1.Mechanism Exploration of Doxorubicin and Sepsis Induced Myocardial Injury: Differences and Convergences
Tao ZHANG ; Zihan NAN ; Lixia LIU ; Jiaqi LIU ; Xiukai CHEN ; Xiaoting WANG ; Suwen SU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):23-32
Doxorubicin (DOX)-induced cardiotoxicity and sepsis-induced myocardial injury (SIMI) represent significant clinical challenges in patients undergoing chemotherapy, sharing a common pathological basis of oxidative stress and mitochondrial dysfunction. Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, has recently been shown to play a critical role in DOX-induced cardiotoxicity and lipopolysaccharide (LPS)-induced SIMI. This article systematically reviews the mechanisms underlying myocardial injury caused by DOX and sepsis, identifying ferroptosis as a central common pathway. DOX triggers a burst of reactive oxygen species within mitochondria and inhibits glutathione peroxidase 4 (GPX4) activity through redox cycling of its quinone group and high-affinity accumulation in mitochondrial cardiolipin. LPS, by activating pattern recognition receptors and related inflammatory signaling pathways, provokes a cytokine storm and mitochondrial dysfunction. Both can disrupt the core regulatory axis of cysteine-glutathione (GSH)-GPX4, synergistically promoting ferroptosis in cardiomyocytes. Moreover, epigenetic regulation plays a key role in DOX- and LPS-induced cardiomyocyte ferroptosis and may serve as a promising therapeutic target. A deeper understanding of the ferroptosis mechanism and its epigenetic regulatory network in the synergistic injury induced by DOX and sepsis is of great importance for developing novel strategies to mitigate chemotherapy-related cardiotoxicity and improve outcomes in cancer patients with concurrent infections.
2.Mechanism of Maimendong Yinzi in Alleviating Cough with Yin Deficiency and Lung Heat Syndrome by Modulating PAR1/Gαi/cAMP Signaling Pathway and TRPV1 Expression
Zihan ZHU ; Jiahui TANG ; Yuanyuan ZHANG ; Junping KOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):81-91
ObjectiveTo investigate the effects of Maimendong Yinzi (MMDYZ) on cough with Yin deficiency and lung heat syndrome and explore its potential mechanism of action. MethodsForty-eight Institute of Cancer Research (ICR) mice were randomly divided into a control group, a model group, a Baihe Gujin Tablet (BHGJP) group (1.36 g·kg-1), and low-dose, medium-dose, and high-dose MMDYZ groups (5, 10, 20 g·kg-1·d-1, based on the weight of crude drug), with eight mice in each group. The mouse model of cough with Yin deficiency and lung heat syndrome was prepared by a combination of smoke exposure, nasal drip of lipopolysaccharide (LPS), intragastric gavage with thyroxine, and capsaicin atomization. After successful modeling, drug interventions were administered for seven days. During modeling, the mice were observed for changes in general status, anal temperature, fecal water content, and water intake. After medication, the above indicators were evaluated again, along with assessments of spontaneous activity, cough sensitivity, lung function, lung index, and tracheal phenol red secretion. Bronchoalveolar lavage fluid (BALF) was analyzed for cell differential counts, and the level of cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in serum was measured via enzyme linked immunosorbent assay (ELISA). Lung injury was assessed via hematoxylin-eosin (HE) staining. Network pharmacology was employed to predict the potential mechanism of MMDYZ in alleviation cough with Yin deficiency and lung heat syndrome. Western blot (WB) was used to measure protease-activated receptor1 (PAR1) and GTPhase αi subunit (Gαi) protein expressions in lung tissue. ELISA was used to determine lung cAMP content, and immunohistochemistry (IHC) was employed to evaluate transient receptor potential vanilloid subtype 1 (TRPV1) expression. ResultsCompared with the control group, the model group exhibited significantly increased water intake and anal temperature and significantly decreased fecal water content (P<0.05). The total distance traveled in 5 min and the central zone duration were reduced, while standing frequency significantly increased (P<0.05). Cough sensitivity and enhanced pause (PenH) were elevated. Peak expiratory flow (PEF) significantly declined (P<0.05). BALF neutrophil (NEU) and white blood cell (WBC) counts rose. Serum cAMP and cAMP/cGMP ratio significantly increased, and cGMP significantly decreased (P<0.05). Serum TNF-α and IL-6 levels were significantly elevated (P<0.05). The lung injury was obvious, and the lung index was significantly elevated (P<0.05). Compared with the model group, the medium-dose and high-dose MMDYZ groups and the BHGJP group showed significantly improved indicators mentioned above. Additionally, network pharmacology suggested that MMDYZ might alleviate cough with Yin deficiency and lung heat syndrome via cAMP, hypoxia inducible factor-1 (HIF-1), and TNF signaling pathways. WB, ELISA, and IHC revealed that, compared with the control group, the model group exhibited significantly upregulated PAR1, Gαi, and TRPV1 expressions and significantly downregulated cAMP in lung tissue (P<0.05). Compared with the model group, MMDYZ reduced PAR1 (P<0.01), Gαi (P<0.05), and TRPV1 (P<0.01) while increasing cAMP level (P<0.01). ConclusionMMDYZ may alleviate cough with Yin deficiency and lung heat syndrome by modulating the PAR1/Gαi/cAMP pathway and TRPV1 expression.
3.Peyton's Four-Step Teaching Method for Intestinal Ultrasound Training: Efficacy and Practical Implications
Zihan NIU ; Xiaoyan ZHANG ; Zhaojue WANG ; Qingli ZHU ; Mengsu XIAO ; Li MA ; Yudi HE ; Wenbo LI
Medical Journal of Peking Union Medical College Hospital 2026;17(2):591-596
To evaluate the application value of the Peyton four-step teaching method in the standardized training of intestinal ultrasound and compare it with traditional teaching methods, so as to provide an optimized approach for clinical ultrasound training. Participants from the Department of Ultrasound at Peking Union Medical College Hospital between September 2024 and March 2025 were randomly assigned to either the traditional group or Peyton group. The traditional group followed the conventional "lecture- demonstration-practice" model, while the Peyton group implemented the standardized "demonstration-deconstruction-comprehension-execution" four-step approach. All training focused on standard intestinal ultrasound scanning techniques. After the training, the operational skills were independently evaluated by the instructors. To verify the reproducibility of the teaching method, the participants in traditional teaching group received additional Peyton method training after the initial assessment and underwent a second evaluation. A total of 18 participants were included in this study, with 9 in the traditional teaching group and 9 in the Peyton teaching group. Participants in the Peyton group demonstrated significantly higher scores than those in the traditional group at every anatomical site assessed (all The Peyton four-step method is significantly more effective than traditional teaching in improving residents' intestinal ultrasound skills, demonstrating its suitability as the preferred approach for standardized training programs.
4.Dissecting antibody-mediated natural killer cell effects reveals a cytotoxic CX3CR1+KLRC2–CD16hi subset linked to hepatitis B virus outcomes
Libo TANG ; Yuhao WANG ; Zihan JIN ; Yurong GU ; Zhaofeng ZENG ; Linnan SONG ; Xuan YI ; Lingtao ZHANG ; Yujing ZHANG ; Weiying HE ; Liping WANG ; Weixin HE ; Jianru SUN ; Xiaoqin LAN ; Xiangyong LI ; Shihong ZHONG ; Yongyin LI
Clinical and Molecular Hepatology 2026;32(2):683-705
Background/Aims:
Natural killer (NK) cell function is generally considered dampened in chronic hepatitis B virus (HBV) infection; however, the NK cell pool exhibits phenotypic and functional heterogeneity, and the antibody--mediated effect of NK cells remains less characterized. This study evaluated the dynamic changes in antibody-mediated NK cell responses and the involvement of distinct NK subsets across disease stages and during antiviral treatment.
Methods:
A T-cell receptor-like antibody specific for the HBV core 18–27 peptide (cTCRL-Ab) was used to determine the antibody-mediated effect of NK cells, and an array of NK cell surface markers were analyzed in cross-sectional and longitudinal cohorts of patients with chronic HBV infection. Single-cell RNA sequencing (scRNA-seq) was performed to identify the heterogeneity of NK subsets.
Results:
The cTCRL-Ab enabled the detection of NK cell cytolytic activity and IFNγ production. Notably, cTCRL-Ab-mediated NK cell responses were compromised in chronically HBV-infected patients, particularly in those receiving pegylated interferon-α (Peg-IFNα), which was associated with the downregulation of CD16 expression. Correspondingly, Peg-IFNα inhibited cTCRL-Ab-mediated NK cell function by reducing CD16 expression in vitro. scRNA-seq revealed that CD16 downregulation occurred mainly within a dysfunctional CD16hi NK subset exhibiting exhaustion properties. In contrast, an activated CD16hiNK subpopulation (CX3CR1⁺KLRC2–CD16hi) with high cytotoxicity was enriched in patients who experienced favorable treatment responses. Furthermore, the intrahepatic CX3CR1+KLRC2–CD16hi subset tended to exhibit functional restoration in HBsAg-loss individuals.
Conclusions
Our data contribute to the understanding of antibody-mediated responses of NK cells in chronic HBV infection, and highlight a previously unappreciated functional CX3CR1+KLRC2–CD16hiNK subset as a potential therapeutic target.
5.LSS deficiency ameliorates MASLD by downregulating NPC1L1 and activating the CD36/TLR4/JNK pathway
Zihan WANG ; Hongmei BAI ; Qingya HE ; Wenjing ZHOU ; Jian ZHONG ; Xiaoli JIANG ; Sumei ZHANG ; Shengquan ZHANG
Acta Universitatis Medicinalis Anhui 2026;61(5):812-818
ObjectiveTo investigate whether intestinal deficiency of lanosterol synthase (LSS), a key enzyme in cholesterol synthesis, influences the progression of metabolic dysfunction-associated steatotic liver disease (MASLD) by regulating intestinal cholesterol absorption and immune response. MethodsLSS heterozygous knockout (LSS+/-) mice and wild-type (WT) controls were generated using CRISPR/Cas9 technology and fed either a high-fat diet (HFD) or regular chow (CHOW). The model was validated by genotyping. Hepatic steatosis was assessed by HE and oil red O staining. Immunohistochemistry was used to detect the localization and expression of NPC1L1 and CD36 proteins in the intestine. Western blot analysis was performed to measure JNK phosphorylation and TLR4 protein levels in intestinal tissues. Real-time quantitative polymerase chain reaction (qPCR) was employed to examine the mRNA expression of TLR4 and IL-6. ResultsLSS+/- mice were successfully validated by genotyping and reduced intestinal LSS protein expression. HE and oil red O staining of liver sections showed that, compared with WT mice fed a CHOW diet, WT mice fed a HFD exhibited a marked increase in hepatic lipid vacuoles. In contrast, compared with HFD-fed WT mice, HFD-fed LSS+/- mice displayed significantly attenuated hepatic lipid deposition and reduced serum ALT levels (P<0.05). Immunohistochemical analysis revealed that, compared with WT mice, the expression of the cholesterol absorption protein NPC1L1 in the intestinal villi of LSS+/- mice was downregulated under both CHOW and HFD conditions (PHFD<0.001). Conversely, the expression of the fatty acid transporter CD36 was upregulated in the intestines of LSS+/- mice (PCHOW<0.05, PHFD<0.01). Western blot analysis demonstrated that, compared with WT mice, TLR4 protein expression in the intestines of LSS+/- mice significantly increased under both CHOW and HFD conditions (both P<0.05). JNK phosphorylation level was significantly elevated in LSS+/- mice under CHOW condition (both P<0.05). Under HFD condition, total JNK protein expression increased, but its phosphorylation level showed no significant change. qPCR analysis showed that, compared with WT mice, the mRNA levels of TLR4 (PCHOW<0.01, PHFD<0.000 1) and IL-6 (PCHOW<0.001, PHFD<0.01) were significantly upregulated in the intestines of LSS+/-mice. ConclusionLSS deficiency counteracts hepatic lipid deposition by orchestrating a synergistic reprogramming involving restricted intestinal cholesterol absorption, enhanced fatty acid utilization, and activation of immune pathways, suggesting intestinal LSS as a potential therapeutic target of MASLD.
6.Effect of Astragalus polysaccharide on the proliferation of rat intestinal mucosal microvascular endothelial cells by regulating VEGF/VEGFR pathway
Haotong GUO ; Zihan ZHAO ; Chang QIAO ; Mengyu FAN ; Weichao MA ; Xiang MU ; Bo FENG ; Qian ZHANG
Chinese Journal of Veterinary Science 2025;45(7):1443-1449
This study explored whether Astragalus polysaccharide(APS)can regulate the VEGF/VEGFR signaling pathway to affect the proliferative activity of rat intestinal mucosal microvascu-lar endothelial cells(RIMMVECs).RIMMVECs were isolated from newborn rats,then purified and treated with APS at concentrations of 0.1,1.0,10.0,100.0,1 000.0,and 10 000.0 mg/L.MTT was used to determine the effect of APS on RIMMVECs proliferation and screen for the optimal concentration of APS.Subsequently,flow cytometry was used to detect the changes in cell cycle to evaluate the stage of action of APS on the cell cycle in RIMMVECs.Then,the ELISA was used to detect the changes of VEGFA in cell supernatant to evaluate the potential of cell proliferation and angiogenesis.The changes in fluorescence intensity of Fluo-8AM was observed using fluorescence microscopy to evaluate intracellular Ca2+levels.Finally,Western blot was used to detect the ex-pression of PERK in RIMMVECs to analyze the possible mechanism of APS.The results showed that 100 mg/L APS significantly enhanced the proliferative activity of RIMMVECs,increased the content of VEGFA in the cell supernatant,the intracellular Ca2+levels,and the expression of PERK protein,indicating that APS promotes the proliferation of RIMMVECs,which may be a-chieved by promoting the expression of VEGFA and activating the ERK pathway.
7.Effect of a novel cryoprotectant in tissues and cells
Qingfang WANG ; Fen ZHANG ; Guangping CHANG ; Zihan LI ; Lan XING ; Hao PENG ; Xiuping ZENG ; Guiqiang ZHONG ; Hui CHEN ; Bo LIU ; Zhenyu LIU ; Xiao LIANG
Chinese Journal of Tissue Engineering Research 2025;29(36):7816-7826
BACKGROUND:The cryopreservation technology enables tissues/cells to be stored for a long time in a low-temperature environment while maintaining the integrity of their activity and function,which is of great significance for the construction of cell therapy,tissue engineering and biological sample banks.Cryoprotective agents often contain dimethyl sulfoxide and serum.To avoid the toxic side effects of dimethyl sulfoxide,the complexity of serum components and immune responses,although some finished cryoprotective agents have been marketed,they are faced with many difficulties such as high cost and limited application.Therefore,there is an urgent need to develop a cryoprotective agent with clear components and the ability to solve the above problems.OBJECTIVE:To evaluate the effects of a novel cryoprotectant on cryopreservation efficiency of different tissue and cell sources.METHODS:By applying the novel cryoprotectant as an experimental group with the commercially available and widely used cryoprotectant(control group)to umbilical cord Wharton's jelly tissue,umbilical cord mesenchymal stem cells,umbilical cord blood/peripheral blood mononuclear cells,NK and CIK cells,comparative analyses were conducted in terms of cell morphology,number,viability,surface markers,differentiation potential,and cell-killing toxicity assay before cryopreservation and after resuscitation thawing.We confirmed the cryopreservation effect of the new cryoprotectant and its potential application value.RESULTS AND CONCLUSION:(1)The novel cryoprotectant facilitated the normal growth of cryopreserved Wharton's jelly tissue upon recovery,exhibiting mesenchymal stem cell morphology.No significant differences were observed between the experimental and control groups in terms of cell recovery rate,surface markers,and differentiation potential.(2)There was no significant difference in the number and viability of cells between the experimental group and the control group after cryopreservation of cord blood/peripheral blood mononuclear cells,and the cryo-resuscitated cell numbers and viability of derived NK cells/CIK cells did not show significant difference between the experimental and control groups.(3)For NK cells derived and differentiated from cord blood/peripheral blood mononuclear cells,there was no significant difference in the proportion of CD56+CD16+cell subpopulations between the experimental group and the control group.For CIK cells derived and differentiated from cord blood/peripheral blood mononuclear cells,there was no significant difference in the proportions of CD3+CD8+and CD3+CD56+cell subpopulations between the experimental group and the control group.(4)In terms of cytotoxicity testing,when the effective-target ratio of immune cells and melanoma cell line Mel624 was 20:1,whether it was NK cells/CIK cells derived from cord blood or peripheral blood mononuclear cells,there was no significant difference in the tumoricidal activity of cells between the experimental group and the control group.These findings suggest that the novel cryoprotectant can replace existing commercially available and widely used cryoprotectants,and is applicable to Wharton's jelly tissue,umbilical cord mesenchymal stem cells,umbilical cord blood/peripheral blood mononuclear cells,as well as NK and CIK cells,providing a solid technical foundation for the scaling,standardization,and commercialization of universal cryoprotectants.
8.Ancient data mining on drug characteristics of knee osteoarthritis
Zihan MENG ; Yueyue YU ; Xiaoyi SHI ; Xinyu MA ; Dingding WU ; Xu ZHANG ; Heyi LI ; Jingya WANG ; Liyuan ZHANG ; Heli ZHAO
China Modern Doctor 2025;63(12):1-4,48
Objective To analyze ancient prescriptions for knee osteoarthritis(KOA),and explore their application patterns,for providing clinical reference value.Methods Prescriptions were collected from ancient documents,and a database was created by using Excel 2016 for frequency analysis.Association rules and hidden structures were analyzed by using SPSS Modeler 18.0 and Lantern 5.0.Results A total of 373 prescriptions and 421 herbs were collected,with 3894 times of frequency of medication.Danggui was the most frequently used herb.Herbs primarily tonified deficiencies,relieved exterior symptoms,and expelled wind-dampness,with warm properties and pungent,sweet,or bitter tastes,mainly targeting the spleen and kidney meridians.Thirteen strong association rules were identified,including Chuanxiong+Niuxi-Danggui,and Bixie-Niuxi.Hidden structure analysis revealed 10 variables,leading to 4 clusters and 4 core prescriptions.Common syndromes included wind-damp,wind-cold-damp,wind-damp-heat,and qi-blood deficiency.Conclusion The treatment of KOA in ancient literature focuses on dispelling wind and removing dampness,taking into account both positive deficiency and evil excess,flexible use of tonifying spleen and kidney,clearing dampness-heat,tonifying Qi and blood and other drugs.
9.Regulatory mechanism of exercise promoting mitochondrial biogenesis in skeletal muscle
Zihan ZHANG ; Jiaxin WANG ; Wenyi YANG ; Lei ZHU
Chinese Journal of Tissue Engineering Research 2025;29(30):6499-6508
BACKGROUND:Mitochond rial biogenesis in skeletal muscle and its regulatory mechanisms during exercise have become focal points of research.Pathways such as AMP-activated protein kinase,peroxisome proliferator-activated receptory coactivator 1α,mitogen-activated protein kinase,calcium-regulated signaling play profound roles in exercise-induced mitochondrial biogenesis,impacting muscle metabolic optimization,enhanced athletic performance,and the prevention of metabolic diseases.However,the interactions among these pathways,their regulatory mechanisms,and their comprehensive effects on exercise-induced mitochondrial biogenesis in skeletal muscle remain unclear.OBJECTIVE:To explore the signaling pathways related to mitochondrial biogenesis in skeletal muscle,precisely analyze the induction and regulatory details of exercise within these pathways,and clearly elucidate the principles by which exercise-activated signaling pathways promote mitochondrial generation and functional enhancement.This will establish a theoretical foundation for improving muscle metabolism,enhancing exercise efficiency,and preventing metabolic diseases.METHODS:An extensive literature search was conducted using China National Knowledge Infrastructure(CNKI),WanFang,VIP,PubMed,and Web of Science.The latest publications related to mitochondrial biogenesis in skeletal muscle and its regulatory mechanisms were collected from inception to August 2024.By integrating findings from multiple signaling pathways,the regulatory mechanisms of exercise on mitochondrial biogenesis were systematically reviewed,with a focus on the interactions and synergistic mechanisms of AMP-activated protein kinase,peroxisome proliferator-activated receptor y coactivator 1α,protein kinase A,mitogen-activated protein kinase,calcium-regulated signaling pathways.RESULTS AND CONCLUSION:(1)Mitochondrial biogenesis in skeletal muscle is a complex biological process involving the coordinated regulation of multiple signaling pathways.This process aims to optimize the metabolic capacity,fatigue resistance,and overall athletic performance of skeletal muscle in response to changes in energy demand and external stress.The core mechanisms include the interactions and regulation of key factors such as AMP-activated protein kinase,peroxisome proliferator-activated receptor gamma coactivator 1α,and mitogen-activated protein kinase.(2)AMP-activated protein kinase senses the cellular energy status and activates peroxisome proliferator-activated receptor gamma coactivator 1α,thereby promoting mitochondrial biogenesis.Peroxisome proliferator-activated receptor gamma coactivator 1α,as the main regulator of mitochondrial biogenesis in skeletal muscle,can modulate the synthesis of mitochondrial proteins and DNA,enhance the antioxidant stress response,and improve mitochondrial function.(3)The mitogen-activated protein kinase signaling pathway,particularly p38 mitogen-activated protein kinase,further promotes mitochondrial generation by activating peroxisome proliferator-activated receptor gamma coactivator 1α during stress responses.(4)Additionally,calcium signaling and protein kinase A pathways play significant roles in the metabolic regulation of skeletal muscle.(5)Exercise can significantly enhance mitochondrial biogenesis capacity in skeletal muscle by activating these multiple signaling pathways,optimizing cellular metabolic efficiency,increasing muscle endurance,and improving athletic performance.(6)Future research should focus on in-depth exploration of the interaction mechanisms among AMP-activated protein kinase,peroxisome proliferator-activated receptor gamma coactivator1α,mitogen-activated protein kinases,and calcium signaling under different exercise intensities and modalities;strengthen studies across diverse age groups,genders,and health conditions;validate the universality and population-specificity of research findings;investigate the intricate mechanisms of emerging regulatory factors such as FNIP1 and PERM1 and their potential in exercise interventions;and promote the translation of exercise health research outcomes into clinical applications.
10.Regulatory mechanism of exercise promoting mitochondrial biogenesis in skeletal muscle
Zihan ZHANG ; Jiaxin WANG ; Wenyi YANG ; Lei ZHU
Chinese Journal of Tissue Engineering Research 2025;29(30):6499-6508
BACKGROUND:Mitochond rial biogenesis in skeletal muscle and its regulatory mechanisms during exercise have become focal points of research.Pathways such as AMP-activated protein kinase,peroxisome proliferator-activated receptory coactivator 1α,mitogen-activated protein kinase,calcium-regulated signaling play profound roles in exercise-induced mitochondrial biogenesis,impacting muscle metabolic optimization,enhanced athletic performance,and the prevention of metabolic diseases.However,the interactions among these pathways,their regulatory mechanisms,and their comprehensive effects on exercise-induced mitochondrial biogenesis in skeletal muscle remain unclear.OBJECTIVE:To explore the signaling pathways related to mitochondrial biogenesis in skeletal muscle,precisely analyze the induction and regulatory details of exercise within these pathways,and clearly elucidate the principles by which exercise-activated signaling pathways promote mitochondrial generation and functional enhancement.This will establish a theoretical foundation for improving muscle metabolism,enhancing exercise efficiency,and preventing metabolic diseases.METHODS:An extensive literature search was conducted using China National Knowledge Infrastructure(CNKI),WanFang,VIP,PubMed,and Web of Science.The latest publications related to mitochondrial biogenesis in skeletal muscle and its regulatory mechanisms were collected from inception to August 2024.By integrating findings from multiple signaling pathways,the regulatory mechanisms of exercise on mitochondrial biogenesis were systematically reviewed,with a focus on the interactions and synergistic mechanisms of AMP-activated protein kinase,peroxisome proliferator-activated receptor y coactivator 1α,protein kinase A,mitogen-activated protein kinase,calcium-regulated signaling pathways.RESULTS AND CONCLUSION:(1)Mitochondrial biogenesis in skeletal muscle is a complex biological process involving the coordinated regulation of multiple signaling pathways.This process aims to optimize the metabolic capacity,fatigue resistance,and overall athletic performance of skeletal muscle in response to changes in energy demand and external stress.The core mechanisms include the interactions and regulation of key factors such as AMP-activated protein kinase,peroxisome proliferator-activated receptor gamma coactivator 1α,and mitogen-activated protein kinase.(2)AMP-activated protein kinase senses the cellular energy status and activates peroxisome proliferator-activated receptor gamma coactivator 1α,thereby promoting mitochondrial biogenesis.Peroxisome proliferator-activated receptor gamma coactivator 1α,as the main regulator of mitochondrial biogenesis in skeletal muscle,can modulate the synthesis of mitochondrial proteins and DNA,enhance the antioxidant stress response,and improve mitochondrial function.(3)The mitogen-activated protein kinase signaling pathway,particularly p38 mitogen-activated protein kinase,further promotes mitochondrial generation by activating peroxisome proliferator-activated receptor gamma coactivator 1α during stress responses.(4)Additionally,calcium signaling and protein kinase A pathways play significant roles in the metabolic regulation of skeletal muscle.(5)Exercise can significantly enhance mitochondrial biogenesis capacity in skeletal muscle by activating these multiple signaling pathways,optimizing cellular metabolic efficiency,increasing muscle endurance,and improving athletic performance.(6)Future research should focus on in-depth exploration of the interaction mechanisms among AMP-activated protein kinase,peroxisome proliferator-activated receptor gamma coactivator1α,mitogen-activated protein kinases,and calcium signaling under different exercise intensities and modalities;strengthen studies across diverse age groups,genders,and health conditions;validate the universality and population-specificity of research findings;investigate the intricate mechanisms of emerging regulatory factors such as FNIP1 and PERM1 and their potential in exercise interventions;and promote the translation of exercise health research outcomes into clinical applications.

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