Co-interventions with Clostridium butyricum and soluble dietary fiber targeting the gut microbiota improve MAFLD via the Acly/Nrf2/NF-κB signaling pathway

Effects of Dietary Modification Based on Complementary and Alternative Iranian Medicine in Patients with Secondary-Progressive Multiple Sclerosis: A Randomized Controlled Clinical Trial

Objectives: To evaluate the efficacy of dietary modifications based on complementary and alternative Iranian medicine (CAIM) in patients with secondary-progressive multiple sclerosis (SPMS). Design: In this randomized controlled trial, 70 SPMS patients were randomized to receive either a moderate-nature diet based on Persian medicine (as intervention) or usual diet plus health-related diet recommendations (as control) for 2 months. Serum high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), Expanded Disability Status Scale (EDSS), Modified Fatigue Impact Scale (MFIS), State-Trait Anxiety Inventory (STAI), Global Pain Scale (GPS), Gastrointestinal Symptom Rating Scale (GSRS), anthropometric measurements, and quality of life (QOL) were assessed at baseline and end of trial. Analysis of covariance was performed, and the results were adjusted for potential confounders using SPSS v.14. Results: All participants completed the study for 2 months. There were significant improvements across the mean changes of hs-CRP (-0.1 ± 0.2 mg/L for intervention vs. -0.01 ± 0.13 mg/L for control; padjusted = 0.012), MFIS (-11.0 ± 11.8 vs. -0.7 ± 9.9; padjusted <0.001), GSRS (-19.9 ± 16.3 to 1.2 ± 17.5; padjusted <0.001), GPS (padjusted = 0.032), and QOL (padjusted <0.05). No significant difference was observed across the ESR, EDSS, STAI, and anthropometric measurements. Conclusion: Dietary modifications based on CAIM may improve inflammation and clinical manifestations in SPMS patients. Nonetheless, further trials are required to confirm these findings. Clinical Trial Registration: IRCT20181113041641N2.

Molecular mechanisms of metabolic disease-associated hepatic inflammation in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis

Non-alcoholic fatty liver disease (NAFLD) is the leading chronic liver disease worldwide, with a progressive form of non-alcoholic steatohepatitis (NASH). It may progress to advanced liver diseases, including liver fibrosis, cirrhosis, and hepatocellular carcinoma. NAFLD/NASH is a comorbidity of many metabolic disorders such as obesity, insulin resistance, type 2 diabetes, cardiovascular disease, and chronic kidney disease. These metabolic diseases are often accompanied by systemic or extrahepatic inflammation, which plays an important role in the pathogenesis and treatment of NAFLD or NASH. Metabolites, such as short-chain fatty acids, impact the function, inflammation, and death of hepatocytes, the primary parenchymal cells in the liver tissue. Cholangiocytes, the epithelial cells that line the bile ducts, can differentiate into proliferative hepatocytes in chronic liver injury. In addition, hepatic non-parenchymal cells, including liver sinusoidal endothelial cells, hepatic stellate cells, and innate and adaptive immune cells, are involved in liver inflammation. Proteins such as fibroblast growth factors, acetyl-coenzyme A carboxylases, and nuclear factor erythroid 2-related factor 2 are involved in liver metabolism and inflammation, which are potential targets for NASH treatment. This review focuses on the effects of metabolic disease-induced extrahepatic inflammation, liver inflammation, and the cellular and molecular mechanisms of liver metabolism on the development and progression of NAFLD and NASH, as well as the associated treatments.

Inverse relationship between dietary fiber intake and environmental exposure to acrylamide

Dietary fiber intake was thought to decrease some environmental pollutant exposure by increasing gastrointestinal excretion. While diet is considered the major source of exposure to acrylamide (AA), the impact of dietary fiber intake on acrylamide (AA) exposure is still unknown. We analyzed the associations between dietary fiber intake and AA hemoglobin biomarkers [hemoglobin adducts of acrylamide (HbAA) and glycinamide (HbGA), and sum of HbAA and HbGA (HbAA + HbGA)] among 3448 US adults who participated in the National Health and Nutrition Examination Survey (NHANES) 2013-2016. Multivariable linear regression and cubic spline models were conducted to estimate the associations between dietary fiber intake and AA hemoglobin biomarkers. Dietary fiber intake had a strong inverse and J-shaped association with AA hemoglobin biomarkers. In the fully adjusted linear regression model, compared with participants in the lowest dietary fiber quantile, the adjusted percent change with 95% confidence intervals (CIs) in HbAA for the highest dietary fiber quantile was - 19.7% (- 26.7%, - 13.1%); for HbGA, it was - 12.2% (- 18.9%, - 4.9%), and for HbAA + HbGA, it was - 17.3% (- 23.7%, - 10.4%). Associations between higher dietary fiber intake and lower levels of environmental exposure to acrylamide hemoglobin biomarkers suggest the need to increase dietary fiber intake.

Decoding the role of immune T cells: A new territory for improvement of metabolic-associated fatty liver disease

Metabolic-associated fatty liver disease (MAFLD) is a new emerging concept and is associated with metabolic dysfunction, generally replacing the name of nonalcoholic fatty liver disease (NAFLD) due to heterogeneous liver condition and inaccuracies in definition. The prevalence of MAFLD is rising by year due to dietary changes, metabolic disorders, and no approved therapy, affecting a quarter of the global population and representing a major economic problem that burdens healthcare systems. Currently, in addition to the common causative factors like insulin resistance, oxidative stress, and lipotoxicity, the role of immune cells, especially T cells, played in MAFLD is increasingly being emphasized by global scholars. Based on the diverse classification and pathophysiological effects of immune T cells, we comprehensively analyzed their bidirectional regulatory effects on the hepatic inflammatory microenvironment and MAFLD progression. This interaction between MAFLD and T cells was also associated with hepatic-intestinal immune crosstalk and gut microbiota homeostasis. Moreover, we pointed out several T-cell-based therapeutic approaches including but not limited to adoptive transfer of T cells, fecal microbiota transplantation, and drug therapy, especially for natural products and Chinese herbal prescriptions. Overall, this study contributes to a better understanding of the important role of T cells played in MAFLD progression and corresponding therapeutic options and provides a potential reference for further drug development.

Perillartine protects against metabolic associated fatty liver in high-fat diet-induced obese mice

Metabolic associated fatty liver disease is the main cause of chronic liver disease in the world, but there is still no effective treatment. In the search for drugs to treat liver steatosis, we screened 303 natural products using HepG2 cells and discovered that perillartine derived from Perilla frutescens (L.) improved fat deposition as well as glucose homeostasis in hepatocytes. In vitro, perillartine reduced the expression of genes involved in lipid synthesis, lipid transport, and gluconeogenesis in hepatocytes, increased the number of mitochondria, and upregulated the phosphorylation of Akt. In vivo, perillartine reduced body weight gain and the fat rate, improved glucose metabolism and energy balance, and altered the gut microbial composition in mice given a high-fat diet. In addition, RORγ was identified as a possible target of perillartine through pharmacophore screening. Functional studies revealed that the overexpression of RORγ blocked the effects of perillartine, suggesting that it reduced lipid accumulation and regulated glucose metabolism by inhibiting the transcriptional activity of RORγ. Our results provide new information on a natural product inhibitor for RORγ and reveal that perillartine is a new candidate for the treatment of obesity and metabolic associated fatty liver disease.

Crosstalk between liver macrophages and gut microbiota: An important component of inflammation-associated liver diseases

Hepatic macrophages have been recognized as primary sensors and responders in liver inflammation. By processing host or exogenous biochemical signals, including microbial components and metabolites, through the gut-liver axis, hepatic macrophages can both trigger or regulate inflammatory responses. Crosstalk between hepatic macrophages and gut microbiota is an important component of liver inflammation and related liver diseases, such as acute liver injury (ALI), alcoholic liver disease (ALD), and nonalcoholic fatty liver disease (NAFLD). This review summarizes recent advances in knowledge related to the crosstalk between hepatic macrophages and gut microbiota, including the therapeutic potential of targeting hepatic macrophages as a component of gut microecology in inflammation-associated liver diseases.