Ferroptosis: Mechanisms and role in diabetes mellitus and its complications

Design, synthesis and biological evaluation of triazolothiadiazole derivatives as FSP1 inhibitors for sensitizing cancer cells to ferroptosis

Ferroptosis suppressor protein 1 (FSP1) is a recently identified ferroptosis suppressor that functions independently of the glutathione peroxidase reductase 4 (GPX4)-mediated pathway. Mechanistically, FSP1 mitigates ferroptosis by catalyzing the reduction of ubiquinone to ubiquinol and vitamin K (VK) to hydroquinone, thereby reducing lethal lipid peroxidation through the neutralization of free radicals. In this study, we designed and synthesized 32 compounds to systematically explore their structure-activity relationship (SAR) with the aim of identifying potent and novel FSP1 inhibitors. Among these, compound 39, a triazolothiadiazole derivative, exhibited the most significant inhibitory activity against FSP1, with an IC50 value of 35 nM. In vitro cellular assays demonstrated that compound 39 markedly enhanced RSL3-induced lipid peroxide (LPO) accumulation and sensitized cancer cells from diverse tissue origins to RSL3-induced ferroptosis. Furthermore, by exploiting the FSP1-mediated reduction of VK, compound 39 effectively augmented ferroptosis in HT1080 cells pretreated with RSL3 and VK through its potent inhibition of FSP1 activity. To the best of our knowledge, this study represents the first pharmacochemical investigation dedicated to the systematic design and synthesis of FSP1 inhibitors. Collectively, our findings underscore the profound impact of compound 39 on tumor ferroptosis, providing a promising foundation for the development of FSP1 inhibitors as potential therapeutic agents in cancer treatment.

Ferroptosis: A novel therapeutic target for diabetic cardiomyopathy

Ferroptosis is a new type of programmed cell death caused by the accumulation of iron-dependent lipid peroxides, and it plays a role in the occurrence and progression of diverse diseases. Diabetic cardiomyopathy (DCM), a serious cardiovascular complication in patients with diabetes, eventually progresses to refractory heart failure (HF), which increases the risk of hospitalization for HF and cardiovascular death in patients with diabetes. Despite glycemic control, effective strategies to prevent DCM onset are currently lacking. Accumulating evidence suggests that ferroptosis is involved in oxidative stress, inflammation, and abnormal autophagy in diabetic myocardium, which plays an important role in myocardial apoptosis, hypertrophy, and cardiac fibrosis. The inhibition of ferroptosis can relieve DCM. Presently, ferroptosis inhibitors have been broadly suggested for the treatment of iron overload-related cardiomyopathy. This article reviewed relevant studies to offer a new therapeutic target for DCM.

Family history of diabetes mellitus and risk of colorectal cancer: A nationwide cohort study

AIMS

Studies have shown the association between personal history of diabetes mellitus (DM type 1/2) and risk of colorectal cancer (CRC). This study aims to find the association between the family history of diabetes and CRC risk.

METHODS

This large nationwide cohort study leveraged data from several Swedish nationwide registers (follow-up: 1964-2018) to compare the risk using standardized incidence ratio (SIR).

RESULTS

11,784,567 individuals (668,348 with DM) were included and followed for up to 54 years (median = 28 years). Those with a personal history of DM had a 1.4-fold increased risk of CRC compared to those without DM (95 % CI: 1.39-1.45). However, the addition of a family history of DM in 1 FDR or ≥ 2 FDRs did not significantly alter the increased risk of early-onset or late-onset CRC.

CONCLUSION

Leveraging one of the world's largest family-disease datasets, our cohort study confirmed that personal history of diabetes is associated with an increased risk of colorectal cancer, but we did not find an association between a family history of diabetes and risk of colorectal cancer.

Plantamajoside: A potentially novel botanical agent for diabetes mellitus management

Diabetes mellitus (DM) and its associated complications are metabolic disorders characterized by hyperglycemia, leading to high morbidity and reduced quality of life worldwide. This global healthcare problem imposes substantial personal and social burdens that warrant comprehensive and in-depth investigation. Plantamajoside (PMS), a naturally bioactive ingredient derived from the traditional Chinese medicinal herb Plantaginis Herba, exhibits a range of pharmacological properties, including anti-inflammatory, antioxidative, and antitumor effects, and has been traditionally utilized in clinical applications such as removing phlegm and clearing heat. However, the potential biological impact of PMS on DM remains largely unexplored. Recent research by Wang et al reported the therapeutic potential of PMS in type 2 DM (T2DM) and elucidated the underlying molecular mechanisms. Specifically, PMS mitigates endoplasmic reticulum stress and apoptosis of pancreatic β-cells by upregulating DnaJ heat shock protein family (Hsp40) member C1, thereby alleviating pancreatic β-cell damage and ameliorating T2DM progression. Given the novel and protective effect of PMS on pancreatic β-cells, this natural ingredient emerges as an innovative and promising therapeutic strategy for improving DM outcomes. PMS has been shown to modulate key signaling pathways involved in multiple types of regulated cell death (RCD), such as apoptosis and autophagy. Various forms of RCD, including apoptosis, ferroptosis, pyroptosis, autophagy, and PANoptosis, contribute to the pathogenesis of DM and its associated complications. There is significant potential for PMS to exert protective effects on β-cells against these forms of RCD and to provide a multitarget approach to DM therapy. Therefore, further exploration into whether PMS shields pancreatic β-cells from these types of RCD, coupled with elucidating the underlying molecular mechanisms, will facilitate the development of more effective therapeutic strategies for DM. Additionally, further investigation on PMS in conjunction with other therapeutic approaches is warranted to enhance therapeutic efficacy for DM.

Systemic immune indicators for predicting renal damage in newly diagnosed type 1 diabetic children

BACKGROUND

Early kidney damage is a significant complication in children with newly diagnosed type 1 diabetes mellitus (T1DM). Systemic inflammation plays a key role in the development of diabetic nephropathy. Several inflammatory markers, including the systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), have been proposed as potential indicators of diabetic complications.

AIM

To investigate the association between SII, NLR, PLR, and early kidney damage in newly diagnosed T1DM children without pre-existing albuminuria, assessing their utility as predictive biomarkers.

METHODS

A longitudinal cohort study was conducted on 102 children aged 3-18 years with newly diagnosed T1DM [baseline urinary albumin-to-creatinine ratio (UACR) < 30 mg/g] recruited between January 2020 and June 2023. Participants were followed biannually for up to three years. Demographic, clinical, and laboratory data, including inflammatory markers (SII, NLR, PLR), were collected at baseline and follow-up. Logistic regression and receiver operating characteristic analyses were used to evaluate the predictive utility of these markers for early kidney damage, defined as UACR ≥ 30 mg/g.

RESULTS

SII emerged as a significant independent predictor of early kidney damage [odds ratio = 1.002, 95% confidence interval (CI): 1.0008-1.0033, P = 0.0016], with an area under the curve of 0.719 (95%CI: 0.612-0.826, P < 0.001). Using an SII threshold of ≥ 624.015 achieved a sensitivity of 59.6% and specificity of 92%. Combining SII with NLR and PLR improved predictive accuracy (area under the curve = 0.787), with sensitivity and specificity of 63.5% and 96%, respectively. Correlation analyses revealed significant associations between SII, metabolic markers (triglycerides, glycated hemoglobin), and UACR.

CONCLUSION

SII is a reliable biomarker for early kidney damage in T1DM children, offering high specificity for identifying at-risk patients. Combining SII with NLR and PLR enhances diagnostic precision, supporting its integration into clinical practice. Longitudinal monitoring of these markers may facilitate early interventions to mitigate renal complications in pediatric T1DM.

Isoquercetin Alleviates Diabetic Retinopathy Via Inhibiting p53-Mediated Ferroptosis

Diabetic retinopathy (DR) is a retinal vasculopathy stemming from diabetes mellitus, characterized by microvascular changes in the retina that can lead to visual impairment or even blindness. Ferroptosis, a form of regulated cell death driven by iron accumulation and lipid peroxidation, has been implicated in the progression of DR. Isoquercetin (IQC), a flavonoid compound, has been shown to inhibit cellular ferroptosis and apoptosis, yet its specific role and underlying mechanisms in DR remain to be elucidated. The present study aimed to investigate the effects of IQC on DR and to delineate its protective mechanisms, particularly focusing on whether these effects are mediated through p53. We employed streptozotocin-induced diabetic C57BL/J mouse models and high glucose (HG)-induced human retinal capillary endothelial cells (HRCECs) models for both in vivo and in vitro experiments. Pathological damage was assessed using hematoxylin and eosin staining, while cell apoptosis rates was detected by TUNEL staining and FITC/PI flow cytometry. Mitochondrial damage was evaluated using transmission electron microscopy. Additionally, we measured levels of reactive oxygen species (ROS) and glutathione (GSH) to assess lipid peroxidation and quantified ferrous ions (Fe2+). Protein expression was detected by immunofluorescence and western blot analysis, and mRNA levels were determined by real-time quantitative PCR. Our findings revealed that IQC mitigated retinal damage in diabetic mice, and in vitro studies further demonstrated that this effect was mediated by the inhibition of p53. In HG-induced HRCECs, we observed decreased cell viability, lipid peroxidation, and ferroptosis. IQC alleviated HG-induced ferroptosis in HRCECs by modulating the p53 pathway, which exhibited varying responses following p53 inhibition or activation. In summary, IQC downregulated the p53 signaling pathway, thereby reducing ferroptosis and apoptosis, and effectively ameliorated the damage associated with DR. These discoveries offer novel insights into the protective mechanisms of IQC in DR.

Changes of N6-methyladenosine and ferroptosis in cadmium-induced reproductive toxicity of male mice fed a high fat and high sugar diet

Cadmium (Cd) and high-fat and high-sugar diet (HFHS) are risk factors contributing to the decline in male sperm quality. N6-methyladenosine (m6A) is essential in the processes of testicular development and spermatogenesis. Ferroptosis, a form of cell death that depends on iron, is prone to causing testicular dysfunction. However, the changes in m6A modification regulatory proteins and ferroptosis signaling molecules in male mice with sperm abnormalities resulting from combined exposure to Cd and HFHS remain incompletely elucidate. Our present data indicate that the combined treatment of Cd and HFHS significantly reduced sperm quality in comparison to those in single Cd or HFHS treatment. In addition, indicators related to ferroptosis in the combined treatment of Cd and HFHS group have also undergone significant changes. In detail, the contents of malondialdehyde (MDA) and Fe2+ as well as Slc7a11 expression were increased while Gclc expressions were reduced in the testicular tissue of Cd and HFHS combined treatment mice. Further detect results showed that the combined exposure to Cd and HFHS synergistically elevated the m6A modification levels alongside a downregulation of the Mettl3, Fto, Alkbh5 and Ythdc2 at the protein level when compared with those in single Cd or HFHS treatment. Altogether, it can be inferred that Cd and HFHS combined treatment may alter the levels of m6A modification regulatory proteins in testicular tissue, leading to increased Fe2+ and MDA production, thus activating the Slc7a11/Gpx4 signaling pathway, ultimately decreasing the sperm quality in mice, providing preliminary evidence for the occurrence of ferroptosis in testicular cells. Our findings may provide direction for the study of reproductive toxicity of cadmium and offer reference for the selection of molecular targets.

Supermolecular poly-N-acryloyl glycinamide/polyglutamic acid/Fe3+ hydrogel incorporated with bioactive small extracellular vesicles promote diabetic wound healing by suppressing ferroptosis

Poorly-controlled blood glucose frequently develop in diabetic wounds and hydrogel has been reported of great performance for diabetic wound healing. Consequently, we prepared poly-N-acryloyl glycinamide (PNAGA) and introduced polyglutamic acid (γ-PGA), Fe3+, small extracellular vesicles (sEVs) into PNAGA to form a dual physical cross-linking supramolecular hydrogel system (PFF) for diabetic wound healing. In this study, we successfully synthesized the PFF hydrogel and extracted the sEVs that were incorporated into PPF as PPF/sEVs. In our research, we find that PFF hydrogel possessed continuous porous structure and, exceptional resilience, excellent extensibility and flexibility, closely mimicking the mechanical performance of human skin. Moreover, the PFF/sEVs hydrogel could release sEVs, playing a critical role in wound healing. Our results showed PFF/sEVs hydrogel improved the wound healing characterized by shorter wound closure time and enhanced blood vessel density in vivo. Also, sEVs counteracted the inhibitory effects of high glucose on proliferation, migration, tube differentiation, malondialdehyde (MDA) and glutathione (GSH) levels, which may attribute to the inhibition of ferroptosis by influencing free fatty acids (FFA) metabolism in vitro. Our findings indicated that the low-cost, biocompatible, and multifunctional bioactive PFF supramolecular hydrogel loaded with sEVs hold tremendous application potential as a clinical platform for diabetic wound healing.

Electromagnetic fields regulate iron metabolism: From mechanisms to applications

BACKGROUND

Electromagnetic fields (EMFs), as a form of physical therapy, have been widely applied in biomedicine. Iron, the most abundant trace metal in living organisms, plays a critical role in various physiological processes, and imbalances in its metabolism are closely associated with the development and progression of numerous diseases. Numerous studies have demonstrated that EMF exposureinduces significant changes in both systemic and cellular iron metabolism.

AIM OF REVIEW

This review aims to summarize the evidence and potential biophysical mechanisms underlying the role of EMFs in regulating iron metabolism, thereby enhancing the understanding of their biological mechanisms and expanding their potential applications in biomedical fields.

KEY SCIENTIFIC CONCEPTS OF REVIEW

In this review, we have synthesized research findings and proposed the hypothesis that the biophysical mechanisms of EMFs regulate iron metabolism involve the special electromagnetic properties of iron-containing proteins and iron-enriched tissues, as well as the modulation of membrane structure and function, ion channels, and the generation and activity of Reactive Oxygen Species (ROS). Then, the review summarizes the latest advances in the effects of EMFs on iron metabolism and their safety, as well as their impact on immunoregulation, cardiovascular diseases, neurological diseases, orthopedic diseases, diabetes, liver injury, and cancer.

Phospholipids and peroxisomes in ferroptosis: the therapeutic target of acupuncture regulating vascular cognitive impairment and dementia

Ferroptosis, since its conceptualization in 2012, has witnessed an exponential growth in research interest over recent years. It is regulated by various cellular metabolic pathways during chronic cerebral ischemia and hypoxia, including reactive oxygen species (ROS) generation, iron accumulation, abnormalities in glutathione metabolism, and disruptions in lipid and glucose metabolism. With the deepening and widespread research, ferroptosis has emerged as a critical pathway in the pathogenesis of vascular cognitive impairment and dementia (VCID). This unique cell death pathway caused by iron-dependent phospholipid peroxidation is strongly related to VICD. We examine the impact of phospholipid composition on neuronal susceptibility to ferroptosis, with a particular focus on the critical role of polyunsaturated fatty acids (PUFAs) in this process. Intriguingly, peroxisomes, as key regulators of lipid metabolism and oxidative stress, influence the susceptibility of neuronal cells to ferroptosis through the synthesis of plasmalogens and other lipid species. In this Review, we provide a critical analysis of the current molecular mechanisms and regulatory networks of acupuncture for ferroptosis, the potential functions of acupuncture in peroxisomal functions and phospholipid metabolism, and its neuroprotective effects in VCID, together with a potential for therapeutic targeting. As such, this highlights the theoretical basis for the application of acupuncture in VCID through multi-target regulation of ferroptosis. This review underscores the potential of acupuncture as a non-pharmacological therapeutic approach in VCID, offering new insights into its role in modulating ferroptosis and associated metabolic pathways for neuroprotection.

From bench to bedside: targeting ferroptosis and mitochondrial damage in the treatment of diabetic cardiomyopathy

Diabetic cardiomyopathy (DCM) is a common and fatal cardiac complication caused by diabetes, with its pathogenesis involving various forms of cell death and mitochondrial dysfunction, particularly ferroptosis and mitochondrial injury. Recent studies have indicated that ferroptosis and mitochondrial damage play crucial roles in the onset and progression of DCM, though their precise regulatory mechanisms remain unclear. Of particular interest is the interaction between ferroptosis and mitochondrial damage, as well as their synergistic effects, which are not fully understood. This review summarizes the roles of ferroptosis and mitochondrial injury in the progression of DCM and explores the molecular mechanisms involved, with an emphasis on the interplay between these two processes. Additionally, the article offers an overview of targeted drugs shown to be effective in cellular experiments, animal models, and clinical trials, analyzing their mechanisms of action and potential side effects. The goal is to provide insights for future drug development and clinical applications. Moreover, the review explores the challenges and prospects of multi-target combination therapies and personalized medicine interventions in clinical practice to offer strategic guidance for the comprehensive prevention and management of DCM.

Preventive treatment of tripdiolide ameliorates kidney injury in diabetic mice by modulating the Nrf2/NF-κB pathway

Introduction

Although tripdiolide has demonstrated a protective role in lupus nephritis, its potential therapeutic and preventive effects on diabetic kidney injury remain inconclusive.

Methods

In this study, a diabetes mice model was used to evaluate the effect of preventive treatment of tripdiolide on the kidney. The study assessed diabetes related factors levels, while comparing kidney pathological changes, alterations in intestinal microbiota composition, oxidative stress and inflammation in kidneys, validating cytokine expression and protein pathway activation.

Results

The experiment demonstrated that tripdiolide preventive treatment effectively suppressed the hyperglycemia and elevated hemoglobin level, attenuated the concentrations of creatinine and blood urea nitrogen, mitigated histopathological alterations in the kidney, and alleviated inflammatory cell infiltration. Tripdiolide regulated intestinal microbiota in diabetes mice and affected the abundance of Allobaculum, Dubosella, and Prevotella, and the differential metabolic pathways primarily revolve around ubiquinol biosynthesis and menaquinol biosynthesis. Tripdiolide treatment significantly attenuated renal oxidative stress and inflammation in diabetic mice, as evidenced by the upregulation of nuclear factor erythroid 2-related factor 2 (Nrf2), heme Oxygenase-1, and the downregulation of phosphorylated nuclear factor-κB (P-NF-κB), and NOD-like receptor protein 3. Experiments performed in RAW264.7 cells demonstrated the effect of tripdiolide.

Discussion

Tripdiolide may play a protective role in hyperglycemia induced kidney injury by changing the composition of intestinal microorganisms, regulating Nrf2/NF-κB pathway activation, and inhibiting oxidative stress and inflammatory reaction. This study contributes scientific evidence that can inform the development of preventive therapeutic approaches for diabetic nephropathy.

Growth Arrest-specific 1 Inhibits Keap1/Nrf2 Signaling Transduction in the Activation of the Ferroptosis Program in Retinal Müller Cells

BACKGROUND

Diabetes retinopathy (DR) represents a microvascular disease in diabetes. Growth arrest-specific 1 (GAS1) is differentially expressed in rat retinal Müller cells under high glucose (HG) conditions, and its promotion of ferroptosis contributes to retinal cell death. However, the influence of GAS1 in DR is elusive. Herein, we aimed to investigate the effect and potential mechanism based on GAS1-mediated ferroptosis on DR.

METHODS

After HG treatment, the differentially expressed genes in rat retinal Müller cells were analyzed by transcriptome sequencing followed by Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) analyses; finally, GAS1 was selected. The effects of GAS1 knockdown/overexpression and nuclear factor erythroid 2-related factor (Nrf2) silencing on viability, apoptosis, lipid peroxidation, Fe2+, and oxidative stress levels in HG-induced/transfected Müller cells were measured by Cell Counting Kit-8 (CCK-8) assay, flow cytometry, and commercial reagent kits. The potential effects of GAS1 and Nrf2, especially on GAS1, Nrf2, and Kelch-like ECH-associated protein 1 (Keap1) expressions in cells, were determined by quantitative real-time polymerase chain reaction (qRT-PCR) or Western blot.

RESULTS

HG treatment decreased cell viability and glutathione (GSH) levels and increased apoptosis, lipid reactive oxygen species (ROS), glutathione disulfide (GSSG), malondialdehyde (MDA), oxidative stress, and Fe2+ levels in Müller cells (p < 0.01). HG treatment also upregulated GAS1, Keap1, and total Nrf2 expressions while downregulating nuclear Nrf2 in Müller cells (p < 0.001). GAS1 downregulation enhanced cell viability, GSH levels, and nuclear Nrf2 expression while reducing the levels of apoptosis, lipid ROS, GSSG, MDA, Fe2+, Keap1, and total Nrf2 in HG-treated Müller cells (p < 0.001), whereas GAS1 overexpression had the opposite effects. Additionally, Nrf2 silencing reversed the impact of GAS1 overexpression in HG-treated Müller cells (p < 0.05).

CONCLUSION

GAS1 inhibits Keap1/Nrf2 signaling transduction in activating ferroptosis in retinal Müller cells; thus, this study can aid in setting the stage for novel treatment methods against DR.

Targeted Management of Diabetic Osteoporosis by Biocatalytic Cascade Reaction Nanoplatform

Diabetic osteoporosis (DOP) is a chronic complication of diabetes mellitus (DM) that impairs bone health, and effective management of DOP remains a formidable challenge. In this study, we developed a biocatalytic cascade nanoplatform, GOx@SrCaP-CAT-Tet, offering osteogenic, angiogenic, and anti-inflammatory activities for targeted DOP management. The platform includes glucose oxidase (GOx) and catalase (CAT), encapsulated in strontium-doped calcium phosphate (SrCaP), converting glucose into gluconic acid and hydrogen peroxide (H2O2), alleviating the hyperglycemia and promoting hypoxia-induced vascularization. Both the generated H2O2 and any overabundance of H2O2 in the DOP microenvironment can be scavenged by CAT, thus relieving inflammation. Via a surface modified with tetracycline (Tet) for bone targeting, the release of Sr2+, Ca2+, and PO43- can stimulate osteogenesis and suppress osteoclastogenesis, thereby hastening bone formation and reversing osteoporosis. This nanoplatform shows promise in managing DOP both in vitro and in vivo. Our findings open a new horizon for managing DOP through biocatalytic cascade reactions.

Iron homeostasis and ferroptosis in muscle diseases and disorders: mechanisms and therapeutic prospects

The muscular system plays a critical role in the human body by governing skeletal movement, cardiovascular function, and the activities of digestive organs. Additionally, muscle tissues serve an endocrine function by secreting myogenic cytokines, thereby regulating metabolism throughout the entire body. Maintaining muscle function requires iron homeostasis. Recent studies suggest that disruptions in iron metabolism and ferroptosis, a form of iron-dependent cell death, are essential contributors to the progression of a wide range of muscle diseases and disorders, including sarcopenia, cardiomyopathy, and amyotrophic lateral sclerosis. Thus, a comprehensive overview of the mechanisms regulating iron metabolism and ferroptosis in these conditions is crucial for identifying potential therapeutic targets and developing new strategies for disease treatment and/or prevention. This review aims to summarize recent advances in understanding the molecular mechanisms underlying ferroptosis in the context of muscle injury, as well as associated muscle diseases and disorders. Moreover, we discuss potential targets within the ferroptosis pathway and possible strategies for managing muscle disorders. Finally, we shed new light on current limitations and future prospects for therapeutic interventions targeting ferroptosis.

Major heme proteins hemoglobin and myoglobin with respect to their roles in oxidative stress - a brief review

Oxidative stress is considered as the root-cause of different pathological conditions. Transition metals, because of their redox-active states, are capable of free radical generation contributing oxidative stress. Hemoglobin and myoglobin are two major heme proteins, involved in oxygen transport and oxygen storage, respectively. Heme prosthetic group of heme proteins is a good reservoir of iron, the most abundant transition metal in human body. Although iron is tightly bound in the heme pocket of these proteins, it is liberated under specific circumstances yielding free ferrous iron. This active iron can react with H2O2, a secondary metabolite, forming hydroxyl radical via Fenton reaction. Hydroxyl radical is the most harmful free radical among all the reactive oxygen species. It causes oxidative stress by damaging lipid membranes, proteins and nucleic acids, activating inflammatory pathways and altering membrane channels, resulting disease conditions. In this review, we have discussed how heme-irons of hemoglobin and myoglobin can promote oxidative stress under different pathophysiological conditions including metabolic syndrome, diabetes, cardiovascular, neurodegenerative and renal diseases. Understanding the association of heme proteins to oxidative stress may be important for knowing the complications as well as therapeutic management of different pathological conditions.

Development of a Highly Selective Ferroptosis Inducer Targeting GPX4 with 2-Ethynylthiazole-4-carboxamide as Electrophilic Warhead

A highly selective ferroptosis inducer with drug-like properties can significantly advance the research on inducing ferroptosis for anticancer treatment. We previously reported a highly active GPX4 inhibitor 26a, but its activity and stability need further improvement. In this work, a novel GPX4 inhibitor (R)-9i with more potent cytotoxicity (IC50 = 0.0003 μM against HT1080) and ferroptosis selectivity (selectivity index = 24933) was gained via further electrophilic warhead screening and structure-based optimization. The cellular thermal shift assay (CETSA) indicated that (R)-9i could stabilize GPX4 with a Tm value of 6.2 °C. Furthermore, (R)-9i showed strong binding affinity against GPX4 (KD = 20.4 nM). More importantly, (R)-9i has more favorable pharmacokinetic properties than 26a, which endowed (R)-9i with potential in antitumor research and as a tool drug for further study of ferroptosis. Associated with these, (R)-9i treatment significantly inhibited tumor growth in the xenograft tumor mouse model without detectable toxicity.

Ferroptosis: mechanism and role in diabetes-related cardiovascular diseases

Cardiovascular diseases represent the principal cause of death and comorbidity among people with diabetes. Ferroptosis, an iron-dependent non-apoptotic regulated cellular death characterized by lipid peroxidation, is involved in the pathogenesis of diabetic cardiovascular diseases. The susceptibility to ferroptosis in diabetic hearts is possibly related to myocardial iron accumulation, abnormal lipid metabolism and excess oxidative stress under hyperglycemia conditions. Accumulating evidence suggests ferroptosis can be the therapeutic target for diabetic cardiovascular diseases. This review summarizes ferroptosis-related mechanisms in the pathogenesis of diabetic cardiovascular diseases and novel therapeutic choices targeting ferroptosis-related pathways. Further study on ferroptosis-mediated cardiac injury can enhance our understanding of the pathophysiology of diabetic cardiovascular diseases and provide more potential therapeutic choices.

Targeting ion homeostasis in metabolic diseases: Molecular mechanisms and targeted therapies

The incidence of metabolic diseases-hypertension, diabetes, obesity, metabolic dysfunction-associated steatotic liver disease (MASLD), and atherosclerosis-is increasing annually, imposing a significant burden on both human health and the social economy. The occurrence and development of these diseases are closely related to the disruption of ion homeostasis, which is crucial for maintaining cellular functions and metabolic equilibrium. However, the specific mechanism of ion homeostasis in metabolic diseases is still unclear. This article reviews the role of ion homeostasis in the pathogenesis of metabolic diseases and assesses its potential as a therapeutic target. Furthermore, the article explores pharmacological strategies that target ion channels and transporters, including existing drugs and emerging drugs under development. Lastly, the article discusses the development direction of future therapeutic strategies, including the possibility of gene therapy targeting specific ion channels and personalized therapy using novel biomarkers. In summary, targeting ion homeostasis provides a new perspective and potential therapeutic approach for the treatment of metabolic diseases.

Advances in the activity of resveratrol and its derivatives in cardiovascular diseases

Cardiovascular diseases (CVDs), the leading cause of human death worldwide, are diseases that affect the heart and blood vessels and include arrhythmias, coronary atherosclerotic heart disease, hypertension, and so on. Resveratrol (RSV) is a natural nonflavonoid phenolic compound with antioxidant, anti-inflammatory, anticancer, and cardiovascular protection functions. RSV has shown significant protective effects against CVD. However, RSV's clinical application is limited by its tendency to be oxidized and metabolized easily. Therefore, it is necessary to optimize the RSV structure. This review will introduce the activity, synthesis, and structure-activity relationships of RSV derivatives, and the mechanism of the action of RSV in CVDs in recent years.

Lapatinib: A Potential Therapeutic Agent for Colon Cancer Targeting Ferroptosis

BACKGROUND

Colon cancer poses a significant threat to the lives of several patients, impacting their quality of life, thus necessitating its urgent treatment. Lapatinib, a new generation of targeted anti-tumor drugs for clinical application, has yet to be studied for its molecular mechanisms in treating colon cancer.

OBJECTIVES

This study aimed to uncover the underlying molecular mechanisms through which lapatinib exerts its therapeutic effects in colon cancer treatment.

METHODS

We accessed pertinent data on patients with colon cancer from the Cancer Genome Atlas (TCGA) database and performed bioinformatics analysis to derive valuable insights. The cell counting kit-8 (CCK8) assay was employed to assess whether lapatinib has a potential inhibitory effect on the growth and proliferation of HT- 29 cells. Additionally, we employed western blot and real-time quantitative polymerase chain reaction methods to investigate whether lapatinib regulates the expression of the ferroptosis-associated protein GPX4 in HT-29 cells. Furthermore, we utilized specific assay kits to measure the levels of reactive oxygen species (ROS) and malondialdehyde in HT-29 cells treated with lapatinib, aiming to elucidate the precise pattern of cell damage induced by this compound.

RESULTS

GPX4 exhibited high expression levels in tissues from patients with colon cancer and was significantly associated with patient prognosis and diagnosis. Lapatinib inhibited the growth and proliferation of the colon cancer cell line HT-29. Additionally, lapatinib suppressed the expression of GPX4 in HT-29 cells, while the ferroptosis inhibitor ferrostatin-1 (Fer-1) partially restored its expression. Lapatinib induced an increase in intracellular ROS levels and malondialdehyde content in HT-29 cells, with Fer-1 partially restoring these levels.

CONCLUSION

Our findings demonstrated that lapatinib could effectively suppress the mRNA and protein expression of GPX4 in colon cancer cells, which elevates intracellular levels of ROS and malondialdehyde, ultimately inducing ferroptosis in these cells. This mechanism underscores the potential of lapatinib as a therapeutic strategy for targeting tumors.

Uncovering the molecular networks of ferroptosis in the pathogenesis of type 2 diabetes and its complications: a multi-omics investigation

BACKGROUND

Diabetes is a multi-factorial disorder and related complications constitute one of the principal causes of global mortality and disability. The role of ferroptosis in diabetes and its complications is intricate and significant. This study endeavors to disclose the role of ferroptosis in the aforementioned diseases from multiple perspectives through multi-omics.

METHODS

We performed genetic correlation analyses via the Linkage Disequilibrium Score and High-Definition Likelihood approaches for type 2 diabetes (T2D) and its complications. The data concerning the expression of ferroptosis-related genes (FRGs) were obtained from the meta-analysis of studies on gene expression and protein abundance. Mendelian randomization analyses and cross-validation were implemented using the discovery cohort, replication cohort, and imaging genomics cohort of T2D and its complications. Moreover, we conducted colocalization analyses on T2D and tissue-specific single-cell RNA sequencing investigations on the complications to complement the results.

RESULTS

Genetic association analysis indicated that the selected datasets could be incorporated into a secondary analysis of T2D complications. In the primary analysis, six FRGs (CDKN1A, ENO3, FURIN, RARRES2, TYRO3, and YTHDC2) were found to be positively associated with T2D risk. Conversely, eight FRGs (ARNTL, CAMKK2, CTSB, FADS2, KDM5A, MEG3, SREBF1, and STAT3) were inversely associated with T2D risk. The 14 FRGs were included in the secondary analysis. Within the FRGs, which received full support from both the discovery and replication cohorts, and were further validated by imaging genomics, higher levels of CDKN1A were positively associated with DKD risk. Higher levels of CAMKK2 and KDM5A were associated with a decreased risk of DKD. For DCM, higher levels of CTSB were positively associated with DCM risk. And genetically predicted higher levels of ARNTL and SREBF1 were associated with a decreased risk of NAFLD. Finally, we validated the tissue-specific expression of each complication with scRNA-seq datasets.

CONCLUSIONS

This study identified FRGs in relation to T2D and its complications, which may enhance the understanding of the pathogenic mechanisms of their development. Meanwhile, it offers cross-validation for imaging genomics and further indicates the direction for non-invasive diagnosis.

Ferroptosis, a therapeutic target for cardiovascular diseases, neurodegenerative diseases and cancer

The identification of ferroptosis represents a pivotal advancement in the field of cell death research, revealing an entirely novel mechanism of cellular demise and offering new insights into the initiation, progression, and therapeutic management of various diseases. Ferroptosis is predominantly induced by intracellular iron accumulation, lipid peroxidation, or impairments in the antioxidant defense system, culminating in membrane rupture and consequent cell death. Studies have associated ferroptosis with a wide range of diseases, and by enhancing our comprehension of its underlying mechanisms, we can formulate innovative therapeutic strategies, thereby providing renewed hope for patients.

Ferroptosis-associated alterations in diabetes following ischemic stroke: Insights from RNA sequencing

OBJECTIVE

Ferroptosis is an iron-dependent form of programmed cell death associated with lipid peroxidation. Though diabetes worsens cerebral injury and clinical outcomes in stroke, it is poorly understood whether ferroptosis contributes to diabetes-exacerbated stroke. This study aimed to identify ferroptosis-associated differentially expressed genes in ischemic stroke under diabetic condition and then explore their roles using comprehensive bioinformatics analyses.

METHODS

Type 1 diabetes (T1D) model was established in male mice at 8-10 weeks of age by one intraperitoneal injection of streptozotocin (110 mg/kg). Ischemic stroke was induced by a transient 45-minute middle cerebral artery occlusion and evaluated three days thereafter. Ischemic brain cortex was dissected 24 h after the reperfusion and subjected to bulk tissue RNA sequencing followed by bioinformatics analysis and verification of key findings via quantitative real-time PCR.

RESULTS

Enlarged infarct size was seen in diabetic, as compared with non-diabetic mice, in conjunction with worsened neurological behaviors. Both body and spleen weights were reduced in diabetic as compared with non-diabetic mice. There was a trend for reduced survival rate in diabetic mice following the stroke. In RNA sequencing analysis, we identified 1299 differentially expressed genes in ischemic brain between diabetic and non-diabetic mice, with upregulation and downregulation for 732 and 567 genes, respectively. Among these genes, 27 genes were associated with ferroptosis. Further analysis reveals that solute carrier family 25 member 28(SLC25A28) and sterol carrier protein 2(SCP2) were the top genes associated with ferroptosis in diabetic mice following ischemic stroke. In several bioinformatics analyses, we found SLC25A28, one of the top ferroptosis-related genes, is involved in several metabolic and regulatory pathways as well as the regulatory complexity of microRNAs and circular RNAs, which demonstrates the potential role of SLC25A28 in diabetes-exacerbated stroke. Drug network analysis suggests SLC25A28 as a potential therapeutic target for ameliorating ischemic injury in diabetes.

CONCLUSIONS

Our bulk RNA sequencing and bioinformatics analyses show that altered ferroptosis signaling pathway was associated with the exacerbation of experimental stroke injury under diabetic condition. Especially, additional investigation into the mechanisms of SLC25A28 and SCP2 in diabetes-exacerbated stroke will be explored in the future study.

Mesenchymal stem cell-derived extracellular vesicles: A promising therapeutic strategy in diabetic osteoporosis

Diabetic osteoporosis (DOP) is a serious complication of diabetes mellitus. It is urgent to explore efficient clinical treatment strategies for DOP. It has been found that mesenchymal stem cell-derived extracellular vesicles (MSC-EVs), as an emerging cell-free therapy, show great potential in DOP treatment. MSC-EVs can effectively promote bone formation, inhibit bone resorption, and modulate the inflammatory microenvironment by delivering cargoes of microRNAs, long non-coding RNAs, and proteins to target cells, thereby ameliorating bone loss in DOP. However, there are limited reports on the treatment of DOP with MSC-EVs. To evoke more attention to this potential strategy, this article summarised the extant literature on MSC-EVs for DOP to provide new directions for further research and to promote the application of MSC-EVs in the clinical management of DOP.

Application of extracellular vesicles in diabetic osteoporosis

As the population ages, the occurrence of osteoporosis is becoming more common. Diabetes mellitus is one of the factors in the development of osteoporosis. Compared with the general population, the incidence of osteoporosis is significantly higher in diabetic patients. Diabetic osteoporosis (DOP) is a metabolic bone disease characterized by abnormal bone tissue structure due to hyperglycemia and insulin resistance, reduced bone strength and increased risk of fractures. This is a complex mechanism that occurs at the cellular level due to factors such as blood vessels, inflammation, and hyperglycemia and insulin resistance. Although the application of some drugs in clinical practice can reduce the occurrence of DOP, the incidence of fractures caused by DOP is still very high. Extracellular vesicles (EVs) are a new communication mode between cells, which can transfer miRNAs and proteins from mother cells to target cells through membrane fusion, thereby regulating the function of target cells. In recent years, the role of EVs in the pathogenesis of DOP has been widely demonstrated. In this article, we first describe the changes in the bone microenvironment of osteoporosis. Second, we describe the pathogenesis of DOP. Finally, we summarize the research progress and challenges of EVs in DOP.

Expression Analysis of FANCD2 in Endometrial Carcinoma

Background

Cisplatin is a major chemotherapy drug in the treatment of Uterine Corpus Endometrial carcinoma (UCEC), and drug resistance often limits its efficacy. Studying the mechanism of cisplatin resistance in endometrial carcinoma is of great clinical importance. This study aims to analyze the expression and value of FANCD2 in UCEC.

Methods

The expression of FANCD2, prognosis, and relationship between FANCD2 and immune cell infiltration in UCEC were analyzed by using bioinformatics. The expression levels of FANCD2 in 62 cases of endometrial carcinoma and 28 cases of normal endometrial tissues were detected by RT-PCR, and the relationship between FANCD2 expression and clinicopathological features was analyzed. A FANCD2 knockdown plasmid was constructed and transfected into Ishikawa cells to detect the levels of GSH and MDA in the presence of different concentrations of cisplatin.

Results

Bioinformatics analysis showed that FANCD2 was highly expressed in UCEC tissues, and patients with high expression had poor prognosis. Immune infiltration analysis revealed that (B cell, CD8 T cell, macrophage, neutrophil, dendritic cell) infiltration was negatively correlated with FANCD2 expression. Compared with those in Ishikawa-Vector, the levels of GSH significantly decreased and those of MDA significantly increased in Ishikawa-FANCD2KD treated with different concentrations of cisplatin.

Conclusion

FANCD2 was highly expressed in UCEC, and the down-regulation of FANCD2 affected the levels of GSH and MDA to increase the cisplatin sensitivity of Ishikawa cells.

Total Alkaloids of Rhizoma Corydalis regulates gut microbiota and restores gut immune barrier to ameliorate cognitive dysfunction in diabetic rats

Background and objectives

Given the widespread dysbiosis of gut microbiota in patients with T2DM, it has been found that the microbiota-gut-brain axis plays an influential regulatory role in diabetic cognitive dysfunction, and improving gut dysbiosis may be a potential strategy for treating diabetic cognitive dysfunction. Total Alkaloids of Rhizoma Corydalis (TAC) is the main active component extracted from Rhizoma Corydalis. Pharmacological studies have demonstrated its significant pharmacological effects on the cardiovascular and cerebrovascular systems, and berberine, the main component of TAC, has a certain regulatory effect on gut microbiota.

Materials and methods

Rats were randomly divided into Control group, Model group, TAC-low group, TAC-mid group and TAC-high group. Cognitive function of diabetic rats was evaluated through behavioral testing using the Morris water maze experiment. The relative abundance of gut bacteria in rat feces was determined via 16S rRNA analysis. IHC and Western blot techniques were employed to assess IL-22, IL-23, Reg3g, ZO-1, occludin 1 expression in the colon tissue; GPX4, xCT, NLRP3, Caspase-1 p20, GSDMD-N were detected in the hippocampus.

Results

The cognitive function of diabetic rats decreased significantly. TAC demonstrated a significant reduction in inflammatory factors in serum, hippocampus, and colon, thus alleviating inflammation. Additionally, it effectively decreased ferroptosis induced by NLRP3 and reduced pathological damage in the hippocampus of diabetic rats. After treatment, the differential microbiota such as Lachnoclotridium and Bacteroides. TAC improved gut barrier permeability and integrity in rats while remodeling gut mucosal homeostasis. Moreover, pyroptosis and ferroptosis caused by the inflammatory cascade in the rat hippocampus were also significantly inhibited.

Conclusion

The combination of high lipid and high glucose with STZ can result in gut microbiota disturbance, damage gut immune barrier, decreased gut mucosal permeability and integrity, aggravated gut inflammation, further spread inflammatory factors to brain tissue, cause inflammatory cascade reaction of encephalopathy, and ultimately resulting in neuronal ferroptosis and cognitive dysfunction in diabetes mellitus. Our study suggests that TAC may regulate gut microbiota, restore gut immune homeostasis, improve gut barrier permeability and integrity, inhibit brain tissue inflammatory cascade, reduce neuronal ferroptosis, and thus improve diabetes. This provides new targets for its treatment strategy.

Ferroptosis: mechanisms and therapeutic targets

Ferroptosis is a nonapoptotic form of cell death characterized by iron-dependent lipid peroxidation in membrane phospholipids. Since its identification in 2012, extensive research has unveiled its involvement in the pathophysiology of numerous diseases, including cancers, neurodegenerative disorders, organ injuries, infectious diseases, autoimmune conditions, metabolic disorders, and skin diseases. Oxidizable lipids, overload iron, and compromised antioxidant systems are known as critical prerequisites for driving overwhelming lipid peroxidation, ultimately leading to plasma membrane rupture and ferroptotic cell death. However, the precise regulatory networks governing ferroptosis and ferroptosis-targeted therapy in these diseases remain largely undefined, hindering the development of pharmacological agonists and antagonists. In this review, we first elucidate core mechanisms of ferroptosis and summarize its epigenetic modifications (e.g., histone modifications, DNA methylation, noncoding RNAs, and N6-methyladenosine modification) and nonepigenetic modifications (e.g., genetic mutations, transcriptional regulation, and posttranslational modifications). We then discuss the association between ferroptosis and disease pathogenesis and explore therapeutic approaches for targeting ferroptosis. We also introduce potential clinical monitoring strategies for ferroptosis. Finally, we put forward several unresolved issues in which progress is needed to better understand ferroptosis. We hope this review will offer promise for the clinical application of ferroptosis-targeted therapies in the context of human health and disease.

Advances in the study of polysaccharides from Anemarrhena asphodeloides Bge.: A review

Anemarrhena asphodeloides Bge. (AA), a traditional Chinese medicine, is used clinically to treat inflammation, diabetes, osteoporosis, and tumors. Polysaccharides are the most abundant components in AA, and have antioxidant, immunomodulatory, anti-inflammatory, hypoglycemic, anti-osteoporosis, and laxative effects. It is necessary to conduct a comprehensive analysis on the structure and pharmacological activity of the polysaccharides from AA (PAAs). This review systematically summarizes the structural characteristics of PAAs, including the monosaccharide compositions, molecular weights, and backbone structures. We discuss the relationship between the structure and pharmacological activities of PAAs. The chemical modification methods of PAAs, including zinc chelation, carboxymethylation, and sulfation, are then reviewed. This review may offer new insights for research on the PAAs and polysaccharides with similar structures.

Iron homeostasis and ferroptosis in human diseases: mechanisms and therapeutic prospects

Iron, an essential mineral in the body, is involved in numerous physiological processes, making the maintenance of iron homeostasis crucial for overall health. Both iron overload and deficiency can cause various disorders and human diseases. Ferroptosis, a form of cell death dependent on iron, is characterized by the extensive peroxidation of lipids. Unlike other kinds of classical unprogrammed cell death, ferroptosis is primarily linked to disruptions in iron metabolism, lipid peroxidation, and antioxidant system imbalance. Ferroptosis is regulated through transcription, translation, and post-translational modifications, which affect cellular sensitivity to ferroptosis. Over the past decade or so, numerous diseases have been linked to ferroptosis as part of their etiology, including cancers, metabolic disorders, autoimmune diseases, central nervous system diseases, cardiovascular diseases, and musculoskeletal diseases. Ferroptosis-related proteins have become attractive targets for many major human diseases that are currently incurable, and some ferroptosis regulators have shown therapeutic effects in clinical trials although further validation of their clinical potential is needed. Therefore, in-depth analysis of ferroptosis and its potential molecular mechanisms in human diseases may offer additional strategies for clinical prevention and treatment. In this review, we discuss the physiological significance of iron homeostasis in the body, the potential contribution of ferroptosis to the etiology and development of human diseases, along with the evidence supporting targeting ferroptosis as a therapeutic approach. Importantly, we evaluate recent potential therapeutic targets and promising interventions, providing guidance for future targeted treatment therapies against human diseases.

Potential pathogenic roles of ferroptosis and cuproptosis in cadmium-induced or exacerbated cardiovascular complications in individuals with diabetes

Diabetes and its complications are major diseases that affect human health. Diabetic cardiovascular complications such as cardiovascular diseases (CVDs) are the major complications of diabetes, which are associated with the loss of cardiovascular cells. Pathogenically the role of ferroptosis, an iron-dependent cell death, and cuproptosis, a copper-dependent cell death has recently been receiving attention for the pathogenesis of diabetes and its cardiovascular complications. How exposure to environmental metals affects these two metal-dependent cell deaths in cardiovascular pathogenesis under diabetic and nondiabetic conditions remains largely unknown. As an omnipresent environmental metal, cadmium exposure can cause oxidative stress in the diabetic cardiomyocytes, leading to iron accumulation, glutathione depletion, lipid peroxidation, and finally exacerbate ferroptosis and disrupt the cardiac. Moreover, cadmium-induced hyperglycemia can enhance the circulation of advanced glycation end products (AGEs). Excessive AGEs in diabetes promote the upregulation of copper importer solute carrier family 31 member 1 through activating transcription factor 3/transcription factor PU.1, thereby increasing intracellular Cu+ accumulation in cardiomyocytes and disturbing Cu+ homeostasis, leading to a decline of Fe-S cluster protein and reactive oxygen species accumulation in cardiomyocytes mitochondria. In this review, we summarize the available evidence and the most recent advances exploring the underlying mechanisms of ferroptosis and cuproptosis in CVDs and diabetic cardiovascular complications, to provide critical perspectives on the potential pathogenic roles of ferroptosis and cuproptosis in cadmium-induced or exacerbated cardiovascular complications in diabetic individuals.

Corilagin alleviates ferroptosis in diabetic retinopathy by activating the Nrf2 signaling pathway

BACKGROUND AND PURPOSE

Diabetic retinopathy (DR) is a prevalent complication of diabetes, with a rising global incidence, and can result in significant vision impairment and potential blindness in adults. Corilagin (COR) has been shown to regulate several pathological processes. However, the specific protective role and mechanism of action of COR in DR remain unknown.

EXPERIMENTAL APPROACH

The protective effects and mechanisms of COR in DR were examined using the ARPE-19 cell line and C57BL/6 mice. Intraretinal tissue damage and molecular markers were evaluated to investigate the impact of COR on oxidative stress and cell death pathways.

KEY RESULTS

In vitro, COR significantly reduced the cytotoxic effects of high glucose (HG) on ARPE-19 cells. Furthermore, COR also effectively decreased HG-induced lipid peroxidation, iron deposition, and ferroptosis and reduced damage to retinal tight junction proteins. Similarly, an in vivo study of streptozotocin (STZ)-induced DM mice showed that the daily gavage of COR for eight weeks notably alleviated DR. Mechanistically, COR activated the Nrf2 antioxidant signaling pathway both in vivo and in vitro, preventing HG-induced alterations in morphological and biochemical parameters. Notably, our study demonstrated that compared with controls, Nrf2 knockout mice and siNrf2-treated cells were more vulnerable to ferroptosis under HG conditions, and the protective effect of COR on DR was substantially diminished in these models.

CONCLUSION AND IMPLICATIONS

These data indicate that COR has a protective effect against HG-induced retinal injury via a mechanism associated with the Nrf2-dependent antioxidant pathway and ferroptosis regulation.

Neutrophil extracellular traps in homeostasis and disease

Neutrophil extracellular traps (NETs), crucial in immune defense mechanisms, are renowned for their propensity to expel decondensed chromatin embedded with inflammatory proteins. Our comprehension of NETs in pathogen clearance, immune regulation and disease pathogenesis, has grown significantly in recent years. NETs are not only pivotal in the context of infections but also exhibit significant involvement in sterile inflammation. Evidence suggests that excessive accumulation of NETs can result in vessel occlusion, tissue damage, and prolonged inflammatory responses, thereby contributing to the progression and exacerbation of various pathological states. Nevertheless, NETs exhibit dual functionalities in certain pathological contexts. While NETs may act as autoantigens, aggregated NET complexes can function as inflammatory mediators by degrading proinflammatory cytokines and chemokines. The delineation of molecules and signaling pathways governing NET formation aids in refining our appreciation of NETs' role in immune homeostasis, inflammation, autoimmune diseases, metabolic dysregulation, and cancer. In this comprehensive review, we delve into the multifaceted roles of NETs in both homeostasis and disease, whilst discussing their potential as therapeutic targets. Our aim is to enhance the understanding of the intricate functions of NETs across the spectrum from physiology to pathology.

Antioxidants from Rubus idaeus leaves: LC-MS/MS chemical profiling, in vitro antiglycation, α-glucosidase and α-amylase inhibitory activities

The present study evaluated a range of biological activities of Rubus idaeus leaves, often considered as by-products, in relation to hyperglycemia. The antiglycation potential of this plant has not been previously reported. In this research, the methanolic leaf extract of R. idaeus was assessed for its antioxidant, enzyme inhibitory and antiglycation activities. The bioactive compounds present in the extract were screened using LC-MS/MS. Enzyme inhibitory activities were tested on α-glucosidase and α-amylase, and the antiglycation effect was investigated using BSA-fructose model. The methanolic extract showed a high polyphenolic contents (176.26 ± 2.26 mg GAE/g) and important IC50 values for DPPH (34.79 ± 2.40 µg/mL) and ABTS radical scavenging activities (49.75 ± 2.47 µg/mL). In addition, the plant leaf extract significantly inhibited hyperglycemia-related enzymes in a dose-dependent manner and demonstrated a reduction in fluorescent AGEs, fructosamine, and dicarbonyl compounds. Therefore, R. idaeus cv Maravilla could be an effective source of therapeutics for improving the healthcare outcomes of diabetic patients.

MicroRNAs in diabetic macroangiopathy

Diabetic macroangiopathy is a leading cause of diabetes-related mortality worldwide. Both genetic and environmental factors, through a multitude of underlying molecular mechanisms, contribute to the pathogenesis of diabetic macroangiopathy. MicroRNAs (miRNAs), a class of non-coding RNAs known for their functional diversity and expression specificity, are increasingly recognized for their roles in the initiation and progression of diabetes and diabetic macroangiopathy. In this review, we will describe the biogenesis of miRNAs, and summarize their functions in diabetic macroangiopathy, including atherosclerosis, peripheral artery disease, coronary artery disease, and cerebrovascular disease, which are anticipated to provide new insights into future perspectives of miRNAs in basic, translational and clinical research, ultimately advancing the diagnosis, prevention, and treatment of diabetic macroangiopathy.

Nanomedicines Targeting Ferroptosis to Treat Stress-Related Diseases

Ferroptosis, a unique form of regulated cell death driven by iron-dependent lethal lipid peroxidation, is implicated in various stress-related diseases like neurodegeneration, vasculopathy, and metabolic disturbance. Stress-related diseases encompass widespread medical disorders that are influenced or exacerbated by stress. These stressors can manifest in various organ or tissue systems and have significant implications for human overall health. Understanding ferroptosis in these diseases offers insights for therapeutic strategies targeting relevant pathways. This review explores ferroptosis mechanisms, its role in pathophysiology, its connection to stress-related diseases, and the potential of ferroptosis-targeted nanomedicines in treating conditions. This monograph also delves into the engineering of ferroptosis-targeted nanomedicines for tackling stress-related diseases, including cancer, cardia-cerebrovascular, neurodegenerative, metabolic and inflammatory diseases. Anyhow, nanotherapy targeting ferroptosis holds promise by both promoting and suppressing ferroptosis for managing stress-related diseases.

Guild-level signature of gut microbiome for diabetic kidney disease

Current microbiome signatures for chronic diseases such as diabetic kidney disease (DKD) are mainly based on low-resolution taxa such as genus or phyla and are often inconsistent among studies. In microbial ecosystems, bacterial functions are strain specific, and taxonomically different bacteria tend to form co-abundance functional groups called guilds. Here, we identified guild-level signatures for DKD by performing in-depth metagenomic sequencing and conducting genome-centric and guild-based analysis on fecal samples from 116 DKD patients and 91 healthy subjects. Redundancy analysis on 1,543 high-quality metagenome-assembled genomes (HQMAGs) identified 54 HQMAGs that were differentially distributed among the young healthy control group, elderly healthy control group, early-stage DKD patients (EDG), and late-stage DKD patients (LDG). Co-abundance network analysis classified the 54 HQMAGs into two guilds. Compared to guild 2, guild 1 contained more short-chain fatty acid biosynthesis genes and fewer genes encoding uremic toxin indole biosynthesis, antibiotic resistance, and virulence factors. Guild indices, derived from the total abundance of guild members and their diversity, delineated DKD patients from healthy subjects and between different severities of DKD. Age-adjusted partial Spearman correlation analysis showed that the guild indices were correlated with DKD disease progression and with risk indicators of poor prognosis. We further validated that the random forest classification model established with the 54 HQMAGs was also applicable for classifying patients with end-stage renal disease and healthy subjects in an independent data set. Therefore, this genome-level, guild-based microbial analysis strategy may identify DKD patients with different severity at an earlier stage to guide clinical interventions.

IMPORTANCE

Traditionally, microbiome research has been constrained by the reliance on taxonomic classifications that may not reflect the functional dynamics or the ecological interactions within microbial communities. By transcending these limitations with a genome-centric and guild-based analysis, our study sheds light on the intricate and specific interactions between microbial strains and diabetic kidney disease (DKD). We have unveiled two distinct microbial guilds with opposite influences on host health, which may redefine our understanding of microbial contributions to disease progression. The implications of our findings extend beyond mere association, providing potential pathways for intervention and opening new avenues for patient stratification in clinical settings. This work paves the way for a paradigm shift in microbiome research in DKD and potentially other chronic kidney diseases, from a focus on taxonomy to a more nuanced view of microbial ecology and function that is more closely aligned with clinical outcomes.

Association between monocyte to lymphocyte ratio and diabetic foot ulcer in the population of the US with diabetes based on the 1999-2004 National Health and Nutrition Examination Survey data: a retrospective cross-sectional study

Background

Diabetic foot ulcer (DFU) is a severe complication that occurs in patients with diabetes and is a primary factor that necessitates amputation. Therefore, the occurrence and progression of DFU must be predicted at an early stage to improve patient prognosis and outcomes. In this regard, emerging evidence suggests that inflammation-related markers play a significant role in DFU. One such potential marker, the monocyte-lymphocyte ratio (MLR), has not been extensively studied in relation to DFU. This study aimed to define a connection between MLR and DFU.

Methods

A cross-sectional study was conducted using National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004. DFU was defined based on survey questionnaires assessing the presence of nonhealing ulcers in the lower extremities for more than 4 weeks in diabetes patients. The MLR was calculated as the ratio of the monocyte count to the lymphocyte count, which was directly obtained from laboratory data files. Logistic regression analysis was performed to assess the relationship between the MLR and DFU. Stratified analysis according to age, sex, body mass index, blood glucose, hemoglobin, and glycated hemoglobin categories was conducted, and multiple imputations were applied to missing data.

Results

In total, 1246 participants were included; the prevalence of DFU was 9.4% (117/1246). A multivariable regression model revealed a significant association between DFU and a 0.1 unit increase in MLR after adjusting for all covariates (adjusted odds ratio=1.16, 95% confidence interval: 1.02-1.33). Subgroup analyses revealed consistent findings regarding the impact of MLR on the presence of DFU (p > 0.05).

Conclusion

MLR is significantly associated with DFU in diabetes patients, and can be used as one of the indicators for predicting the occurrence of DFU. MLR assessment may be a valuable component in the follow-up of patients with diabetes.

High glucose levels accelerate atherosclerosis via NLRP3-IL/ MAPK/NF-κB-related inflammation pathways

BACKGROUND

As a chronic inflammatory disease, diabetes mellitus (DM) contributes to the development of atherosclerosis (AS). However, how the NLRP3 inflammasome participates in diabetes-related AS remains unclear. Therefore, this study aimed to elucidate the mechanism through which NLRP3 uses high glucose (HG) levels to promote AS.

METHODS

Serum and coronary artery tissues were collected from coronary artery disease (CAD) patients with and without DM, respectively. The expression of NLRP3 was detected, and the effects of this inflammasome on diabetes-associated AS were evaluated using streptozotocin (STZ)-induced diabetic apoE-/- mice injected with Adenovirus-mediated NLRP3 interference (Ad-NLRP3i). To elucidate the potential mechanism involved, ox-LDL-irritated human aortic smooth muscle cells were divided into the control, high-glucose, Si-NC, and Si-NLRP3 groups to observe the changes induced by downregulating NLRP3 expression. For up-regulating NLRP3, control and plasmid contained NLRP3 were used. TNF-α, IL-1β, IL-6, IL-18, phosphorylated and total p38, JNK, p65, and IκBα expression levels were detected following the downregulation or upregulation of NLRP3 expression.

RESULTS

Patients with comorbid CAD and DM showed higher serum levels and expression of NLRP3 in the coronary artery than those with only CAD. Moreover, mice in the Ad-NLRP3i group showed markedly smaller and more stable atherosclerotic lesions compared to those in other DM groups. These mice had decreased inflammatory cytokine production and improved glucose tolerance, which demonstrated the substantial effects of NLRP3 in the progression of diabetes-associated AS. Furthermore, using the siRNA or plasmid to downregulate or upregulate NLRP3 expression in vitro altered cytokines and the MAPK/NF-κB pathway.

CONCLUSIONS

NLRP3 expression was significantly increased under hyperglycemia. Additionally, it accelerated AS by promoting inflammation via the IL/MAPK/NF-κB pathway.

Mechanism of traditional Chinese medicine in elderly diabetes mellitus and a systematic review of its clinical application

Objective: Affected by aging, the elderly diabetes patients have many pathological characteristics different from the young people, including more complications, vascular aging, cognitive impairment, osteoporosis, and sarcopenia. This article will explore their pathogenesis and the mechanism of Traditional Chinese medicine (TCM) intervention, and use the method of systematic review to evaluate the clinical application of TCM in elderly diabetes. Method: Searching for randomized controlled trials (RCTs) published from January 2000 to November 2023 in the following databases: Web of Science, Pubmed, Embase, Cochrane Library, Sinomed, China National Knowledge Internet, Wanfang and VIP. They were evaluated by three subgroups of Traditional Chinese Prescription, Traditional Chinese patent medicines and Traditional Chinese medicine extracts for their common prescriptions, drugs, adverse reactions and the quality of them. Results and Conclusion: TCM has the advantages of multi-target and synergistic treatment in the treatment of elderly diabetes. However, current clinical researches have shortcomings including the inclusion of age criteria and diagnosis of subjects are unclear, imprecise research design, non-standard intervention measures, and its safety needs further exploration. In the future, the diagnosis of elderly people with diabetes needs to be further clarified. Traditional Chinese patent medicines included in the pharmacopoeia can be used to conduct more rigorous RCTs, and then gradually standardize the traditional Chinese medicine prescriptions and traditional Chinese medicine extracts, providing higher level evidence for the treatment of elderly diabetes with traditional Chinese medicine.