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Nieuwe meta-analyses, RCTs en systematic reviews die wij dagelijks monitoren in PubMed. Onafhankelijk geïndexeerd, niet redactioneel bewerkt.
Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2026
Targeted nipple-areola complex (NAC) reinnervation (TNR) aims to restore nipple sensation after gender-affirming (GA) chest surgery and oncologic mastectomy; however, the outcomes have not been systematically synthesized. We performed a PRISMA systematic review (PROSPERO CRD420250653209; March 20, 2025) of the PubMed, Embase, Scopus, Web of Science, and ClinicalTrials.gov databases. Two independent reviewers performed screening and data extraction. Risk of bias was assessed using ROBINS-I. Random-effects meta-analysis pooled postoperative Semmes-Weinstein (SW) monofilament thresholds as mean differences (TNR minus control) at the longest comparable follow-up. Included studies were observational (prospective and retrospective cohorts and case series). Ten studies were included (4 GA; 6 oncologic/prophylactic), representing 281 unique patients. The meta-analysis included three comparative cohorts. TNR was associated with improved nipple sensation (-1.40 SW units; 95% CI -1.95, -0.86; I² 58.1%). In a GA subgroup (2 studies), the pooled effect was similar (-1.54; 95% CI -2.28, -0.80; I² 74.9%). Single-arm studies reported recovery of protective sensation after TNR. In the largest comparative cohort with multidimensional quantitative sensory testing, NAC cold detection differed by 11.1 °C (95% CI 7.6, 14.6), and NAC 2-point discrimination was present in 40% of TNR patients versus 0% of controls. In a nipple erection substudy, nipple erection was reported in 73% (16/22) of TNR nipples versus 39% (7/18) of controls. TNR was associated with improved postoperative NAC sensory outcomes, but the available evidence was observational and subject to moderate-to-serious risk of bias. Larger prospective multicenter studies with standardized sensory testing, longer follow-up, and validated patient-reported outcomes are needed.
Journal of animal science · 2026
Dietary supplementation with tryptophan in sows is a promising strategy for optimizing both performance and animal welfare. In addition to its role in protein synthesis, this essential amino acid is a precursor of serotonin and melatonin, which are bioactive compounds that influence appetite, social behavior, and stress regulation. However, the reported effects on reproductive outcomes and maternal metabolism remain inconsistent. This systematic review evaluated the evidence of tryptophan supplementation as a modulator of behavior and productivity in sows. Searches were conducted in Scopus and Web of Science databases. Experimental peer-reviewed studies that assessed tryptophan supplementation across different physiological phases (gestation and lactation), dietary levels, and environmental contexts were included. This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines, and the protocol was preregistered. Screening and data extraction were performed by two independent reviewers, and the risk of bias was assessed using the SYRCLE's (Systematic Review Center for Laboratory Animal Experimentation) risk of bias tool. Eleven studies met the eligibility criteria of this review. Tryptophan supplementation consistently reduced aggressiveness in group-housing systems and supported piglet survival and growth. However, the effects on reproductive performance and maternal metabolism vary depending on the dose, parity, and environmental conditions. The heterogeneity of the study designs and the absence of a meta-analysis due to data variability were identified as the main limitations. Overall, tryptophan supplementation demonstrated potential benefits for sow welfare and productivity, but the results remained context dependent. Long-term and standardized studies are required to clarify its impact, particularly on reproductive efficiency and maternal physiology. Tryptophan is an amino acid that can be added to sow diets to improve both their behavior and productivity. In addition to its role in protein synthesis, tryptophan serves as a precursor for bioactive compounds into substances that influence mood, appetite, and stress. However, the reported effects on sow productivity and metabolism have been inconsistent. This review analyzed scientific evidence to evaluate tryptophan supplementation to improve sow behavior and productivity, highlighting that while it has a positive effect on well-being, its results on production still vary.
Journal of gynecology obstetrics and human reproduction · 2026
Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder, the exact causes of which are still not known. However, studies have emphasized the role of oxidative stress in the pathogenesis of PCOS. The aim of this study is to investigate the effect of sildenafil and melatonin on oxidative stress markers in PCOS patients. 51 PCOS patients were randomly divided into three groups and received treatment for three months. Group 1, only received metformin; Group 2, received melatonin + metformin, and Group 3 received sildenafil + metformin. Blood samples were collected before and after the treatment started, and serum levels of malondialdehyde (MDA), nitric oxide (NO), ferric-reducing antioxidant power (FRAP), protein carbonyl (PC) and total thiol (T-SH) were measured. The findings of the study demonstrated a decline in the mean levels of MDA and PC in the metformin-only, sildenafil, and melatonin groups. This decline was statistically significant for MDA in the metformin-only group (P=0.008) and the sildenafil group (P=0.04), and for PC in the metformin-only group (P=0.005) and melatonin group (P=0.04). The antioxidant markers such as T-SH (P=0.009) and FRAP (P=0.03) levels significantly increased in the melatonin group after the intervention. Overall, biomarkers of oxidative stress improved in the metformin-only, melatonin, and sildenafil groups, suggesting that these drugs may have protective effects in PCOS patients. However, further studies are needed to determine their effectiveness.
British journal of anaesthesia · 2026
Postoperative sleep impairment is common in older adult patients and is associated with delayed recovery and a negative impact on overall health, daily functioning, and quality of life. Older adults are particularly vulnerable because of age-related physiological changes and reduced functional reserves. We conducted a systematic review to assess the efficacy of pharmacotherapeutic interventions for improving postoperative sleep in older adults. PubMed, the Cochrane Library, and Embase were searched from inception to August 20, 2025. Randomised controlled trials investigating pharmacological interventions aimed at improving postoperative sleep in patients aged ≥60 yr were included. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool, and certainty of evidence was evaluated using the GRADE framework. Random-effects meta-analysis was performed where appropriate. The review was registered in PROSPERO (CRD420250651275). Of the 525 identified studies, 21 met the inclusion criteria. Assessed interventions included dexmedetomidine, esketamine, alprazolam, remimazolam, melatonin, and zolpidem. Dexmedetomidine was the most consistently effective, improving both subjective and objective sleep. Subgroup meta-analysis comparing dexmedetomidine with placebo showed a moderate, statistically significant improvement in sleep quality (standardised mean differences -0.51; 95% confidence interval -0.86 to -0.17; p<0.001; I2=94%). Evidence for other agents was limited. Overall certainty of evidence was very low to low. Pharmacological interventions potentially improve postoperative sleep in older adults, but current evidence is limited. Dexmedetomidine appears most promising, with potential benefits across administration regimens. High-quality trials are needed to establish optimal dosing and timing and to assess longer-term effects on sleep and recovery in this vulnerable population.
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026
To describe temporal patterns of use of sleep aids (benzodiazepine receptor agonists [BZRAs], non-BZRAs [e.g., melatonin]) from baseline to 6FU associated with cognitive behavioral therapy for insomnia (CBTI) combined with BZRA tapering and to assess the odds of BZRA use at 6FU associated with non-BZRA use at baseline. Using diary data from a trial comparing CBTI combined with a masked BZRA taper method (MTcap) versus standard open BZRA taper (SGT), we determined the frequency of four temporal patterns of sleep aid use at 6FU relative to baseline: 1) "less BZRA-nonBZRA", 2) "stable use BZRA-nonBZRA", 3) "more BZRA-nonBZRA", and 4) "less BZRA/more nonBZRA." We also assessed the use of specific non-BZAs (e.g., melatonin) and whether non-BZRA use at baseline predicted patterns of sleep aid use at 6FU. Of 139 participants (71 MTcap; 68 SGT), 63% used "less" (68% MTcap, 59% SGT), 26% were "stable use" (20% MTcap, 32% SGT), 5% used "more" (6% MTcap, 4% SGT), and 6% used "less BZRA but more nonBZRA" (7% MTcap, 4% SGT) at 6FU. Combination BZRA-nonBZRA was associated with increased odds of only nonBZRA use (OR = 9.05) and decreased odds of only BZRA (OR = .23) or no BZRA/nonBZRA (OR = .38) at 6FU compared to BZRA only at baseline. The MTcap and SGT programs, both incorporating CBTI, were associated with less use of sleep aids at 6FU. BZRA deprescribing initiatives that include CBTI are effective in lowering sleep aid use among middle-aged and older adults. Clinicaltrials.gov NCT03687086 Registered 9/27/2018. Protocols and clinical tapering guidelines are available to help patients taper off benzodiazepines and z-drugs used for insomnia. These protocols may be combined with cognitive behavioral therapy for insomnia to address underlying factors that perpetuate insomnia symptoms. However, discontinuing these medications may leave patients feeling like they need to turn to other medications or supplements to help them sleep. There is a paucity of empirical evidence on the types of sleep aids patients take after benzodiazepine and z-drug tapering, and whether cognitive behavioral therapy for insomnia in combination with benzodiazepine/z-drug tapering protocols is associated with discontinuation of other sleep aids. This analysis of data from a randomized trial found less sleep aid use 6 months after cognitive behavioral therapy for insomnia in combination with a benzodiazepine/z-drug tapering program. Only 6% of participants used more (i.e., increased) sleep aids that were not benzodiazepine/z-drugs at 6 months follow up.
Plant cell reports · 2026
Heavy metal (HM) pollution is a traditional and ongoing global ecological issue that requires continuous attention. Although studies have focused on how plants cope with HMs stress, the related results ineffectively serve phytoremediation and control HMs toxicity. Melatonin (MT), as a multifunctional signaling molecule, has significant potential in alleviating HMs toxicity in crops. In this meta-analysis, a dataset across different plant families comprising 2476 observations from 140 studies evaluates MT-mediated crosstalk regulating plant growth under HMs stress. Results revealed that exogenous MT significantly improved overall plant performance by 18% (95% CI = 19.5%-14.8%), including plant growth (41.4%), morphology (51.3%) and physiology (44.4%) by stimulating shoot and root biomass 45.5% and 39.5%, respectively. The marked increment in chlorophyll (33.6%) and antioxidant activities (31.8%) was observed by mitigating the adverse effects of oxidative damage (- 23.5%). The elevated nutrient acquisition (24%) and endogenous MT level (59%) were accompanied by 24.2% increase in metabolites and -19.4% reduction in HMs uptake. Random forest machine learning revealed that plant species, MT duration and HMs concentration were the dominant predictors of biomass, whereas HMs type and exposure duration followed by MT level and duration exerted significant influence on plant length and oxidative stress. These effects were significantly associated with MT-mediated genes response and dose or exposure duration, where MT ≤ 100 μM for ≤ 15 days significantly improved results, while excessive level of HMs and prolonged exposure duration diminished MT efficacy. These findings underscore the promising potential of MT-mediated mechanisms in attenuating the injurious effects of HMs on plants.
Physiological reports · 2026
Berberine has been shown to lower core temperature and heart rate during passive heat stress in animal models. This study evaluated the effect of dietary berberine supplementation on physiological and perceptual responses to exercise-heat stress in humans. Eight participants (6 men/2 women; Age: 23 ± 3 years, Stature: 1.75 ± 0.03 m, Mass: 71.8 ± 2.7 kg, VO2max: 57.5 ± 2.1 mL/kg lbm/min-1) ingested 1.5 g of Berberine or Placebo for 7d prior to a 1 h treadmill run (60% VO2max) in hot (35°C), moderately humid (39% RH) conditions. Mean body temperature (Tb), heart rate (HR), expired gasses (VO2, VCO2, RER), minute ventilation, respiratory rate (RR), tidal volume, and perceptual responses (thermal sensation, perceived discomfort, and perceived exertion) were measured throughout exercise. Data are reported as average ± standard deviation over the 60 min exercise trial. Tb was lower (p = 0.030) in Berberine (37.69 ± 0.53°C) than Placebo (37.84 ± 0.38°C). Heart rate was lower (p = 0.025) in Berberine (163 ± 28 bpm) than Placebo (166 ± 30 bpm). RR was lower (p = 0.045) in Berberine (38.8 ± 11.2 bpm) than Placebo (41.4 ± 10.6 bpm). Thermal sensation was lower (p = 0.002) in Berberine (9.5 ± 4.2) than Placebo (12.3 ± 5.0). Generalized discomfort was lower (p = 0.044) in Berberine (9.3 ± 5.1) than Placebo (12.1 ± 5.6). Perceived exertion was lower (p < 0.001) in Berberine (11.4 ± 3.4) than Placebo (13.1 ± 4.0). Dietary berberine supplementation improved mean body temperature, heart rate, respiratory rate, and perceptual responses during exertional heat stress. Many of these changes were of small magnitude, calling into question the potential utility of dietary berberine supplementation for work or exercise in hot ambient conditions.
PloS one · 2026
Type 2 diabetes mellitus is characterized by impaired regulation of blood glucose. Probiotics, synbiotics, and berberine (BBR) have been proposed as adjunctive interventions, but their overall effectiveness remains uncertain. To evaluate the effects of these interventions on glycemic control and to explore a potential molecular interaction of BBR with a key carbohydrate-digesting enzyme. A systematic review and meta-analysis of randomized controlled trials was conducted. Pooled effects were estimated for fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) using random-effects models. A subgroup analysis compared probiotics with placebo. An exploratory computational analysis examined the interaction of BBR with α-glucosidase. More than 30 trials involving over 2,000 participants were included. The pooled analysis showed significant but modest reductions in FPG (-0.71 mmol·L ⁻ ¹) and HbA1c (-0.19%), with substantial between-study variability. Probiotics alone also reduced FPG (approximately -0.80 mmol·L ⁻ ¹) and HbA1c (approximately -0.21%) compared with placebo. Computational analysis indicated weaker enzyme binding for BBR than for the reference inhibitor acarbose. Probiotics, synbiotics, and BBR provide statistically significant but clinically modest improvements in glycemic control. These findings support their use as adjunctive, rather than primary, therapeutic options and highlight the need for larger and longer trials with standardized interventions. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251116387, identifier CRD420251116387.
Clinical nutrition ESPEN · 2026
Weight loss after oesophagectomy remains an unresolved problem. We hypothesised that providing sufficient enteral nutrition (EN) during the first 3 months postoperatively would attenuate weight loss until adequate oral intake resumed. This study aimed to compare postoperative weight loss between patients who received home EN therapy and those who relied on oral intake alone. This single-centre, randomised controlled trial enrolled patients with oesophageal cancer who underwent oesophagectomy and assigned them to either the EN group or the oral ingestion (OI) group. The EN group received 900 kcal/day of enteral nutrition for 90 days. The primary endpoint was the percentage change in BMI at 3 months postoperatively. Secondary endpoints included perioperative complications, body composition, and nutritional parameters. Sixty patients treated between 2020 and 2023 were randomised. Baseline characteristics and postoperative complications were comparable between the two groups. In the intention-to-treat population, the percentage change in BMI at 3 months was significantly smaller in the EN group than in the OI group (-6.8% vs -10.9%; mean difference 4.1%, 95% CI 0.8-7.4; P = 0.015). After excluding protocol discontinuations, 51 patients (EN, n = 27; OI, n = 24) were analysed in the protocol-defined evaluable population, with consistent results (mean difference 4.7%, 95% CI 1.1-8.3; P = 0.012). The EN group tended to show a smaller decrease in body fat mass (-9.5% vs -18.3%; P = 0.189), while experiencing a comparable loss of skeletal muscle mass (-14.4% vs -17.5%; P = 0.475). Concentrations of retinol-binding protein and prealbumin, as well as white blood cell counts, were significantly higher in the EN group. By 12 months postoperatively, BMI and laboratory parameters had converged to comparable levels in both groups. Home enteral nutrition attenuated weight loss and contributed to improved short-term nutritional status during the first 3 months after oesophagectomy. UMIN000047828 (http://www.umin.ac.jp/).
Physiological research · 2026
Obesity and type 2 diabetes mellitus (T2DM) are strongly associated with insulin resistance and chronic inflammation. Retinol-Binding Protein 4 (RBP4), an adipokine secreted by the liver and adipose tissue, has been implicated in metabolic dysfunction, with elevated circulating levels linked to impaired glucose homeostasis. Exercise is known to improve insulin sensitivity; however, its effects on RBP4 remain unclear. This systematic review aimed to synthesize the available evidence on the impact of exercise interventions on circulating RBP4 concentrations and to evaluate differences by exercise modality and population characteristics. The review followed PRISMA guidelines. A systematic search of PubMed, Web of Science, and Google Scholar (2005-2025) was conducted. Inclusion criteria were human studies ?18 years evaluating structured aerobic, resistance, or combined training with pre- and post-intervention RBP4 measurement. Non-exercise interventions and animal studies were excluded. Data extraction and quality appraisal were independently performed using Joanna Briggs Institute checklists. Out of 1,422 records screened, 16 studies met the eligibility criteria, including randomized controlled trials, quasi-experimental studies, and pre-post designs. Participants included healthy individuals, obese subjects, and patients with T2DM or metabolic syndrome. The exercise interventions varied from a single session to structured aerobic or combined aerobic-resistance programs lasting up to 12 weeks. Results showed context-dependent effects with conflicting results between different studies. Aerobic and combined aerobic-resistance exercise were associated with significant reductions in circulating RBP4 levels among obese and T2DM groups, whereas results in healthy individuals remained inconsistent. In contrast, single-session and endurance training interventions did not produce significant effects. Exercise training demonstrates potential to lower circulating RBP4, particularly in metabolically compromised populations. However, inconsistent results highlight the need for larger, standardized trials to clarify exercise modality-specific effects.
International journal of sports physiology and performance · 2026
To examine the effects of combined versus isolated beta-alanine (BA) and sodium bicarbonate (SB) supplementation on physical capacity in highly trained female basketball players. Sixty-eight athletes aged 21.4 (4.2) years participated in a randomized, double-blind, placebo (PL)-controlled parallel trial. Participants were assigned to one of four treatments: BA+SB, BA+PLSB, PLBA+SB, or PLBA+PLSB. They received BA or PLBA (6.4 g·d-1) for 28 days. In the final 7 days, SB or PLSB (0.3 g·kg-1·d-1) was added to the ongoing supplementation. Exercise tests included countermovement jump (CMJ), Wingate Anaerobic Test (WAnT), and incremental cycling test. The tests were performed in the following order: CMJ1, WAnT1, incremental cycling test, WAnT2, and CMJ2. Heart rate, ratings of perceived exertion, body mass, and composition were also assessed. Data were analyzed with repeated-measures analysis of variance. BA+SB and PLBA+SB supplementation increased peak power during WAnT1 compared to presupplementation (both P < .001; large effect). Additionally, mean heart rate was lower in BA+SB during incremental cycling test at postsupplementation compared to PLBA+SB (P = .04; large effect). BA+PLSB did not influence any physical capacity outcomes. Moreover, no changes in ratings of perceived exertion, body mass, and composition were observed. BA+SB and PLBA+SB supplementation enhanced peak power in WAnT1 without compromising subsequent physical capacity indices. BA+SB potentially reduced cardiovascular strain during submaximal exercise. In contrast, BA+PLSB did not confer any ergogenic benefits. These findings suggest that SB-containing protocols may improve high-intensity capabilities in highly trained female basketball players.
PloS one · 2026
β-Alanine (BA) elevates skeletal muscle carnosine and may improve repeated high-intensity performance; however, evidence in kickboxing is limited. This study investigated the effects of 4-week BA supplementation on sport-specific kickboxing anaerobic performance, neuromuscular power, and strength endurance in trained male kickboxers. Twenty-eight athletes were randomly assigned to BA (6.4 g·day ⁻ ¹; n = 14) or placebo (n = 14) in a double-blind, placebo-controlled design. Pre- and post-intervention assessments included the Kickboxing Anaerobic Speed Test (KAST₁-₅, KASTbest, KASTtotal, Performance Decrement Index [PDI]), neuromuscular power (countermovement jump [CMJ], squat jump [SJ]), and strength endurance tests (push-up, pull-up). Baseline differences were tested via t-tests, effect sizes calculated according to Hedges' g formula. Group × time effects were analyzed using two-way repeated-measures ANOVA with partial eta squared (ηp²) effect sizes. Baseline measures were comparable (all p > 0.05). After supplementation, no significant group × time interactions emerged for CMJ (p = 0.148), SJ (p = 0.717), KAST₁-₅ (all p > 0.05), KASTbest (p = 0.071), or PDI (p = 0.454). However significant improvements were observed in the BA group for KASTtotal (F(1,26) = 14.49, p < 0.001, ηp² = 0.358), push-ups (F(1,26) = 5.89, p = 0.023, ηp² = 0.185), and pull-ups (F(1,26) = 9.79, p = 0.004, ηp² = 0.274). Four weeks of BA supplementation enhanced total anaerobic performance (KASTtotal) and upper-body strength endurance (push-up, pull-up), while no significant changes were observed in neuromuscular jump performance (CMJ, SJ). BA appears to be a practical ergogenic aid for improving repeated-effort and strength-endurance capacity in kickboxing. Clinical trial registration ClinicalTrials.gov (NCT07319052).
Journal of the International Society of Sports Nutrition · 2026
Upper-body plyometric training (PT) enhances neuromuscular performance and power production. However, its application in swimming and its potential interaction with β-alanine (BA) supplementation remain largely unexplored. Therefore, this study investigated the combined effects of upper-body PT and BA supplementation on performance and immunoendocrine adaptations in trained male swimmers. Thirty trained male swimmers (age: 25.7 ± 2.6 years; height: 1.83 ± 0.07 m; body mass: 81.6 ± 3.2 kg) were randomly assigned to one of three groups: PT + BA, PT + placebo (PL), or control (CON). Participants in the PT groups completed an 8-week upper-body PT program (2 sessions·week⁻¹). Each session consisted of upper-body plyometric exercises performed for 3-4 sets of 12-16 repetitions with 120 s rest between sets. Participants in the supplementation groups ingested β-alanine (4.8 g·day⁻¹ divided into six 0.8 g doses) or a matched placebo daily throughout the intervention. Assessments conducted before and after the intervention included medicine ball throw (MBT), push-up endurance, one-repetition maximum (1RM) bench press, swim ergometer peak and mean power output (PPO and MPO), and 50-, 100-, and 200-m freestyle performance. Blood samples were also collected pre- and post-intervention to determine testosterone, cortisol, and immunoglobulin A (IgA) concentrations. Both PT groups showed significant improvements in all performance outcomes compared with baseline (all p < 0.05), with effect sizes ranging from small to moderate. Post hoc analyses revealed a significant group × time interaction for MBT (p = 0.045), push-up endurance (p = 0.041), PPO (p = 0.026), and MPO (p = 0.033), indicating greater improvements in the PT + BA group than in the PT + PL group. In addition, following the training intervention, the PT + BA group showed significant changes in testosterone (p = 0.011), cortisol (p = 0.028), and IgA (p = 0.042) concentrations compared with the PT + PL group. Eight weeks of upper-body PT significantly enhanced upper-body power, anaerobic capacity, and swimming performance in trained male swimmers. BA supplementation further amplified these training-induced adaptations and promoted a more favorable immunoendocrine adaptation profile. These findings suggest that combining upper-body PT with β-alanine supplementation may provide synergistic benefits for performance development and physiological recovery in competitive swimmers.
Aging cell · 2026
Older adults are highly vulnerable to infectious diseases, and vaccines are often less effective in this population because of diminished B and T cell memory responses driven by impaired autophagy, immunosenescence, and chronic low-grade inflammation. Spermidine has been shown to counteract immunosenescence and induce autophagy in preclinical models, and its levels decline with age in humans. We conducted a double-blind, randomised, placebo-controlled pilot study in 40 adults over 65 years of age following their third SARS-CoV-2 vaccine dose to assess the safety of Spermidine and its effects on vaccine-induced immunity. Daily oral supplementation (6 mg, 13 weeks) was well-tolerated. Vaccine non-responsiveness was common, and non-responders exhibited a distinct immune-senescence signature marked by elevated p16, mTOR signalling, and γ-H2AX+ DNA damage in lymphocytes. Spermidine reversed these features and significantly enhanced spike-specific IgG secretion, memory B cell recall responses and neutralising antibody activity, specifically in non-responders. Single-cell RNA-seq after treatment revealed increased expression of TFEB targets and autophagy-related genes in B cells, in line with elevated autophagic flux. These findings suggest that targeting immune cell senescence with Spermidine may improve vaccine responsiveness in older adults and highlight immune-senescence markers as potential predictors of vaccine failure in ageing populations.
Nutrients · 2026
Background: Astaxanthin is a lipid-soluble carotenoid with antioxidant and anti-inflammatory properties, but its effects on exercise performance and post-exercise recovery remain uncertain. This systematic review and meta-analysis aimed to evaluate the effects of astaxanthin supplementation on exercise performance and recovery-related biomarkers in healthy participants and athletes. Methods: This review followed PRISMA 2020 guidelines. PubMed, Web of Science, Embase, EBSCO, the Cochrane Library, and CNKI were searched from inception to January 2026. Randomized controlled trials comparing oral astaxanthin supplementation with placebo or control were included. Performance outcomes included VO2max, time-trial or endurance-related performance, and maximal workload or power output. Recovery-related outcomes included creatine kinase, lactate dehydrogenase, malondialdehyde, interleukin-6, and related biomarkers. Standardized mean differences with 95% confidence intervals were pooled. Results: Twenty-four RCTs were included. Astaxanthin significantly reduced creatine kinase levels (SMD = -0.45, 95% CI: -0.83 to -0.07). Lactate dehydrogenase also favored astaxanthin (SMD = -0.93, 95% CI: -1.39 to -0.48), although heterogeneity was substantial. No significant effects were observed for malondialdehyde or interleukin-6. Astaxanthin did not significantly improve VO2max, time-trial performance, or maximal workload/power output. Conclusions: Current evidence suggests that astaxanthin may be more beneficial for post-exercise recovery than for direct performance enhancement. The most consistent effect was observed for creatine kinase, whereas the LDH finding should be interpreted cautiously. Further well-powered trials with standardized dosing, duration, exercise protocols, and outcome assessments are needed.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026
Respiratory tract infections (RTIs) are a leading cause of morbidity in preschool children, particularly in those with recurrent wheezing. Natural compounds such as resveratrol and carboxymethyl-β-glucan have shown immunomodulatory, antiviral, and anti-inflammatory activity, supporting their potential role in preventing pediatric airway infections. To evaluate the efficacy, safety, and tolerability of Linfovir®, a nasal spray containing resveratrol and carboxymethyl-β-glucan, in reducing respiratory infectious symptoms in preschool children with recurrent respiratory infections and wheezing. This multicenter, randomized, double-blind, placebo-controlled trial enrolled children aged 2-6 years with a history of recurrent respiratory infections. Participants were randomized 1:1 to receive Linfovir® or placebo once daily for 12 weeks, with follow-up at 16 weeks. Primary and secondary outcomes including days with respiratory symptoms, number of infections, antibiotic courses, and medical visits were recorded via the VIRAPP® electronic diary. Eighty-two children were included in the Full Analysis Set. The primary endpoint was not statistically significant. However, a numerical reduction in days with respiratory symptoms was observed in the resveratrol/β-glucan nasal spray group compared with placebo (15.0 vs. 20.4 days in the FAS population), corresponding to an approximate 26% relative difference. Similar non-significant patterns favoring the intervention were observed for infectious episodes, antibiotic courses, and medical visits. Treatment adherence was high in both groups, and no serious adverse events occurred. In this pilot randomized controlled trial, the resveratrol/β-glucan nasal spray was safe and well tolerated. Although the study did not show a statistically significant effect on the primary endpoint, the observed numerical differences consistently favored the intervention. These findings should be interpreted as exploratory and hypothesis-generating and require confirmation in larger adequately powered studies.
High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
Hypertension is leading non communicable disease associated with high morbidity and mortality. There is uncertainty about the superiority of angiotensin receptor blocker (ARB)-diuretic versus ARB-calcium channel blocker (CCB) combination for the treatment of hypertension. This meta-analysis compares the effectiveness of angiotensin receptor blocker (ARB)-diuretic versus ARB-calcium channel blocker (CCB) combination therapies in adults with hypertension. RCTs were identified through PubMed, Embase, Scopus, and Cochrane Central; data were analyzed using RevMan 5.4.1 with a random-effects model. Primary outcomes were mortality, systolic blood pressure (SBP), and diastolic blood pressure (DBP); secondary outcomes included serum electrolytes and renal function. 3549 studies were identified based on database searches. 19 studies were included for analyses. Meta-analysis revealed no significant difference between both the combination therapies for primary outcomes: all-cause mortality [RR: 1.19 (95% CI: 0.85 to 1.65; p = 0.31)], SBP [MD: 1.24 mmHg (95% CI: - 0.48 to 2.96; p = 0.16; I² = 59%)], and DBP [MD: 0.62 mmHg (95% CI: - 0.15 to 1.38; p = 0.11; I² = 0%)]. The diuretic group showed significant changes in serum sodium, chloride, creatinine, e-GFR, and increased uric acid. Risk of bias was mostly low, with moderate to high evidence certainty. Both ARB + CCB and ARB + diuretic combinations showed comparable effectiveness in lowering blood pressure and all-cause mortality in hypertensive adults. ARB + CCB seems to be having good safety profile, with better renal functions based on biomarkers.
Nutrients · 2026
Background: The plant Griffonia simplicifolia is marketed as a dietary supplement; it is said to have antidepressant and sleep-promoting properties. Its main ingredient, 5-hydroxytryptophan (5-HTP), is the immediate precursor of serotonin and crosses the blood-brain barrier, thereby enhancing central serotonergic neurotransmission. Reduced serotonergic activity has been associated with affective disorders, sleep disturbances, and impaired central pain modulation. Despite this neurobiological rationale, evidence for analgesic efficacy remains limited. This study investigated the effects of Griffonia simplicifolia on peripheral and central sensitization and descending pain inhibition. Methods: In a randomized, double-blind, placebo-controlled crossover trial, 18 healthy volunteers underwent quantitative sensory testing (QST). Participants received 100 mg Griffonia simplicifolia orally once daily for 28 days or matching placebo. Sensory parameters were reassessed, followed by repetitive phasic heat application (RPHA) to induce short-term peripheral and central sensitization. After a 4-week washout period, participants crossed over to the alternate intervention. Results: A total of 17 participants completed the study. Griffonia simplicifolia showed no significant effect on acute pain perception after RPHA (β = -4.17; 95% CI -14.44 to 6.10; p = 0.401). The only significant difference was an increased distance of mechanical allodynia in the verum group (β = 0.82; 95% CI 0.05-1.59; p = 0.038). No differences were observed in thermal detection or pain thresholds, pressure pain thresholds, conditioned pain modulation, wind-up ratio, mechanical pain sensitivity, or flare area. Mild, transient adverse events occurred in two participants (11%) during Griffonia simplicifolia intake. Conclusions: Griffonia simplicifolia demonstrated limited effects on experimentally induced pain mechanisms compared with placebo and was well tolerated. Increased distance of allodynia may reflect serotonergic facilitation of pronociceptive pathways, suggesting an enhanced central and peripheral sensitization. Larger controlled trials are required to clarify its impact on pain perception.
Veterinary journal (London, England : 1997) · 2026
The choice of anesthetic protocol for canine cesarean section (CS) remains debated, with maternal stability and neonatal outcomes as key concerns. Propofol and alfaxalone are both used for induction, but comparative data on their intraoperative and neonatal effects are limited. The objective of this study was to compare propofol and alfaxalone for induction, each followed by isoflurane maintenance during Cesarean section (CS) in bitches, with respect to maternal hemodynamics, anesthetic requirements, neonatal vitality, and umbilical cord blood parameters. Thirty-five bitches undergoing elective CS were randomly assigned to propofol-isoflurane (PROP, n = 17) or alfaxalone-isoflurane (ALFA, n = 18) induction. Maternal vital signs and isoflurane requirements were monitored intraoperatively. Umbilical cord blood samples were analyzed for gases and electrolytes. Neonatal vitality was assessed using a modified Apgar score at 0, 5, and 20 min. Both protocols provided generally stable anesthesia, but hypotension episodes were more frequent in ALFA dams after fetal removal (44.4% vs. 17.7%) and at the closure (66.7% vs. 17.7%). Isoflurane requirements were higher in the ALFA group. Neonates from ALFA dams showed higher umbilical cord pH (7.19 ± 0.09 vs. 7.16 ± 0.08) and lower pCO₂ (64.4 ± 16.0 vs. 72.3 ± 16.6 mmHg). At 20 min, Apgar scores were significantly higher in the ALFA group (8.22 ± 0.95 vs. 7.79 ± 0.59). All puppies survived the first week of life. Alfaxalone induction was associated with reduced neonatal acidosis and improved vitality compared with propofol, though it increased maternal isoflurane requirements and hypotension risk later in surgery. Alfaxalone-isoflurane may offer neonatal advantages, but close monitoring of maternal blood pressure is essential.
Nutrition research (New York, N.Y.) · 2026
Age-related deterioration in vascular function can lead to cardiovascular diseases and other health problems. The effects of L-citrulline on flow-mediated dilation (FMD) and brachial-ankle pulse wave velocity have been reported; however, its effects on vascular function have only been investigated in high-dose studies of patients with angina pectoris and obesity. We hypothesized that low L-citrulline doses may be effective in healthy adults with declining vascular function and that blood pressure range could be a crucial determinant considering its strong influence on vascular function. This study evaluated the effects of relatively low L-citrulline doses on vascular function in healthy participants and compared its efficacy between participants with normal and high-normal blood pressure. We randomized 66 participants to receive 3000 mg of L-citrulline (n = 33; 21% female; age 63 ± 5 years; systolic blood pressure 130 ± 11 mm Hg; diastolic blood pressure 80 ± 8 mm Hg) or placebo (n = 33; 21% female; age 62 ± 5 years; systolic blood pressure 131 ± 9 mm Hg; diastolic blood pressure 79 ± 8 mm Hg) for 12 weeks. L-citrulline significantly improved FMD (L-citrulline 4.66 ± 0.45%; placebo 3.46 ± 0.37%, p = .045) at week 12 in participants with high-normal blood pressure at baseline. l-citrulline also significantly improved subjective feelings of low back pain and shoulder stiffness among participants with high-normal blood pressure. Moreover, it significantly reduced blood 3-nitrotyrosine concentrations in the overall study population and in the subgroup with high-normal blood pressure. In conclusion, an improvement in FMD after 12 weeks of low-dose l-citrulline supplementation was observed only among participants who had high-normal blood pressure at baseline, indicating that baseline blood pressure influences the vascular response to l-citrulline.