Amelia Tero-Vescan

Exercise induces coordinated metabolic and mitochondrial stress responses that extend beyond ATP production to regulate cellular and systemic adaptation. Lactate, traditionally viewed as a glycolytic product, is now recognized as an oxidative substrate, interorgan carbon shuttle, and signaling metabolite, whereas mitochondrial stress promotes adaptive signaling and the release of mitokines and mitochondrial-derived peptides. This narrative review proposes the lactate–mitokine axis as a conceptual framework integrating these two exercise-responsive systems, while distinguishing experimentally established mechanisms from potential interactions that remain to be functionally validated. Repeated exercise promotes mitochondrial remodeling and increases oxidative capacity, which in turn reshapes the lactate response to subsequent exercise, as reflected by lower post-exercise lactate concentrations and enhanced lactate clearance after training. Conversely, increased lactate flux may influence mitochondrial adaptation through metabolic, redox, and receptor-dependent signaling, supporting a potentially bidirectional relationship between lactate handling and mitochondrial remodeling. The relative contribution of these interconnected responses appears exercise modality-dependent, with high-intensity, prolonged endurance, and resistance exercise generating distinct combinations of glycolytic and mitochondrial stress. Although lactate metabolism and mitochondrial stress signaling share several regulatory pathways, direct causal interactions between lactate signaling and mitokine expression or secretion during exercise remain insufficiently established. Thus, the proposed lactate–mitokine axis should be regarded as a hypothesis-generating framework requiring further experimental validation.

Esports and gaming resemble traditional sports and physical activity because both involve sustained cognitive and emotional stress; however, this stress occurs against a background of prolonged sedentary behavior. This narrative review examines the neuroendocrine, metabolic, and endothelial consequences of this “stress without movement” phenotype and its potential implications for long-term cardiovascular health. Activation of the hypothalamic–pituitary–adrenal (HPA) axis and sympathetic nervous system disrupts sleep and circadian rhythms. Continuous neuroendocrine activation may impair muscle–adipose tissue crosstalk and nitric oxide-dependent endothelial function. Although direct longitudinal evidence linking gaming to cardiovascular disease is currently lacking, these convergent mechanisms identify prolonged sedentary gaming as a potential cardiovascular risk amplifier, particularly when combined with occupational sitting, sleep disruption, adiposity, and other cardiometabolic risk factors.

Hyaluronan (HA) has traditionally been viewed as a structural component of the extracellular matrix, valued primarily for its viscoelastic, lubricating, and hydrating properties. However, accumulating evidence suggests that ultra-high-molecular-weight hyaluronan (UHMW-HA) functions far beyond passive tissue support, acting as a dynamic regulator of inflammation, mechanotransduction, immune homeostasis, cellular senescence, and regeneration. In this narrative review, we examine HA and specifically focus upon UHMW-HA operating as a “living hydrogel”, an adaptive regenerative macromolecule that continuously interacts with its microenvironment to shape tissue function and resilience. We examine evidence spanning evolutionary biology, glycobiology, biomaterials science, and regenerative medicine to examine how polymer size encodes biological activity and how UHMW-HA influences stem cell behaviour, extracellular matrix remodelling, and responses to injury and ageing. Attention is given to unique biological models, including the naked mole-rat, whose exceptional longevity and cancer resistance have been linked to abundant UHMW-HA, offering insights into the relationship between extracellular matrix architecture and organismal health. We further discuss how advances in synthetic biology and biomaterials engineering are enabling the development of next-generation HA-based hydrogels that mimic these adaptive properties for therapeutic applications in tissue engineering, in addition to potential roles in dynamically optimizing wound repair, and musculoskeletal rejuvenation, through precision medicine approaches. Finally, we argue that reclassifying UHMW-HA as a living regenerative material rather than an inert scaffold provides a new concept for designing bioinspired therapeutics and understanding extracellular matrix function. This review demonstrates HA-adaptive macromolecules as critical entities in future regenerative strategies and highlights the specific and unique potential of UHMW-HA to combine material science developments with enhancement of preferable biological outcome.

Hyaluronan (HA) has traditionally been viewed as a structural component of the extracellular matrix, valued primarily for its viscoelastic, lubricating, and hydrating properties. However, accumulating evidence suggests that ultra-high molecular weight hyaluronan (UHMW-HA) functions far beyond passive tissue support, acting as a dynamic regulator of inflammation, mechanotransduction, immune homeostasis, cellular senescence, and regeneration. In this narrative review, we examine HA and specifically focus upon UHMW-HA operating as a “living hydrogel”, an adaptive regenerative macromolecule that continuously interacts with its microenvironment to shape tissue function and resilience. We examine evidence spanning evolutionary biology, glycobiology, biomaterials science, and regenerative medicine to examine how polymer size encodes biological activity and how UHMW-HA influences stem cell behaviour, extracellular matrix remodelling, and responses to injury and ageing. Attention is given to unique biological models, including the naked mole-rat, whose exceptional longevity and cancer resistance have been linked to abundant UHMW-HA, offering insights into the relationship between extracellular matrix architecture and organismal health. We further discuss how advances in synthetic biology and biomaterials engineering are enabling the development of next-generation HA-based hydrogels that mimic these adaptive properties for therapeutic applications in tissue engineering, in addition to potential roles in dynamically optimising wound repair, and musculoskeletal rejuvenation, through precision medicine approaches. Finally, we argue that reclassifying UHMW-HA as a living regenerative material rather than an inert scaffold provides a new concept for designing bioinspired therapeutics and understanding extracellular matrix function. This review demonstrates HA-adaptive macromolecules as critical entities in future regenerative strategies and highlights the specific and unique potential of UHMW-HA to combine material science developments with enhancement of preferable biological outcome.

Neurological disorders, including stroke, traumatic brain injury, and spinal cord injury, constitute one of the most important causes of mortality and morbidity worldwide for which current treatment options focus on resolving neuroinflammation rather than on tissue and neuronal regeneration. Mesenchymal stem cells (MSCs) could be a potential therapeutic option due to their immunomodulatory, neuroprotective, and paracrine secretion of extracellular vesicles and trophic factors which modulate microglial activation, preserve blood–brain barrier (BBB) integrity, and neuroplasticity, but with limitations due by poor survival, retention, and phenotypic instability following direct transplantation. The purpose of this narrative review is to present mechanotransduction signaling pathways (integrin–FAK, PI3K/Akt, Rho/ROCK, and YAP/TAZ) through which MSC-based biomaterial scaffolds, especialy hyaluronic acid (HA) hydrogels, make the transition from reparative to regenerative medicine in central nervous system (CNS) injury. Even if most of the evidence from preclinical studies suggests that dynamically tunable MSC-scaffold systems represent promising platforms for neural tissue engineering and regenerative medicine, further translational studies and well-designed clinical investigations are required to establish their therapeutic efficacy and clinical applicability.

Inflammaging is defined as chronic low-grade inflammation associated with aging and is increasingly recognized as a dynamic and mechanistically driven biological process rather than a state adequately described by circulating biomarkers alone. Traditional inflammatory markers alone, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive Protein (CRP), fail to capture the complexity, tissue specificity, and causal architecture of inflammaging. Recent experimental evidence has demonstrated that diverse upstream drivers, including immunosenescence, gut microbiome dysbiosis, metabolic dysfunction, and cellular senescence, converge on a limited number of central inflammatory hubs, including nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome, GMP–AMP synthase–stimulator of interferon genes (cGAS–STING), Janus kinase/signal transducer and activator of transcription (JAK/STAT), and p38 mitogen-activated protein kinase (p38 MAPK) signaling. These mechanistic nodes represent promising therapeutic targets, potentially modifiable biological processes, and support the emerging concept of ‘druggable inflammaging’, whereby senotherapeutics, inflammasome inhibitors, innate immune modulators, and metabolic interventions may actively modify aging-associated inflammatory biology rather than simply monitor it through biomarkers. This review highlights a paradigm shift from biomarker-based assessment toward mechanism-based intervention, where inflammaging can be characterized as a modifiable biological process and a central target for precision pharmacological strategies in aging-related diseases.

Background: Periodontitis is a chronic inflammatory disease characterized by dysbiotic biofilm formation, progressive destruction of periodontal tissues, and alveolar bone resorption. Conventional periodontal therapy primarily focuses on mechanical biofilm removal; however, adjunctive therapeutic approaches targeting host inflammatory responses and microbial activity have gained increasing attention. Cannabidiol (CBD), a non-psychoactive phytocannabinoid derived from Cannabis sativa, has demonstrated anti-inflammatory, antimicrobial, and immunomodulatory properties that may be relevant in periodontal disease management. Objective: This systematic review aimed to evaluate the available evidence regarding the potential role of CBD in modulating periodontal inflammation, microbial biofilms, and bone resorption processes. Methods: A systematic literature search was conducted in Web of Science, Cochrane, PubMed, Scopus, and Google Scholar. The review was conducted in accordance with PRISMA guidelines. Studies investigating the effects of CBD on periodontal inflammation, oral biofilms, or bone remodeling were included. Both preclinical (in vitro and animal) and clinical studies were considered. Results: Evidence from experimental studies consistently demonstrated that CBD modulates inflammatory signaling pathways, including inhibition of the TLR4/NF-κB pathway and a reduction in pro-inflammatory cytokine expression, but some results are contradictory. Animal studies reported reduced alveolar bone loss and decreased osteoclast activity following CBD administration. Several studies also demonstrated antimicrobial and antibiofilm effects of CBD against oral microorganisms. Conclusions: While preclinical evidence is promising, the current body of clinical data remains limited. Further well-designed randomized clinical trials are required to determine the efficacy, type of formulation, optimal dosing, and long-term safety of CBD as an adjunctive therapy in periodontal treatment.

Considering the increasing consumer demand for natural meat tenderization methods, this study explores the potential of Aspergillus oryzae (Koji) to enhance beef quality. The aim of this study was to evaluate the enzymatic effect of Aspergillus oryzae (A. oryzae) on the physicochemical and sensory characteristics, as well as the perception of satiety, in Angus beef. Two distinct anatomical cuts, the neck and the round, were subjected to enzymatic aging using four different Koji-based mixtures. Parameters such as water content, thermal preparation (grilling) loss, expressible moisture, and pH were determined, supplemented by sensory analysis and a satiety test. Compared to untreated or traditionally marinated samples (Teriyaki sauce), Koji-treated samples exhibited lower grilling loss and improved texture. Sensory analysis highlighted a more intense flavor profile and increased acceptability of the enzymatically treated products. The satiety test indicated a predominantly positive perception of postprandial fullness, with negative ratings being rare and exclusive to the control group. These results support the potential of A. oryzae as a natural alternative for optimizing the technological and sensory quality of red meat, contributing to a favorable consumer experience, including satiety perception.

Benzydamine is a nonsteroidal anti-inflammatory drug widely used in topical formulations but occasionally misused orally at high doses for psychoactive effects. Data regarding the safety of benzydamine at supratherapeutic doses are limited and mainly focus on central nervous system effects. Even less information is available concerning its safety during pregnancy, despite the increased risk of unplanned pregnancies among users of psychoactive substances. In this preliminary study, we aimed to evaluate the maternal and fetotoxic potential of benzydamine to support future targeted reproductive toxicity investigations. Pregnant Wistar rats received benzydamine throughout gestation, followed by cesarean section and evaluation of fetal viability, fetal body weight at term, and macroscopic abnormalities. Maternal biochemical parameters related to hepatic, renal, and metabolic function, and oxidative stress markers, were also assessed. Results were compared with those of a control group. No significant differences in routine biochemical parameters were observed between groups; however, benzydamine exposure was associated with reduced fetal body weight and increased maternal plasma malondialdehyde levels. These findings suggest that benzydamine may impair fetal growth through indirect maternal toxicity and oxidative stress rather than direct teratogenic effects.