To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The effects of maternal broccoli powder (BP) intake on inflammation and AMPK activation in weaning offspring programmed by maternal undernutrition remain poorly understood. This study aimed to investigate whether maternal BP intake during lactation ameliorates inflammation and affects AMPK phosphorylation in the hypothalamus and liver of weaning offspring subjected to maternal undernutrition. Pregnant rats received either a normal protein (NP, 20% casein) or a low protein (LP, 8% casein) diet. During lactation, dams were provided with either a normal protein diet without or with 0.74% BP (NP/NP or NP/NPBP) or a low protein diet without or with 0.74% BP (LP/LP or LP/LPBP). Blood, liver (left lateral lobular region), and hypothalamic samples (region estimated to include the arcuate nucleus and ventromedial hypothalamus) were collected on postnatal day 21. In the liver, macrophage count, NFκB p65 protein expression, and TNF-α mRNA expression were lower in LP/LPBP than in LP/LP. In the hypothalamus, Iba1 mRNA expression, NFκB p65 protein expression, and TNF-α mRNA expression were reduced in LP/LPBP compared to LP/LP. AMPK phosphorylation was upregulated in both the liver and hypothalamus of LP/LPBP offspring relative to LP/LP. In the liver, mTOR and Akt phosphorylation were downregulated in LP/LPBP compared to LP/LP. Additionally, Dnmt1 levels were lower in LP/LPBP than in LP/LP in the liver, whereas in the hypothalamus, Dnmt1 and Dnmt3a mRNA expression levels were higher in NP/NPBP than in NP/NP. In conclusion, maternal BP intake during lactation decreased inflammation and increased AMPK phosphorylation in the liver and hypothalamus of weaning rats programmed by maternal undernutrition.
Anxiety disorders are prevalent neuropsychiatric conditions associated with neuroinflammation and altered cytokine signaling in the hippocampus. This study aimed to evaluate the anxiolytic-like effects of alpha-pinene and its potential modulation of hippocampal neuroinflammatory pathways in a reserpine-induced anxiety model.
Methods:
Adult male Wistar rats were randomly assigned to four groups: control (vehicle), reserpine (0.5 mg/kg, i.p.), and reserpine co-treated with alpha-pinene at 50 or 100 mg/kg. Treatments were administered intraperitoneally for 10 consecutive days. Behavioral assays—including the Open Field Test, Elevated Plus Maze, and Light/Dark Box Test—assessed locomotor activity and anxiety-like behaviors. Following testing, hippocampal tissues were collected for molecular analyses, including real-time PCR for TLR4, MyD88, and NF-κB expression, and ELISA quantification of IL-1β and IL-6 levels.
Results:
Reserpine induced robust anxiety-like behaviors, accompanied by significant upregulation of TLR4, MyD88, and NF-κB expression and increased hippocampal IL-1β and IL-6. Alpha-pinene treatment at both doses significantly attenuated anxiety-like behaviors and reduced neuroinflammatory markers, suggesting involvement of the TLR4/MyD88/NF-κB pathway.
Conclusion:
Alpha-pinene exhibits anxiolytic-like effects in reserpine-treated rats, potentially via suppression of hippocampal neuroinflammation, supporting further investigation into its therapeutic potential for anxiety disorders.
Using NHANES data (2011–2020), we assessed the association between the Nutritional Risk Index (NRI) and stroke risk among 22,839 adults (mean age, 49.61 ± 17.07 years), including 910 individuals (3.98%) with stroke. Weighted multivariable logistic regression and restricted cubic spline (RCS) analysis were used to characterize the association, with subgroup analyses to examine consistency across populations and mediation analyses to investigate the roles of lipid and inflammatory biomarkers. Higher continuous NRI was inversely associated with stroke, with each 1-unit increase associated with 4% lower odds (OR = 0.96, 95% CI: 0.95–0.97), and participants in the highest NRI quartile (Q4) had a significantly lower stroke risk than those in the lowest NRI quartile (Q1) (OR 0.60, 95% CI 0.42–0.85). RCS analysis indicated a linear relationship (P for nonlinearity >0.05), and the protective effect of higher NRI remained robust across nearly all subgroups examined. Mediation analyses revealed that total cholesterol, systemic immune-inflammation index, platelet-neutrophil product, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio each partially mediated the NRI–stroke association, with mediation effects ranging from 1.71% to 13.65%. These findings suggest that favorable nutritional status, reflected by higher NRI, is linked to lower stroke risk, with lipid metabolism and inflammation playing mediating roles in this association. Further longitudinal and mechanistic studies are warranted.
Tail biting in pigs is a serious problem both from an animal welfare and an economic perspective. Once the behaviour starts, it is important to identify it and intervene immediately to restrict the spread and risk of secondary problems, such as infections. In this study, we tested whether thermal camera imaging could be used as an aid for early detection of tail biting. We also assessed links between skin temperature, tail health and saliva biomarkers for stress and inflammation. Bitten tails were slightly warmer based on thermal imaging than non-lesioned tails. However, the difference was not sufficiently large or specific to enable its use as a practical tool in the early detection of tail lesions. The methodology, however, warrants further investigation. Shortened, but healed tails had a lower skin temperature than tails of other health categories. In combination with a lower saliva cortisol level in pigs with shortened tails, potentially indicative of chronic stress, this supports previous studies indicating chronic pain in shortened pig tails, and/or chronic stress as a result of being a victim of tail biting. These findings provide a further insight into the link between stress, infections and tail biting, while also illustrating potential for skin temperature changes to be used as an early indicator of health and welfare challenges in pigs.
Increasing evidences show that inflammation might be involved in bipolar disorder (BD), but the association between abnormal brain function and inflammation in BD is still unclear. In this study, we tried to explore the disrupted brain functional network topology, peripheral inflammatory cytokine levels, and their correlations in unmedicated bipolar II depression (BDII-D).
Methods
In this study, 65 individuals with unmedicated BDII-D and 50 healthy controls (HCs) underwent resting-state magnetic resonance imaging scans. Graph theory analysis was performed to investigate the topological properties of the whole-brain functional connectome at both global and nodal levels. Besides, serum levels of 17 inflammatory cytokines were measured in both BDII-D and HCs. Correlations between topological properties, clinical variables, and peripheral inflammatory cytokine levels in BDII-D were calculated.
Results
Compared with HCs, at the global level, BDII-D showed significantly higher $ \lambda $, decreased $ \gamma $, $ \sigma $, Eglo, and Eloc; at the nodal level, BDII-D showed decreased Enodal in the right olfactory cortex, left pallidum, and vermis. Besides, BDII-D showed higher levels of interleukin-8 (IL-8), interleukin-10 (IL-10), and granulocyte colony-stimulating factor (G-CSF) compared with the HCs. In BDII-D, $ \gamma $ and $ \sigma $ were significantly negatively correlated with the Hamilton Depression Rating Scale (HDRS) scores and number of episodes. Also, IL-8 level showed significant negative correlation with $ \gamma $, $ \sigma $, and Enodal of the left pallidum in BDII-D.
Conclusions
Reduced information segregation and integration, and lower nodal efficiency in the left pallidum were associated with proinflammatory cytokine IL-8 level and might contribute to severe depressive symptoms in unmedicated BDII-D.
The purpose of this systematic review and meta-analysis was to investigate the effects of hesperidin supplementation on inflammatory and oxidative stress biomarkers in human adults. A systematic literature search was conducted in PubMed, EMBASE and Cochrane Central Register of Controlled Trials from inception to 4 January 2025 to identify eligible randomised controlled trials. Ten randomised controlled trials with a total of 532 participants were included. The results indicated that hesperidin supplementation significantly reduced the serum levels of C-reactive protein or high-sensitivity C-reactive protein (SMD: –0·43; 95 % CI –0·71, –0·15; P = 0·002) and TNF-α (SMD: –0·51; 95 % CI –0·95, –0·07; P = 0·02) in adults, while no significant beneficial effect of hesperidin on IL-6 was observed (SMD: –0·25; 95 % CI –0·52, 0·01; P = 0·06). In addition, hesperidin intake showed a beneficial impact on the IL-6 level in patients with diseases (type 2 diabetes and myocardial infarction) (SMD: –0·38; 95 % CI –0·72, –0·04; P = 0·03) yet not in healthy adults without diagnosed diseases. Our findings demonstrated that hesperidin supplementation could lower the serum levels of C-reactive protein or high-sensitivity C-reactive protein and TNF-α in adults.
Vitamin D has been associated with depression, potentially via anti-inflammatory mechanisms, yet data are scarce, particularly in adolescence. We investigated (1) whether lower vitamin D status is associated with greater depression severity and (2) whether this association is statistically moderated by inflammation in patients of a child and adolescent psychiatry department. At admission, fasting morning venous blood was drawn. Serum vitamin D (25-hydroxy-cholecalciferol (25(OH)D)) and C-reactive protein (CRP) were analysed in all participants (n 465 (64·7 %♀; 11·3–18·9 years)). In a subsample (n 177), we additionally measured tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ) and interleukin (IL)-1β, IL-6, IL-8 and IL-10. Depression severity was assessed by the Beck Depression Inventory II (BDI-II) (n 450), the Diagnostic System for Mental Disorders in Childhood and Adolescence via self-assessment (DISYPS Self) (n 441) and parent-assessment (DISYPS Proxy) (n 422). Overall, 43·2 % (n 201) were at risk for vitamin D deficiency (< 30 nmol/l), and 73·5–83·2 % – depending on assessment tool – showed at least mild depression. Linear regression revealed an inverse association between 25(OH)D and BDI-II in both crude and CRP-adjusted full-sample models. Logistic regressions showed a robust inverse association between 25(OH)D and DISYPS Proxy, but not for DISYPS Self. Although 25(OH)D was inversely correlated with some pro-inflammatory markers, neither their inclusion in regression models nor formal mediation analyses supported inflammation as a mediator of the vitamin D–depression association. Overall, our results suggest that vitamin D relates modestly to both depression and inflammation in adolescence. However, based on the measured parameters, we cannot confirm that anti-inflammatory effects are the link between vitamin D and depression.
High-energy, sugar-rich diets are associated with obesity and pancreatic disorders. We investigated the effects of consumption of a high-fat and high-fructose diet (HFFrD) on gene expression related to insulin synthesis, inflammation and apoptosis in pancreatic β-cells. Weaned Wistar rats were fed either a control diet (CD; 11 % kcal from fat and 0 % from fructose) or an HFFrD (48 % kcal from fat and 33 % from fructose) for 22 weeks; after a 6-h fast, animals were euthanised. Body weight and total fat were recorded. Serum analyses included: glucose, insulin, triacylglycerides (TAG), malondialdehyde (MDA), TNFα, IL-6, IL-10 and advanced glycation end-products (AGE). Pancreatic islets were analysed for gene expression linked to insulin synthesis, inflammation and apoptosis. Pancreatic assessments included TUNEL assay and immunohistochemistry. HFFrD increased body weight, total fat, MDA, insulin, homeostatic model assessment for insulin resistance, AGE, TAG and IL-6 concentrations in both sexes. Gene expression revealed sex-dependent differences: Glut2, Gck, Khk, Ins2 and the transcription factor Mafa were downregulated in males but upregulated in females. Pdx1 expression increased in females, whereas NeuroD1 increased in males. Pro-inflammatory markers (Il-1β, Il-6) increased in both sexes, whereas Il-10 decreased in males and increased in females. Bax/Bcl2 ratio decreased in males but increased in females; antioxidant and apoptotic markers Nrf2 and Casp3 increased in females. Endocannabinoid receptors (Cnr1, Cnr2) increased in both sexes. HFFrD altered the expression of genes involved in insulin synthesis, inflammation and apoptosis in a sex-specific manner. Compared with males, females showed lower vulnerability, possibly because of adaptive responses in insulin synthesis signalling influenced by sex hormones.
This study aimed to explore whether health effects of dietary nitrate depend on its source, by investigating associations between plant and animal-sourced dietary nitrate groups with markers of inflammation and CVD risk factors. Among 100 non-smoking adults (mean age 49 (sd 13) years, 31 % male), dietary nitrate intake was assessed using FFQ (n 100) and 3-d food diary (n 89), combined with nitrate food composition databases. Nitrate intake was classified into plant, naturally occurring animal and additive-permitted meat-sourced groups. Associations between source-dependent nitrate intakes and lipoprotein-associated phospholipase A2 (Lp-PLA2), C-reactive protein (CRP), fasting plasma lipids, anthropometry and blood pressure were examined using multivariable linear regression, adjusted for socio-demographic, lifestyle and dietary confounders. Each 1 sd (∼57 mg/d) increment in plant-sourced nitrate intake was associated with a 0·191 sd lower LDL-cholesterol (β = −0·191, 95 % CI (–0·369, −0·004), P = 0·045; equivalent to −0·21 mmol/l) in primary models, though this association was attenuated in sensitivity analyses. Naturally occurring animal-sourced nitrate intake was not associated with any outcomes. A 1 sd (0·08 mg/d) increment in additive-permitted meat-sourced nitrate intake was associated with a 0·208 sd lower HDL-cholesterol (β = −0·208, (–0·362, −0·054), P = 0·009; equivalent to −0·10 mmol/l) and a 0·192 sd higher waist circumference (β = 0·192, (0·005, 0·380), P = 0·042; equivalent to +1·29 cm) but not with LDL-cholesterol, TAG, blood pressure, Lp-PLA2 or CRP. These preliminary findings suggest potential differential associations between nitrate source and cardiometabolic markers that warrant confirmation in larger studies.
The comorbidity of psychiatric and metabolic conditions is prevalent and poses a heavy burden on public health. Several biopsychosocial factors are known to influence both metabolic and psychiatric health, including inflammation, eating behavior, physical activity, and early life stress. Few studies, however, have examined the constellation of interrelationships among multiple risk domains simultaneously.
Methods:
Using a sample of 200 medically healthy adults enrolled in a parent study, we used Gaussian Graphical Modeling, a type of network analysis, to characterize interdependent cross-sectional associations between early life stress (childhood trauma), health behaviors (diet quality and physical activity), blood-based biomarkers of metabolic functioning (insulin resistance, HDL cholesterol, triglycerides) and inflammation (C-reactive protein [CRP]), and three domains of mental health symptoms (depressive, anxious, and post-traumatic stress symptoms). We hypothesized that the network structure would highlight a pattern whereby higher CRP, poorer diet quality, lower physical activity, and higher childhood trauma would associate with increased risk for both metabolic and psychiatric impairments.
Results:
Findings revealed a positive conditional association between CRP and childhood trauma, which may function as an intermediary process to increase risk for both metabolic impairments and psychiatric symptoms in adulthood. Further, higher physical activity was associated with lower insulin resistance and fewer depressive symptoms, and better diet quality was associated with lower CRP levels.
Conclusion:
Results highlight potential avenues for interventions aimed at reducing inflammation, improving health behavior, and addressing the effects of childhood trauma to improve physical and mental health comorbidities.
Bipolar disorder (BD) is associated with increased cardiometabolic risk, contributing to elevated morbidity and premature mortality. Childhood trauma (CT) is a common environmental risk factor in BD and may exacerbate metabolic dysfunction, but no prior systematic synthesis has focused on their intersection. The objective of this review was to systematically review and synthesize evidence on the association between childhood trauma exposure and metabolic biomarkers in adults with bipolar disorder. This review adhered to PRISMA 2020 guidelines and was registered in PROSPERO (ID CRD420251045565). A comprehensive search of PubMed/MEDLINE, Web of Science, Scopus, and Embase (from inception to September 2025) was conducted. Eligible studies were peer-reviewed observational studies assessing associations between CT and metabolic markers (eg, BMI, lipids, HbA1c, hs-CRP) in adult BD populations. Data extraction and NIH quality assessments were performed independently by multiple reviewers. Sixteen studies were included (total n ≈ 6,200 across study samples). CT was significantly associated with higher body mass index and elevated hs-CRP. Two third of studies reported adverse associations with lipid profiles, and one study showed increased HbA1c among CT-exposed BD patients. Most findings emerged from cross-sectional designs, though one longitudinal study revealed large effect sizes across multiple metabolic markers. CT is consistently associated with adverse metabolic outcomes in individuals with BD, particularly elevated BMI, inflammation, and dyslipidemia. These findings support the need for trauma-informed metabolic screening and personalized interventions in this subgroup BD population. Further prospective studies are warranted to elucidate causal pathways and inform personalized care.
Tryptophan is an essential amino acid required for protein synthesis, immune regulation and the production of serotonin, melatonin and kynurenine. Its metabolism proceeds through three major pathways – the kynurenine, serotonin and gut microbiota–derived indole pathways – which are influenced by diet, microbiota and inflammation. The Mediterranean diet generally improves tryptophan bioavailability, enhances serotonin synthesis and limits excessive kynurenine activation through anti-inflammatory and microbiota-mediated mechanisms. In contrast, Western diets promote systemic inflammation, increase kynurenine production and reduce serotonin and beneficial indole metabolites. High-protein and ketogenic diets elevate substrate availability but may increase microbial production of indoles such as skatole and alter the balance of tryptophan utilisation, while calorie-restricted diets appear to downregulate pro-inflammatory tryptophan degradation and improve serotonin-related satiety regulation. Collectively, these findings demonstrate that diet is a key regulator of tryptophan metabolism, with implications for mood, sleep, inflammation, cancer progression and cardiometabolic health. Despite these advances, several knowledge gaps remain, including limited standardisation of dietary assessment methods, insufficient databases on the tryptophan content of foods and a lack of controlled comparative trials. Addressing these limitations may enable the development of nutritional strategies that optimise tryptophan metabolism and improve health outcomes.
Schizophrenia (SZ) is a debilitating psychiatric disorder where patients experience cognitive decline. Antipsychotic drugs alleviate positive symptoms but do not improve cognitive performance. We previously demonstrated that Toll-like receptors (TLRs), involved in cytokine production, can predict cognitive deficits in SZ patients. In this study, we aim to investigate the potential moderating effects of antipsychotic drugs on the associations between cytokines, TLRs, and cognition.
Methods
In total, 280 participants (201 controls and 79 cases of SZ) were recruited in Ireland. Venous blood from the participants was stimulated with TLR ligands. Levels of cytokines were measured from plasma and post-blood stimulation. The participants were administered a battery of cognitive tasks using the Cambridge Neuropsychological Test Automated Battery and Wechsler Adult Intelligence Scale-IIIR. Olanzapine equivalents were calculated using the defined daily dose method.
Results
The results indicate that antipsychotic drug dose does not predict TLR activity or cognition, indicating that antipsychotic drug dose does not have a direct effect on cognition or TLR activity. However, the relationship between TLR4 activity and visual learning and memory is moderated by the antipsychotic drug dose (B = −0.065; p < 0.001), where increasing doses have a decreasing impact on their relationship.
Conclusions
Our data indicate that the dose of antipsychotic drugs alone cannot predict changes in cognitive performance and TLR4-activity. It also suggests that antipsychotic drug doses significantly affect TLR activity and its relationship with cognition. These effects are more pronounced on some domains than others. These findings open up new avenues for understanding the complex interplay between antipsychotic drugs, TLRs, and cognitive deficits in SZ.
When necessary, the turning on of your stress physiologic response can save your life. Maternal stress can affect the fetus so it engages survival strategies. Socioeconomic inequality in early life impacts adults in various ways. Stress in infancy can be positive, such as when taking the first step, tolerable, such as when a family member is seriously ill but supportive adults are present, or toxic, when there is strong, frequent, or prolonged activation in the absence of buffers, which can have lifelong effects. Stress impacts various cellular organelles and produces inflammation. Cumulative chronic stresses produce wear and tear, limiting effective activation when needed to save your life. Those lower down the socioeconomic gradient have poorer functioning organs and suffer more harmful effects of stress. Ever more common obesity can be related to increasing chronic stresses of modern life. Metabolic syndrome, the way energy is stored, is related to many chronic diseases today. Prenatal stress and low birthweight predispose children to this condition
Bipolar disorder (BD) involves immune-inflammatory dysregulation. This systematic review and meta-analysis assessed complete blood count-based inflammatory indices – neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), and platelet-to-lymphocyte (PLR) ratios – in BD versus healthy controls (HCs), major depressive disorder (MDD), and across BD mood states.
Methods
Databases were searched through June 2025 for observational studies reporting at least one ratio in adults with BD and including as comparators either HCs, MDD, or within-BD mood-state contrasts (mania, bipolar depression, euthymia). Quality was appraised using BIOCROSS. Random-effects meta-analyses, sensitivity analyses, and meta-regressions were performed. GRADE was adapted to rate evidence certainty.
Results
Fifty-one studies (38,309 participants) met the inclusion criteria. Compared to HCs, BD showed higher NLR (SMD = 0.44, p < 0.001) and MLR (SMD = 0.28, p < 0.001). In mania, NLR (SMD = 0.62, p < 0.001), MLR (SMD = 0.51, p < 0.001), and PLR (SMD = 0.18, p = 0.014) were all elevated versus HCs. Depression showed lower PLR (SMD = –0.14, p < 0.001) and euthymia higher NLR (SMD = 0.37, p = 0.002). Compared to MDD, BD had higher NLR (SMD = 0.21, p < 0.001) and MLR (SMD = 0.18, p < 0.001). Similarly, mania showed higher NLR (SMD = 0.53, p < 0.001) and MLR (SMD = 0.41, p < 0.001), while bipolar depression lower PLR (SMD = –0.15, p < 0.001). Mania had higher NLR (SMD = 0.32, p < 0.001), MLR (SMD = 0.32, p < 0.001), and PLR (SMD = 0.14, p = 0.028) than depression and higher MLR than euthymia (SMD = 0.44, p = 0.027), while depression had lower NLR (SMD = –0.28, p = 0.012) and PLR (SMD = –0.22, p < 0.001). Evidence certainty was mixed.
Conclusions
NLR, MLR, and PLR emerge as non-specific, group-level correlates of immune-inflammatory dysregulation in BD, however offering limited discrimination between bipolar and unipolar depression. Notwithstanding their potential role as trait- and state-related markers in BD, further studies are needed to support translation into clinically useful biomarkers.
Schizophrenia (SCZ) shows marked biological heterogeneity, with negative symptoms linked to poor outcomes and hypothesised immune dysregulation. This study examined whether a peripheral cytokine–long non-coding RNA (lncRNA) panel could distinguish patients with SCZ and Brief Negative Symptom Scale (BNSS)-defined subgroups from healthy controls (HC).
Methods:
Forty-one hospitalised patients with SCZ completed the BNSS and the Positive and Negative Syndrome Scale (PANSS). Twenty HCs, frequency-matched for age and sex, served as comparison samples. Severe negative-symptom subgroups were defined using two BNSS criteria: a broader (SNS1) and a more restrictive (SNS2) threshold. Serum cytokines – interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), interleukin-10 (IL-10) – and leukocyte lncRNAs (MALAT1, NEAT1, MEG3) were quantified by enzyme-linked immunosorbent assay and quantitative RT-PCR. Covariate-adjusted logistic and multinomial models (adjusting for age, sex, body mass index, and smoking) assessed discrimination using area under the receiver-operating-characteristic curve (AUC) and interquartile-range odds ratios (OR_IQR).
Results:
IL-6 correlated with PANSS Total (ρ = 0.48, p = 0.001) and Negative (ρ = 0.34, p = 0.032) scores and was higher in SCZ than HC (p = 0.033), with further increases in SNS subgroups. NEAT1 was significantly reduced only within BNSS-defined subgroups (p ≤ 0.025). The dual-marker pattern (IL-6 ↑, NEAT1 ↓) showed the strongest discrimination for SNS1 versus HC (AUC = 0.85) and the steepest multinomial contrasts for SNS2 (IL-6 OR_IQR = 4.98; NEAT1 OR_IQR = 0.11).
Conclusions:
Elevated IL-6 and decreased NEAT1 define a peripheral signature linked to negative-symptom severity in SCZ and may support biologically informed stratification and longitudinal research.
Emerging evidence suggests that metabolic and hormonal disturbances in polycystic ovary syndrome (PCOS) may increase vulnerability to neurodegenerative disorders. However, the link between PCOS and Alzheimer’s disease (AD)-related pathology remains unclear.
Methods:
In this cross-sectional study, plasma levels of β-amyloid (Aβ40, Aβ42), phosphorylated tau (p-tau181), neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) were quantified in women with PCOS and age-matched controls. Homeostasis model assessment of insulin resistance (HOMA-IR), inflammatory cytokines (IL-6, TNF-α) and hormonal parameters were assessed. Mediation and moderation analyses were conducted to explore metabolic and hormonal pathways underlying biomarker alterations.
Results:
Among 400 women (200 PCOS, 200 controls), age and BMI were comparable (P > 0.05). Compared with controls, PCOS participants had increased Aβ40, p-tau181, NfL and GFAP, a slightly higher Aβ42, and a lower Aβ42/40 ratio (all P < 0.05). p-tau181 correlated positively with HOMA-IR (r = 0.41) and IL-6 (r = 0.36), while Aβ42/40 ratio correlated negatively with HOMA-IR (r = –0.27). In multivariable analysis, p-tau181 (aOR = 1.34, 95% CI 1.05–1.71), IL-6 (aOR = 1.19) and TNF-α (aOR = 1.14) were independent predictors of insulin resistance. Mediation analysis indicated that HOMA-IR, IL-6 and TNF-α jointly mediated ∼ 71% of the PCOS–p-tau181 association, suggesting a metabolic–inflammatory pathway linking PCOS to AD-related tau pathology.
Conclusions:
PCOS is linked to peripheral markers of early Alzheimer’s pathology, largely mediated by insulin resistance and inflammation. PCOS may provide a clinical context to explore metabolic–inflammatory contributors to early neurodegenerative changes.
Major depression (MDD) is linked to neuro-immune, metabolic, and oxidative stress (NIMETOX) pathways. The gut microbiome may contribute to these pathways via leaky gut and immune–metabolic processes.
Aims:
To identify gut microbial alterations in MDD and to quantify functional pathways and enzyme gene families and integrate these with the clinical phenome and immune–metabolic biomarkers of MDD.
Methods:
Shotgun metagenomics with taxonomic profiling was performed in MDD versus controls using MetaPhlAn v4.0.6, and functional profiling was conducted using HUMAnN v3.9, aligning microbial reads to species-specific pangenomes (Bowtie2 v2.5.4) followed by alignment to the UniRef90 v201901 protein database (DIAMOND v2.1.9).
Results:
Gut microbiome diversity, both species richness and evenness, is quite similar between MDD and controls. The top enriched taxa in the multivariate discriminant profile of MDD reflect gut dysbiosis associated with leaky gut and NIMETOX mechanisms, that is, Ruminococcus gnavus, Veillonella rogosaem, and Anaerobutyricum hallii. The top four protective taxa enriched in controls indicate an anti-inflammatory ecosystem and microbiome resilience, that is, Vescimonas coprocola, Coprococcus, Faecalibacterium prausnitzii, and Faecalibacterium parasitized. Pathway analysis indicates loss of barrier protection, antioxidants, and short-chain fatty acids, and activation of NIMETOX pathways. The differential abundance of gene families suggests that there are metabolic distinctions between both groups, indicating aberrations in purine, sugar, and protein metabolism. The gene and pathway scores explain a larger part of the variance in suicidal ideation, recurrence of illness, neurocognitive impairments, immune functions, and atherogenicity.
Conclusion:
The gut microbiome changes might contribute to activated peripheral NIMETOX pathways in MDD.
With advances in critical care technology, survival of acute critical illness has risen drastically, and many of these patients experience persistent deficits in physical and cognitive functioning, termed post-intensive care syndrome (PICS). This chapter provides a comprehensive overview of the pathophysiologic underpinnings of PICS. Perturbations during acute critical illness and early in recovery can have downstream and long-lasting effects. The immune response response is dysregulated with perturbations in both proinflammatory and immunosuppressive pathways. This dysregulation is more pronounced in patients who go on to have worse functional outcomes. Immune dysregulation also contributes to neuroinflammation, blood-brain barrier dysfunction, and disruptions in brain white matter leading to cognitive impairment. Transcriptomic analyses reveal massive shifts in gene expression, with aberrant expression of many genes related to the inflammatory response and extracellular matrix deposition, which clincially correlate with ICU-related complications, such as ICU-acquired weakness. Furthermore, sepsis and inflammation act together to disrupt the microvasculature, which further contributes to organ failure and ICU-acquired weakness. Mitochondrial dysfunction and ubiquitin-proteasome overactivation accelerate skeletal muscle catabolism and can also contribute to weakness. Finally, disruptions in the gut microbiome can disturb blood-brain barrier permeability and alter gene transcription associated with skeletal muscle growth and function. These perturbations interact deleteriously, resulting in the phenotype of PICS.
Metabolic dysregulation increases the risk of cognitive and motor deficits, exacerbated by diets high in refined carbohydrates and fats. Polyphenol-rich berries, such as red raspberries (RRB; Rubus idaeus), may offer protective benefits. This randomised, single-blinded, controlled crossover study evaluated the acute metabolic and cognitive effects of RRB intake in older adults (55–70 years) with overweight/obesity. Thirty-six adults (61 (sd 5) years, BMI: 30·0 (sd 2·8) kg/m2; 19 females: 17 males) consumed a high-carbohydrate, moderate-fat meal (56 % carbohydrate, 33 % fat) containing 0 g (control) or 25 g of freeze-dried RRB powder. Plasma was collected at baseline and postprandially over 7·5 h to assess glucose, insulin, triacylglyceride (TAG) and IL-6. In vitro, fasting and postprandial serum samples were applied to lipopolysaccharide (LPS)-stimulated microglial cells to assess neuroinflammatory responses (nitric oxide (NO) production, inducible nitric oxide synthase (iNOS) and cyclo-oxygenase-2 (COX-2) expression). Cognitive and vascular function were assessed at baseline and postprandially. The RRB meal significantly reduced peak glucose (by 8 %), insulin concentrations at 0·5 h and overall insulin response compared with control (P < 0·05). Serum from RRB consumers attenuated LPS-induced NO, iNOS and COX-2 expression in microglial cells (P < 0·001). Cognitive performance improved following the RRB meal, with fewer attempts in the CANTAB (Cambridge Neuropsychological Test Automated Battery) Paired Associates Learning task (P < 0·05) and fewer errors with better strategy use in the Spatial Working Memory task (P < 0·05). No significant differences were observed in vascular function. These findings suggest that acute RRB supplementation attenuated postprandial metabolic stress, reduced markers of neuroinflammation and improved cognitive performance, supporting RRB’s potential role in a dietary strategy for ageing populations.