The deubiquitinating enzyme 13 retards non-alcoholic steatohepatitis via blocking inactive rhomboid protein 2-dependent pathway

Nowadays potential preclinical drugs for the treatment of nonalcoholic steatohepatitis (NASH) have failed to achieve expected therapeutic efficacy because the pathogenic mechanisms are underestimated. Inactive rhomboid protein 2 (IRHOM2), a promising target for treatment of inflammation-related diseases, contributes to deregulated hepatocyte metabolism-associated nonalcoholic steatohepatitis (NASH) progression. However, the molecular mechanism underlying Irhom2 regulation is still not completely understood. In this work, we identify the ubiquitin-specific protease 13 (USP13) as a critical and novel endogenous blocker of IRHOM2, and we also indicate that USP13 is an IRHOM2-interacting protein that catalyzes deubiquitination of Irhom2 in hepatocytes. Hepatocyte-specific loss of the Usp13 disrupts liver metabolic homeostasis, followed by glycometabolic disorder, lipid deposition, increased inflammation, and markedly promotes NASH development. Conversely, transgenic mice with Usp13 overexpression, lentivirus (LV)- or adeno-associated virus (AAV)-driven Usp13 gene therapeutics mitigates NASH in 3 models of rodent. Mechanistically, in response to metabolic stresses, USP13 directly interacts with IRHOM2 and removes its K63-linked ubiquitination induced by ubiquitin-conjugating enzyme E2N (UBC13), a ubiquitin E2 conjugating enzyme, and thus prevents its activation of downstream cascade pathway. USP13 is a potential treatment target for NASH therapy by targeting the Irhom2 signaling pathway.

Fisetin protects against high fat diet-induced nephropathy by inhibiting inflammation and oxidative stress via the blockage of iRhom2/NF-κB signaling.

Promoted inflammation enhances the development of nephropathy in obesity. Fisetin (3,3',4',7-tetrahydroxyflavone, FIS) is a naturally occurring dietary flavonoid, and exhibits anti-inflammatory and anti-oxidative properties. Inactive rhomboid protein 2 (iRhom2), an inactive member of the rhomboid intramembrane proteinase family, is an essential inflammation-associated regulator. Here, we attempted to investigate the protective mechanisms of FIS against high fat diet (HFD)-induced nephropathy, with particular focus on iRhom2. We found that HFD induced systematic and renal pro-inflammatory cytokine production. Furthermore, iRhom2 expression was markedly elevated in kidney of HFD-fed mice, and in PAL-incubated macrophages, accompanied with high phosphorylation of NF-κB. Significant oxidative stress was observed in kidney of HFD-fed mice through suppressing Nrf-2/HO-1 signaling. Moreover, activation of iRhom2/NF-κB signaling and oxidative stress by PAL was detected in macrophages, which were effectively reversed by FIS. Importantly, we showed that iRhom2 knockdown significantly abrogated the ability of FIS to restrain inflammation and oxidative stress induced by PAL in macrophages, indicating that iRhom2 might be a potential therapeutic target for FIS during nephropathy treatment. Together, these results revealed that FIS could mitigate HFD-induced renal injury by regulating iRhom2/NF-κB and Nrf-2/HO-1 signaling pathways.

Effects of XIAP on high fat diet-induced hepatic steatosis: a mechanism involving NLRP3 inflammasome and oxidative stress.

Increasing evidence indicates that prolonged fat-rich diet (HFD) ingestion is a predisposing factor for metabolic disorder-associated system inflammation and oxidative stress injury, which contributes to the occurrence of non-alcoholic fatty liver disease (NAFLD). NACHT, LRR and PYD domains-containing protein 3 (NLRP3)-mediated inflammatory infiltration was determined to participate in NAFLD. X-linked inhibitor of apoptosis protein (XIAP) was recently confirmed as an essential regulator for apoptosis in cells. However, the role of XIAP in HFD-induced NAFLD is still not understood. Here, XIAP was characterized with respect to HFD-induced NLRP3 inflammasome activation and reactive oxygen species (ROS) generation in vivo and palmitate (PA)-treated cells in vitro. After HFD administration, hepatic injury was confirmed via histological assessment (grading and staging of NAFLD) and biochemical parameters, oxidative stress, and reduced antioxidant activity. Up-regulated hepatic dysfunction were further indicated by elevated dyslipidemia, lipid accumulation, and decreased fatty acid ß-oxidation associated gene expression. Moreover, in the absence of XIAP, NLRP3 signaling activated by HFD-triggered oxidative stress was up-regulated, accompanied by reduction in antioxidants including HO-1, NQO-1, GST, SOD and Nrf2 activity. The detrimental effects of XIAP blocking on hepatic steatosis and related pathologies were also confirmed in PA-treated mouse liver cells. In contrast, overexpression of XIAP by transfection in vitro restrained PA-stimulated hepatic steatosis by suppression of oxidative stress, NLRP3 related inflammatory response, and impairment of Nrf2 activity, further alleviating abnormal metabolic disorder associated NAFLD. Taken together, the present study helped to elucidate how HFD-induced hepatic steatosis was regulated by XIAP, possibly via the inhibition of NLRP3 signaling and oxidative stress injury.

Loss of RIP3 initiates annihilation of high-fat diet initialized nonalcoholic hepatosteatosis: A mechanism involving Toll-like receptor 4 and oxidative stress.

Non-alcoholic fatty liver disease (NAFLD) is a prevalent and complex disease that confers a high risk of severe liver disorders. Although such public and clinical health importance, very few effective therapies are presently available for NAFLD. Here, we showed that receptor-interacting kinase-3 (RIP3) was up-regulated in liver of mouse with hepatic steatosis induced by high fat diet (HFD). After 16 weeks on a HFD, obesity, insulin resistance, metabolic syndrome, hepatic steatosis, inflammatory response and oxidative stress were significantly alleviated in liver of mice with the loss of RIP3. We provided mechanistic evidence that RIP3 knockdown attenuated hepatic dyslipidemia through preventing the expression of lipogenesis-associated genes. Furthermore, in the absence of RIP3, the transcription factor of nuclear factor-κB (NF-κB) signaling pathway activated by HFD was blocked, accompanied with the inhibition of NLRP3 inflammasome. We also found that RIP3 knockdown-induced activation of nuclear factor-erythroid 2 related factor 2/heme oxygenase-1 (Nrf-2/HO-1) led to the inhibition of oxidative stress. The detrimental effects of RIP3 on hepatic steatosis and related pathologies were confirmed in palmitate (PAL)-treated mouse liver cells. Of note, lipopolysaccharide (LPS)- or PAL-activated TLR-4 resulted in the up-regulation of RIP3 that was accompanied by the elevated inflammation and lipid deposition, and these effects were reversed in TLR-4 knockdown cells. Furthermore, promoting Nrf-2 pathway activation effectively reduced reactive oxygen species (ROS) generation and RIP3 expression in PAL-stimulated cells, consequently leading to the suppression of cellular inflammation and lipid accumulation. In contrast, blocking Nrf-2/HO-1 signaling abrogated RIP3 knockdown-reduced reactive oxygen species (ROS), inflammatory response and lipid deposition in PAL-stimulated cells. Taken together, the present study helped to elucidate how HFD-induced hepatic steatosis was regulated by RIP3, via the TLR-4/NF-κB and Nrf-2/HO-1 signaling pathways.

iRhom2 loss alleviates renal injury in long-term PM2.5-exposed mice by suppression of inflammation and oxidative stress.

Particulate matter (PM2.5) is a risk factor for organ injury and disease progression, such as lung, brain and liver. However, its effects on renal injury and the underlying molecular mechanism have not been understood. The inactive rhomboid protein 2 (iRhom2), also known as rhomboid family member 2 (Rhbdf2), is a necessary modulator for shedding of tumor necrosis factor-α (TNF-α) in immune cells, and has been explored in the pathogenesis of chronic renal diseases. In the present study, we found that compared to the wild type (iRhom2+/+) mice, iRhom2 knockout (iRhom2-/-) protected PM2.5-exposed mice from developing severe renal injury, accompanied with improved renal pathological changes and functions. iRhom2-/- mice exhibited reduced inflammatory response, as evidenced by the reduction of interleukin 1ß (IL-1ß), IL-6, tumor necrosis factor-α (TNF-α) and IL-18 in kidney samples, which might be, at least partly, through inactivating TNF-α converting enzyme/TNF-α receptors (TACE/TNFRs) and inhibitor of α/nuclear factor κ B (IκBα/NF-κB) signaling pathways. In addition, oxidative stress was also restrained by iRhom2-/- in kidney of PM2.5-exposed mice by enhancing heme oxygenase/nuclear factor erythroid 2-related factor 2 (HO-1/Nrf-2) expressions, and reducing phosphorylated c-Jun N-terminal kinase (JNK). In vitro, blockage of HO-1 or Nrf-2 rescued the inflammatory response and oxidative stress that were reduced by iRhom2 knockdown in PM2.5-incubated RAW264.7 cells. Similar results were observed in JNK activator-treated cells. Taken together, our findings indicated that iRhom2 played an essential role in regulating PM2.5-induced chronic renal damage, thus revealing a potential target for preventing chronic kidney diseases development.

Process management of health education pathway to patients with rheumatoid arthritis / 医学研究生学报

Objective It is necessary for nursing staff members to assign priorities in health education to hospitalized patients to ensure curative effect .The purose of the study was to explore the effect of process management application in health education path -way to patients with rheumatoid arthritis ( RA) . Methods A total of 70 patients with rheumatoid arthritis were randomly divided into observation group and control group , 35 patients in each group .Traditional health education was done in control group , while health education pathway was performed in observation in observation group according to process management .A study of patients′satisfaction with hospitalization , compliance of medication and knowledge of health education was undertaken . Results Observation group had priority to control group in satisfaction with hospitalization and medication compliance (77.1% vs 42.9%,P 0.05). Conclusion Compared with traditional health educa-tion, the process management application of RA health education pathway helps to improve patients ′health konwledge and medical compliance , which is an effective adjuvant treatment .

The impact of self-perceived masticatory function on nutrition and gastrointestinal function in the elderly patients / 中国实用护理杂志

Objective To evaluate the impact of masticatory function on malnutrition and gastrointestinal symptoms in senile patients.Methods Dental status and denture quality in 120 senile patients were investigated with questionnaires,and thecorrelation of masticatory ability with nutritional status and gastrointestinal symptoms were evaluated.Results The nutritional status of elderly patients was correlated with the condition of the denture,but not correlated with the number of denture and chewing ability.Gastrointestinal disconffort had correlation with masticatory function,chewing problems,difficulty in chewing and food limit,but chewing function was highly correlated with taking gastrointestinal drugs.Conclusions The chewing ability and nutritional status is not relevant,but since elderly patients with weakened chewing ability avoid certain foods,thus gastrointestinal discomfort and symptoms of gastrointestinal disorders such as medication increased.

The assessment and analysis of nutritional status of 1200 inhospital patients / 肠外与肠内营养

Objective:To assess incidence of malnutrition and malnutrition risk of six department patients.Methods:The information of 1 200 patients were collected,200 in each of 6 departments in our hospital.Nutrition status was assessed according to Nutrition Risk Screening(NRS)published by ESPEN in 2001.Results:The incidence of malnutrition and malnutrition risk varied from 7.5% to 59% and 36% to 72% respectively in different department.Conclusion:The incidence of malnutrition is closely related to the kind and severity of the disease.It is nessissary to assess the nutrition status of high risk patients in time.NRS can be used simply and fastly in most inhospital patients.