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Li Y, Li Q, Niu H, Li H, Jiao L, Wu W. UHPLC-MS-Based Metabolomics Reveal the Potential Mechanism of Armillaria mellea Acid Polysaccharide in and Its Effects on Cyclophosphamide-Induced Immunosuppressed Mice. Molecules 2023; 28:7944. [PMID: 38138434 PMCID: PMC10745530 DOI: 10.3390/molecules28247944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023] Open
Abstract
Armillaria mellea (Vahl) P. Kumm is commonly used for food and pharmaceutical supplements due to its immune regulatory function, and polysaccharides are one of its main components. The aim of this research is to study the immunological activity of the purified acidic polysaccharide fraction, namely, AMPA, isolated from Armillaria mellea crude polysaccharide (AMP). In this study, a combination of the immune activity of mouse macrophages in vitro and serum metabonomics in vivo was used to comprehensively explore the cell viability and metabolic changes in immune-deficient mice in the AMPA intervention, with the aim of elucidating the potential mechanisms of AMPA in the treatment of immunodeficiency. The in vitro experiments revealed that, compared with LPS-induced RAW264.7, the AMPA treatment elevated the levels of the cellular immune factors IL-2, IL-6, IgM, IgA, TNF-α, and IFN-γ; promoted the expression of immune proteins; and activated the TLR4/MyD88/NF-κB signaling pathway to produce immunological responses. The protein expression was also demonstrated in the spleen of the cyclophosphamide immunosuppressive model in vivo. The UHPLC-MS-based metabolomic analysis revealed that AMPA significantly modulated six endogenous metabolites in mice, with the associated metabolic pathways of AMPA for treating immunodeficiency selected as potential therapeutic biomarkers. The results demonstrate that phosphorylated acetyl CoA, glycolysis, and the TCA cycle were mainly activated to enhance immune factor expression and provide immune protection to the body. These experimental results are important for the development and application of AMPA as a valuable health food or drug that enhances immunity.
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Affiliation(s)
| | | | | | | | | | - Wei Wu
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun 130117, China; (Y.L.); (Q.L.); (H.N.); (H.L.); (L.J.)
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2
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Liu Y, Tan D, Cui H, Wang J. Ganoderic acid C2 exerts the pharmacological effects against cyclophosphamide-induced immunosuppression: a study involving molecular docking and experimental validation. Sci Rep 2023; 13:17745. [PMID: 37853057 PMCID: PMC10584852 DOI: 10.1038/s41598-023-44394-y] [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: 05/25/2023] [Accepted: 10/07/2023] [Indexed: 10/20/2023] Open
Abstract
Triterpenoids, as the main active ingredient of Ganoderma lucidum fermented extract, exert multiple pharmacological activities, including immunomodulatory properties. Our study aimed to reveal the pharmacological effects and potential mechanisms of Ganoderic acid C2 (GAC) against cyclophosphamide (CY)-associated immunosuppression. Target genes were collected from several public databases, including the DisGeNET, Comparative Toxicogenomics Database, GeneCards, and PharmMapper. STRING database was used to construct the protein-protein interaction of network. Subsequently, molecular docking was carried out to visualize the protein-GAC interactions. Experimental validations, including ELISA and qRT-PCR were performed to confirm the pharmacological activities of GAC on CY-induced immunosuppression model. A total of 56 GAC-related targets were identified to be closely associated with CY-induced immunosuppression. Enrichment analyses results revealed that these targets were mainly involved in immune and inflammatory response-related pathways. STAT3 and TNF were identified as the core targets of GAC. Molecular docking indicated that GAC combined well with STAT3 and TNF protein. In addition, animal experiments indicated that GAC improved immunity as well as STAT3 and TNF genes expression in CY-induced immunosuppression, which further verified the prediction through bioinformatics analysis and molecular docking. We successfully revealed the potential therapeutics mechanisms underlying the effect of GAC against CY-induced immunosuppression based on the combination of bioinformatics analysis, molecular docking, and animal experiments. Our findings lay a theoretical foundation for the in-depth development and utilization of Ganoderma lucidum fermentation product in the future, and also provide theoretical guidance for the development of innovative drugs that assist in improving immunity.
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Affiliation(s)
- Yuchen Liu
- School of Life Science and Technology, Harbin Normal University (Songbei Campus), No. 1, Shida Road, Hulan District, Harbin, 150025, Heilongjiang Province, China
| | - Dongsheng Tan
- College of Life Science, Northeast Forestry University, Harbin, 150040, China
| | - Hong Cui
- School of Life Science and Technology, Harbin Normal University (Songbei Campus), No. 1, Shida Road, Hulan District, Harbin, 150025, Heilongjiang Province, China
| | - Jihua Wang
- School of Life Science and Technology, Harbin Normal University (Songbei Campus), No. 1, Shida Road, Hulan District, Harbin, 150025, Heilongjiang Province, China.
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Murphy EJ, Fehrenbach GW, Abidin IZ, Buckley C, Montgomery T, Pogue R, Murray P, Major I, Rezoagli E. Polysaccharides-Naturally Occurring Immune Modulators. Polymers (Basel) 2023; 15:polym15102373. [PMID: 37242947 DOI: 10.3390/polym15102373] [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: 03/04/2023] [Revised: 05/06/2023] [Accepted: 05/07/2023] [Indexed: 05/28/2023] Open
Abstract
The prevention of disease and infection requires immune systems that operate effectively. This is accomplished by the elimination of infections and abnormal cells. Immune or biological therapy treats disease by either stimulating or inhibiting the immune system, dependent upon the circumstances. In plants, animals, and microbes, polysaccharides are abundant biomacromolecules. Due to the intricacy of their structure, polysaccharides may interact with and impact the immune response; hence, they play a crucial role in the treatment of several human illnesses. There is an urgent need for the identification of natural biomolecules that may prevent infection and treat chronic disease. This article addresses some of the naturally occurring polysaccharides of known therapeutic potential that have already been identified. This article also discusses extraction methods and immunological modulatory capabilities.
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Affiliation(s)
- Emma J Murphy
- Shannon Applied Biotechnology Centre, Midwest Campus, Technological University of the Shannon, V94EC5T Limerick, Ireland
- LIFE-Health and Biosciences Research Institute, Midwest Campus, Technological University of the Shannon, V94EC5T Limerick, Ireland
- PRISM, Research Institute, Midlands Campus, Technological University of the Shannon, N37 HD68 Athlone, Ireland
| | - Gustavo Waltzer Fehrenbach
- PRISM, Research Institute, Midlands Campus, Technological University of the Shannon, N37 HD68 Athlone, Ireland
- Applied Polymer Technologies, Midlands Campus, Technological University of the Shannon, N37 HD68 Athlone, Ireland
| | - Ismin Zainol Abidin
- PRISM, Research Institute, Midlands Campus, Technological University of the Shannon, N37 HD68 Athlone, Ireland
- Applied Polymer Technologies, Midlands Campus, Technological University of the Shannon, N37 HD68 Athlone, Ireland
| | - Ciara Buckley
- PRISM, Research Institute, Midlands Campus, Technological University of the Shannon, N37 HD68 Athlone, Ireland
- Applied Polymer Technologies, Midlands Campus, Technological University of the Shannon, N37 HD68 Athlone, Ireland
| | - Therese Montgomery
- School of Science and Computing, Atlantic Technological University, H91 T8NW Galway, Ireland
| | - Robert Pogue
- Universidade Católica de Brasilia, QS 7 LOTE 1-Taguatinga, Brasília 71680-613, DF, Brazil
| | - Patrick Murray
- Shannon Applied Biotechnology Centre, Midwest Campus, Technological University of the Shannon, V94EC5T Limerick, Ireland
- LIFE-Health and Biosciences Research Institute, Midwest Campus, Technological University of the Shannon, V94EC5T Limerick, Ireland
| | - Ian Major
- PRISM, Research Institute, Midlands Campus, Technological University of the Shannon, N37 HD68 Athlone, Ireland
- Applied Polymer Technologies, Midlands Campus, Technological University of the Shannon, N37 HD68 Athlone, Ireland
| | - Emanuele Rezoagli
- Department of Emergency and Intensive Care, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
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Choudhury A, Sarma S, Sarkar S, Kumari M, Dey BK. Polysaccharides Obtained from Vegetables: an effective source of alternative excipient. J Pharmacopuncture 2022; 25:317-325. [PMID: 36628349 PMCID: PMC9806151 DOI: 10.3831/kpi.2022.25.4.317] [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: 04/19/2021] [Revised: 02/11/2022] [Accepted: 12/01/2022] [Indexed: 12/30/2022] Open
Abstract
Polymers are the major constructive material of pharmaceutical formulations that play a prime role in designing effective drug-delivery systems and releasing drugs at their sites of application. Polymers are composed of multiple repeating units of high molecular mass components with attendant properties. Most synthetic polymers are non-biocompatible, expensive, and extremely inclined to deliver adverse impacts. Meanwhile, edible polymers obtained from natural sources have gained remarkable recognition for their promising use in modern medicine. Moreover, polymers derived from natural sources are generally preferred due to certain of their unique features such as abundant availability, biocompatibility, nontoxicity, economical, safe, and effective functions that fit the purpose. Polysaccharides including starch, cellulose, hemicellulose, pectin, and mucilage are identified as a major class of naturally obtained molecules that have a substantial role as functional polymers. This review summarizes the potential role of polysaccharides derived from vegetable sources such as adhesives, anticaking agents, binders, disintegrants, emulsifiers, film-framing agents, and thickeners. This is simply an opportunity to abandon synthetic excipients that hurt our bodies and think back to nature from where we originate.
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Affiliation(s)
- Ananta Choudhury
- Faculty of Pharmaceutical Science, Assam Down Town University, Guwahati, Assam, India
| | - Satyabrat Sarma
- Faculty of Pharmaceutical Science, Assam Down Town University, Guwahati, Assam, India,Corresponding Author Satyabrat Sarma, Faculty of Pharmaceutical Science, Assam Down Town University, Panikhaiti, Gandhi Nagar, Guwahati, Assam 781026, India, Tel: +91-995-445-4025, E-mail:
| | - Snehashis Sarkar
- Faculty of Pharmaceutical Science, Assam Down Town University, Guwahati, Assam, India
| | - Madhusmita Kumari
- Faculty of Pharmaceutical Science, Assam Down Town University, Guwahati, Assam, India
| | - Biplab Kumar Dey
- Faculty of Pharmaceutical Science, Assam Down Town University, Guwahati, Assam, India
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Carbonised Human Hair Incorporated in Agar/KGM Bioscaffold for Tissue Engineering Application: Fabrication and Characterisation. Polymers (Basel) 2022; 14:polym14245489. [PMID: 36559856 PMCID: PMC9785055 DOI: 10.3390/polym14245489] [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: 11/13/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 12/16/2022] Open
Abstract
Carbon derived from biomass waste usage is rising in various fields of application due to its availability, cost-effectiveness, and sustainability, but it remains limited in tissue engineering applications. Carbon derived from human hair waste was selected to fabricate a carbon-based bioscaffold (CHAK) due to its ease of collection and inexpensive synthesis procedure. The CHAK was fabricated via gelation, rapid freezing, and ethanol immersion and characterised based on their morphology, porosity, Fourier transforms infrared (FTIR), tensile strength, swelling ability, degradability, electrical conductivity, and biocompatibility using Wharton’s jelly-derived mesenchymal stem cells (WJMSCs). The addition of carbon reduced the porosity of the bioscaffold. Via FTIR analysis, the combination of carbon, agar, and KGM was compatible. Among the CHAK, the 3HC bioscaffold displayed the highest tensile strength (62.35 ± 29.12 kPa). The CHAK also showed excellent swelling and water uptake capability. All bioscaffolds demonstrated a slow degradability rate (<50%) after 28 days of incubation, while the electrical conductivity analysis showed that the 3AHC bioscaffold had the highest conductivity compared to other CHAK bioscaffolds. Our findings also showed that the CHAK bioscaffolds were biocompatible with WJMSCs. These findings showed that the CHAK bioscaffolds have potential as bioscaffolds for tissue engineering applications.
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Ding J, Du H, Tan H, Li J, Wang L, Li L, Zhang Y, Liu Y. Optimization of protein removal process of Lonicera japonica polysaccharide and its immunomodulatory mechanism in cyclophosphamide-induced mice by metabolomics and network pharmacology. Food Sci Nutr 2022; 11:364-378. [PMID: 36655085 PMCID: PMC9834838 DOI: 10.1002/fsn3.3067] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 08/30/2022] [Accepted: 09/02/2022] [Indexed: 01/21/2023] Open
Abstract
In this study, TCA-n-butanol was chosen as the best deproteinization method for Lonicera japonica polysaccharide (LJP) by comparing the polysaccharide retention rate and the protein clearance rate of five different methods. The response surface methodology (RSM) based on the Box-Behnken design (BBD) was used to optimize the deproteinization conditions as follows: TCA: n-butanol = 1: 5.1, polysaccharide solution: (TCA-n-butanol) = 1: 2.8, and shook for 33 min. LJP could promote the thymus and spleen indexes of cyclophosphamide (CTX)-induced immune-deficient mice. Besides, the contents of cytokine interleukin-2 (IL-2) and hemolysin in mice serum were augmented after treatment with LJP. Based on serum metabolomics analysis, a total of 14 metabolites (VIP >1.0, FC >2 or FC <0.5, and p value < .05) were selected as the potential biological biomarkers related to the LJP for treating CTX-induced mice. After the pathway enrichment analysis, these metabolites were mainly involved in the relevant pathways of arginine biosynthesis, Citrate cycle, and other metabolic pathways. Network pharmacology further showed that there were 57 key targeting proteins in the intersection of the potential biological biomarkers and immunodeficiency-related targeting proteins according to protein-protein interactions analysis (PPI). The biological function analysis indicated that the potential biological processes were mainly associated with tricarboxylic acid (TCA) cycle, phospholipid metabolic process, metabolic process, and so on. In conclusion, serum metabolomics combined with network pharmacology could be helpful to clarify the immunomodulatory mechanism of LJP and provide a literature basis for further clinical research on the therapeutic mechanism of LJP.
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Affiliation(s)
- Jie Ding
- School of Pharmaceutical SciencesShandong University of Traditional Chinese MedicineJinanChina
| | - Haitao Du
- School of Pharmaceutical SciencesShandong University of Traditional Chinese MedicineJinanChina
| | - Haining Tan
- Shandong Key Laboratory of Carbohydrate Chemistry and Glycobiology, National Glycoengineering Research CenterShandong UniversityQingdaoChina
| | - Jing Li
- School of Pharmaceutical SciencesShandong University of Traditional Chinese MedicineJinanChina
| | - Lingna Wang
- School of Pharmaceutical SciencesShandong University of Traditional Chinese MedicineJinanChina
| | - Li Li
- Sishui Siheyuan Culture and Tourism Development Company, LtdShandongChina
| | - Yongqing Zhang
- School of Pharmaceutical SciencesShandong University of Traditional Chinese MedicineJinanChina
| | - Yuhong Liu
- School of Pharmaceutical SciencesShandong University of Traditional Chinese MedicineJinanChina
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Kan Y, Liu Y, Huang Y, Zhao L, Jiang C, Zhu Y, Pang Z, Hu J, Pang W, Lin W. The regulatory effects of
Pseudostellaria heterophylla
polysaccharide on immune function and gut flora in immunosuppressed mice. Food Sci Nutr 2022; 10:3828-3841. [DOI: 10.1002/fsn3.2979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 05/31/2022] [Accepted: 06/17/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yongjun Kan
- Fujian Agriculture and Forestry University Fuzhou China
- Fujian Academy of Chinese Medical Sciences Fuzhou China
| | - Yingying Liu
- The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine Fuzhou China
| | - Yating Huang
- Fujian University of Traditional Chinese Medicine Fuzhou China
| | - Li Zhao
- Fujian Academy of Chinese Medical Sciences Fuzhou China
| | - Chang Jiang
- Fujian Academy of Chinese Medical Sciences Fuzhou China
| | - Yanjin Zhu
- Fujian University of Traditional Chinese Medicine Fuzhou China
| | - Ziqin Pang
- Fujian Agriculture and Forestry University Fuzhou China
| | - Juan Hu
- Fujian Academy of Chinese Medical Sciences Fuzhou China
- The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine Fuzhou China
- Fujian University of Traditional Chinese Medicine Fuzhou China
| | - Wensheng Pang
- The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine Fuzhou China
- Fujian University of Traditional Chinese Medicine Fuzhou China
| | - Wenxiong Lin
- Fujian Agriculture and Forestry University Fuzhou China
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8
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Qu D, Hu H, Lian S, Sun W, Si H. The Protective Effects of Three Polysaccharides From Abrus cantoniensis Against Cyclophosphamide-Induced Immunosuppression and Oxidative Damage. Front Vet Sci 2022; 9:870042. [PMID: 35585861 PMCID: PMC9108546 DOI: 10.3389/fvets.2022.870042] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022] Open
Abstract
This study was designed to systematically elucidate the immunomodulatory and antioxidant effects of three polysaccharide fractions (ACP60, ACP80, and ACPt2) from Abrus cantoniensis on cyclophosphamide (CTX)-induced immunosuppressive mice. The experimental mice were divided into 12 groups, then modeled and administrated with different doses of three polysaccharides (50, 150, 300 mg/kg/day) by gavage. The results showed that ACP could markedly recover the CTX-induced decline in immune organ and hemocytes indexes and promote proliferation of splenocytes, earlap swelling rate, secretion of cytokines (TNF-α, IFN-γ, IL-1β, IL-6), and immunoglobulin (Ig-M and Ig-G). Additionally, ACP improved the enzymatic activities of T-SOD and GSH-PX greatly, while the level of MDA was significantly decreased in the liver. In particular, ACPt2 had higher immunomodulatory and antioxidant activities than ACP60 and ACP80. Based on the present findings, ACP could be utilized as an efficacious candidate for immunomodulators and antioxidants, which provide a new application prospect in the food and pharmaceutical industries.
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Affiliation(s)
- Dongshuai Qu
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Hongjie Hu
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Shuaitao Lian
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Wenjing Sun
- Guangxi Key Laboratory of Agricultural Resources Chemistry and Biotechnology, College of Biology & Pharmacy, Yulin Normal University, Yulin, China
- Wenjing Sun
| | - Hongbin Si
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
- *Correspondence: Hongbin Si
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Liu Z, Zhang J, Zhao Q, Wen A, Li L, Zhang Y. The regulating effect of Tibet Opuntia ficus-indica (Linn.) Mill. polysaccharides on the intestinal flora of cyclophosphamide-induced immunocompromised mice. Int J Biol Macromol 2022; 207:570-579. [PMID: 35292280 DOI: 10.1016/j.ijbiomac.2022.03.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/23/2022] [Accepted: 03/07/2022] [Indexed: 12/18/2022]
Abstract
The stem of Opuntia species, a traditional medicinal plant, is widely used as food and functional raw material because of its rich polysaccharide content. There have been many studies on the immune function of polysaccharides from Opuntia stem, but only few have examined this function with respect to intestinal microbes. In this study, the effects of different concentrations of Opuntia stem polysaccharides on the immunity and intestinal microflora of cyclophosphamide (CTX)-induced immunocompromised mice were explored. The results showed that Tibet Opuntia ficus-indica (Linn.) Mill. polysaccharides (ODPs) could effectively increase the white blood cells (WBC) count index of mice and improve their thymus and spleen indices, while effectively promoting the secretion of IL-4, IL-1β, TNF-α and IFN-γ, with these effects being dependent on the concentration of crude polysaccharides. The intake of ODPs significantly regulated the relative abundance of Lactobacillus, Bacteroides and Akkermansia, and the new dominant intestinal bacterial species were Deferribacteres, Actinomycetes, Firmicutes, Tenericutes, Actinomycetes and Pasteurella. In addition, the ODPs could effectively enhance the metabolic level of lysine synthesis and decomposition, regulate the gene expression level after immune disorders, and enhance the overall health of the immunodeficient mice.
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Affiliation(s)
- Zhendong Liu
- Food Science College, Tibet Agriculture & Animal Husbandry University, Nyingchi 860000, China; The Provincial and Ministerial Co-founded Collaborative Innovation Center for R & D in Tibet Characteristic Agricultural and Animal Husbandry Resources, Nyingchi 860000, China
| | - Jinchao Zhang
- Food Science College, Tibet Agriculture & Animal Husbandry University, Nyingchi 860000, China; The Provincial and Ministerial Co-founded Collaborative Innovation Center for R & D in Tibet Characteristic Agricultural and Animal Husbandry Resources, Nyingchi 860000, China
| | - Qian Zhao
- Food Science College, Tibet Agriculture & Animal Husbandry University, Nyingchi 860000, China
| | - Aomei Wen
- Food Science College, Tibet Agriculture & Animal Husbandry University, Nyingchi 860000, China
| | - Liang Li
- Food Science College, Tibet Agriculture & Animal Husbandry University, Nyingchi 860000, China.
| | - Yu Zhang
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China.
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LUO W, Liu F, QI X, DONG G. Research progress of konjac dietary fibre in the prevention and treatment of diabetes. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.23322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Wanyu LUO
- Shandong Traditional Chinese Medicine University, China; Qingdao Chengyang District Yuhe Tang Chinese Medicine clinic, China
| | - Fanghua Liu
- Qingdao Chengyang District Yuhe Tang Chinese Medicine clinic, China
| | - Xin QI
- Guang’anmen Hospital of China Academy of Chinese Medical Sciences, China
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