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Fu Q, Gao Q, Jiao S, Da F, Guo J, Liu Y, Liu J. Adipose-derived stem cells ameliorate radiation-induced lung injury by activating the DDAH1/ADMA/eNOS signaling pathway. Regen Ther 2024; 27:398-407. [PMID: 38694446 PMCID: PMC11061648 DOI: 10.1016/j.reth.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/29/2024] [Accepted: 04/11/2024] [Indexed: 05/04/2024] Open
Abstract
Background Ionizing radiation-induced lung injury is caused by the initial inflammatory reaction and leads to advanced fibrosis of lung tissue. Adipose-derived stem cells (ASCs) are a type of mesenchymal stem cell that can differentiate into various functional cell types with broad application prospects in the treatment of tissue damage. The purpose of this study was to explore the protective effect of ASCs against radiation-induced lung injury and to provide a novel basis for prevention and treatment of radiation-induced lung injury. Materials and methods Fifty mice were randomly divided into a control group (Ctrl), radiation exposure group (IR), radiation exposure plus ASC treatment group (IR + ASC), radiation exposure plus L-257 group (IR + L-257), and radiation exposure plus ASC treatment and L-257 group (IR + ASC + L-257). Mice in IR, IR + ASC, and IR + ASC + L-257 groups were exposed to a single whole-body dose of 5 Gy X-rays (160 kV/25 mA, 1.25 Gy/min). Within 2 h after irradiation, mice in IR + ASC and IR + ASC + L-257 groups were injected with 5 × 106 ASCs via the tail vein. Mice in IR + L-257 and IR + ASC + L-257 groups were intraperitoneally injected with 30 mg/kg L-257 in 0.5 mL saline. Results The mice in the IR group exhibited lung hemorrhage, edema, pulmonary fibrosis, and inflammatory cell infiltration, increased release of proinflammatory cytokines, elevation of oxidative stress and apoptosis, and inhibition of the dimethylarginine dimethylamino hydratase 1 (DDAH1)/ADMA/eNOS signaling pathway. ASC treatment alleviated radiation-induced oxidative stress, apoptosis, and inflammation, and restored the DDAH1/ADMA/eNOS signaling pathway. However, L-257 pretreatment offset the protective effect of ASCs against lung inflammation, oxidative stress, and apoptosis. Conclusions These data suggest that ASCs ameliorate radiation-induced lung injury, and the mechanism may be mediated through the DDAH1/ADMA/eNOS signaling pathway.
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Affiliation(s)
- Quanwei Fu
- Department of Radiation Medical Protection, School of Military Preventive Medicine, Air Force Medical University, Xi’an 710038, China
| | - Qiaohui Gao
- Department of Radiation Medical Protection, School of Military Preventive Medicine, Air Force Medical University, Xi’an 710038, China
| | - Shengyuan Jiao
- Department of Radiation Medical Protection, School of Military Preventive Medicine, Air Force Medical University, Xi’an 710038, China
| | - Fei Da
- Department of Radiation Medical Protection, School of Military Preventive Medicine, Air Force Medical University, Xi’an 710038, China
| | - Juan Guo
- Department of Radiation Medical Protection, School of Military Preventive Medicine, Air Force Medical University, Xi’an 710038, China
| | - Yunen Liu
- Shenyang Medical College, No. 146, Huanghe North Street, Shenyang 110034, China
- Department of Emergency Medicine, General Hospital of Northern Theater Command, No. 83 Road, Shenhe District, Shenyang l10016, China
| | - Junye Liu
- Department of Radiation Medical Protection, School of Military Preventive Medicine, Air Force Medical University, Xi’an 710038, China
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Li J, She X, Ding Z, Yao L, Yang Y, Tang H, Liu H, Zhao D, Li B. Astaxanthin protects the radiation-induced lung injury in C57BL/6 female mice. RADIATION PROTECTION DOSIMETRY 2023; 199:2096-2103. [PMID: 37544990 DOI: 10.1093/rpd/ncad208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 06/01/2023] [Accepted: 06/15/2023] [Indexed: 08/08/2023]
Abstract
Radiation-induced lung injury (RILI) is one of the common complications of radiotherapy for chest tumors and nuclear radiation accidents. The excessive reactive oxygen species induced by radiation is the main mediator. So far, the effective prevention and treatment for RILI are still lacking. Astaxanthin is a carotenoid that belongs to red natural lutein family and is commonly found in Marine organisms such as shrimp, oysters and salmon. It has been confirmed that astaxanthin has strong antioxidant and anti-inflammatory properties, therefore we speculated that astaxanthin may be a potential treatment for RILI. First, with a mice model of RILI, the protected effects of astaxanthin were observed. Furthermore, the experiments in vitro were performed by detecting apoptosis. As a result, astaxanthin protects the RILI, inhibits the process of pulmonary fibrosis, and reduces the elevation of inflammatory factors. The experiments in vitro demonstrated that astaxanthin could reduce radiation-induced apoptosis and especially inhibit activation of apoptosis pathway. In conclusion, astaxanthin could protect RILI of mice, which is mediated by inhibiting activation of apoptosis pathway.
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Affiliation(s)
- Junshi Li
- Department of Radiation Medicine, Faculty of Naval Medicine, Naval Military Medical University, Xiangyin Road 800, Shanghai 200433, China
| | - Xiandong She
- Incubation Base for Undergraduates' Innovative Practice in Department of Radiation Medicine, Faculty of Naval Medicine, Naval Military Medical University, Xiangyin Road 800, Shanghai 200433, China
| | - Zijian Ding
- Incubation Base for Undergraduates' Innovative Practice in Department of Radiation Medicine, Faculty of Naval Medicine, Naval Military Medical University, Xiangyin Road 800, Shanghai 200433, China
| | - Liuhuan Yao
- Department of Radiation Medicine, Faculty of Naval Medicine, Naval Military Medical University, Xiangyin Road 800, Shanghai 200433, China
| | - Yajie Yang
- Incubation Base for Undergraduates' Innovative Practice in Department of Radiation Medicine, Faculty of Naval Medicine, Naval Military Medical University, Xiangyin Road 800, Shanghai 200433, China
| | - Haibo Tang
- Incubation Base for Undergraduates' Innovative Practice in Department of Radiation Medicine, Faculty of Naval Medicine, Naval Military Medical University, Xiangyin Road 800, Shanghai 200433, China
| | - Hu Liu
- Department of Radiation Medicine, Faculty of Naval Medicine, Naval Military Medical University, Xiangyin Road 800, Shanghai 200433, China
| | - Deyun Zhao
- Department of Radiation Medicine, Faculty of Naval Medicine, Naval Military Medical University, Xiangyin Road 800, Shanghai 200433, China
| | - Bailong Li
- Department of Radiation Medicine, Faculty of Naval Medicine, Naval Military Medical University, Xiangyin Road 800, Shanghai 200433, China
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Chen Z, Wang B, Wu Z, Xiao H, Yang Y, Fan J, Gu Y, Chen C, Wu J. The occurrence and development of radiation-induced lung injury after interstitial brachytherapy and stereotactic radiotherapy in SD rats. J Inflamm (Lond) 2023; 20:23. [PMID: 37430327 DOI: 10.1186/s12950-023-00348-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/06/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND To compare the severity of radiation-induced lung injury (RILI) after the right lung of SD rats received interstitial brachytherapy and stereotactic radiotherapy (SBRT). METHODS RILI rat model was established using interstitial brachytherapy and SBRT methods, respectively. CT scan was performed to analyze the lung volume and the CT value difference between the left and right lungs in rats. Then the lung tissues were analyzed through H&E staining, peripheral blood was extracted to detect the expression levels of serum inflammatory cytokines, pro-fibrotic cytokines, and fibrotic-inhibiting cytokines by ELISA. RESULTS The difference between right and left lung CT values was significantly elevated in the SBRT group when compared with the control group and the interstitial brachytherapy group (P < 0.05). The IFN-γ expression in the interstitial brachytherapy group was significantly different from that in the SBRT group at week 1, 4, 8 and 16. Besides, the expressions of IL-2, IL-6 and IL-10 in SBRT group were significantly higher than that of interstitial brachytherapy group (P < 0.05). The TGF-β expression in interstitial brachytherapy group reached its peak with the increase of time from week 1 to week 16, and it was significantly lower than SBRT group (P < 0.05). The mortality rate in the SBRT group was 16.7%, which was significantly higher than that in the interstitial brachytherapy group. CONCLUSION The treatment method of interstitial brachytherapy is considered as an effective and safe tool by reducing the side effects of radiotherapy and increasing the radiation dose of radiotherapy.
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Affiliation(s)
- Zhuo Chen
- Department of Oncology, Daping Hospital, Army Medical University, 10 Changjiang Branch Road, Yuzhong District, Chongqing, 400042, China
- Department of Oncology, Affiliated Hospital of Southwest Medical University, No.25 Taiping Street, Jiangyang District, Luzhou, 646099, Sichuan, China
| | - Bin Wang
- Department of Oncology, the Seventh People's Hospital of Chongqing (Affiliated Central Hospital of Chongqing University of Technology), Banan District Lijiatuo Industry Federation No.1 Village, Chongqing, 401320, China
| | - Zhouxue Wu
- Department of Oncology, Affiliated Hospital of Southwest Medical University, No.25 Taiping Street, Jiangyang District, Luzhou, 646099, Sichuan, China
| | - Hua Xiao
- Department of Neurosurgery, Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Longmatan District, No. 182 Chunhui Road, Luzhou, 646099, Sichuan, China
| | - Yang Yang
- Department of Oncology, Affiliated Hospital of Southwest Medical University, No.25 Taiping Street, Jiangyang District, Luzhou, 646099, Sichuan, China
| | - Junying Fan
- Department of Oncology, Affiliated Hospital of Southwest Medical University, No.25 Taiping Street, Jiangyang District, Luzhou, 646099, Sichuan, China
| | - Yingjiang Gu
- Department of Neurosurgery, Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Longmatan District, No. 182 Chunhui Road, Luzhou, 646099, Sichuan, China.
| | - Chuan Chen
- Department of Oncology, Daping Hospital, Army Medical University, 10 Changjiang Branch Road, Yuzhong District, Chongqing, 400042, China.
| | - Jingbo Wu
- Department of Oncology, Affiliated Hospital of Southwest Medical University, No.25 Taiping Street, Jiangyang District, Luzhou, 646099, Sichuan, China.
- Key Laboratory of Nuclear Medicine and Molecular Imaging, Changzhi, 046099, Sichuan, China.
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Chen P, Liu H, Xin H, Cheng B, Sun C, Liu Y, Liu T, Wen Z, Cheng Y. Inhibiting the Cytosolic Phospholipase A2-Arachidonic Acid Pathway With Arachidonyl Trifluoromethyl Ketone Attenuates Radiation-Induced Lung Fibrosis. Int J Radiat Oncol Biol Phys 2023; 115:476-489. [PMID: 35450754 DOI: 10.1016/j.ijrobp.2022.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Radiation-induced lung fibrosis (RILF) is a serious late complication of thoracic radiation therapy. Inflammation is crucial in fibroblast activation and RILF, and arachidonic acid (AA) is an important inflammatory mediator released by cytosolic phospholipase A2 (cPLA2) and reduced by arachidonyl trifluoromethyl ketone (ATK)-targeting of cPLA2. Here, we aimed to investigate the roles of the cPLA2/AA pathway in RILF and assess the potential of targeting cPLA2 to prevent RILF. METHODS AND MATERIALS A computed tomography scan was used to obtain the mean lung density, and hematoxylin-eosin, Masson's trichrome, and Sirius Red staining were used to assess the histopathologic conditions in mouse models. AA levels in mouse serum and cell supernatants were tested by enzyme-linked immunosorbent assay. Fibroblast phenotype alterations were examined by a Cell Counting Kit-8, manual cell counting, and a Transwell system. The protein levels were evaluated via Western blotting, immunofluorescence, and immunohistochemistry. RESULTS AA protected fibroblasts against radiation-induced growth inhibition and promoted fibroblast activation, which was characterized by enhanced α-smooth muscle actin expression and migration capacity. Radiation could activate fibroblasts by upregulating cPLA2 expression and AA production, which could be reversed by ATK. Moreover, inhibiting cPLA2 with ATK significantly attenuated collagen deposition and radiation-induced pulmonary fibrosis in mouse models. We further identified extracellular-signal regulated protein kinase (ERK) as the downstream target of the radiation-AA regulatory axis. Radiation-induced AA increased phosphorylated-ERK levels, promoting cyclinD1, cyclin-dependent kinase 6, and α-smooth muscle actin expression and contributing to fibroblast activation. Inhibiting P-ERK impaired radiation- and AA-induced fibroblast activation. The related molecular mechanisms were verified using specimens from animal models. CONCLUSIONS Our findings uncover the role of the cPLA2/AA-ERK regulatory axis in response to radiation in pulmonary fibroblast activation and recognize cPLA2 as the key regulatory molecule during RILF for the first time. Targeting cPLA2 may be a promising protective strategy against RILF.
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Affiliation(s)
- Pengxiang Chen
- Department of Radiation Oncology; Laboratory of Basic Medical Sciences
| | - Hui Liu
- Department of Clinical Laboratory, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | | | - Bo Cheng
- Shandong Cancer Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Changhua Sun
- Shandong Institute for Food and Drug Control, Jinan, People's Republic of China
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Ding C, Hong S, Zhang M, Sun Y, Li N, Zhang J, Ma L, Tian L, Ren W, Zhang L, Yao S. Establishment and evaluation of an in vitro blast lung injury model using alveolar epithelial cells. Front Public Health 2022; 10:994670. [PMID: 36620304 PMCID: PMC9816474 DOI: 10.3389/fpubh.2022.994670] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
Background Gas explosion is a fatal disaster commonly occurred in coal mining and often causes systematic physical injuries, of which blast lung injury is the primary one and has not yet been fully investigated due to the absence of disease models. To facilitate studies of this field, we constructed an in vitro blast lung injury model using alveolar epithelial cells. Methods We randomly divided the alveolar epithelial cells into the control group and blast wave group, cells in the blast wave group were stimulated with different strengths of blast wave, and cells in the control group received sham intervention. Based on the standards we set up for a successful blast injury model, the optimal modeling conditions were studied on different frequencies of blast wave, modeling volume, cell incubation duration, and cell density. The changes of cell viability, apoptosis, intracellular oxidative stress, and inflammation were measured. Results We found that cell viability decreased by approximately 50% at 6 h after exposing to 8 bar energy of blast wave, then increased with the extension of culture time and reached to (74.33 ± 9.44) % at 12 h. By applying 1000 ~ 2500 times of shock wave to 1 ~ 5 × 105 cells /ml, the changes of cell viability could well meet the modeling criteria. In parallel, the content of reactive oxide species (ROS), malonaldehyde (MDA), interleukin 18 (IL-18), tumor necrosis factor alpha (TNF-α), and transforming growth factor beta (TGF-β) increased in the blast wave group, while superoxide dismutase (SOD) and Glutathione -S- transferase (GST) decreased, which were highly consistent with that of human beings with gas explosion-induced pulmonary injury. Conclusion An in vitro blast lung injury model is set up using a blast wave physiotherapy under 8 bar, 10 Hz blast wave on (1 ~ 5) ×105 alveolar epithelial cells for 1 000 times. This model is flexible, safe, and stable, and can be used for studies of lung injury caused by gas explosion and blast-associated other external forces.
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Affiliation(s)
- Chunjie Ding
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Shan Hong
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Miao Zhang
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Yunzhe Sun
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Ning Li
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Jing Zhang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Lan Ma
- School of Public Health, Weifang Medical University, Weifang, China
| | - Linqiang Tian
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Wenjie Ren
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Lin Zhang
- Clinical Medical Research Center for Women and Children Diseases, Maternal and Child Health Care Hospital of Shandong Province Affiliated to Qingdao University, Jinan, China,*Correspondence: Lin Zhang ✉
| | - Sanqiao Yao
- School of Public Health, Xinxiang Medical University, Xinxiang, China,Sanqiao Yao ✉
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GPA Peptide Attenuates Sepsis-Induced Acute Lung Injury in Mice via Inhibiting Oxidative Stress and Pyroptosis of Alveolar Macrophage. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2021:5589472. [PMID: 34992715 PMCID: PMC8727129 DOI: 10.1155/2021/5589472] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/03/2021] [Accepted: 12/02/2021] [Indexed: 02/08/2023]
Abstract
Acute lung injury (ALI) has been known to be a devastating form of respiratory infection and an important contributor to mortality in intensive care, due to its lacking of effective treatment. Inflammation, oxidative stress, and pyroptosis are associated with multiple kinds of inflammatory diseases such as ALI. It is commonly accepted that Gly-Pro-Ala (GPA) peptide regulates oxidative stress and pyroptosis in different kinds of inflammatory diseases. Our study is aimed at exploring the regulatory function and protective effects of GPA peptides on ALI. In the current study, the cecal ligation and puncture (CLP) technique was used to evoke sepsis in mice, and GPA peptide was administered intraperitoneally with different concentrations (50, 100, and 150 mg/kg) after CLP. Histopathological changes and the ratio of wet-to-dry in lung were recorded and analyzed. We also investigated the level of oxidative stress, inflammation, and pyroptosis. Results showed that GPA peptide significantly ameliorated CLP-stimulated lung tissue injury, impeded proinflammatory cytokine release, and reduced inflammatory cell infiltration. Additionally, GPA peptide suppressed oxidative stress and caspase-1-dependent pyroptosis in alveolar macrophages. Furthermore, our study showed that the GPA peptide prevents alveolar macrophage from undergoing pyroptosis by attenuating ROS. In conclusion, results demonstrated that GPA peptide has protective effects in CLP-stimulated ALI by inhibiting oxidative stress as well as pyroptosis of alveolar macrophage.
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Nakanishi Y, Horimasu Y, Yamaguchi K, Sakamoto S, Masuda T, Nakashima T, Miyamoto S, Iwamoto H, Ohshimo S, Fujitaka K, Hamada H, Hattori N. IL-18 binding protein can be a prognostic biomarker for idiopathic pulmonary fibrosis. PLoS One 2021; 16:e0252594. [PMID: 34086758 PMCID: PMC8177514 DOI: 10.1371/journal.pone.0252594] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 05/19/2021] [Indexed: 11/19/2022] Open
Abstract
Idiopathic pulmonary fibrosis is a chronic, fibrosing interstitial pneumonia that presents with various clinical courses and progression ranging from rapid to slow. To identify novel biomarkers that can support the diagnosis and/or prognostic prediction of idiopathic pulmonary fibrosis, we performed gene expression analysis, and the mRNA of interleukin-18 binding protein was increasingly expressed in patients with idiopathic pulmonary fibrosis compared with healthy controls. Therefore, we hypothesized that the interleukin-18 binding protein can serve as a diagnostic and/or prognostic biomarker for idiopathic pulmonary fibrosis. We investigated the expression of interleukin-18 binding protein in lung tissue, bronchoalveolar lavage fluid, and serum. Additionally, the correlation between interleukin-18 binding protein expression levels and the extent of fibrosis was investigated using mouse models of lung fibrosis induced by subcutaneous bleomycin injections. Serum interleukin-18 binding protein levels were significantly higher in idiopathic pulmonary fibrosis patients (5.06 ng/mL, interquartile range [IQR]: 4.20-6.35) than in healthy volunteers (3.31 ng/mL, IQR: 2.84-3.99) (p < 0.001). Multivariate logistic regression models revealed that the correlation between serum interleukin-18 binding protein levels and idiopathic pulmonary fibrosis was statistically independent after adjustment for age, sex, and smoking status. Multivariate Cox proportional hazard models revealed that serum interleukin-18 binding protein levels were predictive of idiopathic pulmonary fibrosis disease prognosis independent of other covariate factors (hazard ratio: 1.655, 95% confidence interval: 1.224-2.237, p = 0.001). We also demonstrated a significant positive correlation between lung hydroxyproline expression levels and interleukin-18 binding protein levels in bronchoalveolar lavage fluid from bleomycin-treated mice (Spearman r = 0.509, p = 0.004). These results indicate the utility of interleukin-18 binding protein as a novel prognostic biomarker for idiopathic pulmonary fibrosis.
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Affiliation(s)
- Yu Nakanishi
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Yasushi Horimasu
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Kakuhiro Yamaguchi
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Shinjiro Sakamoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Takeshi Masuda
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Taku Nakashima
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Shintaro Miyamoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Hiroshi Iwamoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Shinichiro Ohshimo
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University Hospital, Minami-ku, Hiroshima, Japan
| | - Kazunori Fujitaka
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Hironobu Hamada
- Department of Physical Analysis and Therapeutic Sciences, Graduate School of Biomedical and Health Sciences Hiroshima University Hospital, Minami-ku, Hiroshima, Japan
| | - Noboru Hattori
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
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Wang Y, Ouyang F, Teng C, Qu J. Optimization for the extraction of polyphenols from Inonotus obliquus and its antioxidation activity. Prep Biochem Biotechnol 2021; 51:852-859. [PMID: 33439073 DOI: 10.1080/10826068.2020.1864642] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In order to study the extraction process and antioxidative activity of Inonotus obliquus polyphenols (IOP), the optimal extraction process was determined by orthogonal experiment optimization. The clearance rate of DPPH and hydroxyl radicals were used as indicators to evaluate the antioxidant activity of IOP. The results showed that the optimum extraction conditions were as follows: ethanol concentration of 50%, solid-liquid ratio of 1:20, temperature of 60 °C, and 90 min. Under these conditions, the extraction yield of IOP was 2.84%. The antioxidant capacity of extracts appeared to be IOP dose-dependent, while it also presented stronger ferric reducing antioxidant power (FRAP). High Performance Liquid Chromatography (HPLC-MS) analysis indicated that the major identified polyphenol compounds extracted at the optimal conditions were ten compounds (procyanidin, caffeic acid, p-coumaric acid, isorhamnetin-3-O-glucoside, astilbin, tangeretin, gallic acid, kaempferol, quercetin, and catechin 7-xyloside). These findings indicate that I. obliquus polyphenols have the potential to be developed as a natural antioxidant and have a good application prospect.
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Affiliation(s)
- Yu Wang
- College of Resources and Environmental Science, Northeast Agricultural University, Harbin, China.,Harbin Center for Disease Control and Prevention, Harbin, China
| | - Fengju Ouyang
- Institute of Advanced Technology, Heilongjiang Academy of Sciences, Harbin, China
| | - Chunying Teng
- College of Resources and Environmental Science, Northeast Agricultural University, Harbin, China
| | - Juanjuan Qu
- College of Resources and Environmental Science, Northeast Agricultural University, Harbin, China
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Wakabayashi Y, Masuda T, Fujitaka K, Nakashima T, Okumoto J, Shimoji K, Nishimura Y, Yamaguchi K, Sakamoto S, Horimasu Y, Miyamoto S, Iwamoto H, Ohshimo S, Hamada H, Hattori N. Clinical significance of BIM deletion polymorphism in chemoradiotherapy for non-small cell lung cancer. Cancer Sci 2020; 112:369-379. [PMID: 33103296 PMCID: PMC7780054 DOI: 10.1111/cas.14711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/12/2020] [Accepted: 10/19/2020] [Indexed: 11/27/2022] Open
Abstract
The standard treatment for locally advanced non‐small cell lung cancer (NSCLC) is chemoradiotherapy (CRT) followed by anti‐programmed cell death‐ligand 1 (anti‐PD‐L1) treatment. BIM deletion polymorphism induces the suppression of apoptosis resulting from epidermal growth factor (EGFR)‐tyrosine kinase inhibitors in EGFR‐mutated NSCLC patients. We aimed to examine the effects of BIM polymorphism on CRT and anti‐PD‐L1/PD‐1 treatment in NSCLC patients. In this retrospective study of 1312 patients with unresectable NSCLC treated at Higashi‐Hiroshima Medical Center and Hiroshima University Hospital between April 1994 and October 2019, we enrolled those who underwent CRT or chemotherapy using carboplatin + paclitaxel or cisplatin + vinorelbine, or anti‐PD‐L1/PD‐1 treatment. Of 1312 patients, 88, 80, and 74 underwent CRT, chemotherapy, and anti‐PD‐L1/PD‐1 treatment, respectively, and 17.0%, 15.2% and 17.6% of these patients showed BIM polymorphism. Among patients receiving CRT, the progression‐free survival was significantly shorter in those with BIM deletion than in those without. In the multivariate analyses, BIM polymorphism was an independent factor of poor anti‐tumor effects. These results were not observed in the chemotherapy and anti‐PD‐L1/PD‐1 treatment groups. In in vitro experiments, BIM expression suppression using small interfering RNA in NSCLC cell lines showed a significantly suppressed anti‐tumor effect and apoptosis after irradiation but not chemotherapy. In conclusion, we showed that BIM polymorphism was a poor‐predictive factor for anti‐tumor effects in NSCLC patients who underwent CRT, specifically radiotherapy. In the implementation of CRT in patients with BIM polymorphism, we should consider subsequent treatment, keeping in mind that CRT may be insufficient.
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Affiliation(s)
- Yu Wakabayashi
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Masuda
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazunori Fujitaka
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Taku Nakashima
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Joe Okumoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kiyofumi Shimoji
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshifumi Nishimura
- Department of Respiratory Internal Medicine, Higashihiroshima Medical Center, Higashihiroshima, Japan
| | - Kakuhiro Yamaguchi
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinjiro Sakamoto
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Yasushi Horimasu
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Shintaro Miyamoto
- Department of Respiratory Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroshi Iwamoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinichiro Ohshimo
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hironobu Hamada
- Department of Physical Analysis and Therapeutic Sciences, Hiroshima University, Hiroshima, Japan
| | - Noboru Hattori
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Shoda S, Hyodo F, Tachibana Y, Kiniwa M, Naganuma T, Eto H, Koyasu N, Murata M, Matsuo M. Imaging of Hydroxyl-Radical Generation Using Dynamic Nuclear Polarization-Magnetic Resonance Imaging and a Spin-Trapping Agent. Anal Chem 2020; 92:14408-14414. [PMID: 33064938 DOI: 10.1021/acs.analchem.0c02331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Reactive oxygen species (ROS) play an important role in cell metabolism, but they can cause oxidative damage to biomolecules. Among ROS, the hydroxyl radical (·OH) is one of the most reactive molecules in biological systems because of its high reaction rate constant. Therefore, imaging of ·OH could be useful for evaluation of the redox mechanism and diagnosis of oxidative diseases. In vivo dynamic nuclear polarization-magnetic resonance imaging (DNP-MRI) is a noninvasive imaging method to obtain spatiotemporal information about free radicals with MRI anatomical resolution. In this study, we investigated the visualization of hydroxyl radicals generated from the Fenton reaction by combining DNP-MRI with a spin-trapping agent (DMPO: 5,5-dimethyl-1-pyrroline N-oxide) for ·OH. Additionally, we demonstrated the radical-scavenging effect using four thiol-related reagents by DNP-MRI. We demonstrated that DNP enhancement could be induced by the DMPO-OH radical using the DNP-MRI/spin-trapping method and visualized ·OH generation for the first time. Maximum DNP enhancement was observed at an electron paramagnetic resonance irradiation frequency of 474.5 MHz. Furthermore, the radical-scavenging effect was simultaneously evaluated by the decrease in the DNP image value of DMPO-OH. An advantage of our methods is that they simultaneously investigate compound activity and the radical-scavenging effect.
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Affiliation(s)
- Shinichi Shoda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Fuminori Hyodo
- Department of Radiology, Frontier Science for Imaging, School of Medicine, Gifu University, Gifu 501-1194, Japan.,Innovation Center for Medical Redox Navigation, Kyushu University,3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yoko Tachibana
- Innovation Center for Medical Redox Navigation, Kyushu University,3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.,Center for Advanced Medical Innovation, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Mamoru Kiniwa
- Innovation Center for Medical Redox Navigation, Kyushu University,3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Tatsuya Naganuma
- Japan Redox Limited, Fukuoka, 4-29 Chiyo, Fukuoka 812-0044, Japan
| | - Hinako Eto
- Innovation Center for Medical Redox Navigation, Kyushu University,3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.,Center for Advanced Medical Innovation, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Norikazu Koyasu
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Masaharu Murata
- Innovation Center for Medical Redox Navigation, Kyushu University,3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.,Center for Advanced Medical Innovation, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
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11
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Tian LQ, Guo ZH, Meng WZ, Li L, Zhang Y, Yin XH, Lai F, Li YY, Feng LL, Shen FF, Sun ZZ, Yao SQ, Wu WD, Weng XG, Ren WJ. The abnormalities of coagulation and fibrinolysis in acute lung injury caused by gas explosion. Kaohsiung J Med Sci 2020; 36:929-936. [PMID: 32643870 DOI: 10.1002/kjm2.12262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 04/06/2020] [Accepted: 06/08/2020] [Indexed: 12/13/2022] Open
Abstract
Acute lung injury (ALI) caused by gas explosion is common, and warrants research on the underlying mechanisms. Specifically, the role of abnormalities of coagulation and fibrinolysis in this process has not been defined. It was hypothesized that the abnormal coagulation and fibrinolysis promoted ALI caused by gas explosion. Based on the presence of ALI, 74 cases of gas explosion injury were divided into the ALI and non-ALI groups. The results of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), and platelet count (PLT) were collected within 24 hours and compared between the groups. ALI models caused by gas explosion were established in Sprague Dawley rats, and injuries were evaluated using hematoxylin and eosin (HE) staining and histopathological scoring. Moreover, the bronchoalveolar lavage fluid (BALF) was collected to examine thrombin-antithrombin complex (TAT), tissue factor (TF), tissue factor pathway inhibitor (TFPI), and plasminogen activator inhibitor-1 (PAI-1) levels by enzyme-linked immunosorbent assay (ELISA). The patients in ALI group had shorter PT and longer APTT, raised concentration of FIB and decreased number of PLT, as compared to the non-ALI group. In ALI rats, the HE staining revealed red blood cells in alveoli and interstitial thickening within 2 hours which peaked at 72 hours. The levels of TAT/TF in the BALF increased continually until the seventh day, while the PAI-1 was raised after 24 hours and 7 days. The TFPI was elevated after 2 hours and 24 hours, and then decreased after 72 hours. Abnormalities in coagulation and fibrinolysis in lung tissues play a role in ALI caused by gas explosion.
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Affiliation(s)
- Lin-Qiang Tian
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Zhi-Hao Guo
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Wei-Zheng Meng
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Long Li
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Yue Zhang
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Xiao-Hang Yin
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Feng Lai
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Yan-Yan Li
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Li-Li Feng
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Fang-Fang Shen
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Zhen-Zhou Sun
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - San-Qiao Yao
- Public Health College, Xinxiang Medical University, Xinxiang, China
| | - Wei-Dong Wu
- Public Health College, Xinxiang Medical University, Xinxiang, China
| | - Xiao-Gang Weng
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
| | - Wen-Jie Ren
- Institute of Trauma and Orthopedics, Xinxiang Medical University, Xinxiang, China
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12
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Qu W, Zhang L, Ao J. Radiotherapy Induces Intestinal Barrier Dysfunction by Inhibiting Autophagy. ACS OMEGA 2020; 5:12955-12963. [PMID: 32548479 PMCID: PMC7288592 DOI: 10.1021/acsomega.0c00706] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 05/19/2020] [Indexed: 06/11/2023]
Abstract
Radiation enteritis is a common complication of abdominal irradiation (IR) therapy. However, the molecular mechanism of radiation enteritis accompanied by impaired intestinal barrier function is not clear. The aim of this study was to investigate the important role of autophagy in radiation-induced intestinal barrier function impairment. IR increased the abundance of autophagy-related genes in the colonic mucosa of mice. An autophagy activator (rapamycin) inhibited the oxidative stress (reactive oxygen species, reactive nitrogen species, malondialdehyde, and hydrogen peroxide) and inflammatory response (interleukin-1β, -6, -8, and tumor necrosis factor-α) in the colon samples. Antioxidant indices (superoxide dismutase, glutathione peroxidase, catalase, and total antioxidant capacity) in serum and colonic mucosa were significantly increased in the rapamycin group. Rapamycin can improve the activity of mitochondrial respiratory chain complexes I-V in colon mucosa. In addition, rapamycin reduced the gene expression and enzyme activity of caspase in the colonic mucosa. Levels of endotoxin, diamine peroxidase, d-lactic acid, and zonulin in serum and colonic mucosa were significantly reduced in the rapamycin group. Moreover, rapamycin significantly elevated the gene abundance of zonula occludens-1, occludin, claudin-1, and claudin-4. In contrast, completely opposite results were obtained for the autophagy inhibitor 3-methyladenine as compared to those of rapamycin. These results revealed that inhibition of autophagy is an important mechanism of intestinal barrier function damage caused by radiation. Collectively, these findings increase our understanding of the pathogenesis of radiation-induced intestinal barrier dysfunction.
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Affiliation(s)
- Wei Qu
- Department of Pharmacy, The Affiliated Jiangyin Hospital of Southeast University
Medical College, Jiangyin, Jiangsu 214400, People’s Republic of China
| | - Lijin Zhang
- Department
of Urinary Surgery, The Affiliated Jiangyin
Hospital of Southeast University Medical College, Jiangyin, Jiangsu 214400, People’s Republic of China
| | - Jinfang Ao
- Department of Pharmacy, the Fourth Affiliated
Hospital of Nanchang University, Nanchang, Jiangxi 330003, People’s Republic of China
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13
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Yang Y, Tai W, Lu N, Li T, Liu Y, Wu W, Li Z, Pu L, Zhao X, Zhang T, Dong Z. lncRNA ZFAS1 promotes lung fibroblast-to-myofibroblast transition and ferroptosis via functioning as a ceRNA through miR-150-5p/SLC38A1 axis. Aging (Albany NY) 2020; 12:9085-9102. [PMID: 32453709 PMCID: PMC7288977 DOI: 10.18632/aging.103176] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/02/2020] [Indexed: 02/07/2023]
Abstract
Pulmonary fibrosis (PF) is a lethal fibrotic lung disease. The role of lncRNAs in multiple diseases has been confirmed, but the role and mechanism of lncRNA zinc finger antisense 1 (ZFAS1) in the progression of PF need to be elucidated further. Here, we found that lncRNA ZFAS1 was upregulated in bleomycin (BLM)-induced PF rats lung tissues and transforming growth factor-β1 (TGF-β1)-treated HFL1 cells, and positively correlated with the expression of solute carrier family 38 member 1 (SLC38A1), which is an important regulator of lipid peroxidation. Moreover, knockdown of lncRNA ZFAS1 significantly alleviated TGF-β1-induced fibroblast activation, inflammation and lipid peroxidation. In vivo experiments showed that inhibition of lncRNA ZFAS1 abolished BLM-induced lipid peroxidation and PF development. Mechanistically, silencing of lncRNA ZFAS1 attenuated ferroptosis and PF progression by lncRNA ZFAS1 acting as a competing endogenous RNA (ceRNA) and sponging miR-150-5p to downregulate SLC38A1 expression. Collectively, our studies demonstrated the role of the lncRNA ZFAS1/miR-150-5p/SLC38A1 axis in the progression of PF, and may provide a new biomarker for the treatment of PF patients.
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Affiliation(s)
- Yanni Yang
- Department of Ophthalmology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China
| | - Wenlin Tai
- Department of Clinical Laboratory, Yunnan Molecular Diagnostic Center, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China
| | - Nihong Lu
- Department of Respiratory, The Third People's Hospital of Kunming, Kunming 650041, Yunnan, China
| | - Ting Li
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China
| | - Yongjun Liu
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China
| | - Wenjuan Wu
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China
| | - Zhengkun Li
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China
| | - Lin Pu
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China
| | - Xiaoyuan Zhao
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China
| | - Tao Zhang
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China
| | - Zhaoxing Dong
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China
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14
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Zhao Z, Cheng W, Qu W, Wang K. Arabinoxylan rice bran (MGN-3/Biobran) alleviates radiation-induced intestinal barrier dysfunction of mice in a mitochondrion-dependent manner. Biomed Pharmacother 2020; 124:109855. [PMID: 31986410 DOI: 10.1016/j.biopha.2020.109855] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/30/2019] [Accepted: 12/18/2019] [Indexed: 12/13/2022] Open
Abstract
MGN-3 is an arabinoxylan from rice bran that has been shown to be an excellent antioxidant and radioprotector. This study examined the protective effects of MGN-3 on radiation-induced intestinal injury. Mice were treated with MGN-3 prior to irradiation, then continued to receive MGN-3 for 4 weeks thereafter. MGN-3 increased the activity of mitochondrial respiratory chain complexes Ⅰ, Ⅲ, Ⅳ and Ⅴ, the intercellular ATP content, the mitochondria-encoded gene expression and mitochondrial copy numbers in the jejunal and colonic mucosa. MGN-3 reduced the oxidative stress levels and inflammatory response indicators in the serum and jejunal and colonic mucosa. Antioxidant indicators such as superoxide dismutase, glutathione peroxidase, catalase and total antioxidant capacity were significantly increased in the serum and jejunal and colonic mucosa in the MGN-3 group. Moreover, MGN-3 decreased the gene abundances and enzymatic activities of caspase-3, 8, 9 and 10 in the jejunal and colonic mucosa. The endotoxin, diamine peroxidase, d-lactate and zonulin levels were significantly reduced in the serum and jejunal and colonic mucosa in the MGN-3 group. MGN-3 also markedly upregulated the gene abundances of ZO-1, occludin, claudin-1 and mucin 2. MGN-3 effectively attenuated radiation-induced changes in the intestinal epithelial mitochondrial function, oxidative stress, inflammatory response, apoptosis, intestinal permeability and barrier function in mice. These findings add to our understanding of the potential mechanisms by which MGN-3 alleviates radioactive intestinal injury.
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Affiliation(s)
- Zhenguo Zhao
- Department of General Surgery, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, Jiangsu 214400, China.
| | - Wei Cheng
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.
| | - Wei Qu
- Department of Pharmacy, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, Jiangsu 214400, China.
| | - Kai Wang
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Xuzhou Medical University, Jiangsu Province, China.
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