Liver Injury Impaired 25-Hydroxylation of Vitamin D Suppresses Intestinal Paneth Cell defensins, leading to Gut Dysbiosis and Liver Fibrogenesis.

Vitamin D deficiency is co-prevalent with various liver diseases including cirrhosis, while the underlying mechanism remains elusive. Vitamin D receptor (VDR) is abundantly expressed in the distal region of small intestine, where the Paneth cells are enriched, suggesting that vitamin D signaling may modulates the intestinal Paneth cells and their production of defensins to restrain microbiome growth in the small intestine. In this study we found that in carbon tetrachloride-induced liver injury, hepatic 25-hydroxylation of vitamin D was impaired, leading to down regulated expression of Paneth cell fensins in the small intestine, gut dysbiosis, and endotoxinemia. While intraperitoneal injection of endotoxin (lipopolysaccharides) alone did not elicit liver fibrosis, it exacerbated the carbon tetrachloride initiated liver fibrogenesis. Oral gavage of synthetic Paneth cell alpha-defensin 5 (DEFA5) restored the homeostasis of gut microbiota, reduced endotoxemia, relieved liver inflammation, and ameliorated liver fibrosis. Likewise, Cholestyramine, cationic resin that can sequestrate endotoxin in the intestine, attenuated the liver fibrosis as well. Fecal transplant of the microbes derived from the DEFA5-treated donors improved liver fibrosis in the recipient mice. The intestinal Vdrconditional knockout mice exhibited reduction of Paneth cell defensins and lysozyme production, and worsened liver injury and fibrogenesis. Thus, liver injury impairs synthesis of 25(OH)VD3, which consequently impedes the Paneth cells functions in the small intestine, leading to gut dysbiosis for liver fibrogenesis.

Vitamin D signaling maintains intestinal innate immunity and gut microbiota: potential intervention for metabolic syndrome and NAFLD.

A lack of sunlight exposure, residence in the northern latitudes, and dietary vitamin D insufficiency are coprevalent with metabolic syndrome (MetS), Type 2 diabetes (T2D), and nonalcoholic fatty liver diseases (NAFLD), implying a potential causality and underlying mechanism. Whether vitamin D supplementation or treatment can improve these disorders is controversial, in part, because of the absence of large-scale trials. Experimental investigations, on the other hand, have uncovered novel biological functions of vitamin D in development, tumor suppression, and immune regulation, far beyond its original role as a vitamin that maintained calcium homeostasis. While the large intestine harbors massive numbers of microbes, the small intestine has a minimal quantity of bacteria, indicating the existence of a gating system located in the distal region of the small intestine that may restrain bacterial translocation to the small intestine. Vitamin D receptor (VDR) was found to be highly expressed at the distal region of small intestine, where the vitamin D signaling promotes innate immunity, including the expression of α-defensins by Paneth cells, and maintains the intestinal tight junctions. Thus, a new hypothesis is emerging, indicating that vitamin D deficiency may impair the intestinal innate immunity, including downregulation of Paneth cell defensins, leading to bacterial translocation, endotoxemia, systemic inflammation, insulin resistance, and hepatic steatosis. Here, we review the studies for vitamin D for innate immunity and metabolic homeostasis, and we outline the clinical trials of vitamin D for mitigating MetS, T2D, and NAFLD.

Developing a predictive nomogram for mortality in patients with extrapulmonary acute respiratory distress syndrome: the prognostic value of serum soluble thrombomodulin, lung ultrasound score, and lactate.

Objective: This study aimed to elucidate the prognostic significance of serum soluble thrombomodulin (sTM), lung ultrasound score (LUS), and lactate levels in patients with extrapulmonary acute respiratory distress syndrome (ARDS), with the goal of refining mortality risk prediction in this cohort. Methods: In a prospective cohort of 95 patients with extrapulmonary ARDS admitted to the intensive care unit, we investigated the primary endpoint of 28-day mortality. Utilizing Lasso-Cox regression analysis, we identified independent prognostic factors for mortality. A predictive nomogram was developed incorporating these factors, and its performance was validated through several statistical measures, including the consistency index, calibration plot, internal validation curve, decision curve analysis, interventions avoided analysis, receiver operating characteristic curve analysis, and Kaplan-Meier survival analysis. We further conducted a subgroup analysis to examine the impact of prone positioning on patient outcomes. Results: The study identified baseline serum sTM, LUS, and lactate levels as independent predictors of 28-day mortality in extrapulmonary ARDS patients. The predictive nomogram demonstrated superior prognostic accuracy compared to the use of sTM, LUS, or lactate levels alone, and outperformed traditional prognostic tools such as the Acute Physiology and Chronic Health Evaluation II score and the partial pressure of arterial oxygen to fractional inspired oxygen ratio. The subgroup analysis did not show a significant impact of prone positioning on the predictive value of the identified biomarkers. Conclusion: Our study results support the development and validation of a novel prognostic nomogram that integrates key clinical biomarkers and ultrasound imaging scores to predict mortality in patients with extrapulmonary ARDS. While our research is preliminary, further studies and validation are required.

Comparative study on physicochemical properties and hypoglycemic activities of intracellular and extracellular polysaccharides from submerged fermentation of Morchella esculenta.

The structural characteristic, physicochemical properties and structure-hypoglycemic activity relationship of intracellular (IPS) and extracellular (EPS) from submerged fermentation of Morchella esculenta were systematically compared and assessed. Both IPS and EPS were neutral, with a triple-helical conformation, and composed of galactose, glucose and mannose monosaccharides in different molar ratios. The molecular weight and particle size of IPS were higher than those of EPS. FTIR and SEM showed that the main functional group absorption peak intensity, glycosidic bond type and surface morphology of the two polysaccharides differed. Analysis of rheological and thermal properties revealed that the viscosity of IPS was higher than that of EPS, while thermal stability of EPS was greater than that of IPS. Hypoglycemic activity analysis in vitro showed that both IPS and EPS were non-competitive inhibitors of α-amylase and α-glucosidase. EPS showed strong digestive enzyme inhibitory activity due to its higher sulphate content and molar ratio of galactose, lower Mw and particle size. Meanwhile, with its higher Mw and apparent viscosity, IPS showed stronger glucose adsorption capacity and glucose diffusion retardation. These results indicate that IPS and EPS differed considerably in structure and physicochemical properties, which ultimately led to differences in hypoglycemic activity. These results not only suggested that IPS and EPS has the potential to be functional foods or hypoglycemic drugs, but also provided a new target for the prevention and treatment of diabetes with natural polysaccharides.

miR­3613­3p/MAP3K2/p38/caspase­3 pathway regulates the heat­stress­induced apoptosis of endothelial cells.

Previous studies have identified microRNA (miRNA/miR)­3613­3p as a heat stress (HS)­related miRNA in endothelial cells that can lead to apoptosis. However, the mechanism underlying the miR­3613­3p­mediated apoptosis of HS­exposed endothelial cells remains unclear. In the present study, western blot analysis and reverse transcription­quantitative PCR were used to determine protein and miRNA expression levels, respectively. Annexin V­fluorescein isothiocyanate/propidium iodide staining, caspase­3 activity measurements and DNA fragmentation assays were performed to detect apoptosis. To evaluate whether mitogen­activated protein kinase kinase kinase 2 (MAP3K2) was a direct target of miR­3613­3p, a luciferase reporter assay was performed. In addition, transient transfection was used to carry out loss­ and gain­of­function experiments. The results revealed that miR­3613­3p expression was reduced in human umbilical vein endothelial cells (HUVECs) following HS, which led to apoptosis. Mechanistically, following HS, a decrease in miR­3613­3p binding to the 3'­untranslated region of MAP3K2 directly upregulated its expression, and the downstream p38 and caspase­3 pathways, thereby leading to apoptosis. Taken together, the results of the present study demonstrated that HS suppressed miR­3613­3p expression, which activated the MAP3K2/p38/caspase­3 pathway, leading to the apoptosis of HUVECs. In conclusion, the miR­3613­3p/MAP3K2/p38/caspase­3 pathway may serve an indispensable role in regulating the progression of apoptosis, indicating a regulatory role of miR­3613­3p in the pathophysiology of HS­exposed endothelial cells.

Analysis of miRNA expression profiling in human umbilical vein endothelial cells affected by heat stress.

To investigate the regulation of endothelial cell (EC) microRNAs (miRNAs) altered by heat stress, miRNA microarrays and bioinformatics methods were used to determine changes in miRNA profiles and the pathophysiological characteristics of differentially expressed miRNAs. A total of 31 differentially expressed miRNAs were identified, including 20 downregulated and 11 upregulated miRNAs. Gene Ontology (GO) enrichment analysis revealed that the validated targets of the differentially expressed miRNAs were significantly enriched in gene transcription regulation. The pathways were also significantly enriched in the Kyoto Encyclopedia of Genes and Genomes analysis, and most were cancer-related, including the mitogen-activated protein kinase signaling pathway, pathways involved in cancer, the Wnt signaling pathway, the Hippo signaling pathway, proteoglycans involved in cancer and axon guidance. The miRNA-gene and miRNA­GO network analyses revealed several hub miRNAs, genes and functions. Notably, miR­3613-3p played a dominant role in both networks. MAP3K2, MGAT4A, TGFBR1, UBE2R2 and SMAD4 were most likely to be controlled by the altered miRNAs in the miRNA-gene network. The miRNA­GO network analysis revealed significantly complicated associations between miRNAs and different functions, and that the significantly enriched functions targeted by the differentially expressed miRNAs were mostly involved in regulating gene transcription. The present study demonstrated that miRNAs are involved in the pathophysiology of heat-treated ECs. Understanding the functions of miRNAs may provide novel insights into the molecular mechanisms underlying the heat­induced pathophysiology of ECs.