (QOL). Current treatments, such as dienogest, are not fully effective, prompting the investigation of curcumin as a potential adjunct therapy. Although curcumin has demonstrated promise in preclinical studies, its clinical efficacy in endometriosis, particularly in combination with standard therapies like dienogest, remains underexplored.

PURPOSE

This is the first study aimed to evaluate the add-on effect of curcumin in combination with dienogest on pain relief, QOL, and sexual function in women with endometriosis.

STUDY DESIGN

A randomized, double-blind, placebo-controlled trial was conducted to compare the efficacy of curcumin combined with dienogest versus dienogest alone with a placebo.

METHODS

Eighty-six women aged 18-45 with stage 2-3 pelvic endometriosis and moderate to severe pain (visual analogue scale (VAS) ≥ 4) were randomly assigned in a 1:1 ratio to receive either nanocurcumin soft gel capsules (80 mg/day) or a placebo, along with dienogest (2 mg/day), for 8 weeks. Outcomes were assessed using adjusted mean differences (aMD) and 95 % confidence intervals (CIs).

RESULTS

After 8 weeks, the curcumin and dienogest group demonstrated significantly greater improvements in pain scores compared to the placebo group: dysmenorrhea (aMD: -1.55, 95 %CI: -2.04 to -1.06; p < 0.001), dyspareunia (aMD: -0.93, 95 %CI: -1.37 to -0.49; p < 0.001), chronic pelvic pain (aMD: -1.55, 95 %CI: -2.04 to -1.06; p < 0.001), and dyschezia (aMD: -0.30, 95 %CI: -0.58 to -0.03; p = 0.030). Additional benefits were observed in QOL and Female Sexual Function Index (FSFI) scores, except for the orgasm domain. Differences in endometrioma size were not statistically significant.

CONCLUSION

The combination of curcumin and dienogest significantly reduced pain and improved QOL and sexual function in women with endometriosis, suggesting curcumin as an effective adjunct therapy.

A tri-compound formula comprising Ginsenoside Rg1, tetrandrine and icariin alleviates atopic dermatitis symptoms in a mouse model

BACKGROUND

Atopic dermatitis (AD) is characterized by both IgE- and non-IgE-mediated immune responses, as well as skin barrier dysfunction. Ginsenoside Rg1, tetrandrine, and icariin each exhibit distinct properties that may contribute to the management of AD. Ginsenoside Rg1 has demonstrated efficacy in mitigating IgE-mediated allergic rhinitis, while tetrandrine is known to suppress abnormal T-cell activation. Icariin has been shown to improve intestinal barrier function, which is crucial in conditions like AD. However, the potential effectiveness of the combined formula of these compounds, referred to as GTI, in treating AD remains unexplored.

PURPOSE

This study aimed to investigate the anti-AD effects and mechanisms of GTI in a mouse model.

METHODS

A calcipotriol (MC903)-induced AD-like dermatitis mouse model was used to evaluate the anti-AD effects of GTI. Dermatitis scores and mouse ear thickness were recorded to assess disease severity. Ear tissues, ear-draining lymph nodes, spleens and sera were collected for use in the investigation of the effects and mechanisms of action of GTI.

RESULTS

Topical application of GTI significantly alleviated AD-like dermatitis in mice, as evidenced by decreased dermatitis scores, reduced ear thickening, and diminished epidermal and dermal thickness, along with lower levels of the inflammatory cytokines IL-1β and IL-4 in ear tissues. Unlike the positive dexamethasone, GTI had no significant toxicity in the model mice. Topical GTI lowered serum IgE levels and diminished the accumulation of eosinophils and mast cells in ear tissues of model mice, suggesting that GTI mitigates IgE-mediated allergic reactions. GTI significantly decreased the numbers of CD4+ T cells in ear tissues, ear-draining lymph nodes and the spleen, demonstrating its suppressive effect on hyperactive immune responses. The protein levels of ZO-1 and claudin-1, two tight junction proteins, were elevated in the ear tissues of mice treated with GTI, indicating a beneficial effect of this formula on skin barrier function. Additionally, GTI inhibited the activation of mitogen-activated protein kinases (MAPKs), as indicated by the downregulation of phospho-p38 (Thr180/182), phospho-ERK (Thr202/Tyr204), and phospho-JNK (Thr183/185) protein levels in mouse ear tissues.

CONCLUSION

This study, for the first time, demonstrated that the topical application of GTI alleviates symptoms of AD without overt toxicity in a calcipotriol-induced AD mouse model. The anti-AD effects of GTI are associated with the suppression of allergic reactions, reduction of hyperactive immune responses, improvement of skin barrier function, and inhibition of MAPK activation. These findings suggest that GTI has the potential to be developed into a safe and effective treatment for AD.

Metabolic dysfunction-associated steatotic liver disease (MASLD) in children with obesity: An Obesity Medicine Association (OMA) and expert joint perspective 2025

Introduction

This Obesity Medicine Association (OMA) Expert Joint Perspective examines steatotic liver disease (SLD), which is composed of metabolic dysfunction-associated steatotic liver disease (MASLD), and metabolic dysfunction-associated steatohepatitis (MASH) in children with obesity. The prevalence of obesity is increasing, rates have tripled since 1963 from 5 % to now 19 % of US children affected in 2018. MASLD, is the most common liver disease seen in children, can be a precursor to the development of Type 2 Diabetes (T2DM) and is the primary reason for liver transplant listing in young adults. We must be vigilant in prevention and treatment of MASLD in childhood to prevent further progression.

Methods

This joint clinical perspective is based upon scientific evidence, peer and clinical expertise. The medical literature was reviewed via PubMed search and appropriate articles were included in this review. This work was formulated from the collaboration of eight hepatologists/gastroenterologists with MASLD expertise and two physicians from the OMA.

Results

The authors who are experts in the field, determined sentinel questions often asked by clinicians regarding MASLD in children with obesity. They created a consensus and clinical guideline for clinicians on the screening, diagnosis, and treatment of MASLD associated with obesity in children.

Conclusions

Obesity and the comorbidity of MASLD is increasing in children, and this is a medical problem that needs to be addressed urgently. It is well known that children with metabolic associated chronic disease often continue to have these chronic diseases as adults, which leads to reduced life expectancy, quality of life, and increasing healthcare needs and financial burden. The authors of this paper recommend healthy weight reduction not only through lifestyle modification but through obesity pharmacotherapy and bariatric surgery. Therefore, this guidance reviews available therapies to achieve healthy weight reduction and reverse MASLD to prevent progressive liver fibrosis, and metabolic disease.

Genome-wide identification, evolution, and expression analysis of the bone morphogenetic protein gene family in Myxocyprinus asiaticus

Bone morphogenetic proteins (BMPs) are important growth factors belonging to the TGF-β superfamily. These factors not only play a vital role in skeleton formation in young fish but also regulate the morphological development of M. asiaticus, with Group II genes regulating morphology mainly during the juvenile stage. This study investigated how BMP genes regulate Myxocyprinus asiaticus development and function and explored the role of the BMP family in fish morphological development. In this study, 43 BMPs were identified and classified into five groups: BMP1/3/11/15 (Group I), BMP12/13/14 (Group II), BMP2/4/16 (Group III), BMP9/10 (Group IV), and BMP5/6/7/8 (Group V). Analyses of the gene structures and conserved motifs revealed the conservation of the BMP gene family in M. asiaticus. In M. asiaticus, gene fragmentation, duplication, and 4R whole-genome duplication events contributed to BMP gene family expansion. Furthermore, expression pattern analysis and qRT-PCR revealed that changes in M. asiaticus BMP gene expression during different developmental stages were due to body size alterations, highlighting the major impact of the BMP gene on body size variation in this species. Our study provides fundamental data for investigating the morphological development of M. asiaticus and lays the framework for understanding the genetic mechanisms of body size variation in scleractinian fishes, with potential applications in the artificial breeding and conservation of M. asiaticus.

The repairing effect of baicalein on lead induced damage to the gut-liver axis in tadpoles

Baicalein has pharmacological functions, such as antioxidant and anti-inflammatory properties, and has been shown to alleviate damage to organs caused by environmental pollutants. However, the mechanism by which baicalein reduces the toxic effects of metals needs further research. This study used Pelophylax nigromaculatus tadpoles as a model to explore the toxicological effects of lead (Pb) on the gut-liver axis, and the mechanism by which baicalein alleviates lead toxicity. Analysis of the gut microbiota showed that baicalein alleviated abnormal changes in the gut microbiota following Pb exposure, mainly by increasing the abundance of beneficial bacterial genera, including Cetobacterium, Clostridioides, and Monoglobus. Liver metabolomics showed that compared to a natural recovery, baicalein treatment significantly increased the content of metabolites such as uridine, 17α-hydroxypregnenolone, niacin, and cucurbitacin E, and significantly reduced the content of metabolites such as linoleic, gluconic acid, and tetrahydrocortisone. These differential metabolites could be enriched in pathways such as pyrimidine metabolism, nicotinic acid and nicotinamide metabolism, and steroid hormone biosynthesis, which were beneficial for the treatment of liver injury. There was a significant correlation between the gut microbiota and the main differential metabolites in the liver with the addition of baicalein. The improvement of these metabolic pathways by baicalein is beneficial for the repair of the liver and intestines. Therefore, baicalein can increase the abundance of beneficial gut microbiota, improve liver metabolism, and thus reduce the damage of Pb exposure to the gut-liver axis.

Unveiling the effects of micro and nano plastics in embryonic development

The improper disposal and degradation of plastics causes the formation and spread of micro and nano-sized plastic particles in the ecosystem. The widespread presence of these micro and nanoplastics leads to their accumulation in the biotic and abiotic components of the environment, thereby affecting the cellular and metabolic functions of organisms. Despite being classified as xenobiotic agents, information about their sources and exposure related to reproductive health is limited. Micro and nano plastic exposure during early developmental stages can cause abnormal embryonic development. It can trigger neurotoxicity and inflammatory responses as well in the developing embryo. In embryonic development, a comprehensive study of their role in pluripotency, gastrulation, and multi-differentiation potential is scarce. Due to ethical concerns associated with the direct use of human embryos, pluripotent cells and its 3D in vitro models (with cell lines) are an alternative source for effective research. Thus, the 3D Embryoid body (EB) model provides a platform for conducting embryotoxicity and multi-differentiation potential research. Pluripotent stem cells such as embryonic and induced pluripotent stem cells derived embryoid bodies (EBs) serve as a robust 3D in vitro model that mimics characteristics similar to that of human embryos. Thus, the 3D EB model provides a platform for conducting embryotoxicity and multi-differentiation potential research. Accordingly, this review discusses the significance of 3D in vitro models in conducting effective embryotoxicity research. Further, we also evaluated the possible sources/routes of microplastic generation and analyzed their surface chemistry and cytotoxic effects reported till date.

CUL4B regulates thyroid cancer differentiation and treatment sensitivity by ubiquitinating ARID1A

BACKGROUND

Thyroid cancer (TC) is a prevalent endocrine malignancy with a generally favorable prognosis. However, dedifferentiation of TC poses a significant challenge, resulting in poorer patient outcomes and necessitating urgent attention. Cullin 4B (CUL4B), a scaffold protein involved in proteolysis and epigenetic regulation, has been reported to play an oncogenic role in many human malignancies, though its involvement in TC remains unclear.

METHODS

The association between CUL4B expression and prognosis in TC patients was assessed using immunohistochemistry. RNA-seq was utilized to investigate the underlying molecular mechanisms, which were further validated through in vitro experiments. The target gene of CUL4B was identified, and the complete ubiquitination regulation process was described. The phenomenon of high expression of CUL4B in TC was explained by identifying that CUL4B-mediated regulation of the SWI/SNF complex.

RESULTS

Our findings revealed that CUL4B expression was positively correlated with tumor progression and poor prognosis in TC. Mechanistically, overexpression of CUL4B promoted the progression and dedifferentiation of TC in vivo models. Crucially, we discovered that CUL4B drives dedifferentiation by promoting the ubiquitination of ARID1A within SWI/SNF complex, leading to decreased expression of the differentiation marker paired box 8 (PAX8). This loss of PAX8 contributes to the dedifferentiation process, ultimately resulting in the formation of anaplastic thyroid carcinoma (ATC). Moreover, silencing CUL4B increased the sensitivity of TC cells to MAPK inhibitors.

CONCLUSION

CUL4B was crucial in driving tumor advancement and inhibiting differentiation in TC by facilitating the ubiquitin-mediated degradation of ARID1A, underscoring its potential as a therapeutic target.

Melatonin ameliorates retinal neurovascular degeneration in Rd1 mice by inhibiting oxidativestress

Oxidative stress has been involved in the occurrence of retinal photoreceptor degeneration and retinal vascular dysfunctions. This study investigated the effects of melatonin (MLT) on neurovascular changes in rd1 mice, evaluating its therapeutic potential as an antioxidant for retinal degeneration. MLT was administered to rd1 mice at postnatal day 7 (P7), and retinal vascular alterations were assessed using retina flatmounts, while neural and functional changes were evaluated through frozen sections and electroretinography at P14. In vitro, human retinal microvascular endothelial cells (HRMECs) were treated with MLT to counteract oxidative stress induced by H2O2. Analyses included assessments of cell function, apoptosis, oxidative stress, and inflammatory markers in both in vivo and in vitro models. The results demonstrated that MLT significantly improved retinal vascular densities in the deep and superficial layers at P14 and P21, though not fully restoring them to wild-type levels. Additionally, MLT exerted protective effects against photoreceptor degeneration, oxidative stress, and inflammation, partially preserving retinal function. In vitro, MLT alleviated functional abnormalities and reduced cell death in HRMECs by decreasing reactive oxygen species levels. These findings suggest that MLT holds promise as a therapeutic approach for retinal degeneration by mitigating oxidative stress, thereby protecting photoreceptors and retinal vasculature. This underscores the importance of vascular preservation in developing therapeutic strategies for retinal degenerative diseases.

iTRAQ-based quantitative proteomics reveals dysregulation of fibronectin 1 contributes to impaired endometrial decidualization in recurrent implantation failure

Recurrent implantation failure (RIF) poses challenges to successful embryo implantation. In this study, we utilized isobaric tags for relative and absolute quantification (iTRAQ) to profile endometrial protein abundance in RIF patients. Through functional and pathway analyses, ECM-related proteins including fibronectin 1 (FN1), collagen type I alpha 2 chain (COL1A2), and integrin beta-1 (ITGB1) were revealed to be associated with RIF. Correlation analysis identified TGF-β1 as an upstream regulator of FN1. Knockdown experiments showed TGF-β1 downregulation could inhibit FN1 expression to inhibit decidualization markers. Our findings suggest a mechanistic link between TGF-β1/FN1 axis dysregulation and impaired decidualization observed in RIF. SIGNIFICANCE: Our study addresses the pressing issue of RIF, a significant obstacle in assisted reproductive technology. By employing isobaric tags for relative and absolute quantification (iTRAQ), we comprehensively analyzed endometrial protein abundance in RIF patients. Through functional and pathway enrichment analyses, we identified dysregulation in extracellular matrix (ECM)-related proteins, including FN1, COL1A2, and ITGB1, shedding light on their potential roles in implantation failure. Additionally, our correlation analysis revealed TGF-β1 as an upstream regulator of FN1, suggesting a novel regulatory axis involved in decidualization. Knockdown experiments further demonstrated the impact of TGF-β1 and FN1 on decidualization markers. This study contributes to a better understanding of the molecular mechanisms underlying RIF.

Bisphenol A enhanced cell migration through Kv3.4 in MCF7 cells

Bisphenol A (BPA) is a well-known endocrine-disrupting chemical (EDC) that has been implicated in cancer development. However, the specific mechanisms of EDCs, including BPA, remain unclear. Voltage-gated potassium (Kv) channels have been closely related to cancer. In particular, Kv3.4 plays a role in cancer malignancy, including cell migration via the ERK and AKT signaling pathways. In this study, we investigated the mechanism of BPA in relation to Kv3.4 expression in human breast cancer MCF7 cells. BPA treatment significantly increased Kv3.4 expression at both the mRNA and protein levels and induced cell migration. Further analysis demonstrated that Kv3.4 is closely related to integrin β and integrin-regulated FAK signaling. However, BPA-induced cell migration and integrin-regulated FAK signaling were significantly abolished by Kv3.4 silencing. Therefore, we concluded that BPA is closely associated with cancer cell migration mediated by Kv3.4 via integrin-regulated FAK signaling. These findings provide novel insights into the role of BPA in cancer progression and suggest Kv3.4 as a potential therapeutic target for BPA-associated cell migration.

Extracorporeal membrane oxygenation combined with intra-aortic balloon counterpulsation for pheochromocytoma: A case report

BACKGROUND

Pheochromocytoma (PHEO) is a type of tumor that originates from chromaffin cells in the adrenal medulla and is classified as an adrenal paraganglioma. PHEOs can secrete catecholamines, leading to a variety of symptoms. Accurate diagnosis and appropriate treatment selection are crucial for favorable outcomes in these cases.

CASE SUMMARY

The patient presented with unexplained chest tightness, palpitations, and pink sputum. Upon examination and analysis of laboratory results, a diagnosis of adrenal PHEO was established. The PHEO secreted high levels of catecholamines, causing sudden fluctuations in blood pressure and heart rate, leading to extremely unstable hemodynamics. Treatment with extracorporeal membrane oxygenation and intra-aortic balloon counterpulsation helped stabilize the patient’s vital signs, allowing for timely surgical intervention.

CONCLUSION

The combination of extracorporeal membrane oxygenation and intra-aortic balloon counterpulsation can enhance tissue perfusion, thus providing a solid foundation for the accurate diagnosis and effective surgical treatment of PHEO.

Lysine enhances the photoresponsive oxidase-like activity of twin Cd0.7Zn0.3S for direct colorimetric detection of lysine

BACKGROUND

Lysine (Lys) is one of the eight essential amino acids for the human body, which can't be synthesized by the body and must be obtained from external sources. And the detection of Lys is of significance for disease monitoring. The construction of photoresponsive nanozymes based analytical methods have received increasing attention and have been successfully achieved for the detection of metal ions, small molecules and natural enzymes. However, the exploration of photoresponsive nanozyme in amino acids detection has not been tapped.

RESULTS

This study presents an innovative method based on surface passivation by Lys to stimulate the photoresponsive nanozyme activity of twin Cd0.7Zn0.3S nanomaterials. Specifically, Lys can bind with twin Cd0.7Zn0.3S, which filled the dangling bonds on the surface of Cd0.7Zn0.3S and caused passivation of the surface state, resulting in the promotion of the separation efficiency of electrons and holes, along with the facilitation of the production of active intermediates. Therefore, the Cd0.7Zn0.3S in the presence of Lys showed a high catalytic oxidation ability for the oxidation of 3,3',5,5'-tetramethylbenzidine (TMB) to oxidized TMB (oxTMB). This new kind of photoresponsive oxidase-like activity could be regulated by switching visible light sources and showed the specificity of being only affected by Lys without influenced by other amino acids, thus achieved direct colorimetric detection of Lys. The linear range for Lys detection was 1-100 μM, with a detection limit of 0.18 μM (S/N = 3).

SIGNIFICANCE

This study developed a new nanozyme of twin Cd0.7Zn0.3S, whose activity leverages on Lys as a stimulator. Moreover, the Lys detection method proposed by us had the characteristics of high sensitivity, good selectivity, fast detection speed, and low cost. Therefore, it holds significant potential application value, making it a promising candidate in the field of Lys detection and related research areas.

Hyperandrogenism triggers mtDNA release to participate in ovarian inflammation via mPTP/cGAS/STING in PCOS

Hyperandrogenism induced ovarian inflammation is associated with the pathogenesis of polycystic ovary syndrome (PCOS), but the specific mechanism behind it remains unclear. The aim of this study was to elucidate the association between mitochondrial DNA-cGAS-STING pathway and PCOS inflammatory response. RNA sequencing analysis and other experiments showed that inflammatory pathways were activated, mitochondria were damaged, and mtDNA-cGAS-STING pathways were activated in PCOS women. In vitro, after stimulation of KGN cells with testosterone, the expression of pro-inflammatory factors was enhanced and the cGAS-STING pathway was activated. Stimulator of the interferon genes (STING) knockout can reduce testosterone-induced inflammatory response and improve follicular function. Cyclosporin A therapy reduces cytoplasmic mtDNA, blocks cGAS-STING pathway activation, alleviates inflammatory markers, and reverses abnormal follicular function. In vivo experiments have shown that inhibiting STING can reduce ovarian dysfunction and inflammation in PCOS patients. Hyperandrogenism in PCOS can trigger mitochondrial permeability transition pore (mPTP) overopening, leading to mtDNA release and cGAS-STING pathway activation, causing inflammation and follicle damage.

Exercise training benefits pancreatic islet by modulating the insulin-like growth factor 1/phosphatidylinositol 3-kinase/protein kinase B pathway

BACKGROUND

Diabetes is characterized by insulin resistance as well as impaired insulin production, with β-cell dysfunction playing a critical role in disease progression. Exercise is known to improve insulin sensitivity, but its effects on pancreatic islet quality and function remain poorly understood. This work hypothesized that swimming training enhances glycemic control and insulin secretion by upregulating the insulin-like growth factor 1 (IGF-1)/phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) pathway in streptozotocin (STZ)-induced diabetic rats.

AIM

To investigate the effects of swimming on pancreatic islet quality and function in STZ-induced diabetic rats via the IGF-1/PI3K/AKT pathway.

METHODS

Twenty-six Sprague-Dawley rats were grouped into diabetic and control groups, with each group further split into exercise and sedentary subgroups. Diabetic rats were induced with STZ. The exercise groups underwent swimming training for 60 minutes/day, 5 days/week, for 8 weeks. Body weight, food intake, blood glucose, insulin, lipids, and muscle glycogen were measured. Pancreatic islet morphology and the protein expression levels of IGF-1, PI3K, and AKT were analyzed. Data were analyzed using two-way repeated-measure ANOVA, followed by Tukey’s post-hoc test.

RESULTS

Exercise training significantly improved body weight [diabetic exercise group (D-Ex): 390.66 ± 50.14 g vs diabetic sedentary group (D-Sed): 315.89 ± 50.12 g, P < 0.05], reduced blood glucose (D-Ex: 12.21 ± 4.43 mmol/L vs D-Sed: 17.79 ± 2.05 mmol/L, P < 0.05), and increased insulin levels (D-Ex: 53.50 ± 15.31 pmol/L vs D-Sed: 25.31 ± 10.23 pmol/L, P < 0.05) in diabetic rats. It also enhanced islet morphology, increased IGF-1 expression, and activated the PI3K/AKT pathway (P < 0.05). In-vitro experiments confirmed that IGF-1 positively regulated insulin expression and inhibited β-cell apoptosis via the PI3K/AKT pathway.

CONCLUSION

Exercise training improves pancreatic islet quality and function in diabetic rats by modulating the IGF-1/PI3K/AKT pathway, highlighting its therapeutic potential for diabetes management.

Advancements in the study of DLK1 in the pathogenesis of diabetes

DLK1, as a membrane-bound protein, has been extensively studied in the field of cancer research. As a ligand downstream of the Notch pathway, it broadly influences developmental and metabolic processes in the body. With deeper research, it has been found that DLK1 can induce the synthesis and secretion of insulin through the ERK and AKT pathways, playing a crucial role in the development of metabolic diseases. Diabetes mellitus (DM) is a chronic metabolic disorder characterized by insufficient insulin production by the pancreas or inadequate utilization of insulin by the body. This article aims to review the relationship between DLK1 and diabetes, recent research advancements, and to discuss future research directions and challenges.

The effects of pharmacologic estradiol on anxiety-related behavior in adolescent and adult female mice

Early pubertal onset during adolescence is consistently linked with increased risk of anxiety and depression in girls. Although estradiol tends to have anxiolytic effects on behavior in adulthood, whether estradiol's anxiolytic actions change pre- to post-adolescent development is not clear. Using a rodent model, the current study tested whether anxiety-like responses to estradiol differ before and after adolescence in female mice. Prepubertal and adult C57BL/6 mice were ovariectomized, implanted with vehicle- or estradiol-filled silastic capsules, and behavioral tested 6 days later in the open field and elevated zero maze. A pharmacologic dose of estradiol was administered in silastic capsules (0.72 μg/0.02 mL) to maximize behavioral responses at both ages. In the open field, estradiol implants decreased anxiety-like behavior in adolescent females (relative to vehicle) and had negligible effects on anxiety-related behavior in adult females. These data suggest that adolescence is associated with changes in behavioral responsiveness to estradiol. In the elevated zero maze, adolescent females displayed higher levels of anxiety-like behavior than adults, irrespective of estradiol treatment. These findings demonstrate that substantial changes in anxiety-related behavior occur during adolescence, including an assay-dependent shift in behavioral responsiveness to estradiol.

SHOX2 and RASSF1A methylation in diagnosing malignant pleural effusion induced by lung cancer

BACKGROUND

Malignant pleural effusion (MPE) is a thoracic complication disease characterized by tumors, predominantly resulting from advanced lung cancer. This study aimed to investigate the efficacy of SHOX2 and RASSF1A methylation as a supplementary diagnostic tool for lung cancer-induced MPE with uncertain pathological diagnoses.

MATERIALS AND METHODS

Methylation-specific polymerase chain reaction (MS-PCR) was used to assess SHOX2 and RASSF1A methylation levels in 98 pleural effusion samples. The cut-off values for SHOX2 and RASSF1A methylation levels for the detection of MPE were determined through receiver operating characteristic (ROC) curve analysis, with corresponding sensitivity and specificity analyses. The chi-square test was used to evaluate the relationship between SHOX2 and RASSF1A methylation levels and clinical characteristics or immunohistochemical markers in patients with MPE.

RESULTS

For the diagnosis of MPE, the area under the ROC curve (AUC) values for SHOX2 and RASSF1A methylation levels were 0.820 and 0.718, respectively, with a combined AUC value of 0.881. The sensitivity and specificity of SHOX2 methylation levels were 68.4 % and 92.7 %, respectively, whereas those of RASSF1A methylation levels were 47.4 % and 97.7 %, respectively. The combined detection of SHOX2 and RASSF1A (using the LungMe® assay kit) exhibited a sensitivity of 82.5 %, which exceeded that of cytological analysis (29.8 %). The sensitivity and specificity of combined cytological analysis and LungMe® assay were 89.5 % and 92.7 %, respectively. SHOX2 methylation levels were significantly higher in patients without EGFR mutations than in those with EGFR mutations. The methylation levels of SHOX2 and RASSF1A were higher in smokers than in non-smokers and PDL1-positive patients than in PDL1-negative patients; however, the differences were not statistically significant. The methylation levels of both genes were higher in TTF-1-positive patients than in TTF-1-negative patients, with the difference being statistically significant for RASSF1A.The methylation levels of neither SHOX2 nor RASSF1A were associated with patient survival, whereas PDL1 expression was identified as an independent risk factor for the survival of patients with MPE (hazard ratio = 4.109).

CONCLUSION

Methylation of SHOX2 and RASSF1A serves as a valuable diagnostic biomarker for MPE, providing an adjunct to cytological diagnosis.

Glucocorticoids as emerging pollutants in surface water: A systematic review on their global occurrence and distribution

Glucocorticoids (GCs) are synthetic drugs widely used for treating several diseases with inflammatory pathophysiology. In general, 1-20% of the concentration of GCs initially administered is eliminated unchanged in the urine while still in its active form, and therefore, fractions of GCs are constantly released in effluents. Currently, water treatment plants do not have sufficiently effective technologies to remove these substances completely, favoring the presence of these emerging pollutants in the effluents of wastewater treatment plants. In this context, we conduct a systematic review to identify studies that found GCs in surface water. The general data of the included studies, the GCs found and their concentration, the water body where the GCs were found, and the place and date of sampling were summarized. GCs have already been found in the surface water of 24 countries, mainly China, Malaysia, and the United States. Countries with the highest concentrations of GCs found in surface water were Mexico, India, and Brazil. Betamethasone, budesonide, corticosterone, cortisol, cortisone, dexamethasone, fludrocortisone, fluticasone, hydrocortisone, methylprednisolone, prednisolone, prednisone, and triamcinolone were reported at concentrations ranging from 0.00098 to 24760 ng/L, including in water for human consumption. Revised data showed that the real presence of these substances worldwide is still underestimated, requiring further studies to determine their real distribution. Furthermore, we believe that some strategies can be adopted to mitigate surface water contamination by GCs, such as the intensification of public programs about educational activities related to the rational use of medicines, and the urgent need to improve and expand the water treatment methods.

Monogenic diabetes: An evidence-based clinical approach

Monogenic diabetes is a heterogeneous disorder characterized by hyperglycemia arising from defects in a single gene. Maturity-onset diabetes of the young (MODY) is the most common type with 14 subtypes, each linked to specific mutations affecting insulin synthesis, secretion and glucose regulation. Common traits across MODY subtypes include early-onset diabetes, a family history of autosomal dominant diabetes, lack of features of insulin resistance, and absent islet cell autoimmunity. Many cases are misdiagnosed as type 1 and type 2 diabetes mellitus. Biomarkers and scoring systems can help identify candidates for genetic testing. GCK-MODY, a common subtype, manifests as mild hyperglycemia and doesn’t require treatment except during pregnancy. In contrast, mutations in HNF4A, HNF1A, and HNF1B genes lead to progressive beta-cell failure and similar risks of complications as type 2 diabetes mellitus. Neonatal diabetes mellitus (NDM) is a rare form of monogenic diabetes that usually presents within the first six months. Half of the cases are lifelong, while others experience transient remission. Permanent NDM is most commonly due to activating mutations in genes encoding the adenosine triphosphate-sensitive potassium channel (KCNJ11 or ABCC8) and can be transitioned to sulfonylurea after confirmation of diagnosis. Thus, in many cases, monogenic diabetes offers an opportunity to provide precision treatment. The scope has broadened with next-generation sequencing (NGS) technologies, replacing older methods like Sanger sequencing. NGS can be for targeted gene panels, whole-exome sequencing (WES), or whole-genome sequencing. Targeted gene panels offer specific information efficiently, while WES provides comprehensive data but comes with bioinformatic challenges. The surge in testing has also led to an increase in variants of unknown significance (VUS). Deciding whether VUS is disease-causing or benign can be challenging. Computational models, functional studies, and clinical knowledge help to determine pathogenicity. Advances in genetic testing technologies offer hope for improved diagnosis and personalized treatment but also raise concerns about interpretation and ethics.

Paeonol regulates autophagy through the PI3K-AKT-mTOR signaling pathway to inhibit apoptosis of osteocytes

Osteoporosis is the most common complication of glucocorticoids and predisposes to fractures. Excessive apoptosis of osteocytes is the pathological feature of glucocorticoid-induced osteoporosis. Paeonol, an effective component of Traditional Chinese Medicine Cortex Moutan, known for its anti-inflammatory and analgesic properties, has a long clinical application history. However, the regulatory effect of paeonol on the fate of osteocytes under excessive glucocorticoid remains unclear. The present study aimed to investigate the effect of paeonol against osteocyte death and osteoporosis induced by glucocorticoid and to explore the underlying mechanisms. We found that paeonol not only improved the low proliferation rate of osteocytes induced by dexamethasone but also weakened the dexamethasone-induced apoptosis of osteocytes by stimulating cytoprotective autophagy. Subsequently, proteomic sequencing identified the phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K) - protein kinase B (AKT) signaling pathway as the potential target of paeonol in attenuating dexamethasone-induced osteocyte injury, and the PI3K activator and inhibitor confirmed this hypothesis. In vivo, paeonol alleviated glucocorticoid-induced osteoporosis, promoted autophagy and inhibited apoptosis of osteocytes by regulating PI3K phosphorylation. In brief, paeonol protects osteocytes from dexamethasone-derived apoptosis by increasing protective autophagy, further inhibiting osteoporosis. Its autophagy-promoting effect was associated with inhibition of PI3K-AKT-mechanistic target of rapamycin (mTOR) of osteocytes.

Prolactin as a novel biomarker in malignancy

Apart from lactation, prolactin is engaged in a wide range of physiological activities and mostly generated by lactotroph cells in the anterior pituitary. Among these actions are metabolic, immunological, and reproductive ones. Prolactin acts through the binding of the hormone to its receptor, PRLR. Among organs in which this receptor is found include the liver, adipose tissue, immunological cells, and the central nervous system. Because of its control of glucose and lipid metabolism, adipogenesis, and leptin production, prolactin is a fundamental component in the control of metabolism. It is responsible for maintaining energy homeostasis during critical physiological states such as increasing immune cell diversity and proliferation. However, elevated levels of prolactin have been linked to exacerbated autoimmune diseases. An association has been established between the hormone prolactin and the development and progression of a number of malignancies, including breast, ovarian, prostate, and hepatic cancers. Investigations are now being conducted to determine the diagnostic and therapeutic potential of prolactin. The objective of this review is to investigate the various functions that prolactin serves, as well as the ways in which high or low amounts of the hormone influence certain cancers.

Body mass index and risk of Hodgkin's lymphoma: Insights from a Norwegian cohort study

BACKGROUND

Several studies have reported positive associations between higher body mass index (BMI) and risk of Hodgkin's lymphoma. However, the evidence is not entirely consistent. We investigated the association between BMI and Hodgkin's lymphoma in a large Norwegian cohort with up to 50 years follow-up.

METHODS

The analytical dataset included 1723,692 men and women aged 16-75 years at baseline in 1963-1975. Multivariable Cox regression analyses were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for the associations between BMI and Hodgkin's lymphoma incidence.

RESULTS

During 56.1 million person-years of follow-up, 1608 incident Hodgkin's lymphoma cases occurred. Compared to individuals with BMI 18.5-< 25, the HRs (95 % CIs) for those with a BMI of 15-< 18.5, 25-< 30, and ≥ 30 were 0.87 (0.59-1.27), 1.05 (0.94-1.18), and 1.61 (1.35-1.91), respectively, and 1.57 (1.30-1.90) and 1.80 (1.24-2.62) for obesity grade 1 and grade 2, respectively. A positive association was also observed per 5 kg/m2 increment with a HR (95 % CI) of 1.16 (1.08-1.24) overall, 1.20 (1.09-1.31) in women, and 1.08 (0.96-1.20) in men. Positive associations were also observed between obesity vs. normal weight in early adulthood (age 16-29 years) and Hodgkin's lymphoma (HR, 95 % CIs: 1.89, 1.10-3.22, ptrend<0.0001, n = 489 cases) and between obesity and early-onset (age <50 years at diagnosis) disease (HR, 95 % CIs: 1.67, 1.01-2.78, ptrend<0.0001, n = 393 cases).

CONCLUSION

The positive associations observed between higher BMI overall and in young adulthood and Hodgkin's lymphoma and between BMI and early-onset disease emphasize the potential role of adiposity in development of this malignancy.

Maternal dopamine agonist treatment before pregnancy reverses infertility and hyperprolactinemia in hCG-overexpressing mice through lactation: Evidence of generational effects

Dopamine agonists, such as cabergoline (Cab), have demonstrated efficacy in restoring reproductive function in cases of hyperprolactinemia and hormonal dysregulation. This study investigates the long-term consequences of maternal Cab treatment on the reproductive phenotype of the progeny in a female transgenic (TG) mouse model with hyperprolactinemia and infertility due to human chorionic gonadotropin (hCG) β-subunit overexpression. The TG females that received Cab between weeks 3-4 of life exhibited a reversion of hyperprolactinemia and infertility, whereas WT females retained their fertility. When TG-cab- or WT-Cab-treated females were crossed with WT or TG males, respectively, their female TG offspring showed a reversal of precocious puberty, regularization of estrous cycles, fertility, and prevention of hyperprolactinemia and prolactinomas. Despite the persistent high LH/hCG bioactivity, the normalization of prolactin levels led to a reduction in ovarian luteinization markers and progesterone levels. The TG female pups born to either WT-cab- or TG-cab-treated females exhibited a normalized phenotype, thus suggesting that the effects were indeed due to maternal Cab administration, and not to the transgene. Cross-fostering experiments showed that the long-lasting programming effect of maternal Cab on offspring occurred during lactation because the TG female pups from non-treated WT female/TG male pregnancies, but nursed by Cab-treated females, were free from the altered TG phenotype. These results suggest that Cab treatment before pregnancy may have a multigenerational effect on the hypothalamic-pituitary-gonadal axis of the offspring, mediated during lactation. This highlights potential implications for generational health and clinical practices regarding the use of dopamine agonists during lactation.

Prenatal exposure to persistent organic pollutants and associations with child behavior problems at 1-5 years

Existing studies have found inconclusive associations between prenatal exposure to persistent organic pollutants (POPs), including per- and polyfluoroalkyl substances (PFAS) and polybrominated diphenyl ethers (PBDEs), and offspring neurodevelopment. However, there is a significant gap in research involving African American populations, who face higher levels of exposure to many POPs relative to other groups. In this study, we assessed the joint effects of PFAS and PBDEs on child behavior problems among mother-child pairs in Atlanta, Georgia. Our study population included a subset of mother-child pairs participating in a prospective birth cohort (N = 159) for whom exposure and outcome data were available. Four PFAS and three PBDEs were measured in serum samples obtained during the first trimester of pregnancy. The Child Behavior Checklist was administered annually from ages 1-5 years and used to assess internalizing and externalizing behavior problems (averaged across all timepoints). We used quantile g-computation, Bayesian kernel machine regression (BKMR), and self-organizing maps (SOM) to assess associations between POPs mixtures and internalizing and externalizing behavior problems. Using quantile g-computation, we observed that increasing concentrations of prenatal PBDEs were associated with more internalizing and externalizing behavior problems (e.g., Ѱ = 0.20, 95 % CI = 0.04, 0.36 for externalizing problems). The SOM cluster reflecting high PFAS and high PBDEs was similarly associated with an increase in internalizing and externalizing behavior problems compared to the reference cluster (e.g., β = 0.44 95 % CI = 0.08, 0.81 for internalizing problems). The positive associations were attributable to PBDEs, while PFAS were negatively associated with both outcomes across all three methods. To conclude, among mother-child pairs in Atlanta, we observed that exposure to PFAS and PBDEs was associated with internalizing and externalizing behavior problems between 1 and 5 years of age.

The Enteric Neuronal Circuitry: A Key Ignored Player in Nutrient Sensing Along the Gut-Brain Axis

The role of the gut-to-brain axis in the regulation of nutrient sensing has been studied extensively for decades. Research has mainly centered on vagal afferent and efferent neurotransmission along the gastrointestinal tract, followed by the integration of luminal information in the nodose ganglia and transmission to vagal integral sites in the brain. The physiological and cellular mechanisms of nutrient sensing by enterocytes and enteroendocrine cells have been well established; however, the roles of the enteric nervous system (ENS) remain elusive. Recent advances in targeting specific neuronal subpopulations and imaging techniques unravel the plausible roles of the ENS in nutrient sensing. In this review, we highlight physiological, cellular, and molecular insights that direct toward direct and indirect roles of the ENS in luminal nutrient sensing and vagal neurotransmission along the gut-brain axis and discuss functional maladaptations observed during metabolic insults, as observed during obesity and associated comorbidities, including type 2 diabetes.

An endocrinological perspective on polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS) is a complex endocrinological disorder that involves dysfunctions across multiple endocrine axes, including the hypothalamic-pituitary-gonadal (HPG), hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-thyroid (HPT) axes. Our review focuses on understanding the pathophysiology of PCOS through an endocrinological perspective, emphasizing the complex interactions between multiple endocrine axes. We have discussed the roles of the HPG, HPA, and HPT axes in PCOS. Dysregulation of the HPG axis, particularly the altered gonadotropin-releasing hormone pulse frequency resulting in elevated ratio of luteinizing hormone to follicle stimulating hormone, is central to the hyperandrogenism and anovulation, observed in PCOS. We have further highlighted the contributions of the HPA and HPT axes, where elevated adrenal androgen levels and hypothyroidism intensifies the phenotypes of PCOS. Additionally, insulin resistance and hyperinsulinemia, commonly associated with PCOS, aggravates hormonal disturbances and heighten the risk of metabolic complications such as type 2 diabetes and cardiovascular diseases. Elevated levels of anti-Müllerian hormone have also been emphasized as a key factor in inhibiting follicular growth, leading to impaired ovarian function and hyperandrogenism. This review further supports that PCOS is a multifactorial condition involving complex feedback mechanisms between the endocrine, metabolic, and reproductive systems. Furthermore, there remains a huge scope for deciphering the precise molecular interactions between the HPG, HPA, and HPT axes in PCOS, which could pave the way for targeted therapies for better management of both the endocrine and metabolic aspects of this disorder. This review will benefit researchers to get an endocrine perspective on PCOS.

The influence of ovarian activity and menopause on mental health: Evidence from animal models and women

Hormonal variations occurring throughout the female reproductive cycle have a significant impact on physical and mental health, particularly due to the influence of estradiol (E2) and progesterone (P4). These changes are directly related to alterations in neurological systems, being associated with conditions such as premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and mood disorders during hormonal transition phases, such as perimenopause and menopause. Studies conducted in humans and animal models indicate that these fluctuations affect neurotransmitters, neural plasticity, and patterns of brain activity, ultimately influencing quality of life and mental health. Despite extensive research on the topic, the interactions between sex hormones, mental health, and reproductive aging still require further investigation, emphasizing approaches that simultaneously address experimental and behavioral aspects. Thus, this review aims to sumarize findings about the influence of hormonal fluctuations throughout the female reproductive lifespan, including transitions such as perimenopause and menopause, on mental health. A comparative analysis of data from studies in animal models and humans was conducted, highlighting neuroendocrine, behavioral, and emotional mechanisms associated with hormonal changes and their impacts on female mental health.

Association between phthalate exposure and metabolic dysfunction-associated steatotic liver disease (MASLD) - Systematic literature review

The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is rising globally. Recent studies have suggested connections between exposure to endocrine disrupting chemicals (EDCs) and the development of MASLD. Phthalates, which are commonly utilized as plasticizers, in building materials and consumer items, exhibit endocrine disrupting effects and have been shown to interfere with lipid metabolism in mechanistic studies. The objective of this systematic review was to examine the association between MASLD and exposure to phthalates in the adult human populations. We searched PubMed, Scopus and Web of Science for studies published from the inception of each database until December 12, 2024. The literature search yielded 10 cross-sectional studies, which were analyzed in detail. The key findings of this study indicate a potential correlation between the prevalence of MASLD and exposure to certain phthalates. Among the phthalates examined, the metabolites of bis(2-ethylhexyl) phthalate (DEHP) - namely MECPP, MEHHP, and MEOHP, demonstrated the strongest and most frequent associations with MASLD. All the current studies followed cross-sectional study designs, which limits the possibility to establish a causal relationship between MASLD and phthalate exposure. Therefore, longitudinal studies are needed to corroborate these findings and shed light on the involvement of phthalate exposure in MASLD.

Examining the impact of 28-week multicomponent and strength exercises on brain health, salivary stress, and mental well-being in frail older women: A controlled trial analysis

BACKGROUND

In recent years, the efficacy of various physical exercise programs in enhancing functional fitness among frail older adults has gained recognition. However, limited research has concurrently explored the long-term effects of exercise on brain health, stress biomarkers, and mental well-being. This study aimed to investigate the impact of two distinct chair-based exercise programs on salivary stress hormones and psychological well-being in frail older women over a 28-week period.

METHODS

A total of 140 individuals participated in the enrollment phase, with 84 eligible participants randomly assigned to three groups. Following the intervention, data from 60 participants were analyzed across the multicomponent exercise (MCE, n = 23), elastic band muscle-strength exercise (ESE, n=19), and non-exercise control (CG n=18) groups. Salivary biomarkers of alpha-amylase (α-AMY) Cortisol (COR), alpha-amylase/cortisol ratio, psychological indicators and physical frailty (PF) and functional fitness were assessed pre- and post-intervention.

RESULTS

Salivary COR levels exhibited a significant time × group interaction, with a moderate increase in MCE, a small decrease in ESE, and a substantial increase in CGne. Salivary α-AMY levels varied significantly over time and by group, with a small decrease in both exercise groups and a moderate increase in CGne. The α-AMY /COR ratio also displayed a significant interaction effect. Additionally, significant improvements were observed in PF compound scores, general self-efficacy, attitudes toward aging, and reductions in perceived stress and depressive symptoms (p < 0.05).

CONCLUSIONS

Notably, the MCE program demonstrated greater benefits than ESE. The observed associations between changes in α-AMY levels, mental well-being, and functional fitness indicators contribute novel evidence on the psychophysiological adaptations to long-term exercise. Importantly, reductions in PF scores correlated with improvements in self-efficacy, attitudes toward aging, and handgrip strength, reinforcing the link between functional fitness, stress regulation, and psychological well-being. These findings emphasize the need for tailored exercise interventions to enhance both physiological resilience and mental health in frail older populations.

Development of a natural porcine-estrogen-receptor-based pseudo immunoassay for screening of 13 estrogens in milk and studying its recognition mechanism

BACKGROUND

There have been some immunoassays reported for screening of the residues of estrogens in milk, but these methods can only determine one drug because of the limited recognition abilities of the used antibodies. Due to the broad specific recognition ability, receptor can be used as "special antibody" to develop pseudo immunoassay. However, there has been no article reporting the use of estrogen receptor for determination of estrogens in foods of animal origin so far. Furthermore, the recognition mechanism of estrogen receptor for estrogens have not been thoroughly studied.

RESULTS

In this study, a type of magnetic probe based on 17β-estradiol was synthesized that was used to produce the natural porcine estrogen receptor with ovarian as the source tissue. Then its recognition mechanisms for 13 estrogens were studied based on the optimal homological model. Results showed it only interacted with estrogens but did not interact with other steroid hormones. Then it was utilized as a broad specific recognition reagent to develop a direct competitive method on 96-well microplate for detection of the 13 drugs in milk. Due to the utilization of streptavidin-biotin labeled horseradish peroxidase as signal amplification system, the sensitivities for the 13 estrogens (limits of detection 0.007-0.0573 ng/mL) were improved for 33-100 folds in comparison with the use of conventional horseradish peroxidase system (limits of detection 0.31-3.53 ng/mL). This method showed no cross-reactivity with other steroid hormones, consistent with the docking result.

SIGNIFICANCE

This is the first study reporting the use of magnetic probe to produce natural receptor from animal tissues, and this is also the first study reporting a natural estrogen-receptor-based method for multi-determination of estrogens in food sample. With the guidance of this study, more receptors and related analytical methods for other drugs or small molecules maybe are reported in the future.

Exploring the nexus: Sleep disorders, circadian dysregulation, and Alzheimer's disease

We reviewed the connections among Alzheimer's disease (AD), sleep deprivation, and circadian rhythm disorders. Evidence is mounting that disrupted sleep and abnormal circadian rhythms are not merely symptoms of AD, but are also involved in accelerating the disease. Amyloid-beta (Aβ) accumulates, a feature of AD, and worsens with sleep deprivation because glymphatic withdrawal is required to clear toxic proteins from the brain. In addition, disturbances in circadian rhythm can contribute to the induction of neuroinflammation and oxidative stress, thereby accelerating neurodegenerative processes. While these interactions are bidirectional, Alzheimer's pathology further disrupts sleep and circadian function in a vicious cycle that worsens cognitive decline, which is emphasized in the review. The evidence that targeting sleep and circadian mechanisms may serve as therapeutic strategies for AD was strengthened by this study through the analysis of the molecular and physiological pathways. Further work on this nexus could help unravel the neurobiological mechanisms common to the onset of Alzheimer's and disrupted sleep and circadian regulation, which could result in earlier intervention to slow or prevent the onset of the disease.

FGFBP1 promotes triple-negative breast cancer progression through the KLK10-AKT axis

Triple-negative breast cancer (TNBC) is highly malignant, with rapid tumor growth and metastasis. Due to ER-, PR- and HER2-of TNBC, FGFR pathway play a pivotal role in the progression of TNBC. Its ligand FGFs is mostly released from the extracellular matrix by fibroblast growth factor binding protein 1 (FGFBP1). However, little is known about the role of FGFBP1 in TNBC. In this study, we found that overexpression of FGFBP1 significantly promoted the proliferation, migration and invasion of TNBC cells in vitro and in vivo and vice versa. Mechanistically, overexpression of FGFBP1 upregulated the expression of KLK10, thereby activating AKT, which led to proliferation, migration and invasion of TNBC cells. After knocking down FGFBP1, the expression of KLK10 was reduced and the AKT pathway was inhibited. In addition, knocking down KLK10 or inhibiting AKT pathway impaired the promotion effect of overexpression of FGFBP1 on the proliferation and invasion of TNBC cells. These results suggest that FGFBP1 may promote the proliferation, migration and invasion of TNBC cells through the KLK10-AKT axis. Targeting FGFBP1 may serve as a new therapeutic strategy for TNBC.

Guhan Yangsheng Jing mitigates oxidative stress and ferroptosis to improve reproductive damage in Diabetic Male Rats

ETHNOPHARMACOLOGICAL RELEVANCE

According to traditional Chinese medicine (TCM) theory, reproductive injury is primarily associated with kidney essence deficiency, with the kidney being the affected organ. Guhan Yangshengjing (GHYSJ) is a traditional Chinese patent medicine, its main ingredients of GHYSJ, such as Polygonatum sibiricum Redouté, Epimedium brevicornu Maxim., and Lycium barbarum L. are believed to have significant kidney-tonifying effects, which can improve reproductive damage.

AIM OF THE STUDY

This study aims to investigate the protective effects of GHYSJ, a traditional Chinese medicine formula, on diabetes-induced male reproductive damage.

METHODS

In this study, we employed LC/Q-TOF-MS to analyze the active components of GHYSJ. A diabetic rat model was established using a high-sugar high-fat (HSHF) diet in combination with streptozotocin (STZ). Sperm quality and motility were assessed, and testicular morphology and sex hormones (testosterone [T], follicle-stimulating hormone [FSH], and luteinizing hormone [LH]) levels were examined to evaluate the impact of diabetes on reproductive function. Transcriptomic analysis was conducted to elucidate the potential mechanisms underlying GHYSJ's protective effects against diabetes-induced reproductive damage. Additionally, we used ELISA, immunofluorescence, transmission electron microscopy (TEM), immunohistochemistry, and Western blot to measure the expression levels of oxidative stress and ferroptosis-related markers, including oxygen species (ROS), superoxide dismutase (SOD), malondialdehyde (MDA), glutathione (GSH), lipid peroxidation (LPO), ferrous ion (Fe2+), nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), glutathione peroxidase 4 (GPX4), and cystine/glutamate antiporter (xCT).

RESULTS

Diabetic rats induced by a HSHF diet combined with STZ exhibited decreased sperm count, reduced sperm motility, and disrupted sex hormone secretion. GHYSJ intervention significantly reduced ROS levels and MDA accumulation in testicular tissue while enhancing SOD activity, thereby effectively alleviating oxidative damage. Additionally, GHYSJ modulated the Nrf2/HO-1 signaling pathway associated with oxidative stress, restoring testicular antioxidant capacity. This was evidenced by increased GSH levels, upregulated expression of antioxidant proteins (GPX4, xCT), decreased Fe2+ content, and reduced LPO levels. These effects collectively inhibited ferroptosis in testicular tissue of diabetic rats, leading to improved reproductive function.

CONCLUSIONS

Our findings demonstrate that GHYSJ exerts significant protective effects against diabetes-induced male reproductive damage by modulating oxidative stress and ferroptosis pathways. GHYSJ's ability to enhance antioxidant defenses and inhibit ferroptosis highlights its potential as a therapeutic agent for managing reproductive dysfunction in diabetic males.

Supramolecular oral delivery technologies for polypeptide-based drugs

Oral supramolecular drug delivery systems (SDDSs) have shown promising potential, along with a rapid increase in the development of polypeptide-based drugs. Biofriendly, biocompatible, and multistimulation-responsive SDDSs achieve their unique deliverability via noncovalent bonds, which can encapsulate drugs and release them at the target site along the oral tract. In this review, we analyze the oral tract from an anatomical perspective and explain the potential physical, microenvironmental, and systematic barriers, as well as the properties of drug delivery. After understanding the specific environment at different oral sites, the application of SDDSs to the mouth, stomach, small intestine, and cell targeting is summarized. Finally, this review summarizes the application of SDDSs for the successful delivery of drugs and describes how to overcome the barriers of SDDSs in drug delivery using a more biofriendly approach.

Inverse Agonists of Peroxisome Proliferator-Activated Receptor Gamma: Advances and Prospects in Cancer Treatment

Peroxisome proliferator-activated receptor gamma (PPARγ) is a ligand-dependent nuclear transcription factor that modulates metabolic homeostasis and cell proliferation. Inverse agonism of PPARγ is an emerging anticancer strategy, particularly for the treatment of bladder cancer. The first-in-class PPARγ inverse agonist, FX-909, is currently being studied in clinical trials for cancer treatment. However, PPARγ inverse agonists are still in the early stages of development. The discovery of compounds with novel chemical structures, potent efficacy, and favorable pharmacokinetic properties is urgently needed. In this perspective, the biological functions of PPARγ and its role in cancer pathology are introduced, and currently available PPARγ inverse agonists and their preliminary structure-activity relationships (SARs) are discussed from a medicinal chemistry viewpoint. These findings inform the development of anticancer agents that act as PPARγ inverse agonists. Furthermore, our discussion of the complex biological functions of PPARγ provides insights into the exploration of its role in various diseases.

Synthesis and Pharmacological Characterization of Novel Peripheral Cannabinoid-1 Receptor Blockers Based on a Tricyclic Scaffold

The development of peripherally selective cannabinoid-1 receptor (CB1R) antagonists offers a promising strategy for obesity treatment. Here, we evaluated the efficacy of novel tricyclic CB1R antagonists, focusing on BNS808. Our findings demonstrate that BNS808 exhibits robust CB1R antagonism with notable CB2R selectivity, minimal brain penetration, and potent in vitro and in vivo efficacy. The compound's high plasma protein binding reduces free drug availability for CNS entry, enhancing safety and minimizing drug-drug interactions. In diet-induced obese mice, BNS808 effectively reduced body weight, adiposity, liver triglycerides, and liver enzymes, supporting its peripherally mediated action. These results highlight BNS808 as a promising candidate for obesity treatment. Additionally, our novel library of peripherally selective CB1R antagonists provides a strong foundation for future drug development. With further refinement, BNS808 holds significant clinical potential to address the global obesity epidemic.

Quercetin down-regulates MCP-1 expression in autoimmune myocarditis via ERK1/2-C/EBPβ pathway: An integrative approach using network pharmacology and experimental models

Myocarditis is one of the common causes of sudden death in adolescents, and autoimmune response and inflammation play an essential role in the development of myocarditis. Quercetin is a natural flavonoid compound with anti-inflammatory and cardioprotective effects. However, the mechanism of quercetin in autoimmune myocarditis remains unclear. This study observed that quercetin significantly improved cardiac function, inflammation and fibrosis in mice with experimental autoimmune myocarditis (EAM). In addition, Network pharmacology predicts the key target C/EBPβ and signalling pathway MAPK for quercetin treatment of autoimmune myocarditis. CESTA and DARTS experiments verified that quercetin and C/EBPβ have strong binding ability. It is shown that quercetin down-regulates MCP-1 expression in H9C2 cells by dephosphorylation of ERK1/2 and C/EBPβ. Specifically, quercetin reduced the binding of C/EBPβ to the MCP-1 promoter, resulting in decreased expression of MCP-1, which was associated with decreased ERK1/2 dependent phosphorylation at the C/EBPβ threonine 188 site. This inhibitory effect of quercetin could be further enhanced by the ERK1/2 inhibitor PD98059. The biological relevance of this regulatory network is demonstrated in EAM mice. In conclusion, these results illustrate the protective effect of quercetin against autoimmune myocarditis. A novel regulatory mechanism was revealed, namely the down-regulation of MCP-1 through the ERK1/2-C/EBPβ axis. This provides a new therapeutic strategy for autoimmune myocarditis.

Emulating randomized trials by observational database studies: the RCT-DUPLICATE initiative in COPD and asthma

Observational studies are increasingly used to provide real-world evidence in regulatory decision-making. The RCT-DUPLICATE initiative conducted observational studies emulating 2 published randomized trials in patients with asthma and 3 in chronic obstructive pulmonary disease (COPD). For each trial, new-user cohorts were constructed from 2 US healthcare claims databases, comparing initiators of the study and comparator drugs, matched on propensity scores. Proportional hazards models were used to compare the treatments on study outcomes. The observational studies involved more subjects than the corresponding trials, with treatment arms well-matched on baseline characteristics. An asthma example involved emulation of the 26-week FDA-mandated D5896 trial. With 6494 asthma patients per arm, the hazard ratio (HR) of a serious asthma-related event with budesonide-formoterol vs budesonide was 1.29 (95% CI, 0.63-2.65) compared with 1.07 (95% CI, 0.70-1.65) in the trial. A COPD example is the emulation of the one-year IMPACT trial. With 4365 COPD patients per arm, the HR of a COPD exacerbation with triple therapy vs dual bronchodilators was 1.08 (95% CI, 1.00-1.17) compared with 0.84 (95% CI, 0.78-0.91) in the trial. We found mainly discordant results between observational analyses and their emulated randomized trials, likely from the forced discontinuation of treatments prior to randomization in the trials, not mimicable in the observational analyses. This article is part of a Special Collection on Pharmacoepidemiology.