1.Pancreatic β-cell failure, clinical implications, and therapeutic strategies in type 2 diabetes
Daxin CUI ; Xingrong FENG ; Siman LEI ; Hongmei ZHANG ; Wanxin HU ; Shanshan YANG ; Xiaoqian YU ; Zhiguang SU
Chinese Medical Journal 2024;137(7):791-805
Pancreatic β-cell failure due to a reduction in function and mass has been defined as a primary contributor to the progression of type 2 diabetes (T2D). Reserving insulin-producing β-cells and hence restoring insulin production are gaining attention in translational diabetes research, and β-cell replenishment has been the main focus for diabetes treatment. Significant findings in β-cell proliferation, transdifferentiation, pluripotent stem cell differentiation, and associated small molecules have served as promising strategies to regenerate β-cells. In this review, we summarize current knowledge on the mechanisms implicated in β-cell dynamic processes under physiological and diabetic conditions, in which genetic factors, age-related alterations, metabolic stresses, and compromised identity are critical factors contributing to β-cell failure in T2D. The article also focuses on recent advances in therapeutic strategies for diabetes treatment by promoting β-cell proliferation, inducing non-β-cell transdifferentiation, and reprograming stem cell differentiation. Although a significant challenge remains for each of these strategies, the recognition of the mechanisms responsible for β-cell development and mature endocrine cell plasticity and remarkable advances in the generation of exogenous β-cells from stem cells and single-cell studies pave the way for developing potential approaches to cure diabetes.
2.Effect and Mechanism of Water Extract of Mori Folium on Oxidative Stress in Adipose Tissue of T2DM Mice
Huilin ZHANG ; Yongcheng AN ; Changhao HE ; Yan HUANG ; Wanxin FU ; Menglu WANG ; Ziyi SHAN ; Yuhang DU ; Jiamei XIE ; Zhanhong JIA ; Baosheng ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):43-50
ObjectiveTo observe the effect of water extract of Mori Folium (MLE) on oxidative stress in adipose tissue of type 2 diabetes mellitus (T2DM) mice and explore its mechanism. MethodTwenty-four male db/db mice were randomly divided into model group, metformin group, low-dose MLE (MLE-L) group, and high-dose MLE (MLE-H) group according to their body weight and blood glucose, with six mice in each group, and other six C57BLKS/JGpt wild littermate mice were selected as normal group. The mice in the metformin group were given 200 mg·kg-1 metformin suspension, and the mice in the MLE-L and MLE-H groups were respectively given 2 g·kg-1 and 4 g·kg-1 MLE, while the mice in the normal group and model group were given the same dose of deionized water by daily gavage for eight weeks. Body weight, subcutaneous fat index, fasting blood glucose (FBG), and oral glucose tolerance level (OGTT) of the mice were detected, and serum superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) were measured. The expression levels of silent information regulator 1 (SIRT1) and NADPH oxidase type 4 (NOX4) protein in subcutaneous adipose tissue of the mice were detected by Western blot. ResultThe FBG level, OGTT, and subcutaneous fat index of T2DM mice were significantly decreased (P<0.05, P<0.01) after administration of MLE compared with the blank group. The contents of serum SOD and GSH were significantly increased, while the level of oxidative stress damage marker MDA was significantly decreased (P<0.05, P<0.01). The expression of SIRT1 protein in adipose tissue was significantly increased, while the expression of NOX4 protein was significantly decreased (P<0.05, P<0.01). ConclusionMLE can ameliorate T2DM by alleviating oxidative stress in adipose tissue of T2DM mice and reducing blood glucose.
3.Protective Effect and Mechanism of Mori Folium Extract on Kidney of db/db Diabetic Mice
Yan HUANG ; Huilin ZHANG ; Changhao HE ; Yongcheng AN ; Wanxin FU ; Menglu WANG ; Ziyi SHAN ; Yuhang DU ; Jiamei XIE ; Zhanhong JIA ; Baosheng ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):51-59
ObjectiveTo investigate the protective effects of Mori Folium extract (MLE) on the kidney of db/db diabetic mice and its mechanism. MethodTwenty-four male C57BLKS/JGpt-Leprdb/Leprdb (db/db) mice were randomly divided into model group, metformin group, low-dose group of MLE (MLE-L), and high-dose group of MLE (MLE-H) according to their fasting blood glucose (FBG), with six mice in each group, and other six C57BLKS/JGpt wild littermate (m/m) mice were selected as normal group. The mice in the drug administration groups were given corresponding drugs by gavage, and the mice in the normal group and model group were given the same dose of deionized water by gavage once a day for continuous eight weeks. Body weight, bilateral kidney weight, and FBG were measured, and an oral glucose tolerance test (OGTT) was performed. The pathological changes in the kidney tissue of mice were observed by hematoxylin-eosin (HE) and periodic acid-silver (PAS) staining, and serum creatinine (SCr) and blood urea nitrogen (BUN) levels were detected. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in serum and urinary microalbumin (U-mAlb) of mice. The expression levels of toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), and nuclear factor-kappa B p65 (NF-κB p65) protein in kidney tissue of mice were tested by Western blot. ResultCompared with the normal group, the body weight, absolute renal weight, FBG, and the area under the curve (AUC) of OGTT of mice in the model group were significantly increased (P<0.01), and the levels of SCr, BUN, and U-mAlb, as well as TNF-α and IL-6 in serum were significantly increased (P<0.01). The glomerular basement membrane in the kidney tissue of mice was thicker, with obvious inflammatory cell infiltration. The protein expression levels of TLR4, MyD88, and NF-κB p65 in the kidney tissue of mice were increased significantly (P<0.01). Compared with the model group, there was no statistical difference in the body weight of mice in each drug administration group. The absolute renal weight of mice in the MLE-H and metformin groups was significantly reduced (P<0.05, P<0.01). The FBG levels of mice in the metformin, MLE-L, and MLE-H groups started to decrease after treatment for four to eight weeks (P<0.05, P<0.01). The AUC of mice in the MLE-H and metformin groups was significantly decreased (P<0.01). The levels of SCr, BUN, and U-mAlb of mice in the MLE-H and metformin groups were significantly decreased (P<0.01), and those of SCr and U-mAlb of mice in the MLE-L group were significantly decreased (P<0.01). The levels of TNF-α and IL-6 in the serum of mice in the MLE-H and metformin groups were significantly decreased (P<0.01). The renal tissue pathology of mice in each drug administration group was improved to varying degrees, and the protein expression levels of TLR4, MyD88, and NF-κB p65 in the MLE-H group were decreased significantly (P<0.05, P<0.01). ConclusionMLE can improve the renal structure and function of db/db diabetic mice, and its mechanism may be related to the inhibition of the TLR4/MyD88/NF-κB signaling pathway.
4.Extraction Process and Mechanism of Active Ingredients of Mori Folium for Lowering Blood Glucose: A Review
Jiamei XIE ; Huilin ZHANG ; Yan HUANG ; Menglu WANG ; Yuhang DU ; Changhao HE ; Yongcheng AN ; Wanxin FU ; Ziyi SHAN ; Baosheng ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):60-69
Mori Folium, the dried leaves of Morus alba, is widely used in clinical practice for dispersing wind and heat, clearing the lung and moistening dryness, soothing the liver and improving vision, and cooling blood and stopping bleeding. It has been used to regulate blood glucose since ancient times, and modern studies have shown that the active components of Mori Folium for lowering blood glucose mainly include flavonoids, alkaloids, polysaccharides, and phenols. These components are mainly extracted by solvents such as water and alcohols with the assistance of ultrasound and microwave. In addition, new extraction methods are emerging, such as CO2 supercritical fluid extraction, enzymatic hydrolysis, and cloud point extraction. Mori Folium lowers blood glucose via multiple components, pathways, and targets. Specifically, it can improve glucose and lipid metabolism, protect pancreatic β cells, and alleviate insulin resistance to reduce the damage caused by hyperglycemia and restore normal physiological functions. Although a large number of studies have been carried out on diabetes, the causes and radical treatment methods remain to be explored, and diabetes is still a major disease that endangers human health and needs to be solved urgently. The articles about extraction process and mechanism of active components in Mori Folium for lowering blood glucose were retrieved from the China National Knowledge Infrastructure (CNKI), Web of Science, and PubMed. We analyzed the applicable extraction methods for the blood glucose-lowering components such as flavonoids, polysaccharides, and alkaloids in Mori Folium, and compared the conventional and emerging methods. Furthermore, we summarized our research achievements in the extraction of active components from Mori Folium and the blood glucose-lowering effect and mechanisms. This review aims to provide theoretical support for the optimization of the extraction process, the research on the blood glucose-lowering components and mechanism, and the development of new drugs and clinical application of Mori Folium.
5.Pathological Mechanism of Diabetes Based on NF-κB Signaling Pathway and Traditional Chinese Medicine Intervention: A Review
Menglu WANG ; Lu SHI ; Changhao HE ; Yongcheng AN ; Yinglan LYU ; Chen WANG ; Huimin LI ; Huilin ZHANG ; Yan HUANG ; Wanxin FU ; Ziyi SHAN ; Baosheng ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(5):246-255
As people's living standards improve, the development trend of diabetes has gradually become severe. Diabetes is a chronic inflammatory disease associated with abnormal expression of nuclear factor-kappa B (NF-κB) in patients. NF-κB exists in various tissue cells and participates in the regulation of a variety of genes related to immune function and inflammation. Varieties of factors can activate NF-κB when the body is stimulated by external factors, so as to produce inflammation and other reactions. Previous studies on NF-κB mainly focus on cancer, and the pathological mechanism of the treatment of diabetes by related signaling pathways and the progress of traditional Chinese medicine (TCM) treatment have not been systematically elaborated on. By referring to the relevant literature in China and abroad, it was found that NF-κB is not isolated in the development and progression of diabetes but is associated with signal molecules related to inflammation, oxidative stress, and energy metabolism, and it is involved in mediating inflammation, pancreatic β cell apoptosis, insulin signal transduction, and other physiological functions. Therefore, blocking the transmission of NF-κB signaling pathway is beneficial to the treatment of diabetes. At present, Western medicine for the treatment of diabetes mainly includes oral hypoglycemic drugs and insulin injections, but the adverse reactions are obvious. TCM has been characterized by multi-target, extensive action, and excellent curative effects in the treatment of diabetes. TCM and its compounds with functions of tonifying Qi and promoting blood circulation, regulating qi and eliminating phlegm, clearing heat and detoxifying, and nourishing Yin and moistening dryness can effectively intervene in the abnormal expression of NF-κB signaling pathway in vivo through anti-inflammatory effects. In this paper, the association between NF-κB signaling pathway and diabetes was summarized, and the modern research progress of TCM intervention of NF-κB signaling pathway in the treatment of diabetes in the past five years was reviewed, so as to lay a laboratory foundation for the study of a new pathological mechanism of diabetes based on NF-κB signaling pathway and provide new targets and research direction for the prevention and treatment of diabetes and development of related TCM.
6.A Survey on the Mental Health Status of Social Workers Under Long-term Stress of COVID-19 and the Exploration of Associated Factors: A Case Study of Chaoyang District, Beijing
Han ZHANG ; Yuan GAO ; Wanxin MA ; Hongxin LIU ; Fanrui MENG ; Danping ZHANG ; Chunyu LIU ; Lu LIU ; Ying XING
Medical Journal of Peking Union Medical College Hospital 2024;15(4):845-854
To study the prevalence of depression, anxiety, and insomnia among social workers during the prolonged battle against the COVID-19 pandemic and explore the associated risk factors. Using a stratified cluster sampling method, we selected all social workers in the five streets of Chaoyang District, Beijing(Jiuxianqiao, Wangjing, Taiyanggong, Shibalidian, Sunhe) from November 2021 to March 2022 as the study population(social worker group), and the frontline medical staffs(medical professional group) of the same age range of the corresponding community hospitals of the same five streets, and the community residents(resident group) as the control population. The ratio of the social worker group, medical professional group, and resident group was 1∶1∶1. The Sojump platform was used to send electronic questionnaires to the wechat groups of social workers, healthcare workers, and community residents to carry out the survey. The screen positive rates for anxiety, depression, and sleep disorders were compared among the 3 groups. Multifactorial Logistic regression and decision tree were used to analyze the influencing factors of anxiety, depression, and sleep disorders among social workers. A total of 954 questionnaires were collected, of which 62 were disqualified and excluded. Finally, 892 valid questionnaires(93.5%) were included for data analysis. Among them, there were 372 questionnaires(41.7%) from the social worker group, 262(29.4%) from the medical professional group, and 258(28.9%) from the resident group. The prevalences of anxiety, depression, and sleep disorders among social workers group were found to be 15.3%, 22.0%, and 48.1%, respectively, which were significantly higher than those in the medical professional group(7.6%, 10.3%, and 30.5%) and the resident group(7.0%, 8.5%, and 29.5%), all Social workers exhibited significant levels of anxiety, depression, and sleep disorders during the long-term pandemic prevention, with CPSS being the most significant influencing factor.
7.Rutin Promotes Browning of 3T3-L1 Preadipocytes and Its Mechanism
Yinglan LYU ; Long CHENG ; Lu SHI ; Hongyu DAI ; Yuhui DUAN ; Yongcheng AN ; Huimin LI ; Chen WANG ; Changhao HE ; Yan HUANG ; Huilin ZHANG ; Wanxin FU ; Yanyan MENG ; Baosheng ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(5):137-143
ObjectiveTo investigate the effect of rutin on the browning of 3T3-L1 preadipocytes and the mechanism. MethodCell counting kit-8 (CCK-8) assay was used to detect the effect of different concentration of rutin (3.125, 6.25, 12.5, 25, 50, 100, 200 μmol·L-1) on 3T3-L1 cell activity, and Western blot to examine the effect of rutin (12.5, 25, 50 μmol·L-1) on the expression of thermogenesis-associated proteins uncoupling protein 1 (UCP1), PR domain containing 16 (PRDM16) and peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) in adipocytes. After the optimal concentration of rutin was determined, the effect of rutin on lipid droplet formation in adipocytes was observed based on oil red O staining, and the expression of nuclear respiratory factor 1 (NRF1), nuclear respiratory factor 2 (NRF2) and mitochondrial transcription factor A (TFAM), which were the landmark proteins of mitochondrial biosynthesis, was detected by Western blot. ResultCompared with the blank group, 200 μmol·L-1 rutin inhibited 3T3-L1 cell activity (P<0.01). Compared with the blank group, at the concentration of 12.5, 25, 50 μmol·L-1 rutin significantly promoted the expression of thermogenesis-associated proteins (UCP1, PRDM16, and PGC-1α) (P<0.01), which was determined as the optimal concentration. Compared with the blank group, 50 μmol·L-1 rutin significantly increased the immunofluorescence intensity of mitochondrial UCP1 protein in 3T3-L1 cells (P<0.01) and the expression of the markers of mitochondrial biosynthesis (NRF1, NRF2, and TFAM) (P<0.01). In addition, 50 μmol·L-1 rutin significantly inhibited lipid droplet formation of 3T3-L1 adipocytes (P<0.01). ConclusionRutin inhibited lipid droplet deposition in 3T3-L1 adipocytes and increased the expression of thermogenesis-related proteins (UCP1, PRDM16, and PGC-1α) and markers of mitochondrial biosynthesis (NRF1, NRF2, and TFAM), thereby inducing the browning of 3T3-L1 adipocytes. This lays a basis for the development of drugs that safely regulate the browning of white cells.
8.Mulberry leaf flavonoids activate BAT and induce browning of WAT to improve type 2 diabetes via regulating the AMPK/SIRT1/PGC-1α signaling pathway.
Long CHENG ; Lu SHI ; Changhao HE ; Chen WANG ; Yinglan LV ; Huimin LI ; Yongcheng AN ; Yuhui DUAN ; Hongyu DAI ; Huilin ZHANG ; Yan HUANG ; Wanxin FU ; Weiguang SUN ; Baosheng ZHAO
Chinese Journal of Natural Medicines (English Ed.) 2023;21(11):812-829
Mulberry (Morus alba L.) leaf is a well-established traditional Chinese botanical and culinary resource. It has found widespread application in the management of diabetes. The bioactive constituents of mulberry leaf, specifically mulberry leaf flavonoids (MLFs), exhibit pronounced potential in the amelioration of type 2 diabetes (T2D). This potential is attributed to their ability to safeguard pancreatic β cells, enhance insulin resistance, and inhibit α-glucosidase activity. Our antecedent research findings underscore the substantial therapeutic efficacy of MLFs in treating T2D. However, the precise mechanistic underpinnings of MLF's anti-T2D effects remain the subject of inquiry. Activation of brown/beige adipocytes is a novel and promising strategy for T2D treatment. In the present study, our primary objective was to elucidate the impact of MLFs on adipose tissue browning in db/db mice and 3T3-L1 cells and elucidate its underlying mechanism. The results manifested that MLFs reduced body weight and food intake, alleviated hepatic steatosis, improved insulin sensitivity, and increased lipolysis and thermogenesis in db/db mice. Moreover, MLFs activated brown adipose tissue (BAT) and induced the browning of inguinal white adipose tissue (IWAT) and 3T3-L1 adipocytes by increasing the expressions of brown adipocyte marker genes and proteins such as uncoupling protein 1 (UCP1) and beige adipocyte marker genes such as transmembrane protein 26 (Tmem26), thereby promoting mitochondrial biogenesis. Mechanistically, MLFs facilitated the activation of BAT and the induction of WAT browning to ameliorate T2D primarily through the activation of AMP-activated protein kinase (AMPK)/sirtuin 1 (SIRT1)/peroxisome proliferator-activated receptor-gamma coactivator 1α (PGC-1α) signaling pathway. These findings highlight the unique capacity of MLF to counteract T2D by enhancing BAT activation and inducing browning of IWAT, thereby ameliorating glucose and lipid metabolism disorders. As such, MLFs emerge as a prospective and innovative browning agent for the treatment of T2D.
Mice
;
Animals
;
Adipose Tissue, Brown
;
Sirtuin 1/pharmacology*
;
Diabetes Mellitus, Type 2/metabolism*
;
AMP-Activated Protein Kinases/metabolism*
;
Morus/metabolism*
;
Flavonoids/metabolism*
;
Prospective Studies
;
Signal Transduction
;
Adipose Tissue, White
;
Plant Leaves
;
Uncoupling Protein 1/metabolism*
;
Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha/metabolism*
9.Nuclear factor-Y mediates pancreatic β-cell compensation by repressing reactive oxygen species-induced apoptosis under metabolic stress.
Siyuan HE ; Xiaoqian YU ; Daxin CUI ; Yin LIU ; Shanshan YANG ; Hongmei ZHANG ; Wanxin HU ; Zhiguang SU
Chinese Medical Journal 2023;136(8):922-932
BACKGROUND:
Pancreatic β-cells elevate insulin production and secretion through a compensatory mechanism to override insulin resistance under metabolic stress conditions. Deficits in β-cell compensatory capacity result in hyperglycemia and type 2 diabetes (T2D). However, the mechanism in the regulation of β-cell compensative capacity remains elusive. Nuclear factor-Y (NF-Y) is critical for pancreatic islets' homeostasis under physiological conditions, but its role in β-cell compensatory response to insulin resistance in obesity is unclear.
METHODS:
In this study, using obese ( ob/ob ) mice with an absence of NF-Y subunit A (NF-YA) in β-cells ( ob , Nf-ya βKO) as well as rat insulinoma cell line (INS1)-based models, we determined whether NF-Y-mediated apoptosis makes an essential contribution to β-cell compensation upon metabolic stress.
RESULTS:
Obese animals had markedly augmented NF-Y expression in pancreatic islets. Deletion of β-cell Nf-ya in obese mice worsened glucose intolerance and resulted in β-cell dysfunction, which was attributable to augmented β-cell apoptosis and reactive oxygen species (ROS). Furthermore, primary pancreatic islets from Nf-ya βKO mice were sensitive to palmitate-induced β-cell apoptosis due to mitochondrial impairment and the attenuated antioxidant response, which resulted in the aggravation of phosphorylated c-Jun N-terminal kinase (JNK) and cleaved caspase-3. These detrimental effects were completely relieved by ROS scavenger. Ultimately, forced overexpression of NF-Y in INS1 β-cell line could rescue palmitate-induced β-cell apoptosis, dysfunction, and mitochondrial impairment.
CONCLUSION
Pancreatic NF-Y might be an essential regulator of β-cell compensation under metabolic stress.
Rats
;
Mice
;
Animals
;
Reactive Oxygen Species/metabolism*
;
Diabetes Mellitus, Type 2/metabolism*
;
Insulin Resistance
;
Insulin
;
Insulin-Secreting Cells/metabolism*
;
Apoptosis
;
Stress, Physiological
;
Transcription Factors/metabolism*
;
Palmitates/pharmacology*
;
Obesity/metabolism*
10.Research concerning traditional Chinese medicine into correlation between mitogen-activated protein kinases and osteoporosis
Wanxin LIU ; Qiugen WANG ; Dong ZHANG
Chinese Journal of Orthopaedic Trauma 2023;25(11):1008-1012
Osteoporosis (OP) is a systemic bone metabolic disease when bone resorption becomes greater than bone formation, resulting in bone mass loss and poor bone structure. The disability or fatality caused by its complications has become a global public problem. As mitogen-activated protein kinases (MAPK) are important molecules that maintain and regulate cellular energy balance, they are closely related to bone metabolism. In clinical practice, traditional Chinese medicine has demonstrated obvious advantages in prevention and treatment of OP. However, there has not been enough comprehensive or systematic summary of the researches into the regulatory mechanisms of this signaling pathway in the treatment of OP by traditional Chinese medicine. Therefore, this paper expounds on the effects of single traditional Chinese herb and compound traditional Chinese herbs on the regulatory mechanisms of MAPK signaling pathway in bone metabolism so that a theoretical basis can be provided for future basic and clinical researches in the prevention and treatment of OP.

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