Sepsis is a highly variable condition, and tracking leukocyte patterns may offer insights for tailored treatment and prognosis. We used the MIMIC-IV database to analyze patients diagnosed with Sepsis-3 within 24 h of ICU admission. Latent class mixed models (LCMM) were applied to leukocyte trajectories to identify sepsis subtypes. The primary outcome was 28-day all-cause mortality, with secondary outcomes including the need for life-support therapies. Associations between leukocyte trajectories and outcomes were assessed using multivariate regression, and findings were externally validated with the eICU database. Use the XGBoost model to identify baseline characteristics of high-risk mortality sepsis subgroups for predicting subgroup allocation upon patient admission to the ICU, and apply the SHAP method to interpret the contributing variables of the model. Among 7410 sepsis patients, eight distinct leukocyte trajectory subtypes were identified. Among those subtypes, patients with persistently high leukocyte levels had the poorest prognosis (HR 3.00; 95% CI 2.48–3.62) and a significantly greater need for life-support therapies; Patients with persistently low white blood cell levels had a higher risk of death (HR 1.68; 95% CI 1.24–2.27) but were less likely to receive invasive mechanical ventilation. Incorporating early ICU baseline variables into an XGBoost algorithm enables effective prediction of high-mortality risk subgroups (AUC > 0.8). SHAP method reveals distinct early clinical characteristics between hyperinflammatory subtypes (class 4, 7, and 8) and the hypoinflammatory subtype (class 1). In ICU-admitted sepsis patients, eight leukocyte trajectories are identified, which is the key independent predictors of prognosis, separating from single leukocyte measurements. High-mortality risk subgroups exhibit distinct clinical characteristics at ICU admission, providing valuable insights for their prediction and personalized early intervention.

Background: The increased inflammation associated with interleukin-1α (IL-1A) induced by monosodium urate (MSU) crystal-induced gouty arthritis is mediated through the NLRP3 inflammasome and NF-κB signaling pathways. This study investigated the role of IL1A in MSU-mediated inflammation and its therapeutic potential. Methods: MSU crystals were applied to THP-1 macrophages and human vascular endothelial cells (HUVECs) with or without IL1A knockdown. Quantitative reverse transcription polymerase chain reaction (qRT-PCR), western blotting (WB), cell counting kit-8 (CCK-8), flow cytometry, and enzyme-linked immunosorbent assay (ELISA) were used to assess IL1A expression, cell viability, apoptosis, and the generation of inflammatory cytokines. The activation of the NLRP3 inflammasome and TLR4/MyD88/NF-κB pathways was evaluated, with TAK-242 used to assess synergistic effects. Results: MSU increased IL1A expression, induced apoptosis, and reduced cell viability in HUVECs, effects reversed by IL1A knockdown. IL1A knockdown media mitigated apoptosis in HUVECs exposed to conditioned media from MSU-stimulated THP-1 macrophages. IL1A knockdown reduced MSU-induced proinflammatory cytokines and NLRP3 activation in THP-1 cells. TAK-242 showed synergistic effects, while IL1A knockdown inhibited TLR4/MyD88/NF-κB activation. Conclusions: IL1A promotes cell death and inflammation in MSU-induced gout. Knockdown of IL1A mitigates these effects, suggesting it may be a potential therapeutic target for MSU-induced inflammation.

The immunomodulatory efficacy of current psoriasis biological therapies is hindered by their limited ability to scavenge multiple cytokines, inefficient delivery to specific inflamed skin regions, and potential side effects. Upon analyzing samples from both patients and mice, we identify a significant increase in type IV collagen within the extracellular matrix (ECM) of psoriatic skin. Thus, we report the microneedle (MN) delivery of type IV collagen targeting peptide-modified dual-cell membrane biomimetic nanodecoys (CRHM@lip) with multiple cytokines scavenging ability for treating psoriasis. The CRHM@lip can scavenge both tumor necrosis factor-α (TNF-α) and interleukin (IL)-17. Upon MN delivery, the nanodecoys target ECM and exhibit skin retention for over 120 h. The treatment by CRHM@lip-integrated MNs reduces skin thickness in mice by 57.9% and shows decreased levels of TNF-α, IL-17, IL-23, and interferon (IFN)-γ in skin sections compared to the psoriasis group. Additionally, the CRHM@lip treatment reduces the CD4+ T cells, M1 macrophages, and dendritic cells in the spleen, and suppresses various inflammatory mediators in serum, significantly demonstrating immunological microenvironmental suppression. Compared to systemic administration routes, MN delivery improves treatment outcomes. No noticeable adverse effects on hepatic and renal functions are observed in mice after treatment. This approach enhances the effectiveness of biological therapies and has the potential for translation.

Chemoradiotherapy (CRT) followed by consolidation of immune checkpoint inhibitors (ICIs), such as durvalumab or pembrolizumab, for patients with unresectable, locally advanced non-small cell lung cancer (NSCLC) with tumor PD-L1 expression <1% remains a topic of controversy. Previous studies from PubMed, Cochrane Library and Embase databases were searched for a meta-analysis. A total of 16 studies were included in part one of the meta-analysis and it was observed that consolidation of ICIs after CRT improved overall survival (OS) [hazard ratio (HR) 1.46; P=0.005] and progression-free survival (PFS) (HR 1.26; P=0.023) for the patients with PD-L1 expression ≥1% compared with those with PD-L1 expression <1%. Then, 15 studies were included in part two of the meta-analysis and the results indicated that the pooled 1, 2 and 3-year OS were 77% vs. 83% (P=0.07), 55% vs. 59% (P=0.327) and 38% vs. 51% (P=0.006) for CRT alone compared with CRT followed by consolidation of ICIs, respectively. The pooled 1, 2 and 3-year PFS were 51% vs. 53% (P=0.632), 29% vs. 40% (P=0.015) and 20% vs. 28% (P=0.153) for CRT alone compared with CRT followed by consolidation of ICIs, respectively. The findings of the present study highlighted that the benefits of CRT followed by consolidation of ICIs were higher compared with CRT alone in patients with unresectable, locally advanced NSCLC and PD-L1 expression <1%. Consolidation of ICIs after CRT would provide greater benefits for locally advanced NSCLC patients with PD-L1 expression ≥1% compared with those with PD-L1 expression <1%.

Psoriasis is a chronic, recurrent, inflammatory systemic disease that is not only characterized by skin manifestations but may also be accompanied by various comorbidities, imposing a heavy burden on patients’ physical and mental health and affecting their quality of life. Although the continuous approval of various biological agents for clinical use has provided more effective treatment options to patients with psoriasis, no consensus on the evaluation of comprehensive treatment goals has yet been established. The treat-to-target (T2T) strategy requires consideration of multiple dimensions of treatment outcomes, the development of long-term management goals, and regular assessments of treatment conditions, which are often used in the management of chronic diseases. Therefore, based on the latest consensuses and guidelines, research data, and clinical experience as well as the combination of survey results and expert group discussions, the present consensus focuses on 4 dimensions of short- and long-term integrated management goals for biological agents: alleviating skin lesions, improving quality of life, screening and managing psoriasis comorbidities, and ensuring drug safety. The implementation methods, evaluation time, treatment monitoring, and program adjustments are also herein described to achieve comprehensive management of psoriasis to the maximum extent. This consensus provides a reference for clinical practice.

ObjectiveThere is a lack of effective and long-term safe drugs for the treatment of osteoarthritis (OA). Tetrandrine (Tet) has been approved and used to treat rheumatoid arthritis for several decades, but its effect on OA has not been investigated. Herein, we explored the effect of Tet on OA and its underlying mechanism.MethodsOA was induced using destabilization of the medial meniscus (DMM) in C57BL/6J mice. The animals were randomly divided into sham, DMM, Tet, celecoxib (CXB), and indomethacin (INDO) groups. Each group was given solvent or corresponding drugs by gavage for 7 weeks after convalescence. Pathological staining, OARSI scores, micro-computed tomography and behavior tests were performed to evaluate the effects of Tet.ResultsTet remarkably alleviated cartilage injury in the knee joint, limited bone remodeling in the subchondral bone, and delayed progression of OA. Tet also significantly relieved joint pain and maintained function. Further mechanistic studies revealed that Tet lowered inflammatory cytokine levels and selectively suppressed gene and protein expression of cyclooxygenase (COX)-2 but not COX-1 (P<0.01). Tet also reduced the production of prostaglandin E2 without damaging the gastric mucosa.ConclusionWe found that Tet could selectively inhibit COX-2 gene expression and decrease cytokine levels in mice, thus reducing inflammation and improving OA without obvious gastric adverse events. These results provide a scientific basis for the clinical application of Tet in the treatment of OA.

OBJECTIVES:This study aimed to explore the correlations of Lnc-UCA1/miR-138 axis with gestational diabetes mellitus (GDM) risk and neonatal prognosis. MATERIAL AND METHODS:First, the blood samples from sixty GDM patients and 60 healthy pregnant women were collected to detect the change of Lnc-UCA1/miR-138 axis by using real-time polymerase chain reaction (RT-qPCR). The clinical characteristics of GDM patients, healthy controls, and neonates were recorded. Then, the correlation analysis of Lnc-UCA1, miR-138, and Lnc-UCA1/miR-138 axis levels with clinicopathological characteristics was performed to explore the clinical value of Lnc-UCA1/miR-138 axis in GDM. Finally, the specificity and sensitivity of Lnc-UCA1, miR-138, and Lnc-UCA1/miR-138 axis for GDM diagnosis was evaluated using receiver operating characteristic (ROC) curves. RESULTS:Our present study found that, when compared with healthy pregnancies, the expression levels of Lnc-UCA1 and miR-138 were increased and decreased, respectively, and Lnc-UCA1/miR-138 axis profile was elevated. Second, Lnc-UCA1 and Lnc-UCA1/miR-138 axis were positively correlated with fasting glucose, one-hour glucose, and two-hour glucose, while miR-138 showed the opposite trend. Furthermore, the area under the ROC curve (AUC) were 0.8196, 0.8021, and 0.8901 for diagnostic efficiencies of Lnc-UCA1, miR-138, and Lnc-UCA1/miR-138, respectively. In addition, higher profiles of Lnc-UCA1 were correlated with birth asphyxia of neonate. CONCLUSIONS:Circulating Lnc-UCA1/miR-138 axis might be involved in the pathogenesis of GDM and could function as a novel and effective biomarker for GDM risk and neonatal prognosis.

The stratum corneum (SC) and cell membrane are two major barriers that hinder the therapeutic outcomes of transdermal drug delivery for the treatment of skin diseases. While microneedles (MNs) can efficiently penetrate the SC to deliver nanomedicines, the optimization of physicochemical properties of nanomedicines in MNs to enhance their in vivo cellular delivery efficiency remains unclear. Here, how the size and surface charge of drug-loaded liposomes in MNs influence the retention time and cellular delivery in psoriatic skin is systematically investigated. The results indicate that while 100 nm negatively-charged liposomes in MNs show higher cellular uptake in vitro, 250 and 450 nm liposomes could enhance skin retention and the long-term in vivo cellular delivery efficiency of drugs. Moreover, 250 nm cationic liposomes with a stronger positive charge show an extraordinarily long skin retention time of 132 h and significantly higher in vivo cellular internalization. In the treatment study, dexamethasone (dex)-loaded cationic liposomes-integrated MNs show better therapeutic outcomes than dex-loaded anionic liposomes-integrated MNs in a psoriasis-like animal model. The design principles of liposomes in MN drug delivery systems explored in the study hold the potential for enhancing the therapeutic outcomes of psoriasis and are instrumental for successful translation.

Background and Aims:We previously reported that carboxylesterase 1 (CES1) expression was suppressed following liver injury. The study aimed to explore the role of interleukin (IL)-33 in liver injury and examine the mechanism by which IL-33 regulates CES1. Methods:IL-33 and CES1 levels were determined in the livers of patients and lipopolysaccharide (LPS)-, acetaminophen (APAP)-treated mice. We constructed IL-33 and ST2 knockout (KO) mice. ST2-enriched immune cells in livers were screened to identify the responsible cells. Macrophage-derived exosome (MDE) activity was tested by adding exosome inhibitors. Micro-RNAs (miRs) were extracted from control and IL-33-stimulated MDEs (IL-33-MDEs) and subjected miR sequencing (miR-Seq). Candidate miR was tested in vitro and in vivo and its binding of a target gene was assessed by luciferase reporter assays. Lentivirus-vector cellular transfection and transcript silencing were used to examine pathways mediating IL-33 suppression of miR-27b-3p. Results:Patient liver IL-33 and CES1 expression levels were inversely correlated. CES1 downregulation in liver injury was rescued in both IL-33-deficient and ST2 KO mice. Macrophages were shown to be responsible for IL-33 effects. IL-33-MDEs reduced CES1 levels in hepatocytes. Exosomal miR-Seq and qRT-PCR demonstrated increased miR-27b-3p levels in IL-33-MDEs; miR-27b-3p was implicated in Nrf2 targeting. IL-33 inhibition of miR-27b-3p was found to be GATA3-dependent. Conclusions:IL-33-ST2-GATA3 pathway signaling increases miR-27b-3p content in MDEs, which upon being internalized by hepatocytes reduce CES1 expression by inhibiting Nrf2. The elucidation of this mechanism in this study contributes to a better understanding of CES1 dysregulation in liver injury.

Recent years, cardiac vascular disease has arisen owing to acute myocardial infarction (MI) and heart failure leading to death worldwide. Various treatments are available for MI in modern medicine such as implantation of devices, pharmaceutical therapy, and transplantation of organs, nonetheless, it has many complications in finding an organ donor, devices for stenosis, high intrusiveness and long-time hospitalization. To overcome these problems, we have designed and developed a novel hydrogel material with a combination of Se NPs loaded poly(ethylene glycol)/tannic acid (PEG/TA) hydrogel for the treatment of acute MI repair. Herein, Se NPs were characterized by effective analytical and spectroscopic techniques. In vitro cell compatibility and anti-oxidant analyses were examined on human cardiomyocytes in different concentrations of Se NPs and appropriate Se NPs loaded hydrogel samples to demonstrate its greater suitability for in vivo cardiac applications. In vivo investigations of MI mice models injected with Se hydrogels established that LV wall thickness was conserved significantly from the value of 235.6 mu m to 390 mu m. In addition, the relative scar thickness (33.6%) and infarct size (17.1%) of the MI model were enormously reduced after injection of Se hydrogel when compared to the Se NPs and control (MI) sample, respectively, which confirmed that Se introduced hydrogel have greatly influenced on the restoration of the infarcted heart. Based on the investigated results of the nanoformulation samples, it could be a promising material for future generations treatment of acute myocardial infarction and cardiac repair applications.

Periodic pandemics of coronavirus (CoV)-related pneumonia have been a major challenging issue since the outbreak of severe acute respiratory syndrome (SARS) in 2002 and Middle East respiratory syndrome (MERS) in 2012. The ongoing pandemic of CoV disease (COVID-19) poses a substantial threat to public health. As for the treatment options, only limited antiviral agents have been approved hitherto, and clinicians mainly focus on currently available drugs including the conventional antiviral interferons (IFNs). In clinical practice, IFNs, when used either alone or in combination with ribavirin and/or lopinavir/ritonavir, have shown promising outcomes, to some extent, in SARS-CoV or MERS-CoV treatment. Although the efficacy and safety of IFNs in COVID-19 treatment remain unclear, their possible use merits further evaluation. We present a review that summarizes current evidence of IFN treatment for COVID-19 and elaborates on other challenges in terms of the timing of IFN treatment initiation, treatment duration, and IFN type to be used. The review findings suggested that IFN acts by directly inhibiting viral replication and activating immune cell subsets. However, there is a lack of well-designed and controlled clinical trials providing firm evidence for the efficacy or safety of IFN therapy for CoVs. Additionally, critically ill patients with multiple immunosuppression-associated comorbidities may not benefit from IFN therapy, necessitating screening of those patients who would most benefit from IFN treatment.

In this study, we have investigated the potential of two classes of thioglucoside analogues of gliflozins as antidiabetic drugs, one with substitutions of S-atoms in meta-positions (similar to C-glucoside SGLT2 inhibitors, TAGs A, B, and C) and the other with substitutions of S-atoms in ortho-positions (similar to O-glucoside SGLT2 inhibitors, TAGs D, E, F, and G). These TAGs were confirmed to show good stability against beta-glucosidase and to have no acute toxicity to cultured cells. Most importantly, TAGs D, E, F, and G all showed high inhibitory activity against SGLT2 (IC50: 2.0-5.9 nM) and thus have great potential to be developed as new gliflozin drugs. Compared with the synthesis of C-glucoside gliflozins, the synthesis of TAGs is simple, efficient, and associated with low costs, high yields, and very mild reaction conditions.

An applicable method for the precise measurement of major carboxylesterase (CESs) activity in liver still limited. Clopidogrel and irinotecan are specific substrates for CES1 and CES2, respectively. Clopidogrel is metabolized to the inactive metabolite clopidogrel carboxylate (CCAM) by CES1. Irinotecan is metabolized to the active metabolite 7-ethyl-10-hydroxycamptothecin (SN-38) by CES2. In the present study, the LC-MS/MS method for the determination of CCAM and SN-38 were separately developed to characterize the metabolic activities of CES1 and CES2 in mouse liver microsomal. CCAM was separated on a Ecosil ODS column with an isocratic mobile phase consisted of 5 mmol/L ammonium formate and 0.1% formic acid in water and acetonitrile (15:85, V:V) at a flow rate of 0.4mL/min. SN-38 was separated on a Waters symmetry C18 column with an gradient mobile phase consisted of 5 mmol/L ammonium formate and 0.1% formic acid in water and acetonitrile at a flow rate of 0.3 mL/min. Calibration curves were linear within the concentration range of 100-20,000 ng/mL for CCAM and 1-200 ng/mL for SN-38. The results of method showed excellent accuracy and precision. The recovery rate, matrix effect and stability inspection results were within the acceptance criteria. The optimized incubation conditions were as follows: protein concentration of microsomes were all 0.1 mg/mL, incubation time was 60 min for clopidogrel and 30 min for irinotecan, respectively. This method was sensitive and applicable for the determination of the activity of CESs in the mouse liver microsomes.

The authors examined the original data of their work and noticed misuse of images in fig. 1 and fig. 3 (as shown below on the upper panels, red box). The correct images are shown on the lower panels (red box). The authors sincerely apologize for the mistake and confirm the change does not affect the scientific conclusion of the published work.

目的 研究白细胞介素(IL)-33对RAW264.7巨噬细胞羧酸酯酶(CESs)的作用和细胞极化状态的影响.方法 以不同浓度IL-33刺激RAW264.7细胞,通过Western blotting检测CESs的蛋白表达,CCK-8检测CESs活性变化,油红0检测细胞脂质沉积.检测M1型巨噬细胞标志物诱导型一氧化氮合酶iNOS、IL-1β、肿瘤坏死因子-α(TNF-α)和M2型巨噬细胞标志物CD206、IL-10等的表达,评价其极化状态.结果 IL-33剂量依赖性地显著下调巨噬细胞CES1的蛋白表达水平,且对CES1和CES2的代谢活性均产生抑制作用(P＜0.05);IL-33干预后,巨噬细胞中三酰甘油(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)等出现不同程度升高(P＜0.05).IL-33刺激后,RAW264.7小鼠巨噬细胞的CD206蛋白表达显著增多,而iNOS的蛋白表达无明显变化.结论 IL-33刺激后促进巨噬细胞向M2型转化,显著抑制RAW264.7巨噬细胞中CES1的表达及活性,增加巨噬细胞脂质沉积.

Selenoprotein F (SELENOF) might play an important role in maintaining human health since an increasing number of studies have linked SELENOF deficiency to various pathologies such as cancer and neurodegeneration. We have previously reported on glucose metabolism disorders in SELENOF knockout mice, which imply a novel biological function of SELENOF in glucose metabolism. However, the underlying mechanism and whether the effect of SELENOF on glucose metabolism is age-dependent remain unknown. In the present study, we compare the metabolic phenotype in more detail as well as the oxidative stress parameters in SELENOF knockout mice (C57BL/6J background) and naïve C57BL/6J mice of different ages (12, 16 and 21 weeks old). The results showed that SELENOF knockout caused glucose metabolism disorders only in young mice, especially in 12-week-old mice, characterized by hyperglycemia, serum insulin reduction, impaired glucose tolerance, decreased insulin sensitivity, decreased glucose catabolism, increased gluconeogenesis and impaired insulin signaling pathway. These abnormalities gradually improved with age and disappeared in knockout mice at 21 weeks old. Furthermore, before 16 weeks old, SELENOF knockout mice showed increased lipid peroxidation and decreased glutathione/glutathione disulfide ratio and glutathione peroxidase activity in the serum and liver. Furthermore, the expression of glutathione peroxidase 1 significantly reduced in the liver and pancreas. Our findings suggest that SELENOF knockout might cause glucose metabolism disorders in young mice via the disruption of redox homeostasis.

Psoriasis, a chronic and immune-mediated inflammatory disease, adversely affects patients' lives. We previously prepared selenium-rich yeast peptide fraction (SeP) from selenium-rich yeast protein hydrolysate and found that SeP could effectively alleviate ultraviolet radiation-induced skin damage in mice and inhibited H2O2-induced cytotoxicity in cultured human epidermal keratinocyte (HaCaT) cells. This study aimed to investigate whether SeP had a protective effect on imiquimod (IMQ)-induced psoriasis-like dermatitis in mice and the underlying mechanisms. Results showed that SeP significantly ameliorated the severity of skin lesion in IMQ-induced psoriasis-like mouse model. Moreover, SeP treatment significantly attenuated the expression of key inflammatory cytokines, including interleukin (IL)-23, IL-17A, and IL-17F, in the dorsal skin of mice. Mechanistically, SeP application not only inhibited the activation of JNK and p38 MAPK, but also the translocation of NF-κB into the nucleus in the dorsal skin. Furthermore, SeP treatment inhibited the levels of inflammatory cytokines and the activation of MAPK and NF-κB signaling induced by lipopolysaccharide in HaCaT cells and macrophage cell line RAW264.7. Overall, our findings showed that SeP alleviated psoriasis-like skin inflammation by inhibiting MAPK and NF-κB signaling pathways, which suggested that SeP would have a potential therapeutic effect against psoriasis.

OBJECTIVE:To investigate the influence of the expression of DNA methyltransferase 1 (DNMT1) on the differentiation of spermatogonial stem cells (SSC) in mice. METHODS:SSCs were isolated from the testis tissue of 1-week-old BALB/c male mice by two-step enzyme digestion. DNMT1-siRNA and negative control siRNA (NC-siRNA) were transfected into the third-generation SSCs after isolation and purification, and the untransfected cells were used as the control. At 24 hours after transfection, the mRNA and protein expressions of DNMT1 were detected by real-time quantitative PCR (RT-qPCR) and Western blot, respectively, and the methylation level of DNMT1 was determined. The SSCs were induced to differentiate into spermatocytes using the stem cell growth factor, and the expressions of the germ cell proliferation-related protein (Nanos2), promyelocytic leukemia zinc finger protein (PLZF) and retinoic acid-stimulated protein 8 (Stra8) were measured by RT-qPCR and Western blot after 48 hours of differentiation. RESULTS:At 24 hours after transfection, the relative mRNA and protein expressions of DNMT1 and the DNA methylation level were significantly decreased in the DNMT1-siRNA group compared with those in the control and DNMT1-NC groups (P < 0.05), but showed no statistically significant difference between the latter two (P > 0.05). The relative mRNA and protein expressions of Nanos2 and PLZF were also decreased while those of Stra8 increased in the DNMT1-siRNA group in comparison with those in the control and DNMT1-NC groups after 48 hours of differentiation (P < 0.05), but none exhibited any statistically significant difference between the control and DNMT1-NC groups (P > 0.05). CONCLUSION:Knockdown of DNMT1 promotes the differentiation of SSCs into spermatocytes in mice, which may be related to the reduction of the genome methylation level, inhibition of the expressions of Nanos2 and PLZF, and promotion of the expression of Stra8.

Slow transit constipation is an intractable constipation with unknown aetiology and uncertain pathogenesis. The gut microbiota maintains a symbiotic relationship with the host and has an impact on host metabolism. Previous studies have reported that some gut microbes have the ability to produce 5-hydroxytryptamine (5-HT), an important neurotransmitter. However, there are scarce data exploiting the effects of gut microbiota-derived 5-HT in constipation-related disease. We genetically engineered the probiotic Escherichia coli Nissle 1917 (EcN-5-HT) for synthesizing 5-HT in situ. The ability of EcN-5-HT to secrete 5-HT in vitro and in vivo was confirmed. Then, we examined the effects of EcN-5-HT on intestinal motility in a loperamide-induced constipation mouse model. After two weeks of EcN-5-HT oral gavage, the constipation-related symptoms were relieved and gastrointestinal motility were enhanced. Meanwhile, administration of EcN-5-HT alleviated the constipation related depressive-like behaviors. We also observed improved microbiota composition during EcN-5-HT treatment. This work suggests that gut microbiota-derived 5-HT might promise a potential therapeutic strategy for constipation and related behavioral disorders.