insulin (insulin, HGT / Insuman Implantable / Insuman Comb)

Systematic engineering of Pichia pastoris for high-level production of recombinant human granulocyte-macrophage colony-stimulating factor.

Cheng Zhenzhen Z, Gong Keyu K, Song Yuchao Y, Guo Zhenchang Z et al.

Human granulocyte-macrophage colony-stimulating factor (hCSF2) is a clinically important therapeutic glycoprotein with growing market demand, underscoring the need for efficient recombinant production platforms. To enable high-level production of recombinant hCSF2 (rhCSF2), the Pichia pastoris GS115 strain was systematically engineered through multi-copy integration of the expression cassette, screening for suitable secretory signal peptides, and enhancement of protein folding and transport pathways. The combination of multi-copy integration at multiple genomic loci with the combinatorial use of endogenous and exogenous signal peptides proved critical for improving rhCSF2 titers, while reinforcement of the folding and transport machinery further alleviated the bottleneck of protein throughput. Following high-density fermentation in a 3‑L bioreactor, the optimally engineered strain achieved an rhCSF2 titer of 3.4 g/L-markedly exceeding the highest titer previously reported in yeast hosts by an order of magnitude. Importantly, this engineering strategy was successfully extended to a glycoengineered strain SuperMan5, where it enabled production of rhCSF2 with more homogeneous and humanized N‑glycans and a titer of 4.3 g/L under high‑density fermentation condition. Our work demonstrates that the high-yield production of recombinant human therapeutic glycoproteins bearing homogeneous, humanized N-glycans in engineered yeast offers promising prospects.

Role of macrophage NLRP3 inflammasome activation in real-ambient particulate matter-induced abnormal hepatic glucose metabolism.

Wu Dong D, Zhang Zhen Z, Chen Sixin S, Chen Haoran H et al.

Evidence regarding the effects of particulate matter (PM) exposure on hepatic glucose metabolism and insulin resistance is limited, and its mechanisms remain unclear. Macrophages, as key regulators of the liver microenvironment, may mediate PM-induced metabolic processes. This study used an individually ventilated cage (IVC)-based real-ambient PM exposure system mouse model, co-cultured macrophages and hepatocytes, and NOD-like receptor protein 3 (Nlrp3)-knockdown model to investigate the impact of macrophages on hepatic insulin resistance (IR) and glucose metabolism under PM exposure. Our findings revealed that glycogen storage was impaired, insulin signaling was suppressed, the mRNA expression of glucose metabolism-related genes was altered, and the number of macrophages increased in the mouse liver after 15 weeks of PM exposure. Additionally, PM exposed mice exhibited reduced glucose tolerance and insulin sensitivity. In the transwell co-culture model, macrophages exposed to PM for 72 h exhibited NLRP3 inflammasome activation and IL-1β release, which were associated with lysosomal damage and cathepsin B release, accompanied by inhibition of insulin signaling and abnormal expression of glucose metabolism-related genes in hepatocytes. In vitro inhibition of NLRP3 and in vivo knockdown of Nlrp3 significantly attenuated these effects of PM exposure. Additionally, IL-1β inhibition improved glucose metabolism abnormalities. These findings reflect specific effects on insulin signaling and glucose metabolism mediated by the NLRP3 inflammasome or IL-1β. These results suggest that PM exposure leading to macrophage NLRP3 inflammasome activation and IL-1β release is an important cause of abnormal hepatic glucose metabolism, providing new insights into the underlying mechanisms of PM-related hepatic glucose metabolism and IR.

Metformin + Insulin vs. Insulin for GDM and T2DM during pregnancy: systematic review and meta-analysis.

Hallack Christiano C, Nogueira Bernardo Vieira BV, Bomfim Maressa M, Meireles Nathália N et al.

Evaluate the effectiveness and safety of adding metformin to insulin (M+I) versus insulin alone for pregnant women with type 2 diabetes mellitus (T2DM) or gestational diabetes mellitus (GDM), focusing on stillbirth as the primary outcome. PubMed, Embase, and Cochrane Central were searched. No date limits. Last search: January 2025. Randomized clinical trials including women with T2DM or GDM were eligible. Trials restricted to type 1 diabetes were excluded. Two reviewers extracted maternal and neonatal outcomes and assessed risk of bias with the Cochrane RoB 2 tool. Evidence certainty was graded using GRADE. Data were pooled with random-effects models and reported as risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals. Nine RCTs (2,420 women) were included, most with GDM and some with T2DM. Moderate-quality evidence indicated reduced stillbirth risk with M+I (6 RCTs, 2,196 participants; RR 0.36, 95% CI 0.14-0.90; NNT 111). Low-quality evidence suggested lower risks of gestational hypertension (4 RCTs; RR 0.68, 95% CI 0.48-0.97) and neonatal hypoglycemia (7 RCTs; RR 0.49, 95% CI 0.30-0.80). No significant differences were found for cesarean section, preterm delivery, or other neonatal outcomes. Heterogeneity, baseline imbalances, and small samples limited certainty. M+I may reduce stillbirth and some adverse outcomes compared with insulin alone, but most evidence remains low certainty. Further high-quality RCTs are needed.Registered in PROSPERO: CRD42024617330.

Herpes zoster recurrence in primary care: Unmeasured residual confounding, the recombinant vaccine era, and external validity for Latin America.

Therán-León Juan Sebastián JS, Hernández-Cañas María Camila MC, Quintero-Arévalo Bárbara Yuliana BY