Association of Oxidative Stress and Proinflammation with Insomnia in Perimenopause

Podophyllum hexandrum Royle mitigates perimenopausal symptoms in an OVX rat model by activating the PI3K/AKT/mTOR pathway and enhancing estrogen receptor expression

ETHNOPHARMACOLOGICAL RELEVANCE

Podophyllum hexandrum Royle, recorded in the Pharmacopoeia of the People's Republic of China as Sinopodophyllum hexandrum (Royle) Ying (SH), is a nationally protected Tibetan medicinal plant in China, which has been traditionally used to regulate menstruation, enhance blood circulation, and treat blood stasis and dystocia. However, its potential role and mechanisms in managing perimenopausal syndrome (PMS) remain unclear.

AIM OF THE STUDY

This study evaluates the therapeutic potential of Sinopodophyllum hexandrum (Royle) Ying rhizomes (SHR) and fruits (SHF) in PMS and investigates their underlying molecular mechanisms.

MATERIALS AND METHODS

The anti-PMS effects of SHR and SHF were examined in an ovariectomized (OVX) rat model by assessing uterine histopathology and hormone levels. Serum lipid profiles, including triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), as well as malondialdehyde (MDA) levels and superoxide dismutase (SOD) levels, were analyzed using biochemical assays. Astral-DIA proteomics identified differentially expressed proteins (DEPs) and key signaling pathways affected by SHF. Protein expression was evaluated via western blotting, immunohistochemistry, and RT-qPCR. Estrogenic activity was further assessed in vitro through MCF-7 cell viability and estrogen receptor (ER) expression analysis.

RESULTS

SHR and SHF treatment significantly improved uterine morphology in OVX rats, restoring endometrial and epithelial thickness. High-dose SHF (SHF-H) increased serum estradiol (E2) by 100.02 %, anti-Müllerian hormone (AMH) by 34.68 %, and progesterone (PROG) by 39.96 % while decreasing luteinizing hormone (LH) by 31.53 %. High-dose SHR (SHR-H) treatment resulted in a 112.89 % increase in E2 levels and a 23.88 % decrease in LH levels. Additionally, SHR-H and SHF-H regulated the level of oxidative stress and serum lipid levels, showing a significant decline in MDA (48.32 %, 65.52 %), TG (34.71 %, 33.30 %), TC (22.34 %, 27.77 %), and LDL-C (57.09 %, 42.96 %). Proteomic analysis identified the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway and apoptotic regulation as key mechanisms underlying SHF's effects. SHF reversed the OVX-induced suppression of p-PI3K/PI3K, p-AKT/AKT, and p-mTOR in the uterus. SHR and SHF also modulated apoptosis-related proteins, downregulating Bax and Cleaved caspase-3/9 while upregulating Bcl-2. Moreover, SHF significantly increased uterine ERα and ERβ expression at both mRNA and protein levels. In vitro, SHR and SHF extracts promoted MCF-7 cell viability and upregulated ERα, ERβ, and proliferating cell nuclear antigen (PCNA), indicating estrogenic activity.

CONCLUSIONS

SH alleviates PMS by inhibiting uterine apoptosis via PI3K/AKT/mTOR pathway activation and enhancing estrogen receptor expression. It also regulates hormone levels, lipid metabolism, and oxidative stress, potentially slowing PMS progression. These findings highlight SH as a promising therapeutic agent for PMS and provide novel insights into the molecular mechanisms of Tibetan medicine.

Investigation of the mechanism of Dan Zhi Qing'e Formula for treating menopausal hot flashes using UHPLC-Q-TOF MS and network pharmacology

This study aims to investigate the material basis and underlying mechanisms of action of the Dan Zhi Qing'e Formula in the treatment of menopausal hot flashes. The composition analysis of the Dan Zhi Qing'e Formula was conducted using UHPLC-Q-TOF MS, facilitated by MassLynx V4.1 software. Subsequently, Cytoscape 3.10.1 was employed to merge the data with information from Swiss, GeneCards, and OMIM databases to identify the active components and primary targets. GO and KEGG analyses were performed to elucidate the potential mechanisms of action. Finally, the molecular docking technique was applied to validate the results. A total of 118 components, 73 blood-absorbed components, and 89 potential targets were identified. Seven key targets were obtained, which were aldose reductase (AKR1B1, UniProtKB: P15121), carbonic anhydrase 4 (CA4, UniProtKB: P22748), carbonic anhydrase 2 (CA2, UniProtKB: P00918), acetylcholinesterase (ACHE, UniProtKB: P22303), estrogen receptor beta (ESR2, UniProtKB: Q92731), cytochrome P450 19A1 (CYP19A1, UniProtKB: P11511), and matrix metalloproteinase-2 (MMP2, UniProtKB: P08253). Molecular docking studies indicate that these core components exhibit strong affinity for the identified targets. These targets contribute to the tonic function of the liver and kidneys through hormone response. The findings provide a scientific foundation for further in-depth research into the therapeutic mechanisms of Dan Zhi Qing'e Formula for menopausal hot flashes.

Functional Connectivity Alterations Associated with COVID-19-Related Sleep Problems: A Longitudinal Resting-State fMRI Study

Background

COVID-19 has led to reports of fatigue and sleep problems. Brain function changes underlying sleep problems (SP) post-COVID-19 are unclear.

Purpose

This study investigated SP-related brain functional connectivity (FC) alterations.

Patients and methods

Fifty-five COVID-19 survivors with SP (COVID_SP) and 33 without SP (COVID_NSP), matched for demographics, completed PSQI and underwent rs-fMRI at baseline and 2-month follow-up. Correlations between FC and clinical data were analyzed by Pearson correlation analysis with Gaussian random field (GRF) correction. The repeated-measures analysis of variance (R-M ANOVA) was completed to explore the interaction with time.

Results

At baseline, COVID_SP exhibited elevated FC: right precentral gyrus (PrG) with left lateral occipital cortex (LOcC)/right PrG, left inferior parietal lobule (IPL) with right superior frontal gyrus (SFG), left hippocampus with right inferior frontal gyrus (IFG). Higher FC between left hippocampus and right SFG correlated with PSQI scores. At 2-month follow-up, decreased FC implicated in emotion regulation, executive function, and memory; increased FC in semantics, attention, and auditory-visual processing. The changes in these regions are correlated with the scores of PSQI, GAD, and PHQ. The Repeated-Measures Analysis of Variance (R-M ANOVA) revealed a significant time interaction effect between sleep and various emotion scales. Moreover, the analysis of the functional connectivity between the right PrG and the right PrG as well as that between the left IPL and the right SFG also discovered a significant time interaction effect.

Conclusion

This study provides insight into the changes in brain function associated with SP after COVID-19. These changes may partially explain the development of SP, and they also changed over time.