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        <title>Frontiers in Physiology | Integrative Physiology section | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/physiology/sections/integrative-physiology</link>
        <description>RSS Feed for Integrative Physiology section in the Frontiers in Physiology journal | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-05-13T16:29:24.442+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1811438</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1811438</link>
        <title><![CDATA[Effect of acupuncture on monoaminergic neurotransmitters in animal models of vascular dementia: a preclinical systematic review and meta-analysis]]></title>
        <pubdate>2026-05-11T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Lixiang Gan</author><author>Yuqing Fan</author><author>Dongmin Liu</author><author>Jialing Zheng</author><author>Jize Han</author><author>Chuyu Deng</author><author>Xiaorong Tang</author><author>Nenggui Xu</author><author>Zhennan Wu</author>
        <description><![CDATA[BackgroundVascular dementia (VaD) is characterized by progressive cognitive impairment associated with chronic cerebral hypoperfusion. Monoaminergic neurotransmitter dysfunction has been implicated in its pathogenesis. Acupuncture has shown neuroprotective potential in experimental models; however, its regulatory effects on monoaminergic systems remain to be systematically clarified. This study aimed to evaluate the effects of acupuncture on monoaminergic neurotransmitters and cognitive function in animal models of VaD through a preclinical systematic review and meta-analysis.MethodsIn accordance with the PRISMA 2020 guidelines, a comprehensive search across eight English and Chinese databases was conducted from inception to October 2025 to identify randomized controlled animal studies investigating acupuncture in VaD models. Primary outcomes focused on the levels of monoaminergic neurotransmitters, including serotonin (5-HT), norepinephrine (NE), and dopamine (DA). Secondary outcomes encompassed acetylcholine (ACh) levels, long-term potentiation (LTP), and behavioral performance. Risk of bias was systematically assessed using the SYRCLE tool, and statistical synthesis was performed using R software (version 4.3.1).ResultsNine studies involving 386 rodents were included. Meta-analysis demonstrated that acupuncture elevated the levels of 5-HT (SMD = 1.35), NE (SMD = 2.67), and DA (SMD = 1.43). Furthermore, acupuncture treatment was associated with increased ACh levels (SMD = 3.75) and enhanced synaptic plasticity, as evidenced by improved LTP (SMD = 4.75). Behavioral assessments revealed substantial cognitive improvements, indicated by a reduction in escape latency (SMD = −4.66) and an increased number of platform crossings (SMD = 3.00) in the Morris water maze test.ConclusionAcupuncture may ameliorate cognitive impairment in VaD by modulating monoaminergic systems and enhancing synaptic plasticity. However, substantial heterogeneity and small sample sizes underscore the exploratory nature of these findings. To avoid overgeneralization of mechanistic pathways, further rigorous studies are essential.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251179267.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1811508</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1811508</link>
        <title><![CDATA[Advancing the 3Rs in bone tissue engineering: emerging in vitro, in silico, and refined in vivo strategies]]></title>
        <pubdate>2026-05-11T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Adelaide L. Cagle</author><author>Afton K. Limberg</author><author>Amritha Anup</author><author>Aleyna E. La Croix</author><author>Katherine R. Hixon</author>
        <description><![CDATA[Tissue engineering is an interdisciplinary field integrating materials science, biology, chemistry, and immunology to develop regenerative solutions for complex tissues. Validation of tissue-engineered therapies, however, remains challenging—particularly for bone, whose hierarchical organization governs vascularization, mechanical loading, and continuous remodeling. Historically, these complexities have necessitated extensive reliance on in vivo animal models. Here we examine contemporary advances in modeling and validating bone tissue engineering strategies through the framework of the 3Rs principles: Replacement, Reduction, and Refinement. This review summarizes recent progress in advanced in vitro platforms, including organoids, bioprinting, and organ-on-a-chip systems, as well as in silico modeling approaches designed to decrease reliance on animal experimentation. We also highlight evolving best practices in experimental design, longitudinal imaging, welfare optimization, and reporting standards that improve the ethical and scientific conduct of necessary animal studies. Drawing primarily from literature published since 2020, this review provides an updated assessment of how the 3Rs are being operationalized within bone tissue engineering. Although significant technical and biological limitations remain, particularly in replicating vascularized, mechanically competent, and immunologically integrated bone tissue, the field demonstrates measurable progress toward Reducing animal use and improving translational relevance. Collectively, current developments reflect a realistic yet optimistic trajectory in which non-animal methodologies increasingly Replace in vivo work while also highlighting achievable short-term strategies to Refine necessary animal research.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1741526</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1741526</link>
        <title><![CDATA[Is there a link between fascia and cancer? From potential mechanisms to future treatment options]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Stephanie Otto</author><author>Werner Klingler</author>
        <description><![CDATA[Fascia, the connective tissue network enveloping muscles, organs, nerves, and vasculature, plays an important role in maintaining structural integrity, biomechanical function, and integrative physiological processes. Traditionally considered a passive support structure, fascia is increasingly discussed as an active component in cancer biology, particularly within the tumor microenvironment (TME), although many mechanistic pathways remain incompletely characterized. Experimental and clinical studies suggest that tumor-associated remodeling of the extracellular matrix (ECM) within fascial tissues can increase tissue stiffness, fibrosis, and desmoplasia, changes that may facilitate tumor progression, invasion, metastasis, and immune escape, and could contribute to resistance against conventional therapies in at least some tumor entities. Cancer-associated fibroblasts (CAFs) appear to be central mediators of these processes by producing collagen, enzymatically modifying ECM structure, and influencing mechanotransduction pathways involving transcriptional regulators such as YAP/TAZ and integrins, thereby promoting pro-malignant cellular phenotypes in model systems. Fascia also interfaces closely with immune and nervous systems, potentially influencing immune cell trafficking, neuroinflammatory signaling, and systemic stress responses via the hypothalamic pituitary adrenal axis and vagal pathways, but these interactions are only partly understood in the context of cancer. Emerging preclinical and early clinical data indicate that physical exercise and movement-based interventions, including controlled stretching and other mechanical therapies, may modulate fascial stiffness and low-grade inflammation, with possible effects on tumor biology and patient-reported outcomes that appear at least partly distinct from those of aerobic exercise, yet this requires confirmation in larger, well-controlled trials. Clinically, patterns of fascial involvement and ECM remodeling correlate with aggressive behavior and poorer outcome in several cancers, suggesting potential prognostic value, although standardized assessment and validation across entities are still lacking. Targeting fascia- and ECM-related components, such as collagen cross-linking enzymes (for example lysyl oxidase), is being explored as a translational strategy to enhance drug delivery and immunotherapy responses, but these approaches remain largely experimental. Priority areas for future research include the development of imaging and molecular tools for more precise fascia assessment, mechanobiological interventions tailored to individual patients, and rigorous clinical trials evaluating fascia-modulating therapies as adjuncts in integrative oncology. In summary, current evidence supports a view of fascia as a dynamic, multifunctional tissue that is likely implicated in cancer progression and therapy response while highlighting substantial knowledge gaps and the need for cautious, hypothesis-driven translation into clinical practice.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1808008</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1808008</link>
        <title><![CDATA[A study on brain waves with electroencephalogram through the appreciation of virtual reality K-pop: a revised analysis with multiple comparison corrections]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Taeseung Park</author><author>Hyunsoo Kim</author><author>Deok Su Yoo</author>
        <description><![CDATA[BackgroundKorean popular culture (K-pop) has become increasingly popular worldwide and the convergence of K-pop and virtual reality (VR) has contributed to the popularity of metaverse technologies. Previous studies on K-pop and VR were largely conducted in the fields of cognitive psychology and qualitative research. Recently, the use of functional magnetic resonance imaging (MRI), electroencephalogram (EEG), and eye-trackers have gained attention.MethodsIn this study, EEG analysis was used to evaluate alpha waves, beta waves, and theta/beta ratios of 20 participants who had experienced VR or normal K-pop music video content, and the data analyzed based on the Media Richness Theory. Statistical analyses employed paired t-tests with False Discovery Rate (FDR) correction for multiple comparisons using the Benjamini-Hochberg procedure, and effect sizes (Cohen’s d) were calculated to assess practical significance.ResultsThe results revealed differences in alpha wave (p <.05), beta wave (p <.05), and theta/beta ratios between the general and VR music video groups. After FDR correction, 11 electrodes showed significant alpha wave differences (d = 0.54-1.51), 13 electrodes showed significant beta wave differences (d = 0.50-1.04), and 8 electrodes showed significant theta/beta ratio differences (d = 0.63-0.87). Alpha waves were higher in the normal music video group, whereas beta waves and the theta/beta ratio were higher in the VR music video group.ConclusionThe EEG results suggest that VR K-pop music videos are rich in media content, providing more information than normal K-pop music videos. The robustness of findings was confirmed through rigorous statistical correction, with medium to large effect sizes indicating substantial practical significance beyond statistical significance. This approach has the potential to develop a strategy for metaverse K-pop content.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1807587</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1807587</link>
        <title><![CDATA[Effectiveness of non-pharmacological therapies in complementary and alternative medicine on improving fatigue levels, oxidative stress, inflammation, and endocrine levels in animal models of chronic fatigue-like conditions: a systematic review and network meta-analysis]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Shumeng Ren</author><author>Jingyuan Wei</author><author>Shan Zhao</author><author>Linghua Li</author><author>Jingshi Zhang</author><author>Chaoqun Yan</author><author>Jun Wang</author>
        <description><![CDATA[ObjectiveTo systematically evaluate the effects of various complementary and alternative medicine (CAM) non-pharmacological therapies on fatigue levels, oxidative stress, inflammation, and endocrine indicators in chronic fatigue-like conditions animal models, and to rank the efficacy of these interventions.MethodsA computerized search was conducted across databases including PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and CBMdisc, to collect animal experiments on fatigue-like conditions treated with CAM non-pharmacological therapies published from the establishment of the databases to January 14, 2026. Two researchers independently screened the literature, extracted data, and assessed risk of bias. Stata 16.0 software was used for network meta-analysis, and SYRCLE’s risk of bias tool was employed to evaluate the quality of the included studies.ResultsA total of 77 studies involving nine types of CAM non-pharmacological therapies were included. In terms of improving fatigue levels, compared to the control group, electroacupuncture (MD = 347.00 s, 95% CI [144.70, 549.29]) and moxibustion (MD = 311.28 s, 95% CI [146.36, 476.20]) significantly prolonged exhaustive swimming time. In terms of improving oxidative stress damage, fire acupuncture (MD = -13.15 nmol/ml, 95% CI [-18.06, -8.24]), manual acupuncture (MD = -3.85 nmol/ml, 95% CI [-5.12, -2.58]), needle-pricking (MD = -11.43 nmol/ml, 95% CI [-16.54, -6.32]), and moxibustion (MD = -479.16 nmol/ml, 95% CI [-567.05, -391.27]) significantly reduced MDA levels. In terms of improving inflammatory damage, Tuina (MD = -552.03 pg/ml, 95% CI [-700.81, -403.25]) and electroacupuncture (MD = -156.59 pg/ml, 95% CI [-259.85, -53.34]) can significantly reduce the level of IL-1β. In terms of regulating endocrine, electroacupuncture (MD = -9.91 pg/ml, 95% CI [-14.77, -5.05]) and Tuina (MD = -16.96 pg/ml, 95% CI [-25.37, -8.55]) can significantly reduce the level of CRH.ConclusionNon-pharmacological therapies in complementary and alternative medicine have great potential in improving fatigue-related phenotypes, oxidative stress damage, inflammatory damage, and regulating endocrine levels in animal models of fatigue-like conditions. Future research should focus on developing animal models that better replicate the pathogenesis and core characteristics of CFS, and then extend them to randomized controlled trials involving CFS patients to verify the transformation potential.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251177070.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1851497</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1851497</link>
        <title><![CDATA[Correction: Exercise and the hepatic sirtuin network: rethinking the research focus on SIRT1, SIRT3, and SIRT6]]></title>
        <pubdate>2026-05-05T00:00:00Z</pubdate>
        <category>Correction</category>
        <author>Jun Woo Kwon</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1785483</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1785483</link>
        <title><![CDATA[Physiological responses and adaptive mechanisms of amphibians and reptiles to multiple interacting environmental stressors: an integrative review]]></title>
        <pubdate>2026-04-30T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Muammer Kurnaz</author>
        <description><![CDATA[This integrative review synthesizes current knowledge on the physiological responses and adaptive mechanisms of amphibians and reptiles to multiple interacting environmental stressors, with particular emphasis on synergistic effects among temperature, hydric stress, disease, and pollution. Given the stronger empirical basis for amphibians in the existing literature, amphibian responses are covered in greater depth, while reptile-specific physiology, immunology, and emerging infectious diseases are explicitly addressed in dedicated sections throughout the review. Critical thermal tolerance analyses reveal that approximately 7.5% of amphibian species will exceed their physiological limits under a 4 °C warming scenario, with tropical lowland species already operating near their CTmax thresholds. Thermal plasticity is limited, with acclimation responses averaging only 0.13 °C increase in CTmax per 1 °C environmental warming—insufficient to track rapid climate change. Water balance regulation shows dramatic interspecific variation, with cutaneous resistance ranging from 0.05 s/cm in aquatic amphibians to >1000 s/cm in desert-adapted reptiles. Synergistic interactions between thermal and hydric stress significantly amplify vulnerability, particularly in dehydration scenarios that reduce critical thermal limits. Chemical pollutants, including heavy metals and pesticides, cause developmental abnormalities (535% increase in malformation frequency), immunosuppression, and endocrine disruption across multiple life stages. Emerging infectious diseases, particularly chytridiomycosis (Batrachochytrium dendrobatidis and B. salamandrivorans) and ranaviruses, drive mass mortality events globally, with co-infections exacerbating population declines. Climate change intensifies disease susceptibility through stress-mediated immunosuppression and altered pathogen dynamics. Adaptive capacity varies markedly among species. While amphibians exhibit strong phenological responses (2-4× greater than other taxa), genetic adaptation potential remains limited by narrow dispersal abilities and habitat fragmentation. Microhabitat buffering can reduce thermal extremes by several degrees but depends critically on habitat structural integrity. This review demonstrates that the pace of anthropogenic change challenges the adaptive capacity of most species, necessitating integrated conservation strategies including microhabitat preservation, climate corridor establishment, pollution mitigation, disease surveillance, and ex-situ conservation programs.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1813708</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1813708</link>
        <title><![CDATA[25 years of applying the 3Rs principles in safety pharmacology: success stories and future perspectives]]></title>
        <pubdate>2026-04-27T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Katayoun Derakhchan</author><author>Kimberly Rockley</author><author>Matthias Gossmann</author><author>Raafat Fares</author><author>Eric Delpy</author><author>Yasunari Kanda</author><author>Elisa Passini</author><author>Colleen M. Pike</author><author>Janette Turner</author><author>Annie Delaunois</author>
        <description><![CDATA[Safety pharmacology is a relatively young discipline dedicated to identifying adverse pharmacodynamic effects of new drugs that may impact human safety. Since the publication of the ICH S7A guideline in 2000, the field has made significant efforts in implementing the 3Rs principles—Replacement, Reduction, and Refinement of animal use. This review provides a comprehensive overview of key milestones and innovations that have shaped the application of the 3Rs in safety pharmacology over the past 25 years. Typical examples are the use of non-invasive jacket telemetry for real-time cardiovascular monitoring in conscious freely moving animals and the introduction of the CiPA (Comprehensive in Vitro Proarrhythmia Assessment) paradigm in 2014. The review explores 3Rs-driven advances across core organ systems—cardiovascular, central nervous, and respiratory—as well as supplemental systems including gastrointestinal and renal. Furthermore, it examines the evolving global regulatory landscape and the emergence of new approach methodologies (NAMs), such as artificial intelligence tools and complex microphysiological systems (MPS), and their integration into drug development pipelines. Finally, the review discusses future directions and potential challenges in achieving broader adoption of 3Rs-compliant strategies and NAMs in safety pharmacology.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1818880</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1818880</link>
        <title><![CDATA[Changes in cardio-respiratory-vascular coupling dynamics across altitude gradients: a shift from linear synchrony to nonlinear complexity]]></title>
        <pubdate>2026-04-23T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Hongyun Liu</author><author>Shijing Wu</author><author>Ping Zhan</author><author>Xiaohua Yu</author><author>Yiming Kuang</author><author>Yi Han</author><author>Hongyue Zu</author><author>Guojing Wang</author><author>Weidong Wang</author>
        <description><![CDATA[IntroductionProlonged high-altitude hypoxia induces acclimatization-related changes of multiple human physiological systems. The cardio-respiratory-vascular (CRV) coupling system, a core homeostasis-maintaining integrative mechanism, has incompletely elucidated altitude-acclimatization-related patterns. This study aimed to systematically explore CRV coupling and related physiological parameter changes across a broad altitude range in long-term acclimatized individuals.MethodsA multicenter cross-sectional study was conducted across five altitude gradients (HA0: <100 m, n=62; HA1: 1300 m, n=74; HA2: 3700 m, n=60; HA3: 4300 m, n=71; HA4: 5100 m, n=74). Synchronous electrocardiogram, hemodynamic, and respiratory signals were collected from healthy adults with ≥3 months of acclimatization. CRV coupling strength and complexity were computed, integrated with heart rate variability (HRV), hemodynamic, and respiratory parameters for analysis, with a HA4-specific physiological correlation network constructed.ResultsCRV coupling strength showed altitude-dependent attenuation, while complexity increased with elevation. At HA4, HRV indices changed distinctly: Mean RR, logHF, and SampEn decreased (P<0.0001), and LF/HF increased (P<0.0001). SpO2 declined and PPV rose with altitude; DBP (P = 0.0042) and MAP (P = 0.0204) increased only at HA4. Respiratory parameters exhibited asymmetric characteristics: AED and BR elevated (P<0.05), with BR_CV and EDC_CV increasing significantly only at HA4 (P<0.01). At HA4, coupling strength correlated positively with vagal activity/heart rate complexity and negatively with sympathetic dominance/respiratory variability, while complexity correlated positively with sympathetic dominance.DiscussionLong-term high-altitude acclimatization is characterized by a regulatory shift of the CRV system from strength-dominant linear synchrony to complexity-prioritized nonlinear flexibility. Extreme hypoxia may trigger enhanced nonlinear interactions to compensate for reduced linear synchrony, relying on respiratory rhythm stabilization and precise autonomic balance modulation. The findings may provide novel insights into the integrated physiology of high-altitude acclimatization.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1808472</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1808472</link>
        <title><![CDATA[Bridging physiology and psychology: a new framework for teaching homeostasis]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Perspective</category>
        <author>Suzan Kamel-ElSayed</author><author>Nermien E. Waly</author><author>Changiz Mohiyeddini</author>
        <description><![CDATA[Classical physiology teaches homeostasis as a set of reactive feedback loops that stabilize the body’s internal environment. Yet emerging science shows that human regulation is not merely reactive but profoundly shaped by cognition, emotion, belief, and predictive brain processes. We propose an updated definition of homeostasis that positions the brain as an anticipatory, meaning-making regulator integrating physiological, emotional, and environmental demands. This predictive regulation also unfolds across time through circadian organization, in which central neural systems coordinate daily rhythms in endocrine, immune, metabolic, and cognitive activity to prepare the organism for anticipated environmental and behavioral demands. By reframing homeostasis as a psychophysiological process, this work highlights the need for medical education to move beyond reductionist feedback-loop models and adopt a more integrated, clinically relevant understanding of human regulation. Within this framework, cognitive expectations, emotional appraisal, and circadian timing together shape how the brain allocates physiological resources in anticipation of daily challenges. This framework offers a rigorous yet human-centered lens for interpreting health, disease, and the therapeutic power of the clinical encounter.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1802999</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1802999</link>
        <title><![CDATA[Efficacy and safety of gabapentinoid combination therapy versus monotherapy for the treatment of neuropathic pain]]></title>
        <pubdate>2026-04-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Dandan Li</author><author>Yang He</author><author>Zhiqiang Fan</author><author>Zhen Chen</author><author>Guiming Deng</author><author>Linqi Ouyang</author>
        <description><![CDATA[BackgroundWhether combining gabapentinoids with other agents yields superior efficacy and safety outcomes compared to gabapentinoid monotherapy in patients with neuropathic pain remains unknown.ObjectiveTo compare the efficacy and safety of gabapentinoid combination therapy versus monotherapy in patients with neuropathic pain in head-to-head comparative studies.MethodsPubMed, Web of Science, Embase, and Cochrane Library were systematically searched from inception to November 4, 2025. Data abstraction and quality assessment were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline and the Cochrane risk-of-bias tool, respectively. Pain scores (standardized to a 0–10 scale) were the primary outcomes, sleep interference scores, Patient Global Impression of Change (PGIC) and adverse events were the secondary outcomes. Study screening and selection were performed independently by 2 reviewers, with any disagreements resolved by a third adjudicator. Heterogeneity among studies was assessed using the I2 statistic.ResultsTwenty-one clinical trials comprising 2204 patients were included in this meta-analysis. Gabapentinoid combination therapy was superior to monotherapy in reducing pain (MD = − 1.27, 95% CI = − 1.55 to − 0.99; n =18) and sleep interference scores (MD = − 0.92, 95% CI = − 1.40 to − 0.45; n =5) and increasing the PGIC response rate (RR = 1.80, 95% CI = 1.36 to 2.39; n =4). Subgroup analyses demonstrated that gabapentinoids, both gabapentin and pregabalin, achieved statistically significant greater pain reduction when combined with other gabapentinoids or antidepressants, dietary supplements, local anesthetic, non-pharmacological treatment, and opioids, whereas only a non-significant decreasing trend with immunomodulators. Notably, patients with painful diabetic neuropathy (PDN) and postherpetic neuralgia (PHN) may benefit more from combination therapy. Although combination therapy was associated with higher overall discontinuation rates and certain adverse events, these safety concerns were largely driven by opioid–gabapentinoid combinations; most other combinations had a safety profile comparable to monotherapy.ConclusionGabapentinoid combination therapy was more effective than monotherapy for neuropathic pain, but the benefit-risk profile of specific combinations warrants careful consideration in clinical decision-making.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251275655.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1791778</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1791778</link>
        <title><![CDATA[High intellectual ability and the gut-brain-sex steroids axis: a perspective on cognitive and emotional diversity]]></title>
        <pubdate>2026-04-13T00:00:00Z</pubdate>
        <category>Perspective</category>
        <author>Ítalo M. Urrutia</author><author>Nicolás Plaza</author><author>Felipe Moraga</author><author>Constanza Griffiths-Sanhueza</author><author>Diliana Pérez-Reytor</author><author>Eduardo Karahanian</author><author>Sebastián Ramírez-Araya</author><author>Ana Kinkead</author><author>María Paz Gómez</author><author>Katherine Garcia</author>
        <description><![CDATA[The gut-brain axis is a bidirectional communication network integrating neural, endocrine, immune, and metabolic signals that regulate neurodevelopment, cognition, and emotion. It contributes to neurotransmitter production, inflammatory regulation, and the microbial metabolism of sex steroids, processes that have been shown to modulate synaptic plasticity and emotional behavior in experimental and clinical contexts, although their specific relevance to high intellectual ability remains unknown. In this perspective, we propose that high intellectual ability could be explored as a heterogeneous construct, within which some individuals identified as having HIA may exhibit responses potentially associated with differential sensitivity to gut-brain-sex hormone interactions. We discuss that microbial modulation of steroid bioavailability and neuroactive metabolites may represent one hypothetical pathway through which variations in steroid bioavailability and neuroactive metabolites could intersect with cognitive performance and emotional intensity, traits frequently described in some individuals with HIA. Integrating evidence from neuroendocrinology, microbiome science, and cognitive neuroscience, we outline a conceptual framework linking microbial, hormonal, and neural processes. This model aims to stimulate empirical research examining how physiological variation across the gut-brain-sex hormone axis may underlie cognitive and emotional diversity in gifted subpopulations. Importantly, this framework is conceptual and extrapolates from converging evidence in microbiome science and neuroendocrinology, as direct empirical studies in high intellectual ability are currently lacking.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1794215</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1794215</link>
        <title><![CDATA[Molecular mechanism of Danshen injection in treating endometrial fibrosis induced by intrauterine adhesions via the LAMC2-CD44-TGF-β1-SMAD2/3 signaling pathway]]></title>
        <pubdate>2026-04-10T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Sisi Tang</author><author>Renzhi Hu</author><author>Shuangyan Weng</author><author>Mei Luo</author>
        <description><![CDATA[IntroductionDanshen injection, derived from the traditional Chinese medicine Salvia miltiorrhiza Bunge, has been clinically validated for its safety and efficacy in treating various gynecological diseases, including endometrial fibrosis caused by Intrauterine Adhesion (IUA). However, its molecular mechanism in regulating the Laminin Subunit Gamma 2 (LAMC2)-CD44-TGF-β1-SMAD2/3 signaling pathway remains unclear.MethodsAn IUA rat model was established and treated with low-, medium-, or high-dose Danshen injection via tail vein injection. Endometrial injury and fibrosis were assessed by H&E and Masson’s staining, and epithelial/mesenchymal markers were evaluated by immunohistochemistry and Western blot. Single-cell RNA sequencing (scRNA-seq) was performed to characterize cellular composition, pathway enrichment, and predicted intercellular communication. In vitro, Lipopolysaccharide (LPS)-stimulated uterine fibroblasts were used to examine LAMC2 expression, Epithelial-Mesenchymal Transition (EMT)-related marker changes, and TGF-β1/Smad signaling, with pathway interrogation using a CD44 blocker. Simultaneously, corresponding verification was conducted in vivo.ResultsDanshen injection improved uterine histopathology, increased endometrial gland number, and reduced collagen deposition in IUA rats. CK-19 and Vimentin showed changes consistent with epithelial–mesenchymal marker alterations, which were partially reversed after Danshen treatment. scRNA-seq revealed an increased fibroblast proportion in the Model group that decreased after Danshen intervention, with differentially expressed genes enriched in fibrosis-related pathways. Cell–cell communication analysis suggested reduced repair-associated signaling and increased LAMC2-associated interactions in the Model group. In vitro, LPS induced LAMC2 upregulation and activation of TGF-β1/SMAD2/3 signaling, which was attenuated by CD44 blockade; similarly, Danshen injection and CD44 inhibition reduced LAMC2 and TGF-β1/SMAD2/3 activation in vivo.ConclusionDanshen injection may mitigate endometrial fibrosis in IUA, potentially by modulating fibroblast abundance, reducing EMT-related changes, and dampening LAMC2-CD44-associated TGF-β1/SMAD2/3 signaling.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1795656</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1795656</link>
        <title><![CDATA[The fascial-interstitial system and the sanjiao-mocou system: an analogy-based hypothesis for the anatomical basis of meridian pathways]]></title>
        <pubdate>2026-03-27T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Yu Xia</author><author>Yuxin Jia</author><author>Hui Qu</author><author>Qianxue Wei</author><author>Limei Yan</author><author>Xiuqin Li</author>
        <description><![CDATA[BackgroundThe anatomical basis of meridian pathways remains a central challenge in modernizing Traditional Chinese Medicine (TCM). Concurrently, modern science has redefined the integrated fascial-interstitial system as a pervasive, fluid-filled cavitary organ system involved in signaling and transport. This parallel invites novel theoretical integration.ObjectiveThis review proposes a translational hypothesis positing that the classical TCM concept of the “Sanjiao-Mocou” system is analogous to the modern fascial-interstitial system, together constituting the anatomical and functional substrate of meridians.MethodsWe conducted a systematic comparative analysis of classical TCM texts describing the Sanjiao (Triple Energizer) and Mocou (interstitial spaces) and contemporary literature on the structure and function of the fascial-interstitial system. This theoretical integration focuses on their shared attributes: being ubiquitous, fluid-transporting, cavity-containing connective tissue systems that facilitate systemic communication and homeostasis.FindingsThe hypothesis elucidates how the Sanjiao-Mocou system, long understood as the “passageway for Yuan-Primordial Qi and body fluids,” aligns closely with the fascial-interstitial system’s role in interstitial fluid transport, mechanotransduction, and immune surveillance. This analogy provides a coherent, testable model where meridians may be conceptualized as specialized functional channels within this pervasive cavitary organ.ConclusionThe proposed analogy bridges a foundational TCM theory with contemporary biomedical science. It offers a potential anatomical framework for understanding meridians and opens new avenues for interdisciplinary research in biomechanics, fluid dynamics, and integrative physiology, potentially advancing the understanding of both TCM and fascial science.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1801306</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1801306</link>
        <title><![CDATA[Myofascial release and fascial-targeted mechanical interventions in musculoskeletal rehabilitation: mechanisms, modalities, and integrative physiology]]></title>
        <pubdate>2026-03-27T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Yuqing Gao</author><author>Dongxu Gao</author>
        <description><![CDATA[Fascia is a continuous connective tissue network that surrounds and integrates muscles, bones, nerves, and organs, contributing to force transmission, postural organization, movement coordination, and sensory processing within the musculoskeletal system. Any alterations in fascial properties, including increased stiffness, adhesions, and densification, have been associated with pain, restricted mobility, and functional impairment in musculoskeletal conditions. These associations have supported the growing use of myofascial release interventions within rehabilitation practice. Mechanical loading of fascial tissues through pressure, shear, vibration, or acoustic stimulation may influence tissue mechanics and sensory signaling. Across manual, instrument-assisted, and device-based modalities, myofascial release interventions apply these mechanical stimuli through different modes while sharing overlapping physiological targets. Proposed mechanisms include modulation of tissue mechanics, sensory receptor stimulation, and neurophysiological effects on muscle tone and pain perception. Evidence reported in the literature indicates that myofascial release interventions are frequently associated with short-term improvements in pain and joint range of motion. In contrast, findings related to long-term functional outcomes and direct, modality-specific structural adaptation of fascial tissues remain inconsistent. Interpretation of available data is further constrained by heterogeneity in intervention protocols, operator dependence, variable outcome measures, and limited use of objective methods capable of quantifying fascial mechanical properties in vivo. Within an integrative physiological framework, myofascial release interventions are most consistently supported as adjunctive components of musculoskeletal rehabilitation rather than stand-alone treatments. Their clinical value appears greatest when used to facilitate movement, reduce symptom burden, and enhance engagement with active rehabilitation strategies such as exercise and movement re-education. Continued advancement in this field will depend on standardized reporting, improved methodological rigor, longer-term follow-up, and the incorporation of objective assessments to clarify mechanisms and guide evidence-based integration.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1788828</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1788828</link>
        <title><![CDATA[Short-term cigarette smoke exposure aggravates oxidative stress and airway inflammation induced by lipopolysaccharides]]></title>
        <pubdate>2026-03-19T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ziyao Liang</author><author>Zhihang Liu</author><author>Wenchao Pan</author><author>Long Fan</author><author>Jingyu Quan</author><author>Lin Lin</author><author>Lei Wu</author><author>Xuhua Yu</author>
        <description><![CDATA[AimThis study discloses the early synergistic effects of short-term cigarette smoke (CS) exposure combined with lipopolysaccharide (LPS) on pulmonary inflammation and tissue stress.MethodSix- to eight-week-old BALB/c mice were divided into CS-exposed groups (9 cigarettes per day for 4 days) and sham-exposed control groups. On the fourth day, intratracheal instillation of LPS or saline was administered to both groups. The study examined several indicators, including changes in body weight, bronchoalveolar lavage fluid (BALF) cell counts, mRNA expression of inflammatory factors and oxidative stress markers, lung histopathology, and airway remodeling markers.ResultThe results showed that short-term CS exposure alone did not induce significant oxidative stress or inflammation. However, short-term CS exposure exacerbated LPS-induced pulmonary inflammation, as evidenced by increased expression of pro-inflammatory cytokines, including IL-6, IL-1β, and TNF-α. It also intensified oxidative stress, as indicated by upregulation of NADPH oxidase 2 (NOX2) and heme oxygenase-1 (HO-1). Additionally, activation of early airway remodeling–associated signaling was observed, with elevated expression of collagen I/III, alpha-smooth muscle actin (α-SMA), and transforming growth factor-β1 (TGF-β1). These effects occurred through activation of NF-κB-mediated inflammatory pathways, increased macrophage-derived reactive oxygen species (ROS) production, and reduced antioxidant defenses. Notably, short-term CS exposure did not significantly affect the number of immune cells in BALF after LPS stimulation.ConclusionThese results indicate that short-term CS exposure can “sensitize” the lungs—that is, increase their sensitivity—to acute lung injury upon subsequent bacterial stimulation. These findings suggest that even brief CS exposure may increase sensitivity to infection-associated acute lung injury in passive or intermittent smokers.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2025.1600369</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2025.1600369</link>
        <title><![CDATA[Impact of cricothyroid membrane puncture anesthesia on elderly patients undergoing endotracheal intubation after anesthesia induction: a clinical study]]></title>
        <pubdate>2026-03-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yanbing Wang</author><author>Hongchuan Zhao</author><author>Yanjiao Liang</author><author>Xiaoli Li</author><author>Xiao Bi</author><author>Hao Lian</author>
        <description><![CDATA[ObjectiveThis study investigated the clinical effects of cricothyroid membrane puncture (CMP) anesthesia surface anesthesia following anesthesia induction on elderly patients undergoing endotracheal intubation (ETI).MethodsEighty elderly patients scheduled for general anesthesia with endotracheal intubation at our hospital from January to December 2023 were enrolled and randomly assigned (n = 40 each) to a study group or a control group. After intravenous anesthesia induction, the study group received 2% lidocaine via CMP for surface anesthesia, while the control group received no CMP administration. The incidence of coughing during extubation in the emergence phase, first-attempt intubation success, hypoxemia, hypotension, and vasoactive drug use were recorded. Hemodynamic parameters and adverse events were compared between groups.ResultsAll patients achieved successful first-attempt intubation. There were no significant differences in hypoxemia incidence between groups (P > 0.05). The study group had lower rates of hypotension and vasoactive drug use compared with the control group (P < 0.05), as well as a lower incidence of coughing during extubation (P < 0.05). At T0, heart rate (HR), systolic blood pressure (SBP), mean arterial pressure (MAP), and SpO2 did not differ significantly (P > 0.05). At T1-T3, HR, SBP, and MAP were significantly lower in the study group (P < 0.05), with no significant differences in SpO2 (P > 0.05). Total adverse event rates were similar between groups (P > 0.05).ConclusionCMP surface anesthesia following anesthesia induction in elderly patients provides favorable clinical effects by improving hemodynamic stability and reducing coughing during emergence, without increasing adverse events.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1784015</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1784015</link>
        <title><![CDATA[How should we teach homeostasis? Filling the gaps and envisioning the future]]></title>
        <pubdate>2026-03-02T00:00:00Z</pubdate>
        <category>Conceptual Analysis</category>
        <author>Serena Y. Kuang</author><author>Akshata R. Naik</author>
        <description><![CDATA[This article provides a conceptual and pedagogical analysis aimed at advancing homeostasis education within integrative physiology. Although homeostasis was originally formulated to describe the stability of the internal environment (IE), educators have traditionally emphasized the regulation of individual parameters such as body temperature, blood glucose, and blood pressure. This emphasis reflects historical methodological limitations rather than the full conceptual scope intended by Claude Bernard and Walter Cannon. Building on conceptual developments articulated in Kuang (2023), the present analysis examines how homeostasis education can be refined and reoriented by clarifying several foundational conceptual distinctions. In particular, it addresses persistent gaps in current teaching, including common ambiguities related to the concepts of steady state, dynamic equilibrium, constancy, and stability and builds upon the distinction between parameter homeostasis and, IE homeostasis to strengthen its pedagogical and conceptual application. At the organism level, the article addresses how, IE homeostasis can be appropriately interpreted and taught, highlighting its emergent nature and the role of modern integrative measurements, including multi-omics approaches, in supporting a system-level understanding of homeostasis. Overall, the analysis supports the following central conclusions: (1) Parameter homeostasis refers to the relatively stable oscillation of the parameter value; (2) IE homeostasis constitutes a high-level emergent property of the organism; (4) modern integrative measurement approaches make it possible to study the IE as a whole, providing system-level readouts relevant to IE homeostasis; and (4) the conceptual scope of homeostasis or homeostatic tendency, is expanded in two directions: across health, subhealth, disease, and psychological steady states, and toward an explicit recognition of the constitutive role of organism–environment interactions in shaping internal stability. In sum, this article envisions an integrated direction for homeostasis education that moves beyond parameter-centric approaches and supports a coherent understanding of organismal regulation, adaptation, and resilience across diverse conditions.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1809357</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1809357</link>
        <title><![CDATA[Editorial: Exploring the physiological and molecular benefits of physical exercise in cardiovascular diseases]]></title>
        <pubdate>2026-02-25T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Alex Cleber Improta-Caria</author><author>Roque Aras Júnior</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fphys.2026.1740223</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fphys.2026.1740223</link>
        <title><![CDATA[mRNA expression profiling and pathway analysis of chronic intermittent hypoxia–induced pancreatic injury in ob/ob mice]]></title>
        <pubdate>2026-02-25T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yaopeng Guo</author><author>Shengquan Huang</author><author>Jiayi Lin</author><author>Chaowei Li</author><author>Ruhai Lin</author><author>Qingshi Chen</author>
        <description><![CDATA[BackgroundIncreasing evidence suggests that messenger RNA (mRNA) is centrally involved in the initiation and progression of various diseases. However, its involvement in pancreatic injury resulting from obstructive sleep apnea (OSA) continues to be incompletely elucidated. The present investigation aimed to characterize mRNA expression changes using a murine model of chronic intermittent hypoxia (CIH) to provide new insights into the mechanisms underlying OSA-associated pancreatic injury.MethodsAn ob/ob murine model for pancreatic injury triggered by CIH was established. RNA sequencing (RNA-seq) was conducted to detect differentially expressed mRNAs, and subsequently Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were applied to delineate the associated functional annotations and signaling cascades. Furthermore, several selected mRNAs were validated using reverse transcription PCR (RT-qPCR). Finally, we constructed a protein–protein interaction (PPI) network to delineate the interplay among the protein targets of the differentially expressed genes (DEGs).ResultsIn a mouse model of CIH-induced pancreatic dysfunction, 481 mRNAs were upregulated and 165 were downregulated. KEGG enrichment analysis indicated that the NOD-like receptor signaling pathway is implicated in CIH-induced pancreatic dysfunction. Subsequently, several differentially expressed mRNAs were subjected to RT-qPCR validation. On the basis of these data, a subset of DEGs were selected to construct a PPI network.ConclusionOverall, we identified 646 DEGs in the CIH mouse model. These results may offer important perspectives on the pathophysiological processes that underlie OSA–induced diabetes mellitus.]]></description>
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