An artificial intelligence system for comprehensive pathologic outcome prediction in early gastric cancer through endoscopic image analysis (with video).

BACKGROUND: Accurate prediction of pathologic results for early gastric cancer (EGC) based on endoscopic findings is essential in deciding between endoscopic and surgical resection. This study aimed to develop an artificial intelligence (AI) model to assess comprehensive pathologic characteristics of EGC using white-light endoscopic images and videos. METHODS: To train the model, we retrospectively collected 4,336 images and prospectively included 153 videos from patients with EGC who underwent endoscopic or surgical resection. The performance of the model was tested and compared to that of 16 endoscopists (nine experts and seven novices) using a mutually exclusive set of 260 images and 10 videos. Finally, we conducted external validation using 436 images and 89 videos from another institution. RESULTS: After training, the model achieved predictive accuracies of 89.7% for undifferentiated histology, 88.0% for submucosal invasion, 87.9% for lymphovascular invasion (LVI), and 92.7% for lymph node metastasis (LNM), using endoscopic videos. The area under the curve values of the model were 0.992 for undifferentiated histology, 0.902 for submucosal invasion, 0.706 for LVI, and 0.680 for LNM in the test. In addition, the model showed significantly higher accuracy than the experts in predicting undifferentiated histology (92.7% vs. 71.6%), submucosal invasion (87.3% vs. 72.6%), and LNM (87.7% vs. 72.3%). The external validation showed accuracies of 75.6% and 71.9% for undifferentiated histology and submucosal invasion, respectively. CONCLUSIONS: AI may assist endoscopists with high predictive performance for differentiation status and invasion depth of EGC. Further research is needed to improve the detection of LVI and LNM.

Safety and Efficacy of HL301 In Radiation Pneumonitis in Patients With Unresectable Non-Small Cell Lung Cancer Receiving Curative Concurrent Chemoradiotherapy: A Multicenter, Randomized, Double-Blinded, Placebo-Controlled, Phase 2a Clinical Trial.

PURPOSE: We aimed to investigate the safety and efficacy of HL301, a standardized combination product of 7 medicinal plants, in radiation pneumonitis in patients with unresectable non-small cell lung cancer undergoing curative concurrent chemoradiotherapy. METHODS AND MATERIALS: The target accrual was 87 and a total of 63 patients were enrolled due to poor accrual rate. We randomly assigned the 63 patients to receive a placebo (arm A), or 1200 mg HL301 (arm B), or 1800 mg HL301 (arm C). Patients received weekly paclitaxel and carboplatin concurrently with intensity-modulated radiation therapy at 60 to 66 Gy in conventional fractionation. Durvalumab was administered as a maintenance treatment according to standard clinical practice. HL301 was administered orally, daily for 12 weeks. The primary endpoint was incidence of grade ≥2 radiation pneumonitis at 24 weeks postchemoradiotherapy. RESULTS: The baseline characteristics of the patients were well balanced. The drug was tolerable with a compliance rate of 86.6%, 86.2%, and 88.8% in arms A, B, and C, respectively (P = .874). None of the patients experienced severe drug-related adverse events. No significant difference in the rate of adverse events were observed between the treatment arms. The incidence of grade ≥2 radiation pneumonitis at 24 weeks postchemoradiotherapy was 37.5% (95% CI, 18.5%-61.4%), 55.6% (95% CI, 33.7%-75.4%), and 52.4% (95% CI, 32.4%-71.7%) in arms A, B, and C, respectively (P = .535). CONCLUSIONS: This is the first exploratory clinical trial to test the safety and efficacy of HL301 in patients with non-small cell lung cancer. Safety and feasibility of HL301 were established but no signals of efficacy in reducing radiation pneumonitis was observed in this dose level.

Risk Assessment of Metachronous Gastric Neoplasm after Endoscopic Resection for Early Gastric Cancer According to Age at Helicobacter pylori Eradication.

Background/Aims: Helicobacter pylori eradication can reduce the incidence of metachronous gastric neoplasm (MGN) after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). This study evaluated the risk of developing MGN after ESD for EGC based on age at H. pylori eradication. Methods: Data of patients who underwent curative ESD for EGC with H. pylori infection between 2005 and 2018 were retrospectively analyzed. The patients were allocated to four groups according to age at H. pylori eradication: group 1 (<50 years), group 2 (50-59 years), group 3 (60-69 years), and group 4 (≥70 years). Results: All patients were followed up for at least 5 years after ESD. The 5-year cumulative incidence of MGN was 2.1%, 7.0%, 8.7%, and 16.7% in groups 1, 2, 3, and 4, respectively (p<0.001), and groups 3 and 4 showed a significant increase in the risk of MGN (hazard ratio [HR], 4.66; 95% confidence interval [CI], 1.09 to 19.92 and HR, 10.75; 95% CI, 2.45 to 47.12). After adjustments for moderate to severe intestinal metaplasia based on the updated Sydney system, groups 3 and 4 remained significantly associated with MGN (HR, 4.40; 95% CI, 1.03 to 18.84 and HR, 10.14; 95% CI, 2.31 to 44.57). Conclusions: The incidence of MGN after ESD for EGC increased with age at H. pylori eradication. Age at H. pylori eradication ≥60 years was an independent risk factor for MGN, even after adjusting for the presence of advanced intestinal metaplasia.

Risk of gastric cancer in relation with serum cholesterol profiles: A nationwide population-based cohort study.

Obesity is a known risk factor for gastric cancer. However, the relationship between serum lipids and gastric cancer risk has not been fully established. We investigated the relationship between serum cholesterol levels and gastric cancer risk using a nationwide population cohort. Adults who received health care screening in 2009 from the Korean National Health Insurance Service were enrolled. Gastric cancer risk in relation to quartiles of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) were compared according to sex, using adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). Among 9690,168 subjects enrolled, 92,403 gastric cancer cases were diagnosed. Higher HDL-C levels were associated with lower gastric cancer risk in the total population, men, and women (aHR [for the highest quartile] = 0.98 [0.96-0.99, P < .0001], aHR = 0.98 [0.96-1.004, P = .0004], and aHR = 0.91 [0.88-0.94, P < .0001], respectively). HDL-C showed consistent trends regardless of age or statin use. Higher LDL-C levels were also associated with lower gastric cancer risk in the total population (aHR = 0.92 [0.91-0.94], P < .0001) and men (aHR = 0.94 [0.91-0.96], P < .0001), but not in women (P = .4073). A subgroup analysis of LDL-C showed significant interactions with age and statin use (Pinteraction < .0001 and Pinteraction = .0497, respectively). The risk of gastric cancer was higher in subjects with elevated LDL-C levels in the younger group (age < 55, HR [for the highest quartile] = 1.02 [0.99-1.04] in the total population; HR = 1.03 [1.003-1.06] in men), the risk was lower in subjects with elevated LDL-C in the elderly (age ≥ 55, HR = 0.93 [0.91-0.95] in the total population; HR = 0.94 [0.92-0.96] in men). Elevated TC was associated with lower gastric cancer risk in the total population (aHR = 0.95 [0.94-0.97], P < .0001), but not in each sex separately (P = .3922 in men; P = .1046 in women). Overall, higher HDL-C levels may play a protective role in gastric cancer pathogenesis. The association between LDL-C/TC and gastric cancer seems to vary according to sex, age, and statin use. Especially in young males under age 55, high LDL-C and TC levels were associated with higher risk of gastric cancer.

Thyme Extract Alleviates High-Fat Diet-Induced Obesity and Gut Dysfunction.

Prolonged intake of a high-fat diet (HFD) disturbs the composition of gut microbiota, contributing to the development of metabolic diseases, notably obesity and increased intestinal permeability. Thyme (Thymus vulgaris L.), an aromatic plant, is known for its several therapeutic properties. In this study, we explored the potential of thyme extract (TLE) to mitigate HFD-induced metabolic derangements and improve the gut environment. Eight-week-old C57BL/6 mice were administered 50 or 100 mg/kg TLE for eight weeks. Administration of 100 mg/kg TLE resulted in decreased weight gain and body fat percentage, alongside the regulation of serum biomarkers linked to obesity induced by a HFD. Moreover, TLE enhanced intestinal barrier function by increasing the expression of tight junction proteins and ameliorated colon shortening. TLE also altered the levels of various metabolites. Especially, when compared with a HFD, it was confirmed that 2-hydroxypalmitic acid and 3-indoleacrylic acid returned to normal levels after TLE treatment. Additionally, we investigated the correlation between fecal metabolites and metabolic parameters; deoxycholic acid displayed a positive correlation with most parameters, except for colon length. In contrast, hypoxanthine was negatively correlated with most parameters. These results suggest a promising role for thyme in ameliorating obesity and related gut conditions associated with a HFD.

Anti-obesity effects of red pepper (Capsicum annuum L.) leaf extract on 3T3-L1 preadipocytes and high fat diet-fed mice.

Patients with obesity mostly have metabolic syndrome and this can lead to multiple health problems. In the present study, we evaluated the anti-obesity effect of water-soluble red pepper (Capsicum annuum L.) leaf extract (PLE) on 3T3-L1 adipocytes and high-fat diet (HFD)-fed mice. The adipocyte lipid content was determined using Oil Red O staining, which revealed that 100 µg mL-1 PLE markedly reduced fat accumulation without affecting the cell viability. PLE exhibited high prebiotic activity scores by modulating probiotic strains, contributing to host health improvement. In vivo investigation in HFD-fed mice revealed that PLE supplementation significantly decreased the HFD-induced increases in the body weight, amount of white adipose tissue, and serum triglyceride, total cholesterol, leptin, and insulin levels. Consistent with its effects on reduced lipid droplet formation in the liver, PLE supplementation suppressed the expression of lipid synthesis-related proteins including SREBP-1, FAS, and PPAR-γ in the liver and increased that of PGC-1α, CPT1, and adiponectin in epididymal WAT. PLE treatment improved intestinal barrier function and inflammation and reduced harmful intestinal enzyme activities in the feces. Collectively, these results indicate that PLE inhibits fat accumulation in HFD-fed mice via the suppression of adipogenesis and lipogenesis, suggesting its potential in preventing obesity.

Gellan gum prevents non-alcoholic fatty liver disease by modulating the gut microbiota and metabolites.

Gellan gum (GG) is an anionic polysaccharide used as an additive in the food industry. However, the effect of GG on gut microbiota regulation and nonalcoholic fatty liver disease (NAFLD) has not yet been investigated. In vitro fermentation experiments have demonstrated that GG promoted the growth of probiotic strains such as Lactiplantibacillus rhamnosus and Bifidobacterium bifidum, producing metabolites beneficial to gut health. In mice, GG reduced hepatic triglyceride content, serum biomarkers, and body fat mass and weight gain induced by a high fat diet. Additionally, GG regulated the gut microbiota including Desulfovibrionales, Deferribacterales, Bacteroidales, and Lactobacillales at the order level and also promoted short-chain fatty acid production. Moreover, GG improved the expression of proteins related to hepatic inflammation and lipid metabolism. Taken together, GG ameliorated NAFLD, possibly by acting on the gut-liver axis via improving the gut health, indicating its potential as a food supplement and/or prebiotic against NAFLD.

Morinda citrifolia Extract Prevents Alcoholic Fatty Liver Disease by Improving Gut Health.

Alcoholic liver disease (ALD) is a major chronic liver disease. Chronic alcohol consumption induces dysbiosis, disruption of gut barrier function, oxidative stress, inflammation, and changes in lipid metabolism, thereby leading to ALD. In this study, we investigated whether the commercial Morinda citrifolia extract Nonitri can ameliorate ALD symptoms through the gut-liver axis. We used mice chronically administered EtOH and found a marked increase in serum endotoxin levels and biomarkers of liver pathology. Moreover, the EtOH-treated group showed significantly altered gut microbial composition particularly that of Alistipes, Bacteroides, and Muribaculum and disrupted gut barrier function. However, Nonitri improved serum parameters, restored the microbial proportions, and regulated levels of zonula occludens1, occludin, and claudin1. Furthermore, Nonitri suppressed inflammation by inhibiting endotoxin-triggered toll-like receptor 4-signaling pathway and fat deposition by reducing lipogenesis through activating AMP-activated protein kinase in the liver. Furthermore, Pearson's correlation analysis showed that gut microbiota and ALD-related markers were correlated, and Nonitri regulated these bacteria. Taken together, our results indicate that the hepatoprotective effect of Nonitri reduces endotoxin levels by improving gut health, and inhibits fat deposition by regulating lipid metabolism.

Lactococcus lactis KF140 Reduces Dietary Absorption of Nε - (Carboxymethyl)lysine in Rats and Humans via ß-Galactosidase Activity.

Background and Aims: Excessive intake of advanced glycation end products (AGEs), which are formed in foods cooked at high temperatures for long periods of time, has negative health effects, such as inflammatory responses and oxidative stress. Nε-(Carboxymethyl)lysine (CML) is one of the major dietary AGEs. Given their generally recognized as safe status and probiotic functionalities, lactic acid bacteria may be ideal supplements for blocking intestinal absorption of food toxicants. However, the protective effects of lactic acid bacteria against dietary AGEs have not been fully elucidated. Materials and Methods: We investigated the effect of treatment with Lactococcus lactis KF140 (LL-KF140), which was isolated from kimchi, on the levels and toxicokinetics of CML. The CML reduction efficacies of the Lactococcus lactis KF140 (LL-KF140), which was isolated from kimchi, were conducted by in vitro test for reducing CML concentration of the casein-lactose reaction product (CLRP) and in vivo test for reducing serum CML level of LL-KF140 administered rats at 2.0 × 108 CFU/kg for14 days. In addition, 12 volunteers consuming LL-KF140 at 2.0 × 109 CFU/1.5 g for 26 days were determined blood CML concentration and compared with that before intake a Parmesan cheese. Results: Administration of LL-KF140 reduced serum CML levels and hepatic CML absorption in rats that were fed a CML-enriched product. In a human trial, the intake of LL-KF140 prevented increases in the serum levels of CML and alanine aminotransferase after consumption of a CML-rich cheese. LL-KF140 was determined to presence in feces through metagenome analysis. Furthermore, ß-galactosidase, one of the L. lactis-produced enzymes, inhibited the absorption of CML and reduced the levels of this AGE, which suggests an indirect inhibitory effect of LL-KF140. This study is the first to demonstrate that an L. lactis strain and its related enzyme contribute to the reduction of dietary absorption of CML.

A water soluble extract of radish greens ameliorates high fat diet-induced obesity in mice and inhibits adipogenesis in preadipocytes.

Radish (Raphanus sativus L.) is a rich source of nutrients and its greens have reported functionalities. This study aimed to investigate the effects of a water-soluble extract from radish greens (WERG) on adipogenesis in 3T3-L1 adipocytes and high-fat diet-induced obesity in model mice. We also quantified the phytochemical composition of WERG such as glucoraphenin and ferulic acid. These findings show that treatment with 100 µg mL-1 WERG reduced lipid accumulation in 3T3-L1 adipocytes, whereas in mice, the administration of 100 mg kg-1 WERG reduced weight gain and hepatic lipid accumulation and improved the levels of serum lipid biomarkers. Furthermore, WERG treatment improved intestinal permeability and suppressed the activities of harmful intestinal enzymes in feces, thus improving gut health. It also inhibited metabolic endotoxemia and inflammatory marker levels in serum. Moreover, WERG reduced the expression of lipid-metabolism-related proteins in the liver and white adipose tissue. Collectively, these results indicate that WERG may potentiate the anti-obesity effect by improving gut health and regulating lipid metabolism.

Bifidobacterium animalis ssp. lactis MG741 Reduces Body Weight and Ameliorates Nonalcoholic Fatty Liver Disease via Improving the Gut Permeability and Amelioration of Inflammatory Cytokines.

Diet-induced obesity is one of the major causes of the development of metabolic disorders such as insulin resistance and nonalcoholic fatty liver disease (NAFLD). Recently, specific probiotic strains have been found to improve the symptoms of NAFLD. We examined the effects of Bifidobacterium animalis ssp. lactis MG741 (MG741) on NAFLD and weight gain, using a mouse model of high-fat-diet (HFD)-induced obesity. HFD-fed mice were supplemented daily with MG741. After 12 weeks, MG741-administered mice exhibited reduced fat deposition, and serum metabolic alterations, including fasting hyperinsulinemia, were modulated. In addition, MG741 regulated Acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS), sterol regulatory element-binding protein 1 (SREBP-1), and carbohydrate-responsive element-binding protein (ChREBP) expression and lipid accumulation in the liver, thereby reducing the hepatic steatosis score. To determine whether the effects of MG741 were related to improvements in gut health, MG741 improved the HFD-induced deterioration in gut permeability by reducing toxic substances and inflammatory cytokine expression, and upregulating tight junctions. These results collectively demonstrate that the oral administration of MG741 could prevent NAFLD and obesity, thereby improving metabolic health.

Dietary rhamnogalacturonan-â rich extracts of molokhia ameliorate high fat diet-induced obesity and gut dysbiosis.

Obesity is a global health issue associated with increased prevalence of disease and mortality. Molokhia (Corchorus olitorius L.) leaves, used as vegetables in Asia and Africa, comprise abundant water-soluble mucilage polysaccharides. The present study aimed to evaluate the effects of molokhia leaf polysaccharide fraction (MPF) on high-fat diet (HFD)-induced obesity and gut dysbiosis in mice. A significant decrease was observed in the body weight, adipocyte size, triglyceride serum, and low-density lipoprotein cholesterol levels, as well as in the expression of lipid synthesis-related proteins in mice treated with 4 mg/kg of MPF (MPF4). Moreover, the expression of the tight junction protein increased significantly; however, gut permeability and related inflammatory marker levels decreased in the MPF4 group. Furthermore, MPF ameliorated gut dysbiosis, whereas the MPF4 group presented a decreased Firmicutes to Bacteroidetes ratios and an increased abundance of Akkermansia during exposure to HFD. Our findings reveal that rhamnogalacturonan-Ⅰ rich MPF attenuates obesity in mice subjected to HFD by modulating the gut microbiota.

A Pilot Study of Allogeneic Hematopoietic Stem Cell Transplantation for Intermediated-risk Acute Myeloid Leukemia Patients.

BACKGROUND/AIM: For intermediate risk acute myeloid leukemia patients, allogeneic hematopoietic stem cell transplantation (alloSCT) and chemotherapy are equally recommended as consolidation after first complete remission (CR1). In real-world, alloSCT might not be readily available, but there is paucity of data on the optimal timing of alloSCT for these patients. PATIENTS AND METHODS: In this pilot study, we compared the outcomes of 13 patients undergoing alloSCT in CR1 with 13 patients undergoing alloSCT after relapse (non-CR1) to examine whether upfront alloSCT yields a better prognosis. RESULTS: There were no differences between the two groups with regards to relapse-free survival (p=0.507) and overall survival (p=0.798). There were more chronic graft-versus-host-disease (GVHD) in the CR1 group compared to the non-CR group (p=0.001), but no difference in acute GVHD. CONCLUSION: The outcome of alloSCT after relapse is not inferior to that of alloSCT in CR1, supporting the role of alloSCT after relapse in the setting of limited donors and resources.

Polysaccharide fraction from greens of Raphanus sativus alleviates high fat diet-induced obesity.

Radish (Raphanus sativus) greens are commonly used as a vegetable in Korea; however, their anti-obesity effect has not been reported yet. We prepared the polysaccharide fraction of radish greens (PRG) and assessed its anti-obesity activity in high fat diet (HFD)-induced obese C57BL/6J mice. Supplementation with 4 mg/kg PRG reduced weight gain and body fat percentage, and regulated serum biomarkers against HFD-induced obesity. Moreover, PRG treatment improved gut permeability by increasing tight junction protein expression and colon length shortening. HFD intake increased the proportion of Firmicutes and decreased the proportion of Bacteroidetes and Verrucomicrobia; however, PRG supplementation maintained gut microbial composition to normal diet condition. Moreover, PRG reduced HFD-induced increase of lipid metabolism-related protein expression, along with adipocyte size in white adipose tissue. These results indicated that PRG as a potential prebiotic, has anti-obesity properties by improving gut barrier function, modulating gut microbiota and regulating lipid metabolism.

Molokhia leaf extract prevents gut inflammation and obesity.

ETHNOPHARMACOLOGICAL RELEVANCE: Molokhia is highly consumed in Egypt as edible and medicinal plants, and its leaves are used for the treatment of pain, fever, and inflammation. AIM OF THE STUDY: High-fat diet (HFD) induces gut dysbiosis, which is closely linked to metabolic diseases including obesity and leaky gut. The effects of molokhia (Corchorus olitorius L.) on anti-obesity and gut health were investigated in this study. MATERIALS AND METHODS: The effects of a water-soluble extract from molokhia leaves (WM) on lipid accumulation in 3T3-L1 adipocytes and on body weight, gut permeability, hormone levels, fecal enzyme activity of the intestinal microflora, and gut microbiota in HFD-induced C57BL/6J mice were examined. RESULTS: WM treatment significantly inhibited lipid accumulation in 3T3-L1 adipocytes. Mice treated with 100 mg/kg WM had 13.1, 52.4, and 17.4% significantly lower body weights, gut permeability, and hepatic lipid accumulation than those in the HFD group, respectively. In addition, WM influenced gut health by inhibiting metabolic endotoxemia and colonic inflammation. It also altered the composition of the gut microbiota; in particular, it increased the abundance of Lactobacillus and decreased that of Desulfovibrio. CONCLUSION: Our results extend our understanding of the beneficial effects of WM consumption, including the prevention of gut dysbiosis and obesity.

N ε-(carboxymethyl)lysine formation from the Maillard reaction of casein and different reducing sugars.

Dietary advanced glycation end products (AGEs) are involved in the pathogenesis of diabetic complications, atherosclerosis, and kidney disease. Formation of N ε-(carboxymethyl)lysine (CML), a well-known AGEs, was evaluated from the reaction of casein from bovine milk with different reducing sugars (glucose, tagatose, and xylose) at various sugar concentrations and heating temperatures (75 and 120 °C) used in food processing to determine the best sweetener to be used in dairy products. The concentration of CML was measured using an enzyme-linked immunosorbent assay. Additionally, SDS-PAGE was carried out to observe the changes in the molecular weight of casein. The results reveal that tagatose leads to a lower CML concentration at 75 °C than glucose or xylose, whereas no significant differences are observed at 120 °C. We conclude that it would be more appropriate to use tagatose rather than glucose or xylose as a sweetener, considering the AGEs contents in heat-treated dairy products.

Consumption of salt leads to ameliorate symptoms of metabolic disorder and change of gut microbiota.

PURPOSE: Metabolic diseases caused by high-carbohydrate and/or high-salt diets are becoming major public health concerns. However, the effects of salt on high-carbohydrate diet-induced obesity are unclear. Accordingly, in this study, we investigated the effects of high-salt intake on high-carbohydrate diet-induced obesity. METHODS: We performed a 12-week study on gut microbiota and metabolic changes in high-rice diet (HRD) or HRD supplemented with high-salt (HRS)-fed C57BL/6 J mice by 16S rRNA analysis, glucose and insulin tolerance testing, gut barrier function, western blot and histological analysis. Moreover, the effects of salt on lipid metabolism were confirmed in vitro using 3T3-L1 cells. RESULTS: High salt intake decreased HRD-induced increases in body and white adipose tissue (WAT) weight. Alternatively, HRS did not reverse the observed increases in glucose intolerance and insulin resistance. Moreover, HRD caused changes in the gut microbiota, thereby impairing gut barrier function and increasing inflammation in the liver. HRS altered HRD-induced microbial composition, however, did not ameliorate gut barrier dysfunction or hepatic inflammation. HRS diets regulated the HRD-induced increase in peroxisome proliferator-activated receptor-γ (PPAR-γ) and lipid metabolism-related protein expression. Moreover, within WAT, HRS was found to reverse the observed decrease in adiponectin and increase in PPAR-γ expression induced by HRD. In vitro, high NaCl concentration also significantly reduced 3T3-L1 cell differentiation and modulated lipid metabolism without causing cytotoxicity. CONCLUSION: These results indicate that high salt intake ameliorates metabolic changes associated with a high-rice diet, including changes in fecal microbiota composition.

Prediction of CML contents in the Maillard reaction products for casein-monosaccharides model.

Response surface methodology (RSM) was applied to predict the processing parameters of the casein-glucose/galactose Maillard reaction (MR) for determining the level of Nε-(1-carboxymethyl)-l-lysine (CML), one of the typically harmful dietary advanced glycation end products (AGEs). The effect of industrial heating time and temperature of the MR on casein-glucose reactant (CGR) and casein-galactose reactant (CGaR) was evaluated. An increase in temperature and time was associated with an increased level of CML. A heating time of 114.8/117.9min and a temperature of 145.1/148.8°C maximised the formation of CML on CGR/CGaR and resulted in a CML production of 12.0/14.0µg/mL. Evaluation of foam stability, SDS-PAGE, and energy filtering-TEM indicated that the CGR and CGaR had different characteristics. Moreover, level of intracellular reactive oxygen species was accumulated with increasing CML contents. In summary, RSM provided a basis for understanding CGR/CGaR-reactivity and for predicting the formation of CML in heat-treated milk products.

High-Glucose or -Fructose Diet Cause Changes of the Gut Microbiota and Metabolic Disorders in Mice without Body Weight Change.

High fat diet-induced changes in gut microbiota have been linked to intestinal permeability and metabolic endotoxemia, which is related to metabolic disorders. However, the influence of a high-glucose (HGD) or high-fructose (HFrD) diet on gut microbiota is largely unknown. We performed changes of gut microbiota in HGD- or HFrD-fed C57BL/6J mice by 16S rRNA analysis. Gut microbiota-derived endotoxin-induced metabolic disorders were evaluated by glucose and insulin tolerance test, gut permeability, Western blot and histological analysis. We found that the HGD and HFrD groups had comparatively higher blood glucose and endotoxin levels, fat mass, dyslipidemia, and glucose intolerance without changes in bodyweight. The HGD- and HFrD-fed mice lost gut microbial diversity, characterized by a lower proportion of Bacteroidetes and a markedly increased proportion of Proteobacteria. Moreover, the HGD and HFrD groups had increased gut permeability due to alterations to the tight junction proteins caused by gut inflammation. Hepatic inflammation and lipid accumulation were also markedly increased in the HGD and HFrD groups. High levels of glucose or fructose in the diet regulate the gut microbiota and increase intestinal permeability, which precedes the development of metabolic endotoxemia, inflammation, and lipid accumulation, ultimately leading to hepatic steatosis and normal-weight obesity.