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Topic Review
Microvascular Skeletal-Muscle Crosstalk in Health and Disease
As an organ system, skeletal muscle is essential for the generation of energy that underpins muscle contraction, plays a critical role in controlling energy balance and insulin-dependent glucose homeostasis, as well as vascular well-being, and regenerates following injury. To achieve homeostasis, there is requirement for “cross-talk” between the myogenic and vascular components and their regulatory factors that comprise skeletal muscle. Accordingly, here will describe the following: [a] the embryonic cell-signaling events important in establishing vascular and myogenic cell-lineage, the cross-talk between endothelial cells (EC) and myogenic precursors underpinning the development of muscle, its vasculature and the satellite-stem-cell (SC) pool, and the EC–SC cross-talk that maintains SC quiescence and localizes ECs to SCs and angio-myogenesis postnatally; [b] the vascular–myocyte cross-talk and the actions of insulin on vasodilation and capillary surface area important for the uptake of glucose/insulin by myofibers and vascular homeostasis, the microvascular-myocyte dysfunction that characterizes the development of insulin resistance, diabetes and hypertension, and the actions of estrogen on muscle vasodilation and growth in adults; [c] the role of estrogen in utero on the development of fetal skeletal-muscle microvascularization and myofiber hypertrophy required for metabolic/vascular homeostasis after birth; [d] the EC–SC interactions that underpin myofiber vascular regeneration post-injury; and [e] the role of the skeletal-muscle vasculature in Duchenne muscular dystrophy.
  • 487
  • 13 Oct 2023
Topic Review
Metabolism as New Avenue for Hepatocellular Carcinoma Therapy
Alterations in cellular metabolism are important drivers of the tumorigenesis process and the promotion of drug resistance. The balance between glycolysis and oxidative phosphorylation (OXPHOS) is a central point. The complex interplay between tumor cell metabolism and drug resistance is an important aspect, and that the balance between OXPHOS and fermentative glycolysis is critical for determining the cellular behavior during neoplastic transformation and the acquisition of drug resistance by tumor cells. Furthermore, it is worth mentioning that, modulating the balance between OXPHOS and lactic acid fermentation to trigger OXPHOS and inhibit fermentation could be considered a strategy to reduce tumor invasiveness and drug resistance.
  • 480
  • 16 Mar 2023
Topic Review
Ketogenic Diet in Alzheimer’s Disease Treatment
Alzheimer’s disease (AD) is the most common cause of dementia in the elderly and its development is linked to multifactorial interactions between the environment, genetics, aging and lifestyle. The pathological hallmarks in AD are the accumulation of β-amyloid peptide (Aβ), the hyperphosphorylation of tau protein, neurotoxic events and impaired glucose metabolism. Due to pharmacological limitations and in view of the prevailing glycemic hypometabolism, the ketogenic diet (KD) emerges as a promising non-pharmacological possibility for managing AD, an approach that has already demonstrated efficacy in addressing other disorders, notably epilepsy. The KD consists of a food regimen in which carbohydrate intake is discouraged at the expense of increased lipid consumption, inducing metabolic ketosis whereby the main source of energy becomes ketone bodies instead of glucose. Thus, under these dietary conditions, neuronal death via lack of energy would be decreased, inasmuch as the metabolism of lipids is not impaired in AD. In this way, the clinical picture of patients with AD would potentially improve via the slowing down of symptoms and delaying of the progression of the disease.
  • 480
  • 16 Jan 2024
Topic Review
Time-Restricted Feeding and Weight Loss in Obesity
Across the globe, obesity is a significant concern for public health, a disease characterized by excessive accumulation of body fat, with a negative impact on health. Time-restricted feeding (TRF), in which food accessibility is restricted to a variable period of 8–10 h, especially in the active phase, inducing a prolonged fasting period, is a strategy with potential effects in preventing obesity. Evidence in preclinical studies demonstrated that TRF attenuates the impacts of metabolic disturbances related to high-fat diet feeding in rodents. Through these discoveries, there has been growing interest in revealing the effects associated with TRF in preventing obesity and its comorbidities, as well as investigating its effects in humans. Although TRF is a promising alternative to reduce the impact of obesity, it is necessary to investigate the results on skeletal muscle tissue. Muscle tissue is important for body energy expenditure; however, caloric restriction can negatively impact protein turnover and induce loss of muscle mass, influencing the basal metabolic rate and weight loss.
  • 478
  • 21 Aug 2023
Topic Review
Selective Modulators on the Renin–Angiotensin–Aldosterone System
The renin–angiotensin–aldosterone system (RAAS) plays a crucial role in maintaining various physiological processes in the body, including blood pressure regulation, electrolyte balance, and overall cardiovascular health. However, any compounds or drugs known to perturb the RAAS might have an additional impact on transmembrane ionic currents. Herein, a selection of chemical compounds or medications that have long been recognized as interfering with the RAAS are presented.
  • 478
  • 27 Sep 2023
Topic Review
Somatic Genetic Variation in Pituitary Neuroendocrine Tumors
Mutational hotspots have gained importance as oncological biomarkers in recent years because of their potential as predictors of clinical outcomes and/or therapeutic targets. In addition, they are easily detectable in clinical samples via Sanger or next-generation sequencing (NGS). The role of these genetic defects is less clear in pituitary neuroendocrine tumors (PitNETs), even though the most common genetic drivers of these neoplasms are located within mutational hotspots. Indeed, hotspots in six different genes are of particular importance in this context. Two of them, USP48 and SF3B1, represent very recent and infrequent genetic associations; thus, their clinical relevance remains unclear. For two other genes, GNAS and USP8, discrepancies exist among studies regarding their associated phenotypes. Finally, the phenotypes associated with BRAF and DICER1 are well defined in other settings, but not yet in sporadic PitNETs. Additional studies are required to assess the potential of these molecular alterations as druggable targets in PitNETs.
  • 462
  • 14 Dec 2023
Topic Review
Regulation of Macronutrients during Type 2 Diabetes Mellitus
Insulin resistance is an important feature of metabolic syndrome and a precursor of type 2 diabetes mellitus (T2DM). Overnutrition-induced obesity is a major risk factor for the development of insulin resistance and T2DM. The intake of macronutrients plays a key role in maintaining energy balance. The components of macronutrients distinctly regulate insulin sensitivity and glucose homeostasis. Precisely adjusting the beneficial food compound intake is important for the prevention of insulin resistance and T2DM. 
  • 457
  • 19 Dec 2023
Topic Review
Intelligent Insulins
The concept of intelligent/smart insulins is straightforward, and it can be summed up as “from complexity to simplicity.” In essence, it is a question of creating an insulin capable of self-regulating according to changes in blood sugar, so-called “glucose responsive insulin” (GRI), eliminating the need to consider all the variables involved in dose calculation (calories, carbohydrates, exercise, time, etc.).
  • 454
  • 11 Sep 2023
Topic Review
Gut Microbiota, Inflammation, and Obesity
The increased prevalence of obesity and several other metabolic disorders, including diabetes and non-alcoholic fatty liver disease, has reached global pandemic proportions. Lifestyle changes may result in a persistent positive energy balance, hastening the onset of these age-related disorders and consequently leading to a diminished lifespan. Although suggestions have been raised on the possible link between obesity and the gut microbiota, progress has been hampered due to the extensive diversity and complexities of the gut microbiota. Being recognized as a potential biomarker owing to its pivotal role in metabolic activities, the dysregulation of the gut microbiota can give rise to a persistent low-grade inflammatory state associated with chronic diseases during aging.
  • 451
  • 06 Mar 2024
Topic Review
Irisin in Women’s Life Span
Since its discovery, irisin has attracted much attention for its potential involvement in metabolic and reproductive diseases. It appears to play an important role in different physiological and pathological conditions that can involve women throughout their entire lives. Irisin appears to be an important factor for the hypothalamic–pituitary–gonadal axis activation, and it seems to play a role in the timing of puberty onset. Additionally, serum irisin levels have been proposed as a biomarker for predicting the future development of gestational diabetes (GDM). Its role in polycystic ovary syndrome (PCOS) is still controversial, although an “irisin resistance” mechanism has been hypothesized. Beyond its influence on metabolism, irisin also appears to influence bone health. Irisin levels are inversely correlated with the prevalence of fractures in postmenopausal women. Similar mechanisms have also been postulated in young women with functional hypothalamic amenorrhea (FHA).
  • 442
  • 20 Feb 2024
Topic Review
RAAS Activity, Osteoporosis  and Estrogen Deficiency in Diabetes
Type 2 diabetes (T2D) is associated with a plethora of comorbidities, including osteoporosis, which occurs due to an imbalance between bone resorption and formation. Numerous mechanisms have been explored to understand this association, including the renin–angiotensin–aldosterone system (RAAS). An upregulated RAAS has been positively correlated with T2D and estrogen deficiency in comorbidities such as osteoporosis in humans and experimental studies. 
  • 439
  • 03 Aug 2023
Topic Review
IGF-II–Insulin Receptor Isoform-A Autocrine Signal in Cancer
Insulin receptor overexpression is a common event in human cancer. Its overexpression is associated with a relative increase in the expression of its isoform A (IRA), a shorter variant lacking 11 aa in the extracellular domain, conferring high affinity for the binding of IGF-II along with added intracellular signaling specificity for this ligand. Since IGF-II is secreted by the vast majority of malignant solid cancers, where it establishes autocrine stimuli, the co-expression of IGF-II and IRA in cancer provides specific advantages such as apoptosis escape, growth, and proliferation to those cancers bearing such a co-expression pattern.
  • 426
  • 13 Mar 2024
Topic Review
Adiponectin as a Treatment Target for Diabetes
Diabetes mellitus, a chronic metabolic disorder characterized by hyperglycemia, presents a formidable global health challenge with its associated complications. Adiponectin, an adipocyte-derived hormone, has emerged as a significant player in glucose metabolism and insulin sensitivity. Beyond its metabolic effects, adiponectin exerts anti-inflammatory, anti-oxidative, and vasoprotective properties, making it an appealing therapeutic target for mitigating diabetic complications.
  • 370
  • 24 Nov 2023
Topic Review
Organokines in Obesity and Type 2 Diabetes
Maintaining systemic homeostasis requires the coordination of different organs and tissues in the body. Our bodies rely on complex inter-organ communications to adapt to perturbations or changes in metabolic homeostasis. Consequently, the liver, muscle, and adipose tissues produce and secrete specific organokines such as hepatokines, myokines, and adipokines in response to nutritional and environmental stimuli. Emerging evidence suggests that dysregulation of the interplay of organokines between organs is associated with the pathophysiology of obesity and type 2 diabetes (T2D). 
  • 368
  • 15 Sep 2023
Topic Review
SPINA Carb
SPINA Carb is a physiological approach for the quantitative evaluation of insulin-glucose homeostasis. It delivers calculated biomarkers for pancreatic beta-cell function (SPINA-GBeta) and insulin sensitivity (SPINA-GR), and a static disposition index (SPINA-DI) as an estimate for the loop gain of the feedback loop.
  • 336
  • 20 Oct 2025
Topic Review
Disposition Index
The disposition index, abbreviated DI, is an important concept in both theoretical and clinical diabetology. Serving as a biomarker for the function of the insulin-glucose feedback control system, it can be determined using various methods and provides an estimate of the loop gain of the homeostatic system. Generally, it is calculated as the product of pancreatic beta-cell function times insulin sensitivity.
  • 317
  • 24 Sep 2025
Topic Review
Syndrome T
Syndrome T, or SORSHOT, refers to persistent symptoms in patients affected by hypothyroidism who appear euthyroid by TSH levels. Seen in about 10% of hypothyroid patients, causes are unclear but likely include psychosomatic factors, inadequate treatment, autoimmunity, and neuropathy. Common symptoms are fatigue, heart-related issues, mood changes, weight gain, and pain. No standard treatment exists, but options may include combined hormone therapy, personalised dosing, and nutritional supplementation.
  • 251
  • 29 Sep 2025
Topic Review
Diabetes-Related Mechanisms of  Croton Species
Over the years, ethnopharmacological and phytochemical investigations have been conducted to understand the potential effects of the Croton genus on several diseases. It has been revealed that these terpenoid-rich species traditionally used to treat gastrointestinal diseases, heal wounds, and relieve pain have a wide range of therapeutic effects; however, those used to treat diabetes, as well as their action mechanisms, have not been reviewed so far. Therefore, the main objective of this review was to compile all Croton species that have shown pharmacological effects against diabetes and describe their action mechanisms. Through a search of the literature, 17 species with hypoglycemic, antihyperglycemic, antilipidemic, antihypertensive, antioxidant, and anti-inflammatory effects were found. Among the mechanisms by which they exerted these effects were the inhibition of α-glucosidases, the promotion of insulin secretion, and the increase in glucose uptake. Interestingly, it was found that some of them may have antihyperglycemic properties, although there were no ethnopharmacological reports that support their traditional use. Moreover, others only presented studies on their hypoglycemic effect in fasting, so further works are encouraged to describe the mechanisms involved in lowering fasting blood glucose levels, such as hepatic glucose production, especially for C. cajucara, C. cuneatus, C. gratissimus var. gratissimus, C. guatemalensis, and C. membranaceus. It is expected that this review contributes to the plant science knowledge of the genus, and it can be used in future references on the identification and development of new molecules/phytomedicines that help in the treatment of diabetes.
  • 113
  • 30 Jun 2025
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