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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Microbiol.</journal-id>
<journal-title>Frontiers in Microbiology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Microbiol.</abbrev-journal-title>
<issn pub-type="epub">1664-302X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fmicb.2024.1509124</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Microbiology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Antifungal activity of paeonol against <italic>Botrytis cinerea</italic> by disrupting the cell membrane and the application on cherry tomato preservation</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Jiao</surname> <given-names>Yang</given-names></name>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Zheng</surname> <given-names>Yu</given-names></name>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Wu</surname> <given-names>Shiqin</given-names></name>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Zhou</surname> <given-names>Li</given-names></name>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Jiang</surname> <given-names>Hua</given-names></name>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Li</surname> <given-names>Yuanhong</given-names></name>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/469240/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Lin</surname> <given-names>Fuxing</given-names></name>
<xref ref-type="corresp" rid="c002"><sup>&#x002A;</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/2864123/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
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</contrib-group>
<aff><institution>School of Public Health, Xuzhou Medical University</institution>, <addr-line>Xuzhou</addr-line>, <country>China</country></aff>
<author-notes>
<fn fn-type="edited-by" id="fn0001">
<p>Edited by: Achour Amiri, Washington State University, United States</p>
</fn>
<fn fn-type="edited-by" id="fn0002">
<p>Reviewed by: Ibrahim Kutay Ozturk, University of Maine, United States</p>
<p>Yuru Chang, University of Florida, United States</p>
</fn>
<corresp id="c001">&#x002A;Correspondence: Yuanhong Li, <email>lyh@xzhmu.edu.cn</email></corresp>
<corresp id="c002">Fuxing Lin, <email>lfx@xzhmu.edu.cn</email></corresp>
</author-notes>
<pub-date pub-type="epub">
<day>02</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="collection">
<year>2024</year>
</pub-date>
<volume>15</volume>
<elocation-id>1509124</elocation-id>
<history>
<date date-type="received">
<day>10</day>
<month>10</month>
<year>2024</year>
</date>
<date date-type="accepted">
<day>20</day>
<month>11</month>
<year>2024</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2024 Jiao, Zheng, Wu, Zhou, Jiang, Li and Lin.</copyright-statement>
<copyright-year>2024</copyright-year>
<copyright-holder>Jiao, Zheng, Wu, Zhou, Jiang, Li and Lin</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p><italic>Botrytis cinerea</italic> may cause gray mold in fruits and vegetables. Paeonol, an active component of traditional Chinese medicine, could suppress various microbial growth. However, reports on its effect on <italic>B. cinerea</italic> have not yet been documented. In this paper, we demonstrated that paeonol completely inhibited <italic>B. cinerea</italic> growth at 250&#x202F;mg/L, corroborated by the observation of irregular morphological alterations in <italic>B. cinerea</italic> exposed to paeonol. Notably, the investigation of the operating mechanism revealed that paeonol induced cell death by disrupting the cell membrane, potentially mediated by the interaction between paeonol and ergosterol from the membrane. Further studies indicated that paeonol decreased ergosterol content and the expression of certain genes involved in ergosterol biosynthesis was significantly downregulated. In addition, paeonol treatment reduced the gray mold of cherry tomatoes. Meanwhile, compared to the control treatment, paeonol treatment could reduce weight loss and maintain higher contents of total soluble solid (TSS) and ascorbic acid, leading to a higher quality of the stored cherry tomato. Together, the data indicate that paeonol was effective as an alternative agent targeting disrupting the cell membrane to control gray mold and prolong the shelf life of cherry tomatoes, suggesting that paeonol could be used as a natural antifungal compound during postharvest storage.</p>
</abstract>
<kwd-group>
<kwd>paeonol</kwd>
<kwd><italic>Botrytis cinerea</italic></kwd>
<kwd>ergosterol</kwd>
<kwd>cherry tomato</kwd>
<kwd>quality</kwd>
</kwd-group>
<counts>
<fig-count count="6"/>
<table-count count="2"/>
<equation-count count="0"/>
<ref-count count="50"/>
<page-count count="10"/>
<word-count count="6390"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Food Microbiology</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec1">
<label>1</label>
<title>Introduction</title>
<p><italic>Botrytis cinerea</italic>, a typical broad host necrotrophic pathogen, causes gray mold rot in more than 200 economically important crops including strawberry, tomato, grape, blueberry, and raspberry (<xref ref-type="bibr" rid="ref32">Sarven et al., 2020</xref>; <xref ref-type="bibr" rid="ref27">Orozco-Mosqueda et al., 2023</xref>). It can infect leaves, stems, and fruits of crops, either through direct penetration or through wounds, seriously affecting yield and quality (<xref ref-type="bibr" rid="ref31">Rodr&#x00ED;guez and Rodr&#x00ED;guez, 2014</xref>). It is estimated that <italic>B. cinerea</italic> causes losses of $10 billion to $100 billion annually worldwide (<xref ref-type="bibr" rid="ref42">Weiberg et al., 2013</xref>). Synthetic fungicides effectively control <italic>B. cinerea</italic> (<xref ref-type="bibr" rid="ref27">Orozco-Mosqueda et al., 2023</xref>). However, excessive application of synthetic fungicides is harmful to human health and the environment, and may lead to the emergence of fungicide-resistant strains (<xref ref-type="bibr" rid="ref33">Shao et al., 2021</xref>). Therefore, it is urgent to develop new kinds of fungicides that are safe, efficient, biocompatible, and environmentally friendly to control <italic>B. cinerea</italic>.</p>
<p>Promising results have been obtained using plant-derived natural bioactive compounds (e.g., flavonoids, alkaloids, and phenols) to control <italic>B. cinerea</italic> (<xref ref-type="bibr" rid="ref25">Matrose et al., 2021</xref>). For instance, carvacrol, derived from aromatic plants, exhibits antifungal activity against <italic>B. cinerea</italic> with a minimum inhibitory concentration of 120&#x202F;&#x03BC;L/L, and the anti-fungal activity can be derived from cell membrane integrity damage and cell components leakage (<xref ref-type="bibr" rid="ref50">Zhang et al., 2019</xref>). <xref ref-type="bibr" rid="ref39">Wang et al. (2023)</xref> demonstrated that flavonoids from <italic>Sedum aizoon</italic> L. (FSAL) induced a decrease in the proline, GSH, and membrane phospholipid content and reduced the expression of major genes in membrane lipid metabolism, resulting in damage the integrity and stability of the cell membrane, and finally leading to the <italic>B. cinerea</italic> cell death. In addition, <xref ref-type="bibr" rid="ref23">Ma et al. (2020)</xref> found that anti-<italic>B. cinerea</italic> mechanism of plant-derived honokiol compound may be associated with autophagic, reactive oxygen species accumulation and mitochondrial dysfunction. Many plant-derived natural bioactive compounds have no negative impact on the environment or human health, and can be used to develop safe and sustainable antifungal products (<xref ref-type="bibr" rid="ref24">Makhuvele et al., 2020</xref>; <xref ref-type="bibr" rid="ref11">Khursheed et al., 2022</xref>).</p>
<p>Cherry tomato is a popular fruit worldwide for its nutritional value due to its high vitamins A, vitamins C, lycopene, and <italic>&#x03B2;</italic>-carotenoids (<xref ref-type="bibr" rid="ref9">Ji et al., 2020</xref>). However, cherry tomato is susceptible to mechanical injury due to its thin exocarp and rich pulp, which increases the risk of pathogen infection (<xref ref-type="bibr" rid="ref8">Guo et al., 2023</xref>). Gray mold, caused by <italic>B. cinerea</italic>, has been reported as an important postharvest disease of cherry tomato (<xref ref-type="bibr" rid="ref45">Wu et al., 2024</xref>). Chemical fungicides and physical treatments (hot air, blue light, or temperature regulation) can effectively control gray mold on tomato during storage (<xref ref-type="bibr" rid="ref46">Yan et al., 2022</xref>; <xref ref-type="bibr" rid="ref41">Wei et al., 2017</xref>; <xref ref-type="bibr" rid="ref36">Sun et al., 2024</xref>; <xref ref-type="bibr" rid="ref14">Li et al., 2023</xref>). However, environmental pollution and fruit safety issues of chemical fungicides, high energy inputs, and costs of physical treatments restricted their use.</p>
<p>Paeonol, derived from <italic>Paeonia suffruticosa</italic> Andr and <italic>Paeonia lactiflora</italic> Pall, exhibits antimicrobial properties against <italic>Klebsiella pneumonia</italic>, <italic>Enterobacter cloacae</italic>, <italic>Staphylococcus aureus</italic>, <italic>Listeria monocytogenes</italic>, <italic>Candida albicans</italic>, and <italic>Aspergillus flavus</italic> (<xref ref-type="bibr" rid="ref30">Qian et al., 2021</xref>; <xref ref-type="bibr" rid="ref49">Zeng et al., 2022</xref>; <xref ref-type="bibr" rid="ref29">Qian et al., 2022</xref>; <xref ref-type="bibr" rid="ref16">Li Q. et al., 2021</xref>). Moreover, paeonol has been considered to have no obvious toxicity and can be added to pharmaceuticals, cosmetics, and health care foods (<xref ref-type="bibr" rid="ref15">Li P. et al., 2021</xref>; <xref ref-type="bibr" rid="ref16">Li Q. et al., 2021</xref>). Thus, paeonol provides an ideal alternative for <italic>B. cinerea</italic> control without food safety concerns. However, there is little information on the inhibitory effect of paeonol on <italic>B. cinerea</italic>, and its mechanism of action remains unclear.</p>
<p>In this study, we used <italic>in vitro</italic> and <italic>in vivo</italic> experiments to assess the efficacy of paeonol in inhibiting the growth and pathogenicity of <italic>B. cinerea</italic> on harvested cherry tomato fruit. Furthermore, using scanning electron microscopy (SEM), flow cytometry, and RT-PCR assays, we explored the potential mechanisms of action. Meanwhile, the quality of fruit treated with paeonol during postharvest storage was analyzed. These data will help determine the antifungal mechanism of paeonol and guide its application in the postharvest storage of cherry tomato.</p>
</sec>
<sec sec-type="materials|methods" id="sec2">
<label>2</label>
<title>Materials and methods</title>
<sec id="sec3">
<label>2.1</label>
<title>Strain, compound, and fruit</title>
<p><italic>Botrytis cinerea</italic> (ACCC 37346) was purchased from the Agricultural Culture Collection of China (ACCC). Paeonol was purchased from Aladdin Industrial Corporation (Shanghai, China). Cherry tomato fruit (<italic>Solanum lycopersicum</italic> &#x2018;Qian xi&#x2019;) of similar maturity, size, and color and without mechanical damage or disease were purchased from commercial orchards located in Xuzhou, Jiangsu Province, China.</p>
</sec>
<sec id="sec4">
<label>2.2</label>
<title>Determination of minimal inhibitory concentration (MIC)</title>
<p>The MIC of paeonol against <italic>B. cinerea</italic> was determined by sterile 96-well plate assays according to <xref ref-type="bibr" rid="ref18">Lin et al. (2021)</xref>. The absorbance was recorded at 560&#x202F;nm by UV spectrophotometer (Versa max, Molecular Devices, China). MIC was set as the lowest concentration with no growth in plate assays (<xref ref-type="bibr" rid="ref6">Fan et al., 2023</xref>). All analyses were performed with three replicates.</p>
</sec>
<sec id="sec5">
<label>2.3</label>
<title>Measurement of mycelial growth and spores germination</title>
<p>The mycelial growth method was based on the previous study of <xref ref-type="bibr" rid="ref19">Lin et al. (2019)</xref>. <italic>B. cinerea</italic> mycelial disks were positioned at the center of each potato dextrose agar (PDA) plate incorporating varying concentrations of paeonol and were concurrently incubated at 23&#x00B0;C. The diameters of the colonies were measured at 72&#x202F;h after treatment. The <italic>B. cinerea</italic> mycelial growth inhibition was quantified using this formula: Inhibition (%)&#x202F;=&#x202F;[control mycelial diameter (mm) &#x2212; paeonol treated mycelial diameter (mm)] &#x00F7; [control mycelial diameter (mm)]&#x202F;&#x00D7;&#x202F;100%. The value of EC<sub>50</sub> (concentration to inhibit 50% of mycelial growth) was calculated by linear regression of mycelial growth inhibition versus log<sub>10</sub> transformation of paeonol concentrations. All analyses were performed with three replicates.</p>
<p>Paeonol was diluted to different concentrations in potato dextrose broth (PDB). The <italic>B. cinerea</italic> spore suspension was mixed with paeonol-containing PDB and incubated at 23&#x00B0;C for 12&#x202F;h. Spore germination was determined using a microscope (BX41, Olympus, Japan). The spore germination rate was calculated based on observations of 100 spores. Triple replications were used in all analyses.</p>
</sec>
<sec id="sec6">
<label>2.4</label>
<title>Scanning electron microscopy analysis</title>
<p><italic>Botrytis cinerea</italic> mycelia exposed to paeonol at the final concentration of 0, 125, or 250&#x202F;mg/L at 23&#x00B0;C for 12&#x202F;h. Treated mycelia were re-suspended in 2.5% glutaraldehyde solution for SEM observation (Teneo <italic>VS</italic>, FEI Company, United States) (<xref ref-type="bibr" rid="ref20">Lin et al., 2022</xref>).</p>
</sec>
<sec id="sec7">
<label>2.5</label>
<title>Determination of paeonol mode of action</title>
<sec id="sec8">
<label>2.5.1</label>
<title>Sorbitol assay</title>
<p>Sorbitol serves as an osmoregulatory agent for fungal cell wall protection (<xref ref-type="bibr" rid="ref7">Frost et al., 1995</xref>). Cells shielded by sorbitol can proliferate in the presence of fungal cell wall inhibitors, whereas growth would be suppressed in the absence of sorbitol (<xref ref-type="bibr" rid="ref13">Leite et al., 2014</xref>). To assess whether paeonol interacts with <italic>B. cinerea</italic> cell wall, the MIC against <italic>B. cinerea</italic> was determined using 96-well plates in medium with and without 0.8&#x202F;mol L<sup>&#x2212;1</sup> exogenous sorbitol (<xref ref-type="bibr" rid="ref13">Leite et al., 2014</xref>). Triple replications were used in all analyses.</p>
</sec>
<sec id="sec9">
<label>2.5.2</label>
<title>Ergosterol assay</title>
<p>Ergosterol, responsible for stabilizing the membrane structure via incorporation of phospholipids, represents the principal sterol constituent present in the plasma membrane of fungi, holding indispensable status for the majority of fungi (<xref ref-type="bibr" rid="ref44">Wu et al., 2020</xref>). To determine if paeonol binds fungal membrane sterols, its MIC against <italic>B. cinerea</italic> in 96-well plates, with and without 400&#x202F;mg/L exogenous ergosterol (<xref ref-type="bibr" rid="ref13">Leite et al., 2014</xref>). Amphotericin B served as the positive control. Triple replications were used in all analyses.</p>
</sec>
</sec>
<sec id="sec10">
<label>2.6</label>
<title>Determination of the integrity of cell membrane</title>
<p><italic>Botrytis cinerea</italic> spore suspension was exposed to 0, 125, or 250&#x202F;mg/L paeonol at 23&#x00B0;C for 6&#x202F;h. After centrifugation, spore cells were stained with propidium iodide (PI) for 15&#x202F;min. Ten thousand cells were calculated and analyzed using a flow cytometry (FACS Verse, Becton, Dickinson and Company, United States).</p>
</sec>
<sec id="sec11">
<label>2.7</label>
<title>Determination of calcein leakage from large unilamellar vesicles (LUVs)</title>
<p>To mimic the <italic>B. cinerea</italic> cell membrane, LUVs were synthesized by mixing phosphatidylcholine (PC)/phosphatidylethanolamine (PE)/phosphatidylinositol (PI)/ergosterol (5:4:1:2) (<xref ref-type="bibr" rid="ref2">Cho et al., 2013</xref>). The four components were dissolved in chloroform and dried by nitrogen. LUVs-embedded calcein was created by stirring the dried LUVs in dye buffer (70&#x202F;mM calcein, 10&#x202F;mM Tris, 150&#x202F;mM NaCl, and 0.1&#x202F;mM EDTA). This solution underwent 11&#x202F;cycles of freezing in liquid nitrogen and passing through polycarbonate filters with a Liposome extruder (Hand extruder, Genizer, United States). Different concentrations of paeonol were applied to calcein-encapsulating LUVs, and calcein release was measured by spectrofluorophotometer (SparkControl, Tecan, Switzerland) at wavelengths (&#x03BB;ex&#x202F;=&#x202F;490&#x202F;nm, &#x03BB;em&#x202F;=&#x202F;520&#x202F;nm). Calcein leakage was calculated as: calcein leakage (%)&#x202F;=&#x202F;[(<italic>A</italic><sub>added paeonol</sub> &#x2212; <italic>A</italic><sub>without paeonol</sub>)/(<italic>A</italic><sub>added</sub> Triton X-100 &#x2212; <italic>A</italic><sub>without paeonol</sub>)]&#x202F;&#x00D7;&#x202F;100. All analyses utilized three replications.</p>
</sec>
<sec id="sec12">
<label>2.8</label>
<title>Determination of cellular content leakage</title>
<p><italic>Botrytis cinerea</italic> mycelia (500&#x202F;mg) were suspended in PBS and exposed to paeonol at final concentrations of 0, 125, or 250&#x202F;mg/L at 23&#x00B0;C for 0, 2, 4, 6, or 8&#x202F;h. The detection of protein, nucleic acid, and ion leakage was conducted utilizing the BCA Protein Assay Kit (Solarbio, Beijing, China), UV spectrophotometer (Versa max, Molecular Devices, China), and ICP-Optical Emission Spectroscopy (Avio 200, PerkinElmer, Waltham, United States), respectively. Each treatment was conducted in triplicate.</p>
</sec>
<sec id="sec13">
<label>2.9</label>
<title>Measurement of ergosterol content</title>
<p>The ergosterol content of <italic>B. cinerea</italic> was measured as reported by <xref ref-type="bibr" rid="ref38">Tian et al. (2012)</xref>. <italic>B. cinerea</italic> spore suspension was inoculated into PDB containing 0, 62.5, 125, and 250&#x202F;mg/L of paeonol for 4&#x202F;days at 23&#x00B0;C. After incubation, mycelia were collected, re-suspended in 3&#x202F;mL alcoholic KOH (25% w/v), and incubated at 85&#x00B0;C for 4&#x202F;h. Sterols extraction involved adding 1&#x202F;mL distilled water and 3&#x202F;mL n-heptane to each sample. Then, a vigorous vortexing was conducted for 3&#x202F;min to isolate the heptane layer. Analysis was performed on this layer using a UV spectrophotometer (Versa max, Molecular Devices, China) at 282 and 230&#x202F;nm. Ergosterol content was calculated as: ergosterol (%)&#x202F;=&#x202F;[(<italic>A</italic><sub>282</sub>/290)/mycelia weight]&#x202F;&#x2212;&#x202F;[(<italic>A</italic><sub>230</sub>/518)/mycelia weight]. All analyses were made with three biological replicates.</p>
</sec>
<sec id="sec14">
<label>2.10</label>
<title>Ergosterol synthesis genes expression analysis</title>
<p><italic>Botrytis cinerea</italic> spores were incubated in PDB (containing 0, 125, or 250&#x202F;mg/L paeonol) at 23&#x00B0;C and 180&#x202F;rpm for 4&#x202F;days, then mycelia were lyophilized and pulverized. Total RNA was extracted with a kit (Sangon Biotech, Shanghai, China) and reverse transcribed with HiScript III All-in-one RT SuperMix Perfect (Vazyme, Nanjing, China). RT-PCR was run with Taq Pro Universal SYBR qPCR Master Mix (Vazyme, Nanjing, China) on a Step One System (7,500, Applied Biosystems, United States). The 2<sup>&#x2212;&#x25B3;&#x25B3;C(T)</sup> method was used for relative quantification (<xref ref-type="bibr" rid="ref22">Livak and Schmittgen, 2001</xref>). The <italic>Actin</italic> gene acted as the internal control for analyzing four ergosterol synthase genes: <italic>Erg1</italic>, <italic>Erg3</italic>, <italic>Erg10</italic>, and <italic>Erg13</italic>. PCR primer pairs are shown in <xref ref-type="table" rid="tab1">Table 1</xref>. Triple replications were used in all RT-PCR analyses.</p>
<table-wrap position="float" id="tab1">
<label>Table 1</label>
<caption>
<p>Sequences of primers.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top">Gene name</th>
<th align="left" valign="top">Genbank number</th>
<th/>
<th align="left" valign="top">Primer sequence (5&#x2032;&#x202F;&#x2192;&#x202F;3&#x2032;)</th>
<th align="center" valign="top">Size</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top"><italic>Actin</italic></td>
<td align="left" valign="top">XM_024697950.1</td>
<td align="left" valign="top">Forward</td>
<td align="left" valign="top">GAAGATCTTGGCTGAGCGTG</td>
<td align="center" valign="top">132</td>
</tr>
<tr>
<td/>
<td/>
<td align="left" valign="top">Reverse</td>
<td align="left" valign="top">GAGGATTGACTGGCGGTTTG</td>
<td/>
</tr>
<tr>
<td align="left" valign="top"><italic>Erg1</italic></td>
<td align="left" valign="top">XM_001547426.2</td>
<td align="left" valign="top">Forward</td>
<td align="left" valign="top">ATACCGTCGTCCTCCCAATC</td>
<td align="center" valign="top">178</td>
</tr>
<tr>
<td/>
<td/>
<td align="left" valign="top">Reverse</td>
<td align="left" valign="top">CCGCCAGTTAAAGGATGACG</td>
<td/>
</tr>
<tr>
<td align="left" valign="top"><italic>Erg3</italic></td>
<td align="left" valign="top">XM_001549088.2</td>
<td align="left" valign="top">Forward</td>
<td align="left" valign="top">GAGGCGGAAGGAGAAGATGA</td>
<td align="center" valign="top">136</td>
</tr>
<tr>
<td/>
<td/>
<td align="left" valign="top">Reverse</td>
<td align="left" valign="top">TGTTCCCATTCCTCTCCCAC</td>
<td/>
</tr>
<tr>
<td align="left" valign="top"><italic>Erg10</italic></td>
<td align="left" valign="top">XM_001550593.2</td>
<td align="left" valign="top">Forward</td>
<td align="left" valign="top">TTGTTCTCGTCTCGGAAGCT</td>
<td align="center" valign="top">105</td>
</tr>
<tr>
<td/>
<td/>
<td align="left" valign="top">Reverse</td>
<td align="left" valign="top">CGGTGGTGAATTTGCTTGGA</td>
<td/>
</tr>
<tr>
<td align="left" valign="top"><italic>Erg13</italic></td>
<td align="left" valign="top">XM_001552372.2</td>
<td align="left" valign="top">Forward</td>
<td align="left" valign="top">ACCATTGGACGTCTTGAGGT</td>
<td align="center" valign="top">166</td>
</tr>
<tr>
<td/>
<td/>
<td align="left" valign="top">Reverse</td>
<td align="left" valign="top">CCCAGTTGACAGCGTTGAAA</td>
<td/>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="sec15">
<label>2.11</label>
<title>Postharvest treatment and inoculation</title>
<p>Cherry tomato were wounded with a sterile borer (2&#x202F;mm diameter and 2&#x202F;mm depth) in each fruit&#x2019;s equator and then inoculated with 5&#x202F;&#x03BC;L of <italic>B. cinerea</italic> spore suspension (2&#x202F;&#x00D7;&#x202F;10<sup>4</sup> spores/mL). About 30&#x202F;min later, each wound received 5&#x202F;&#x03BC;L of paeonol solution at 0, 250, 500, 1,000, and 2000&#x202F;mg/L. Treated fruit were then stored at room temperature and 90% relative humidity. Disease incidence was determined at 72&#x202F;h after treatment. Each treatment was triplicated with 20 fruits per replicate.</p>
</sec>
<sec id="sec16">
<label>2.12</label>
<title>Measurement of fruit physical and chemical properties</title>
<p>Cherry tomato were immersed in 0 or 2000&#x202F;mg/L paeonol for 20&#x202F;min, then stored under 25&#x00B0;C/90% humidity for 15&#x202F;days. Twenty fruits were sampled at 0, 3, 6, 9, 12, and 15&#x202F;days to assess physiological and quality indices.</p>
<p>Weight loss was measured based on previously described protocols (<xref ref-type="bibr" rid="ref18">Lin et al., 2021</xref>). Cherry tomato were weighed at 0, 3, 6, 9, 12, and 15&#x202F;days. The weight loss percentage was calculated as the difference between the initial weight and the weight recorded on the harvest day.</p>
<p>Total soluble solids (TSS), titratable acidity (TA), and ascorbic acid content were determined according to the method of <xref ref-type="bibr" rid="ref18">Lin et al. (2021)</xref>. The TSS result was reported as a percentage. TA was expressed as the percentage of citric acid. The ascorbic acid content was expressed as mg/Kg. All analyses were performed with three replicates.</p>
</sec>
<sec id="sec17">
<label>2.13</label>
<title>Statistical analysis</title>
<p>Data were analyzed via ANOVA and Duncan&#x2019;s multiple range with SPSS 19.0. <italic>p</italic>&#x202F;&#x003C;&#x202F;0.05 indicated statistical significance.</p>
</sec>
</sec>
<sec sec-type="results" id="sec18">
<label>3</label>
<title>Results</title>
<sec id="sec19">
<label>3.1</label>
<title>Effect of paeonol on <italic>B. cinerea</italic> growth</title>
<p>The MIC of paeonol against <italic>B. cinerea</italic> was determined as a means of investigating the effect of paeonol on <italic>B. cinerea</italic> growth. When paeonol concentration was &#x003C;125&#x202F;mg/L, <italic>B. cinerea</italic> growth was almost unaffected. Furthermore, when paeonol concentration was &#x2265;250&#x202F;mg/L, <italic>B. cinerea</italic> growth was completely inhibited (<xref ref-type="fig" rid="fig1">Figure 1A</xref>). Thus, the MIC of paeonol against <italic>B. cinerea</italic> was 250&#x202F;mg/L.</p>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p>Effect of paeonol on the growth of <italic>Botrytis cinerea in vitro</italic>. <bold>(A)</bold> MIC of paeonol against <italic>B. cinerea</italic>. <bold>(B)</bold> Paeonol inhibited mycelial growth and spore germination of <italic>B. cinerea</italic>. Data were represented by means &#x00B1; standard deviations. Experiments were carried out with three replicates.</p>
</caption>
<graphic xlink:href="fmicb-15-1509124-g001.tif"/>
</fig>
<p>As demonstrated in <xref ref-type="fig" rid="fig1">Figure 1B</xref>, paeonol suppresses the mycelial expansion of <italic>B. cinerea</italic> in dose-responsive manners. The value of EC<sub>50</sub> (concentration to inhibit 50% of the mycelial growth) was 120&#x202F;mg/L. Mycelial growth exhibits complete suppression when paeonol concentration is elevated to 500&#x202F;mg/L. Concurrently, spore germination is suppressed demonstrating analogous patterns in the presence of paeonol. These findings validate that paeonol can also effectively inhibit mycelial growth and spore germination of <italic>B. cinerea in vitro</italic>.</p>
</sec>
<sec id="sec20">
<label>3.2</label>
<title>Effect of paeonol on the morphology and structure of <italic>B. cinerea</italic></title>
<p>The SEM images showed the impact of paeonol on the morphology and structure of <italic>B. cinerea</italic> (<xref ref-type="fig" rid="fig2">Figure 2</xref>). Control group mycelia were smooth, regular, and plump, but 125&#x202F;mg/L paeonol induced slight irregularities and collapse, while 250&#x202F;mg/L paeonol led to severe irregularities and collapse.</p>
<fig position="float" id="fig2">
<label>Figure 2</label>
<caption>
<p>SEM images of <italic>B. cinerea</italic> mycelia exposed to varied concentrations of paeonol for 12&#x202F;h. <bold>(A)</bold> Control; <bold>(B)</bold> 125&#x202F;mg/L paeonol; and <bold>(C)</bold> 250&#x202F;mg/L paeonol.</p>
</caption>
<graphic xlink:href="fmicb-15-1509124-g002.tif"/>
</fig>
</sec>
<sec id="sec21">
<label>3.3</label>
<title>Modes of action</title>
<sec id="sec22">
<label>3.3.1</label>
<title>Sorbitol assay</title>
<p>As shown in <xref ref-type="table" rid="tab2">Table 2</xref>, the MIC values of paeonol in both sorbitol and sorbitol-free media were identical, suggesting that the cell wall may not be the target of paeonol.</p>
<table-wrap position="float" id="tab2">
<label>Table 2</label>
<caption>
<p>Minimal inhibitory concentration (MIC) (mg/L) of antifungal agents in the absence and presence of sorbitol (0.8&#x202F;mol/L) and ergosterol (400&#x202F;mg/L) against <italic>B. cinerea</italic>.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top" rowspan="2">Antifungal agents</th>
<th align="center" valign="top" colspan="2">Sorbitol</th>
<th align="center" valign="top" colspan="2">Ergosterol</th>
</tr>
<tr>
<th align="center" valign="top">Absence</th>
<th align="center" valign="top">Presence</th>
<th align="center" valign="top">Absence</th>
<th align="center" valign="top">Presence</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Paeonol</td>
<td align="center" valign="top">250</td>
<td align="center" valign="top">250</td>
<td align="center" valign="top">250</td>
<td align="center" valign="top">500</td>
</tr>
<tr>
<td align="left" valign="top">Amphotericin B&#x002A;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">8</td>
<td align="center" valign="top">128</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn1">
<label>&#x002A;</label>
<p>Positive control. &#x2013;, not tested.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="sec23">
<label>3.3.2</label>
<title>Ergosterol assay</title>
<p>The inhibitory effect of paeonol against <italic>B. cinerea</italic> was profoundly influenced by extracellular ergosterol, whereby the MIC of paeonol in the presence of ergosterol was elevated 2-fold in comparison to the absence of exogenous ergosterol (<xref ref-type="table" rid="tab2">Table 2</xref>). Amphotericin B interacts with ergosterol, showing a 16-fold increase in its MIC. This result suggested that ergosterol may be the target of paeonol.</p>
</sec>
</sec>
<sec id="sec24">
<label>3.4</label>
<title>Effect of paeonol on membrane integrity</title>
<p>Propidium iodide (PI) was used to measure cell membrane integrity as it can only enter cells that have damaged plasma membranes and are dying or already dead. The results of staining <italic>B. cinerea</italic> cells with PI are shown in <xref ref-type="fig" rid="fig3">Figure 3A</xref>. Paeonol treatment at different concentrations causes varying degrees of damage to <italic>B. cinerea</italic>, escalating with increasing paeonol concentration. In comparison with the control, cell damage increased from 28.9 to 51.3% when <italic>B. cinerea</italic> cells were exposed to 125 and 250&#x202F;mg/L paeonol, respectively.</p>
<fig position="float" id="fig3">
<label>Figure 3</label>
<caption>
<p>The impact of paeonol on the plasma membrane integrity of <italic>B. cinerea</italic>. <bold>(A)</bold> The PI-stained cell population of <italic>B. cinerea</italic> following exposure to 0, 125, and 250&#x202F;mg/L paeonol for 6&#x202F;h. M1, events of dead cells; 10,000 cells were calculated. <bold>(B)</bold> The effect of paeonol (125, 250, and 500&#x202F;mg/L) on the leakage of calcein from large unilamellar vesicles. Triton X-100 solution was the positive control. The effect of paeonol (125 or 250&#x202F;mg/L) on the leakage of nucleic acids <bold>(C)</bold>, proteins <bold>(D)</bold>, K<sup>+</sup> <bold>(E)</bold>, and Ca<sup>2+</sup> <bold>(F)</bold> over 8&#x202F;h. Experiments were repeated thrice. &#x201C;&#x002A;&#x201D; represents a significant difference (<italic>p</italic>&#x202F;&#x003C;&#x202F;0.05) compare to control.</p>
</caption>
<graphic xlink:href="fmicb-15-1509124-g003.tif"/>
</fig>
<p>In order to confirm the ability of paeonol to disrupt fungal plasma membranes, the percentage of calcein leakage from LUVs was determined (<xref ref-type="fig" rid="fig3">Figure 3B</xref>). LUVs-embedded calcein was promptly liberated in a paeonol concentration-dependent manner. A concentration of 500&#x202F;mg/L paeonol could instigate a leakage rate of 93.5%.</p>
<p>To further confirm the integrity of the cell membrane was disrupted, leakage of cytoplasm, including nucleic acids, proteins, potassium ions, and calcium ions, was measured. As shown in <xref ref-type="fig" rid="fig3">Figures 3C</xref>&#x2013;<xref ref-type="fig" rid="fig3">F</xref>, nucleic acids, protein, K<sup>+</sup> and Ca<sup>2+</sup> of the supernatant increased in a time- and dose-dependent manner when <italic>B. cinerea</italic> mycelial was exposed to paeonol.</p>
</sec>
<sec id="sec25">
<label>3.5</label>
<title>Effect of paeonol on ergosterol content and gene expression related to ergosterol synthesis</title>
<p>The effects of paeonol on ergosterol content in the plasma membrane of <italic>B. cinerea</italic> are illustrated in <xref ref-type="fig" rid="fig4">Figure 4A</xref>. The ergosterol content of <italic>B. cinerea</italic> was remarkably suppressed by varying concentrations of paeonol. Following incubation of <italic>B. cinerea</italic> in 0.5 MIC or 1 MIC paeonol, ergosterol content was reduced by 24.7 and 48.2%, respectively, compared to the control.</p>
<fig position="float" id="fig4">
<label>Figure 4</label>
<caption>
<p>Effect of paeonol on ergosterol content <bold>(A)</bold> and gene expression <bold>(B)</bold> of <italic>B. cinerea</italic>. &#x201C;&#x002A;&#x201D; indicates significant differences (<italic>p</italic>&#x202F;&#x003C;&#x202F;0.05) compared to control. Experiments were performed with three replicates.</p>
</caption>
<graphic xlink:href="fmicb-15-1509124-g004.tif"/>
</fig>
<p>Ergosterol biosynthesis is tightly regulated by Erg genes (<xref ref-type="bibr" rid="ref35">Song et al., 2022</xref>). To gain insight into paeonol&#x2019;s role in regulating ergosterol synthesis, expression levels of <italic>Erg1</italic>, Erg3, <italic>Erg10</italic>, and <italic>Erg13</italic> were analyzed (<xref ref-type="fig" rid="fig4">Figure 4B</xref>). Paeonol significantly suppressed the transcript levels of <italic>Erg1</italic>, <italic>Erg3</italic>, and <italic>Erg10</italic> genes.</p>
</sec>
<sec id="sec26">
<label>3.6</label>
<title>Effects of paeonol on the growth of <italic>B. cinerea</italic> in cherry tomato</title>
<p>Considering that paeonol showed effective antifungal effects against <italic>B. cinerea in vitro</italic>, cherry tomato fruit was treated with paeonol during the infection assay. The incidence of gray mold decreased slightly when paeonol concentration increased from 0 to 500&#x202F;mg/L at 72&#x202F;h after the inoculation of the pathogen (<xref ref-type="fig" rid="fig5">Figure 5</xref>), with no significant difference between them (<italic>p</italic>&#x202F;&#x003E;&#x202F;0.05). However, disease incidence decreased significantly when paeonol concentration was increased to 2,000&#x202F;mg/L (<italic>p</italic>&#x202F;&#x003C;&#x202F;0.05) as gray mold was completely inhibited.</p>
<fig position="float" id="fig5">
<label>Figure 5</label>
<caption>
<p>Effect of different concentrations of paeonol on the growth of <italic>B. cinerea</italic> in cherry tomato fruit. <bold>(A)</bold> Disease incidences; <bold>(B)</bold> representative photographs.</p>
</caption>
<graphic xlink:href="fmicb-15-1509124-g005.tif"/>
</fig>
</sec>
<sec id="sec27">
<label>3.7</label>
<title>Effects of paeonol on cherry tomato fruit quality</title>
<p><xref ref-type="fig" rid="fig6">Figure 6</xref> illustrates the effects of paeonol treatment on fruit weight loss, TSS, TA, and ascorbic acid in cherry tomato. <xref ref-type="fig" rid="fig6">Figure 6A</xref> showed that the weight loss of the control fruit and paeonol-treated fruit all increased with the extension of the storage period. The paeonol-treated fruit&#x2019;s weight loss was significantly lower than the control group (<italic>p</italic>&#x202F;&#x003C;&#x202F;0.05) from the ninth to the fifteenth day.</p>
<fig position="float" id="fig6">
<label>Figure 6</label>
<caption>
<p>Paeonol improves the quality of cherry tomato. Weight loss <bold>(A)</bold>, TSS <bold>(B)</bold>, TA <bold>(C)</bold>, and ascorbic acid <bold>(D)</bold> of cherry tomato during storage at 25&#x00B0;C and 90% humidity. The asterisk symbolizes significant distinctions (<italic>p</italic>&#x202F;&#x003C;&#x202F;0.05) in comparison to the control. Triple replications in all experiments.</p>
</caption>
<graphic xlink:href="fmicb-15-1509124-g006.tif"/>
</fig>
<p>TSS content of control fruit increased on the third day, then declined until the fifteenth day. TSS content of the paeonol-treated group increased until the sixth day, then decreased until the ninth day. A significant difference (<italic>p</italic>&#x202F;&#x003C;&#x202F;0.05) was observed between the paeonol treated-tomato and the control group from the sixth to the fifteenth day.</p>
<p>As displayed in <xref ref-type="fig" rid="fig6">Figure 6C</xref>, TA content decreased in control and paeonol treatments during the whole storage period, but no significant differences were discovered in the two treatments of cherry tomato.</p>
<p>The ascorbic acid content in the control group rapidly declined during the whole storage time, while the paeonol-treated group exhibited a minor decrease (<xref ref-type="fig" rid="fig6">Figure 6D</xref>). Further comparison found that the ascorbic acid content in paeonol-treated group was observably higher than those in the control group.</p>
</sec>
</sec>
<sec sec-type="discussion" id="sec28">
<label>4</label>
<title>Discussion</title>
<p>As previously reported, paeonol could effectively inhibit the growth of bacterial cells, such as <italic>Escherichia coli</italic>, <italic>Staphylococcus</italic> spp., <italic>Salmonella</italic> spp., <italic>Bacillus subtilis</italic>, <italic>Klebsiella pneumonia</italic>, <italic>Enterobacter cloacae</italic>, <italic>Listeria monocytogenes</italic>, and others (<xref ref-type="bibr" rid="ref34">Song, 2012</xref>; <xref ref-type="bibr" rid="ref49">Zeng et al., 2022</xref>; <xref ref-type="bibr" rid="ref30">Qian et al., 2021</xref>). However, reports of paeonol inhibiting fungal cell growth are limited to <italic>Candida albicans</italic> (<xref ref-type="bibr" rid="ref29">Qian et al., 2022</xref>) and <italic>Aspergillus flavus</italic> (<xref ref-type="bibr" rid="ref17">Li et al., 2022</xref>), and research on <italic>B. cinerea</italic> has not yet been reported. In the present study, we determined that paeonol inhibited mycelial growth and spore germination of <italic>B. cinerea</italic>, with a MIC value of 250&#x202F;mg/L for paeonol against <italic>B. cinerea</italic>. The effect of paeonol on <italic>B. cinerea</italic> was further illuminated by SEM, which shows distortion and collapse of the fungal mycelia treated with paeonol (<xref ref-type="fig" rid="fig2">Figure 2</xref>). These results indicated that paeonol showed a potent inhibitory effect on the growth of <italic>B. cinerea in vitro</italic>. We also found that paeonol alleviated the severity of gray mold, caused by <italic>B. cinerea</italic>, in cherry tomato fruit. Compared with the results of paeonol treatment <italic>in vitro</italic>, the complete inhibitory concentration of paeonol <italic>in vivo</italic> (2,000&#x202F;mg/L) was higher than that <italic>in vitro</italic> (250&#x202F;mg/L). It may be explained by the fact that environmental conditions at the wound site are more complex and conducive to the growth of <italic>B. cinerea</italic> when compared to the PDB medium. This phenomenon was observed in luteolin, <italic>&#x03B5;</italic>-polylysine, and hinokitiol studies by <xref ref-type="bibr" rid="ref21">Liu et al. (2021)</xref>, <xref ref-type="bibr" rid="ref10">Jiao et al. (2020)</xref>, and <xref ref-type="bibr" rid="ref40">Wang et al. (2020)</xref>, respectively. Paeonol&#x2019;s complete inhibitory concentration against gray mold in fruit was lower than vanillin (<xref ref-type="bibr" rid="ref47">Yang et al., 2021</xref>) or magnolol (<xref ref-type="bibr" rid="ref3">Cui et al., 2021</xref>), suggesting that the former may be more suitable for controlling gray mold in agriculture.</p>
<p>Most antifungal agents target the cell wall and membrane of fungi (<xref ref-type="bibr" rid="ref28">Pereira et al., 2015</xref>; <xref ref-type="bibr" rid="ref37">Teixeira et al., 2023</xref>). Therefore, the mechanism of paeonol action was tested to determine whether paeonol antifungal activity involved direct interaction with the cell wall structure of <italic>B. cinerea</italic> (via sorbitol testing) and/or with the membrane structure of <italic>B. cinerea</italic> (via ergosterol testing) (<xref ref-type="bibr" rid="ref1">Biernasiuk et al., 2021</xref>). Our results found that paeonol targets the cell membrane rather than the cell wall (<xref ref-type="table" rid="tab2">Table 2</xref>). At the same time, we clearly showed that paeonol would destroy the integrity of cell membranes of <italic>B. cinerea</italic>, as leakage of cellular contents, including nucleic acids, proteins, potassium ions, and calcium ions, was significantly observed (<xref ref-type="fig" rid="fig4">Figure 4</xref>). A similar result was also confirmed by <xref ref-type="bibr" rid="ref16">Li Q. et al. (2021)</xref>, who discovered that paeonol strongly destroyed the integrity of cell membranes, leading to the leakage of cellular components in <italic>A. flavus</italic>. Ergosterol, pivotal in preserving cell functionality and integrity, is the main sterol component of the fungal cell membrane (<xref ref-type="bibr" rid="ref5">Dupont et al., 2012</xref>). Previous studies have shown that plant-derived natural bioactive compounds, such as citral and perillaldehyde, can interfere with the ergosterol biosynthetic pathway or diminish ergosterol content (<xref ref-type="bibr" rid="ref4">Cui et al., 2024</xref>; <xref ref-type="bibr" rid="ref26">Meng et al., 2024</xref>). In our study, paeonol treatment reduced ergosterol content (<xref ref-type="fig" rid="fig4">Figure 4</xref>). Furthermore, RT-PCR results showed that ergosterol biosynthesis enzyme genes (<italic>Erg1</italic>, <italic>Erg3</italic>, and <italic>Erg10</italic>) were down-regulated in the presence of paeonol. The above results indicated that paeonol inhibited the expression of ergosterol biosynthesis enzyme gene, diminished ergosterol content, and disrupted cell membrane integrity of mycelia, leading to leakage of nucleic acids, proteins, potassium ions, and calcium ions.</p>
<p>In addition, several physicochemical parameters (e.g., water loss, TSS, TA, ascorbic acid content) were evaluated to establish the impact of paeonol on the quality of cherry tomato fruit, which is crucial to consumer satisfaction. In this research, paeonol exhibited no appreciable influence on the TA content of cherry tomato. Conversely, it can aid in maintaining the moisture, TSS, and ascorbic acid content. Water constitutes the major component of tomato fruit, maintaining cell turgor during growth and postharvest storage, along with fruit texture and appearance (<xref ref-type="bibr" rid="ref12">Lai et al., 2018</xref>). TSS content can affect the taste of tomato fruits, which is a quality attribute very appreciated by consumers (<xref ref-type="bibr" rid="ref48">Zahid et al., 2024</xref>). Ascorbic acid, a vital plant metabolite, functions as a cell-signaling modulator, antiradical agent, and enzyme cofactor in various critical physiological processes, including cell wall biosynthesis, secondary metabolites and phytohormones, stress resistance, photoprotection, cell division, and growth (<xref ref-type="bibr" rid="ref43">Wolucka et al., 2005</xref>). The aforementioned findings indicated that the paeonol treatment could delay water loss in cherry tomato fruit, maintain higher contents of TSS and ascorbic acid, and culminate in retaining higher quality in the pulp of harvested.</p>
</sec>
<sec sec-type="conclusions" id="sec29">
<label>5</label>
<title>Conclusion</title>
<p>In conclusion, paeonol could effectively inhibit the growth of <italic>B. cinerea in vitro</italic>. The possible mechanism was that paeonol targets the cell membrane, which downregulated ergosterol synthase genes, inhibited ergosterol synthesis, damaged cell membrane integrity, and led to cell death. Meanwhile, paeonol could control the gray mold caused by <italic>B. cinerea</italic> in cherry tomato fruit and prolong the shelf life of cherry tomato fruit. Overall, this potent action of paeonol on the management of gray mold and extension of the shelf life of postharvest fruit positions it as a promising candidate for advancement as a substitute for synthetic fungicides.</p>
</sec>
</body>
<back>
<sec sec-type="data-availability" id="sec30">
<title>Data availability statement</title>
<p>The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding authors.</p>
</sec>
<sec sec-type="author-contributions" id="sec31">
<title>Author contributions</title>
<p>YJ: Writing &#x2013; original draft. YZ: Writing &#x2013; original draft. SW: Writing &#x2013; review &#x0026; editing. LZ: Writing &#x2013; review &#x0026; editing. HJ: Writing &#x2013; review &#x0026; editing. YL: Writing &#x2013; review &#x0026; editing. FL: Writing &#x2013; original draft, Writing &#x2013; review &#x0026; editing.</p>
</sec>
<sec sec-type="funding-information" id="sec32">
<title>Funding</title>
<p>The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Natural Science Foundation of the Jiangsu Higher Education Institutions (23KJB550010), Science and Technology Innovation Project of Xuzhou City (KC23250), and the Scientific Research Foundation for Excellent Talents of Xuzhou Medical University (D2020022).</p>
</sec>
<sec sec-type="COI-statement" id="sec33">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="generative-ai-confirmation" id="sec333">
<title>Generative AI statement</title>
<p>The authors declare that no Generative AI was used in the creation of this manuscript.</p>
</sec>
<sec sec-type="disclaimer" id="sec34">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<ref-list>
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