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Liu T, Sun W, Guo S, Chen T, Zhu M, Yuan Z, Li B, Lu J, Shao Y, Qu Y, Sun Z, Feng C, Yang T. Research progress on pathogenesis of chronic fatigue syndrome and treatment of traditional Chinese and Western medicine. Auton Neurosci 2024; 255:103198. [PMID: 39047501 DOI: 10.1016/j.autneu.2024.103198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 06/11/2024] [Accepted: 06/30/2024] [Indexed: 07/27/2024]
Abstract
Chronic Fatigue Syndrome (CFS) is a complex and perplexing medical disorder primarily characterized by persistent and debilitating fatigue, often accompanied by a constellation of symptoms, including weakness, dyspnea, arthromyalgia, sore throat, and disrupted sleep patterns. CFS is defined by its persistent or recurrent manifestation for a minimum duration of six months, marked by an enduring and unrelenting fatigue that remains refractory to rest. In recent decades, this condition has garnered significant attention within the medical community. While the precise etiology of CFS remains elusive, it is postulated to be multifactorial. CFS is potentially associated with various contributory factors such as infections, chronic stress, genetic predisposition, immune dysregulation, and psychosocial influences. The pathophysiological underpinnings of CFS encompass viral infections, immune system dysregulation, neuroendocrine aberrations, heightened oxidative stress, and perturbations in gut microbiota. Presently, clinical management predominantly relies on pharmaceutical interventions or singular therapeutic modalities, offering alleviation of specific symptoms but exhibiting inherent limitations. Traditional Chinese Medicine (TCM) interventions have emerged as a promising paradigm, demonstrating notable efficacy through their multimodal, multi-target, multi-pathway approach, and holistic regulatory mechanisms. These interventions effectively address the lacunae in contemporary medical interventions. This comprehensive review synthesizes recent advancements in the understanding of the etiological factors, pathophysiological mechanisms, and interventional strategies for CFS, drawing from a corpus of domestic and international literature. Its aim is to furnish valuable insights for clinicians actively involved in diagnosing and treating CFS, as well as for pharmaceutical researchers delving into innovative drug development pathways. Moreover, it seeks to address the intricate challenges confronted by clinical practitioners in managing this incapacitating condition.
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Affiliation(s)
- Tingting Liu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Weibo Sun
- Harbin Medical University, Harbin, China
| | - Shuhao Guo
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Tao Chen
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Minghang Zhu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Zhiying Yuan
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Binbin Li
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jing Lu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yuying Shao
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yuanyuan Qu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Zhongren Sun
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Chuwen Feng
- Heilongjiang University of Chinese Medicine, Harbin, China; Rehabilitation Medicine Department, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China; Key Laboratory of Chinese Medicine Informotics in Heilongjiang Province, 24 Heping Road, Harbin, China
| | - Tiansong Yang
- Heilongjiang University of Chinese Medicine, Harbin, China; Rehabilitation Medicine Department, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China; Key Laboratory of Chinese Medicine Informotics in Heilongjiang Province, 24 Heping Road, Harbin, China.
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Li Z, Zheng Y, Liu K, Liang Y, Lu J, Li Q, Zhao B, Liu X, Li X. Lignans as multi-targeted natural products in neurodegenerative diseases and depression: Recent perspectives. Phytother Res 2023; 37:5599-5621. [PMID: 37669911 DOI: 10.1002/ptr.8003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/09/2023] [Accepted: 08/19/2023] [Indexed: 09/07/2023]
Abstract
As the global population ages, the treatment of neurodegenerative diseases is becoming more and more important. There is an urgent need to discover novel drugs that are effective in treating neurological diseases. In recent years, natural products and their biological activities have gained widespread attention. Lignans are a class of metabolites extensively present in Chinese herbal medicine and possess good pharmacological effects. Latest studies have demonstrated their neuroprotective pharmacological activity in preventing acute/chronic neurodegenerative diseases and depression. In this review, the pharmacological effects of these disorders, the pharmacokinetics, safety, and clinical trials of lignans were summarized according to the scientific literature. These results proved that lignans mainly exert antioxidant and anti-inflammatory activities. Anti-apoptosis, regulation of nervous system functions, and modulation of synaptic signals are also potential effects. Despite the substantial evidence of the neuroprotective potential of lignans, it is not sufficient to support their use in the clinical management. Our study suggests that lignans can be used as prospective agents for the treatment of neurodegenerative diseases and depression, with a view to informing their further development and utilization.
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Affiliation(s)
- Zhibei Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yu Zheng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Kai Liu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Youdan Liang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Lu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qiuxia Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Bolin Zhao
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xing Liu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaofang Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Mi X, Zhang Z, Cheng J, Xu Z, Zhu K, Ren Y. Cardioprotective effects of Schisantherin A against isoproterenol-induced acute myocardial infarction through amelioration of oxidative stress and inflammation via modulation of PI3K-AKT/Nrf2/ARE and TLR4/MAPK/NF-κB pathways in rats. BMC Complement Med Ther 2023; 23:277. [PMID: 37542250 PMCID: PMC10401759 DOI: 10.1186/s12906-023-04081-x] [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: 03/25/2023] [Accepted: 07/10/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND AND AIMS The scientific community is concerned about cardiovascular disease mortality and morbidity, especially myocardial infarction (MI). Schisantherin A (SCA), a dibenzocyclooctadiene lignan monomer found in S. chinensis fruits has cardiovascular advantages such as increasing NO production in isolated rat thoracic aorta and reducing heart damage caused by ischemia-reperfusion (I/R) through decreasing apoptosis. The present study was undertaken to explore the potential effects of SCA on ISO-induced myocardial infarction in rats. METHODS Rats were randomly allocated to four groups: control; ISO-treated, and two additional groups of ISO + SCA (5 or 10 mg/kg body weight). All SCA-treated groups were administered with SCA for 20 days and all ISO groups were challenged with ISO on days 19 and 20. RESULTS SCA significantly attenuated ISO-induced rise in heart/body weight ratio, myocardial infarct size, and cardiac functional biomarkers (CK-MB, cTnI and BNP). SCA pre- and co-treatment resulted in a significant reduction in oxidative stress (via MDA, NO and GSH and increased activities of SOD, CAT and GPx) and inflammation (via decreased levels of TNF-α, IL-6 and IL-1β) markers when compared to the same levels in cardiac tissue of ISO-treated rats. This study also showed that SCA protects ISO-induced oxidative stress and inflammation by activating the PI3K-AKT/Nrf2/ARE pathway and suppressing TLR4/MAPK/NF-κB pathways. Furthermore, SCA treatment protected histopathological alterations observed in only ISO-treated cardiac transverse sections of rats. CONCLUSION In conclusion, the findings of this study suggest that SCA protects against cardiac injury in the ISO-induced MI model of rats.
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Affiliation(s)
- Xiaolong Mi
- Department of Cardiovascular Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
- Department of Cardiovascular Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhijun Zhang
- Department of Cardiovascular Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
- Department of Cardiovascular Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Jinfang Cheng
- Department of Cardiovascular Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
- Department of Cardiovascular Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zheng Xu
- Department of Cardiovascular Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
- Department of Cardiovascular Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kaiyi Zhu
- Department of Cardiovascular Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
- Department of Cardiovascular Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yunxia Ren
- Department of Cardiovascular Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
- Department of Cardiovascular Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Jia M, Zhou L, Lou Y, Yang X, Zhao H, Ouyang X, Huang Y. An analysis of the nutritional effects of Schisandra chinensis components based on mass spectrometry technology. Front Nutr 2023; 10:1227027. [PMID: 37560060 PMCID: PMC10408133 DOI: 10.3389/fnut.2023.1227027] [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: 05/26/2023] [Accepted: 07/12/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE Schisandra chinensis (Turcz.) Baill. (S. chinensis) is a Traditional Chinese medicinal herb that can be used both for medicinal purposes and as a food ingredient due to its beneficial properties, and it is enriched with a wide of natural plant nutrients, including flavonoids, phenolic acids, anthocyanins, lignans, triterpenes, organic acids, and sugars. At present, there is lack of comprehensive study or systemic characterization of nutritional and active ingredients of S. chinensis using innovative mass spectrometry techniques. METHODS The comprehensive review was conducted by searching the PubMed databases for relevant literature of various mass spectrometry techniques employed in the analysis of nutritional components in S. chinensis, as well as their main nutritional effects. The literature search covered the past 5 years until March 15, 2023. RESULTS The potential nutritional effects of S. chinensis are discussed, including its ability to enhance immunity, function as an antioxidant, anti-allergen, antidepressant, and anti-anxiety agent, as well as its ability to act as a sedative-hypnotic and improve memory, cognitive function, and metabolic imbalances. Meanwhile, the use of advanced mass spectrometry detection technologies have the potential to enable the discovery of new nutritional components of S. chinensis, and to verify the effects of different extraction methods on these components. The contents of anthocyanins, lignans, organic acids, and polysaccharides, the main nutritional components in S. chinensis, are also closely associated to its quality. CONCLUSION This review will provide guidelines for an in-depth study on the nutritional value of S. chinensis and for the development of healthy food products with effective components.
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Affiliation(s)
- Mengzhen Jia
- Department of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Li Zhou
- School of Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Yuanyuan Lou
- Department of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Xiaoqing Yang
- Department of Pediatrics, The First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan, China
| | - Hangyu Zhao
- Department of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Xinshou Ouyang
- Department of Internal Medicine, Digestive Disease Section, Yale University, New Haven, CT, United States
| | - Yanjie Huang
- Department of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, Henan, China
- Department of Pediatrics, The First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan, China
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Zhou Y, Wu Q, Yu W, Ye F, Cao Y, Akan OD, Wu X, Xie T, Lu H, Cao F, Luo F, Lin Q. Gastrodin ameliorates exercise-induced fatigue via modulating Nrf2 pathway and inhibiting inflammation in mice. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2022.102262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Zhang Z, Gao B. Mechanism of Hyperbaric Oxygen Combined with Astaxanthin Mediating Keap1/Nrf2/HO-1 Pathway to Improve Exercise Fatigue in Mice. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:6444747. [PMID: 35875785 PMCID: PMC9300351 DOI: 10.1155/2022/6444747] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/25/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022]
Abstract
Objective This work aimed to explore the application and optimization of the electrophysiological monitoring system to real-time monitor the exercise-induced fatigue (EIF) animals and investigate the intervention mechanism of hyperbaric oxygen (HBO) combined with natural astaxanthin (NAX) on EIF. Methods First, a system was constructed for acquisition, processing, and feature extraction of electrocardiograph (ECG) signal and surface electromyography (EMG) signal for EIF monitoring. The mice were randomly divided into a control group (CG), EIF group (EG), HBO treatment (HBO) group, and HBO combined with NAX treatment (HBO + NAX) group. The effect of the constructed system on classification recognition of EIF was analyzed. The levels of serum antioxidative stress indicators of mice in each group were detected, including malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), glutathione (GSH), glutathione-peroxidation (GSH-Px), and total antioxidant capacity (T-AOC). In addition, the mRNA and protein levels of Keap1/Nrf2/HO-1 pathway related genes in liver tissue were detected. Results The results showed that the normalized least mean squares algorithm effectively removed the motion artifact interference of ECG signal and can clearly display the signal peak, and high-pass filtering and power frequency filtering effectively removed the motion and baseline drift interference of surface EMG signal. The recognition sensitivity, specificity, and accuracy of the EIF recognition model based on the long- and short-term memory network were 90.0%, 93.3%, and 92.5%, respectively. Compared with the CG, the characteristics of ECG signal and surface EMG signal of the mice in the EIF group changed greatly (P < 0.05); the serum MDA level was increased obviously; the CAT, SOD, GSH, GSH-Px, and T-AOC levels were observably reduced (P < 0.05); the expressions of Keap1 and HO-1 in the liver were reduced remarkably, while the expression of Nrf2 was increased notably (P < 0.05). Compared with the EIF group, the characteristics of ECG signal and surface EMG signal of the mice in the HBO and HBO + NAX groups were obviously improved (P < 0.05); the serum MDA level was significantly reduced; the CAT, SOD, GSH, GSH-Px, and T-AOC levels were greatly increased (P < 0.05); the expressions of Keap1 and HO-1 in the liver were greatly increased, while the expression of Nrf2 was decreased sharply (P < 0.05). Conclusion Therefore, the feature extraction and classification system of ECG signal combined with surface EMG signal could realize real-time monitoring of EIF status. HBO intervention could improve the body's ability to resist oxidative stress through the Keap1/Nrf2/HO-1 pathway and then improve the EIF state. In addition, the improvement effect of HBO + NAX was more obvious.
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Affiliation(s)
- Zheng Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Binghong Gao
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200030, China
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Osmakov DI, Kalinovskii AP, Belozerova OA, Andreev YA, Kozlov SA. Lignans as Pharmacological Agents in Disorders Related to Oxidative Stress and Inflammation: Chemical Synthesis Approaches and Biological Activities. Int J Mol Sci 2022; 23:ijms23116031. [PMID: 35682715 PMCID: PMC9181380 DOI: 10.3390/ijms23116031] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/17/2022] [Accepted: 05/24/2022] [Indexed: 02/06/2023] Open
Abstract
Plant lignans exhibit a wide range of biological activities, which makes them the research objects of potential use as therapeutic agents. They provide diverse naturally-occurring pharmacophores and are available for production by chemical synthesis. A large amount of accumulated data indicates that lignans of different structural groups are apt to demonstrate both anti-inflammatory and antioxidant effects, in many cases, simultaneously. In this review, we summarize the comprehensive knowledge about lignan use as a bioactive agent in disorders associated with oxidative stress and inflammation, pharmacological effects in vitro and in vivo, molecular mechanisms underlying these effects, and chemical synthesis approaches. This article provides an up-to-date overview of the current data in this area, available in PubMed, Scopus, and Web of Science databases, screened from 2000 to 2022.
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Affiliation(s)
- Dmitry I. Osmakov
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, ul. Miklukho-Maklaya 16/10, 117997 Moscow, Russia; (D.I.O.); (A.P.K.); (O.A.B.); (Y.A.A.)
- Institute of Molecular Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Aleksandr P. Kalinovskii
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, ul. Miklukho-Maklaya 16/10, 117997 Moscow, Russia; (D.I.O.); (A.P.K.); (O.A.B.); (Y.A.A.)
| | - Olga A. Belozerova
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, ul. Miklukho-Maklaya 16/10, 117997 Moscow, Russia; (D.I.O.); (A.P.K.); (O.A.B.); (Y.A.A.)
| | - Yaroslav A. Andreev
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, ul. Miklukho-Maklaya 16/10, 117997 Moscow, Russia; (D.I.O.); (A.P.K.); (O.A.B.); (Y.A.A.)
- Institute of Molecular Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Sergey A. Kozlov
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, ul. Miklukho-Maklaya 16/10, 117997 Moscow, Russia; (D.I.O.); (A.P.K.); (O.A.B.); (Y.A.A.)
- Correspondence:
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Yan K, Gao H, Liu X, Zhao Z, Gao B, Zhang L. Establishment and identification of an animal model of long-term exercise-induced fatigue. Front Endocrinol (Lausanne) 2022; 13:915937. [PMID: 36093084 PMCID: PMC9459130 DOI: 10.3389/fendo.2022.915937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/15/2022] [Indexed: 12/01/2022] Open
Abstract
In competitive sports, the training load is close to the human physiological limit, which will inevitably lead to exercise-induced fatigue. If fatigue cannot be recovered in time, it will eventually lead to excessive training and affect sport performance. Therefore, fatigue has become an important part of the physical function assessment for athletes. This paper will review animal models of long-term exercise-induced fatigue, modeling schemes of mice under treadmill and swimming training, phenotypes of long-term exercise-induced fatigue (e.g., nervous system damage, myocardial cell damage, bone mineral density changes, and skeletal muscle damage), and fatigue indicators. The relationship between physiological indicators and biomarkers and long-term exercise-induced fatigue is analyzed to promote exercise-induced fatigue monitoring. This paper attempts to provide a reference for the selection of animal models of long-term exercise-induced fatigue and provide a new theoretical basis for medical supervision and recovery of exercise-induced fatigue.
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Affiliation(s)
- Kai Yan
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Haoyang Gao
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xiaohua Liu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Zhonghan Zhao
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Bo Gao
- Institute of Orthopaedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- *Correspondence: Lingli Zhang, ; Bo Gao,
| | - Lingli Zhang
- College of Athletic Performance, Shanghai University of Sport, Shanghai, China
- *Correspondence: Lingli Zhang, ; Bo Gao,
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