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Pan P, Chen W, Wu X, Li C, Gao Y, Qin D. Active Targets and Potential Mechanisms of Erhuang Quzhi Formula in Treating NAFLD: Network Analysis and Experimental Assessment. Cell Biochem Biophys 2024:10.1007/s12013-024-01413-7. [PMID: 39120856 DOI: 10.1007/s12013-024-01413-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2024] [Indexed: 08/10/2024]
Abstract
The purpose of this research was to investigate the main active components, potential targets of action, and pharmacological mechanisms of Erhuang Quzhi Formula (EHQZF) against NAFLD using network pharmacology, molecular docking, and experimental validation. The main active chemical components of EHQZF and the potential targets for treating NAFLD were extracted and analyzed. The PPI network diagram of "Traditional Chinese Medicine-Active Ingredients-Core Targets" was constructed and the GO, KEGG, and molecular docking analysis were carried out. Identification of components in traditional Chinese medicine compounds was conducted by LC-MS. NAFLD models were established and relevant pathologic indicators and Western blot were analyzed in vivo and ex vivo. Totally 8 herbs attributed to the liver meridian and 20 corresponding targets of NAFLD were obtained from EHQZF. Flavonoids and phenolic acids as the main components of EHQZF treated NAFLD through the MAPK/AKT signaling pathway. Pathway enrichment analysis focused on the MAPK/AKT signaling pathway and apoptosis signaling pathway. Molecular docking showed that Quercetin and Luteolin had stable binding structures with AKT1, STAT3, and other targets. Experiments showed that EHQZF reduced lipid accumulation, regulated changes in adipose tissue, inhibited the MAPK/AKT signaling pathway and exert multiple components, several targets, and multiple pathway interactions to treat NAFLD.
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Affiliation(s)
- Peiyan Pan
- Key Laboratory of Xinjiang Phytomedicine Resource and Utilization, Ministry of Education, School of Pharmacy, Shihezi University, Shihezi, China
| | - Weijun Chen
- Xinjiang Second Medical College, Karamay, China
| | - Xi Wu
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Cong Li
- Key Laboratory of Xinjiang Phytomedicine Resource and Utilization, Ministry of Education, School of Pharmacy, Shihezi University, Shihezi, China
| | - Yuefeng Gao
- College of Applied Engineering, Henan University of Science and Technology, Sanmenxia, China
| | - Dongmei Qin
- Key Laboratory of Xinjiang Phytomedicine Resource and Utilization, Ministry of Education, School of Pharmacy, Shihezi University, Shihezi, China.
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Eslami Z, Aghili SS, Ghafi AG. Atorvastatin on Treatment of Nonalcoholic Fatty Liver Disease Patients. Chonnam Med J 2024; 60:13-20. [PMID: 38304133 PMCID: PMC10828082 DOI: 10.4068/cmj.2024.60.1.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 02/03/2024] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a condition in which excess fat builds up in the liver, often related to obesity and insulin resistance, which can lead to inflammation and scarring of the liver tissue. While efforts have been made to develop effective treatments for NAFLD, the need for pharmaceutical interventions remains unmet. Large clinical trials investigating the association between statin use and NAFLD are scarce, leading to contradictory results. Statins play a crucial role in cholesterol synthesis in the liver. Several studies have demonstrated that statins possess anti-inflammatory, anti-thrombotic, and anti-fibrotic properties. These properties make statins potentially useful in preventing the progression of NAFLD from simple steatosis to more severe forms like non-alcoholic steatohepatitis (NASH) and fibrosis. The results indicate that statin use is associated with a lower prevalence of NASH and fibrosis and may have a preventive effect on NAFLD.
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Affiliation(s)
- Zahra Eslami
- Department of Clinical Biochemistry, Hamadan University of Medical Science, Hamadan, Iran
| | | | - Amir Ghaleh Ghafi
- Department of Biology, Islamic Azad University Damghan Branch, Semnan, Iran
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Eslami Z, Moghanlou AE, Kandi YMP, Arabi MS, Norouzi A, Joshaghani H. Atorvastatin and Flaxseed Effects on Biochemical Indices and Hepatic Fat of NAFLD Model in Rats. Adv Biomed Res 2023; 12:98. [PMID: 37288026 PMCID: PMC10241636 DOI: 10.4103/abr.abr_21_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/22/2022] [Accepted: 04/24/2022] [Indexed: 06/09/2023] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is one of the most common forms of chronic liver disease that affects about 25% of the general population. No definitive treatment for NAFLD has been identified yet. The aim was to determine the effect of atorvastatin (ATO) and flaxseed on related indicators of NAFLD-induced fat/fructose-enriched diet (FFD). Materials and Methods Forty male Wistar rats were divided into five groups. NAFLD groups received FFD and carbon tetrachloride (CCl4) to induce NAFLD. After intervention with ATO (10 mg/kg/day) and/or flaxseed (7.5 g/kg/day), liver enzymes and lipid profiles in serum were determined at eight week of interventions. Results Triglycerides (TG) and cholesterol (CHO) in FFD + ATO, FFD + flaxseed, and FFD + ATO + flaxseed had a significant decrease and low-density lipoprotein (LDL) level and LDL/high-density lipoprotein (HDL) ratio showed a significant increase in the FFD + flaxseed compared to the FFD. The levels of aspartate transaminase (AST), alanine transaminase (ALT), and gamma-glutamyltransferase (GGT) were significantly reduced in the FFD + ATO, FFD + flaxseed, and the FFD + ATO + flaxseed. In addition, Alkaline phosphatase (ALP) levels were significantly different between normal and FFD. Fasting blood sugar (FBS) levels were significantly different in the FFD + flaxseed and the FFD + ATO + flaxseed compared to the FFD. Conclusion ATO therapy along with flaxseed controls NAFLD-related indices and FBS. Therefore, it can be stated with caution that ATO and flaxseed can be used to improve lipid profile and reduce the complications of NAFLD.
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Affiliation(s)
- Zahra Eslami
- Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Golestan Province, Iran
| | | | - Yahya M.N. P. Kandi
- Department of Exercise Physiology, Faculty of Physical Education, Islamic Azad University, Islamshahr Branch, Islamshahr, Iran
| | - Mehdi S. Arabi
- Medical Cellular and Molecular Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Alireza Norouzi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hamidreza Joshaghani
- Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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YiQi YangYin Decoction Attenuates Nonalcoholic Fatty Liver Disease in Type 2 Diabetes Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5511019. [PMID: 34621322 PMCID: PMC8492297 DOI: 10.1155/2021/5511019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/16/2021] [Accepted: 08/31/2021] [Indexed: 01/09/2023]
Abstract
Background YiQi YangYin Decoction (YQ) is a modern Chinese formula composed by the guidance of traditional Chinese medicine theory, which consists of nine traditional Chinese medicines and is applied to treat type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver in clinic in China for more than a decade. This study aims to evaluate the antidiabetes and lipid-lowering effect of YQ and explore the possible mechanisms of this action. Methods T2DM rat models were established and given YQ at three different doses for three weeks. Tissues, including pancreas islet and liver, and blood serum were collected. The levels of fasting blood glucose (FBG), fasting insulin (Fins), lipid index, such as total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), and hepatic function index such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) in serum were measured. Pancreas islet damage and liver damage were observed by hematoxylin and eosin staining. The glycogen content and lipid accumulation in liver were determined by periodic acid-Schiff (PAS) staining and Oil Red O staining. The expression levels of insulin receptor substrate 2 (IRS-2), phosphatidylinositol 3 kinase-associated p85alpha (PI3K p85α), AKT, and Glucose Transporter 2 (Glut4) in pancreas islet and AMP-activated protein kinase alpha (AMPKα), sterol regulatory element-binding protein 1c (SREBP1c), acetyl-CoA carboxylase (ACC1), and peroxisome proliferator-activated receptor-α (PPARα) in liver were determined by western blotting. The relative expressions of ACC1, fatty acid synthase (FAS), stearoyl-CoA desaturase 1 (SCD1), carnitine palmityl transferase-1 (CPT-1), and SREBP-1 mRNA were detected by qRT-PCR. Results After administering YiQi for three weeks, the levels of fast blood glucose, fasting insulin, TC, TG, LDL, ALT, AST, and ALP were significantly decreased, while HDL significantly increased compared with the model group. YQ could obviously attenuate pancreatic damage and improve islet α- and ß-cell survival compared with the model group. Furthermore, YQ could attenuate hepatic damage caused by lipid accumulation, decrease the content of lipid, and increase the hepatic glycogen content, compared with the model group. In addition, YQ remarkably elevated the proteins expression of p-PI3K, p-AKT, and GLUT4 in pancreas islet and elevated the proteins expression of p-PI3K, p-AKT, GLUT4, p-AMPK, SREBP1, and PPARα and inhibited the expression of p-ACC1 in liver. Besides, YQ reduced the relative expression of ACC1, FAS, SERBP-1c, and SCD mRNA along with the decreased production of CPT-1 mRNA. Conclusions YQ could attenuate type 2 diabetes mellitus by improving islet α- and ß-cells via IRS-2/AKT/GLUT4 pathway and nonalcoholic fatty liver by ameliorating lipid accumulation via AMPK/PPARα/SREBP1/ACC1 pathway.
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Dehnavi S, Kiani A, Sadeghi M, Biregani AF, Banach M, Atkin SL, Jamialahmadi T, Sahebkar A. Targeting AMPK by Statins: A Potential Therapeutic Approach. Drugs 2021; 81:923-933. [PMID: 33939118 PMCID: PMC8144155 DOI: 10.1007/s40265-021-01510-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 12/13/2022]
Abstract
Statins are a group of lipid-lowering drugs that inhibit cholesterol biosynthesis and have anti-inflammatory, anti-tumor, and immunomodulatory properties. Several lines of evidence indicate that statins regulate multiple proteins associated with the regulation of differing cellular pathways. The 5'-adenosine monophosphate-activated protein kinase (AMPK) pathway plays an important role in metabolism homeostasis with effects on cellular processes including apoptosis and the inflammatory responses through several pathways. Recently, it has been shown that statins can affect the AMPK pathway in differing physiological and pathological ways, resulting in anti-cancer, cardio-protective, neuro-protective, and anti-tubercular effects; additionally, they have therapeutic effects on non-alcoholic fatty liver disease and diabetes mellitus-associated complications. Statins activate AMPK as an energy sensor that inhibits cell proliferation and induces apoptosis in cancer cells, whilst exerting its cardio-protective effects through inhibition of inflammation and fibrosis, and promotion of angiogenesis. Furthermore, statin-associated AMPK activation leads to decreased lipid accumulation and decreased amyloid beta deposition in the liver and brain, respectively, and may have therapeutic effects on the liver and neurons. In this review, we summarize the results of studies of AMPK-associated therapeutic effects of statins in different pathological conditions.
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Affiliation(s)
- Sajad Dehnavi
- Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amirhossein Kiani
- Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahvash Sadeghi
- Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Farhadi Biregani
- Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | | | - Tannaz Jamialahmadi
- Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Razavi Khorasan Province, Daneshgah Street, 9177948564, Mashhad, Iran.
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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Hou X, Zhang C, Wang L, Wang K. Natural Piperine Improves Lipid Metabolic Profile of High-Fat Diet-Fed Mice by Upregulating SR-B1 and ABCG8 Transporters. JOURNAL OF NATURAL PRODUCTS 2021; 84:373-381. [PMID: 33492139 DOI: 10.1021/acs.jnatprod.0c01018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Natural piperine from black pepper is known to function as hypocholesterolemic agent, but how it lowers the blood cholesterol remains unclear. In this study, we found that intragastric administrations of piperine (25 mg/kg/day) for 8 weeks significantly reduced the plasma triglyceride (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) in high-fat diet (HFD)-fed mice. H&E staining indicated that piperine significantly decreased hepatic lipid accumulation compared with the control group. The Oil Red O staining further showed that piperine attenuated lipid deposition in liver HepG2 cells in a concentration-dependent manner. Mechanistically, piperine treatment caused a significant upregulation of hepatic scavenger receptor B1 (SR-B1) in the liver and transporter protein of ATP binding cassette SGM8 (ABCG8) in the small intestine. Taken together, our findings demonstrate the role of natural piperine in improving lipid metabolic profile that is involved in the reverse cholesterol transport (RCT)-mediated mechanism through upregulation of SR-B1 in the liver and ABCG8 in the small intestine.
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Affiliation(s)
- Xingming Hou
- Department of Pharmacology, Qingdao University School of Pharmacy, Qingdao 266071, China
| | - Congxiao Zhang
- Department of Pharmacology, Qingdao University School of Pharmacy, Qingdao 266071, China
| | - Limei Wang
- Department of Pharmacology, Qingdao University School of Pharmacy, Qingdao 266071, China
| | - KeWei Wang
- Department of Pharmacology, Qingdao University School of Pharmacy, Qingdao 266071, China
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Svop Jensen V, Fledelius C, Max Wulff E, Lykkesfeldt J, Hvid H. Temporal Development of Dyslipidemia and Nonalcoholic Fatty Liver Disease (NAFLD) in Syrian Hamsters Fed a High-Fat, High-Fructose, High-Cholesterol Diet. Nutrients 2021; 13:nu13020604. [PMID: 33673227 PMCID: PMC7917647 DOI: 10.3390/nu13020604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 02/06/2023] Open
Abstract
The use of translationally relevant animal models is essential, also within the field of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Compared to frequently used mouse and rat models, the hamster may provide a higher degree of physiological similarity to humans in terms of lipid profile and lipoprotein metabolism. However, the effects in hamsters after long-term exposure to a NASH diet are not known. Male Syrian hamsters were fed either a high-fat, high-fructose, high-cholesterol diet (NASH diet) or control diets for up to 12 months. Plasma parameters were assessed at two weeks, one, four, eight and 12 months and liver histopathology and biochemistry was characterized after four, eight and 12 months on the experimental diets. After two weeks, hamsters on NASH diet had developed marked dyslipidemia, which persisted for the remainder of the study. Hepatic steatosis was present in NASH-fed hamsters after four months, and hepatic stellate cell activation and fibrosis was observed within four to eight months, respectively, in agreement with progression towards NASH. In summary, we demonstrate that hamsters rapidly develop dyslipidemia when fed a high-fat, high-fructose, high-cholesterol diet. Moreover, within four to eight months, the NASH-diet induced hepatic changes with resemblance to human NAFLD.
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Affiliation(s)
- Victoria Svop Jensen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Ridebanevej 9, DK-1870 Frederiksberg, Denmark;
- Diabetes Pharmacology 1, Novo Nordisk A/S, Novo Nordisk Park 1, DK-2760 Måløv, Denmark;
- Correspondence:
| | - Christian Fledelius
- Diabetes Pharmacology 1, Novo Nordisk A/S, Novo Nordisk Park 1, DK-2760 Måløv, Denmark;
| | - Erik Max Wulff
- Gubra ApS, Hørsholm Kongevej 11B, DK-2970 Hørsholm, Denmark;
| | - Jens Lykkesfeldt
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Ridebanevej 9, DK-1870 Frederiksberg, Denmark;
| | - Henning Hvid
- Pathology & Imaging, Novo Nordisk A/S, Novo Nordisk Park 1, DK-2760 Måløv, Denmark;
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Bae-Gartz I, Kasper P, Großmann N, Breuer S, Janoschek R, Kretschmer T, Appel S, Schmitz L, Vohlen C, Quaas A, Schweiger MR, Grimm C, Fischer A, Ferrari N, Graf C, Frese CK, Lang S, Demir M, Schramm C, Fink G, Goeser T, Dötsch J, Hucklenbruch-Rother E. Maternal exercise conveys protection against NAFLD in the offspring via hepatic metabolic programming. Sci Rep 2020; 10:15424. [PMID: 32963289 PMCID: PMC7508970 DOI: 10.1038/s41598-020-72022-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 05/11/2020] [Indexed: 12/13/2022] Open
Abstract
Maternal exercise (ME) during pregnancy has been shown to improve metabolic health in offspring and confers protection against the development of non-alcoholic fatty liver disease (NAFLD). However, its underlying mechanism are still poorly understood, and it remains unclear whether protective effects on hepatic metabolism are already seen in the offspring early life. This study aimed at determining the effects of ME during pregnancy on offspring body composition and development of NAFLD while focusing on proteomic-based analysis of the hepatic energy metabolism during developmental organ programming in early life. Under an obesogenic high-fat diet (HFD), male offspring of exercised C57BL/6J-mouse dams were protected from body weight gain and NAFLD in adulthood (postnatal day (P) 112). This was associated with a significant activation of hepatic AMP-activated protein kinase (AMPK), peroxisome proliferator-activated receptor alpha (PPARα) and PPAR coactivator-1 alpha (PGC1α) signaling with reduced hepatic lipogenesis and increased hepatic β-oxidation at organ programming peak in early life (P21). Concomitant proteomic analysis revealed a characteristic hepatic expression pattern in offspring as a result of ME with the most prominent impact on Cholesterol 7 alpha-hydroxylase (CYP7A1). Thus, ME may offer protection against offspring HFD-induced NAFLD by shaping hepatic proteomics signature and metabolism in early life. The results highlight the potential of exercise during pregnancy for preventing the early origins of NAFLD.
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Affiliation(s)
- Inga Bae-Gartz
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch Str. 16, Building 44a, 50931, Cologne, Germany.
| | - Philipp Kasper
- Department of Gastroenterology and Hepatology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Nora Großmann
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch Str. 16, Building 44a, 50931, Cologne, Germany
| | - Saida Breuer
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch Str. 16, Building 44a, 50931, Cologne, Germany
| | - Ruth Janoschek
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch Str. 16, Building 44a, 50931, Cologne, Germany
| | - Tobias Kretschmer
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch Str. 16, Building 44a, 50931, Cologne, Germany
| | - Sarah Appel
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch Str. 16, Building 44a, 50931, Cologne, Germany
| | - Lisa Schmitz
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch Str. 16, Building 44a, 50931, Cologne, Germany
| | - Christina Vohlen
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch Str. 16, Building 44a, 50931, Cologne, Germany
| | - Alexander Quaas
- Department of Pathology, University Hospital of Cologne, Cologne, Germany
| | - Michal R Schweiger
- Translational Epigenetics and Tumor Genetic, University Hospital of Cologne, Cologne, Germany
| | - Christina Grimm
- Translational Epigenetics and Tumor Genetic, University Hospital of Cologne, Cologne, Germany
| | | | - Nina Ferrari
- Cologne Center for Prevention in Childhood and Youth / Heart Center Cologne, University Hospital of Cologne, Cologne, Germany.,Institute of Movement and Neuroscience, Department of Movement and Health Promotion, German Sport University, Cologne, Germany
| | - Christine Graf
- Institute of Movement and Neuroscience, Department of Movement and Health Promotion, German Sport University, Cologne, Germany
| | - Christian K Frese
- Proteomics Core Facility, CECAD Research Center, University Hospital of Cologne, Cologne, Germany.,Max-Planck-Unit for the Science of Pathogens, Charité University Medicine Berlin, Berlin, Germany
| | - Sonja Lang
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Münevver Demir
- Department of Hepatology and Gastroenterology, Charité Campus Mitte and Campus Virchow Clinic, Charité University Medicine Berlin, Berlin, Germany
| | - Christoph Schramm
- Department of Gastroenterology and Hepatology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Gregor Fink
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch Str. 16, Building 44a, 50931, Cologne, Germany
| | - Tobias Goeser
- Department of Gastroenterology and Hepatology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Jörg Dötsch
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch Str. 16, Building 44a, 50931, Cologne, Germany
| | - Eva Hucklenbruch-Rother
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch Str. 16, Building 44a, 50931, Cologne, Germany
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