Capparis spinosa improves non-alcoholic steatohepatitis through down-regulating SREBP-1c and a PPARα-independent pathway in high-fat diet-fed rats

Objective

Non-alcoholic steatohepatitis (NASH) has become a global medical problem. Currently, there is no approved pharmacologic treatment for this condition. Previous studies have suggested that in the pathogenesis of this disease, regulatory pathways associated with de novo lipogenesis and β-oxidation pathways genes are misregulated. Capparis spinosa (CS) belongs to the family of Capparidaceae and is a traditional plant used to treat various diseases, particularly dyslipidemia. The compounds and extracts of this plant in In vivo and in vitro studies resulted in a reduction in lipid profiles and glucose. However, the mechanism of these effects remains unknown. This study aimed to evaluate the effects of (CS) fruit extract on NASH compared to fenofibrate and explored the related molecular mechanism.

Results

In the rats (n = 40) model of NASH, biochemical and histopathological examinations showed that liver steatosis, inflammation, and hepatic fibrosis were markedly attenuated in response to CS and fenofibrate interventions. At the molecular level, CS treatment down-regulated sterol regulatory element-binding protein-1c (SREBP-1c) (p < 0.001), acetyl-CoA carboxylase (ACC) (p < 0.001), and up-regulated Carnitine palmitoyltransferase I (CPT1) expression (p < 0.001). In conclusion, CS has favorable therapeutic effects for NASH, which was associated with ameliorating steatosis and fibrosis via regulation of the DNL and β-oxidation pathway genes.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-022-06205-x.

Alleviative effects of fibroblast growth factor 21 on fibrogenic genes expression in the fructose activated hepatic stellate cells, an in vitro study

Introduction: Liver fibrosis occurs through hepatic stellate cells (HSCs) activation during chronic liver injury. Cytokines especially transforming growth factor-β (TGF-β), activate HSCs by an autocrine effect. The activated HSCs generate more α-smooth muscle actin (α-SMA) and Collagen1. The activation of human HSCs by high fructose concentrations has been confirmed. Fibroblast growth factor 21 (FGF21) as a hepatic hormone possesses favorable metabolic effects, but its effect on activated HSCs and the process of fibrogenesis have not been studied yet. Objectives: In this study, we evaluated the effect of FGF21 on suppressing the fructose-activated human HSCs and its effect on the TGF-β/ Smad3 signaling pathway. Materials and Methods: The LX-2 cells were grown in the presence of high fructose concentrations (25 and 30 mM) for 48 hours for activation and then were treated with FGF21. Quantitative real-time polymerase chain reaction (real-time PCR) was performed to measure the expression of fibrogenic genes and western blotting to analyze the TGF-β signaling. Results: Our results showed increased levels of mRNA expression of αSMA, collagen1, and TGF-β genes and smad3 phosphorylation in fructose-activated HSCs. FGF21 treatment significantly attenuated the induced fibrogenic gene expression and smad3 phosphorylation. Conclusion: High fructose leads to fibrogenic pathways in the liver by activating HSCs and increasing TGF-β signaling. FGF21 is effective in reducing fibrogenesis in activated HSCs through downregulating the TGF-β/smad3 signaling and fibrogenic gene expression. Therefore, FGF21 may provide anti-fibrotic properties in liver fibrosis.

Saroglitazar improved hepatic steatosis and fibrosis by modulating inflammatory cytokines and adiponectin in an animal model of non-alcoholic steatohepatitis

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) have become significant global health concerns. In the present study, we aimed to investigate the effects of saroglitazar, a dual PPARα/γ agonist, fenofibrate, a PPAR-α agonist, and pioglitazone, a PPAR-γ agonist on an animal model of NASH.

METHODS

Male Wistar rats were fed a high-fat (HF) emulsion via gavage for 7 weeks to induce NASH. The HF-treated rats were grouped into four groups to receive saroglitazar, pioglitazone, fenofibrate, or vehicle. We measured body and liver weight, liver enzymes, serum levels of adiponectin and leptin. We also performed histopathological examinations and gene expression analysis of interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF- α), transforming growth factor-beta (TGF-β), and monocyte chemoattractant protein 1 (MCP-1).

RESULTS

Body weight was markedly normalized by both saroglitazar and fenofibrate, while the liver index only decreased significantly with saroglitazar. Saroglitazar corrected ALT, AST, leptin, and adiponectin levels better than pioglitazone and fenofibrate. All PPAR agonists significantly attenuated the upregulation of the proinflammatory and TGF-β genes, which correlated with the improved steatosis, inflammation of liver tissue, and fibrotic lesions.

CONCLUSIONS

As documented by our results, the dual activation of PPARα/γ by saroglitazar could effectively improve steatosis, fibrosis, and aspects of necro-inflammation in the HF-induced NASH model more than fenofibrate and pioglitazone, and it can be more beneficial in the management of NASH.

Possible role of WNT10B in increased proliferation and tubule formation of human umbilical vein endothelial cell cultures treated with hypoxic conditioned medium from human adipocytes

Regulation of angiogenesis plays an important role in adipose tissue expansion and function. The Wnt pathway and WNT10B, the main member of Wnt family, participate in angiogenesis in cancer tumors, but there is limited evidence to support the regulatory role of WNT10B in human adipose tissue angiogenesis. Subcutaneous white adipose tissue (scWAT) of 80 participants including obese and non-obese subjects was obtained and the expression of WNT10B and VEGFA genes were evaluated using qPCR. Human adipose-derived stem cells (hADSC) were differentiated to adipocytes and incubated under either hypoxic or normoxic conditions. The conditioned media of these adipocytes were collected and used as growth media for human umbilical vein endothelial cells (HUVEC) in Matrigel. We evaluated the proliferation, cell cycle phases, tubule formation and β-catenin activation of these treated cells. We found a significant correlation between WNT10B and VEGFA expression in the scWAT of both obese and non-obese subjects. Proliferation and tubule formation of HUVEC treated with conditioned media of hypoxic adipocytes (hCM) in the S-phase were increased significantly compared to the HUVEC treated with the conditioned media of normoxic adipocytes (nCM). The expression of WNT10B and VEGFA was enhanced in hypoxic adipocytes compared to normoxic adipocytes; also, activation and nuclear translocation of β-catenin was enhanced in the HUVEC treated with hCM compared to nCM. WNT10B acts as an angiogenic protein in scWAT under hypoxic conditions. Hypoxia induced WNT10B increases VEGFA expression and causes tube formation by HUVECs and angiogenesis in adipose tissue via the canonical Wnt/β-catenin pathway.

The IFN-Ɣ + 874 A/T polymorphism is associated with malignant breast cancer in a population from the southwest of Iran

Objective

Breast cancer (BC) is one of the most common diseases in women globally, with an increasing number of deaths associated with it. Recently the role of polymorphisms in the genes encoding cytokines and immune cells has been demonstrated. This study aimed to evaluate the association of IFN-Ɣ + 874 A/T polymorphism with BC clinical symptoms.

Results

The study included 88 women with BC and 88 healthy women who had no history of cancer and were matched for age and sex. Allele-specific oligonucleotide-polymerase chain reaction technique was used to investigate the IFN-Ɣ polymorphism. Clinical data were obtained from the patients’ records. Our results showed that the frequencies of genotypes in the BC patients were not significantly different from the control subjects. However, in the patients, the AT genotype was associated with the risk of malignant BC. The age at BC diagnosis was not different in patients with AA and AT genotypes; however, it was significantly earlier in HER2 negative subjects (p = 0.002). Given the higher frequency of AT in malignant BC patients, our results confirm the association of the IFN-Ɣ polymorphism with the disease’s progression to a malignant state.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-021-05543-6.

The efficacy of calcitriol treatment in non-alcoholic fatty liver patients with different genotypes of vitamin D receptor FokI polymorphism

Background

Vitamin D deficiency is prevalent in patients with non-alcoholic fatty liver disease (NAFLD), but there are debates on the usefulness of vitamin D treatment. The interindividual variations in response may be due to different genetic backgrounds.

The present study evaluated the efficacy of calcitriol treatment in NAFLD patients with regard to the vitamin D receptor (VDR) genotypes of FokI polymorphism.

Methods

The study was conducted on 128 NAFLD patients randomly divided into two groups and were subjected to intervention with 0.25 mcg calcitriol/day or placebo for 4 months, while anthropometric parameters, glycemic status, lipid profiles, inflammatory markers, liver enzymes, and fatty liver indices were measured. The ARMS-PCR method was used to genotype the VDR FokI polymorphism.

Results

Calcitriol treatments along with weight loss and diet recommendations decreased the liver enzymes (AST, ALT, and ALP, p < 0.001 for all) and fatty liver indices (HSI, p < 0.01 and APRI, p < 0.001), compared to the baseline. But when the calcitriol effects were compared to the placebo group, only ALP decrease remained significant (17.5 IU. P = 0.02). The prevalent FokI variants in our population were FF (53.1%) and Ff genotype (45.3%). No significant interaction of FokI variants to the calcitriol effects was found except for ALP. The decrease in the ALP activity was higher in calcitriol-received patients with the Ff genotype (p = 0.05).

Conclusions

The FF and Ff variants of VDR FokI polymorphism did not interact with the effects of calcitriol on fatty liver, but the ALP was more responsive in subjects with the Ff variant.

IRCT registration number

IRCT2017053034222N1 Registration date: 2017-06-28 - Retrospectively registered, https://en.irct.ir/trial/26203

Capparis spinosa improves the high fat diet-induced non-alcoholic steatohepatitis in rats: the possible role of FGF21

OBJECTIVES

This study focused on the beneficial effects of Capparis spinosa (CS) treatment on the steatohepatitis induced by the administration of a high-fat emulsion in rats. Changes of hepatic expression and secretion of fibroblast growth factor 21 (FGF21) were also evaluated as a probable mechanism of the CS effects on fatty liver. Male Wistar rats were allocated in different groups to receive a normal diet (NC group), a high-fat diet (HF group), or the high-fat emulsion plus CS extract at a dose of 20 mg/kg (HF+CS group). Body and liver weight, liver index, serum biochemical factors, histopathological examination, and serum level and hepatic gene expression of FGF21 were determined.

RESULTS

CS administration markedly reduced liver weight and index, serum levels of glucose, lipids, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) and improved histological features of nonalcoholic steatohepatitis (NASH) which were induced by HF feeding in this model. CS supplementation also restored the decreased hepatic and serum FGF21 levels in the fatty liver rats. We propose that the FGF21 up-regulation may partly account for the favorable effects of CS in this steatohepatitis model.

Evaluation of the Protective Effects of Doxycycline on Acetaminophen-Induced Hepatotoxicity in Mice

Acetaminophen (APAP) toxicity threatens human health due to increased mortality associated with its overdose. Doxycycline (DC) because of its properties such as antioxidant and anti-inflammatory can be a good therapeutic strategy to treat the acute toxicity induced by APAP. Male mice were divided into six groups in two periods of 3 h and 24 h as normal saline, APAP 400 mg/kg, DC 100 mg/kg and groups treated by 25, 50 and 100 mg/kg DC just before APAP, respectively. At the end of the 3 h and 24 h periods, the hepatic index, biochemical parameters including serum aspartate transaminase (AST) and alanine transaminase (ALT) activity and hepatic catalase activity, glutathione (GSH) and malondialdehyde (MDA) levels in liver and histopathological changes were evaluated. The results indicated that DC had no apparent effect on the hepatic index but significantly normalized the level of biochemical parameters and reduced APAP induced liver damage. Overall, it could be concluded that DC can inhibit or resolve harmful effects of APAP through antioxidant and anti-inflammatory properties. However, more studies are needed to understand exact mechanism of DC and its application for clinical use.

Serum lipids and brain-derived neurotrophic factor in a cross-section of male students with symptoms of depression at a university in Iran: an observational study

Background

Depression is a neuroprogressive disorder that is characterized by neurotransmitter derangement and decreased neurogenesis and neurotrophic factors including brain-derived neurotrophic factor (BDNF).

Objectives

To determine the lipid profiles and BDNF levels in university students at an institution in Iran and association of these factors with Beck Depression Inventory (BDI) scores.

Methods

We conducted an observational study of a cross-section of male students at the Ahvaz Jundishapur University of Medical Sciences in Iran. For each of the 100 participants, a BDI score was obtained and serum levels of BDNF were measured by enzyme-linked immunosorbent assay. Levels of serum lipids, including cholesterol, triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL), were measured using a biochemical analyzer. Castelli’s risk index type I (CRI-I), Castelli’s risk index type II (CRI-II), CRI-I = TG/HDL-C and CRI-II = LDL-cholesterol/ HDL-cholesterol, and atherogenic index of plasma (AIP), AIP = log (triglycerides/HDL-cholesterol), were calculated.

Results

Based on BDI scores, lower levels of BDNF, triglycerides, cholesterol, and HDL, but higher levels of LDL were found in participants with higher BDI scores. CRI-I was also increased in participants with depression.

Conclusion

The levels of BDNF and lipid factors are associated with the severity of depression in Iranian male university students. Deranged levels of BDNF and lipids may predispose depressed students to cardiovascular diseases.

Increased level of advanced glycation end-products in renal transplant patients is associated with decreased measured GFR and grafted kidney function

Background: Advanced glycation end-products (AGEs) cause proinflammatory responses and macromolecular damages. Advanced oxidation protein products (AOPPs) are protein biomarkers for oxidative stress. Levels of AGEs and AOPPs increase with the progression of chronic renal dysfunction. Objectives: In this study, we aimed to measure these species in patients with renal transplantation and to analyze their correlation with the measured glomerular filtration rate (GFR) and renal function parameters. Patients and Methods: Eighty renal transplant patients and normal subjects were recruited. GFR was measured by the two-sample plasma method with technetium-99m-labeled diethylenetriaminepentaacetic acid (TC99m-DTPA) clearance. Biochemical measurements included creatinine, cystatin C, urea, total protein, and pentosidine. Serum AGEs were determined using a fluorometric assay and AOPPs were estimated spectrophotometrically. Results: The measured GFR found to be significantly decreased in renal transplant patients compared to the control subjects (P< 0.001). Levels of AGEs, AOPPs, serum creatinine, and cystatin C were increased in renal transplant patients with lower values of measured GFR (mGFR). A significant association between the levels of AGEs species (serum fluorescence and pentosidine) and mGFR when adjusted for creatinine and other risk factors in multiple linear regression model analysis was found (P=0.05 and P=0.001, respectively). Conclusions: This study demonstrated increased levels of pentosidine and AGEs in transplant recipients were associated with decreased mGFR. Their accumulation can be predictive for the progression of chronic allograft loss of function.

Role of antioxidant property of carvedilol in mild to moderate hypertensive patients: A prospective open-label study

Objective:

Carvedilol is a nonselective third generation β-blocker that does not display the negative effects of traditional β-blockers. Regarding the antioxidant, anti-inflammatory and distinct metabolic properties of carvedilol which are similar to that of high-density lipoprotein (HDL) and paraoxonase 1 (PON1), the present study intends to investigate the effects of carvedilol treatment on malondialdehyde (MDA) and soluble lectin-like ox-low-density lipoprotein (LDL) receptor (sLOX-1) as markers of oxidative stress in association to lipid profiles, apolipoproteins (apo), and PON1 activity in hypertensive patients.

Patients and Methods:

This clinical trial study was performed on forty patients with mild to moderate essential hypertension. Subjects were studied before and after 2 months treatment with carvedilol, 25 mg daily. Lipids and lipoproteins were measured using a biochemistry analyzer. PON and arylesterase activity were assayed using paraoxon and phenyl acetate as substrates, respectively. MDA was quantified using a chemical colorimetric assay. ELISA was used to measure sLOX-1.

Results:

Our results showed that carvedilol treatment decreased systolic and diastolic blood pressure as much as forty and 16 mmHg, respectively (P < 0.001). It also increased HDL, total cholesterol, and serum PON1 activity (P < 0.05), but the levels of triglyceride, LDL, apo A-I, and apo B did not significantly change. There was an inverse correlation between serum PON1 activity and serum MDA.

Conclusion:

This study confirmed the antihypertensive effect of the drug and its beneficial metabolic effects through augmenting HDL and PON1 activity. We propose that the antioxidant effects of carvedilol can be partially attributed to increased PON-1 activity.

Ellagic acid protects against arsenic trioxide-induced cardiotoxicity in rat

Arsenic trioxide (As₂O₃) is utilized for treating patients suffering from hematological malignancies particularly acute promyelocytic leukemia. Unfortunately, the extensive application of this chemotherapeutic agent has been limited due to its adverse effects such as cardiotoxicity. Ellagic acid, as a phenolic compound, has shown to exert antioxidant, anti-inflammatory, antifibrotic, and antiatherogenic properties. It is also capable of protecting against drug toxicity. In this study, we evaluated whether ellagic acid can protect against As₂O₃-induced heart injury in rats. Thirty-two male Wistar rats were randomly divided into four treatment groups, that is, control (0.2 mL of normal saline, intraperitoneally (ip)), As₂O₃ (5 mg/kg, ip), As₂O₃ plus ellagic acid, and ellagic acid (30 mg/kg, orally) groups. The drugs were administered daily for 10 days and pretreatment with ellagic acid was performed 1 h prior to As₂O₃ injection. Cardiotoxicity was characterized by electrocardiological, biochemical, and histopathological evaluations. Our results showed that ellagic acid pretreatment significantly ameliorated As₂O₃-induced increase in glutathione peroxidase activity and malondialdehyde concentration ( p < 0.05 and p < 0.001, respectively) and also diminished QTc prolongation ( p < 0.0001) and cardiac tissue damages. Pretreatment with ellagic acid also lowered the increased troponin I ( p < 0.0001) and creatine kinase isoenzyme MB ( p < 0.01) levels in response to As₂O₃. In conclusion, results of this study demonstrated that ellagic acid has beneficial cardioprotective effects against As₂O₃ toxicity. It is suggested that the protective effects were mediated by antioxidant properties of ellagic acid.

Thalidomide is more efficient than sodium butyrate in enhancing GATA-1 and EKLF gene expression in erythroid progenitors derived from HSCs with β-globin gene mutation

BACKGROUND

Efficient induction of fetal hemoglobin (HbF) is considered as an effective therapeutic approach in beta thalassemia. HbF inducer agents can induce the expression of γ-globin gene and produce high levels of HbF via different epigenetic and molecular mechanisms. Thalidomide and sodium butyrate are known as HbF inducer drugs.

MATERIAL AND METHODS

CD133(+) stem cells were isolated from umbilical cord blood of a newborn with minor β-thalassemia in order to evaluate the effects of these two drugs on the in vitro expression of GATA-1 and EKLF genes as erythroid transcription factors. CD133(+) stem cells were expanded and differentiated into erythroid lineage and then treated with thalidomide and sodium butyrate and finally analyzed by quantitative real-time PCR. Statistical analysis was performed using student's t-test by SPSS software.

RESULTS

Thalidomide and sodium butyrate increased GATA-1 and EKLF gene expression, compared to the non-treated control (P<0.05).

CONCLUSION

Thalidomide was more efficient than sodium butyrate in augmenting expression of GATA-1 and EKLF genes. It seems that GATA-1 and EKLF have crucial roles in the efficient induction of HbF by thalidomide.

Effect of royal jelly on formalin induced-inflammation in rat hind paw

BACKGROUND

Royal Jelly (RJ), a food item secreted by worker honeybees, is a mixture that contains protein, glucose, lipid, vitamins, and minerals; it is widely used as a commercial medical product. Previous studies have shown that RJ has a number of physiological effects, such as anti-inflammatory, antitumor, antiallergic and antioxidant activities.

OBJECTIVES

In the present study, the anti-inflammatory properties of RJ were investigated in formalin-induced rat paw edema.

MATERIALS AND METHODS

In this study, 30 male Wistar albino rats were divided into five equal groups (n = 6) as follows: test groups received different doses (25, 50 and 100 mg/kg, ip) of RJ and a negative control group received normal saline (5 mL/kg) and a positive control group received aspirin (300 mg/kg, i.p). Edema was induced on the right hind paw of the rat by a subplantar injection of 100 µL of formalin (2.5%) after 30 minutes. Paw edema was measured in the rats received the drugs, saline and aspirin before and after the formalin injection during 5 hours, using a plethysmometer.

RESULTS

The results showed that RJ has a dose-dependent anti-inflammatory effect and the highest anti-inflammatory effect was observed in the doses of 50 and 100 mg/kg.

CONCLUSIONS

Royal jelly has potent anti-inflammatory effects compared to aspirin and it could be used in the treatment of inflammation. However, further studies are required to determine the active components in RJ responsible for this effect and its mechanism of action.

The Effect of Date Seed (Phoenix dactylifera) Extract on Paraoxonase and Arylesterase Activities in Hypercholesterolemic Rats

BACKGROUND

Paraoxonase 1 (PON1) is a high- density lipoprotein (HDL)-associated enzyme, displaying esterase and lactonase activity. The PON1 is involved in a variety of inflammatory diseases, metabolizing toxic oxidized lipids and detoxifying of organophosphorus insecticide compounds and nerve agents.

OBJECTIVES

The aim of this study was to investigate the effects of methanolic date seed extract (DSE) on paraoxonase and arylesterase activities in hypercholesterolemic rats.

MATERIALS AND METHODS

Experiments were conducted in two groups of normal and hypercholesterolemic rats and continued for four weeks. Two weeks after receiving the normal and hypercholesterolemic diet, different dosages of DSE were administered during the last two weeks of the treatment. Blood samples were taken from animals before administration of DSE (at day 14) and at the end of the experimental period (at day 28). Paraoxonase and arylesterase activities of PON1 enzyme were assayed by kit using paraoxone and phenylacetate as the substrates. Relative changes in serum paraoxonase and arylesterase activities and total antioxidant capacity (TAOC) were compared between the two groups during this interval.

RESULTS

Administration of DSE significantly increased serum paraoxonase and arylesterase activities in treated hypercholesterolemic groups compared to untreated ones. There was a significant difference in the TAOC of serum between the normal diet and hypercholesterolemic groups. However, DSE did not change the TAOC in hypercholesterolemic groups significantly.

CONCLUSIONS

DSE increases serum paraoxonase and arylesterase activities. These beneficial effects may be subjected to the presence of natural antioxidants such as phenolic compounds in the date seed. Despite this, DSE did not increase TAOC in treated hypercholesterolemic groups compared to the untreated ones based on ABTS (2,2'-azino-di-(3-ethylbenzothiazoline)-6-sulfonic acid) radical reduction assay. This indicates that the hypercholesterolemic diet, apart from DSE and atorvastatin effects, may be responsible for the serum TAOC reduction. However, it is concluded that DSE may be useful in decreasing the symptoms of diseases resulting from the low activity of paraoxonase.

Angiotensin II Differentially Induces Matrix Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinase-1 Production and Disturbs MMP/TIMP Balance

Angiotensin II, the main component of the renin-angiotensin system, is associated with cardiovascular diseases such as hypertension, vascular remodeling and inflammation. Remodeling process results from dysregulation of Matrix Metalloproteinases (MMPs) and their tissue inhibitors (TIMPs). MMPs are considered as important target genes for angiotensin II. The aim of this study was to determine the effects of angiotensin II on MMP-9 and TIMP-1 production and MMP/TIMP balance in a monocytic cell type. Human monocytic U-937 cells were cultured and treated with 100 nM angiotensin II. Supernatants were analyzed for MMP-9 and TIMP-1 using ELISA and zymography methods. Real-time PCR was utilized to evaluate relative MMP-9 and TIMP-1 genes expression following treatments. Cytotoxicity potentials of treatments were determined by assaying lactate dehydrogenase leakage from the cells. Stimulation of the monocytic cells with angiotensin II significantly increased MMP-9 and TIMP-1 secretion as measured by ELISA (p < 0.05). It also augmented gelatinolytic activity of MMP-9 in the conditioned media as much as 49% (p < 0.05). Incubation of the cells with angiotensin II for 12 hr increased MMP-9 and TIMP-1 gene expression 2.7 and 1.8 folds, respectively (p < 0.05). Angiotensin II treatments did not establish significant cytotoxic effects. In summary, our data provide further evidences that monocytic MMP-9 is a major effector of angiotensin II. It is induced more efficiently than TIMP-1 by angiotensin II that leads to MMP/TIMP imbalance. Our data also reveal the pivotal participation of these cells in pathological cardiovascular remodeling mediated by angiotensin II.