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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Physiol.</journal-id>
<journal-title>Frontiers in Physiology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Physiol.</abbrev-journal-title>
<issn pub-type="epub">1664-042X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">1092032</article-id>
<article-id pub-id-type="doi">10.3389/fphys.2023.1092032</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Physiology</subject>
<subj-group>
<subject>Brief Research Report</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Effect of <italic>Mucuna pruriens</italic> on brain NMDA receptor and tau protein gene expression in cerebral ischemic rats</article-title>
<alt-title alt-title-type="left-running-head">Parvatikar et al.</alt-title>
<alt-title alt-title-type="right-running-head">
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fphys.2023.1092032">10.3389/fphys.2023.1092032</ext-link>
</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Parvatikar</surname>
<given-names>Prachi P.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2183154/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Patil</surname>
<given-names>S. M.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Patil</surname>
<given-names>Bheemshetty S.</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Reddy</surname>
<given-names>R. Chandramouli</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bagoji</surname>
<given-names>Ishwar</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kotennavar</surname>
<given-names>Manjunath S.</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Patil</surname>
<given-names>Sumangala</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Patil</surname>
<given-names>Aravind V.</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Das</surname>
<given-names>Kusal K.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Das</surname>
<given-names>Swastika N.</given-names>
</name>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Bagali</surname>
<given-names>Shrilaxmi</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2008569/overview"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>Laboratory of Vascular Physiology and Medicine</institution>, <institution>Department of Physiology</institution>, <institution>Shri B. M. Patil Medical College</institution>, <institution>Hospital &#x26; Research Centre</institution>, <institution>BLDE (Deemed to be University)</institution>, <addr-line>Vijayapura</addr-line>, <addr-line>Karnataka</addr-line>, <country>India</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of Anatomy</institution>, <institution>Shri B. M. Patil Medical College</institution>, <institution>Hospital &#x26; Research Center</institution>, <institution>BLDE (Deemed to be University)</institution>, <addr-line>Vijayapura</addr-line>, <addr-line>Karnataka</addr-line>, <country>India</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Department of Biochemistry</institution>, <institution>Shri B. M. Patil Medical College</institution>, <institution>Hospital &#x26; Research Center</institution>, <institution>BLDE (Deemed to be University)</institution>, <addr-line>Vijayapura</addr-line>, <addr-line>Karnataka</addr-line>, <country>India</country>
</aff>
<aff id="aff4">
<sup>4</sup>
<institution>Department of Surgery</institution>, <institution>Shri B. M. Patil Medical College</institution>, <institution>Hospital &#x26; Research Center</institution>, <institution>BLDE (Deemed to be University)</institution>, <addr-line>Vijayapura</addr-line>, <addr-line>Karnataka</addr-line>, <country>India</country>
</aff>
<aff id="aff5">
<sup>5</sup>
<institution>Department of Chemistry</institution>, <institution>BLDEA&#x2019;s V P Dr PG Halakatti College of Engineering and Technology</institution>, <addr-line>Vijayapura</addr-line>, <addr-line>Karnataka</addr-line>, <country>India</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1012726/overview">Dewan S. Majid</ext-link>, Tulane University, United States</p>
</fn>
<fn fn-type="edited-by">
<p>
<bold>Reviewed by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1764860/overview">Badrinathan Sridharan</ext-link>, Pukyong National University, Republic of Korea</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1206417/overview">Prasunpriya Nayak</ext-link>, All India Institute of Medical Sciences Jodhpur, India</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Shrilaxmi Bagali, <email>shrilaxmi.bagali@bldedu.ac.in</email>
</corresp>
<fn fn-type="other">
<p>This article was submitted to Vascular Physiology, a section of the journal Frontiers in Physiology</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>16</day>
<month>02</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="collection">
<year>2023</year>
</pub-date>
<volume>14</volume>
<elocation-id>1092032</elocation-id>
<history>
<date date-type="received">
<day>07</day>
<month>11</month>
<year>2022</year>
</date>
<date date-type="accepted">
<day>06</day>
<month>02</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2023 Parvatikar, Patil, Patil, Reddy, Bagoji, Kotennavar, Patil, Patil, Das, Das and Bagali.</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Parvatikar, Patil, Patil, Reddy, Bagoji, Kotennavar, Patil, Patil, Das, Das and Bagali</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>Present study aimed to assess effect of pre-treatment with <italic>Mucuna pruriens</italic> seed extract and its bioactive molecule(s) on NMDAR and Tau protein gene expression in cerebral ischemic rodent model. Methanol extract of <italic>M. pruriens</italic> seeds was characterized by HPLC, and &#x3b2;-sitosterol was isolated by flash chromatography. <italic>In vivo</italic> studies to observe the effect of pre-treatment (28 days) with methanol extract of <italic>M. pruriens</italic> seed and &#x3b2;-sitosterol on the unilateral cerebral ischemic rat model. Cerebral ischemia induced by left common carotid artery occlusion (LCCAO) for 75&#xa0;min (on day 29) followed by reperfusion for 12&#xa0;h. Rats (<italic>n</italic> &#x3d; 48) divided into four groups. GroupI (control,Untreated &#x2b; LCCAO)-No pre-treatment &#x2b; cerebral ischemia; GroupII(&#x3b2;-sitosterol &#x2b; Sham)-pre-treatment with &#x3b2;-sitosterol, 10&#xa0;mg/kg/day &#x2b; sham-operated; GroupIII(&#x3b2;-sitosterol &#x2b; LCCAO)-pre-treatment with &#x3b2;-sitosterol, 10&#xa0;mg/kg/day &#x2b; cerebral ischemia; GroupIV(methanol extract &#x2b; LCCAO)-pre-treatment with methanol extract of <italic>M. pruriens</italic> seeds, 50&#xa0;mg/kg/day &#x2b; cerebral ischemia. Neurological deficit score was assessed just before sacrifice. Experimental animals were sacrificed after 12&#xa0;h reperfusion. Brain histopathology was performed. Gene expression of NMDAR and Tau protein of left cerebral hemisphere (occluded side) was performed by RT-PCR. Results revealed that the neurological deficit score was lower in groups III and IV compared to group I. NMDAR and tau protein mRNA expression in left cerebral hemisphere were upregulated in Group I, downregulated in groups III and IV. Histopathology of left cerebral hemisphere (occluded side) in Group I showed features of ischemic brain damage. Groups III and IV, left cerebral hemisphere showed less ischemic damage compared GroupI. Right cerebral hemisphere showed no areas of ischemia-induced brain changes. Pre-treatment with &#x3b2;-sitosterol and methanol extract of <italic>M. pruriens</italic> seeds may reduce ischemic brain injury following unilateral common carotid artery occlusion in rats.</p>
</abstract>
<kwd-group>
<kwd>
<italic>Mucuna pruriens</italic>
</kwd>
<kwd>&#x3b2;-sitosterol</kwd>
<kwd>left common carotid artery occlusion</kwd>
<kwd>NMDA receptor</kwd>
<kwd>tau protein</kwd>
<kwd>brain histopathology</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec id="s1">
<title>1 Introduction</title>
<p>With its two subtypes, ischemic and hemorrhagic, stroke is among the leading causes of morbidity and mortality. Ischemic cerebral injury accounts for 87% of all stroke cases (<xref ref-type="bibr" rid="B30">Silva et al., 2017</xref>; <xref ref-type="bibr" rid="B35">Wu and Tymianski, 2018</xref>). To date, the recanalization of the occluded vessels with tissue plasminogen activator is the widely used therapeutic option. However, the narrow therapeutic time window (within 4.5&#xa0;h post-stroke) and the severe tissue damage following reperfusion are significant limitations to this treatment modality (<xref ref-type="bibr" rid="B21">Martin and Wang, 2010</xref>).</p>
<p>The role of NMDA (N-methyl-d-aspartate) receptors and Tau protein in &#x2018;excitotoxicity&#x2019;, a mechanism central to neuronal death post cerebral ischemia, have been delineated (<xref ref-type="bibr" rid="B21">Martin and Wang, 2010</xref>). Consequently, targeting NMDA receptors and Tau protein could be potentially effective in managing ischemic stroke that can be further explored.</p>
<p>Medicinal plants have long been relied upon in managing several diseases, including cerebrovascular diseases. They have an important place in traditional medicine, including Ayurveda, an Indian system of medicine. The health benefits and therapeutic effects of plants are due to the properties of secondary plant metabolites (phytochemicals) they contain. Phytochemicals have been demonstrated to affect several pathophysiological processes underlying stroke like oxidative stress, inflammation and apoptotic cell death. Hence, phytochemicals are a better, safer, and cost-effective alternative to synthetic drugs (<xref ref-type="bibr" rid="B15">Kim et al., 2016</xref>; <xref ref-type="bibr" rid="B11">Hussein et al., 2018</xref>; <xref ref-type="bibr" rid="B31">Surguchov et al., 2021</xref>). <italic>Mucuna pruriens</italic> is one such medicinal plant that is widely used in Ayurveda (<xref ref-type="bibr" rid="B23">Pathania et al., 2020</xref>).</p>
<p>
<italic>Mucuna pruriens</italic> (<italic>M. pruriens</italic>), routinely known as Mucuna or velvet bean, is a popular medicinal plant belonging to the legume family and common in tropical and subtropical areas worldwide. In India, it is widely found in the eastern part of the country (<xref ref-type="bibr" rid="B13">Kamkaen et al., 2022</xref>). Several studies have reported the anti-Parkinson, antidiabetic, antioxidant, antibacterial, antiepileptic, antineoplastic, male fertility, and aphrodisiac effects of <italic>M. pruriens</italic> (<xref ref-type="bibr" rid="B26">Rane et al., 2019</xref>; <xref ref-type="bibr" rid="B32">Theansungnoen et al., 2022</xref>)<italic>.</italic> Phytochemical analysis of <italic>M. pruriens</italic> seed extract has demonstrated a significant content of L-dopa accounting for its anti-parkinsonism properties. It has been widely used in Ayurveda as a medicinal plant since Vedic times and is used to treat various nervous disorders, probably due to its neuroprotective properties (<xref ref-type="bibr" rid="B26">Rane et al., 2019</xref>; <xref ref-type="bibr" rid="B13">Kamkaen et al., 2022</xref>). Hence, the primary objective of the present work was to study the possible neuroprotective effect of pretreatment with <italic>M. pruriens</italic> seed extract and its isolated bioactive molecule(s) in the cerebral ischemic rat model and its impact on NMDA receptor and Tau protein gene expression.</p>
</sec>
<sec sec-type="materials|methods" id="s2">
<title>2 Materials and methods</title>
<sec id="s2-1">
<title>2.1 <italic>In vitro</italic> studies</title>
<p>
<italic>In vitro</italic> studies involved phytochemical extraction of <italic>M. pruriens</italic> seeds and determining the total alkaloids, flavonoids, phenols, in the seed extract. The antioxidant property of the seed extract was assayed. Further, the study involved HPLC and flash chromatography to estimate and isolate bioactive molecule(s) from <italic>M. pruriens</italic> seed extract.</p>
<sec id="s2-1-1">
<title>2.1.1 Phytochemical extraction</title>
<p>The seeds of <italic>M. pruriens</italic> were collected from Karnataka, India. The seed powder was subjected to extraction using methanol, ethanol, petroleum ether, chloroform, and water solvents (<xref ref-type="bibr" rid="B27">Senguttuvan et al., 2014</xref>; <xref ref-type="bibr" rid="B12">Kalebar et al., 2020</xref>). The qualitative analysis of the solvent extracts revealed that the methanol extract of <italic>M. pruriens</italic> seeds possessed a superior phytochemical profile additionally supported by the <italic>in vitro</italic> antioxidant assays (<xref ref-type="bibr" rid="B20">Lampariello et al., 2012</xref>; <xref ref-type="bibr" rid="B26">Rane et al., 2019</xref>). Hence, in the present study methanol extract of <italic>M. pruriens</italic> seeds was used. Methanol extract of <italic>M. pruriens</italic> seed will be denoted as <italic>M. pruriens</italic> seed extract, henceforth.</p>
<p>Methanol extract of <italic>M. pruriens</italic> seeds was subjected to determination of total alkaloids, flavonoids, phenols as per standard protocol (<xref ref-type="bibr" rid="B27">Senguttuvan et al., 2014</xref>; <xref ref-type="bibr" rid="B12">Kalebar et al., 2020</xref>). The antioxidant efficiency of <italic>M. pruriens</italic> seed extract was determined by hydrogen peroxide scavenging assay and 1,1-Diphenyl-2-Picrylhydrazyl (DPPH) radical scavenging assay as per standard protocol (<xref ref-type="bibr" rid="B4">Brand-Williams et al., 1995</xref>; <xref ref-type="bibr" rid="B29">Siddhuraju and Becker, 2003</xref>; <xref ref-type="bibr" rid="B14">Keser et al., 2012</xref>).</p>
</sec>
<sec id="s2-1-2">
<title>2.1.2 HPLC and flash chromatography analysis</title>
<p>By using HPLC, the bioactive molecules, namely, L-DOPA and &#x3b2;-sitosterol were identified from <italic>Mucuna prurines</italic> seed extract (<xref ref-type="bibr" rid="B18">Kshirsagar et al., 2016</xref>). Waters HPLC system (Waters/Millipore, Milsford, MA, United States) which included a model 515 pump, a model 2,487 dual wavelength absorbance detector was employed. A C18 column was used. The mobile phase was constituted by A (water) and B (acetonitrile). The gradient range varied linearly from 50% to 90% B in 4&#xa0;min with injection volume 2&#xa0;mL for the RRHT column. The flow rate was 1.0&#xa0;mL/min, the column temperature was maintained at 30&#xb0;C, and the detection wavelength was 280&#xa0;nm (<xref ref-type="bibr" rid="B24">Pawar et al., 2010</xref>). The extraction of bioactive molecule &#x3b2;-sitosterol from <italic>M. pruriens</italic> seed extract was done by Reversed-Phase Flash Chromatography. The isolation was carried out in Biotage Flash 75 system (Biotage, A Division of Dyax Corporation, Charlottsville, VA, United States) (<xref ref-type="bibr" rid="B9">Herrera et al., 2020</xref>).</p>
</sec>
</sec>
<sec id="s2-2">
<title>2.2 <italic>In vivo</italic> study</title>
<p>
<italic>In vivo</italic> study was undertaken to investigate for the possible neuroprotective effect of <italic>M. pruriens</italic> seed extract as well as its isolated bioactive molecule in rat model of cerebral ischemia and to understand the underlying molecular mechanism by analyzing the gene expression of brain NMDAR and Tau protein.</p>
<sec id="s2-2-1">
<title>2.2.1 Ethical approval</title>
<p>Ethical approval for the study was obtained from Institutional Animal Ethics Committee (IAEC) (No.08/BLDE (DU)/2021). The animal care guidelines set forth by the Committee for the Purpose and Control and Supervision of Experiments on Animals (CPCSEA), Ministry of Environment and Forests (Animal Welfare Division), Government of India were strictly adhered to throughout the study.</p>
</sec>
<sec id="s2-2-2">
<title>2.2.2 Experimental animals</title>
<p>The study involved 48 male Wistar rats, aged 8&#x2013;10&#xa0;weeks, weighing 180&#x2013;250&#xa0;gm. The experimental animals were maintained at 22&#xb0;C&#x2013;24&#xb0;C and a 12-h light/12-h dark cycle with food and water <italic>ad libitum</italic>. The animals were acclimatized to the laboratory conditions for 7&#xa0;days before initiating the experimental protocol.</p>
</sec>
<sec id="s2-2-3">
<title>2.2.3 Study design</title>
<p>The experimental animals (<italic>n</italic> &#x3d; 48) were allocated to one of the four groups. Group I (Untreated &#x2b; LCCAO) served as control. No pre-treatment. Cerebral ischemia induced (on day 29) by LCCAO for 75&#xa0;min followed by reperfusion for 12&#xa0;h. Group II (&#x3b2;-sitosterol &#x2b; Sham)&#x2014;Pre-treatment with &#x3b2;-sitosterol, 10&#xa0;mg/kg/day, (<xref ref-type="bibr" rid="B1">Ayaz et al., 2017</xref>), oral, 28&#xa0;days &#x2b; sham-operated (on day 29). Group III (&#x3b2;-sitosterol &#x2b; LCCAO) - pre-treatment with &#x3b2;-sitosterol, 10&#xa0;mg/kg/day, oral, 28&#xa0;days &#x2b; cerebral ischemia induced (on day 29) by LCCAO for 75&#xa0;min followed by reperfusion for 12&#xa0;h. Group IV (methanol extract &#x2b; LCCAO) - pre-treatment with methanol extract of <italic>Mucuna pruriens</italic> seeds, 50&#xa0;mg/kg/day (<xref ref-type="bibr" rid="B22">Nayak et al., 2017</xref>), oral, 28 days &#x2b; cerebral ischemia induced by LCCAO for 75&#xa0;min followed by reperfusion for 12&#xa0;h (on day 29).</p>
<p>The bodyweight of rats was measured using digital weighing machine (Practum 1102-10IN, Germany). The experimental animals in each group were matched for the body weight at the study onset. Daily food consumption of each rat was monitored during the intervention period.</p>
</sec>
<sec id="s2-2-4">
<title>2.2.4 Cerebral ischemia</title>
<p>Cerebral ischemia was induced by left common carotid artery occlusion (LCCAO) for 75&#xa0;min followed by 12&#xa0;h reperfusion (<xref ref-type="bibr" rid="B6">Das et al., 2018</xref>). The surgical procedure for inducing cerebral ischemia was performed in the morning hours in overnight fasted rats. The animals were subjected to the procedure after the intervention period of 28&#xa0;days (i.e., on day 29). Strict aseptic precautions were taken during the surgical procedure. The experimental animals were anesthetized with ketamine (60&#xa0;mg/kg body weight, i. p.) and xylazine (6&#xa0;mg/kg body weight). An oblique incision was taken alongside sternocleidomastoid in the neck from the base of the mandible to sternum. At the level of greater of cornu of thyroid cartilage, deep fascia and carotid sheath were incised. The common carotid artery was exposed and separated from the fascia, while protecting the vagus and jugular vein from any damage. A nylon thread (0.5&#xa0;mm) was passed from behind the artery and ligated. The occlusion was maintained for 75&#xa0;min following which the ligature was released and allowed for 12&#xa0;h reperfusion. The deep fascia and carotid sheath were closed with proline. Superficial fascia and skin were closed with all aseptic precautions. Sham operation (group II) involved the same surgical steps except for left common carotid artery occlusion. The experimental animals were closely monitored for physiological parameters like heart rate, blood pressure and respiratory rate. Non-Invasive Blood Pressure was recorded with a tail cuff sensor (Biopac NIBP200A model). For heart rate, ECG was recorded using needle subcutaneous electrodes (Biopac Student Lab 4.1). For respiratory rate, pneumogram was recorded using respiratory pad transducer (Biopac Student Lab 4.1). Body temperature was maintained at 36&#xb0;C&#x2013;37.5&#xb0;C using a warm pad. The surgery was uneventful and all the rats recovered following surgery.</p>
</sec>
<sec id="s2-2-5">
<title>2.2.5 Neurological deficit score</title>
<p>Post-ischemic neurological deficit was assessed after 12&#xa0;h of reperfusion and before sacrifice using a six point scale neurological score: 0 &#x3d; no neurological deficit; 1 &#x3d; failure to extend contralateral forelimb fully on lifting the animal by tail; 2 &#x3d; circling to the contralateral side; 3 &#x3d; falling to the contralateral side; 4 &#x3d; no spontaneous walk or in a comatose state; 5 &#x3d; death (<xref ref-type="bibr" rid="B16">Komatsu et al., 2021</xref>).</p>
</sec>
<sec id="s2-2-6">
<title>2.2.6 Analysis of brain NMDA receptor and tau protein gene expression</title>
<p>The experimental animals were sacrificed (<italic>n</italic> &#x3d; 6/group) after 12&#xa0;h reperfusion. The brain was carefully dissected. For gene expression analysis, the left cerebral hemisphere (occluded side) was used. Tissue was immediately stored in RNAlater at &#x2212;80&#xb0;C for RT-PCR analysis.</p>
<p>NMDA receptor, tau protein and &#x3b2;-actin (endogenous control) mRNA expressions were assessed by using quantitative reverse transcription-PCR (RTPCR). RNeasy kit was used to extract RNA from left cerebral hemisphere homogenates as per the manufacturer&#x2019;s protocol. Reverse transcription of RNA was done using SuperScript II Reverse Transcriptase as per the prescribed protocol. cDNA was amplified with quantitative reverse transcription-PCR (<xref ref-type="bibr" rid="B17">Kong et al., 2021</xref>). The gene expression of NMDAR and Tau protein are presented as fold change calculated by using the formula 2&#x5e;-&#x394;&#x394;Cq (<xref ref-type="bibr" rid="B10">Herur et al., 2022</xref>). PCR primers specific to each gene are as depicted in <xref ref-type="table" rid="T1">Table 1</xref>. The PCR conditions are provided as <xref ref-type="sec" rid="s13">Supplementary Table S1</xref>.</p>
<table-wrap id="T1" position="float">
<label>TABLE 1</label>
<caption>
<p>Primer pairs used for quantitative RT-PCR analysis.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left"/>
<th align="center">Direction</th>
<th align="center">Primer</th>
<th align="center">Amplicon size (bp)</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td rowspan="2" align="left">NMDA receptor</td>
<td align="left">Forward</td>
<td align="left">TGC&#x200b;ATC&#x200b;TAT&#x200b;GAT&#x200b;CAT&#x200b;GGC&#x200b;TGA&#x200b;C</td>
<td rowspan="2" align="char" char=".">206</td>
</tr>
<tr>
<td align="left">Reverse</td>
<td align="left">ATA&#x200b;AAG&#x200b;CTG&#x200b;ATG&#x200b;AAG&#x200b;TCT&#x200b;CGG&#x200b;TAG-</td>
</tr>
<tr>
<td rowspan="2" align="left">Tau Protein</td>
<td align="left">Forward</td>
<td align="left">CGG&#x200b;CGT&#x200b;AAG&#x200b;CAA&#x200b;AGA&#x200b;CA-3&#x2032;</td>
<td rowspan="2" align="char" char=".">65</td>
</tr>
<tr>
<td align="left">Reverse</td>
<td align="left">TGTAGCCGCTTCGTTCT</td>
</tr>
<tr>
<td rowspan="2" align="left">&#x3b2;-actin (House keeping)</td>
<td align="left">Forward</td>
<td align="left">TAC&#x200b;AAC&#x200b;CTC&#x200b;CTT&#x200b;GCA&#x200b;GCT&#x200b;CC</td>
<td rowspan="2" align="char" char=".">120</td>
</tr>
<tr>
<td align="left">Reverse</td>
<td align="left">TAC&#x200b;AAC&#x200b;CTC&#x200b;CTT&#x200b;GCA&#x200b;GCT&#x200b;CC</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="s2-2-7">
<title>2.2.7 Histopathological examination</title>
<p>The animals (<italic>n</italic> &#x3d; 6/group) were sacrificed after 12&#xa0;h reperfusion. Brain was carefully dissected and initially fixed in bouin&#x2019;s fluid and shifted to 10% neutral buffered formalin 24&#xa0;h later. For histopathological examination, 2&#x2013;3&#xa0;mm thick slices of cerebral hemispheres were made. Bilateral blocks of the brain were embedded in paraffin wax and 2.0 to 3.0 &#x3bc; sections were cut on a rotary microtome and stained with hematoxylin and eosin (H and E). Blocks included sections from the body of the corpus callosum with coronal section of white matter, splenium of the corpus callosum, posterior limb of the internal capsule with adjacent thalamus, and rostral pons. The stained sections were examined under light microscope (Olympus CH20i) with Samsung Digital Color Camera (Model No. SDC-242, N. J 07094, United States).</p>
</sec>
</sec>
</sec>
<sec id="s3">
<title>3 Statistical analysis</title>
<p>SPSS software (version 20.0) was used for statistical analysis. Data are presented as Mean &#xb1; SD. To analyze statistical significant difference across multiple groups, one way ANOVA was used followed by Tukey&#x2019;s <italic>post hoc</italic> test to ascertain significant intergroup differences. <italic>p</italic> &#x3c; 0.05 was considered statistically significant.</p>
</sec>
<sec sec-type="results" id="s4">
<title>4 Results</title>
<sec id="s4-1">
<title>4.1 <italic>In vitro</italic> studies</title>
<p>In the present study the pharmacognostical and phytochemical profile of <italic>M. pruriens</italic> was screened by sequential phytochemical extraction from its seed powder using different solvents <italic>viz.</italic>, methanol, ethanol, petroleum ether, chloroform, and water. The qualitative analysis of the phytochemical constituents of <italic>M. pruriens</italic> seed extract with different solvents is provided as <xref ref-type="sec" rid="s13">Supplementary Table S2</xref>. The phytochemical constituents in <italic>M. pruriens</italic> seed extract is provided as <xref ref-type="sec" rid="s13">Supplementary Tables S3, S4</xref>. The antioxidant activity was evaluated by H<sub>2</sub>O<sub>2</sub> scavenging assay and DPPH radical scavenging assay. The results of DPPH radical scavenging assay and H<sub>2</sub>O<sub>2</sub> scavenging assay are provided as <xref ref-type="sec" rid="s13">Supplementary Tables S5, S6</xref>. The DPPH and hydrogen peroxide scavenging activity of methanol extract of <italic>M. pruriens</italic> seeds was concentration dependent with greater scavenging at higher concentration. Ascorbic acid was used as a control and the scavenging activity of ascorbic acid was similarly concentration dependent.</p>
<sec id="s4-1-1">
<title>4.1.1 HPLC and flash chromatography</title>
<p>HPLC chromatograms of standard solutions of L-DOPA and &#x3b2;-sitosterol and methanol extract of <italic>M. pruriens</italic> are presented in <xref ref-type="fig" rid="F1">Figure 1</xref>. The calibration curve showed good linearity with correlation coefficients (R<sup>2</sup>- 0.9975). Based on the data, the estimates of L-DOPA and &#x3b2;-sitosterol in the <italic>M. pruriens</italic> seed extract was 20mg/100&#xa0;gm and 12mg/100&#xa0;gm respectively.</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>HPLC chromatograms of <bold>(A)</bold> L-DOPA standard; <bold>(B)</bold> L-DOPA from methanol extract of <italic>M. pruriens</italic> seed; <bold>(C)</bold> &#x3b2;-sitosterol standard; <bold>(D)</bold> &#x3b2;-sitosterol from methanol extract of <italic>M. pruriens</italic> seed.</p>
</caption>
<graphic xlink:href="fphys-14-1092032-g001.tif"/>
</fig>
</sec>
</sec>
<sec id="s4-2">
<title>4.2 <italic>In vivo</italic> studies</title>
<sec id="s4-2-1">
<title>4.2.1 Physiological parameters</title>
<p>The comparison of physiological parameters before and after surgery as presented as <xref ref-type="sec" rid="s13">Supplementary Table S7</xref>. Heart rate, SBP, DBP and respiratory rate were similar between groups before surgery. After surgery there was an increase in heart rate, SBP, DBP and respiratory rate across all groups. Heart rate and SBP were higher in group I (control) compared to other groups.</p>
</sec>
<sec id="s4-2-2">
<title>4.2.2 Neurological deficit score</title>
<p>
<xref ref-type="table" rid="T2">Table 2</xref> presents comparison of neurological deficit scores among groups. Neurological deficit score was higher in group I (Control, Untreated &#x2b; LCCAO), group III (&#x3b2;-sitosterol &#x2b; LCCAO) and group IV (methanol extract &#x2b; LCCAO) compared to group II (&#x3b2;-sitosterol &#x2b; Sham). The scores were lower in group III (&#x3b2;-sitosterol &#x2b; LCCAO) and IV (methanol extract &#x2b; LCCAO) compared to group I (Control, Untreated &#x2b; LCCAO) although not statistically significant.</p>
<table-wrap id="T2" position="float">
<label>TABLE 2</label>
<caption>
<p>Neurological deficit score of experimental animals.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th rowspan="2" align="left"/>
<th rowspan="2" align="left">Group I (control, Untreated &#x2b; LCCAO)</th>
<th rowspan="2" align="left">Group II (&#x3b2;-sitosterol &#x2b; sham)</th>
<th rowspan="2" align="left">Group III (&#x3b2;-sitosterol &#x2b; LCCAO)</th>
<th rowspan="2" align="left">Group IV (methanol extract &#x2b; LCCAO)</th>
<th colspan="2" align="left">ANOVA</th>
</tr>
<tr>
<th align="left">F</th>
<th align="left">P</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Neurological deficit score</td>
<td align="char" char="plusmn">4.5 &#xb1; 1.64<sup>a</sup>
</td>
<td align="char" char="plusmn">0 &#xb1; 0<sup>b</sup>
</td>
<td align="char" char="plusmn">4.0 &#xb1; 1.54<sup>a</sup>
</td>
<td align="char" char="plusmn">4.0 &#xb1; 154<sup>a</sup>
</td>
<td align="char" char=".">14.06</td>
<td align="char" char=".">0.000&#x2a;</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Superscripts a, b, indicate significant difference between groups. &#x2a;<italic>p</italic> &#x2264; 0.05. <italic>n</italic> &#x3d; 6 per group.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="s4-2-3">
<title>4.2.3 NMDAR and tau protein gene expression in left cerebral hemisphere homogenate</title>
<p>
<xref ref-type="table" rid="T3">Table 3</xref> presents Real time PCR results for NMDAR and Tau protein mRNA expression in experimental animals. mRNA expression of NMDAR and Tau protein was higher in Group I (control,Untreated &#x2b; LCCAO) compared to group II (&#x3b2;-sitosterol &#x2b; sham). In the pretreated groups, group III (&#x3b2;-sitosterol &#x2b; LCCAO) and group IV (methanol extract &#x2b; LCCAO) mRNA expression of NMDAR and Tau protein was lower compared to group 1 (control, Untreated&#x2b;LCCAO).</p>
<table-wrap id="T3" position="float">
<label>TABLE 3</label>
<caption>
<p>Gene expression of NMDAR and Tau protein in left cerebral hemisphere homogenate.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left"/>
<th align="left">Group I (control, Untreated &#x2b; LCCAO)</th>
<th align="left">Group II (&#x3b2;-sitosterol &#x2b; sham)</th>
<th align="left">Group III (&#x3b2;-sitosterol &#x2b; LCCAO)</th>
<th align="left">Group IV (methanol extract &#x2b; LCCAO)</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">NMDA receptor</td>
<td align="char" char=".">1.5</td>
<td align="char" char=".">1.00</td>
<td align="char" char=".">1.28</td>
<td align="char" char=".">1.23</td>
</tr>
<tr>
<td align="left">Tau Protein</td>
<td align="char" char=".">1.4</td>
<td align="char" char=".">1.00</td>
<td align="char" char=".">1.31</td>
<td align="char" char=".">1.27</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>
<italic>n</italic> &#x3d; 6/group.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="s4-2-4">
<title>4.2.4 Histopathological examination of cerebral hemispheres</title>
<p>
<xref ref-type="fig" rid="F2">Figure 2</xref> presents the photomicrograph of cerebral cortices stained with H&#x26;E. In Group I (control, Untreated &#x2b; LCCAO), left cerebral hemisphere (occluded side) showed cerebral edema (gross alteration), altered microscopic architecture with scattered cellular layers of grey matter and white matter. Neuronal damage (red neurons) with eosinophilic cytoplasm and pyknotic nuclei with a hazy appearance were noticed. Localized cystic infarcts with features of diffuse cerebral infarction were seen (<xref ref-type="fig" rid="F2">Figure 2A - i, ii</xref>). There were no microscopic alterations in the left cerebral hemisphere of group II (&#x3b2;-sitosterol &#x2b; Sham) (<xref ref-type="fig" rid="F2">Figure 2B - i, ii</xref>). In Group III (&#x3b2;-sitosterol &#x2b; LCCAO) (<xref ref-type="fig" rid="F2">Figure 2C - i, ii</xref>) and IV (methanol extract &#x2b; LCCAO) (<xref ref-type="fig" rid="F2">Figure 2D - i, ii</xref>), left cerebral hemisphere (occluded side) showed less ischemic changes compared to group I (control, LCCAO). Right cerebral hemisphere of the brain (non-occluded side) showed no evidence of ischemic changes in all groups (<xref ref-type="fig" rid="F2">Figures 2A-D - iii, iv</xref>). However, mild increase in intracellular space was noticed with no evidence of changes in corticomedullary junction in group I (<xref ref-type="fig" rid="F2">Figure 2A - iii, iv</xref>).</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Photomicrograph depicting cerebral cortices stained with hematoxylin and eosin of Groups I, II, III, IV. <bold>(A)</bold>: Photomicrograph of cerebral cortices stained with hematoxylin and eosin of Group I (control, Untreated &#x2b; LCCAO) showing; i) Left (occluded) cerebral cortex (&#xd7;10), ii) Left (occluded) cerebral cortex (&#xd7;40), iii) Right (non-occluded) cerebral cortex (&#xd7;10), iv) Right (non-occluded) cerebral cortex (&#xd7;40). a - Pyknotic nuclei, b &#x2013; red neurons with purkinje fibre, c- mild lymphocytic infiltration, d - prominent stained nuclear component, e - multiple hazy nuclei with increased intercapsular space. <bold>(B)</bold>: Photomicrograph of cerebral cortices stained with hematoxylin and eosin of Group II (&#x3b2;-sitosterol &#x2b; Sham) showing: i) Left (occluded) cerebral cortex (&#xd7;10), ii) Left (occluded) cerebral cortex (&#xd7;40), iii) Right (non-occluded) cerebral cortex (&#xd7;10), iv) Right (non-occluded) cerebral cortex (&#xd7;40). <bold>(C)</bold>: Photomicrograph of cerebral cortices stained with hematoxylin and eosin of Group III (&#x3b2;-sitosterol &#x2b; LCCAO) showing; i) Left (occluded) cerebral cortex (&#xd7;10), ii) Left (occluded) cerebral cortex (&#xd7;40), iii) Right (non-occluded) cerebral cortex (&#xd7;10), iv) Right (non-occluded) cerebral cortex (&#xd7;40). <bold>(D)</bold>: Photomicrograph of cerebral cortices stained with hematoxylin and eosin of Group IV (methanol extract &#x2b; LCCAO) showing; i) Left (occluded) cerebral cortex (&#xd7;10), ii) Left (occluded) cerebral cortex (&#xd7;40), iii) Right (non-occluded) cerebral cortex (&#xd7;10), iv) Right (non-occluded) cerebral cortex (&#xd7;40).</p>
</caption>
<graphic xlink:href="fphys-14-1092032-g002.tif"/>
</fig>
</sec>
</sec>
</sec>
<sec sec-type="discussion" id="s5">
<title>5 Discussion</title>
<p>Brain tissue is highly vulnerable to ischemia. Even brief ischemia can trigger a complicated chain of events that could eventually lead to neuronal death (<xref ref-type="bibr" rid="B34">Woodruff et al., 2011</xref>). Excitotoxicity is one of the earliest discovered and widely recognized molecular mechanisms of post-ischemic neuronal damage and death. Glutamate and NMDAR (N-methyl-D-aspartate receptor) have an essential role in this mechanism (<xref ref-type="bibr" rid="B28">Shen et al., 2022</xref>). Additionally, the role of tau protein in excitotoxicity has been reported (<xref ref-type="bibr" rid="B5">Chen and Jiang, 2019</xref>).</p>
<p>Reduced cerebral blood flow during ischemia deranges the normal ionic homeostasis of neurons. The deranged ionic homeostasis depolarizes the neurons initiating a train of events, including the release of excitatory neurotransmitter glutamate into the synaptic cleft while impairing its re-uptake. Consequently, excess glutamate in the extracellular space causes the over-activation of NMDARs on the post-synaptic neurons (<xref ref-type="bibr" rid="B35">Wu and Tymianski, 2018</xref>). The excessively activated NMDARs allow uncontrolled Ca<sup>2&#x2b;</sup> influx causing calcium overload and triggering downstream pro-death signalling events that include activation of calpain, generation of reactive oxygen species (ROS), and mitochondrial damage, causing cell necrosis or apoptosis (<xref ref-type="bibr" rid="B21">Martin and Wang, 2010</xref>; <xref ref-type="bibr" rid="B35">Wu and Tymianski, 2018</xref>). Additionally, excitotoxicity causes tau hyperphosphorylation, significantly reducing its biological activity. There are reports of the critical role of tau in eliciting excitotoxicity. However, the molecular mechanisms underlying tau-induced excitotoxicity are yet to be elucidated (<xref ref-type="bibr" rid="B5">Chen and Jiang, 2019</xref>). Given the pivotal role of NMDARs and tau protein in mediating neuronal death in ischemic stroke, interventions directed at NMDAR and tau-mediated pathology could serve as a clinically beneficial approach in the prevention/management of ischemic stroke.</p>
<p>The present study aimed to evaluate the neuroprotective effect of pre-treatment with <italic>M. pruriens</italic> seed extract and its isolated bioactive molecule, &#x3b2;-sitosterol, in experimental animals subjected to cerebral ischemia by LCCAO. Additionally, the study explores the underlying molecular mechanisms of cerebral ischemia that include expression of NMDAR and Tau protein in experimental cerebral ischemia with or without pre-treatment with <italic>M. pruriens</italic> seed extract and its isolated bioactive molecule, &#x3b2;-sitosterol.</p>
<p>The current research involved <italic>in vitro</italic> and <italic>in vivo</italic> studies. <italic>In vitro</italic> studies aimed to screen the pharmacognostical and phytochemical profile of <italic>M. pruriens</italic>. For this, the shade-dried seeds of <italic>M. pruriens</italic> were subjected to sequential phytochemical extraction using different solvents, <italic>viz.</italic>, methanol, ethanol, petroleum ether, chloroform, and water. The qualitative phytochemical analysis showed the presence of alkaloids, flavonoids, terpenoids, steroids, tannins, saponins and glycosides. Of the different solvents used for phytochemical extraction the methanol extract of <italic>M. pruriens</italic> seeds had a better profile than others. Hence, the present study proceeded with the methanol extract of <italic>M. pruriens</italic> seeds. The antioxidant activity of <italic>M. pruriens</italic> seed extract was demonstrated <italic>in vitro</italic> by its ability to scavenge DPPH radicals and hydrogen peroxide. Further, <italic>M. pruriens</italic> seed extract was subjected to HPLC and flash chromatography to identify and isolate its bioactive molecules. L-DOPA and &#x3b2;-sitosterol were identified as the predominant ones. L-DOPA is a predominant constituent in <italic>M. pruriens</italic> seed and has been used in neurodegenerative diseases like Parkinson&#x2019;s disease (<xref ref-type="bibr" rid="B25">Rai et al., 2020</xref>). &#x3b2;-sitosterol was the next predominant bioactive molecule, estimated at approximately 12mg/100&#xa0;gm. The present study aimed to explore the role of &#x3b2;-sitosterol in cerebral ischemia-induced neuropathology. &#x3b2;-sitosterol, a bioactive phytosterol, is naturally present in plant cell membranes with a chemical structure similar to mammalian cell-derived cholesterol (<xref ref-type="bibr" rid="B2">Babu and Jayaraman, 2020</xref>). &#x3b2;-sitosterol possesses an array of biological functions including antioxidant, antimicrobial, angiogenic, immunomodulatory, antidiabetic, anti-inflammatory, anticancer, and antinociceptive activities (<xref ref-type="bibr" rid="B3">Bin Sayeed et al., 2016</xref>).</p>
<p>The results of <italic>in vivo</italic> study revealed that pretreatment with <italic>M. pruriens</italic> seed extract and its specific bioactive molecule, &#x3b2;-sitosterol improved neurological deficit score, decreased ischemic brain damage and reduced the gene expression of NMDAR and tau protein in cerebral ischemia induced by LCCAO in experimental animals. The neuroprotective effects of <italic>M. pruriens</italic> seed extract and its isolated bioactive molecule, &#x3b2;-sitosterol, can be attributed to the downregulation of NMDAR and tau protein gene expression and the downstream signalling pathways, particularly the reactive oxygen species generation. There is increasing evidence that phytochemicals regulate gene expression by modulating the transcriptional activity of genes <italic>via</italic> specific transcriptional factors or epigenetic mechanisms (<xref ref-type="bibr" rid="B31">Surguchov et al., 2021</xref>). A previous study by <xref ref-type="bibr" rid="B8">Fung et al. (2014)</xref> demonstrated a cardioprotective effect of pretreatment with <italic>M. pruriens</italic> seed extract against experimental Naja Sputatrix envenomation due to upregulation of genes related to energy production and metabolism, nervous system, inflammatory response, and apoptosis, among several others in the rat heart. Additionally, the neuroprotective effect of <italic>M. pruriens</italic> seed extract and &#x3b2;-sitosterol may be partly attributed to their potent antioxidant properties. Since the brain has high oxygen consumption, it is susceptible to the damaging effects of reactive oxygen species generated during ischemia-reperfusion (<xref ref-type="bibr" rid="B19">Lalkovi&#x10d;ov&#xe1; and Danielisov&#xe1;, 2016</xref>). Studies have reported that pre-treatment with synthetic antioxidants decreased the infarct size in animals subjected to ischemia/reperfusion injury (<xref ref-type="bibr" rid="B7">Duong et al., 2008</xref>).</p>
<p>Interestingly, the methanol extract of <italic>M. pruriens</italic> seeds was more effective than its isolated bioactive molecule, &#x3b2;-sitosterol. Medicinal plant extract may be superior to an equivalent dose of an isolated bioactive molecule. Plant extract contains hundreds or even thousands of different bioactive molecules in variable concentrations that may contribute to its medicinal value. The interaction between these multiple compounds may be synergistic, additive or antagonistic, which may be responsible for the overall activity of the medicinal plant extract (<xref ref-type="bibr" rid="B33">Vaou et al., 2022</xref>). L-DOPA was a predominant phytochemical in the seed extract of <italic>M. pruriens</italic>. L-DOPA might have contributed to better neuroprotection offered by <italic>M. pruriens</italic> seed extract compared to its isolated bioactive molecule &#x3b2;-sitosterol.</p>
<p>A significant neuroprotective activity of methanol extract of <italic>M. pruriens</italic> seeds and its isolated bioactive molecule, &#x3b2;-sitosterol suggest a potential for their use in the prevention/reducing the cerebral ischemia induced neuropathology.</p>
</sec>
<sec sec-type="conclusion" id="s6">
<title>6 Conclusion</title>
<p>Pre-treatment with methanol extract of <italic>M. pruriens</italic> and its bioactive molecule &#x3b2;-sitosterol confers a protection against cerebral ischemic injury by down regulating the gene expression of NMDAR and tau protein that mediate excitotoxicity.</p>
</sec>
</body>
<back>
<sec sec-type="data-availability" id="s7">
<title>Data availability statement</title>
<p>The raw data supporting the conclusion of this article will be made available by the authors, without undue reservation.</p>
</sec>
<sec id="s8">
<title>Ethics statement</title>
<p>The animal study was reviewed and approved by Institutional Animal Ethics Committee, Shri B M Patil Medical College, Hospital &#x26; Research Centre, BLDE (Deemed to be University), Vijayapura, Karnataka.</p>
</sec>
<sec id="s9">
<title>Author contributions</title>
<p>PP&#x2014;acquisition, analysis, or interpretation of data for the work, wrote sections of the manuscript SMP&#x2014;organized the database, BP&#x2014; acquisition, analysis, or interpretation of data, wrote sections of the manuscript, RR&#x2014;acquisition, analysis, or interpretation of data, performed the statistical analysis. IB&#x2014;acquisition, analysis, or interpretation of data MK&#x2014;organized the database, performed the statistical analysis SP&#x2014;organized the database, performed the statistical analysis AP&#x2014;contributed to the conception and design of the study and provided approval for the publication of the content KD&#x2014;contributed to the conception and design of the study, provided approval for publication of the content SD&#x2014;contributed to the conception and design of the study, provided approval for publication of the content SB&#x2014;acquisition, analysis, or interpretation of data for the work, wrote the first draft of the manuscript. All authors contributed to the manuscript revision and read and approved the submitted version.</p>
</sec>
<sec id="s10">
<title>Funding</title>
<p>This work was supported by BLDE (Deemed to be University), Vijayapura, Karnataka, India (No DUPO05-0063/21-22 dated 25 Aug 2021).</p>
</sec>
<sec sec-type="COI-statement" id="s11">
<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="disclaimer" id="s12">
<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>
<sec id="s13">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fphys.2023.1092032/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fphys.2023.1092032/full&#x23;supplementary-material</ext-link>
</p>
<supplementary-material xlink:href="Table1.DOCX" id="SM1" mimetype="application/DOCX" xmlns:xlink="http://www.w3.org/1999/xlink"/>
</sec>
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