Bcl-2 contains an unusually long loop between the first and the second helices. This loop has been shown to be highly flexible based on NMR and X-ray crystallographic analyses of this region. Bcl-2 is regulated at the posttranslational level through phosphorylation of specific residues within the flexible loop. The biological role and posttranslational modifications of the loop of Bcl-2 is currently unclear. FK-506 binding protein 38 (FKBP38) has been reported to interact with Bcl-2, suggesting that FKBP38 could act as a docking molecule to localize Bcl-2 at the mitochondrial membrane [Shirane, M. and Nakayama, K.I. (2003) Inherent calcineurin inhibitor FKBP38 targets Bcl-2 to mitochondria and inhibits apoptosis. Nat. Cell Biol. 5, 28-37]. Here, we investigated the molecular interaction between FKBP38 and Bcl-2, and demonstrated that Bcl-2 interacts with FKBP38 through the unstructured loop, and the interaction appears to regulate phosphorylation in the loop of Bcl-2.

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Background Continuous enteral nutrition (CEN) remains standard practice in intensive care units (ICUs) worldwide. Intermittent enteral nutrition (IEN) may be a suitable alternative method. This meta‐analysis aims to investigate the safety, tolerance, and effectiveness of IEN compared with that of CEN in critically ill adults in the ICU. Methods MEDLINE, CINAHL, Scopus, Embase, and Google Scholar were searched for studies published up until April 30, 2020, along with manual searches in bibliographies. Eligible studies were trials that compared CEN with IEN feeding in the ICU and reported on at least one of the relevant outcomes (nutrition intake, gastric residual volume [GRV], aspiration pneumonia, vomiting, diarrhea, abdominal distension, and glycemic variability). Secondary outcomes were ICU length of stay (LOS) and mortality. The Cochrane risk‐of‐bias tool for randomized trials was used to assess methodological quality. Results Ten studies with 664 participants were included in the meta‐analysis. Most studies had an overall “high” risk of bias. Incidence of vomiting was significantly higher in CEN than in IEN groups (risk ratio, 2.76; 95% CI, 1.23–6.23). There were no significant differences between CEN and IEN groups for nutrition intake, GRV, incidence of aspiration pneumonia, diarrhea, abdominal distension, ICU LOS, and mortality. Definition and reporting of outcome measures were not standardized across studies; hence, this heterogeneity limits the generalizability of results. Conclusion Overall, the safety, tolerance, and effectiveness of CEN and IEN were found to be comparable. Future studies should explore monitoring larger sample sizes to determine best feeding practices in the ICU.