Myostatin inhibitor YK11 as a preventative health supplement for bacterial sepsis

Impact of underweight status on mortality in sepsis patients: a meta-analysis

Objective

The evidence regarding the impact of underweight status on clinical outcomes in patients with sepsis are still scarce and controversial. We aimed at conducting a meta-analysis to evaluate the potential associations between underweight and the mortality rate among sepsis patients.

Methods

A comprehensive electronic search was performed in PubMed, Cochrane Library, Embase, and Web of Science databases. Odds ratios (ORs) or mean differences and 95% confidence intervals (CIs) were calculated using RevMan 5.3.

Results

A total of 58,348 patients (normal weight group: 49,084 patients; underweight group: 9,264 patients) from 23 studies were included in this meta-analysis. The results indicated that the in-hospital mortality (OR, 1.28; 95% CI, 1.21, 1.35; heterogeneity: I 2 = 21%, P = 0.21), 28-day mortality (OR, 1.54; 95% CI, 1.26, 1.88; heterogeneity: I 2 = 74%, P < 0.0001) and 1-year mortality (OR, 1.78; 95% CI, 1.58, 2.00; heterogeneity: I 2 = 41%, P = 0.17) of underweight patients were significantly higher than those of normal weight patients. However, there was no significant difference in length of hospital stay or intensive care unit length of stay between underweight patients and normal-weight patients.

Conclusion

Underweight is associated with increased mortality in patients with sepsis. Physicians should pay more attention to the management of underweight sepsis patients.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=631417, identifier CRD42025631417.

From gains to gaps? How Selective Androgen Receptor Modulator (SARM) YK11 impact hippocampal function: In silico, in vivo, and ex vivo perspectives

Selective Androgen Receptor Modulators (SARMs), particularly (17α,20E)-17,20-[(1-methoxyethylidene)bis(oxy)]-3-oxo-19-norpregna-4,20-diene-21-carboxylic-acid-methyl-ester (YK11), are increasingly popular among athletes seeking enhanced performance. Serving as an Androgen Receptor (AR) agonist, YK11 stimulates muscle growth while inhibiting myostatin. Our study delved into the impact of YK11 on the rat hippocampus, analyzing potential alterations in neurochemical mechanisms and investigating its synergistic effects with exercise (EXE), based on the strong relationship between SARM users and regular exercise. Utilizing Physiologically Based Pharmacokinetic (PBPK) modeling, we demonstrated YK11 remarkable brain permeability, with molecular docking analysis revealing YK11 inhibitory effects on 5-alpha-reductase type II (5αR2), suggesting high cell bioavailability. Throughout a 5-week experiment, we divided the animals into the following groups: Control, YK11 (0.35 g/kg), EXE (swimming exercise), and EXE + YK11. Our findings showed that YK11 displayed a high binding affinity with AR in the hippocampus, influencing neurochemical function and modulating aversive memory consolidation, including the downregulation of the BDNF/TrkB/CREB signaling, irrespective of EXE combination. In the hippocampus, YK11 increased pro-inflammatory IL-1β and IL-6 cytokines, while reducing anti-inflammatory IL-10 levels. However, the EXE + YK11 group counteracted IL-6 effects and elevated IL-10. Analysis of apoptotic proteins revealed heightened p38 MAPK activity in response to YK11-induced inflammation, initiating the apoptotic cascade involving Bax/Bcl-2/cleaved caspase-3. Notably, the EXE + YK11 group mitigated alterations in Bcl-2 and cleaved caspase-3 proteins. In conclusion, our findings suggest that YK11, at anabolic doses, significantly alters hippocampal neurochemistry, leading to impairments in memory consolidation. This underscore concerns about the misuse risks of SARMs among athletes and challenges common perceptions of their minimal side effects.

Post-intensive care syndrome follow-up system after hospital discharge: a narrative review

BACKGROUND

Post-intensive care syndrome (PICS) is the long-lasting impairment of physical functions, cognitive functions, and mental health after intensive care. Although a long-term follow-up is essential for the successful management of PICS, few reviews have summarized evidence for the efficacy and management of the PICS follow-up system.

MAIN TEXT

The PICS follow-up system includes a PICS follow-up clinic, home visitations, telephone or mail follow-ups, and telemedicine. The first PICS follow-up clinic was established in the U.K. in 1993 and its use spread thereafter. There are currently no consistent findings on the efficacy of PICS follow-up clinics. Under recent evidence and recommendations, attendance at a PICS follow-up clinic needs to start within three months after hospital discharge. A multidisciplinary team approach is important for the treatment of PICS from various aspects of impairments, including the nutritional status. We classified face-to-face and telephone-based assessments for a PICS follow-up from recent recommendations. Recent findings on medications, rehabilitation, and nutrition for the treatment of PICS were summarized.

CONCLUSIONS

This narrative review aimed to summarize the PICS follow-up system after hospital discharge and provide a comprehensive approach for the prevention and treatment of PICS.

Locomotor and respiratory muscle abnormalities in HFrEF and HFpEF

Heart failure (HF) is a chronic and progressive syndrome affecting worldwide billions of patients. Exercise intolerance and early fatigue are hallmarks of HF patients either with a reduced (HFrEF) or a preserved (HFpEF) ejection fraction. Alterations of the skeletal muscle contribute to exercise intolerance in HF. This review will provide a contemporary summary of the clinical and molecular alterations currently known to occur in the skeletal muscles of both HFrEF and HFpEF, and thereby differentiate the effects on locomotor and respiratory muscles, in particular the diaphragm. Moreover, current and future therapeutic options to address skeletal muscle weakness will be discussed focusing mainly on the effects of exercise training.

YK11 induces oxidative stress and mitochondrial dysfunction in hippocampus: The interplay between a selective androgen receptor modulator (SARM) and exercise

Our study investigates potential neurochemical effects of (17α,20E)- 17,20-[(1-methoxyethylidene)bis(oxy)]- 3-oxo-19-norpregna-4,20-diene-21-carboxylic acid methyl ester (YK11), a selective androgen receptor modulator (SARM), in the rat hippocampus, with a particular focus on oxidative stress and mitochondrial function, as well as its potential effect when combined with exercise (EXE). To validate YK11's anabolic potential, we performed a molecular docking analysis with the androgen receptor (AR), which showed high affinity with YK11, highlighting hydrogen interactions in Arg752. During the five-week protocol, we divided male Wistar rats into the following groups: Control, YK11 (0.35 g/kg), EXE (swimming protocol), and EXE+YK11. The administration of YK11 resulted in alterations in the endogenous antioxidant system, promoting increased oxidative stress and proteotoxic effects, impairing all mitochondrial function markers in the hippocampus. In contrast, EXE alone had a neuroprotective effect, increasing antioxidant defenses and improving mitochondrial metabolism. When combined, EXE+YK11 prevented alterations in some mitochondrial toxicity markers, including MnSOD/SOD2 and MTT reduction capacity, but did not reverse YK11's neurochemical impairments regarding increased oxidative stress and dysfunction of the mitochondrial respiratory chain and mitochondrial dynamics regulatory proteins in the hippocampus. In summary, our study identifies important pathways of YK11's hippocampal effects, revealing its potential to promote oxidative stress and mitochondrial dysfunction, suggesting that the administration of YK11 may pose potential neurological risks for athletes and bodybuilders seeking to enhance performance. These findings highlight the need for further research to assess the safety and efficacy of YK11 and SARM use in humans.

IOX1 impedes host inflammation in imiquimod-triggered psoriasis

Psoriasis is a chronic autoimmune disease with an unknown etiology and highly limited treatment strategies. The drugs currently used in the treatment of psoriasis are rarely recommended for long-term use owing to the serious side effects. Although different targets have been identified for controlling psoriasis, the role of epigenetic modifications as therapeutic targets is yet to be elucidated. Here, we investigated the therapeutic potential of 8-hydroxyquinoline-5-carboxylic acid (IOX1), a novel drug with a genetic target, in psoriasis. The daily topical administration of IOX1 in a mouse model of imiquimod (IMQ)-induced psoriatic inflammation reduced inflammatory reactions in the skin and lowered the PASI score. Furthermore, intraperitoneally injected IOX1 repressed the inflammatory status induced by IMQ in psoriatic mice by reducing the mRNA levels of pro-inflammatory cytokines, restoring splenocyte populations, and regulating macrophage polarization. Our findings indicate the remedial effects of IOX1 on dermatitis psoriasis and the potential of IOX1 as a therapeutic compound in psoriasis.