Leptin hormone and its effectiveness in reproduction, metabolism, immunity, diabetes, hopes and ambitions

FSH, LH, lipid and adipokines in Polycystic Ovary Syndrome: Clinical biochemistry insights for diagnosis and management

Polycystic Ovary Syndrome (PCOS) is a common endocrine syndrome characterized by hormonal imbalances, metabolic disturbances, and clinical symptoms. The pathophysiology of this syndrome involves disruptions in hormonal signaling, particularly changes in levels of luteinizing hormone (LH), and follicle-stimulating hormone (FSH) which can lead to anovulation and infertility. Additionally, insulin resistance and dysfunctional adipose tissue are other complicating factors of this condition. Biochemical markers such as FSH, LH, lipid profiles, and adipokines (like leptin and adiponectin) are crucial for diagnosing PCOS and assessing its severity. In PCOS patients, elevated LH levels relative to FSH are typically observed, and lipid abnormalities increase the risk of cardiovascular diseases. Diagnosing this syndrome usually requires comprehensive biochemical tests to confirm hyperandrogenism and insulin resistance. Management strategies include lifestyle modifications and pharmacological interventions aimed at correcting hormonal imbalances and dyslipidemia. Monitoring treatment outcomes through biochemical markers is essential for evaluating therapeutic efficacy. This review article examines the roles of FSH and LH hormones, lipids, and adipokines in the diagnosis and management of PCOS, emphasizing the importance of clinical biochemistry in improving diagnostic and treatment methods for this disorder. Furthermore, research into identifying emerging biomarkers for early diagnosis and new therapeutic targets is suggested.

Intermittent fasting versus continuous caloric restriction for glycemic control and weight loss in type 2 diabetes: A traditional review

Type 2 Diabetes Mellitus (T2DM) represents a major global health issue, with its incidence anticipated to increase markedly in the forthcoming decades. Efficient non-pharmacological therapies, especially dietary approaches, are essential for regulating glycemic control and facilitating weight reduction. Intermittent Fasting (IF) and Continuous Caloric Restriction (CCR) are two well researched methodologies, but their relative effectiveness and enduring advantages continue to be topics of active discussion. This review systematically assesses and contrasts the impacts of intermittent fasting (IF) and continuous calorie restriction (CCR) on glycemic regulation and weight reduction in persons with type 2 diabetes mellitus (T2DM), highlighting their short-term and long-term effects, safety profiles, and adherence rates. A thorough literature analysis was performed utilizing PubMed and Google Scholar, concentrating on papers published from 2000 to 2024. The review encompassed randomized controlled trials and observational studies that investigated the effects of intermittent fasting (IF) and continuous calorie restriction (CCR) on glycemic indicators (HbA1c, fasting glucose) and body weight. IF shown substantial short-term advantages, encompassing marked decreases in HbA1c levels, fasting glucose, and body weight. Mechanistic discoveries emphasized better insulin sensitivity, augmented fat metabolism, and autophagy as key aspects. In contrast, CCR was linked to enduring metabolic enhancements, including decreased visceral fat and improved insulin sensitivity. Nevertheless, both dietary approaches demonstrated constraints.

Exercise-mediated modulation of autonomic nervous system and inflammatory response in sleep-deprived individuals: A narrative reviews of implications for cardiovascular health

Sleep deprivation is a growing concern in cardiovascular risk, causing physiological disruptions like autonomic dysregulation and inflammation. Recent research indicates that sleep deprivation increases sympathetic nervous activity while decreasing parasympathetic activity, leading to increased blood pressure, impaired endothelial function, and heightened inflammation. Exercise has emerged as a non-pharmacological approach to increase cardiovascular health. However, the impact of exercise on sleep deprivation-induced changes in autonomic activity and inflammation remains unclear. To explore this, we reviewed studies investigating the effects of acute exercise on autonomic regulation and inflammatory markers following sleep deprivation. We conducted a narrative review of the literature. PubMed/MEDLINE, Google Scholar, and Web of Science (WOS) searched the articles between May 2022 and April 2023. The papers had to: [1] focus on recent studies between 2000 and 2023; [2] consist of sleep deprivation participants; [3] be published in English. Acute moderate- to high-intensity exercise after sleep deprivation may reduce parasympathetic activity, trigger pro-inflammatory cytokines, and delay recovery to normal levels. In contrast, regular exercise routines may mitigate the adverse effects of sleep deprivation on autonomic regulation and reduce systemic inflammation. Sleep deprivation can lead to autonomic imbalance, increased blood pressure, and increased inflammatory responses, which are further amplified by acute exercise, increasing the cardiovascular burden. When sleep deprivation occurs, exercise intensity and timing should be carefully chosen to avoid adverse cardiovascular health risks.

Imo-induced changes in gut hormones and glucose metabolism: A key to improving insulin sensitivity in type 2 diabetes

Isomalto-oligosaccharides (IMO) are prebiotic oligosaccharides that have shown promise in improving insulin sensitivity and glucose metabolism, making them potential therapeutic agents for Type 2 Diabetes (T2D). IMO selectively stimulates beneficial gut microbiota, particularly Bifidobacterium and Lactobacillus, leading to the production of short-chain fatty acids (SCFAs) like acetate, propionate, and butyrate. These SCFAs play a pivotal role in enhancing the release of gut hormones such as GLP-1 (Glucagon-like peptide-1) and PYY (Peptide YY), which improve insulin secretion and promote satiety, thus improving glucose homeostasis. Clinical studies have reported that IMO supplementation can lower HbA1c by 0.5% and reduce postprandial glucose spikes, demonstrating its efficacy in glycemic control. Additionally, IMO promotes insulin sensitivity by reducing inflammation and enhancing adiponectin levels. Although the current findings are promising, further research is needed to determine optimal dosing, long-term safety, and the role of individual gut microbiomes in tailoring IMO interventions. Future studies focusing on personalized nutrition strategies and the synergistic effects of IMO with other lifestyle interventions could enhance its applicability as a key component in T2D management.

Leptin, adiponectin, body mass index, and incident cognitive impairment

BackgroundDisordered metabolism affects risk for cognitive decline, Alzheimer's disease, and other dementias, likely through pathways involving adipokines.ObjectiveAnalyze incident cognitive impairment in relation to leptin, adiponectin, body mass index, and other risk factors.MethodsNested case-control study within the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort of 30,239 adults in the US. Cases with incident cognitive impairment (n = 489) scored >1.57 SD below demographically adjusted means on ≥2 of 3 cognitive tests: word list learning, word list delayed recall, and category fluency. Cognitively intact controls (n = 583) were randomly selected within demographic strata. Leptin and adiponectin were assayed in thawed blood that had been stored at baseline.ResultsIn participants with normal weight, lower leptin was associated with higher odds of cognitive impairment. Relative to leptin = 25 ng/mL, adjusted ORs were 1.5 (95% CI: 1.2, 1.9) at leptin = 15 ng/mL, 0.8 (0.8, 0.9) at leptin = 30 ng/mL, and 0.5 (0.4, 0.8) at leptin = 45 ng/mL. In participants with obesity, higher adiponectin was associated with higher odds of cognitive impairment. Relative to adiponectin = 25 ng/mL, adjusted ORs were 0.8 (95% CI: 0.7, 1.0) at adiponectin = 15 ng/mL, 1.1 (1.0, 1.2) at adiponectin = 30 ng/mL, and 1.3 (1.0, 1.7) at adiponectin = 45 ng/mL. Associations of adipokines with cognitive impairment varied across levels of other risk factors.ConclusionsAdipokines, in concert with body mass index, play complex roles in cognitive health, with many avenues open for further investigation.

Examining the weight status criterion as a perpetuator of harm and racial/ethnic disparities in anorexia nervosa

Anorexia Nervosa is distinguished from a similar - if not identical - disorder, atypical Anorexia Nervosa, based on weight status. Atypical Anorexia Nervosa is diagnosed when, "despite significant weight loss, [an] individual's weight is within or above the normal range." The current scholarly commentary grapples with the historical, biological, and psychosocial flaws inherently entangled in utilizing weight status (and its standardized metrics - i.e., Body Mass Index) as proxies for dietary restriction and health status. We briefly synthesize evidence suggesting that utilization of weight status to differentiate Anorexia Nervosa and Atypical Anorexia Nervosa perpetuates systemic and structural health inequities for individuals with marginalized racial and ethnic identities. This commentary aims to spark discussion on the lack of utility in maintaining two seemingly identical disorders at the cost of perpetuating harm toward historically marginalized groups.

The role of PTP1B in cardiometabolic disorders and endothelial dysfunction

Cardiovascular diseases (CVD) are a global health concern that accounts for a large share of annual mortality. Endothelial dysfunction is the main underlying factor that eventually leads to cardiovascular events. Recent studies have underscored the critical function of Protein Tyrosine Phosphatase 1B (PTP1B) in the onset of endothelial dysfunction, chiefly through its involvement in metabolic diseases such as diabetes, obesity, and leptin resistance. PTP1B attenuates insulin and leptin signalling by dephosphorylating their respective receptors at key tyrosine residues, resulting in resistance-both of which are significant mechanisms underpinning the development of endothelial dysfunction. PTP1B also contributes to the disruption of the endoplasmic reticulum, causing endoplasmic reticulum stress, another molecular driver of endothelial dysfunction. Efforts to inhibit PTP1B activity hold the promise of advancing the prevention and management of CVD and metabolic disorders, as these conditions share common risk factors and underlying cellular mechanisms. Numerous small molecules have been reported as PTP1B inhibitors; however, their progression to advanced clinical trials has been hindered by major challenges such as low selectivity and undesirable side effects. This review provides an in-depth analysis of PTP1B's involvement in metabolic diseases and its interaction with CVD and examines the strategies and challenges related to inhibiting this enzyme.

Roles of thyroid and leptin hormones and their crosstalk in male reproductive functions: an updated review

PURPOSE

This review aims to provide updated information regarding the role of thyroid and leptin hormones and their crosstalk in affecting the male reproductive function in hypothyroid and obesity conditions.

METHOD

A wide literature search was made using online search engines on published articles using keywords including thyroid hormone, hypothyroidism, leptin hormone, hyperleptinemia, obesity, the relationship between thyroid and leptin hormones and male reproduction, and hypothyroidism, obesity, and male reproduction.

RESULTS

All information pertaining thyroid and leptin hormone effects on male reproduction, hypothyroidism, hyperleptinemia, and obesity effect on male fertility as well as the related molecular mechanisms are obtained.

CONCLUSION

Thyroid and leptin hormones individually play a significant role in male reproduction. Alterations of these hormones' levels could adversely affect the male reproductive functions. PI3K/AKT signaling was found to be the major signaling pathway involved in mediating the effect of both hormones on male reproduction. Impaired crosstalk between the two hormones may occur in hypothyroidism with obesity which would contribute towards male reproductive dysfunction.

Molecular Findings Before Vision Loss in the Streptozotocin-Induced Rat Model of Diabetic Retinopathy

The streptozotocin-induced rat model of diabetic retinopathy presents similarities to the disease observed in humans. After four weeks following the induction of diabetes, the rats experience vision impairment. During this crucial four-week period, significant changes occur, with vascular damage standing out as a clinically significant factor, alongside neovascularization. While redox imbalance, activation of microglia, secretion of pro-inflammatory cytokines, and neuronal cell death are also observed, the latter remains an emerging hypothesis requiring further exploration. This review is a comprehensive and up-to-date chronological depiction of the progression of diabetic retinopathy within the initial four weeks of hyperglycemia, which precede the onset of vision loss. The data are structured in weekly changes. In the first week, oxidative stress triggers the activation of retinal microglia, which produces inflammation, leading to altered neurotransmission. The second week is characterized by leukostasis, which promotes ischemia, while neural degeneration begins and is accompanied by a simultaneous increase in vessel permeability. The progression of redox and inflammatory imbalances characterized the third week. Finally, in the fourth week, significant developments occur as vessels dilate and become tortuous, neovascularization develops, and retinal thickness diminishes, ultimately leading to vision loss. Through this clearly structured outline, this review aims to delineate a framework for the progression of streptozotocin-induced diabetic retinopathy.

Hormonal Imbalance in Obesity and Arthritis: Points of Contact

Obesity is a growing global health crisis intricately connected to various chronic conditions, including arthritis. This paper explores the intricate web of hormonal changes in the context of obesity and their profound influence on the development and progression of arthritis. Hormones, such as leptin, insulin, cortisol, and estrogen, all altered in obesity, play pivotal roles in inflammation, cartilage degradation, mechanical stress, and pain associated with obesity-related arthritis. Additionally, the mechanical stress placed on weight-bearing joints by excess body weight accelerates joint wear and tear, contributing to arthritis. Genetic factors, shared biomarkers, and pathways further link these conditions. Recognizing these connections is vital for healthcare professionals and individuals facing the challenges of obesity and arthritis, offering insights into strategies for prevention, management, and intervention. This comprehensive understanding of the complex interplay between hormonal changes, obesity, and arthritis sheds light on multifaceted mechanisms underlying this intricate relationship.

Cellular and molecular mechanisms of action of ovarian steroid hormones II: Regulation of sexual behavior in female rodents

Female sexual behaviors in rodents (lordosis and appetitive or "proceptive" behaviors) are induced through a genomic mechanism by the sequential actions of estradiol (E2) and progesterone (P), or E2 and testosterone (T) at their respective receptors. However, non-steroidal agents, such as gonadotropin-releasing hormone (GnRH), Prostaglandin E2 (PGE2), noradrenaline, dopamine, oxytocin, α-melanocyte stimulating hormone, nitric oxide, leptin, apelin, and others, facilitate different aspects of female sexual behavior through their cellular and intracellular effects at the membrane and genomic levels in ovariectomized rats primed with E2. These neurotransmitters often act as intermediaries of E2 and P (or T). The classical model of steroid hormone action through intracellular receptor binding has been complemented by an alternative scenario wherein the steroid functions as a transcription factor after binding the receptor protein to DNA. Another possible mechanism occurs through the activation of second messenger systems (cyclic AMP, cyclic GMP, calcium), which subsequently initiate phosphorylation events via diverse kinase systems (protein kinases A, G, or C). These kinases target the progesterone receptor (PR) or associated effector proteins that connect the PR to the trans-activation machinery. This may also happen to the androgen receptor (AR). In addition, other cellular mechanisms could be involved since the chemical structure of these non-steroidal agents causes a change in their lipophobicity that prevents them from penetrating the cell and exerting direct transcriptional effects; however, they can exert effects on different components of the cell membrane activating a cross-talk between the cell membrane and the regulation of the transcriptional mechanisms.

L-arginine mitigates cardiac lipid and glucose accumulation through leptin modulation and enhancement of PIK3 activities in high fat-fed male Wistar rats

BACKGROUND AND AIM

Insulin resistance and other metabolic risk factors are associated with increased cardiovascular diseases in animals fed with high fat diets (HFD). L-arginine is a semi-essential amino acid produced both endogenously and taken in the diet as supplements. It has been documented to possess antioxidant and anti-inflammatory properties and has been considered a plausible candidate for the management of metabolic disorders. Therefore, this study is aimed to determine the effects of L-arginine on lipid dysregulation and insulin resistance in high fat-fed male Wistar rats.

METHODS AND RESULTS

Twenty-four (24) male Wistar rats randomly selected into 4 groups, mean weight 110 ± 5 and, (n = 6) were fed rat chow + distilled water (vehicle); CTR, rat chow + L-arginine (150 mg/kg), HFD + vehicle, HFD + L-Arginine (150 mg/kg) for 6 weeks. The animals were anesthetized with 50 mg/kg pentobarbital sodium intraperitoneally, blood sample was taken via cardiac puncture and thereafter collected into a heparinized tube. Data were expressed as means ± SEM. HFD increased body weight gain, serum Insulin, Homeostasis model assessment of insulin resistance (HOMA-IR), area under the curve (AUC), leptin, Lipoprotein(a) or Lp(a), triglyceride-glucose index (TYG), triglycerides (TG), free fatty acids (FFAs), total cholesterol (TC), low density lipoprotein (LDL-C), TC/HDL-C, Log TG/HDL-C, TC-HDL-C)/HDL-C but decreased phospoinositide-3-kinase (PIK3) when compared with control. L-arginine, resulted in significant reduction in weight gain, fasting blood sugar (FBS), insulin, AUC, HOMA-IR, leptin, while increasing PIK3, Lp(a), TG, TC and FFA when compared with HFD.

CONCLUSION

The amelioration of lipid and glucose accumulation by L-arginine supplementation in high fat diet-fed male Wistar rats is accompanied by reduced leptin levels and PIK3 augmentation.

Investigating the effect of radiofrequency electromagnetic field exposure on molecular pathways related to insulin resistance and adipogenesis in zebrafish embryos - A pilot study without quantitative exposure metrics

In recent years, obesity has become a global problem in children and adolescents, in parallel with the rapid increase in the use of information and communication technology. Recognizing the embryonic causes of obesity may help prevent adverse adult health outcomes. In our study, we hypothesized that radiofrequency-electromagnetic field (RF-EMF) exposure during embryogenesis would affect the molecular mechanisms related to adipogenesis and insulin resistance in zebrafish. To achieve this, we set up a system that emits RF-EMF in the 900 MHz band and subjected zebrafish embryos to its RF-EMF. We created two groups in which we exposed 30 min (EMF-30) and 60 min (EMF-60) per day, and a control group that was not exposed to RF-EMF. We ended the exposure at 96 hpf and analyzed the expression of lepa, ins, and pparg that are involved in the regulation of glucose and lipid metabolism. In addition, we analyzed oxidative stress parameters, embryonic development, and locomotor activity. We found decreased mRNA transcript abundance of lepa, ins, pparg, and activities of superoxide dismutase and acetylcholine esterase, along with increased lipid peroxidation (LPO), nitric oxide (NO), and glutathione S-transferase (GST). Locomotor activity increased in the EMF-30 group and decreased in the EMF-60 group. Our results showed that exposure to RF-EMF during the embryonic period disrupted the molecular pathways related to insulin resistance and adipogenesis in zebrafish. However, due to limited available resources, we were not able to appropriately quantify the actual RF exposure strength of the samples. Hence the results reported here should only be seen as preliminary, and further studies employing high quality exposure apparatus and dosimetry should be carried out in future.

Rodent models in polycystic ovarian syndrome: Dissecting reproductive and metabolic phenotypes for therapeutic advancements

The most prevalent reason for female infertility is polycystic ovarian syndrome (PCOS) exhibiting two of three phenotypes including biochemical or clinical hyperandrogenism, anovulation and polycystic ovaries. Insulin resistance and obesity are common in PCOS-afflicted women. Androgens are thought to be the primary cause of PCOS causing symptoms including anovulation, follicles that resemble cysts, higher levels of the luteinizing hormone (LH), increased adiposity, and insulin resistance. However, due to the heterogeneity of PCOS, it is challenging to establish a single model that accurately mimics all the reproductive and metabolic phenotypes seen in PCOS patients. In this review, we aimed to investigate rodent models of PCOS and related phenotypes with or without direct hormonal treatments and to determine the underlying mechanisms to comprehend PCOS better. We summarized rodent models of PCOS that includes direct and indirect hormone intervention and discussed the aetiology of PCOS and related phenotypes produced in rodent models. We presented combined insights on multiple rodent models of PCOS and compared their reproductive and/or metabolic phenotypes. Our review indicates that there are various models for studying PCOS and one should select a model most suitable for their purpose. This review will be helpful for consideration of rodent models for PCOS which are not conventionally used to determine mechanisms at the molecular/cellular levels encouraging development of novel treatments and control methods for PCOS.

Toxicological Characteristics of Bacterial Nanocellulose in an In Vivo Experiment-Part 2: Immunological Endpoints, Influence on the Intestinal Barrier and Microbiome

Bacterial nanocellulose (BNC) is considered a promising alternative to microcrystalline cellulose, as well as an ingredient in low-calorie dietary products. However, the risks of BNC when consumed with food are not well characterized. The aim of this study is to investigate the impact of BNC on immune function, the intestinal microbiome, intestinal barrier integrity, and allergic sensitization in subacute experiments on rats. Male Wistar rats received BNC with a diet for eight weeks in a dose range of 1-100 mg/kg of body weight. The measurements of serum levels of cytokines, adipokines, iFABP2, indicators of cellular immunity, composition of the intestinal microbiome, and a histological study of the ileal mucosa were performed. In a separate four-week experiment on a model of systemic anaphylaxis to food antigen, BNC at a dose of 100 mg/kg of body weight did not increase the severity of the reaction or change the response of IgG antibodies. Based on dose-response effects on immune function, the non-observed adverse effect level for BNC was less than 100 mg/kg of body weight per day. The effects of BNC on the gut microbiome and the intestinal mucosal barrier were not dose-dependent. Data on the possible presence of prebiotic effects in BNC have been obtained.

A systematic scoping review of the multifaceted role of phoenixin in metabolism: insights from in vitro and in vivo studies

Phoenixin (PNX) is an emerging neuropeptide that plays a significant role in regulating metabolism and reproduction. This comprehensive review examines findings from human, in vivo, and in vitro studies to elucidate the functions of PNX in metabolic processes. PNX has been identified as a key player in essential metabolic pathways, including energy homeostasis, glucose, lipid and electrolyte metabolism, and mitochondrial dynamics. It modulates food and fluid intake, influences glucose and lipid profiles, and affects mitochondrial biogenesis and function. PNX is abundantly expressed in the hypothalamus, where it plays a crucial role in regulating reproductive hormone secretion and maintaining energy balance. Furthermore, PNX is also expressed in peripheral tissues such as the heart, spleen, and pancreas, indicating its involvement in the regulation of metabolism across central and peripheral systems. PNX is a therapeutic peptide that operates through the G protein-coupled receptor 173 (GPR173) at the molecular level. It activates signaling pathways such as cAMP-protein kinase A (PKA) and Epac-ERK, which are crucial for metabolic regulation. Research suggests that PNX may be effective in managing metabolic disorders like obesity and type 2 diabetes, as well as reproductive health issues like infertility. Since metabolic processes are closely linked to reproduction, further understanding of PNX's role in these areas is necessary to develop effective management/treatments. This review aims to highlight PNX's involvement in metabolism and identify gaps in current knowledge regarding its impact on human health. Understanding the mechanisms of PNX's action is crucial for the development of novel therapeutic strategies for the treatment of metabolic disorders and reproductive health issues, which are significant public health concerns globally.

Targeting the Epigenetic Marks in Type 2 Diabetes Mellitus: Will Epigenetic Therapy Be a Valuable Adjunct to Pharmacotherapy?

Although genetic, environmental, and lifestyle factors largely contribute to type 2 diabetes mellitus (T2DM) risk, the role of epigenetics in its pathogenesis is now well established. The epigenetic mechanisms in T2DM mainly consist of DNA methylation, histone modifications and regulation by noncoding RNAs (ncRNAs). For instance, DNA methylation at CpG islands in the promoter regions of specific genes encoding insulin signaling and glucose metabolism suppresses these genes. Modulating the enzyme mediators of these epigenetic marks aims to restore standard gene expression patterns and improve glycemic control. In targeting these epigenetic marks, using epigenetic drugs such as DNA methyltransferase (DNAMT), histone deacetylase (HDAC) and histone acetyltransferase (HAT) inhibitors has led to variable success in humans and experimental murine models. Specifically, the United States' Food and Drug Administration (US FDA) has approved DNAMT inhibitors like 5-azacytidine and 5-aza-2'-deoxycytidine for use in diabetic retinopathy: a T2DM microvascular complication. These DNAMT inhibitors block the genes for methylation of mitochondrial superoxide dismutase 2 (SOD2) and matrix metallopeptidase 9 (MMP-9): the epigenetic marks in diabetic retinopathy. Traditional pharmacotherapy with metformin also have epigenetic effects in T2DM and positively alter disease outcomes when combined with epigenetic drugs like DNAMT and HDAC inhibitors, raising the prospect of using epigenetic therapy as a valuable adjunct to pharmacotherapy. However, introducing small interfering RNAs (siRNAs) in cells to silence specific target genes remains in the exploratory phase. Future research should focus on regulating gene expression in T2DM using long noncoding RNA (lncRNA) molecules, another type of ncRNA. This review discusses the epigenetics of T2DM and that of its macro- and microvascular complications, and the potential benefits of combining epigenetic therapy with pharmacotherapy for optimal results.

Metabolic syndrome and psoriatic arthritis: the role of weight loss as a disease-modifying therapy

Psoriatic arthritis (PsA) is an inflammatory joint and entheseal disease associated with significant personal and public health burden. PsA has a prevalence of up to 1%, affecting ~20% of people suffering with psoriasis. PsA is frequently accompanied by metabolic syndrome (MetS), and both conditions are characterised by a chronic pro-inflammatory state, with several key cytokines in PsA (interleukin (IL)-17 and IL-23) also elevated in those with MetS. This narrative review aims to provide an update on MetS in PsA, focusing on its prevalence, pathogenesis, prognosis, treatment interactions and future therapeutic options. MetS is particularly prevalent in PsA compared to other inflammatory arthritides. Cohort studies indicate a higher risk of PsA in individuals with obesity, while Mendelian randomization studies link childhood obesity, insulin resistance, and dyslipidaemia to PsA. Weight loss interventions have been shown to reduce disease activity in PsA. Additionally, MetS negatively impacts the efficacy of tumour necrosis factor inhibitor (TNFi) drugs in treating PsA. Drugs given for PsA may also affect the conditions constituting MetS. Leflunomide has been shown to reduce body weight but also increase blood pressure. TNFi drugs lead to weight gain but reduce cardiovascular risk. Janus kinase inhibitors increase lipid levels and cardiovascular risk among high-risk groups. Anti-IL-17 and anti-IL-12/IL-23 drugs may cause a short-term increase in cardiovascular risk, although the long-term effects have yet to be established. Weight loss represents an unexplored avenue for disease modification in PsA, alongside a plethora of general health benefits. Dietary and exercise modifications are the cornerstone of weight management but vary substantially across individuals. Novel therapies to treat weight loss, such as glucagon-like peptide 1 agonists and sodium-glucose cotransporter 2 inhibitors, may prove useful alongside disease-modifying therapies for those with PsA and MetS and should be investigated as potential therapeutic adjuncts.

Use of Guazuma ulmifolia Lam. Stem Bark Extracts to Prevent High-Fat Diet Induced Metabolic Disorders in Mice

This study aimed to evaluate the effects of supplementation with ethanolic and aqueous extracts from the bark of the stem of Guazuma ulmifolia in mice submitted to a high-fat diet as well as to evaluate the chemical composition of these extracts. The chemical composition and antioxidant potential was evaluated in aqueous and ethanolic extracts of the stem bark. The in vivo test consisted of evaluating the effects of the aqueous and ethanolic extracts of the stem bark on C57BL/6 mice receiving a high-fat diet. The animals were evaluated for weight gain, feed consumption, visceral adiposity, serum, and inflammatory and hormonal parameters. The results of the chemical analyses corroborate those obtained by the literature, which reported gallocatechin, epigallocatechin and epigallocatechin gallate. Compared with the ethanolic extract, the aqueous extract showed greater antioxidant capacity. Both extracts resulted in lower feed consumption in the animals, but they did not influence weight gain or visceral adiposity and resulted in varied changes in the lipid profile. In addition, they did not influence glucose tolerance, insulin sensitivity, or fasting blood glucose. Furthermore, the leptin levels increased, which may have contributed to satiety, but this was shown to have a negative impact on other inflammatory and hormonal parameters. Therefore, under the conditions of this study, the biologically active compounds present in the plant species Guazuma ulmifolia were not able to contribute to the treatment of metabolic changes related to the consumption of a high-fat diet.

Oral Findings, Salivary Copper, Magnesium, and Leptin in Type II Diabetic Patients in Relation to Oral Candida Species

Background

Type 2 diabetes is a condition in which the body becomes resistant to the effects of insulin, leading to reduced insulin production in the pancreas. It has genetic- and family-related risk factors that cannot be changed, along with modifiable lifestyle factors. The precise genetic causes of type 2 diabetes are still unknown. However, individuals can potentially slow or stop the progression of the condition by making dietary adjustments and increasing physical activity levels. Material and Methods. Forty-five type II diabetic patients in the study included participants between 40 and 60 years old, with a minimum duration of one year, as well as 45 healthy control subjects who were matched in terms of age and sex, and had no underlying systemic diseases. Oral examination is done for the symptoms including burning sensation, candidiasis, and a reduction in the production of saliva. The rate of saliva flow (in milliliters per minute) was measured in samples of saliva that were not stimulated. The salivary trace elements and levels of adipocytokines were evaluated using colorimetric and Ethylenediaminetetraacetic acid (ELISA) testing. The quantification of Candida colony numbers, an enrichment and culture approach, was used to achieve a concentration of 100,000 colony-forming units per milliliter (CFU/ml). The ShowNovo WG1 halimeter was used to measure volatile sulfur compounds in breath. The salivary glucose oxidase assay was conducted using a colorimetric technique, while the determination of trace elements was also performed using a colorimetric assay method.

Result

The diabetic group exhibited a significant increase in the number of Candida spp colonies due to elevated levels of glucose in the saliva (p > 0.05). However, the variables being examined, such as body mass index (BMI), burning mouth syndrome (BMS), salivary flow rate (SFR), salivary leptin, salivary copper, and salivary magnesium, did not exhibit any significant variations in quantities between the diabetic and healthy groups (p > 0.05).

Conclusion

The data collected in this research aid in the creation of a preventative program for oral fungal infections in individuals with type 2 diabetes. The program utilizes saliva and its constituents.

Antimicrobial management of dental infections: Updated review

Dental infections, which include anything from severe periodontal illnesses and abscess forms to routine tooth caries, are a major public health risk. This review article focuses on the pathophysiology and treatment of dental infections. A narrative review was conducted based on several published articles, relevant journals, and books in Google Scholar PubMed using the keywords dental caries, periodontal disease, gingivitis, and related diseases; we excluded duplicated information. Our review illustrated the types of dental infections and the proper antimicrobial drug that is suitable for this disease. Drawing from recent research findings and clinical evidence, we explore the spectrum of bacteria commonly associated with dental infections and their susceptibility profiles to various antibiotics. Emphasis is placed on understanding the mechanisms of antibiotic action and resistance in the context of dental pathogens, shedding light on optimal treatment regimens and potential challenges in clinical management. Additionally, we go over the clinical consequences of antibiotic therapy in dentistry, taking into account factors like patient selection, dose guidelines, and side effects. The management of dental infections through antimicrobial strategies has undergone significant advancements, as evidenced by this updated review. Besides the normal methods, emerging technologies such as 3D printing for drug delivery of antibiotics and disinfectants hold promise in enhancing treatment efficacy and patient outcomes. By leveraging the precision and customization afforded by 3D printing, dentistry can tailor antimicrobial interventions to individual patient needs, optimizing therapeutic outcomes while minimizing adverse effects.

The Intersection of the Pathogenic Processes Underlying Psoriasis and the Comorbid Condition of Obesity

In the past decade, our understanding of psoriasis pathogenesis has made significant steps forward, leading to the development of multiple game-changing therapies. While psoriasis primarily affects the skin, it is increasingly recognized as a systemic disease that can have effects beyond the skin. Obesity is associated with more severe forms of psoriasis and can potentially worsen the systemic inflammation and metabolic dysfunction seen in psoriatic patients. The exact mechanisms underlying the link between these two conditions are not fully understood, but it is believed that chronic inflammation and immune dysregulation play a role. In this review, we examine the existing body of knowledge regarding the intersection of pathogenic processes responsible for psoriasis and obesity. The ability of biological therapies to reduce systemic and obesity-related inflammation in patients with psoriasis will be also discussed.

Adaptive thermogenesis, at the level of resting energy expenditure, after diet alone or diet plus bariatric surgery

OBJECTIVE

The objective of this study was to compare the magnitude of adaptive thermogenesis (AT), at the level of resting energy expenditure (REE), after a very low-energy diet alone or combined with Roux-en-Y gastric bypass or sleeve gastrectomy, as well as to investigate the association between AT and changes in appetite.

METHODS

A total of 44 participants with severe obesity underwent 10 weeks of a very low-energy diet alone or combined with Roux-en-Y gastric bypass or sleeve gastrectomy. Body weight and composition, REE, subjective appetite feelings, and plasma concentrations of gastrointestinal hormones were measured at baseline and week 11. AT, at the level of REE, was defined as a significantly lower measured versus predicted (using a regression model with baseline data) REE.

RESULTS

Participants lost 18.4 ± 3.9 kg of body weight and experienced AT, at the level of REE (-121 ± 188 kcal/day; p < 0.001), with no differences among groups. The larger the AT, at the level of REE, the greater the reduction in fasting ghrelin concentrations and the smaller the reduction in feelings of hunger and desire to eat in the postprandial state.

CONCLUSIONS

Weight-loss modality does not seem to modulate the magnitude of AT, at the level of REE. The greater the AT, at the level of REE, the greater the drive to eat following weight loss.

Can Adipokine FAM19A5 Be a Biomarker of Metabolic Disorders?

Aim

One of the most critical functions of adipose tissue is the production of adipokines, ie, numerous active substances that regulate metabolism. One is the newly discovered FAM19A5, whose older name is TAFA-5.

Purpose

The study aimed to review the literature on the FAM19A5 protein.

Methods

The review was conducted in December 2023 using the PubMed (Medline) search engine. Sixty-four papers were included in the review.

Results

This protein exhibits the characteristics of an adipokine with positive features for maintaining homeostasis. The results showed that FAM19A5 was highly expressed in adipose tissue, with mild to moderate expression in the brain and ovary. FAM19A5 may also inhibit vascular smooth muscle cell proliferation and migration through the perivascular adipose tissue paracrine pathway. Serum levels of FAM19A5 were decreased in obese children compared with healthy controls. There are negative correlations between FAM19A5, body mass index, and fasting insulin. Serum FAM19A5 level is correlated with type 2 diabetes, waist circumference, waist-to-hip ratio, glutamic pyruvic transferase, fasting plasma glucose, HbA1c, and mean shoulder pulse wave velocity. FAM19A5 expression was reduced in mice with obesity. However, the data available needs to be clarified or contradictory.

Conclusion

Considering today's knowledge about FAM19A5, we cannot consider this protein as a biomarker of the metabolic syndrome. According to current knowledge, FAM19A5 cannot be considered a marker of metabolic disorders because the results of studies conducted in this area are unclear.

Potential of postbiotics for the treatment of metabolic disorders

Postbiotics, the next generation of probiotics, are extracts that are free of living and nonviable bacteria and show strong modulatory effects on the gut flora. Examples include vitamin B12, vitamin K, folate, lipopolysaccharides, enzymes, and short-chain fatty acids (SCFAs), representing a subset of essential nutrients commonly found in the human diet. Postbiotics have been observed to demonstrate antiobesity and antidiabetic effects through a variety of mechanisms. These pathways primarily involve an elevation in energy expenditure, a decrease in the formation and differentiation of adipocytes and food intake, modification of lipid and carbohydrate absorption and metabolism, and regulation of gut dysbiosis. Based on these above effects and mechanisms, the use of postbiotics can be considered as potential strategy for the treatment of metabolic disorders.

ANMCO (Italian Association of Hospital Cardiologists) scientific statement: obesity in adults-an approach for cardiologists

Obesity is a complex, chronic disease requiring a multidisciplinary approach to its management. In clinical practice, body mass index and waist-related measurements can be used for obesity screening. The estimated prevalence of obesity among adults worldwide is 12%. With the expected further increase in overall obesity prevalence, clinicians will increasingly be managing patients with obesity. Energy balance is regulated by a complex neurohumoral system that involves the central nervous system and circulating mediators, among which leptin is the most studied. The functioning of these systems is influenced by both genetic and environmental factors. Obesity generally occurs when a genetically predisposed individual lives in an obesogenic environment for a long period. Cardiologists are deeply involved in evaluating patients with obesity. Cardiovascular risk profile is one of the most important items to be quantified to understand the health risk due to obesity and the clinical benefit that a single patient can obtain with weight loss. At the individual level, appropriate patient involvement, the detection of potential obesity causes, and a multidisciplinary approach are tools that can improve clinical outcomes. In the near future, we will probably have new pharmacological tools at our disposal that will facilitate achieving and maintaining weight loss. However, pharmacological treatment alone cannot cure such a complex disease. The aim of this paper is to summarize some key points of this field, such as obesity definition and measurement tools, its epidemiology, the main mechanisms underlying energy homeostasis, health consequences of obesity with a focus on cardiovascular diseases and the obesity paradox.Level of evidence V: report of expert committees.

Neuropeptide Network of Polycystic Ovary Syndrome - A Review

BACKGROUND

Polycystic Ovary Syndrome (PCOS), the ubiquitous reproductive disorder, has been documented as highly prevalent (6-9%) in India. 10% of women globally are predicted to have the disease. The highly mutable endocrinopathy, with differential clinical criteria for each diagnosis of PCOS, can mask the severity of the syndrome by influencing the incidence and occurrence of PCOS.

AREA COVERED

When there is a solid theoretical hypothesis between the neuroendocrine origin and ovarian origin of PCOS, recent evidence supports the neuroendocrine derivation of the pathology. It is considered of neuroendocrine basis - as it controls the ovarian axis and acts as a delicate target because it possesses receptors for various gonadal hormones, neurotransmitters & neuropeptides. Can these neuroendocrine alterations, variations in central brain circuits, and neuropeptide dysregulation be the tie that would link the pathophysiology of the disorder, the occurrence of all the 1˚ and 2˚ symptoms like polycystic ovaries, hyperandrogenism, obesity, insulin resistance, etc., in PCOS?

CONCLUSION

This review anticipates providing a comprehensive overview of how neuropeptides such as Kisspeptin, Neurokinin B, Dynorphin A, β-Endorphin, Nesfatin, Neuropeptide Y, Phoenixin, Leptin, Ghrelin, Orexin, and Neudesin influence PCOS, the understanding of which may help to establish potential drug candidates against precise targets in these central circuits.

Sensitivity of the Neuroendocrine Stress Axis in Metabolic Diseases

Metabolic diseases are prevalent in modern society and have reached pandemic proportions. Metabolic diseases have systemic effects on the body and can lead to changes in the neuroendocrine stress axis, the critical regulator of the body's stress response. These changes may be attributed to rising insulin levels and the release of adipokines and inflammatory cytokines by adipose tissue, which affect hormone production by the neuroendocrine stress axis. Chronic stress due to inflammation may exacerbate these effects. The increased sensitivity of the neuroendocrine stress axis may be responsible for the development of metabolic syndrome, providing a possible explanation for the high prevalence of severe comorbidities such as heart disease and stroke associated with metabolic disease. In this review, we address current knowledge of the neuroendocrine stress axis in response to metabolic disease and discuss its role in developing metabolic syndrome.

Leptin-Mediated Induction of IL-6 Expression in Hofbauer Cells Contributes to Preeclampsia Pathogenesis

Leptin plays a crucial role in regulating energy homoeostasis, neuroendocrine function, metabolism, and immune and inflammatory responses. The adipose tissue is a main source of leptin, but during pregnancy, leptin is also secreted primarily by the placenta. Circulating leptin levels peak during the second trimester of human pregnancy and fall after labor. Several studies indicated a strong association between elevated placental leptin levels and preeclampsia (PE) pathogenesis and elevated serum interleukin-6 (IL-6) levels in PE patients. Therefore, we hypothesized that a local increase in placental leptin production induces IL-6 production in Hofbauer cells (HBCs) to contribute to PE-associated inflammation. We first investigated HBCs-specific IL-6 and leptin receptor (LEPR) expression and compared their immunoreactivity in PE vs. gestational age-matched control placentas. Subsequently, we examined the in vitro regulation of IL-6 as well as the phosphorylation levels of intracellular signaling proteins STAT3, STAT5, NF-κB, and ERK1/2 by increasing recombinant human leptin concentrations (10 to 1000 ng/mL) in primary cultured HBCs. Lastly, HBC cultures were incubated with leptin ± specific inhibitors of STAT3 or STAT5, or p65 NF-κB or ERK1/2 MAPK signaling cascades to determine relevant cascade(s) involved in leptin-mediated IL-6 regulation. Immunohistochemistry revealed ~three- and ~five-fold increases in IL-6 and LEPR expression, respectively, in HBCs from PE placentas. In vitro analysis indicated that leptin treatment in HBCs stimulate IL-6 in a concentration-dependent manner both at the transcriptional and secretory levels (p < 0.05). Moreover, leptin-treated HBC cultures displayed significantly increased phosphorylation levels of STAT5, p65 NF-κB, and ERK1/2 MAPK and pre-incubation of HBCs with a specific ERK1/2 MAPK inhibitor blocked leptin-induced IL-6 expression. Our in situ results show that HBCs contribute to the pathogenesis of PE by elevating IL-6 expression, and in vitro results indicate that induction of IL-6 expression in HBCs is primarily leptin-mediated. While HBCs display an anti-inflammatory phenotype in normal placentas, elevated levels of leptin may transform HBCs into a pro-inflammatory phenotype by activating ERK1/2 MAPK to augment IL-6 expression.

Frailty in end-stage liver disease: Understanding pathophysiology, tools for assessment, and strategies for management

Frailty and sarcopenia are frequently observed in patients with end-stage liver disease. Frailty is a complex condition that arises from deteriorations across various physiological systems, including the musculoskeletal, cardiovascular, and immune systems, resulting in a reduced ability of the body to withstand stressors. This condition is associated with declined resilience and increased vulnerability to negative outcomes, including disability, hospitalization, and mortality. In cirrhotic patients, frailty is influenced by multiple factors, such as hyperammonemia, hormonal imbalance, malnutrition, ascites, hepatic encephalopathy, and alcohol intake. Assessing frailty is crucial in predicting morbidity and mortality in cirrhotic patients. It can aid in making critical decisions regarding patients' eligibility for critical care and transplantation. This, in turn, can guide the development of an individualized treatment plan for each patient with cirrhosis, with a focus on prioritizing exercise, proper nutrition, and appropriate treatment of hepatic complications as the primary lines of treatment. In this review, we aim to explore the topic of frailty in liver diseases, with a particular emphasis on pathophysiology, clinical assessment, and discuss strategies for preventing frailty through effective treatment of hepatic complications. Furthermore, we explore novel assessment and management strategies that have emerged in recent years, including the use of wearable technology and telemedicine.

Obesity associated pancreatic ductal adenocarcinoma: Therapeutic challenges

Obesity is a prominent health issue worldwide and directly impacts pancreatic health, with obese individuals exhibiting a significant risk for increasing pancreatic ductal adenocarcinoma (PDAC). Several factors potentially explain the increased risk for the development of PDAC, including obesity-induced chronic inflammation within and outside of the pancreas, development of insulin resistance and metabolic dysfunction, promotion of immune suppression within the pancreas during inflammation, pre- and malignant stages, variations in hormones levels (adiponectin, ghrelin, and leptin) produced from the adipose tissue, and acquisition of somatic mutations in tumor once- and suppressor proteins critical for pancreatic tumorigenesis. In this manuscript, we will explore the broad impact of these obesity-induced risk factors on the development and progression of PDAC, focusing on changes within the tumor microenvironment (TME) as they pertain to prevention, current therapeutic strategies, and future directions for targeting obesity management as they relate to the prevention of pancreatic tumorigenesis.

A review of the pathophysiology and evidence-based management of varicoceles and pelvic congestion syndrome

Pelvic congestion syndrome (PCS) in females and varicoceles in males may be regarded as closely related conditions since the main pathophysiological cause for both processes is pelvic venous insufficiency. Varicoceles are more prevalent amongst sub-fertile males, with an approximate incidence of 15% in the general male population. PCS is commonly diagnosed amongst premenopausal multiparous women, representing one of the leading causes of chronic pelvic pain. Both conditions appear to be predominantly left-sided and are associated with oxidative stress and pro-inflammatory cascades with subsequent effects on fertility. Clinical examination and pelvic ultrasonography play an essential role in the assessment of varicoceles, PCS and chronic pelvic pain. Venography is generally considered as a gold-standard procedure for both conditions. There is still much debate on how these conditions should be managed. This review article provides a comparative analysis of the underlying pathophysiological mechanisms of both PCS and varicoceles, their impact on fertility, as well as their clinical management.

Associations of leptin receptors and miRNA polymorphisms with susceptibility to hypertension

Leptin receptors (LEPR) are located in the central nervous system and other tissues including adipocytes and endothelial cells, where they play a key role in mediating the effects of leptin. MicroRNA (miR/miRNA)-27a and miR-155 have been shown to play an important role in the regulation of LEPR expression and are differentially expressed in various diseases. Therefore, the present study analyzed potential associations of LEPR deletion/insertion (Del/Ins), miR-27aA>G (rs895819) and miR-155T>A (rs767649) polymorphisms with a predisposition to hypertension (HTN). Genotyping was performed by a PCR-restriction fragment length polymorphism assay. Frequencies of LEPR Del/Ins and miRNA gene polymorphisms in patients diagnosed with HTN (n=232) and randomly selected healthy controls (n=247) were assessed. The present study found that Del/Ins and Ins/Ins genotypes and the Ins allele of the LEPR Del/Ins polymorphism were associated with a decreased risk of HTN compared with controls, whereas the miR-27aA>G rs895819 polymorphism was associated with an increased risk of HTN. Combined genotype and allele analyses for LEPR Del/Ins and two miRNA polymorphisms revealed an association with an increased risk or a decreased risk of HTN. Furthermore, stratification analysis revealed that HTN risk factors were associated with waist circumference (WC) and high-density lipoprotein cholesterol (HDL-C) values in LEPR Del/Ins polymorphism. They were also associated with body mass index, WC, triglyceride and HDL-C values in miR-27aA>G polymorphism. The present study revealed a combined effect of LEPR Del/Ins and miR-27aA>G polymorphisms on the risk of HTN in Koreans, suggesting that these gene polymorphisms could be potential markers for predicting HTN risk.

Gender Differences in the Pathogenesis and Risk Factors of Hepatocellular Carcinoma

Several chronic liver diseases are characterized by a clear gender disparity. Among them, hepatocellular carcinoma (HCC) shows significantly higher incidence rates in men than in women. The different epidemiological distribution of risk factors for liver disease and HCC only partially accounts for these gender differences. In fact, the liver is an organ with recognized sexual dysmorphism and is extremely sensitive to the action of androgens and estrogens. Sex hormones act by modulating the risk of developing HCC and influencing its aggressiveness, response to treatments, and prognosis. Furthermore, androgens and estrogens are able to modulate the action of other factors and cofactors of liver damage (e.g., chronic HBV infection, obesity), significantly influencing their carcinogenic power. The purpose of this review is to examine the factors related to the different gender distribution in the incidence of HCC as well as the pathophysiological mechanisms involved, with particular reference to the central role played by sex hormones.

Chemotherapy-induced cardiotoxicity: a new perspective on the role of Digoxin, ATG7 activators, Resveratrol, and herbal drugs

Cancer is a major public health problem, and chemotherapy plays a significant role in the management of neoplastic diseases. However, chemotherapy-induced cardiotoxicity is a serious side effect secondary to cardiac damage caused by antineoplastic's direct and indirect toxicity. Currently, there are no reliable and approved methods for preventing or treating chemotherapy-induced cardiotoxicity. Understanding the mechanisms of chemotherapy-induced cardiotoxicity may be vital to improving survival. The independent risk factors for developing cardiotoxicity must be considered to prevent myocardial damage without decreasing the therapeutic efficacy of cancer treatment. This systematic review aimed to identify and analyze the evidence on chemotherapy-induced cardiotoxicity, associated risk factors, and methods to decrease or prevent it. We conducted a comprehensive search on PubMed, Google Scholar, and Directory of Open Access Journals (DOAJ) using the following keywords: "doxorubicin cardiotoxicity", "anthracycline cardiotoxicity", "chemotherapy", "digoxin decrease cardiotoxicity", "ATG7 activators", retrieving 59 articles fulfilling the inclusion criteria. Therapeutic schemes can be changed by choosing prolonged infusion application over boluses. In addition, some agents like Dexrazoxane can reduce chemotherapy-induced cardiotoxicity in high-risk groups. Recent research found that Digoxin, ATG7 activators, Resveratrol, and other medical substances or herbal compounds have a comparable effect on Dexrazoxane in anthracycline-induced cardiotoxicity.

Crosstalk of Inflammatory Cytokines within the Breast Tumor Microenvironment

Several immune and immunocompetent cells, including dendritic cells, macrophages, adipocytes, natural killer cells, T cells, and B cells, are significantly correlated with the complex discipline of oncology. Cytotoxic innate and adaptive immune cells can block tumor proliferation, and others can prevent the immune system from rejecting malignant cells and provide a favorable environment for tumor progression. These cells communicate with the microenvironment through cytokines, a chemical messenger, in an endocrine, paracrine, or autocrine manner. These cytokines play an important role in health and disease, particularly in host immune responses to infection and inflammation. They include chemokines, interleukins (ILs), adipokines, interferons, colony-stimulating factors (CSFs), and tumor necrosis factor (TNF), which are produced by a wide range of cells, including immune cells, such as macrophages, B-cells, T-cells, and mast cells, as well as endothelial cells, fibroblasts, a variety of stromal cells, and some cancer cells. Cytokines play a crucial role in cancer and cancer-related inflammation, with direct and indirect effects on tumor antagonistic or tumor promoting functions. They have been extensively researched as immunostimulatory mediators to promote the generation, migration and recruitment of immune cells that contribute to an effective antitumor immune response or pro-tumor microenvironment. Thus, in many cancers such as breast cancer, cytokines including leptin, IL-1B, IL-6, IL-8, IL-23, IL-17, and IL-10 stimulate while others including IL-2, IL-12, and IFN-γ, inhibit cancer proliferation and/or invasion and enhance the body's anti-tumor defense. Indeed, the multifactorial functions of cytokines in tumorigenesis will advance our understanding of cytokine crosstalk pathways in the tumor microenvironment, such as JAK/STAT, PI3K, AKT, Rac, MAPK, NF-κB, JunB, cFos, and mTOR, which are involved in angiogenesis, cancer proliferation and metastasis. Accordingly, targeting and blocking tumor-promoting cytokines or activating and amplifying tumor-inhibiting cytokines are considered cancer-directed therapies. Here, we focus on the role of the inflammatory cytokine system in pro- and anti-tumor immune responses, discuss cytokine pathways involved in immune responses to cancer and some anti-cancer therapeutic applications.

Cytotoxic Activity of the Ethyl Acetate Extract of Iraqi Carica papaya Leaves in Breast and Lung Cancer Cell Lines

The aim of this study was to evaluate the cytotoxic effect of the ethyl acetate fraction of Iraqi Carica papaya (C. papaya) in breast and lung cancer cell lines, MCF-7 and A549, respectively.

METHODS

The ethyl acetate extract of Iraqi C. papaya leaves was prepared and tested for its phytochemical constitution.  The  3-(4,5-dimethylthiazoline-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed in breast (MCF-7) and lung (A549) cells lines that were treated with different concentrations of ethyl acetate extract (3.125,6.25,12.5, 25, 50, and 100μg/ml). After 72 hrs of treatment, cell viability was evaluated.

RESULTS

The ethyl acetate extract of C. papaya showed considerable cytotoxic activity in the MCF-7 and A549 cell lines. The activity was dose-dependent; The half-maximum inhibitory concentration (IC50) values were 22.74μg/ml and 8.674 μg/ml in the MCF-7 and A549 cell lines, respectively.

CONCLUSION

The  ethyl acetate fraction of Iraqi C. papaya leaves has potential anticancer activity in lung and breast cancer.

Allelic to genome wide perspectives of swine genetic variation to litter size and its component traits

Litter size is a complex and sex limited trait that depends on various biological, managemental and environmental factors. Owing to its low heritability it is inefficaciously selected by traditional methods. However, due to higher heritability of ovulation rate and embryo survival, selection based on component traits of litter size is advocated. QTL analysis and candidate gene approach are among the various supplementary/alternate strategies for selection of litter size. QTL analysis is aimed at identifying genomic regions affecting trait of interest significantly. Candidate gene approach necessitates identification of genes potentially affecting the trait. There are various genes that significantly affect litter size and its component traits viz. ESR, LEP, BF, IGFBP, RBP4, PRLR, CTNNAL1, WNT10B, TCF12, DAZ, and RNF4. These genes affect litter size in a complex interacting manner. Lately, genome wide association study (GWAS) have been utilized to unveil the genetic and biological background of litter traits, and elucidate the genes governing litter size. Favorable SNPs in these genes have been identified and offers a scope for inclusion in selection programs thereby increasing breeding efficiency and profit in pigs. The review provides a comprehensive coverage of investigations carried out globally to unravel the genetic variation in litter size and its component traits in pigs, both at allelic and genome wide level. It offers a current perspective on different strategies including the profiling of candidate genes, QTLs, and genome wide association studies as an aid to efficient selection for litter size and its component traits.

Non-alcoholic fatty liver disease: relation to juvenile obesity, lipid profile, and hepatic enzymes

The prevalence of juvenile obesity is increasing, reaching epidemic proportions, presenting a link not only to NAFLD (non-alcoholic fatty liver disease) but to abnormal lipid profiles and liver enzyme abnormalities. Liver ultrasonography is a sensitive and specific tool for the recognition of NAFLD. This study aims to assess the association between NAFLD and juvenile obesity and to determine the other related changes in a set of indicators, including lipid profile abnormalities and serum transaminases. The sample included 470 obese and 210 non-obese individuals aged 6-16. Anthropometric measures were assessed, with the serum lipid profile and liver transaminases, and abdominal ultrasonography was used to detect NAFLD. Fatty liver was found in 38% of the obese subjects and none of the non-obese subjects. Within obese subjects, mean body mass index (BMI) and waist circumference increased significantly in patients with NAFLD compared to those without fatty liver. Moreover, LDL (low-density lipoprotein), CHOL (cholesterol), and serum liver enzymes were significantly higher in the presence of NAFLD. In conclusion, NAFLD commonly associates with juvenile obesity, relating to obesity and the abnormal lipid profile (including elevated CHOL and LDL) among obese people, reflecting elevated liver transaminases, which increase the risk of cirrhosis.

Relationships between Sclerostin, Leptin and Metabolic Parameters in Non-Dialysis Chronic Kidney Disease Males

Sclerostin is an inhibitor of the Wnt-beta-catenin pathway. The relationship between sclerostin and adipose tissue or between sclerostin and nutritional status has been the subject of research interest in the last decade. Sclerostin concentrations are elevated in patients with chronic kidney disease (CKD). Leptin is an adipocytokine which inhibits food intake by stimulating the satiety center in the hypothalamus. Leptin concentrations rise with the reduction of eGFR (glomerular filtration rate). The aim of this study was to investigate the possible association between sclerostin and leptin, between sclerostin and selected poor prognostic factors of CKD progression, and between sclerostin and nutritional parameters in non-dialysis CKD male patients. 101 men with non-dialysis CKD stage 3-5 were included in the study. Bioimpedance spectroscopy (BIS) was used to measure body composition. Blood samples were drawn to measure the serum concentrations of sclerostin, leptin, creatinine, hemoglobin (Hgb), parathormone (PTH), inflammatory markers, and markers of nutritional status. We also measured homeostatic model assessment of insulin resistance (HOMA-IR) as well as blood pressure. We observed a significant, positive relationship between sclerostin and age, leptin, and glycated hemoglobin (HgbA1c) concentrations. A significant, negative association was observed between sclerostin and eGFR. Sclerostin is associated with leptin in non-dialysis CKD male patients. Sclerostin is also related to metabolic disturbances such as hyperglycemia in this population.

Telomerase and Anticancer Treatment

Current chemotherapy uses compounds of organometallic nature that act with different mechanisms of action. Many pharmacological studies are directed toward the creation of compounds with more specific and selective activity toward tumor targets, including telomerase. The design and synthesis of such compounds with specific antitelomerase activity must consider the mechanism of action of the enzyme and its structure. The discovery of a close correlation between telomerase activation, cell immortalization and oncogenesis has suggested that telomerase inhibitors could be potent therapeutic agents, capable of selectively killing cancer cells. Inhibition of telomerase is expected to lead toward shortening of telomeres to a critical length, such that replicative senescence and cell death due to irreparable chromosomal damage can result. It has been observed that cancer cells generally have shorter telomeres than the normal replicative cell population, probably because the malignant cells have undergone more divisions. Therefore, the inhibition telomeres of cancer cells after a few cycles of cell division, without the normal cells suffering harmful consequences during therapy. Telomerase is certainly an interesting target on which to continue to study molecules that inhibit its function to obtain a specificity of therapeutic intervention and a reduction of the nonspecific cytotoxicity of chemotherapy.

The role of COVID-19 in myopathy: incidence, causes, treatment, and prevention

Myopathy is a disease characterized by muscle dysfunction in general and may be associated with genetics, medication such as statins, or inflammation. In 2019, an epidemic viral infection (SARS-CoV-2 virus) that invaded most countries worldwide appeared and caused acute respiratory disease. Consequently, patients had to take a group of drugs for a relatively long treatment period. According to several studies, there was an increase in the cases of muscular disorders due to several factors. This study aimed to (1) investigate the relationship between COVID-19 and myopathy and (2) identify the causes and prevention methods. A systematic review was conducted, analyzing several articles from the following databases: ResearchGate, Medline, DOAJ (The Directory of Open-Access Journals), PubMed, and Google Scholar. After performing the search and filtering the results, we included 61 articles. There was a strong relationship between COVID-19 and myopathy, especially in patients admitted to the ICU department, due to medication or neurological dysregulation with multiorgan dysfunctions such as polyneuropathy, peripheral nerve involvement, dysautonomia, Guillain-Barré syndrome, and many others.

Impact of Obesity on the Course of Management of Inflammatory Bowel Disease-A Review

It is already well-known that visceral adipose tissue is inseparably related to the pathogenesis, activity, and general outcome of inflammatory bowel disease (IBD). We are getting closer and closer to the molecular background of this loop, finding certain relationships between activated mesenteric tissue and inflammation within the lumen of the gastrointestinal tract. Recently, relatively new data have been uncovered, indicating a direct impact of body fat on the pattern of pharmacological treatment in the course of IBD. On the other hand, ileal and colonic types of Crohn's disease and ulcerative colitis appear to be more diversified than it was thought in the past. However, the question arises whether at this stage we are able to translate this knowledge into the practical management of IBD patients or we are still exploring the scientific background of this pathology, having no specific tools to be used directly in patients. Our review explores IBD in the context of obesity and associated disorders, focusing on adipokines, creeping fat, and possible relationships between these disorders and the treatment of IBD patients.

Effect of Gender on Serum Leptin in Type 2 Diabetes Mellitus: A System Review and Meta-Analysis

Objective

To assess the effect of gender factors on serum leptin levels in patients with diabetes mellitus.

Methods

To remove any studies that indicated a relationship between leptin-based inflammatory variables and the prevalence of type 2 diabetes in particular patient categories, a comprehensive search of all articles published between July 2019 and June 2021 was performed on PubMed/MEDLINE, Web of Science, Scopus, and EBSCO Host, including Academic Search Premier, Africa-Wide Information, and Cumulative Index to Nursing and Allied Health Literature. A summary description of the combined analysis across multiple centers, regions, and continents will help us better understand the effect of gender on serum leptin levels in patients with diabetes. The meta-analysis was performed using RevMan 5.2 software on the literature that satisfied the inclusion and exclusion criteria.

Results

Plasma CRP levels in women with type 2 diabetes were found to be no different from those in males with type 2 diabetes, with an OR of 0.12, 95 percent confidence interval (CI) of 0.12 to 0.12, P = 0.01. There was no statistically significant difference in the plasma level of interleukin-6 (IL-6) between women with type 2 diabetes and males with type 2 diabetes However, the “inverted funnel” diagram is asymmetrical, indicating a publication bias in the included studies, despite the fact that there was no statistically significant difference in abnormal leptin levels between men with type 2 diabetes and women patients (OR = −0.69, 95 percent CI (0.88, 1.00), P < 0.05).

Conclusion

Gender factors did not affect the level of inflammatory factors and leptin level in type 2 diabetes.

Knowledge, Attitude, and Practice Regarding Needle Stick Injuries Among Health Care Workers in Baghdad Teaching Hospital and Ghazy Al-Hariri Hospital for Surgical Specialties in 2020

Background: Needle stick injuries are serious occupational hazards in the transmission of a variety of bloodborne diseases, more than twenty pathogens can be transmitted through NSI including hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (AIDS) among healthcare workers. Objectives: Assess the knowledge, attitude and practice of health care workers towards needle stick injuries. Determine the prevalence of needle stick injuries among healthcare workers and its predisposing factors.  Methods: Cross-sectional descriptive study, a convenient sample of 260 health care workers was selected from Baghdad Teaching hospital and Ghazy Al Hariri hospital in Baghdad, Iraq. Data were collected by an anonymous questionnaire from January to June 2020. The collected data were analyzed by using statistical package for the social sciences (SPSS version 23). Results Prevalence of NSIs among HCWs was found to be 53.8%, which was higher in nurses (29.3%) and laboratory technicians (28.5%) followed by surgeon doctors (15.7%), assistant surgeons (13.6%) and dentists (12.9%) .The highest number of needle stick injuries occurred by recapping of needles (41.4%) followed by during drug administration (27.9%), from hand to hand  (10.7%) and during blood drawing (7.9%). A proportion of (64.5%) of  health care workers whom sustained needle stick injury had reported their Injury. Doctors scored better than others regarding mean scores of knowledge, attitude and practice. There was a highly significant association among knowledge, attitude and practice scores of the HCWs (P<0.001). A considerable percentage of the participants (80.2%) were completely immunized against HBV. Conclusions: The study showed a high prevalence of NSIs among health care workers. The score of knowledge was high, moreover acceptable responses were obtained in most attitude and practice statements, except for recapping of needles statements.  

Leptin mediates the suppressive effect of partial fat removal on cellular and humoral immunity in striped hamsters

Leptin secreted mainly by white adipose tissues (WAT) plays an important role in immune responses. To understand the role of energy status and leptin in immunity, bilateral perigonadal fat pads were removed or sham-removed in male striped hamsters (Cricetulus barabensis). Half of these hamsters were injected with sterile saline, and another half were administrated with exogenous leptin each day, which lasted for 20 days. Fat removal reduced total body fat mass and leptin titers significantly, leptin administration increased leptin levels in the fat removed hamsters to the control levels, but did not affect total body fat mass. Body mass and gross energy intake were not affected by fat removal, leptin supplement or their interaction. Fat removal decreased thymus mass, phytohaemagglutinin (PHA) response at 12 h, and the levels of immunoglobin (Ig) G 5, IgG10, IgM5, IgM10, IL-2, IL-4, and TNF-α, indicating a reduction in fat mass suppressed cellular and humoral immunity and the production of cytokines. However, fat removal had no effect on spleen mass, bacteria killing activity and IFN-γ titers. Leptin supplement increased PHA response at 6 h and 12 h, and the levels of IgG5, IgG10, IL-4, and IFN-γ to the control levels, implying its boosting effects on these parameters. In addition, leptin level was positively correlated with body fat mass, PHA 6 h, 12 h, Ig G10, Ig M5, Ig M10, IL-2, IL-4, and TNF-α. Collectively, these findings implied leptin was a link between energy status and immunity, and leptin mediated the suppressive effects of reduced energy storage on cellular and humoral immunity.

The Head-to-Toe Hormone: Leptin as an Extensive Modulator of Physiologic Systems

Leptin is a well-known hunger-sensing peptide hormone. The role of leptin in weight gain and metabolic homeostasis has been explored for the past two decades. In this review, we have tried to shed light upon the impact of leptin signaling on health and diseases. At low or moderate levels, this peptide hormone supports physiological roles, but at chronically higher doses exhibits detrimental effects on various systems. The untoward effects we observe with chronically higher levels of leptin are due to their receptor-mediated effect or due to leptin resistance and are not well studied. This review will help us in understanding the non-anorexic roles of leptin, including their contribution to the metabolism of various systems and inflammation. We will be able to get an alternative perspective regarding the physiological and pathological roles of this mysterious peptide hormone.

Large-scale isolation of functional dermal papilla cells using novel surface marker LEPR

Dermal papilla (DP) cells regulate hair follicle epithelial cells and melanocytes by secreting functional factors, playing a key role in hair follicle morphogenesis and hair growth. DP cells can reconstitute new hair follicles and induce hair regeneration, providing a potential therapeutic strategy for treating hair loss. However, current methods for isolating DP cells are either inefficient (physical microdissection) or only applied to genetically labeled mice. We systematically screened for the surface proteins specifically expressed in skin DP using mRNA expression databases. We identified two antibodies against receptors LEPR and SCARA5 which could specifically label and isolate DP cells by flow cytometry from mice back skin at the growth phase. The sorted LEPR⁺ cells maintained the DP characteristics after culturing in vitro, expressing DP marker alkaline phosphatase and functional factors including RSPO1/2 and EDN3, the three major DP secretory factors that regulate hair follicle epithelial cells and melanocytes. Furthermore, the low-passage LEPR⁺ DP cells could reconstitute hair follicles on nude mice using chamber graft assay when combined with epithelial stem cells. The method of isolating functional DP cells we established here lays a solid foundation for developing DP cell-based therapy. This article is protected by copyright. All rights reserved.

The Use of Panax Ginseng to Reduce the Cardiotoxicity of Doxorubicin and Study its Effect on Modulating Oxidative Stress, Inflammatory, and Apoptosis Pathways

BACKGROUND: Doxorubicin (DOX) is a broad-spectrum anti-cancer drug that is used to treat a variety of cancers, including blood cancers such as leukemia and solid tissue cancers. However, its use some time limited because of its cardiotoxicity. OBJECTIVE: The objective of the study was to determine the cardioprotective effect of ginseng in the case of cardiotoxicity caused by doxorubicin therapy. Methods: Thirty experimental animals (male Sprague Wistar rats) were used in this research and they were separated into three groups: Rats in Group I (n# = 10) were given distilled water plus normal saline, rats in Group II (n# = 10) were given distilled water plus doxorubicin, and rats in Group III (n# = 10) were given Panax ginseng plus doxorubicin. Serum concentration, malondialdehyde (MDA), glutathione reductase (GSH), lipid peroxidase (LPO), TNF (ng/L), cardiac troponin (ng/L), brain natriuretic peptide BNP(g/L), and caspase-3 (pmol/L) levels were measured in all groups. RESULTS: Doxorubicin caused substantial cardiotoxicity as a result of a significant increase in the elevation of cTnI to 40.09 ± 6.67 (ng/L). In addition, MDA, LPO, TNF-α, and caspase-3 levels were increased in doxorubicin group compared to the control group p < 0.05. Panax ginseng reduced cardiac troponin (cTnI) However, its effect on reduction of BNP levels insignificantly compared to the doxorubicin group p = 0.06. Panax ginseng reduced LPO and MDA and raised the antioxidant potential biomarker GSH significantly compared to the doxorubicin group p < 0.05. Panax ginseng significantly reduced inflammatory (TNF-α) and apoptotic (caspase-3) biomarkers when compared to the doxorubicin group. CONCLUSIONS: According to the findings of this study, Panax ginseng suppresses reactive oxygen species and inflammatory and apoptotic pathways in experimental rats, thereby preventing doxorubicin-induced cardiovascular events.