Nutritional value,bioactive compounds and health benefits of lettuce (Lactuca sativa L.)

Lettuce is one of the most widely consumed vegetables worldwide, but its nutritional value has been underestimated. Lettuce is low in calories, fat and sodium. It is a good source of fiber, iron, folate, and vitamin C. Lettuce is also a good source of various other health-beneficial bioactive compounds. In vitro and in vivo studies have shown anti-inflammatory, cholesterol-lowering, and anti-diabetic activities attributed to the bioactive compounds in lettuce. However, nutrient composition and bioactive compounds vary among lettuce types. Crisphead lettuce, the most popular type of lettuce in the US, is comparatively low in minerals, vitamins, and bioactive compounds. More nutritious lettuces are leaf type lettuce and romaine with folate content comparable to other rich leafy vegetable sources. Red pigmented lettuce contains higher phenolic compounds than green lettuce. Due to increasing popularity, the nutrient contents in baby lettuce were also examined. Baby green romaine was especially high in vitamin C. In this review composition and nutritional value of different lettuce types were summarized, which can help growers and consumers choose lettuce types with higher nutritional benefits.     

Short bowel syndrome

Extensive anatomical or functional loss of small bowel results in a spectrum of metabolic and physiological disturbance known as the short bowel syndrome (SBS). This is most commonly encountered in the newborn infant with congenital or acquired loss of small bowel. Since there is inadequate absorptive capacity, enteral feeding initially results in diarrhoea. Management is therefore aimed at promoting and maintaining growth in the expectation that subsequent adaptational changes in the residual bowel will eventually allow full enteral feeding to be established. When there is insufficient residual small bowel, home parenteral feeding may permit long term survival with a good quality of life. Although intravenous nutrition has transformed the prognosis for patients with short bowel syndrome, complications associated with this treatment represent an important cause of morbidity and mortality.     

Lactobacillus rhamnosus GG Derived Extracellular Vesicles Modulate Gut Microbiota and Attenuate Inflammatory in DSS-Induced Colitis Mice

Ulcerative colitis (UC) is a relapsing and remitting inflammatory disease. Probiotics have a potential beneficial effect on the prevention of UC onset and relapse in clinical trials. Lactobacillus rhamnosus GG (L. rhamnosus GG) have shown clinical benefits on UC patients, however, the precise mechanisms are unknown. The aim of this study is to explore the effect of extracellular vesicles released from L. rhamnosus GG (LGG-EVs) on dextran sulfate sodium (DSS)-induced colitis and propose the underlying mechanism of LGG-EVs for protecting against colitis. The results showed that LGG-EVs could prevent colonic tissue damage and shortening of the colon (p < 0.01), and ameliorate intestinal inflammation by inhibiting TLR4-NF-κB-NLRP3 axis activation. Consistently, the pro-inflammatory cytokines (TNF-α, IL-1β, IL-6, IL-2) were suppressed effectively upon LGG-EVs treatment (p < 0.05). The 16S rRNA sequencing showed that LGG-EVs administration could reshape the gut microbiota in DSS-induced colitis mice, which further alters the metabolism pathways of gut microbiota. These findings propose a novel perspective of L. rhamnosus GG in attenuating inflammation mediated by extracellular vesicles and offer consideration for developing oral gavage of LGG-EVs for colitis therapies.     

Pomalidomide-Based Regimens for Treatment of Relapsed and Relapsed/Refractory Multiple Myeloma: Systematic Review and Meta-analysis of Phase 2 and 3 Clinical Trials

IntroductionPomalidomide (Pom) has demonstrated synergistic antiproliferative activity in combination regimens as a result of its distinct anticancer, antiangiogenic, and immunomodulatory effects. This review aimed to compare outcome measures of different Pom regimens for relapsed/refractory multiple myeloma.MethodsA comprehensive literature search identified a total of 1374 studies. Thirty-five studies assessing 4623 subjects met the inclusion criteria: phase 2/3 trial, ≥ 2 prior lines of therapy, and clearly documented efficacy outcomes like overall response rate (ORR), overall survival, and progression-free survival. Statistical analyses for meta-analysis was performed by CMA version 3 and Cochrane Q statistics (P < .05 considered significant, I² index for heterogeneity). A random effects model was used if there was significant heterogeneity (P ≥ .05 over I² ≥ 50%).ResultsPooled analysis showed ORR 47.1% across all Pom-based (2- and 3-drug) regimens. Stratified analysis for efficacy outcomes (pooled ORR [%] and mean progression-free survival [months]) are reported. With doublet regimen, Pom with low-dose dexamethasone (LoDex) was the most common regimen (35.7%, 6.1 months), and overall survival was 14.37 months. With triplet regimens, pooled ORR was 61.9% (I² = 87.3%). These included bortezomib + Pom + LoDex (83.5%, 15.7 months), carfilzomib-Pom + LoDex (77.1%, 15.3 months), Pom + LoDex-bendamustine (74.2%), Pom-dexamethasone-daratumumab (64.5%), Pom + LoDex-cyclophosphamide (59.4%, 9.5 months), and Pom + LoDex-doxorubicin (32%). Leading adverse events were myelosuppression, with mean incidences of grade 3 or higher neutropenia, anemia, and thrombocytopenia of 47.6%, 26.5%, and 20.8%, respectively. Mean incidence of grade 3 or higher nonhematologic adverse events were infections 29.1%, pneumonia 13.8%, and fatigue 10%.ConclusionThree-drug Pom regimens yielded double the response rates compared to Pom + LoDex (pooled ORR, 61.9% vs. 35.7%), with bortezomib + Pom + LoDex and carfilzomib-Pom + LoDex demonstrating better outcomes than other regimens.