Endocrine, Metabolic & Immune Disorders-Drug Targets - Volume 25, Issue 13, 2025

Research on RNA in diabetic retinopathy (DR) has received increasing attention in recent years. However, there is a lack of comprehensive and systematic research on the current status and future direction of RNA research in DR. Therefore, this study used bibliometric analysis to summarize the global trends and current status of DR RNA research to date.

We searched the Web of Science for studies related to DR RNA research before July 2024 and then used CiteSpace and VOSviewer to generate knowledge visualization maps.

A total of 1,103 articles related to RNA research in DR were retrieved. China has the most articles, followed by the USA and Japan. Wayne State University, Nanjing Medical University, and Shanghai Jiao Tong University were the three most productive institutions. Investigative Ophthalmology & Visual Science was the most popular journal in this field. Kowluru, Renu A from Wayne State University published the most number of articles. Keyword analysis showed that the research hotspot in this field is the role of miRNAs in apoptosis and neovascularization in DR. Non-coding RNAs and extracellular vesicles are future research trends.

The results of this bibliometric study provide information on the current status and trends in the field of RNA research in DR. RNA research could lead to new diagnostic methods and therapeutic strategies for DR. Our findings can help researchers understand the current status of RNA research in DR and identify new directions for further research.

This study systematically evaluated the efficacy and safety of Ling Gui Zhu Gan Decoction for treating non-alcoholic fatty liver disease.

Registered under CRD42024501460 on the PROSPERO platform, we searched eight major databases, including Web of Science, PubMed, Cochrane, Embase, China National Knowledge Infrastructure, Wanfang database, Chinese Scientific Journals Database, and Chinese Biomedicine Database, from inception to December 2023 for randomized controlled trials on Ling Gui Zhu Gan Decoction in non-alcoholic fatty liver disease treatment. We extracted data on total efficiency, TC, TG, ALT, AST, GGT, and HOMA-IR, analyzing results with RevMan 5.4 software.

Twelve studies met the inclusion criteria, encompassing 970 cases. Ling Gui Zhu Gan Decoction, alone or combined with standard therapy, significantly improved non-alcoholic fatty liver disease outcomes, regardless of treatment duration. Only one study reported adverse events, including bloating, diarrhea, nausea, vomiting, and rash.

Ling Gui Zhu Gan Decoction appears to be an effective and safe option for non-alcoholic fatty liver disease treatment. However, due to limited studies and methodological weakness, further rigorous randomized controlled trials are necessary for conclusive results.

Hepatic inflammation, e.g., Nonalcoholic Fatty Liver Diseases (NAFLD) and the severe form of steatohepatitis (NASH), has been associated with a higher risk of MetS in the general population.

This study aimed to investigate the associations of chronic hepatitis B (CHB) and fatty liver diseases with the incidence of metabolic syndrome (MetS) in young adults, which have not been verified before.

The associations between NAFLD, NASH, and CHB and the incidence of new-onset MetS remain inconclusive in young adults.

This cohort study included 2,614 military personnel aged 18-39 years who were free of baseline MetS in 2014 and were followed for the incidence of MetS in each annual health examination until the end of 2020. CHB was defined by the presence of the hepatitis B surface antigen with an established diagnosis history. NAFLD and NASH were defined by the ultrasound finding with an elevated alanine transaminase (27-53.9 and ≥54 U/L in men and 15-29.9 and ≥30 U/L in women, respectively). MetS was defined based on the International Diabetes Federation criteria. Multivariable Cox regression analysis was used to determine the associations between hepatitis and incident MetS.

During a mean follow-up of 6.0 years, 582 new-onset MetS cases occurred (22.3%). NAFLD and NASH were associated with a greater risk of new-onset MetS (hazard ratios (HRs) and 95% confidence intervals: 1.47 (1.21-1.79) and 1.66 (1.16-2.39), respectively), while no association for CHB was found (HR: 1.31 (0.88-1.96)).

This study found that NAFLD and NASH, while not CHB, were independent risk factors of new-onset MetS with adjustments for potential covariates, e.g., physical activity and fitness in young adults.

While the annual incidence of diabetic kidney disease (DKD) has been soaring, the exact mechanisms underlying its onset and progression remain partially understood.

The present study delved into the underlying mechanisms of Jisheng Shenqi Pill (JSP) in the treatment of DKD.

The active constituents and prospective targets of JSP were identified from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), while DKD-associated disease targets were obtained from the GeneCards database. Subsequently, Gene Ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed to assess the overlapping segment of drugs and disease targets. Meanwhile, a component-target-pathway network was constructed to identify pivotal components, targets, and pathways. Molecular docking and molecular dynamics simulation were also carried out to validate the binding efficacy of the pivotal components with the targets. Finally, animal experiments were conducted to corroborate the efficacy of the aforementioned targets and pathways.

According to bioinformatics analysis, the primary targets included JUN, TNF, and BAX, while the pivotal pathways involved were AGE/RAGE and PI3K/AKT signaling cascades. In vivo experiments demonstrated that JSP effectively mitigated renal impairment in DKD by reducing renal inflammation and apoptosis. This effect was presumably achieved by modulating the AGE-RAGE axis and the PI3K/AKT signaling pathway.

Our findings imply that JSP could ameliorate renal inflammation and apoptosis in DKD mice by modulating the AGE/RAGE axis and the PI3K/AKT signaling pathway. These findings provide valuable insights into traditional Chinese medicine-based treatments for DKD.

Buzhong Yiqi decoction (BZYQ) is a classical traditional Chinese formula that has shown potential in alleviating diabetic nephropathy (DN). However, its underlying mechanisms remain unclear.

We aimed to explore the potential targets and mechanisms of action of BZYQ in DN.

A DN rat model was induced using a high-fat and high-sugar diet combined with intraperitoneal injection of streptozotocin (STZ), followed by treatment with different doses of BZYQ. Initially, the protective effects of BZYQ on renal tissue were assessed by measuring fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), 24-hour urinary total protein (24h-UTP), urinary albumin (ALB), and serum creatinine (SCr) after administration, along with performing hematoxylin-eosin (HE) staining. Subsequently, transcriptomics and bioinformatics approaches were employed to identify the action targets and potential mechanisms of BZYQ in DN rats. Finally, real-time PCR and Western blot analyses were conducted to validate key targets and mechanisms.

We observed significant improvements in renal injury in DN rats treated with medium and high doses of BZYQ. Transcriptomic and bioinformatic analyses identified NLRP3, ASC, caspase-1, GSDMD, IL-1β, and IL-18 as hub genes, along with differential expression of immune-related transcription factors T-bet and GATA-3 in various transcriptomes. In the validation phase, the mRNA and protein expressions of NLRP3, ASC, caspase-1, GSDMD, IL-18, IL-1β, and T-bet were significantly elevated in the DN rat model group, while GATA-3 mRNA and protein levels were significantly decreased; BZYQ was able to reverse these changes.

BZYQ has been found to have a protective effect on renal tissue damage in DN rats, potentially related to the inhibition of NLRP3 inflammasome pathway activation and the improvement of Th1/Th2 immune cell balance.

Acute suppurative thyroiditis (AST) is a rare form of thyroid inflammation prevalently of bacterial origin that usually affects subjects with risk factors such as immunodeficiency, sepsis, and neck fistulas. The most prevalent pathogens associated with AST are gram-positive aerobic bacteria, followed by gram-negatives, while infections by anaerobic germs are exceptionally rare. Gemella morbillorum is a facultative anaerobic gram- positive bacterium that commonly populates the upper respiratory tract. Infections by Gemella Morbillorum have been previously documented in different regions (i.e., lung, brain, bone, liver), but never in the thyroid.

An 18-year-old male with no previous medical history presented to the emergency department complaining of a rapidly enlarging painful neck mass in left anterior latero-cervical region progressively worsening over the last two weeks, accompanied by dysphagia and fever. Blood tests showed the presence of thyroiditis (suppressed TSH with increased free thyroxine, elevated inflammation markers and neutrophilic leucocytosis). Neck ultrasonography and CT showed a large abscess involving the left thyroid lobe and extending to the ipsilateral laterocervical region, suggesting the diagnosis of AST. Prompt antibiotic therapy was started and subsequent surgical drainage of the abscess was performed, resulting in a rapid clinical recovery and the restoration of normal thyroid function. The bacterial culture of the abscess showed exclusively the presence of Gemella morbillorum.

We present the first documented case of AST caused by Gemella morbillorum in an otherwise healthy young man. Although rare, AST in immunocompetent patients is possible; prompt diagnosis and treatment of this condition are fundamental to avoid severe complications.

Denosumab, a fully humanized monoclonal neutralizing antibody inhibiting the RANK/RANKL/OPG signaling pathway, is widely used for treating patients with bone metastases. However, its use in cancer patients with bone metastases is burdened by the risk of all grades of hypocalcemia, with the severe grade being rare. In the literature, several cases of severe symptomatic hypocalcemia have been reported, particularly in patients with breast and prostate cancers. In this report, we present a rare case of asymptomatic hypocalcemia in a 78 years-old patient with sigmoid cancer and bone metastases.

Hypocalcemia was detected two weeks after the first denosumab administration, during routine biochemical evaluation. The patient reported only a mild nonspecific paresthesia after medical questioning, without relevant clinical symptoms. Despite the severity of the hypocalcemia, serum calcium levels began to improve after a short period of low-dose calcium and calcitriol therapy, though complete stabilization and normalization occurred after several weeks.

This case highlights the importance to consider severe paucisymptomatic or asymptomatic hypocalcemia as a possible side effect in bone-metastatic patients treated with denosumab. It is advisable to monitor serum calcium levels even in the absence of typical hypocalcemia-related symptoms.

Hypophysitis is a rare inflammatory disorder of the pituitary gland. Symptoms and signs of hypophysitis can be various, progressing insidiously, and its recognition may be challenging.

We report the clinical history and therapeutic management of a 59-year-old man diagnosed with arginine vasopressin deficiency (AVP-D) due to an infundibulo-neuro-hypophysitis (INH) that occurred after the patient had inhaled spray film containing toluene. In consideration of the clinical signs and radiological imaging suggestive of INH, therapy with desmopressin and corticosteroids was instituted, with gradual improvement of polyuria and resolution of the radiological features of INH.

To our knowledge, we described the first case of INH, manifested with AVP-D, secondary to toluene exposure. In addition, the endocrine effects of toluene inhalation were discussed. Finally, given the scarcity of data available, an overview of all the known toxic substances inducing AVP-D was also provided.