BACKGROUND Organ transplantation has emerged as a globally prevalent therapeutic modality for end-stage organ failure,yet the post-transplantation trajectory is increasingly complicated by a spectrum of metabolic sequ...BACKGROUND Organ transplantation has emerged as a globally prevalent therapeutic modality for end-stage organ failure,yet the post-transplantation trajectory is increasingly complicated by a spectrum of metabolic sequelae,with obesity emerging as a critical clinical challenge.AIM To systematically review the multifactorial mechanisms underlying obesity following organ transplantation and to integrate evidence from pharmacological,behavioral,and molecular perspectives,thereby providing a foundation for targeted interventions.METHODS We conducted a systematic search in PubMed and Web of Science for literature published from 2020 to 15 July 2025.The search strategy incorporated terms including“obesity”,“overweight”and“post organ transplantation”.Only randomized controlled trials,meta-analyses,and systematic reviews were included.Non-empirical publications and irrelevant studies were excluded.Data extraction and quality assessment were performed by two independent reviewers,with disagreements resolved by a third researcher.RESULTS A total of 1457 articles were initially identified,of which 146 met the inclusion criteria.These studies encompassed liver,kidney,heart,and lung transplant recipients.Key findings indicate that immunosuppressive drugs-especially corticosteroids and calcineurin inhibitors-promote hyperphagia,insulin resistance,and dyslipidemia.Post-transplant sedentary behavior and hypercaloric diets further contribute to positive energy balance.At the molecular level,immunosuppressants disrupt adipokine signaling(e.g.,leptin and adiponectin),induce inflammatory and oxidative stress responses,and activate adipogenic pathways leading to lipid accumulation.CONCLUSION Post-transplant obesity arises from a complex interplay of pharmacological,behavioral,and molecular factors.A multidisciplinary approach-incorporating pharmacological modification,nutritional management,physical activity,and molecular-targeted therapies-is essential to mitigate obesity and improve transplant outcomes.Further large-scale and mechanistic studies are warranted to establish evidence-based preventive and treatment strategies.展开更多
Objective:Microneedles(MNs),as a key component of third-generation transdermal drug delivery sys-tems,show strong potential for obesity treatment.This study aimed to integrate traditional Chinese medicine(TCM)therapie...Objective:Microneedles(MNs),as a key component of third-generation transdermal drug delivery sys-tems,show strong potential for obesity treatment.This study aimed to integrate traditional Chinese medicine(TCM)therapies,including Chinese patent medicine(CPM)injections and patches,with MN technology to identify commonly used administration sites and Chinese medicinal material(CMM)con-stituents suitable for MN-based weight loss interventions.Methods:Literature was retrieved from PubMed,Web of Science,Google Scholar,CNKI,and Google Patents.First,existing studies on MN-based weight loss were narratively reviewed.Then,studies on CPM injections or patches were analyzed to extract intervention elements,including administration sites,CMM constituents,and symptoms.Acupoint-symptom and CMM constituent-symptom pairs were compiled,and key nodes were identified through complex network analysis using eigenvector centrality,PageRank,and betweenness centrality.Results:Forty-four studies and thirteen patents were included.The review indicated that MN-based in-terventions demonstrated significant weight loss effects;however,current research remains limited by a focus on fat-deposition sites and insufficient development of CMM carriers.Network analysis identi-fied Guanyuan(CV4)and Poria cocos(Fuling)as central nodes across all metrics,suggesting their strong potential as key elements in MN-based therapies.Conclusion:CV4 and Poria cocos represent promising candidates for delivery sites and CMM constituents in MN-mediated obesity treatment.By integrating TCM principles with modern MN technology,these findings provide a theoretical basis for developing more targeted,efficient,and integrative anti-obesity interventions.展开更多
Obesity is a major contributor to metabolic dysfunction,and its impact on pancreatic health has garnered increasing attention.Macrophages,as key regulators of inflammation and metabolism,play a central role in mediati...Obesity is a major contributor to metabolic dysfunction,and its impact on pancreatic health has garnered increasing attention.Macrophages,as key regulators of inflammation and metabolism,play a central role in mediating obesity-induced pancreatic damage.In obese individuals,excessive lipid accumulation and chronic low-grade inflammation drive the infiltration and polarization of macrophages within the pancreas.These macrophages,particularly the pro-inflammatory Macrophage,pro-inflammatory phenotype(M1)phenotype,secrete cytokines such as C-C motif ligand 2(CCL2)and transforming growth factor beta(TGF-β),which disrupt pancreaticβ-cell function and impair insulin secretion.Conversely,anti-inflammatory Macrophage,anti-inflammatory phenotype(M2)macrophages contribute to tissue repair but may also promote fibrotic changes under prolonged metabolic stress.Pancreatic macrophages are activated under high-fat diet conditions,promoting inflammation and impairingβ-cell function through the SUCLA2-HIF-1αaxis and mechanistic Target of Rapamycin Complex 1(mTORC1)/PD-1 pathway,thereby establishing a self-perpetuating"metabolicimmunosuppressive"vicious cycle.Targeted intervention strategies against macrophages—such as SUCLA2 inhibitors can ameliorate metabolic dysregulation.Meanwhile,exosome-mediated interorgan communication[e.g.,via microRNA-155(miR-155)and miR-30a]offers novel insights for multi-system synergistic therapies.Understanding the mechanisms by which macrophages mediate metabolic dysregulation in the pancreas under obese conditions provides critical insights into the pathogenesis of obesity-related pancreatic disorders.展开更多
基金Supported by the National Natural Science Foundation of China,No.82305376the Youth Talent Support Project of the China Acupuncture and Moxibustion Association,No.2024-2026ZGZJXH-QNRC005+2 种基金the 2024 Jiangsu Province Youth Science and Technology Talent Support Project,No.JSTJ-2024-3802025 Jiangsu Provincial Science and Technology Think Tank Program Project,No.JSKX0125035and 2025 College Student Innovation Training Program Project,No.X202510315373。
文摘BACKGROUND Organ transplantation has emerged as a globally prevalent therapeutic modality for end-stage organ failure,yet the post-transplantation trajectory is increasingly complicated by a spectrum of metabolic sequelae,with obesity emerging as a critical clinical challenge.AIM To systematically review the multifactorial mechanisms underlying obesity following organ transplantation and to integrate evidence from pharmacological,behavioral,and molecular perspectives,thereby providing a foundation for targeted interventions.METHODS We conducted a systematic search in PubMed and Web of Science for literature published from 2020 to 15 July 2025.The search strategy incorporated terms including“obesity”,“overweight”and“post organ transplantation”.Only randomized controlled trials,meta-analyses,and systematic reviews were included.Non-empirical publications and irrelevant studies were excluded.Data extraction and quality assessment were performed by two independent reviewers,with disagreements resolved by a third researcher.RESULTS A total of 1457 articles were initially identified,of which 146 met the inclusion criteria.These studies encompassed liver,kidney,heart,and lung transplant recipients.Key findings indicate that immunosuppressive drugs-especially corticosteroids and calcineurin inhibitors-promote hyperphagia,insulin resistance,and dyslipidemia.Post-transplant sedentary behavior and hypercaloric diets further contribute to positive energy balance.At the molecular level,immunosuppressants disrupt adipokine signaling(e.g.,leptin and adiponectin),induce inflammatory and oxidative stress responses,and activate adipogenic pathways leading to lipid accumulation.CONCLUSION Post-transplant obesity arises from a complex interplay of pharmacological,behavioral,and molecular factors.A multidisciplinary approach-incorporating pharmacological modification,nutritional management,physical activity,and molecular-targeted therapies-is essential to mitigate obesity and improve transplant outcomes.Further large-scale and mechanistic studies are warranted to establish evidence-based preventive and treatment strategies.
文摘Objective:Microneedles(MNs),as a key component of third-generation transdermal drug delivery sys-tems,show strong potential for obesity treatment.This study aimed to integrate traditional Chinese medicine(TCM)therapies,including Chinese patent medicine(CPM)injections and patches,with MN technology to identify commonly used administration sites and Chinese medicinal material(CMM)con-stituents suitable for MN-based weight loss interventions.Methods:Literature was retrieved from PubMed,Web of Science,Google Scholar,CNKI,and Google Patents.First,existing studies on MN-based weight loss were narratively reviewed.Then,studies on CPM injections or patches were analyzed to extract intervention elements,including administration sites,CMM constituents,and symptoms.Acupoint-symptom and CMM constituent-symptom pairs were compiled,and key nodes were identified through complex network analysis using eigenvector centrality,PageRank,and betweenness centrality.Results:Forty-four studies and thirteen patents were included.The review indicated that MN-based in-terventions demonstrated significant weight loss effects;however,current research remains limited by a focus on fat-deposition sites and insufficient development of CMM carriers.Network analysis identi-fied Guanyuan(CV4)and Poria cocos(Fuling)as central nodes across all metrics,suggesting their strong potential as key elements in MN-based therapies.Conclusion:CV4 and Poria cocos represent promising candidates for delivery sites and CMM constituents in MN-mediated obesity treatment.By integrating TCM principles with modern MN technology,these findings provide a theoretical basis for developing more targeted,efficient,and integrative anti-obesity interventions.
基金Supported by National Natural Science Foundation of China Youth Science Fund Project,No.82305376the Young Talent Support Program of the China Association for Acupuncture-Moxibustion,No.2024-2026ZGZJXH-QNRC005+1 种基金the 2024 Jiangsu Provincial Young Scientific and Technological Talent Support Program,No.JSTJ-2024-380the 2025 Jiangsu Science and Technology Think Tank Program Project,No.JSKX0125035。
文摘Obesity is a major contributor to metabolic dysfunction,and its impact on pancreatic health has garnered increasing attention.Macrophages,as key regulators of inflammation and metabolism,play a central role in mediating obesity-induced pancreatic damage.In obese individuals,excessive lipid accumulation and chronic low-grade inflammation drive the infiltration and polarization of macrophages within the pancreas.These macrophages,particularly the pro-inflammatory Macrophage,pro-inflammatory phenotype(M1)phenotype,secrete cytokines such as C-C motif ligand 2(CCL2)and transforming growth factor beta(TGF-β),which disrupt pancreaticβ-cell function and impair insulin secretion.Conversely,anti-inflammatory Macrophage,anti-inflammatory phenotype(M2)macrophages contribute to tissue repair but may also promote fibrotic changes under prolonged metabolic stress.Pancreatic macrophages are activated under high-fat diet conditions,promoting inflammation and impairingβ-cell function through the SUCLA2-HIF-1αaxis and mechanistic Target of Rapamycin Complex 1(mTORC1)/PD-1 pathway,thereby establishing a self-perpetuating"metabolicimmunosuppressive"vicious cycle.Targeted intervention strategies against macrophages—such as SUCLA2 inhibitors can ameliorate metabolic dysregulation.Meanwhile,exosome-mediated interorgan communication[e.g.,via microRNA-155(miR-155)and miR-30a]offers novel insights for multi-system synergistic therapies.Understanding the mechanisms by which macrophages mediate metabolic dysregulation in the pancreas under obese conditions provides critical insights into the pathogenesis of obesity-related pancreatic disorders.
