Sophocarpine attenuates septic liver injury through suppression of the NLRP3 inflammasome via autophagy-mediated degradation.

Septic liver injury remains a challenge in sepsis treatment. Nucleotide-binding oligomerization domain, leucine rich repeat and pyrin domain containing 3 (NLRP3) inflammasome activation has been suggested to be a major cause of hepatocyte cell death in liver diseases. However, insufficient research has been performed to explore the underlying mechanisms associated with this. In the present study, sophocarpine, a pharmaceutical monomer originally isolated from Sophora flavescens, was suggested to attenuate septic liver injury in a mouse cecal ligation and puncture (CLP) model. By utilizing western blotting, ELISA, H&E staining and immunohistochemistry, the results demonstrated that sophocarpine treatment reversed CLP-induced elevations in serum aspartate transaminase, alanine transaminase, interleukin (IL)-6 and IL-1ß levels. Additionally, sophocarpine appeared to have suppressed the activation of the NLRP3 inflammasome, as indicated by observed reductions in liver IL-1ß, NLRP3, caspase 1-p20 and gasdermin D-p30 protein levels. Further investigation suggested that sophocarpine-induced autophagy was essential for this suppression of NLRP3 inflammasome activation, the inhibition of which reversed the protective effects of sophocarpine on CLP-induced liver injury. Collectively, results from the present study suggested a protective role for sophocarpine against septic liver injury, where sophocarpine may suppress NLRP3 inflammasome activation by autophagy-mediated degradation.

The efficacy and safety of remimazolam tosylate versus propofol in patients undergoing colonoscopy: a multicentered, randomized, positive-controlled, phase III clinical trial.

This study aimed to evaluate the efficacy and safety of remimazolam tosylate versus propofol in patients undergoing colonoscopy. In this multicentered, blinded, randomized, active-controlled, non-inferior phase III trial, 384 eligible patients who were about to undergo colonoscopy were randomized as a ratio of 1:1 into remimazolam and propofol group. Procedure success was assessed and defined as the completion of colonoscopy without administration of rescue sedative agent or more than 5 top-ups of trial drug in any 15 minute-period after initial administration of trial drug. Sedation quality was evaluated by Modified Observer's Assessment of Alertness/Sedation score. Treatment-emergent adverse events were recorded. Procedure success rate was 96.91% (188/194) in remimazolam group and 100% (190/190) in propofol group, and the difference in rate was -3.09% with 95% confidence interval (CI) of -5.53%~-0.66%. Since the lower limit of 95% CI was greater than the non-inferiority margin of -8.00%, the efficacy of remimazolam tosylate was non-inferior to propofol. Besides, induction time of sedation was increased (P<0.001), while hypotension and respiratory depression was decreased in remimazolam group compared to propofol group; however, time to fully alert (P>0.05) or time to discharge (P>0.05) were unchanged. For safety assessment, total treatment-emergent adverse events were decreased in remimazolam group compared to propofol group (P<0.001); specifically, administration site pain (P<0.001), increased bilirubin (P=0.019), decreased respiratory rate (P<0.001) and decreased SpO2 (P<0.001) were less frequent in remimazolam group compared with propofol group. In conclusion, remimazolam tosylate is non-inferior in sedation efficacy while safer than propofol in patients undergoing colonoscopy.

MiR-101 relates to chronic peripheral neuropathic pain through targeting KPNB1 and regulating NF-κB signaling.

Accumulating evidences indicates that chronic neuropathic pain is a kind of neuro-immune disorder with enhanced activation of the immune system. Although the prevalence is very high, neuropathic pain remains extremely difficult to cure. miRNAs are a group of short nonprotein coding RNAs, regulating target genes expression via targeting 3'-untranslated region. More and more research indicates that altered miRNAs expression profile relates to the pathogenesis of neuropathic pain. In this study, we firstly detected the expression of six candidate miRNAs in the plasma samples from 23 patients with neuropathic pain and 10 healthy controls. Subsequently, the level of miR-132 and miR-101 was detected in the sural nerve biopsies. We found miR-101 level was significantly repressed in both the plasma samples and sural nerve biopsies from neuropathic pain patients. Predicted by bioinformatics tools and confirmed by dual luciferase assay and immunoblotting, we identified that KPNB1 is a direct target of miR-101. The negative correlation between miR-101 and KPNB1 was also confirmed in the sural nerve biopsies, and miR-101 reduction relates to the activation of NF-κB signaling in vivo and in vitro which contributes to the pathogenesis of neuropathic pain.

Acetic acid alleviates the inflammatory response and liver injury in septic mice by increasing the expression of TRIM40.

Sepsis remains a significant health care issue in clinical practice due to its high mortality rate and healthcare cost, despite extensive efforts to better understand the pathophysiology of sepsis. The systemic inflammatory response often leads to severe liver injury, even acute liver dysfunction and failure. Acetic acid, as a type of chemical compound, has been reported to be an emerging drug for improving metabolic syndrome and inhibiting inflammation in rats and human. To verify the effects of acetic acid in protecting the liver and reducing the inflammatory response, a septic mouse model was established by cecal ligation and puncture (CLP), and then the CLP-model mice were treated with acetic acid or PBS. Following the treatment, it was determined that, in CLP-model mice, acetic acid could alleviate the inflammatory response by decreasing the expression of cytokines including interleukin-6 and tumor necrosis factor-α. Additionally, acetic acid also alleviated the liver injury, and the levels of alanine aminotransaminase, aspartate aminotransferase, Toll-like receptor (TLR)4 and nuclear factor-κB (NF-κB) were decreased. The expression of tripartite motif-containing protein (TRIM)40 was also upregulated significantly. Therefore, the authors of the current study hypothesized that acetic acid could decrease the inflammatory response by increasing the expression of TRIM40 and TRIM40 may regulate the activity of the TLR4 signaling pathway. To further illustrate the interaction between TRIM40 and the TLR4 signaling pathway, the authors collected macrophages from the peritoneal cavity by intraperitoneally administering mice with 5 ml ice-cold normal saline. Following the collection, peritoneal macrophages were treated with acetic acid, TRIM40 small interfering RNA or PBS. It was demonstrated that acetic acid upregulated the expression of TRIM40. When TRIM40 was silenced, the protective effect of acetic acid would be reversed as well. The results suggested that TRIM40 could act on and downregulate the activity of the TLR4 signaling pathway. TRIM40 is possibly the major target for acetic acid, which may function as a protective factor in septic mice.

AS-IV protects against kidney IRI through inhibition of NF-κB activity and PUMA upregulation.

OBJECTIVE: To determine and explore the effect of Astragalus saponin IV (AS-IV) on ischemia/reperfusion (IR)-induced renal injury and its mechanisms. METHODS: Experimental model of renal I/R was induced in rats by bilateral renal artery clamp for 45 min followed by reperfusion of 6 h. Rats were divided into three groups: ① sham ② IRI ③ IRI/AS-IV. In IRI/AS-IV groups, AS-IV was orally administered once a day to rats at 2 mg·kg(-1)·d(-1) for 7 days prior to ischemia. At 6 h after reperfusion, the inflammatory cytokines and renal function was assessed and NF-κB activity and PUMA expression was detected. Apoptotic cells was detected by TUNEL assay. RESULTS: AS-IV significantly decreased serum and tissue levels of IL-6 and TNF-α, and reduced apoptotic cell counts and histological damage. AS-IV down-regulated the phosphorylation of p65 subunit of NF-κB (NF-κB p65) and PUMA expression, and the NF-κB activity compared to the I/R groups. CONCLUSIONS: AS-IV provided protection against IRI-induced renal injury by reducing apoptosis and inflammation through inhibition of NF-κB activity and PUMA expression. AS-IV pre-treatment ameliorated tubular damage and suppressed the NF-κB p65 expression.