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Fighting fire with fire: PLA2G15 inhibition mobilizes BMP lipids to combat NPC1 disease 以毒攻毒:抑制PLA2G15调动BMP脂质对抗NPC1疾病
IF 2.7 Pub Date : 2025-12-01 DOI: 10.1016/j.metop.2025.100390
Wei Meng , Junli Liu , Xun Huang
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引用次数: 0
Deoxycholic Acid and Lipoteichoic Acid cooperatively drive macrophage M2/M1 polarization via TGR5/STAT3 and TLR2/NF-κB to fuel HCC progression in obesity 去氧胆酸和脂质胆酸通过TGR5/STAT3和TLR2/NF-κB共同驱动巨噬细胞M2/M1极化,促进肥胖患者HCC进展
IF 2.7 Pub Date : 2025-12-01 DOI: 10.1016/j.metop.2025.100420
Jian Wu , wen Zheng , Xu-zhen Ding , Qiao-ping Jin , Ming-xing Ding

Background

Obesity-related hepatocellular carcinoma (HCC) is associated with gut microbiota dysbiosis. However, the specific roles of key microbial metabolites, deoxycholic acid (DCA) and lipoteichoic acid (LTA), in modulating the immune microenvironment and promoting HCC progression are not fully understood.

Aim

This study aimed to elucidate the synergistic effects and mechanisms of DCA and LTA in obesity-related HCC.

Methods

An obesity-related HCC model was established in mice using a high-fat diet combined with diethylnitrosamine. In vitro, macrophage and HCC cell co-culture systems were utilized, along with gene knockdown approaches.

Results

Combined DCA and LTA treatment synergistically exacerbated liver fibrosis and tumorigenesis in the mouse model. This was accompanied by suppressed expression of Cdkn1a and Cdkn2a, and activation of GPC-3 and CD44. Mechanistically, DCA promoted M2 macrophage polarization via the TGR5-STAT3 axis, whereas LTA drove M1 polarization via TLR2-NF-κB. In co-culture, knockdown of TLR2 and TGR5 reversed the pro-tumorigenic effects of DCA and LTA, inhibiting the epithelial-mesenchymal transition and reducing cancer cell invasion.

Conclusion

DCA and LTA synergistically promote HCC progression in obesity by co-modulating the TLR2-TGR5 signaling axis in macrophages, thereby reshaping the tumor immune microenvironment.
背景:肥胖相关性肝细胞癌(HCC)与肠道菌群失调有关。然而,关键微生物代谢物脱氧胆酸(DCA)和脂磷胆酸(LTA)在调节免疫微环境和促进HCC进展中的具体作用尚不完全清楚。目的探讨DCA和LTA在肥胖相关性肝癌中的协同作用及其机制。方法采用高脂饮食联合二乙基亚硝胺建立小鼠肥胖相关肝癌模型。在体外,利用巨噬细胞和HCC细胞共培养系统,以及基因敲低方法。结果DCA和LTA联合治疗可协同加重小鼠肝纤维化和肿瘤发生。这伴随着Cdkn1a和Cdkn2a的表达抑制,以及GPC-3和CD44的激活。在机制上,DCA通过TGR5-STAT3轴促进M2巨噬细胞极化,而LTA通过TLR2-NF-κB轴促进M1极化。在共培养中,TLR2和TGR5的下调逆转了DCA和LTA的致瘤作用,抑制了上皮-间质转化,减少了癌细胞的侵袭。结论dca和LTA通过共同调节巨噬细胞中TLR2-TGR5信号轴,协同促进肥胖HCC进展,从而重塑肿瘤免疫微环境。
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引用次数: 0
Corrigendum to “Prevalence of normal weight obesity among adults in Southeast Asia: Insights from a systematic review and meta-analysis” [Metabol. Open 28C (2025) 100416] “东南亚成年人中正常体重肥胖的患病率:来自系统回顾和荟萃分析的见解”的勘误表。打开28C (2025) 100416]
IF 2.7 Pub Date : 2025-12-01 DOI: 10.1016/j.metop.2025.100425
K.G. Sruthi , C. Aditya , Paramjot Panda , Jyoti Ranjan Mohanty , Manas Ranjan Behera
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引用次数: 0
Gestational diabetes alters prefrontal neurochemistry and disrupts maternal behaviors: Role of Fibrillin-1, serotonin, and TNF-α in rats 妊娠期糖尿病改变大鼠前额叶神经化学并扰乱母体行为:纤原蛋白-1、血清素和TNF-α的作用
IF 2.7 Pub Date : 2025-12-01 DOI: 10.1016/j.metop.2025.100422
Samira Khayat , Hamed Fanaei , Abdolvahed Safarzaei

Objective

Gestational diabetes mellitus (GDM) is a metabolic disorder that can impact various aspects of maternal behavior and neurochemical processes. This study aimed to investigate the effects of GDM on FBN1 (fibrillin-1) gene expression, TNF-alpha, serotonin and maternal behavior in rat.

Materials and methods

A total of twenty female Wistar rats were randomly divided into two groups: the control group and the gestational diabetes mellitus (GDM) group. The study compared maternal behavior patterns between the GDM and control groups and measured the following in the hippocampus and prefrontal cortex: TNF-α and serotonin levels (via ELISA), and FBN1 mRNA expression (via qRT-PCR).

Results

The findings demonstrated that TNF-α levels (P = 0.0025) were significantly higher in the prefrontal cortex of the GDM group compared to the control group, whereas serotonin levels (P = 0.0037) were significantly lower. Additionally, FBN1 mRNA expression levels (P = 0.012) in the prefrontal cortex of GDM group were significantly higher than those in the control group. In terms of maternal behavior, the GDM group exhibited weakened behaviors compared to the control group. Specifically, endurance of maternal behaviors such as the duration of breastfeeding (P = 0.024), nesting (P = 0.016), and pup grooming (P = 0.017) were significantly decreased in the GDM group compared to control group. The speed of integration of maternal behaviors, specifically the latency to onset of pup retrieval (P = 0.0018), significantly increased, while the number of breastfeeding instances (P = 0.0026) significantly decreased in the GDM group compared to the control group. Furthermore, the emotionality (self-calming) aspect of maternal behavior, specifically self-grooming, exhibited a significant decreases in both duration (P = 0.0097) and number of instances (P = 0.0029) in the GDM group compared to the control group. In the hippocampus, only TNF-α levels were significantly elevated in the GDM group (P = 0.0003); no significant differences were found in serotonin or FBN1 mRNA expression.

Conclusion

These results demonstrate that GDM significantly dysregulates prefrontal cortex neurochemistry (increasing TNF-α and FBN1 mRNA while decreasing serotonin) and profoundly weakens maternal behavior, affecting its endurance, speed of integration, and emotional components in rats.
目的:植物性糖尿病(GDM)是一种影响母体行为和神经化学过程的代谢性疾病。本研究旨在探讨GDM对大鼠FBN1(纤原蛋白-1)基因表达、tnf - α、血清素及母性行为的影响。材料与方法选用雌性Wistar大鼠20只,随机分为对照组和妊娠期糖尿病(GDM)组。该研究比较了GDM组和对照组之间的母亲行为模式,并测量了海马和前额皮质的以下指标:TNF-α和血清素水平(通过ELISA),以及FBN1 mRNA表达(通过qRT-PCR)。结果GDM组前额叶皮层TNF-α水平显著高于对照组(P = 0.0025),血清素水平显著低于对照组(P = 0.0037)。GDM组大鼠前额叶皮层FBN1 mRNA表达量显著高于对照组(P = 0.012)。在母性行为方面,GDM组表现出较对照组弱的行为。其中,与对照组相比,GDM组母性行为的持续时间(P = 0.024)、筑巢时间(P = 0.016)和幼崽梳理时间(P = 0.017)均显著降低。与对照组相比,GDM组母性行为整合的速度,特别是幼崽检索开始的潜伏期(P = 0.0018)显著增加,而母乳喂养次数(P = 0.0026)显著减少。此外,与对照组相比,GDM组的母性行为的情绪(自我镇静)方面,特别是自我梳理,在持续时间(P = 0.0097)和实例数量(P = 0.0029)上都显着减少。在海马中,GDM组只有TNF-α水平显著升高(P = 0.0003);血清素和FBN1 mRNA表达无显著差异。结论GDM显著失调大鼠前额叶皮层神经化学(升高TNF-α和FBN1 mRNA,降低血清素),严重削弱母性行为,影响其耐力、整合速度和情绪成分。
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引用次数: 0
A lysosomal surveillance response promotes healthspan in C. elegans 溶酶体监测反应促进秀丽隐杆线虫的健康寿命
IF 2.7 Pub Date : 2025-12-01 DOI: 10.1016/j.metop.2025.100396
Liaoyuan Zheng , Junli Liu
Lysosomes, the cellular recycling hubs, are indispensable for maintaining homeostasis by degrading misfolded proteins, damaged organelles, and foreign pathogens. Their dysfunction is a hallmark of aging and age-related neurodegenerative diseases, where impaired clearance of toxic protein aggregates drives pathogenesis. Nevertheless, the mechanisms by which lysosomal function can be enhanced to mitigate these detrimental processes remain inadequately understood. A recent study conducted by Li et al. describes a newly identified transcriptional program, the Lysosomal Surveillance Response (LySR), that, when activated, significantly extends healthspan and reduces proteotoxicity in C. elegans. This adaptive transcriptional program, governed by the GATA transcription factor, ELT-2, and modulated by the acetyltransferase CBP-1, operates independently of canonical longevity pathways such as the DAF-2 insulin-like signaling. This work not only unveils a previously unrecognized longevity pathway but also charts a new course for developing therapies targeting aging and neurodegeneration.
溶酶体是细胞的循环中心,通过降解错误折叠的蛋白质、受损的细胞器和外来病原体来维持体内平衡是必不可少的。它们的功能障碍是衰老和与年龄相关的神经退行性疾病的标志,其中毒性蛋白聚集体的清除受损驱动发病机制。然而,通过增强溶酶体功能来减轻这些有害过程的机制仍然没有得到充分的了解。Li等人最近进行的一项研究描述了一个新发现的转录程序,即溶酶体监测反应(LySR),当被激活时,可以显著延长秀丽隐杆线虫的健康寿命并降低蛋白质毒性。这种适应性转录程序由GATA转录因子ELT-2控制,并由乙酰转移酶CBP-1调节,独立于典型的长寿途径,如DAF-2胰岛素样信号传导。这项工作不仅揭示了以前未被认识的长寿途径,而且为开发针对衰老和神经退行性疾病的治疗方法开辟了新的道路。
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引用次数: 0
Close multilevel links between metabolic dysfunction-associated steatotic liver disease and type 2 diabetes mellitus 代谢功能障碍相关脂肪变性肝病与2型糖尿病之间的密切多层次联系
IF 2.7 Pub Date : 2025-11-20 DOI: 10.1016/j.metop.2025.100424
A.G. Holleboom , S.M. Francque , K. Cusi , C. Caussy
Since liver cirrhosis due to Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) was first described in patients with diabetes mellitus, the prevalence and severity of this liver disease have increased dramatically, driven by the increase in obesity and type 2 diabetes mellitus (T2DM). Strong epidemiological links between MASLD, insulin resistance and T2DM exist: T2DM is associated with higher prevalence and severity of MASLD, up to hepatic decompensation and hepatocellular carcinoma, and MASLD is in turn associated with incident T2DM Mechanistic studies support insulin resistance of metabolic tissues as the root cause of MASLD, whereas hepatic insulin resistance in turn contributes to hyperglycemia. Several pharmacological agents including incretin-based strategies, FGF21 analogues and the panPPAR agonist lanifibranor target the interface of MASLD and T2DM and have thereby shown promise to improve MASH and associated liver fibrosis. In light of the evident close multilevel links between MASLD and T2DM, care development efforts for MASLD in guidelines, local protocols and implementation strategies should aim to involve hepatologists, diabetologists, PCPs and their affiliated care teams in a joint effort to address the growing burden of fibrotic MASLD.
由于代谢功能障碍引起的肝硬化相关脂肪变性肝病(MASLD)首次在糖尿病患者中被描述,由于肥胖和2型糖尿病(T2DM)的增加,这种肝脏疾病的患病率和严重程度急剧增加。MASLD、胰岛素抵抗和T2DM之间存在很强的流行病学联系:T2DM与MASLD的高患病率和严重程度相关,直至肝功能失代偿和肝细胞癌,而MASLD反过来又与T2DM的发生率相关。机制研究支持代谢组织的胰岛素抵抗是MASLD的根本原因,而肝脏胰岛素抵抗反过来又导致高血糖。几种药物,包括基于肠促胰岛素的策略,FGF21类似物和panPPAR激动剂lanifbranor靶向MASLD和T2DM的界面,因此显示出改善MASH和相关肝纤维化的希望。鉴于MASLD和2型糖尿病之间明显的密切的多层次联系,MASLD在指南、地方协议和实施策略方面的护理开发工作应旨在涉及肝病学家、糖尿病学家、pcp及其附属护理团队,共同努力解决纤维化MASLD日益增加的负担。
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引用次数: 0
Association between triglyceride glucose-body mass index and MASH, cardiovascular disease in MASLD patients: a cross-sectional study and machine learning analysis 甘油三酯葡萄糖体重指数与MASLD患者的MASH、心血管疾病之间的关系:一项横断面研究和机器学习分析
IF 2.7 Pub Date : 2025-11-19 DOI: 10.1016/j.metop.2025.100423
Xiaoxuan Tang , Fenglan Wang , Yiran Liu , Yujia Gao , Mengxi Li , Chong Liu , Duanming Zhuang , Bin Zhang

Background

The triglyceride glucose-body mass index (TyG-BMI) is a useful marker for metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiovascular disease (CVD). However, its ability to differentiate metabolic dysfunction-associated steatohepatitis (MASH) and CVD risk among patients with MASLD requires further investigation. This study evaluates the association between TyG-BMI and MASH/CVD risk in patients with MASLD and applies machine learning (ML) to identify relevant risk factors.

Methods

The study used data from National Health and Nutrition Examination Survey (NHANES) to analyzed associations between TyG-BMI and two clinical outcomes: MASH, defined by the FibroScan-AST (FAST) score ≥0.35, and self-reported CVD. Participants were categorized based on TyG-BMI quartiles: Q1 (<246.79), Q2 (246.79–280.32), Q3 (280.33–323.99), and Q4 (≥324.00). Multivariate survey-weighted logistic regression and restricted cubic splines (RCS) were used to assess relationships and potential nonlinearity. Multiple ML models were employed, with feature importance interpreted via Shapley Additive Explanations (SHAP) analysis.

Results

Among 674 MASLD participants (390 males), higher TyG-BMI was independently associated with increased risks of MASH and CVD risk. Compared with Q1, Q4 had adjusted odds ratios of 24.46 (95 % CI: 2.94–203.31, P = 0.003) for MASH and 3.53 (95 % CI: 1.26–9.90, P = 0.017) for CVD. RCS indicated linear relationships between TyG-BMI and both outcomes. The gradient boosting machine and support vector machine exhibited the optimal performance best in discriminating high-risk MASH (ROC: 0.910) and CVD (ROC: 0.773), confirming TyG-BMI as a significant risk factors.

Conclusion

TyG-BMI effectively identifies MASH and CVD risk in patients with MASLD, offering clinicians a practical tool for risk stratification and management.
背景甘油三酯葡萄糖体重指数(TyG-BMI)是代谢功能障碍相关脂肪变性肝病(MASLD)和心血管疾病(CVD)的有用标志物。然而,其在MASLD患者中区分代谢功能障碍相关脂肪性肝炎(MASH)和心血管疾病风险的能力需要进一步研究。本研究评估了MASLD患者TyG-BMI与MASH/CVD风险之间的关系,并应用机器学习(ML)识别相关危险因素。方法该研究使用国家健康与营养调查(NHANES)的数据分析TyG-BMI与两种临床结果之间的关系:MASH(由纤维扫描- ast (FAST)评分≥0.35定义)和自我报告的CVD。参与者根据TyG-BMI四分位数进行分类:Q1 (246.79), Q2 (246.79 - 280.32), Q3(280.33-323.99)和Q4(≥324.00)。多变量调查加权逻辑回归和限制三次样条(RCS)用于评估关系和潜在的非线性。采用多个ML模型,通过Shapley加性解释(SHAP)分析来解释特征重要性。结果在674名MASLD参与者(390名男性)中,较高的TyG-BMI与MASH和CVD风险增加独立相关。与Q1相比,Q4的MASH校正比值比为24.46 (95% CI: 2.94-203.31, P = 0.003), CVD校正比值比为3.53 (95% CI: 1.26-9.90, P = 0.017)。RCS显示TyG-BMI与两种结果呈线性关系。梯度增强机和支持向量机在区分高风险MASH (ROC: 0.910)和CVD (ROC: 0.773)方面表现最佳,证实TyG-BMI是显著的危险因素。结论tyg - bmi可有效识别MASLD患者的MASH和CVD风险,为临床医生提供了一种实用的风险分层和管理工具。
{"title":"Association between triglyceride glucose-body mass index and MASH, cardiovascular disease in MASLD patients: a cross-sectional study and machine learning analysis","authors":"Xiaoxuan Tang ,&nbsp;Fenglan Wang ,&nbsp;Yiran Liu ,&nbsp;Yujia Gao ,&nbsp;Mengxi Li ,&nbsp;Chong Liu ,&nbsp;Duanming Zhuang ,&nbsp;Bin Zhang","doi":"10.1016/j.metop.2025.100423","DOIUrl":"10.1016/j.metop.2025.100423","url":null,"abstract":"<div><h3>Background</h3><div>The triglyceride glucose-body mass index (TyG-BMI) is a useful marker for metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiovascular disease (CVD). However, its ability to differentiate metabolic dysfunction-associated steatohepatitis (MASH) and CVD risk among patients with MASLD requires further investigation. This study evaluates the association between TyG-BMI and MASH/CVD risk in patients with MASLD and applies machine learning (ML) to identify relevant risk factors.</div></div><div><h3>Methods</h3><div>The study used data from National Health and Nutrition Examination Survey (NHANES) to analyzed associations between TyG-BMI and two clinical outcomes: MASH, defined by the FibroScan-AST (FAST) score ≥0.35, and self-reported CVD. Participants were categorized based on TyG-BMI quartiles: Q1 (&lt;246.79), Q2 (246.79–280.32), Q3 (280.33–323.99), and Q4 (≥324.00). Multivariate survey-weighted logistic regression and restricted cubic splines (RCS) were used to assess relationships and potential nonlinearity. Multiple ML models were employed, with feature importance interpreted via Shapley Additive Explanations (SHAP) analysis.</div></div><div><h3>Results</h3><div>Among 674 MASLD participants (390 males), higher TyG-BMI was independently associated with increased risks of MASH and CVD risk. Compared with Q1, Q4 had adjusted odds ratios of 24.46 (95 % CI: 2.94–203.31, P = 0.003) for MASH and 3.53 (95 % CI: 1.26–9.90, P = 0.017) for CVD. RCS indicated linear relationships between TyG-BMI and both outcomes. The gradient boosting machine and support vector machine exhibited the optimal performance best in discriminating high-risk MASH (ROC: 0.910) and CVD (ROC: 0.773), confirming TyG-BMI as a significant risk factors.</div></div><div><h3>Conclusion</h3><div>TyG-BMI effectively identifies MASH and CVD risk in patients with MASLD, offering clinicians a practical tool for risk stratification and management.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"28 ","pages":"Article 100423"},"PeriodicalIF":2.7,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Novel causal associations between plasma metabolites and prostate cancer risk revealed by mendelian randomization 孟德尔随机化揭示血浆代谢物与前列腺癌风险之间新的因果关系
IF 2.7 Pub Date : 2025-11-14 DOI: 10.1016/j.metop.2025.100421
Hanghang Chen , Huiduo Zhao , Bingxin Meng , Qi Liu

Background

Prostate cancer (PCa) is a major global health concern for men, yet its underlying metabolic mechanisms are not fully understood. Identifying causal metabolites could reveal novel pathways for risk assessment and prevention.

Methods

We conducted a comprehensive two-sample Mendelian randomization (TSMR) study following STROBE-MR guidelines. Genetic instruments for plasma metabolites were derived from two independent sources, including the METSIM study, a cohort exclusively comprising Finnish men, and the Canadian Longitudinal Study on Aging (CLSA). Summary-level data for PCa were obtained from the PRACTICAL consortium and FinnGen. Inverse variance weighted (IVW) was the primary analysis method, supplemented by sensitivity analyses and Bayesian colocalization (coloc) to assess shared causal genetic variants, a key methodological strength enhancing causal inference.

Results

Our analysis identified four plasma metabolites with a significant causal relationship with PCa risk. Ribitol was associated with a reduced risk, while N2,N5-diacetylornithine, N-acetylarginine, and N-acetylcitrulline were associated with an elevated risk. These findings were consistent across datasets and robust in sensitivity analyses. Colocalization analysis provided strong evidence (PP.H4 > 0.8) for a shared causal variant at the rs10201159 locus between N2,N5-diacetylornithine and PCa.

Conclusion

This study provides robust genetic evidence supporting a causal role of specific plasma metabolites in prostate cancer development. The incorporation of a male-exclusive metabolomic dataset (METSIM) strengthens the validity of our findings for this male-specific cancer. These metabolites represent promising candidates for further mechanistic investigation into prostate cancer etiology and potential translation into clinical biomarkers.
前列腺癌(PCa)是全球男性健康关注的主要问题,但其潜在的代谢机制尚不完全清楚。确定因果代谢物可以揭示风险评估和预防的新途径。方法采用双样本孟德尔随机化(TSMR)研究,采用STROBE-MR方法。血浆代谢物的遗传仪器来自两个独立的来源,包括METSIM研究(一个完全由芬兰男性组成的队列)和加拿大老龄化纵向研究(CLSA)。PCa的汇总数据来自PRACTICAL consortium和FinnGen。以逆方差加权法(IVW)为主要分析方法,以敏感性分析和贝叶斯共定位法(coloc)为辅助分析方法来评估共有的因果遗传变异,这是增强因果推理的关键方法优势。结果我们的分析确定了四种血浆代谢物与PCa风险有显著的因果关系。利比醇与风险降低相关,而N2、n5 -二乙酰鸟氨酸、n -乙酰精氨酸和n -乙酰瓜氨酸与风险升高相关。这些发现在数据集之间是一致的,在敏感性分析中是稳健的。共定位分析提供了强有力的证据(PP.H4 > 0.8),表明N2、n5 -二乙酰虫氨酸和PCa之间在rs10201159位点存在共同的因果变异。结论本研究提供了强有力的遗传学证据,支持特定血浆代谢物在前列腺癌发展中的因果作用。纳入男性专属代谢组学数据集(METSIM)加强了我们研究结果对这种男性特异性癌症的有效性。这些代谢物代表了前列腺癌病因进一步机制研究和潜在转化为临床生物标志物的有希望的候选者。
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引用次数: 0
The role of pancreatic islet macrophages in type 2 diabetes mellitus: from underlying pathological mechanisms to therapeutic target discovery 胰岛巨噬细胞在2型糖尿病中的作用:从潜在的病理机制到治疗靶点的发现
IF 2.7 Pub Date : 2025-11-13 DOI: 10.1016/j.metop.2025.100418
Zhongpeng Qiu , Dejing Shang
The pathogenesis of type 2 diabetes mellitus (T2DM) is closely associated with chronic inflammation within the islet microenvironment, where pancreatic islet macrophages serve as central orchestrators of local immune regulation. This review provides a systematic overview of the ontogeny, phenotypic heterogeneity, and functional roles of pancreatic islet macrophages in T2DM pathology. Pancreatic islet macrophages contribute to β-cell proliferation and the maintenance of islet homeostasis through the secretion of various growth factors, such as platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF). Under conditions of metabolic stress, including lipotoxicity and glucotoxicity, these macrophages are polarized toward a pro-inflammatory phenotype. In this state, they impair β-cell function by releasing inflammatory mediators, including interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α). Furthermore, this article discusses potential clinical strategies that target pancreatic islet macrophages—such as anti-inflammatory agents and immunomodulators—highlighting their promise as novel perspectives for precise intervention in T2DM.
2型糖尿病(T2DM)的发病机制与胰岛微环境中的慢性炎症密切相关,胰岛巨噬细胞在胰岛微环境中充当局部免疫调节的中枢协调者。本文综述了胰岛巨噬细胞在T2DM病理中的个体发生、表型异质性和功能作用。胰岛巨噬细胞通过分泌各种生长因子,如血小板衍生生长因子(PDGF)和血管内皮生长因子(VEGF),促进β细胞增殖和维持胰岛稳态。在代谢应激条件下,包括脂毒性和糖毒性,这些巨噬细胞向促炎表型极化。在这种状态下,它们通过释放炎症介质,包括白细胞介素-1β (IL-1β)和肿瘤坏死因子-α (TNF-α),损害β细胞功能。此外,本文还讨论了针对胰岛巨噬细胞的潜在临床策略,如抗炎剂和免疫调节剂,强调了它们作为精确干预T2DM的新前景。
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引用次数: 0
Probiotics, prebiotics, synbiotics, and FMT for glycemic control: A systematic review of clinical efficacy and mechanistic readouts in type 2 diabetes and related dysglycemia 益生菌、益生元、合成菌和FMT用于血糖控制:对2型糖尿病和相关血糖异常的临床疗效和机制的系统回顾
IF 2.7 Pub Date : 2025-11-12 DOI: 10.1016/j.metop.2025.100419
Neda Shalbaf , Soheila Sadeghi , Sina Homaee , Farnaz Saberian

Objective

To systematically evaluate the clinical efficacy of probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) on glycemic control in adults with type 2 diabetes (T2D) and related dysglycemia, and to synthesize associated mechanistic changes in microbial metabolites and composition.

Methods

A systematic review was conducted following PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception through August 2025 for randomized controlled trials (RCTs) in adults with T2D, prediabetes, or metabolic syndrome. Interventions included probiotics, prebiotics, synbiotics, or FMT compared to control. Outcomes were glycemic indices (e.g., HbA1c, HOMA-IR) and mechanistic biomarkers (e.g., SCFAs, bile acids). Risk of bias was assessed using the Cochrane RoB 2 tool. A narrative synthesis was performed.

Results

Thirty studies were included. Multi-strain probiotics, prebiotics, and synbiotics yielded modest but significant improvements in HbA1c (≈−0.2 to −0.4 %), fasting glucose, and HOMA-IR, particularly with durations ≥12 weeks. These benefits were linked to mechanistic shifts, including increased circulating butyrate and ursodeoxycholate, enrichment of SCFA-producing taxa, and reduced endotoxemia. Efficacy was moderated by concomitant medications: metformin use was synergistic, while sulfonylureas attenuated effects. FMT consistently improved clamp-measured insulin sensitivity in insulin-resistant phenotypes, but its effects on HbA1c were less consistent and donor-dependent.

Conclusion

Microbiome-targeted interventions, especially multi-strain probiotics and substrate-matched synbiotics, are effective adjuncts for improving glycemic control, with effects mediated through microbial metabolite production. FMT primarily modulates insulin sensitivity. Clinical outcomes are context-dependent, influenced by intervention design, duration, and pharmacomicrobiomic interactions.
目的系统评价益生菌、益生元、合成菌和粪便微生物群移植(FMT)对成人2型糖尿病(T2D)及相关血糖异常患者血糖控制的临床疗效,并综合相关微生物代谢物及组成变化的机制。方法按照PRISMA 2020指南进行系统评价。我们检索了PubMed/MEDLINE、Scopus和Web of Science从成立到2025年8月的t2dm、糖尿病前期或代谢综合征成人随机对照试验(rct)。与对照组相比,干预措施包括益生菌、益生元、合成菌或FMT。结果是血糖指数(如HbA1c, HOMA-IR)和机制生物标志物(如scfa,胆汁酸)。使用Cochrane RoB 2工具评估偏倚风险。进行了叙事综合。结果共纳入30项研究。多菌株益生菌、益生元和合成菌对HbA1c(≈−0.2至−0.4%)、空腹血糖和HOMA-IR有适度但显著的改善,尤其是持续时间≥12周的患者。这些益处与机制变化有关,包括循环丁酸盐和熊脱氧胆酸盐的增加、scfa生成类群的富集和内毒素血症的减少。联合用药可减缓疗效:二甲双胍的使用具有协同作用,而磺脲类药物可减弱疗效。FMT在胰岛素抵抗表型中持续改善钳测胰岛素敏感性,但其对HbA1c的影响不太一致且依赖于供体。结论以微生物组为目标的干预措施,特别是多菌株益生菌和底物匹配的合生剂,是改善血糖控制的有效辅助手段,其作用通过微生物代谢物的产生介导。FMT主要调节胰岛素敏感性。临床结果依赖于环境,受干预设计、持续时间和药物微生物组相互作用的影响。
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引用次数: 0
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