Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Journal of Medical Research
Published in: European Journal of Medical Research 1/2023

Open Access 01-12-2023 | Miscarriage | Review

The impact of early pregnancy metabolic disorders on pregnancy outcome and the specific mechanism

Authors: Xi-Zi Zhu, Zhi-Min Deng, Fang-Fang Dai, Hua Liu, Yan-Xiang Cheng

Published in: European Journal of Medical Research | Issue 1/2023

Login to get access

Abstract

Miscarriage is the most common complication of pregnancy. The most common causes of early miscarriage are chromosomal abnormalities of the embryo, maternal endocrine abnormalities, organ malformations, and abnormal immune factors. Late miscarriages are mostly caused by factors such as cervical insufficiency. However, the causes of 50% of miscarriages remain unknown. Recently, increasing attention has been given to the role of metabolic abnormalities in miscarriage. In this review, we mainly discuss the roles of four major metabolic pathways (glucose, lipid, and amino acid metabolism, and oxidation‒reduction balance) in miscarriage and the metabolism-related genes that lead to metabolic disorders in miscarriage. Depending on aetiology, the current treatments for miscarriage include hormonal and immunological drugs, as well as surgery, while there are few therapies for metabolism. Therefore, we also summarize the drugs for metabolism-related targets. The study of altered metabolism underlying miscarriage not only helps us to understand the mechanisms involved in miscarriage but also provides an important basis for clinical research on new therapies.
Literature
1.
2.
3.
Quenby S, et al. Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss. Lancet. 2021;397(10285):1658–67.CrossRefPubMed
4.
Christiansen OB, et al. Multifactorial etiology of recurrent miscarriage and its scientific and clinical implications. Gynecol Obstet Invest. 2008;66(4):257–67.CrossRefPubMed
5.
Toth B, et al. Recurrent miscarriage: current concepts in diagnosis and treatment. J Reprod Immunol. 2010;85(1):25–32.CrossRefPubMed
6.
Bashiri A, et al. Recurrent pregnancy loss–evaluation and treatment. Harefuah. 2011;150(11):852–6.PubMed
7.
8.
9.
Herrera E, et al. Enhanced utilization of glycerol for glyceride synthesis in isolated adipocytes from early pregnant rats. J Physiol Biochem. 2010;66(3):245–53.CrossRefPubMed
10.
Villar J, et al. Effect of fat and fat-free mass deposition during pregnancy on birth weight. Am J Obstet Gynecol. 1992;167(5):1344–52.CrossRefPubMed
11.
Herrera E. Metabolic adaptations in pregnancy and their implications for the availability of substrates to the fetus. Eur J Clin Nutr. 2000;54(Suppl 1):S47-51.CrossRefPubMed
12.
Herrera E. Lipid metabolism in pregnancy and its consequences in the fetus and newborn. Endocrine. 2002;19(1):43–55.CrossRefPubMed
13.
14.
Zeng Z, Liu F, Li S. Metabolic adaptations in pregnancy: a review. Ann Nutr Metab. 2017;70(1):59–65.CrossRefPubMed
15.
Burton GJ, Scioscia M, Rademacher TW. Endometrial secretions: creating a stimulatory microenvironment within the human early placenta and implications for the aetiopathogenesis of preeclampsia. J Reprod Immunol. 2011;89(2):118–25.CrossRefPubMed
16.
Banerjee RR, et al. Gestational diabetes mellitus from inactivation of prolactin receptor and MafB in islet beta-cells. Diabetes. 2016;65(8):2331–41.PubMedCentralCrossRefPubMed
17.
Huang C, Snider F, Cross JC. Prolactin receptor is required for normal glucose homeostasis and modulation of beta-cell mass during pregnancy. Endocrinology. 2009;150(4):1618–26.CrossRefPubMed
18.
Sorenson RL, Brelje TC. Adaptation of islets of Langerhans to pregnancy: beta-cell growth, enhanced insulin secretion and the role of lactogenic hormones. Horm Metab Res. 1997;29(6):301–7.CrossRefPubMed
19.
Ernst S, et al. Mechanisms in the adaptation of maternal beta-cells during pregnancy. Diabetes Manag (Lond). 2011;1(2):239–48.CrossRefPubMed
20.
Grattan DR, Kokay IC. Prolactin: a pleiotropic neuroendocrine hormone. J Neuroendocrinol. 2008;20(6):752–63.CrossRefPubMed
21.
Bell AW, Bauman DE. Adaptations of glucose metabolism during pregnancy and lactation. J Mammary Gland Biol Neoplasia. 1997;2(3):265–78.CrossRefPubMed
22.
23.
Stanirowski PJ, et al. Expression of placental glucose transporter proteins in pregnancies complicated by fetal growth disorders. Adv Protein Chem Struct Biol. 2021;123:95–131.CrossRefPubMed
24.
Stanirowski PJ, et al. Placental expression of glucose transporter proteins in pregnancies complicated by gestational and pregestational diabetes mellitus. Can J Diabetes. 2018;42(2):209–17.CrossRefPubMed
25.
Jansson T, Wennergren M, Illsley NP. Glucose transporter protein expression in human placenta throughout gestation and in intrauterine growth retardation. J Clin Endocrinol Metab. 1993;77(6):1554–62.PubMed
26.
27.
Janzen C, et al. Placental glucose transporter 3 (GLUT3) is up-regulated in human pregnancies complicated by late-onset intrauterine growth restriction. Placenta. 2013;34(11):1072–8.CrossRefPubMed
28.
Wang Q, Liu C, Zhang Z. Transthyretin and normal human pregnancy: mini review. Crit Rev Eukaryot Gene Expr. 2016;26(3):273–7.CrossRefPubMed
29.
Murphy SP, Abrams BF. Changes in energy intakes during pregnancy and lactation in a national sample of US women. Am J Public Health. 1993;83(8):1161–3.PubMedCentralCrossRefPubMed
30.
Palacin M, et al. Circulating metabolite utilization by periuterine adipose tissue in situ in the pregnant rat. Metabolism. 1991;40(5):534–9.CrossRefPubMed
31.
Duttaroy AK, Basak S. Maternal fatty acid metabolism in pregnancy and its consequences in the feto-placental development. Front Physiol. 2021;12: 787848.CrossRefPubMed
32.
Catov JM, et al. Maternal leptin across pregnancy in women with small-for-gestational-age infants. Am J Obstet Gynecol. 2007;196(6):558.e1-8.CrossRefPubMed
33.
34.
Martineau MG, et al. The metabolic profile of intrahepatic cholestasis of pregnancy is associated with impaired glucose tolerance, dyslipidemia, and increased fetal growth. Diabetes Care. 2015;38(2):243–8.CrossRefPubMed
35.
Li Z, Zhang H. Reprogramming of glucose, fatty acid and amino acid metabolism for cancer progression. Cell Mol Life Sci. 2016;73(2):377–92.CrossRefPubMed
36.
Economides DL, et al. Plasma amino acids in appropriate- and small-for-gestational-age fetuses. Am J Obstet Gynecol. 1989;161(5):1219–27.CrossRefPubMed
37.
Cetin I, et al. Maternal concentrations and fetal-maternal concentration differences of plasma amino acids in normal and intrauterine growth-restricted pregnancies. Am J Obstet Gynecol. 1996;174(5):1575–83.CrossRefPubMed
38.
Desforges M, et al. The SNAT4 isoform of the system A amino acid transporter is functional in human placental microvillous plasma membrane. J Physiol. 2009;587(1):61–72.CrossRefPubMed
39.
Audette MC, et al. Antenatal dexamethasone treatment in midgestation reduces system A-mediated transport in the late-gestation murine placenta. Endocrinology. 2011;152(9):3561–70.CrossRefPubMed
40.
Regnault TR, de Vrijer B, Battaglia FC. Transport and metabolism of amino acids in placenta. Endocrine. 2002;19(1):23–41.CrossRefPubMed
41.
Agarwal A, et al. Redox considerations in female reproductive function and assisted reproduction: from molecular mechanisms to health implications. Antioxid Redox Signal. 2008;10(8):1375–403.CrossRefPubMed
42.
Chapple SJ, Siow RC, Mann GE. Crosstalk between Nrf2 and the proteasome: therapeutic potential of Nrf2 inducers in vascular disease and aging. Int J Biochem Cell Biol. 2012;44(8):1315–20.CrossRefPubMed
43.
Chigusa Y, et al. Decreased lectin-like oxidized LDL receptor 1 (LOX-1) and low Nrf2 activation in placenta are involved in preeclampsia. J Clin Endocrinol Metab. 2012;97(10):E1862–70.CrossRefPubMed
44.
45.
Hirsila M, et al. Characterization of the human prolyl 4-hydroxylases that modify the hypoxia-inducible factor. J Biol Chem. 2003;278(33):30772–80.CrossRefPubMed
46.
47.
Clambey ET, et al. Hypoxia-inducible factor-1 alpha-dependent induction of FoxP3 drives regulatory T-cell abundance and function during inflammatory hypoxia of the mucosa. Proc Natl Acad Sci U S A. 2012;109(41):E2784–93.PubMedCentralCrossRefPubMed
48.
Edugbe AE, et al. Beta-cell dysfunction and abnormal glucose metabolism among non-diabetic women with recurrent miscarriages. Arch Gynecol Obstet. 2020;301(2):559–64.CrossRefPubMed
49.
Milwidsky A, Palti Z, Gutman A. Glycogen metabolism of the human endometrium. J Clin Endocrinol Metab. 1980;51(4):765–70.CrossRefPubMed
50.
Burton GJ, et al. Uterine glands provide histiotrophic nutrition for the human fetus during the first trimester of pregnancy. J Clin Endocrinol Metab. 2002;87(6):2954–9.CrossRefPubMed
51.
52.
Salker MS, et al. Loss of endometrial sodium glucose cotransporter SGLT1 is detrimental to embryo survival and fetal growth in pregnancy. Sci Rep. 2017;7(1):12612.PubMedCentralCrossRefPubMed
53.
54.
55.
56.
Gardner DK. Lactate production by the mammalian blastocyst: manipulating the microenvironment for uterine implantation and invasion? BioEssays. 2015;37(4):364–71.PubMedCentralCrossRefPubMed
57.
58.
Gao L, et al. Trophoblast-derived lactic acid orchestrates decidual macrophage differentiation via SRC/LDHA signaling in early pregnancy. Int J Biol Sci. 2022;18(2):599–616.PubMedCentralCrossRefPubMed
59.
60.
61.
62.
63.
Kaczmarek E, et al. Identification and characterization of CD39/vascular ATP diphosphohydrolase. J Biol Chem. 1996;271(51):33116–22.CrossRefPubMed
64.
65.
Eltzschig HK, Sitkovsky MV, Robson SC. Purinergic signaling during inflammation. N Engl J Med. 2013;368(13):1260.CrossRefPubMed
66.
Zhu J, et al. CD39/CD73 dysregulation of adenosine metabolism increases decidual natural killer cell cytotoxicity: implications in unexplained recurrent spontaneous abortion. Front Immunol. 2022;13: 813218.PubMedCentralCrossRefPubMed
67.
Emilio H, Henar OS. Maternal lipid metabolism during normal pregnancy and its implications to fetal development. Clinical Lipidology. 2014;15(1):24–31.
68.
Risto K. Lipid abnormalities in pre-eclampsia:implications for vascular health. Clinical Lipidology. 2011;6(1):71–8.CrossRef
69.
70.
Towfighi A, Ovbiagele B. Partial peroxisome proliferator-activated receptor agonist angiotensin receptor blockers. Potential multipronged strategy in stroke prevention. Cerebrovasc Dis. 2008;26(2):106–12.CrossRefPubMed
71.
Giaginis C, Spanopoulou E, Theocharis S. PPAR-gamma signaling pathway in placental development and function: a potential therapeutic target in the treatment of gestational diseases. Expert Opin Ther Targets. 2008;12(8):1049–63.CrossRefPubMed
72.
73.
Schaiff WT, et al. Ligand-activated peroxisome proliferator activated receptor gamma alters placental morphology and placental fatty acid uptake in mice. Endocrinology. 2007;148(8):3625–34.CrossRefPubMed
74.
Yessoufou A, et al. Peroxisome proliferator-activated receptor alpha deficiency increases the risk of maternal abortion and neonatal mortality in murine pregnancy with or without diabetes mellitus: Modulation of T cell differentiation. Endocrinology. 2006;147(9):4410–8.CrossRefPubMed
75.
Barak Y, et al. Effects of peroxisome proliferator-activated receptor delta on placentation, adiposity, and colorectal cancer. Proc Natl Acad Sci USA. 2002;99(1):303–8.CrossRefPubMed
76.
Barak Y, et al. PPAR gamma is required for placental, cardiac, and adipose tissue development. Mol Cell. 1999;4(4):585–95.CrossRefPubMed
77.
78.
Wieser F, et al. PPAR action in human placental development and pregnancy and its complications. PPAR Res. 2008;2008: 527048.CrossRefPubMed
79.
Al-Gubory KH, Fowler PA, Garrel C. The roles of cellular reactive oxygen species, oxidative stress and antioxidants in pregnancy outcomes. Int J Biochem Cell Biol. 2010;42(10):1634–50.CrossRefPubMed
80.
Schisterman EF, et al. Influence of endogenous reproductive hormones on F2-isoprostane levels in premenopausal women: the BioCycle Study. Am J Epidemiol. 2010;172(4):430–9.PubMedCentralCrossRefPubMed
81.
82.
83.
Liu Y, et al. Triglyceride induced metabolic inflammation: potential connection of insulin resistance and recurrent pregnancy loss. Front Endocrinol. 2021;12: 621845.CrossRef
84.
Li M, et al. The arachidonic acid metabolism mechanism based on UPLC-MS/MS metabolomics in recurrent spontaneous abortion rats. Front Endocrinol. 2021;12: 652807.CrossRef
85.
Zhao ZA, et al. Arachidonic acid regulation of the cytosolic phospholipase A 2alpha/cyclooxygenase-2 pathway in mouse endometrial stromal cells. Fertil Steril. 2012;97(5):1199–205.CrossRefPubMed
86.
Wang H, Dey SK. Roadmap to embryo implantation: clues from mouse models. Nat Rev Genet. 2006;7(3):185–99.CrossRefPubMed
87.
Srinivasan G, et al. Leptin receptor stimulation in late pregnant mouse uterine tissue inhibits spontaneous contractions by increasing NO and cGMP. Cytokine. 2021;137: 155341.CrossRefPubMed
88.
89.
Hong L, et al. Multi-omics reveals a relationship between endometrial amino acid metabolism and autophagy in women with recurrent miscarriagedagger. Biol Reprod. 2021;105(2):393–402.CrossRefPubMed
90.
Ye J, et al. The GCN2-ATF4 pathway is critical for tumour cell survival and proliferation in response to nutrient deprivation. EMBO J. 2010;29(12):2082–96.PubMedCentralCrossRefPubMed
91.
Oh SY, et al. Autophagy-related proteins, LC3 and Beclin-1, in placentas from pregnancies complicated by preeclampsia. Reprod Sci. 2008;15(9):912–20.CrossRefPubMed
92.
Bolnick JM, et al. Sildenafil prevents apoptosis of human first-trimester trophoblast cells exposed to oxidative stress: possible role for nitric oxide activation of 3’,5’-cyclic guanosine monophosphate signaling. Reprod Sci. 2015;22(6):718–24.PubMedCentralCrossRefPubMed
93.
Tsatsaris V, et al. Calcitonin gene-related peptide (CGRP) and CGRP receptor expression at the human implantation site. J Clin Endocrinol Metab. 2002;87(9):4383–90.CrossRefPubMed
94.
Rochette L, et al. Nitric oxide synthase inhibition and oxidative stress in cardiovascular diseases: possible therapeutic targets? Pharmacol Ther. 2013;140(3):239–57.CrossRefPubMed
95.
Matsuguma K, et al. Molecular mechanism for elevation of asymmetric dimethylarginine and its role for hypertension in chronic kidney disease. J Am Soc Nephrol. 2006;17(8):2176–83.CrossRefPubMed
96.
Hao F, et al. Decreased nitric oxide content mediated by asymmetrical dimethylarginine and protein l-arginine methyltransferase 3 in macrophages induces trophoblast apoptosis: a potential cause of recurrent miscarriage. Hum Reprod. 2021;36(12):3049–61.CrossRefPubMed
97.
Ota K, et al. Effects of MTHFR C677T polymorphism on vitamin D, homocysteine and natural killer cell cytotoxicity in women with recurrent pregnancy losses. Hum Reprod. 2020;35(6):1276–87.CrossRefPubMed
98.
Poddar R, et al. Homocysteine induces expression and secretion of monocyte chemoattractant protein-1 and interleukin-8 in human aortic endothelial cells: implications for vascular disease. Circulation. 2001;103(22):2717–23.CrossRefPubMed
99.
Dudman NP, et al. Homocysteine enhances neutrophil-endothelial interactions in both cultured human cells and rats In vivo. Circ Res. 1999;84(4):409–16.CrossRefPubMed
100.
Nelen WL, et al. Genetic risk factor for unexplained recurrent early pregnancy loss. Lancet. 1997;350(9081):861.CrossRefPubMed
101.
102.
Nandi AA, et al. Maternal vitamin D deficiency influences long-chain polyunsaturated fatty acids and pregnancy outcome in association with alterations in one-carbon metabolism. Nutr Res. 2021;86:37–49.CrossRefPubMed
103.
Zhang Y, et al. Hyperandrogenism and insulin resistance-induced fetal loss: evidence for placental mitochondrial abnormalities and elevated reactive oxygen species production in pregnant rats that mimic the clinical features of polycystic ovary syndrome. J Physiol. 2019;597(15):3927–50.CrossRefPubMed
104.
Agarwal A, Allamaneni SS. Role of free radicals in female reproductive diseases and assisted reproduction. Reprod Biomed Online. 2004;9(3):338–47.CrossRefPubMed
105.
106.
Poston L, et al. Role of oxidative stress and antioxidant supplementation in pregnancy disorders. Am J Clin Nutr. 2011;94(6 Suppl):1980S-1985S.CrossRefPubMed
107.
108.
Xu Q, et al. Effect of Fas/FasL signaling pathway activation in trophoblasts on recurrent spontaneous abortion. J Obstet Gynaecol Res. 2021;47(6):1978–86.CrossRefPubMed
109.
Simsek M, et al. Blood plasma levels of lipoperoxides, glutathione peroxidase, beta carotene, vitamin A and E in women with habitual abortion. Cell Biochem Funct. 1998;16(4):227–31.CrossRefPubMed
110.
Vural P, et al. Antioxidant defence in recurrent abortion. Clin Chim Acta. 2000;295(1–2):169–77.CrossRefPubMed
111.
112.
Nair RR, Khanna A, Singh K. Association of GSTT1 and GSTM1 polymorphisms with early pregnancy loss in an Indian population and a meta-analysis. Reprod Biomed Online. 2013;26(4):313–22.CrossRefPubMed
113.
Polimanti R, et al. Glutathione S-transferase genes and the risk of recurrent miscarriage in Italian women. Fertil Steril. 2012;98(2):396–400.CrossRefPubMed
114.
Hu L, et al. SO2 derivatives induce dysfunction in human trophoblasts via inhibiting ROS/IL-6/STAT3 pathway. Ecotoxicol Environ Saf. 2021;210: 111872.CrossRefPubMed
115.
116.
Tarin JJ, et al. Oral administration of pharmacological doses of vitamins C and E reduces reproductive fitness and impairs the ovarian and uterine functions of female mice. Theriogenology. 2002;57(5):1539–50.CrossRefPubMed
117.
Cederberg J, Siman CM, Eriksson UJ. Combined treatment with vitamin E and vitamin C decreases oxidative stress and improves fetal outcome in experimental diabetic pregnancy. Pediatr Res. 2001;49(6):755–62.CrossRefPubMed
118.
Chen Y, et al. Astaxanthin alleviates gestational diabetes mellitus in mice through suppression of oxidative stress. Naunyn Schmiedebergs Arch Pharmacol. 2020;393(12):2517–27.CrossRefPubMed
119.
Di Tucci C, et al. Alpha lipoic acid in obstetrics and gynecology. Gynecol Endocrinol. 2018;34(9):729–33.CrossRefPubMed
120.
Monastra G, et al. Immunomodulatory activities of alpha lipoic acid with a special focus on its efficacy in preventing miscarriage. Expert Opin Drug Deliv. 2016;13(12):1695–708.CrossRefPubMed
121.
Smith S, Pfeifer SM, Collins JA. Diagnosis and management of female infertility. JAMA. 2003;290(13):1767–70.CrossRefPubMed
122.
Tulppala M, et al. A prospective study of 63 couples with a history of recurrent spontaneous abortion: contributing factors and outcome of subsequent pregnancies. Hum Reprod. 1993;8(5):764–70.CrossRefPubMed
123.
124.
Tempfer C, et al. Endothelial nitric oxide synthase gene polymorphism in women with idiopathic recurrent miscarriage. Hum Reprod. 2001;16(8):1644–7.CrossRefPubMed
125.
Morales SA, et al. FAK activation and the role of epithelial membrane protein 2 (EMP2) in collagen gel contraction. Invest Ophthalmol Vis Sci. 2009;50(1):462–9.CrossRefPubMed
126.
127.
Williams CJ, et al. Epithelial membrane protein 2 (EMP2) deficiency alters placental angiogenesis, mimicking features of human placental insufficiency. J Pathol. 2017;242(2):246–59.PubMedCentralCrossRefPubMed
128.
Bahia W, et al. Contribution of ADIPOQ variants to the genetic susceptibility of recurrent pregnancy loss. Reprod Sci. 2021;28(1):263–70.CrossRefPubMed
129.
Dendana M, et al. Association of adiponectin gene variants with idiopathic recurrent miscarriage according to obesity status: a case-control study. J Transl Med. 2018;16(1):76.PubMedCentralCrossRefPubMed
130.
131.
132.
Zhao J, et al. Association of genetic variants in complement factor H and factor H-related genes with systemic lupus erythematosus susceptibility. PLoS Genet. 2011;7(5): e1002079.PubMedCentralCrossRefPubMed
133.
Brai M, et al. Combined homozygous factor H and heterozygous C2 deficiency in an Italian family. J Clin Immunol. 1988;8(1):50–6.CrossRefPubMed
134.
Xu YY, et al. Hypoxic effects on the mitochondrial content and functions of the placenta in fetal growth restriction. Placenta. 2021;114:100–7.CrossRefPubMed
135.
Anton L, et al. HIF-1alpha stabilization increases miR-210 eliciting first trimester extravillous trophoblast mitochondrial dysfunction. Front Physiol. 2019;10:699.PubMedCentralCrossRefPubMed
136.
Fang M, et al. Hypoxia-inducible microRNA-218 inhibits trophoblast invasion by targeting LASP1: Implications for preeclampsia development. Int J Biochem Cell Biol. 2017;87:95–103.CrossRefPubMed
137.
Wang F, et al. Circulating miRNAs miR-574-5p and miR-3135b are potential metabolic regulators for serum lipids and blood glucose in gestational diabetes mellitus. Gynecol Endocrinol. 2021;37(7):665–71.CrossRefPubMed
Metadata
Title
The impact of early pregnancy metabolic disorders on pregnancy outcome and the specific mechanism
Authors
Xi-Zi Zhu
Zhi-Min Deng
Fang-Fang Dai
Hua Liu
Yan-Xiang Cheng
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Miscarriage
Published in
European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-023-01161-z

Other articles of this Issue 1/2023

European Journal of Medical Research 1/2023 Go to the issue

Research

Protective effects of paraoxonase-1, vitamin E and selenium, and oxidative stress index on the susceptibility of low density lipoprotein to oxidation in diabetic patients with/without coronary artery disease

Research

Nanocrystal-induced chronic tubular-nephropathy in tropical countries: diagnosis, mitigation, and eradication

Research

Pharmacovigilance-based drug repurposing: searching for putative drugs with hypohidrosis or anhidrosis adverse events for use against hyperhidrosis

Research

Schisandrin A regulates the Nrf2 signaling pathway and inhibits NLRP3 inflammasome activation to interfere with pyroptosis in a mouse model of COPD

Review

Circadian rhythm in cardiovascular diseases: a bibliometric analysis of the past, present, and future

Research

Risk-stratified multi-round PSA screening for prostate cancer integrating the screening reference level and subgroup-specific progression indicators