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Trimetallic nanoparticles (TMNPs) have emerged as a pivotal area of research due to their unique properties and diverse applications across medicine, agriculture, and environmental sciences. This review provides several novel contributions that distinguish it from existing literature on trimetallic nanoparticles (TMNPs). Firstly, it offers a focused exploration of TMNPs, specifically addressing their unique properties and applications, which have been less examined compared to other multimetallic nanoparticles. This targeted analysis fills a significant gap in current research. Secondly, the review emphasizes innovative biosynthesis methods utilizing microorganisms and plant extracts, positioning these green synthesis approaches as environmentally friendly alternatives to traditional chemical methods. This focus aligns with the increasing demand for sustainable practices in nanotechnology. Furthermore, the review integrates discussions on both medical and agricultural applications of TMNPs, highlighting their multifunctional potential across diverse fields. This comprehensive perspective enhances our understanding of how TMNPs can address various challenges. Additionally, the review explores the synergistic effects among the different metals in TMNPs, providing insights into how these interactions can be harnessed to optimize their properties for specific applications. Such discussions are often overlooked in existing studies. Moreover, this review identifies critical research gaps and challenges within the field, outlining future directions that encourage further investigation and innovation in TMNP development. By doing so, it proactively contributes to advancing the field. Finally, the review advocates for interdisciplinary collaboration among material scientists, biologists, and environmental scientists, emphasizing the importance of diverse expertise in enhancing the research and application of TMNPs.

AimPublished reports showed conflicting results regarding the sustained alterations in leptin, chemerin, and ghrelin concenratios after metabolic surgery. Therefore, we performed the present work to contrast the alterations in leptin, chemerin, and ghrelin levels one year after Roux-en-Y gastric bypass (RYGB) versus laparoscopic sleeve gastrectomy (LSG).MethodsThe present research is a prospective, comparative one that followed 100 cases for whom RYGB or LSG was done. We assessed the serum values of adiposity-associated mediators, including adipokcytokines (leptin and active chemerin) and gastrointestinal hormones (total ghrelin). The primary outcome in the present study was the alterations in leptin, chemerin, and ghrelin values at 12 months after RYGB and LSG.ResultsThe serum leptin level decreased significantly in the LSG group with a mean change of − 170.8 ± 29.4 ng/mL (p < 0.001). Similarly, the serum leptin concentration decreased significantly in the RYGB group, with a mean change of − 165.42 ± 53.4 (p < 0.001). In addition, the mean reduction in baseline chemerin levels 12 months after the operation was considerable in the LSG cohort (− 23.24 ± 9.5 ng/mL) and RYGB group (− 22.12 ± 15.9 ng/mL). The ghrelin values demonstrated a notable reduction in the LSG cohort (− 0.083 ± 0.11 pg/mL) and RYGB group (− 0.068 ± 0.097 pg/mL). However, the changes in the three hormones were not substantially different between both groups (p > 0.05).ConclusionBoth RYGB and LSG result in a considerable, comparable decrease in the postoperative serum concentrations of leptin, chemerin, and ghrelin.

PurposeBariatric surgery can improve non-alcoholic fatty liver disease (NAFLD). Yet data on the effect on fibrosis are insufficient and controversial. This work endeavored to evaluate the safety of laparoscopic sleeve gastrectomy (LSG) in cases that have compensated non-alcoholic steatohepatitis (NASH)-related cirrhosis and its impact on fibrosis stage.MethodsThe current prospective work involved 132 cases with Child-A NASH-related cirrhosis suffering from morbid obesity scheduled for LSG. They were subjected to preoperative assessment, wedge biopsy, and ultrasound-guided true-cut liver biopsy after 30 months. Patients were included if proved to have F4 fibrosis initially. The liver condition was assessed based on the NALFD Activity Score (NAS). The primary outcome measure was the impact of LSG on fibrosis stage and its relation to weight loss.ResultsThe analysis included only 71 patients who completed the 30-month follow-up period. By the end of the follow-up interval, there was a substantial weight loss with a reasonable resolution of comorbidities. The median NAS decreased significantly from 6 (1–8) to 3 (0–6) after surgery. Fibrosis score regressed to F2 in 19 patients (26.8%) and F3 in 29 (40.8%). Patients with improved scores had a significantly higher amount of weight loss (p < 0.001). Improvement was more frequent in males (p = 0.007). By 30 months after treatment, 53.8% of cases with borderline NASH and 36.8% of those with probable NASH showed complete resolution, and 44.7% of patients with NASH showed improvement. Steatosis improved in 74.6% of patients (p < 0.001).ConclusionIn patients with NASH-related liver cirrhosis of Child class A, LSG may be a secure approach for the management of morbid obesity. It has a long-term benefit for both obesity and liver condition with significant improvement of steatosis, steatohepatitis, and fibrosis.

PurposeWeight reduction can effectively improve nonalcoholic fatty liver disease (NAFLD), which is a constant companion of severe obesity. This study aimed to determine the effect of one-anastomosis gastric bypass (OAGB) on pathological liver changes in severely obese cases with NAFLD.MethodsThe present prospective research comprised 67 subjects with morbid obesity scheduled for OAGB during the period from February 2015 to August 2018. Clinical, biological, and histologic data were evaluated pre and 15 months postoperatively.ResultsFifteen months after surgery, a considerable reduction was noted in the grades of fat deposition, liver cell ballooning, and lobular inflammatory changes, in addition to the total NAS score. Fifteen months after surgery, nonalcoholic steatohepatitis (NASH) disappeared in 42% of the patients. A significant regression of fibrosis stage occurred after surgery in 79.1% of patients (p < 0.001). After surgery, patients had substantial reductions in aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, HbA1c, total cholesterol, and Low-density lipoprotein (p < 0.001, for all comparisons). Diabetes mellitus, hypertension, and dyslipidemia resolved in 54%, 59%, and 69% of the patients, respectively.ConclusionOAGB resolved NASH from nearly 42% of patients and reduced the histological features of NAFLD 15 months after surgery. Bariatric procedures might be adopted as a therapeutic modality in severely obese cases with NAFLD after the failure of lifestyle modifications.

The incidence of chronic kidney disease is escalating; cardiorenal syndrome (CRS) type 4 is gaining a major health concern causing significant morbidity and mortality, putting major burdens on the healthcare system. This study was designed to compare the cardioprotective effects of carvedilol versus atenolol against CRS type 4 induced by subtotal 5/6 nephrectomy in rats and to explore the underlying mechanisms. Immediately after surgery, carvedilol (20 mg/kg/day) or atenolol (20 mg/kg/day) was added to drinking water for 10 weeks. Carvedilol was more effective than atenolol in improving kidney functions, decreasing elevated blood pressures, attenuating cardiac hypertrophy, reducing serum brain natriuretic peptide, and diminished cardiac fibrous tissue deposition. However, carvedilol was equivalent to atenolol in modulating β 1 -adrenergic receptors (β 1 ARs) and cardiac diacylglycerol (DAG) signaling, but carvedilol was superior in modulating β-arrestin2, phosphatidyl inositol 4,5 bisphosphates (PIP2), and caspase 3 levels. Carvedilol has superior cardioprotective effects than atenolol in a rat model of CRS type 4. These protective effects are mediated through modulating cardiac β 1 ARs/β-arrestin2/PIP2/DAG as well as abating cardiac apoptotic signaling pathways (caspase3/pS473 protein kinase B (Akt)).

Introduction and Aim Recently, the incidence of obesity has been rising exponentially. Clinical studies have demonstrated that different subtypes of pulmonary hypertension (PH) are linked to obesity. The current work mainly aims to assess the impact of laparoscopic sleeve gastrectomy (LSG) on PH in a cohort of obese cases. Patients and Methods The present prospective work included 37 obese cases with PH for whom LSG was done. Only cases with PH and presurgical right ventricular systolic pressure (RVSP) ≥ 35 mmHg using Doppler echocardiogram were enrolled. Fifteen months later, patients were reassessed regarding new weight and BMI in addition to changes in RVSP. Results At the end of follow-up, the average BMI improved from 45.8  +  3.9 to 33.8  +  2.5 Kg/m 2 ( p value < 0.001). Improved right ventricular (RV) size compared to baseline echo was observed in 20 patients. RV size decreased from 2.68  +  0.44 cm to 2.34  +  0.36 cm ( p value < 0.001). Notable decrease of PH to less than 30 mmHg occurred in 33 patients. Mean RVSP decreased from 39.62  +  2.1 to 31.81  +  3.1 mmHg ( p value < 0.001). LSG significantly decreased the requirements for PH drugs and supplemental oxygen therapy. Conclusion The current work suggests that LSG-induced weight loss may result in a considerable decrease in pulmonary pressures as well as RV size with a concurrent resolution of other metabolic comorbidities.