1.Efficacy of N-acetylcysteine plus beta-blocker versus beta-blocker alone in preventing postoperative atrial fibrillation after cardiac surgery: A meta-analysis of randomized controlled trials
Giovanni Vista ; Von Jerick B. Tenorio ; Marivic V. Vestal
Philippine Journal of Cardiology 2025;53(1):73-86
BACKGROUND
Postoperative atrial fibrillation (POAF) is the most common arrythmia to occur after cardiovascular surgery. Inflammation being pivotal in POAF perpetuation has been utilized as a therapeutic target. Owing to their anti-inflammatory and anti-oxidant effects, beta-blockers (BB) and N-acetylcysteine (NAC) became research interests in the pursuit for an effective POAF prevention strategy.
OBJECTIVETo determine the efficacy of NAC plus BB versus BB alone in preventing POAF in cardiac surgery patients.
METHODOLOGYA literature search using the following search engines: PubMed/Medline, Cochrane Review Central, Clinical Trials Registry, ResearchGate, Mendeley and Google Scholar for relevant randomized trials were conducted. Published and unpublished studies indexed from inception until 2023 were included. Three independent reviewers evaluated the randomized clinical trials (RCTs) for eligibility. The pooled estimates for POAF prevention as primary outcome and MACE, mortality, myocardial infarction, stroke, ICU LOS and hospital LOS as secondary outcomes were measured using the RStudio statistical software.
RESULTSSeven eligible RCTs allocated 1069 cardiac surgery patients to NAC + BB (n=539) and BB alone (N = 530) treatment arms. The effect estimate using random effect model disclosed significantly reduced POAF events (RR 0.62, 95% CI [0.44, 0.86], p = 0.005) in those on NAC + BB. While no statistical difference between the study arms were demonstrated in reducing mortality (RR 0.63, 95% CI [0.23, 1.73], p = 0.37); myocardial infarction (RR 1.02, 95% CI [0.49, 2.13], p = 0.96); stroke (RR 0.95, 95% CI [0.24, 3.68], p = 0.94); ICU LOS (std. mean difference 0.14, 95% CI [-0.43, 0.70], p = 0.41), and hospital LOS (std. mean difference 0.08, 95% CI [-0.06, 0.21], p = 0.19).
CONCLUSIONAmong cardiac surgery patients, the use of NAC in combination with BB compared with BB alone significantly reduced POAF.
Acetylcysteine ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Myocardial Infarction ; Omega-chloroacetophenone
2.Effect of Wenpi Pills on lipid metabolism in mice with non-alcoholic fatty liver disease induced by various diets.
Chen-Fang ZHANG ; Kai LIU ; Chao-Wen FAN ; Mei-Ting TAI ; Xin ZHANG ; Rong ZHANG ; Qin-Wen CHEN ; Zun-Li KE
China Journal of Chinese Materia Medica 2025;50(10):2730-2739
The aim of this study was to investigate the improvement effect of Wenpi Pills(WPP) on non-alcoholic fatty liver disease(NAFLD). The experiment was divided into two parts, using C57BL/6 mouse models induced by a high-fat diet(HFD) and a methionine and choline deficiency diet(MCD). The HFD-induced experiment lasted for 16 weeks, while the MCD-induced experiment lasted for 6 weeks. Mice in both parts were divided into four groups: control group, model group, low-dose WPP group(3.875 g·kg~(-1), WPP_L), and high-dose WPP group(15.5 g·kg~(-1), WPP_H). After sample collection from the HFD-induced mice, lipid content in the serum and liver, liver function indexes in the serum, and hepatic pathology were examined. Real-time fluorescent quantitative reverse transcription PCR(qRT-PCR) was used to detect the expression of lipid-related genes. After sample collection from the MCD-induced mice, serum liver function indexes and inflammatory factors were measured, and hepatic pathology and lipid changes were analyzed by hematoxylin-eosin(HE) staining and widely targeted lipidomic profiling, respectively. The results from the HFD-induced experiment showed that, compared with the HFD group, WPP administration significantly reduced the levels of aspartate aminotransferase(AST), alanine aminotransferase(ALT), triglyceride(TG), and total cholesterol(TC) in the serum, with the WPP_H group showing the most significant improvement. HE staining results indicated that, compared with the HFD group, WPP treatment improved the morphology of white adipocytes, reducing their size, and alleviated hepatic steatosis and lipid droplet accumulation. The qRT-PCR results suggested that WPP might increase the mRNA expression of liver cholesterol-converting genes, such as liver X receptor α(LXRα) and cytochrome P450 family 27 subfamily A member 1(CYP27A1), as well as lipid consumption genes like peroxisome proliferator-activated receptor α(PPARα) and adenosine mono-phosphate-activated protein kinase(AMPK). Meanwhile, WPP decreased the mRNA expression of lipid synthesis genes, including fatty acid synthetase(FAS), stearoyl-CoA desaturase 1(SCD1), and sterol regulatory element-binding protein 1c(SREBP-1c), thereby reducing liver lipid accumulation. The results from the MCD-induced experiment showed that, compared with the MCD group, WPP administration reduced the levels of ALT, AST, and inflammatory factors in the serum, thereby alleviating liver injury and the inflammatory response. HE staining of liver tissue indicated that WPP effectively improved hepatic steatosis. Non-targeted lipidomics analysis showed that WPP improved lipid metabolism disorders in the liver, mainly by affecting the metabolism of TG and cholesterol esters. In conclusion, WPP can improve hepatic lipid accumulation in NAFLD mice induced by both HFD and MCD. This beneficial effect is primarily achieved by alleviating liver injury and inflammation, as well as regulating lipid metabolism.
Animals
;
Non-alcoholic Fatty Liver Disease/genetics*
;
Lipid Metabolism/drug effects*
;
Mice
;
Mice, Inbred C57BL
;
Drugs, Chinese Herbal/administration & dosage*
;
Male
;
Diet, High-Fat/adverse effects*
;
Liver/drug effects*
;
Humans
;
Disease Models, Animal
;
Methionine
3.Expanding molecular diversity of ribosomally synthesized and post-translationally modified peptide (RiPP) natural products by radical S-adenosylmethionine (SAM) enzymes: recent advances and mechanistic insights.
Jiawei FENG ; Jiarong MO ; Xinya HEMU
Chinese Journal of Natural Medicines (English Ed.) 2025;23(3):257-268
Ribosomally synthesized and post-translationally modified peptides (RiPPs) constitute a vast and diverse family of bioactive peptides. These peptides, synthesized by ribosomes and subsequently modified by various tailoring enzymes, possess a wide chemical space. Among these modifications, radical S-adenosylmethionine (rSAM) enzymes employ unique radical chemistry to introduce a variety of novel peptide structures, which are crucial for their activity. This review examines the major types of modifications in RiPPs catalyzed by rSAM enzymes, incorporating recent advancements in protein structure analysis techniques and computational methods. Additionally, it elucidates the diverse catalytic mechanisms and substrate selectivity of these enzymes through an analysis of the latest crystal structures.
Protein Processing, Post-Translational
;
S-Adenosylmethionine/chemistry*
;
Ribosomes/metabolism*
;
Peptides/metabolism*
;
Biological Products/metabolism*
;
Humans
4.A systematic review on the effectiveness of N-acetylcysteine in children with dengue-associated liver injury
DJ G. Leañ ; o ; Meadina G. Cruz
The Philippine Children’s Medical Center Journal 2024;20(1):46-58
Objectives:
This study aimed to determine the effectiveness of N-acetylcysteine (NAC) in reversal of liver enzyme abnormalities among pediatric patients with dengue induced liver injury.
Materials and Methods:
The preferred reporting items for systematic review and
meta-analysis protocols (PRISMA-P 2020) declaration was used to create this systematic review.
The study population included children (<18 years old) diagnosed with dengue-associated Liver
Injury and given NAC. The outcome of interest was full recovery. A search was performed in
PubMed/MEDLINE, EMBASE, Google Scholar, HERDIN PLUS, WPRIM, clinicaltrials.gov, and
Cochrane databases on March 2023. The New Castle-Ottawa Quality Assessment Scale was
adapted for risk of bias assessment for cohort studies.
Results:
Three case series and one pre-post cohort study published from 2013 to 2022 were
included. The studies were of acceptable quality. In two studies with overall 10 pediatric patients
given NAC for dengue-related ALF, all recovered without adverse events. In one study with 4
patients given NAC, half survived with their liver function tests returning to normal values.
Finally, in one comparative study, the durations of time before the liver function tests returned to
normal levels, and the mortality rates between those treated with and without N-acetyl cysteine
were not significantly different. All studies reported no occurrence of adverse drug reaction related
to NAC.
Conclusion
This systematic review shows limited evidence on the effectiveness of NAC in
the reversal of liver enzymes among pediatric patients because of the low incidence of dengue
induced liver injury seen in observational studies. Given that NAC is reported by all four studies to
be accessible, effective, and with no attributable adverse events, its use can be considered.
However, clinicians must still be cautioned given the limited available evidence.
Acetylcysteine
5.Association between maternal plasma one-carbon biomarkers during pregnancy and fetal growth in twin pregnancies.
Xiao Li GONG ; Yu Feng DU ; Yang Yu ZHAO ; Tian Chen WU ; Hui Feng SHI ; Xiao Li WANG ; Yuan WEI
Chinese Journal of Obstetrics and Gynecology 2023;58(10):774-782
Objective: To characterize the relationship between the levels of plasma methyl donor and related metabolites (including choline, betaine, methionine, dimethylglycine and homocysteine) and fetal growth in twin pregnancies. Methods: A hospital-based cohort study was used to collect clinical data of 92 pregnant women with twin pregnancies and their fetuses who were admitted to Peking University Third Hospital from March 2017 to January 2018. Fasting blood was collected from the pregnant women with twin pregnancies (median gestational age: 18.9 weeks). The levels of methyl donors and related metabolites in plasma were quantitatively analyzed by high-performance liquid chromatography combined with mass spectrometry. The generalized estimation equation was used to analyze the relationship between maternal plasma methyl donors and related metabolites levels and neonatal outcomes of twins, and the generalized additive mixed model was used to analyze the relationship between maternal plasma methyl donors and related metabolites levels and fetal growth ultrasound indicators. Results: (1) General clinical data: of the 92 women with twin pregnancies, 66 cases (72%) were dichorionic diamniotic (DCDA) twin pregnancies, and 26 cases (28%) were monochorionic diamniotic (MCDA) twin pregnancies. The comparison of the levels of five plasma methyl donors and related metabolites in twin pregnancies with different basic characteristics showed that the median levels of plasma choline and betaine in pregnant women ≥35 years old were higher than those in pregnant women <35 years old, and the differences were statistically significant (all P<0.05). (2) Correlation between plasma methyl donor and related metabolites levels and neonatal growth indicators: after adjusting for confounding factors, plasma homocysteine level in pregnant women with twins was significantly negatively correlated with neonatal birth weight (β=-47.9, 95%CI:-94.3- -1.6; P=0.043). Elevated methionine level was significantly associated with decreased risks of small for gestational age infants (SGA; OR=0.5, 95%CI: 0.3-0.9; P=0.021) and low birth weight infants (OR=0.6, 95%CI: 0.4-0.9; P=0.020). Increased homocysteine level was associated with increased risks of SGA (OR=1.5, 95%CI: 1.0-2.2; P=0.029) and inconsistent growth in twin fetuses (OR=1.9, 95%CI: 1.0-3.7; P=0.049). (3) Correlation between the levels of plasma methyl donors and related metabolites and intrauterine growth indicators of twins pregnancies: for every 1 standard deviation increase in plasma choline level in pregnant women with twin pregnancies, fetal head circumference, abdominal circumference, femoral length and estimated fetal weight in the second trimester increased by 1.9 mm, 2.6 mm, 0.5 mm and 20.1 g, respectively, and biparietal diameter, abdominal circumference and estimated fetal weight increased by 0.7 mm, 3.0 mm and 38.4 g in the third trimester, respectively, and the differences were statistically significant (all P<0.05). (4) Relationship between plasma methyl donor and related metabolites levels in pregnant women with different chorionicity and neonatal birth weight and length: the negative correlation between plasma homocysteine level and neonatal birth weight was mainly found in DCDA twin pregnancy (β=-65.9, 95%CI:-110.6- -21.1; P=0.004). The levels of choline, betaine and dimethylglycine in plasma of MCDA twin pregnancy were significantly correlated with the birth weight and length of newborns (all P<0.05). Conclusion: Homocysteine level is associated with low birth weight in twins, methionine is associated with decreased risk of SGA, and choline is associated with fetal growth in the second and third trimesters of pregnancy.
Adult
;
Female
;
Humans
;
Infant, Newborn
;
Pregnancy/metabolism*
;
Betaine/metabolism*
;
Birth Weight/physiology*
;
Choline/metabolism*
;
Cohort Studies
;
Fetal Development/physiology*
;
Fetal Weight/physiology*
;
Homocysteine/metabolism*
;
Methionine/metabolism*
;
Pregnancy, Twin/physiology*
;
Biomarkers/metabolism*
;
Pregnancy Trimesters/physiology*
;
Pregnancy Outcome
6.Efficient synthesis of L-methionine by engineering the one carbon module of Escherichia coli.
Bo ZHANG ; Ying WANG ; Kun NIU ; Zhiqiang LIU ; Yuguo ZHENG
Chinese Journal of Biotechnology 2023;39(8):3302-3317
L-methionine, also known as L-aminomethane, is one of the eight essential amino acids required by the human body and has important applications in the fields of feed, medicine, and food. In this study, an L-methionine high-yielding strain was constructed using a modular metabolic engineering strategy based on the M2 strain (Escherichia coli W3110 ΔIJAHFEBC/PAM) previously constructed in our laboratory. Firstly, the production of one-carbon module methyl donors was enhanced by overexpression of methylenetetrahydrofolate reductase (methylenetetrahydrofolate reductase, MetF) and screening of hydroxymethyltransferase (GlyA) from different sources, optimizing the one-carbon module. Subsequently, cysteamine lyase (hydroxymethyltransferase, MalY) and cysteine internal transporter gene (fliY) were overexpressed to improve the supply of L-homocysteine and L-cysteine, two precursors of the one-carbon module. The production of L-methionine in shake flask fermentation was increased from 2.8 g/L to 4.05 g/L, and up to 18.26 g/L in a 5 L fermenter. The results indicate that the one carbon module has a significant impact on the biosynthesis of L-methionine, and efficient biosynthesis of L-methionine can be achieved through optimizing the one carbon module. This study may facilitate further improvement of microbial fermentation production of L-methionine.
Humans
;
Methionine
;
Methylenetetrahydrofolate Reductase (NADPH2)
;
Carbon
;
Cysteine
;
Escherichia coli/genetics*
;
Hydroxymethyl and Formyl Transferases
;
Carrier Proteins
;
Escherichia coli Proteins
7.Synthesis and application of the methyl analogues of S-adenosyl-L-methionine.
Chinese Journal of Biotechnology 2023;39(11):4428-4444
Methylation plays a vital role in biological systems. SAM (S-adenosyl-L-methionine), an abundant cofactor in life, acts as a methyl donor in most biological methylation reactions. SAM-dependent methyltransferases (MTase) transfer a methyl group from SAM to substrates, thereby altering their physicochemical properties or biological activities. In recent years, many SAM analogues with alternative methyl substituents have been synthesized and applied to methyltransferases that specifically transfer different groups to the substrates. These include functional groups for labeling experiments and novel alkyl modifications. This review summarizes the recent progress in the synthesis and application of SAM methyl analogues and prospects for future research directions in this field.
S-Adenosylmethionine/metabolism*
;
Methionine
;
Methyltransferases/metabolism*
;
Methylation
;
Racemethionine
8.Effects of Methionine Restriction on Proliferation, Cell Cycle, and Apoptosis of Human Acute Leukemia Cells.
Yu-Jie HE ; Si-Shu YU ; Bin ZHANG ; Mei-Rong LI ; Li-Jun XU ; Long-Ming LIANG ; Zheng-Gang ZHAO ; Zi-Jian ZHAO ; Su-Jin ZHOU ; Fang-Hong LI
Journal of Experimental Hematology 2023;31(5):1290-1295
OBJECTIVE:
To investigate the effects of methionine restriction on proliferation, cell cycle and apoptosis of human acute leukemia cells.
METHODS:
Cell Counting Kit-8 (CCK-8) assay was used to detect the effect of methionine restriction on HL-60 and Jurkat cells proliferation. The effect of methionine restriction on cell cycle of HL-60 and Jurkat cells was examined by PI staining. Annexin V-FITC / PI double staining was applied to detect apoptosis of HL-60 and Jurkat cells following methionine restriction. The expression of cell cycle-related proteins cyclin B1, CDC2 and apoptosis-related protein Bcl-2 was evaluated by Western blot assay.
RESULTS:
Methionine restriction significantly inhibited the proliferation of HL-60 and Jurkat cells in a time-dependent manner (HL-60: r =0.7773, Jurkat: r =0.8725), arrested the cells at G2/M phase (P < 0.001), and significantly induced apoptosis of HL-60 and Jurkat cells (HL-60: P < 0.001; Jurkat: P < 0.05). Furthermore, Western blot analysis demonstrated that methionine restriction significantly reduced the proteins expression of Cyclin B1 (P < 0.05), CDC2 (P < 0.01) and Bcl-2 (P < 0.001) in HL-60 and Jurkat cells.
CONCLUSION
Acute leukemia cells HL-60 and Jurkat exhibit methionine dependence. Methionine restriction can significantly inhibit the proliferation, promote cell cycle arrest and induce apoptosis of HL-60 and Jurkat cells, which suggests that methionine restriction may be a potential therapeutic strategy for acute leukemia.
Humans
;
Cyclin B1/pharmacology*
;
Cell Proliferation
;
Methionine/pharmacology*
;
Cell Cycle
;
Apoptosis
;
Leukemia, Myeloid, Acute
;
Cell Division
;
Cell Cycle Proteins
;
Jurkat Cells
;
Proto-Oncogene Proteins c-bcl-2/metabolism*
;
HL-60 Cells
9.Mechanism of active ingredients in Periploca forrestii compound against rheumatoid arthritis based on integrative metabolomics and network pharmacology.
Qin ZHANG ; Hong ZHANG ; Chun-Mei YANG ; Bo WANG ; Chen-Yang LI ; Qi LI
China Journal of Chinese Materia Medica 2023;48(2):507-516
In this study, an ultra-performance liquid chromatography-quadrupole time-of-flight high resolution mass spectrometer(UPLC-Q-TOF-HRMS) was used to investigate the effects of the active ingredients in Periploca forrestii compound on spleen metabolism in rats with collagen-induced arthritis(CIA), and its potential anti-inflammatory mechanism was analyzed by network pharmacology. After the model of CIA was successfully established, the spleen tissues of rats were taken 28 days after administration. UPLC-Q-TOF-HRMS chromatograms were collected and analyzed by principal component analysis(PCA), orthogonal partial least squares discriminant analysis(OPLS-DA), and MetPA. The results showed that as compared with the blank control group, 22 biomarkers in the spleen tissues such as inosine, citicoline, hypoxanthine, and taurine in the model group increased, while 9 biomarkers such as CDP-ethanolamine and phosphorylcholine decreased. As compared with the model group, 21 biomarkers such as inosine, citicoline, CDP-ethanolamine, and phosphorylcholine were reregulated by the active ingredients in P. forrestii. Seventeen metabolic pathways were significantly enriched, including purine metabolism, taurine and hypotaurine metabolism, glycerophospholipid metabolism, and cysteine and methionine metabolism. Network pharmacology analysis found that purine metabolism, glycerophospholipid metabolism, and cysteine and methionine metabolism played important roles in the pathological process of rheumatoid arthritis. This study suggests that active ingredients in P. forrestii compound can delay the occurrence and development of inflammatory reaction by improving the spleen metabolic disorder of rats with CIA. The P. forrestii compound has multi-target and multi-pathway anti-inflammatory mechanism. This study is expected to provide a new explanation for the mechanism of active ingredients in P. forrestii compound against rheumatoid arthritis.
Rats
;
Animals
;
Periploca
;
Cysteine
;
Cytidine Diphosphate Choline
;
Network Pharmacology
;
Phosphorylcholine
;
Metabolomics
;
Arthritis, Rheumatoid/drug therapy*
;
Biomarkers
;
Glycerophospholipids
;
Methionine
;
Purines
;
Chromatography, High Pressure Liquid
10.Microbial production of S-adenosyl-l-methionine: a review.
Meijing LI ; Zheyan MI ; Jinhao WANG ; Zhongce HU ; Haibin QIN ; Yuanshan WANG ; Yuguo ZHENG
Chinese Journal of Biotechnology 2023;39(6):2248-2264
S-adenosyl-l-methionine (SAM) is ubiquitous in living organisms and plays important roles in transmethylation, transsulfuration and transamination in organisms. Due to its important physiological functions, production of SAM has attracted increasing attentions. Currently, researches on SAM production mainly focus on microbial fermentation, which is more cost-effective than that of the chemical synthesis and the enzyme catalysis, thus easier to achieve commercial production. With the rapid growth in SAM demand, interests in improving SAM production by developing SAM hyper-producing microorganisms aroused. The main strategies for improving SAM productivity of microorganisms include conventional breeding and metabolic engineering. This review summarizes the recent research progress in improving microbial SAM productivity to facilitate further improving SAM productivity. The bottlenecks in SAM biosynthesis and the solutions were also addressed.
S-Adenosylmethionine/metabolism*
;
Plant Breeding
;
Fermentation
;
Metabolic Engineering


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