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Lee E, Nissinen TA, Ylä-Outinen L, Jalkanen A, Karppinen JE, Vieira-Potter VJ, Lipponen A, Karvinen S. Estrogen deficiency reduces maximal running capacity and affects serotonin levels differently in the hippocampus and nucleus accumbens in response to acute exercise. Front Neurosci 2024; 18:1399229. [PMID: 38983274 PMCID: PMC11231437 DOI: 10.3389/fnins.2024.1399229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/07/2024] [Indexed: 07/11/2024] Open
Abstract
Introduction Estrogen deficiency is associated with unfavorable changes in body composition and metabolic health. While physical activity ameliorates several of the negative effects, loss of ovarian function is associated with decreased physical activity levels. It has been proposed that the changes in brain neurochemical levels and /or impaired skeletal muscle function may underlie this phenomenon. Methods We studied the effect of estrogen deficiency induced via ovariectomy (OVX) in female Wistar rats (n = 64). Rats underwent either sham or OVX surgery and were allocated thereafter into four groups matched for body mass and maximal running capacity: sham/control, sham/max, OVX/control, and OVX/max, of which the max groups had maximal running test before euthanasia to induce acute response to exercise. Metabolism, spontaneous activity, and maximal running capacity were measured before (PRE) and after (POST) the surgeries. Three months following the surgery, rats were euthanized, and blood and tissue samples harvested. Proteins were analyzed from gastrocnemius muscle and retroperitoneal adipose tissue via Western blot. Brain neurochemical markers were measured from nucleus accumbens (NA) and hippocampus (HC) using ultra-high performance liquid chromatography. Results OVX had lower basal energy expenditure and higher body mass and retroperitoneal adipose tissue mass compared with sham group (p ≤ 0.005). OVX reduced maximal running capacity by 17% (p = 0.005) with no changes in muscle mass or phosphorylated form of regulatory light chain (pRLC) in gastrocnemius muscle. OVX was associated with lower serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) level in the NA compared with sham (p = 0.007). In response to acute exercise, OVX was associated with low serotonin level in the HC and high level in the NA (p ≤ 0.024). Discussion Our results highlight that OVX reduces maximal running capacity and affects the response of brain neurochemical levels to acute exercise in a brain region-specific manner. These results may offer mechanistic insight into why OVX reduces willingness to exercise.
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Affiliation(s)
- Earric Lee
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Montreal Heart Institute, Montréal, QC, Canada
- School of Kinesiology and Physical Activity Sciences, University of Montréal, Montréal, QC, Canada
| | - Tuuli A. Nissinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Laura Ylä-Outinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Aaro Jalkanen
- Faculty of Health Sciences, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Jari E. Karppinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Victoria Jeanne Vieira-Potter
- Division of Foods, Nutrition and Exercise Sciences, Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Arto Lipponen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Sira Karvinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Zhou M, An YZ, Guo Q, Zhou HY, Luo XH. Energy homeostasis in the bone. Trends Endocrinol Metab 2024; 35:439-451. [PMID: 38242815 DOI: 10.1016/j.tem.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/21/2024]
Abstract
The bone serves as an energy reservoir and actively engages in whole-body energy metabolism. Numerous studies have determined fuel requirements and bioenergetic properties of bone under physiological conditions as well as the dysregulation of energy metabolism associated with bone metabolic diseases. Here, we review the main sources of energy in bone cells and their regulation, as well as the endocrine role of the bone in systemic energy homeostasis. Moreover, we discuss metabolic changes that occur as a result of osteoporosis. Exploration in this area will contribute to an enhanced comprehension of bone energy metabolism, presenting novel possibilities to address metabolic diseases.
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Affiliation(s)
- Min Zhou
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, PR China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan 410008, PR China; Key Laboratory of Aging-Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, PR China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Hunan 410008, PR China
| | - Yu-Ze An
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, PR China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan 410008, PR China; Key Laboratory of Aging-Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, PR China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Hunan 410008, PR China
| | - Qi Guo
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, PR China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan 410008, PR China; Key Laboratory of Aging-Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, PR China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Hunan 410008, PR China
| | - Hai-Yan Zhou
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, PR China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan 410008, PR China; Key Laboratory of Aging-Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, PR China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Hunan 410008, PR China.
| | - Xiang-Hang Luo
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, PR China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan 410008, PR China; Key Laboratory of Aging-Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, PR China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Hunan 410008, PR China.
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Wang H, Xie X, Duan Y, Chai L, Li K, Qiu J, Cheng Z. Rabbit systemic glucose metabolism map by total-body dynamic PET/CT technology. Nucl Med Commun 2023; 44:1144-1150. [PMID: 37706260 PMCID: PMC10631506 DOI: 10.1097/mnm.0000000000001767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND This study evaluated total-body glucose metabolism in a preclinical lab animal, the rabbit, by employing a dynamic glucose metabolic image obtained with total-body fluorine-18 fluorodeoxyglucose ( 18 F-FDG) PET/computed tomography (PET/CT). METHODS The dynamic total-body PET/CT system was used to obtain glucose metabolic imaging from 10 sedated body-matched rabbits. The standard uptake value (SUV) of 18 F-FDG was used to evaluate glucose metabolism. In addition, the correlation between glucose metabolism and sexes was assessed, as well as metabolic differences between left- and right sides. RESULTS We found significant distribution heterogeneity of glucose in several organs across the entire body. There were no significant metabolic differences between sexes and between bilateral sides in the 10 rabbits. Thereafter, we assayed the major organ SUV changes by dynamic PET/CT of the major organs. The heart, liver, and urinary system showed more 18 F-FDG, whereas the skeletal muscle, brain, spinal cord, and lungs incorporated less 18 F-FDG. The phenotype of 18 F-FDG uptake was highly correlated with the physiological functions. The 18 F-FDG accumulation in urinary system were observed which could reflect the renal parenchyma glucose metabolism indirectly. However, the low 18 F-FDG uptake in the brain and spinal cord was due to sedation. CONCLUSION The total-body glucose metabolic atlas depicted with 18 F-FDG dynamic PET/CT may be used as a reference for assessing pathological 18 F-FDG uptake. Furthermore, this study could be a reference for preclinical research involving abnormality of glucose metabolism.
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Affiliation(s)
- Haochen Wang
- Department of General Surgery, the First Affiliated Hospital of Shandong First Medical University
| | - Xue Xie
- Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences and
| | - Yanhua Duan
- Department of Nuclear Medicine, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Leiying Chai
- Department of Nuclear Medicine, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Kun Li
- Department of Nuclear Medicine, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Jianfeng Qiu
- Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences and
| | - Zhaoping Cheng
- Department of Nuclear Medicine, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
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Rong K, Chen P, Lang Y, Zhang Y, Wang Z, Wen F, Lu L. Morinda officinalis polysaccharide attenuates osteoporosis in rats underwent bilateral ovariectomy by suppressing the PGC-1α/PPARγ pathway. J Orthop Surg (Hong Kong) 2022; 30:10225536221130824. [PMID: 36369661 DOI: 10.1177/10225536221130824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Osteoporosis (OP) is a widespread disease that causes risks of spine and hip fractures. Morinda officinalis polysaccharide (MOP) shows therapeutic potential in OP. This article intended to understand the mechanism by which MOP impacts bone mineral density (BMD) and serum trace elements in OP rats. METHODS OP rat models were established by bilateral ovariectomy (OVX). Rats were intragastrically administered with MOP or ZLN005 [the activator of peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α)] since the first day after operation for 8 weeks. Microstructural changes in OP rats were analyzed using micro-computed tomography system. Contents of serum Zn, Cu, Fe, and Mg in rats were measured. Levels of serum superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), GSH, and malondialdehyde (MDA) in rats were determined by Enzyme-linked immunosorbent assay. Protein levels of PGC-1α and peroxisome proliferator-activated receptor γ (PPARγ) in cartilage tissues of rats were determined via Western blotting. RESULTS MOP enhanced BMD, bone volume per trabecular volume (BV/TV), Tb.N, and Tb.Th and reduced Tb.Sp in the distal femur of OVX rats, elevated levels of serum Cu, Fe, and Mg and contents of SOD, GSH, and GSH-PX and decreased MDA content. Moreover, MOP suppressed the PGC-1α/PPARγ pathway. Activation of PGC-1α partially abolished the action of MOP on ameliorating OP in OVX rats and strengthening anti-oxidation ability. CONCLUSION MOP mitigated OP in OVX rats by inhibiting the PGC-1α/PPARγ pathway.
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Affiliation(s)
- Kai Rong
- Department of Hand and Foot Surgery, 117971The First Hospital of Jilin University, Changchun, China
| | - Pingbo Chen
- Department of Traumatology, 91593Hospital of Traditional Chinese Medicine Affiliated to Xinjiang Medical University, Wulumuqi, China
| | - Yi Lang
- Department of Traumatology, 91593Hospital of Traditional Chinese Medicine Affiliated to Xinjiang Medical University, Wulumuqi, China
| | - Yaowu Zhang
- Department of Traumatology, 91593Hospital of Traditional Chinese Medicine Affiliated to Xinjiang Medical University, Wulumuqi, China
| | - Zhan Wang
- Department of Traumatology, 91593Hospital of Traditional Chinese Medicine Affiliated to Xinjiang Medical University, Wulumuqi, China
| | - Fengli Wen
- Department of Traumatology, 91593Hospital of Traditional Chinese Medicine Affiliated to Xinjiang Medical University, Wulumuqi, China
| | - Laijin Lu
- Department of Hand and Foot Surgery, 117971The First Hospital of Jilin University, Changchun, China
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Weng B, Chen C. Effects of Bisphosphonate on Osteocyte Proliferation and Bone Formation in Patients with Diabetic Osteoporosis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2368564. [PMID: 35844452 PMCID: PMC9279083 DOI: 10.1155/2022/2368564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/07/2022] [Accepted: 06/18/2022] [Indexed: 11/28/2022]
Abstract
Background Bisphosphonate is currently considered one of the drugs for the first-line treatment of osteoporosis because of its ability to inhibit bone resorption, but the molecular mechanism of its effect on osteocyte proliferation and bone formation of diabetic osteoporosis is still unclear. Objective To confirm the potential effect on of bisphosphonate on osteocyte proliferation and bone formation in patients having diabetic osteoporosis (DO). Methods Sixty DO patients admitted to our hospital from February 2019 to April 2021 were randomly selected and divided into the bisphosphonate group and the control group. The total incidence, incidence of hip fracture, efficacy, bone mineral density, osteocalcin, pain score, osteocyte proliferation, bone formation index, serum calcium, and phosphorus contents were compared between two groups. Results The curative effect of bisphosphonic acid group was better than that of control group, and the difference was statistically significant (P < 0.05). Compared with the control group, the bone mineral density and osteocalcin in the bisphosphonic acid group were significantly improved after treatment, and the pain score in the bisphosphonic acid group was significantly lower than that in the control group (P < 0.05). After intervention treatment, the OD and PINP values in the bisphosphonate group were significantly different from those in the control group (P < 0.05). After treatment, the contents of serum calcium and phosphorus in the bisphosphonic acid group were significantly higher than those in the control group (P < 0.05). The incidence of hip fracture, spinal fracture, and other fractures in the bisphosphonic acid group was significantly lower than that in the control group (P < 0.05). Conclusion The treatment of DO with bisphosphonate is capability of effectively improving bone cell proliferation and bone formation, further alleviating clinical symptoms and promoting the improvement of the disease.
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Affiliation(s)
- Beifang Weng
- Department of Orthopaedics and Traumatology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
| | - Chunhua Chen
- Department of Orthopaedics and Traumatology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
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Tsai SH, Tseng YH, Chiou WF, Chen SM, Chung Y, Wei WC, Huang WC. The Effects of Whole-Body Vibration Exercise Combined With an Isocaloric High-Fructose Diet on Osteoporosis and Immunomodulation in Ovariectomized Mice. Front Nutr 2022; 9:915483. [PMID: 35795589 PMCID: PMC9251498 DOI: 10.3389/fnut.2022.915483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundOsteoporosis and immune-associated disorders are highly prevalent among menopausal women, and diet control and exercise exert beneficial effects on physiological modulation in this population. A controlled diet with a low fat content and a balanced caloric intake improves menopausal health, but the health effects of excessive fructose consumption on menopausal women are yet to be confirmed. In addition, whole-body vibration (WBV), a safe passive-training method, has been shown to have multiple beneficial effects on metabolism regulation, obesity, and bone health.MethodsThe ovariectomized (OVX) C57BL/6J model was used to verify the effects of WBV combined with a high-fructose diet (HFrD) for 16 weeks on physiological modulation and immune responses. The mice were randomly allocated to sham, OVX, OVX+HFrD, and OVX+HFrD+WBV groups, which were administered with the indicated ovariectomy, dietary and WBV training treatments. We conducted growth, dietary intake, glucose homeostasis, body composition, immunity, inflammation, histopathology, and osteoporotic assessments (primary outcomes).ResultsOur results showed that the isocaloric HFrD in OVX mice negated estrogen-deficiency–associated obesity, but that risk factors such as total cholesterol, glucose intolerance, osteoporosis, and liver steatosis still contributed to the development of metabolic diseases. Immune homeostasis in the OVX mice was also negatively affected by the HFrD diet, via the comprehensive stimulation of T cell activation, causing inflammation. The WBV intervention combined with the HFrD model significantly ameliorated weight gain, glucose intolerance, total cholesterol, and inflammatory cytokines (interferon gamma [IFN-γ], interleukin [IL]-17, and IL-4) in the OVX mice, although osteoporosis and liver steatosis were not affected compared to the negative control group. These findings indicate that an isocaloric high-fructose diet alone may not result in menopausal obesity, but that some deleterious physiological impacts still exist.ConclusionThe WBV method may modulate the physiological impacts of menopause and the HFrD diet, and should be considered as an alternative exercise prescription for people with poor compliance or who are unable or unwilling to use traditional methods to improve their health. In future studies, using the WBV method as a preventive or therapeutic strategy, combined with nutritional interventions, medication, and other exercise prescriptions, may prove beneficial for maintaining health in menopausal women.
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Affiliation(s)
- Syun-Hui Tsai
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- National Research Institute of Chinese Medicine, Taipei, Taiwan
| | - Yu-Hwei Tseng
- National Research Institute of Chinese Medicine, Taipei, Taiwan
| | - Wen-Fei Chiou
- National Research Institute of Chinese Medicine, Taipei, Taiwan
| | | | - Yi Chung
- College of Human Development and Health, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wen-Chi Wei
- National Research Institute of Chinese Medicine, Taipei, Taiwan
- Wen-Chi Wei
| | - Wen-Ching Huang
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- *Correspondence: Wen-Ching Huang
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Costa-Beber LC, Goettems-Fiorin PB, Dos Santos JB, Friske PT, Heck TG, Hirsch GE, Ludwig MS. Ovariectomy reduces the cardiac cytoprotection in rats exposed to particulate air pollutant. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:23395-23404. [PMID: 33443732 DOI: 10.1007/s11356-021-12350-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 01/02/2021] [Indexed: 06/12/2023]
Abstract
Fine particulate matter (PM2.5) has been considered a risk factor for cardiovascular diseases by inducing an oxidative and inflammatory phenotype. Besides, the reduction of 17β-estradiol (E2) levels during menopause is a natural risk for cardiovascular outcomes. During the E2 downfall, there is a high requirement of the 70-kDa heat shock proteins (HSP70), which present essential antioxidant, anti-inflammatory, and anti-senescence roles. We investigated if the ovariectomy, an animal model for menopause, could induce additional effects in cardiac health by impairing oxidative and heat shock response parameters of female rats chronically exposed to residual oil fly ash (ROFA; an inorganic fraction of PM2.5). Thus, ROFA was obtained from São Paulo (Brazil) and solubilized it in saline. Further, female Wistar rats were exposed to 50 μL of saline (control group) or ROFA solution (250 μg) (polluted) by intranasal instillation, 5 days/week, 12 weeks. At the 12th week, animals were subdivided into four groups (n = 6 p/group): control, OVX, polluted, and polluted + OVX. Control and polluted were submitted to false surgery, while OVX and polluted + OVX were ovariectomized. ROFA or saline exposure continued for 12 weeks. Ovariectomy reduced the cardiac catalase activity and iHSP70 expression in female rats exposed to ROFA. Neither plasma eHSP72 levels nor H-index (eHSP72 to cardiac iHSP70 ratio) was affected. In conclusion, ovariectomy reduces the cardiac cytoprotection and antioxidant defense, and enhances the susceptibility to premature cellular senescence in rats exposed to ROFA.
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Affiliation(s)
- Lílian Corrêa Costa-Beber
- Research Group in Physiology, Department of Life Sciences, Postgraduate Program in Integral Attention to Health, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil.
- Postgraduate Program in Integral Attention to Health (PPGAIS-UNIJUÍ/UNICRUZ), Ijuí, RS, Brazil.
| | - Pauline Brendler Goettems-Fiorin
- Research Group in Physiology, Department of Life Sciences, Postgraduate Program in Integral Attention to Health, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Atmospheric Pollution Laboratory, Postgraduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Rua Sarmento Leite 245, Porto Alegre, RS, Brazil
| | - Jaíne Borges Dos Santos
- Research Group in Physiology, Department of Life Sciences, Postgraduate Program in Integral Attention to Health, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Paula Taís Friske
- Research Group in Physiology, Department of Life Sciences, Postgraduate Program in Integral Attention to Health, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Thiago Gomes Heck
- Research Group in Physiology, Department of Life Sciences, Postgraduate Program in Integral Attention to Health, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduate Program in Integral Attention to Health (PPGAIS-UNIJUÍ/UNICRUZ), Ijuí, RS, Brazil
- Medicine Course, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUÍ), Ijuí, RS, Brazil
| | - Gabriela Elisa Hirsch
- Research Group in Physiology, Department of Life Sciences, Postgraduate Program in Integral Attention to Health, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduate Program in Integral Attention to Health (PPGAIS-UNIJUÍ/UNICRUZ), Ijuí, RS, Brazil
| | - Mirna Stela Ludwig
- Research Group in Physiology, Department of Life Sciences, Postgraduate Program in Integral Attention to Health, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduate Program in Integral Attention to Health (PPGAIS-UNIJUÍ/UNICRUZ), Ijuí, RS, Brazil
- Medicine Course, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUÍ), Ijuí, RS, Brazil
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Negligible Effect of Estrogen Deficiency on Development of Skeletal Changes Induced by Type 1 Diabetes in Experimental Rat Models. Mediators Inflamm 2020; 2020:2793804. [PMID: 33204216 PMCID: PMC7665927 DOI: 10.1155/2020/2793804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/09/2020] [Accepted: 08/05/2020] [Indexed: 01/21/2023] Open
Abstract
Although postmenopausal osteoporosis often occurs concurrently with diabetes, little is known about interactions between estrogen deficiency and hyperglycemia in the skeletal system. In the present study, the effects of estrogen deficiency on the development of biochemical, microstructural, and mechanical changes induced by streptozotocin-induced diabetes mellitus (DM) in the rat skeletal system were investigated. The experiments were carried out on nonovariectomized (NOVX) and ovariectomized (OVX) control and diabetic mature female Wistar rats. Serum levels of bone turnover markers (CTX-I and osteocalcin) and 23 cytokines, bone mass and mineralization, histomorphometric parameters, and mechanical properties of cancellous and compact bone were determined. The results were subjected to two-way ANOVA and principal component analysis (PCA). Estrogen deficiency induced osteoporotic changes, with increased bone resorption and formation, and worsening of microstructure (femoral metaphyseal BV/TV decreased by 13.0%) and mechanical properties of cancellous bone (the maximum load in the proximal tibial metaphysis decreased by 34.2%). DM in both the NOVX and OVX rats decreased bone mass, increased bone resorption and decreased bone formation, and worsened cancellous bone microarchitecture (for example, the femoral metaphyseal BV/TV decreased by 17.3% and 18.1%, respectively, in relation to the NOVX controls) and strength (the maximum load in the proximal tibial metaphysis decreased by 35.4% and 48.1%, respectively, in relation to the NOVX controls). Only in the diabetic rats, profound increases in some cytokine levels were noted. In conclusion, the changes induced by DM in female rats were only slightly intensified by estrogen deficiency. Despite similar effects on bone microstructure and strength, the influence of DM on the skeletal system was based on more profound systemic homeostasis changes than those induced by estrogen deficiency.
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Blackcurrant ( Ribes nigrum) Extract Prevents Dyslipidemia and Hepatic Steatosis in Ovariectomized Rats. Nutrients 2020; 12:nu12051541. [PMID: 32466275 PMCID: PMC7284623 DOI: 10.3390/nu12051541] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/21/2020] [Accepted: 05/21/2020] [Indexed: 12/11/2022] Open
Abstract
Estrogen is involved in lipid metabolism. Menopausal women with low estrogen secretion usually gain weight and develop steatosis associated with abnormal lipid metabolism. A previous study showed that blackcurrant (Ribes nigrum L.) extract (BCE) had phytoestrogen activity. In this study, we examined whether BCE improved lipid metabolism abnormalities and reduced liver steatosis in ovariectomized rats, as a menopausal animal model. Twelve-week-old ovariectomized (OVX) rats were fed a regular diet (Ctrl) or a 3% BCE supplemented diet while sham rats were fed a regular diet for three months. Body weight, visceral fat weight, levels of serum triglycerides, total cholesterol, and LDL cholesterol decreased in the BCE-treated OVX and sham rats, but not in OVX Ctrl rats. The results of hematoxylin and eosin staining revealed that BCE decreased the diameters of adipocytes and the nonalcoholic fatty liver disease activity score. Furthermore, quantitative RTPCR indicated a decreased expression of hepatitis-related genes, such as tumor necrosis factor-α, IL-6, and IL-1β in OVX rats after BCE treatment. This is the first study that reported improvement of lipid metabolism abnormalities in OVX rats by BCE administration. These results suggest that the intake of BCE alleviated dyslipidemia and prevented nonalcoholic steatohepatitis during menopause in this animal model.
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Lissarassa YPS, Vincensi CF, Costa-Beber LC, Dos Santos AB, Goettems-Fiorin PB, Dos Santos JB, Donato YH, Wildner G, Homem de Bittencourt Júnior PI, Frizzo MN, Heck TG, Ludwig MS. Chronic heat treatment positively impacts metabolic profile of ovariectomized rats: association with heat shock response pathways. Cell Stress Chaperones 2020; 25:467-479. [PMID: 32215846 PMCID: PMC7192980 DOI: 10.1007/s12192-020-01087-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 02/28/2020] [Accepted: 03/05/2020] [Indexed: 01/11/2023] Open
Abstract
Low estrogen levels may predispose women to increased bodyweight and dyslipidemia. Previous studies from our laboratory suggest an involvement of depressed heat shock response (HSR) in this scenario because estrogen potently stimulates HSR. As heat treatment induces the expression of the anti-inflammatory heat shock proteins of the 70-kDa family (HSP70) and its accompanying HSR, we aimed to investigate whether chronic heat treatment promotes beneficial effects on biometric, lipid profile, oxidative stress, and HSR in ovariectomized rats. Wistar adult female rats (n = 32) were divided into four groups: control (C, n = 7), ovariectomized (OVX, n = 9), heat-treated (HT, n = 9), and heat-treated ovariectomized rats (OVX+HT, n = 7). HT and OVX+HT rats were anesthetized and submitted to heat treatment (once a week for 12 weeks) in a water bath (41 °C) to increase rats' rectal temperature up to 41 °C for 15 min, while C and OVX animals were submitted to a 36 °C water bath. HT attenuated the weight gain induced by OVX and increased HDL cholesterol and triglyceride serum levels. Also, OVX rats showed increased total cholesterol and LDL cholesterol levels that were not influenced by HT. Interestingly, it was found that an overall trend for HT to decrease tissue catalase and superoxide dismutase antioxidant activities was paralleled by a decrease in malondialdehyde levels (indicative of lower lipoperoxidation), especially in the skeletal muscle. Surprisingly, OVX was not able to depress intracellular HSP70 expression in the skeletal muscle, as expected, and this remained unchanged with HT. However, chronic HT did enhance intracellular HSP70 contents in white adipose tissue of OVX animals. As both glucose and insulin tolerance tests were not affected by OVX, which was not modified by HT, we suppose that estrogen absence alone is not sufficient to determine a state of insulin resistance associated with low intramuscular HSP70 content.
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Affiliation(s)
- Yana Picinin Sandri Lissarassa
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduation Program in Integral Attention to Health (PPGAIS), Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Carolain Felipin Vincensi
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduation Program in Integral Attention to Health (PPGAIS), Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Lílian Corrêa Costa-Beber
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduation Program in Integral Attention to Health (PPGAIS), Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Analú Bender Dos Santos
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduation Program in Integral Attention to Health (PPGAIS), Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Pauline Brendler Goettems-Fiorin
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Jaíne Borges Dos Santos
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduation Program in Integral Attention to Health (PPGAIS), Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Yohanna Hannnah Donato
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduation Program in Integral Attention to Health (PPGAIS), Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Guilherme Wildner
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Paulo Ivo Homem de Bittencourt Júnior
- Laboratory of Cellular Physiology, Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, ICBS, Porto Alegre, RS, Brazil
| | - Matias Nunes Frizzo
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduation Program in Integral Attention to Health (PPGAIS), Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Thiago Gomes Heck
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil.
- Postgraduation Program in Integral Attention to Health (PPGAIS), Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil.
| | - Mirna Stela Ludwig
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil.
- Postgraduation Program in Integral Attention to Health (PPGAIS), Regional University of Northwestern Rio Grande do Sul State (UNIJUI), Rua do Comércio, 3000, Bairro Universitário, Ijuí, RS, 98700-000, Brazil.
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Chudoba C, Wardelmann K, Kleinridders A. Molecular effects of dietary fatty acids on brain insulin action and mitochondrial function. Biol Chem 2019; 400:991-1003. [PMID: 30730834 DOI: 10.1515/hsz-2018-0477] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 01/28/2019] [Indexed: 01/17/2023]
Abstract
The prevalence of obesity and its co-morbidities such as insulin resistance and type 2 diabetes are tightly linked to increased ingestion of palatable fat enriched food. Thus, it seems intuitive that the brain senses elevated amounts of fatty acids (FAs) and affects adaptive metabolic response, which is connected to mitochondrial function and insulin signaling. This review will address the effect of dietary FAs on brain insulin and mitochondrial function with a special emphasis on the impact of different FAs on brain function and metabolism.
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Affiliation(s)
- Chantal Chudoba
- Central Regulation of Metabolism, German Institute of Human Nutrition (DIfE), Arthur-Scheunert-Allee 114-116, D-14558 Nuthetal, Germany.,German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, D-85764 Neuherberg, Germany
| | - Kristina Wardelmann
- Central Regulation of Metabolism, German Institute of Human Nutrition (DIfE), Arthur-Scheunert-Allee 114-116, D-14558 Nuthetal, Germany.,German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, D-85764 Neuherberg, Germany
| | - André Kleinridders
- Central Regulation of Metabolism, German Institute of Human Nutrition (DIfE), Arthur-Scheunert-Allee 114-116, D-14558 Nuthetal, Germany.,German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, D-85764 Neuherberg, Germany
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Goettems-Fiorin PB, Costa-Beber LC, Dos Santos JB, Friske PT, Sulzbacher LM, Frizzo MN, Ludwig MS, Rhoden CR, Heck TG. Ovariectomy predisposes female rats to fine particulate matter exposure's effects by altering metabolic, oxidative, pro-inflammatory, and heat-shock protein levels. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:20581-20594. [PMID: 31104233 DOI: 10.1007/s11356-019-05383-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 05/03/2019] [Indexed: 06/09/2023]
Abstract
The reduction of estrogen levels, as a result of menopause, is associated with the development of metabolic diseases caused by alterations in oxidative stress (OS), inflammatory biomarkers, and 70-kDa heat-shock protein (HSP70) expression. Additionally, exposure to fine particulate matter air pollution modifies liver OS levels and predisposes organisms to metabolic diseases, such as type 2 diabetes (T2DM). We investigated whether ovariectomy affects hepatic tissue and alters glucose metabolism in female rats exposed to particulate air pollution. First, 24 female Wistar rats received an intranasal instillation of saline or particles suspended in saline 5 times per week for 12 weeks. The animals then received either bilateral ovariectomy (OVX) or false surgery (sham) and continued to receive saline or particles for 12 additional weeks, comprising four groups: CTRL, Polluted, OVX, and Polluted+OVX. Ovariectomy increased body weight and adiposity and promoted edema in hepatic tissue, hypercholesterolemia, glucose intolerance, and a pro-inflammatory profile (reduced IL-10 levels and increased IL-6/IL-10 ratio levels), independent of particle exposure. The Polluted+OVX group showed an increase in neutrophils and neutrophil/lymphocyte ratios, decreased antioxidant defense (SOD activity), and increased liver iHSP70 levels. In conclusion, alterations in the reproductive system predispose female organisms to particulate matter air pollution effects by affecting metabolic, oxidative, pro-inflammatory, and heat-shock protein expression.
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Affiliation(s)
- Pauline Brendler Goettems-Fiorin
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUÍ), Rua do Comércio, 3000 - Bairro Universitário, Ijuí, RS, 98700-000, Brazil.
- Atmospheric Pollution Laboratory, Postgraduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, RS, Brazil.
| | - Lilian Corrêa Costa-Beber
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUÍ), Rua do Comércio, 3000 - Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduate Program in Integral Attention to Health (PPGAIS-UNIJUÍ/UNICRUZ), Ijuí, RS, Brazil
| | - Jaíne Borges Dos Santos
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUÍ), Rua do Comércio, 3000 - Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Paula Taís Friske
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUÍ), Rua do Comércio, 3000 - Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Lucas Machado Sulzbacher
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUÍ), Rua do Comércio, 3000 - Bairro Universitário, Ijuí, RS, 98700-000, Brazil
| | - Matias Nunes Frizzo
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUÍ), Rua do Comércio, 3000 - Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduate Program in Integral Attention to Health (PPGAIS-UNIJUÍ/UNICRUZ), Ijuí, RS, Brazil
| | - Mirna Stela Ludwig
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUÍ), Rua do Comércio, 3000 - Bairro Universitário, Ijuí, RS, 98700-000, Brazil
- Postgraduate Program in Integral Attention to Health (PPGAIS-UNIJUÍ/UNICRUZ), Ijuí, RS, Brazil
| | - Cláudia Ramos Rhoden
- Atmospheric Pollution Laboratory, Postgraduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, RS, Brazil
| | - Thiago Gomes Heck
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUÍ), Rua do Comércio, 3000 - Bairro Universitário, Ijuí, RS, 98700-000, Brazil.
- Postgraduate Program in Integral Attention to Health (PPGAIS-UNIJUÍ/UNICRUZ), Ijuí, RS, Brazil.
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Tao Y, Huang S, Yan J, Li W, Cai B. Integrated metallomic and metabolomic profiling of plasma and tissues provides deep insights into the protective effect of raw and salt-processed Achyranthes bidentata Blume extract in ovariectomia rats. JOURNAL OF ETHNOPHARMACOLOGY 2019; 234:85-95. [PMID: 30784959 DOI: 10.1016/j.jep.2019.01.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/27/2019] [Accepted: 01/27/2019] [Indexed: 06/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Achyranthes bidentata Blume (AB) is a well-known traditional Chinese medicine for treating osteoporosis and bone fracture. In the current, researches on pharmacological mechanism of AB mostly focused on molecular pathways, knowledge about its metabolic signatures is largely unclear. This study aims to develop an integrative metabolomics and metallomic approach for deciphering the biochemical basis of anti-osteoporosis effects of raw and salt-processed AB. METHOD Gas chromatography-mass spectrometry (GC-MS) and inductively coupled plasma mass spectrometry (ICP-MS) were combined for metabolomic and metallomic profiling of rats serum, liver and kidney derived from the sham group, model group, E2, raw and salt-processed AB treated groups. Meanwhile, micro-CT and biomechanical analysis were carried out to ensure the success of the osteoporosis model and to validate the anti-osteoporosis effect of raw and salt-processed AB. Partial least squares discriminant analysis (PLS-DA) was employed to screen potential biomarkers and the MetaboAnalyst and KEGG PATHWAY Database were used to investigate the metabolic pathway. RESULTS Raw and salt-processed AB protected the rats against osteoporosis, as evidenced by the restoration of the alkaline phosphatase activity, osteocalcin concentration, urine calcium/creatinine ratio and urine phosphorus/creatinine ratio. The combination of PCA and PLS-DA revealed deviations in ninety-four differential biomarkers between raw AB treated group and model group. The identified biomarkers were primarily engaged in the metabolic pathways including galactose metabolism, urea cycle, arginine and proline metabolism, alanine metabolism, lactose degradation, ammonia recycling and glycine and serine metabolism. The levels of these biomarkers showed significant alterations and a tendency to be restored to normal values in raw and salt-processed AB treated osteoporosis rats. Of note, the levels of trace elements, such as Zn, Se, Mn, Cu and Fe, were elevated after raw and salt-processed AB treatment. Finally, a correlation network diagram was constructed to show the biomarkers perturbed by raw and salt-processed AB. CONCLUSION Our findings indicate that raw and salt-processed AB has positive effects on osteoporosis rats. Meanwhile, metabolomic and metallomic method coupled with metabolites enrichment analysis and pattern recognition serves as a useful tool for revealing the action mechanism of traditional Chinese medicine.
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Affiliation(s)
- Yi Tao
- College of Pharmaceutical Science, Zhejiang University of Technology, Hangzhou 310032, China; Jiangsu Key Laboratory of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Surun Huang
- Jiangsu Key Laboratory of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Jizhong Yan
- College of Pharmaceutical Science, Zhejiang University of Technology, Hangzhou 310032, China.
| | - Weidong Li
- Jiangsu Key Laboratory of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Baochang Cai
- Jiangsu Key Laboratory of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing 210023, China.
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