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1.
Supplementation with Lactiplantibacillus brevis GKEX Combined with Resistance Exercise Training Improves Muscle Mass, Strength Performance, and Body Fat Condition in Healthy Humans.
Lee, MC, Hsu, YJ, Ho, CS, Tsai, YS, Chen, CC, Huang, CC
Foods (Basel, Switzerland). 2024;(7)
Abstract
In addition to maintaining good exercise and dietary habits, recent studies have shown that probiotics may have potential benefits for muscle mass and strength. It is worth noting that the effects may vary depending on the specific strains used. To date, no studies have analyzed the effects of Lactiplantibacillus brevis in this context. Here, we combine the L. brevis strain GKEX with resistance training to further understand its effects on muscle mass, thickness, performance, and fat loss. In a six-week intervention for a double-blind randomized trial, 52 healthy subjects were divided into two groups (10 male and 16 female participants in each group): a placebo group (two capsules/day, containing 0 CFU of GKEX per capsule) and a GKEX group (two capsules/day, containing 1 × 1010 CFU of GKEX per capsule). Before the intervention, no differences were observed between the two groups in any of the tests (body composition, muscle thickness, exercise performance, and blood parameters). However, supplementation with GKEX significantly improved muscle mass and thickness, as well as grip strength, muscle strength, and explosive performance, when compared to the associated parameters before the intervention. Additionally, GKEX supplementation promoted a reduction in the body fat percentage (p < 0.05). Through analysis of the change amount, we observed that GKEX supplementation yielded significantly improved benefits when compared to the placebo group (p < 0.05). In summary, our findings support the notion that a six-week resistance exercise training program combined with L. brevis GKEX supplementation has superior additive effects that enhance muscle mass and strength performance, while also reducing body fat percentage. This intervention can promote muscle gain and fat loss.
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Identifying Children Likely to Benefit From Antibiotics for Acute Sinusitis: A Randomized Clinical Trial.
Shaikh, N, Hoberman, A, Shope, TR, Jeong, JH, Kurs-Lasky, M, Martin, JM, Bhatnagar, S, Muniz, GB, Block, SL, Andrasko, M, et al
JAMA. 2023;(4):349-358
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Abstract
IMPORTANCE The large overlap between symptoms of acute sinusitis and viral upper respiratory tract infection suggests that certain subgroups of children being diagnosed with acute sinusitis, and subsequently treated with antibiotics, derive little benefit from antibiotic use. OBJECTIVE To assess if antibiotic therapy could be appropriately withheld in prespecified subgroups. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial including 515 children aged 2 to 11 years diagnosed with acute sinusitis based on clinical criteria. The trial was conducted between February 2016 and April 2022 at primary care offices affiliated with 6 US institutions and was designed to evaluate whether symptom burden differed in subgroups defined by nasopharyngeal Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis on bacterial culture and by the presence of colored nasal discharge. INTERVENTIONS Oral amoxicillin (90 mg/kg/d) and clavulanate (6.4 mg/kg/d) (n = 254) or placebo (n = 256) for 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was symptom burden based on daily symptom scores on a validated scale (range, 0-40) during the 10 days after diagnosis. Secondary outcomes included treatment failure, adverse events including clinically significant diarrhea, and resource use by families. RESULTS Most of the 510 included children were aged 2 to 5 years (64%), male (54%), White (52%), and not Hispanic (89%). The mean symptom scores were significantly lower in children in the amoxicillin and clavulanate group (9.04 [95% CI, 8.71 to 9.37]) compared with those in the placebo group (10.60 [95% CI, 10.27 to 10.93]) (between-group difference, -1.69 [95% CI, -2.07 to -1.31]). The length of time to symptom resolution was significantly lower for children in the antibiotic group (7.0 days) than in the placebo group (9.0 days) (P = .003). Children without nasopharyngeal pathogens detected did not benefit from antibiotic treatment as much as those with pathogens detected; the between-group difference in mean symptom scores was -0.88 (95% CI, -1.63 to -0.12) in those without pathogens detected compared with -1.95 (95% CI, -2.40 to -1.51) in those with pathogens detected. Efficacy did not differ significantly according to whether colored nasal discharge was present (the between-group difference was -1.62 [95% CI, -2.09 to -1.16] for colored nasal discharge vs -1.70 [95% CI, -2.38 to -1.03] for clear nasal discharge; P = .52 for the interaction between treatment group and the presence of colored nasal discharge). CONCLUSIONS In children with acute sinusitis, antibiotic treatment had minimal benefit for those without nasopharyngeal bacterial pathogens on presentation, and its effects did not depend on the color of nasal discharge. Testing for specific bacteria on presentation may represent a strategy to reduce antibiotic use in this condition. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02554383.
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Titanium Alloy Knee Implant Is Associated with Higher Bone Density over Cobalt Chromium: A Prospective Matched-Pair Case-Control Study.
Lee, DW, Ro, DH, Han, HS, Lee, MC
Clinics in orthopedic surgery. 2023;(4):581-588
Abstract
BACKGROUND Little is known about the relationship between implant material and periprosthetic bone mineral density (pBMD) in total knee arthroplasty (TKA). The purpose of this study was to investigate the change in pBMD after TKA and to compare pBMD changes between two different implant materials. METHODS A prospective matched-pair case-control study was conducted on 29 patients who underwent bilateral TKAs. The participants were randomly allocated to undergo cemented TKAs with a titanium nitride (TiN)-coated implant on one knee (TiN group) and a cobalt-chromium (CoCr) implant on the other knee (CoCr group). The pBMD was measured using dual-energy X-ray absorptiometry scans before surgery and at 1 and 2 years after surgery. The results were then compared between the two groups. The pBMDs at longer follow-ups (> 2 years) were estimated using simple radiographs (pBMDe). RESULTS At 2 years after surgery, the pBMD significantly decreased in both groups at medial metaphysis of the tibia and anterior portion of the distal femur (all p < 0.001). The CoCr group showed a larger decrease in pBMD than did the TiN group in the medial and anterior metaphysis of the proximal tibia (p = 0.003 and p = 0.046, respectively). The pBMDe was significantly higher in the TiN group at the anterior portion of the distal femur 7 years after surgery (p = 0.019). CONCLUSIONS The pBMD significantly decreased 2 years after TKA in certain regions regardless of the implant material used. However, the decrease was significantly less in the TiN group in specific regions of the tibia and femur. The TiN implant was beneficial in preserving the periprosthetic bone stock after TKA.
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A functional evaluation of anti-fatigue and exercise performance improvement following vitamin B complex supplementation in healthy humans, a randomized double-blind trial.
Lee, MC, Hsu, YJ, Shen, SY, Ho, CS, Huang, CC
International journal of medical sciences. 2023;(10):1272-1281
Abstract
B vitamins play a crucial role in maintaining fundamental cellular functions and various essential metabolic pathways in the body. Although they do not directly provide energy, each B vitamin acts as a cofactor in energy metabolism processes. Based on the evidence presented above, we hypothesized that a 28-day supplementation of vitamin B would enhance physical performance and reduce physical fatigue. The objective of this study was to evaluate the anti-fatigue effect of vitamin B supplementation, specifically vitamin B1, B2, B6, and B12, and its potential to improve exercise performance. We employed a randomized double-blind crossover design with a 28-day supplementation period. Sixteen male and sixteen female subjects, aged 20-30 years, were divided into two groups: the placebo group (n=16, equal gender distribution) and the Ex PLUS® group (n=16, equal gender distribution). The participants received either placebo or Ex PLUS® (one tablet per day) for 28 consecutive days. Following the intervention, there was a 14-day wash-out period during which the subjects did not receive any further interventions. After supplementation with Ex PLUS®, we found a significant increase in the running time by 1.26-fold (p < 0.05) to exhaustion compared to that before supplementation and that in the placebo group. In addition, the Ex PLUS® supplementation group presented significantly reduced blood lactate and blood ammonia concentrations during exercise and at rest after exercise compared with placebo (p < 0.05). In conclusion, 28 consecutive days of vitamin B complex (Ex PLUS®) supplementation significantly improved exercise endurance performance and reduced exercise fatigue biochemical metabolites in not athletes. In addition, it does not cause adverse effects in humans when taken at appropriate doses.
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Clinical efficacy of SGLT2 inhibitors with different SGLT1/SGLT2 selectivity in cardiovascular outcomes among patients with and without heart failure: A systematic review and meta-analysis of randomized trials.
Lee, MC, Hua, YM, Yang, CT, Kuo, FH, Chang, WT, Tang, HJ, Siong Toh, H, Lin, YM, Chen, SY, Chang, HY, et al
Medicine. 2022;(51):e32489
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Abstract
BACKGROUND Some sodium-glucose co-transporter-2 (SGLT2) inhibitors showed benefits on heart failure (HF), but different SGLT2/SGLT1 selectivity might influence the treatment effect. This study aimed to meta-analyze the treatment effects of SGLT2 inhibitors and the diversity of receptor selectivity for patients with and without HF. METHODS Randomized controlled trials were searched in PubMed, Embase, Cochrane databases and ClinicalTrials.gov registry from inception to October 2020. The interest outcomes were analyzed with random-effects models and presented with a risk ratio (RR) and 95% confidence interval (CI). Subgroup analyses examined the treatment effects among SGLT2 inhibitors with different SGLT2/SGLT1 selectivity. RESULTS The final analyses included 10 trials and 52,607 patients. The RR of total cardiovascular (CV) death or hospitalization for HF (HHF) between SGLT2 inhibitors and placebo was 0.79 (95% CI 0.74-0.84, I2 = 31%). With SGLT2 inhibitors, HF patients had reduced mortality risks (RR 0.89, 95% CI 0.80-0.99, I2 = 0), and non-HF patients had lower risks of major adverse CV events (RR 0.92, 95% CI 0.85-0.99, I2 = 0). The risk reduction of HHF was consistent in groups of HF (RR 0.72, 95% CI 0.64-0.80, I2 = 8%) and non-HF (RR 0.74, 95% CI 0.61-0.89, I2 = 0), but the effect of the low SGLT2/SGLT1 selectivity inhibitor was insignificant in non-HF patients. CONCLUSION The efficacy of SGLT2 inhibitors on risk reduction of total CV death or HHF is consistent with the previous studies. The regimen is beneficial for reducing mortality in patients with HF and major adverse CV events in those without HF. Different SGLT2/SGLT1 selectivity may differ in the treatment effects in patients with and without HF.
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Impact of comprehensive geriatric assessment on the risk of adverse events in the older patients receiving anti-cancer therapy: a systematic review and meta-analysis.
Chuang, MH, Chen, JY, Tsai, WW, Lee, CW, Lee, MC, Tseng, WH, Hung, KC
Age and ageing. 2022;(7)
Abstract
BACKGROUND to assess the efficacy of comprehensive geriatric assessment (CGA) for preventing treatment-related toxicity in older people undergoing non-surgical cancer therapies. METHODS MEDLINE, EMBASE and Cochrane library databases were searched from inception till January 2022 to identify randomised controlled trials (RCTs) on the incidence of toxicity measured by the Common Terminology Criteria for Adverse Events (primary outcome) and that of therapeutic modifications, early treatment discontinuation, progression-free survival, overall survival and hospitalisation (secondary outcomes). RESULTS analysis of six RCTs published from 2016 to 2021 recruiting 2,126 participants (median age: 71-77) who received chemotherapy as the major therapeutic approach revealed 51.7% and 64.7% of Grade 3+ toxicity in the CGA and control (i.e. standard care) groups, respectively (RR = 0.81, 95% CI: 0.7-0.94, P = 0.005, I2 = 65%, certainty of evidence [COE]: moderate). There were no significant differences in the incidence of early treatment discontinuation (RR = 0.88, P = 0.47; I2 = 63%,1,408 participants, COE: low), initial reduction in treatment intensity (RR = 0.99, P = 0.94; I2 = 83%, 2055 participants, COE: low), treatment delay (RR = 1.06, P = 0.77, I2 = 0%, 309 participants, COE: moderate), hospitalisation (RR = 0.86, P = 0.39, I2 = 41%, 914 participants, COE: moderate), progression-free and overall survival with or without CGA. However, there was an association between CGA and a lower incidence of dose reduction during treatment (RR = 0.73, P < 0.00001, 956 participants, COE: moderate). CONCLUSIONS our results demonstrated that comprehensive geriatric assessment may be associated with a lower incidence of treatment-related toxicity and dose reduction compared to standard care in older people receiving non-surgical cancer treatments. Further large-scale studies are warranted to support our findings.
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The Post-Translational Modification Networking in WNK-Centric Hypertension Regulation and Electrolyte Homeostasis.
Lin, SC, Ma, C, Chang, KJ, Cheong, HP, Lee, MC, Lan, YT, Wang, CY, Chiou, SH, Huo, TI, Hsu, TK, et al
Biomedicines. 2022;(9)
Abstract
The with-no-lysine (WNK) kinase family, comprising four serine-threonine protein kinases (WNK1-4), were first linked to hypertension due to their mutations in association with pseudohypoaldosteronism type II (PHAII). WNK kinases regulate crucial blood pressure regulators, SPAK/OSR1, to mediate the post-translational modifications (PTMs) of their downstream ion channel substrates, such as sodium chloride co-transporter (NCC), epithelial sodium chloride (ENaC), renal outer medullary potassium channel (ROMK), and Na/K/2Cl co-transporters (NKCCs). In this review, we summarize the molecular pathways dysregulating the WNKs and their downstream target renal ion transporters. We summarize each of the genetic variants of WNK kinases and the small molecule inhibitors that have been discovered to regulate blood pressure via WNK-triggered PTM cascades.
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Live and Heat-Killed Probiotic Lactobacillus paracasei PS23 Accelerated the Improvement and Recovery of Strength and Damage Biomarkers after Exercise-Induced Muscle Damage.
Lee, MC, Ho, CS, Hsu, YJ, Huang, CC
Nutrients. 2022;(21)
Abstract
Excessive, high-intensity or inappropriate exercise may cause muscle damage. How to speed up recovery and reduce exercise discomfort are currently very important issues for athletes and sports people. Past research has shown that probiotics can improve inflammation and oxidative stress, as well as improve exercise performance and antifatigue. However, further research is needed to confirm the recovery benefits for muscle damage. In this double-blind design study, all subjects were randomly assigned to placebo, a live Lactobacillus paracasei group (L-PS23, 2 × 1010 colony forming unit (CFU)/day), or a heat-killed L. paracasei group (HK-PS23, 2 × 1010 cells/day), and supplemented for six consecutive weeks. Afterwards, subjects completed 100 maximal vertical jumps to bring about exercise-induced muscle damage (EIMD). Countermovement jump (CMJ), isometric mid-thigh pull (IMTP), and Wingate anaerobic test (WAnT), as well as blood tests for markers of muscle damage and inflammation were made pre-exercise and 3, 24, 48 h post exercise. The results show that both L-PS23 and HK-PS23 supplementation significantly slowed the loss of muscle strength after muscle injury, and they significantly reduced the production of markers of muscle damage and inflammation (p < 0.05). In addition, L-PS23 and HK-PS23 had the benefits of accelerating the recovery and improvement of muscle strength, the blood markers of muscle injury and inflammation, and slowing the decline in testosterone concentrations (p < 0.05). Especially in the HK-PS23 supplemented group, there was a better trend. In conclusion, we found that L-PS23 or HK-PS23 supplementation for six weeks prevented strength loss after muscle damage and improved blood muscle damage and inflammatory markers, with protective, accelerated recovery and anti-fatigue benefits.
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Protective and Recovery Effects of Resveratrol Supplementation on Exercise Performance and Muscle Damage following Acute Plyometric Exercise.
Huang, CC, Lee, MC, Ho, CS, Hsu, YJ, Ho, CC, Kan, NW
Nutrients. 2021;(9)
Abstract
Plyometric exercise (PE) is an effective training method to increase muscle mass and strength. However, excessive or inappropriate conditions might cause exercise-induced muscle damage (EIMD). Resveratrol (RES) is a natural polyphenol plant antitoxin, which improves exercise performance, and exhibits anti-oxidation, anti-inflammatory, and anti-cancer effects. Therefore, this study investigated the effect of RES supplementation on the recovery of muscle damage, inflammation, soreness, muscle power, and anaerobic performance following plyometric-exercise-induced muscle damage (PEIMD). The present study was a double-blind, placebo-controlled research trial. Thirty-six young, untrained males were enrolled into the placebo (n = 12), RES-500 (500 mg RES/day, n = 12), or RES-1000 (1000 mg RES/day, n = 12) group by a jumping height-counterbalanced grouping design. At baseline, to pre-PEIMD, supplements were pre-loaded 7 days before they conducted PEIMD, and the exercise performance, delayed-onset muscle soreness (DOMS) and muscle damage biomarkers were measured over the experimental period at baseline, pre-PEIMD, and post-PEIMD at 2, 24, 48, and 72 h. As a result, we found that, at 72 h post-EIMD, the force peak (FP) and rate of force development (RFD) of the counter movement jump (CMJ) in RES groups showed no significant difference compared to that at baseline but was significantly greater than the placebo group. In the Wingate anaerobic test (WAnT), supplementation in the RES group had a better recovery effect on the relative peak power (RPP), relative mean power (RMP) and fatigue index (FI) (p < 0.05), especially in the high-dose group. For the detection of muscle pain after PEIMD, the RES supplement group was significantly better than the placebo group (p < 0.05). In addition, for muscle damage indexes, such as creatine kinase (CK) and lactate dehydrogenase (LDH), after PEIMD, supplementation with RES could significantly reduce and accelerate recovery (p < 0.05). In addition, the blood biochemical indicators of blood count, liver function, and kidney function showed that RES will not cause adverse risks to the human body. Our results suggest that replenishing RES in advance could effectively reduce muscle pain, increase exercise performance, and decrease muscle damage indicators caused by PEIMD, and the recovery was faster. Therefore, plyometric exercises combined with suitable RES supplementation could be an effective candidate for controlling muscle damage, improving physical adaption, and recovering anaerobic capacity.
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Evaluation of the Efficacy of Supplementation with Planox® Lemon Verbena Extract in Improving Oxidative Stress and Muscle Damage: A Randomized Double-Blind Controlled Trial.
Lee, MC, Hsu, YJ, Ho, CS, Chang, CH, Liu, CW, Huang, CC, Chiang, WD
International journal of medical sciences. 2021;(12):2641-2652
Abstract
Excessive exercise load can cause muscle soreness and fatigue, as well as inflammation and oxidative stress. Lemon verbena (Aloysia triphylla; Lippia citriodora) is often used as a spice in tea or beverages. Its leaves are rich in polyphenols, which have antioxidant and anti-inflammatory bioactivities. In the present study, we investigated whether supplementation with Planox® lemon verbena extract (LVE) could improve muscle damage and biochemical indicators after exhaustive exercise challenge. All subjects (30 males and 30 females) underwent a double-blind trial and were randomly divided into a placebo group (0 mg/human/day) and an LVE supplement group (400 mg/human/day), with gender-equal distribution. All subjects started supplementation 10 days before exhaustive exercise and continued it until all tests were completed. Before the intervention, after the exhaustive exercise, and on the following 3 days, the participants underwent 12-minute Cooper running/walking; blood collection; assessments of pain, muscle stiffness, maximum jump heights, and isometric maximum muscle strength. The results showed that supplementation with LVE effectively increased GPx and reduced CK, IL-6, 8-OHdG and muscle pain after the exhaustive exercise, but it had significant effect on strength recovery. In summary, LVE is a safe and edible natural plant extract that can reduce muscle damage and soreness after exercise. This trial was registered at clinicaltrials.gov as NCT04742244.