Efficacy of Laurus nobilis L. for Tight Junction Protein Imbalance in Leaky Gut Syndrome.

Laurus nobilis L. (LNL) belongs to the evergreen Lauraceae family. It is native to the Mediterranean and widely distributed in the southern United States, Europe, and the Middle East. LNL is rich in active ingredients of the sesquiterpene lactone series and has been reported to have antioxidant, anti-inflammatory, and anticancer effects. And parthenolide, known as a sesquiterpene lactone-based compound, inhibits the activation of lipopolysaccharide-binding protein (LBP), which is a major trigger for leaky gut syndrome. However, the effectiveness of LNL in improving the state of increased intestinal permeability has not yet been reported. Therefore, we demonstrated the efficacy of LNL, which is known to be rich in parthenolide, in improving intestinal permeability induced by IL-13. We investigated the improvement in permeability and analyzed major tight junction proteins (TJs), permeability-related mechanisms, weight and disease activity indices, and corresponding cytokine mechanisms. LNL maintained TJs homeostasis and clinical improvement by reducing increased claudin-2 through the inhibition of IL-13/STAT6 activation in TJ-damaged conditions. These results are expected to be effective in preventing leaky gut syndrome through the TJ balance and to further improve intestinal-related diseases, such as inflammatory bowel disease.

Glucose Control in Korean Patients with Type 2 Diabetes Mellitus according to Body Mass Index.

Background: The prevalence of type 2 diabetes mellitus has continued to rise. Although many studies have focused on the connection between weight loss and glucose control, only a few studies have investigated the association between body mass index (BMI) and glucose control status. We examined the association between glucose control and obesity. Methods: We analyzed 3,042 participants with diabetes mellitus who were aged ≥19 years when they participated in the 2014 to 2018 Korean National Health and Nutrition Examination Survey. The participants were divided into four groups according to their BMI (<18.5, 18.5-23, 23-25, and ≥25 kg/m2). We used guidelines from the Korean Diabetes Association to compare the glucose control in those groups, with a cross-sectional design, multivariable logistic regression, and glycosylated hemoglobin <6.5% as the reference. Results: Overweight males aged ≥60 years had a high odds ratio (OR) for degraded glucose control (OR, 1.706; 95% confidence interval [CI], 1.151 to 2.527). Among obese females, those in the ≥60 years age group showed an increased OR for uncontrolled diabetes (OR, 1.516; 95% CI, 1.025 to 1.892). Moreover, in females, the OR for uncontrolled diabetes tended to increase as the BMI increased (P=0.017). Conclusion: Obesity is associated with uncontrolled diabetes in female patients with diabetes who are aged ≥60 years. Physicians should closely monitor this group for diabetes control.

Restoration for the foregut surgery: bridging gaps between foregut surgery practice and academia.

Foregut surgery largely involves benign diseases, and not only malignant diseases. However, for foregut surgeons in Asia, this fact has not been extensively utilized in their clinical practice due to the high burden of gastric cancer surgery. Although the prevalence of gastroesophageal reflux disease (GERD) in Eastern Asia, including Korea, is increasing, antireflux surgery (ARS) is still a fairly rare procedure in Korea. ARS is effective as proton pump inhibitors and is cost-effective compared to continuous double-dose proton pump inhibitors in patients with severe GERD. Therefore, we should focus on ARS as a treatment option for GERD also in Asian population. Similarly, although bariatric/metabolic surgery is effective in weight reduction and diabetes mellitus (DM) remission in patients with morbid obesity or DM, bariatric/metabolic surgery is only performed in a limited number of patients. Given that the prevalence of obesity and DM is continuously increasing in Korea, bariatric/metabolic surgery should become an interest among Korean foregut surgeons and should be considered a treatment for obesity and DM. Furthermore, there are new surgical fields that can control both benign and malignant diseases. Oncometabolic surgery is a field under foregut surgery that treats both malignant and benign components of a condition, an example being the control of metabolic syndrome while performing gastric cancer surgery. Therefore, in future gastric cancer treatment, oncometabolic surgery can be applied to patients with gastric cancer accompanied by obesity or metabolic syndrome.