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Huang M, Mo Y, Lei H, Chen M. Edaravone: A Possible Treatment for Acute Lung Injury. Int J Gen Med 2024; 17:3975-3986. [PMID: 39286534 PMCID: PMC11403130 DOI: 10.2147/ijgm.s467891] [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: 05/28/2024] [Accepted: 09/06/2024] [Indexed: 09/19/2024] Open
Abstract
Despite technological advances in science and medicine, acute lung injury (ALI) is still associated with high mortality rates in the ICU. Therefore, finding novel drugs and treatment approaches is crucial to preventing ALI. Drug repurposing is a common practice in clinical research, primarily for drugs that have previously received approval for use in patients, to investigate novel uses of drugs and therapies. One such medication is edaravone, which is a highly effective free-radical scavenger that also has anti-inflammatory, anti-apoptotic, antioxidant, and anti-fibrotic effects. Both basic and clinical studies have shown that edaravone can treat different types of lung injury through its distinct properties. Edaravone exhibits significant protective benefits and holds promising clinical treatment potential for ALI caused by diverse factors, thereby offering a novel approach to treating ALI. This study aims to provide new insights and treatment options for ALI by reviewing both basic and clinical research on the use of edaravone. The focus is on evaluating the effectiveness of edaravone in treating ALI caused by various factors.
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Affiliation(s)
- Ma Huang
- Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China
| | - Yalan Mo
- Centre for Infectious Diseases, General Hospital of Hunan Medical College, Huaihua, Hunan, People's Republic of China
| | - Haiyun Lei
- Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China
| | - Miao Chen
- Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China
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2
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Hu Y, Huang Y, Zong L, Lin J, Liu X, Ning S. Emerging roles of ferroptosis in pulmonary fibrosis: current perspectives, opportunities and challenges. Cell Death Discov 2024; 10:301. [PMID: 38914560 PMCID: PMC11196712 DOI: 10.1038/s41420-024-02078-0] [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: 03/15/2024] [Revised: 06/13/2024] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
Pulmonary fibrosis (PF) is a chronic interstitial lung disorder characterized by abnormal myofibroblast activation, accumulation of extracellular matrix (ECM), and thickening of fibrotic alveolar walls, resulting in deteriorated lung function. PF is initiated by dysregulated wound healing processes triggered by factors such as excessive inflammation, oxidative stress, and coronavirus disease (COVID-19). Despite advancements in understanding the disease's pathogenesis, effective preventive and therapeutic interventions are currently lacking. Ferroptosis, an iron-dependent regulated cell death (RCD) mechanism involving lipid peroxidation and glutathione (GSH) depletion, exhibits unique features distinct from other RCD forms (e.g., apoptosis, necrosis, and pyroptosis). Imbalance between reactive oxygen species (ROS) production and detoxification leads to ferroptosis, causing cellular dysfunction through lipid peroxidation, protein modifications, and DNA damage. Emerging evidence points to the crucial role of ferroptosis in PF progression, driving macrophage polarization, fibroblast proliferation, and ECM deposition, ultimately contributing to alveolar cell death and lung tissue scarring. This review provides a comprehensive overview of the latest findings on the involvement and signaling mechanisms of ferroptosis in PF pathogenesis, emphasizing potential novel anti-fibrotic therapeutic approaches targeting ferroptosis for PF management.
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Affiliation(s)
- Yixiang Hu
- Department of Clinical Pharmacy, The Affiliated Xiangtan Center Hospital of Hunan University, Xiangtan, 411100, China
| | - Ying Huang
- Zhongshan Hospital of Traditional Chinese Medicine Afflilated to Guangzhou University of Chinese Medicine, Zhongshan, 528400, China
| | - Lijuan Zong
- Department of Rehabilitation Medicine, Zhongda Hospital of Southeast University, Nanjing, 210096, China
| | - Jiaxin Lin
- Department of Breast Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530000, China
| | - Xiang Liu
- Department of Clinical Pharmacy, The Affiliated Xiangtan Center Hospital of Hunan University, Xiangtan, 411100, China.
| | - Shipeng Ning
- Department of Breast Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530000, China.
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3
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Duranti E, Cordani N, Villa C. Edaravone: A Novel Possible Drug for Cancer Treatment? Int J Mol Sci 2024; 25:1633. [PMID: 38338912 PMCID: PMC10855093 DOI: 10.3390/ijms25031633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/18/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Despite significant advancements in understanding the causes and progression of tumors, cancer remains one of the leading causes of death worldwide. In light of advances in cancer therapy, there has been a growing interest in drug repurposing, which involves exploring new uses for medications that are already approved for clinical use. One such medication is edaravone, which is currently used to manage patients with cerebral infarction and amyotrophic lateral sclerosis. Due to its antioxidant and anti-inflammatory properties, edaravone has also been investigated for its potential activities in treating cancer, notably as an anti-proliferative and cytoprotective drug against side effects induced by traditional cancer therapies. This comprehensive review aims to provide updates on the various applications of edaravone in cancer therapy. It explores its potential as a standalone antitumor drug, either used alone or in combination with other medications, as well as its role as an adjuvant to mitigate the side effects of conventional anticancer treatments.
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Affiliation(s)
| | | | - Chiara Villa
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (E.D.); (N.C.)
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Yu D, Xiang Y, Gou T, Tong R, Xu C, Chen L, Zhong L, Shi J. New therapeutic approaches against pulmonary fibrosis. Bioorg Chem 2023; 138:106592. [PMID: 37178650 DOI: 10.1016/j.bioorg.2023.106592] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
Pulmonary fibrosis is the end-stage change of a large class of lung diseases characterized by the proliferation of fibroblasts and the accumulation of a large amount of extracellular matrix, accompanied by inflammatory damage and tissue structure destruction, which also shows the normal alveolar tissue is damaged and then abnormally repaired resulting in structural abnormalities (scarring). Pulmonary fibrosis has a serious impact on the respiratory function of the human body, and the clinical manifestation is progressive dyspnea. The incidence of pulmonary fibrosis-related diseases is increasing year by year, and no curative drugs have appeared so far. Nevertheless, research on pulmonary fibrosis have also increased in recent years, but there are no breakthrough results. Pathological changes of pulmonary fibrosis appear in the lungs of patients with coronavirus disease 2019 (COVID-19) that have not yet ended, and whether to improve the condition of patients with COVID-19 by means of the anti-fibrosis therapy, which are the questions we need to address now. This review systematically sheds light on the current state of research on fibrosis from multiple perspectives, hoping to provide some references for design and optimization of subsequent drugs and the selection of anti-fibrosis treatment plans and strategies.
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Affiliation(s)
- Dongke Yu
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China; Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Yu Xiang
- College of Medicine, University of Electronic Science and Technology, Chengdu 610072, China
| | - Tingting Gou
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacology, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Rongsheng Tong
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China; Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Chuan Xu
- Department of Oncology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan 610072, China
| | - Lu Chen
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China; Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China.
| | - Ling Zhong
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Center for Medical Genetics, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology, Chengdu 610072, China.
| | - Jianyou Shi
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China; Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China.
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5
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Signaling pathways involved in paraquat-induced pulmonary toxicity: Molecular mechanisms and potential therapeutic drugs. Int Immunopharmacol 2022; 113:109301. [DOI: 10.1016/j.intimp.2022.109301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/19/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022]
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Regnault R, Kouach M, Goossens L, Thuru X, Bailly C, Goossens J. Mono‐ and bis‐edaravone adducts formed in the presence of vanillin in an aqueous solution. SEPARATION SCIENCE PLUS 2022. [DOI: 10.1002/sscp.202200031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Romain Regnault
- CHU Lille, ULR 7365 ‐ GRITA ‐ Groupe de Recherche sur les formes Injectables et les Technologies Associées Univ. Lille Lille France
| | - Mostafa Kouach
- CHU Lille, ULR 7365 ‐ GRITA ‐ Groupe de Recherche sur les formes Injectables et les Technologies Associées Univ. Lille Lille France
| | - Laurence Goossens
- CHU Lille, ULR 7365 ‐ GRITA ‐ Groupe de Recherche sur les formes Injectables et les Technologies Associées Univ. Lille Lille France
| | - Xavier Thuru
- CHU Lille, CNRS, Inserm, UMR9020 – UMR1277 – Canther – Cancer Heterogeneity, Plasticity and Resistance to Therapies Univ. Lille Lille France
| | | | - Jean‐François Goossens
- CHU Lille, ULR 7365 ‐ GRITA ‐ Groupe de Recherche sur les formes Injectables et les Technologies Associées Univ. Lille Lille France
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Zhou J, Tan Y, Wang R, Li X. Role of Ferroptosis in Fibrotic Diseases. J Inflamm Res 2022; 15:3689-3708. [PMID: 35783244 PMCID: PMC9248952 DOI: 10.2147/jir.s358470] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
Abstract
Ferroptosis is a unique and pervasive form of regulated cell death driven by iron-dependent phospholipid peroxidation. It results from disturbed cellular metabolism and imbalanced redox homeostasis and is regulated by various cellular metabolic pathways. Recent preclinical studies have revealed that ferroptosis may be an attractive therapeutic target in fibrotic diseases, such as liver fibrosis, pulmonary fibrosis, kidney fibrosis, and myocardial fibrosis. This review summarizes the latest knowledge on the regulatory mechanism of ferroptosis and its roles in fibrotic diseases. These updates may provide a novel perspective for the treatment of fibrotic diseases as well as future research.
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Affiliation(s)
- Jian Zhou
- Department of Anesthesiology, Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Yuan Tan
- Department of Anesthesiology, Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Rurong Wang
- Department of Anesthesiology, Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Xuehan Li
- Department of Anesthesiology, Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
- Correspondence: Xuehan Li, Department of Anesthesiology, Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan Province, 610041, People’s Republic of China, Tel +86 18980099133, Email
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Yang HQ, Yin WJ, Liu K, Liu MC, Zuo XC. Renal safety evaluation of aspirin plus edaravone in patients with ischaemic stroke: a retrospective cohort study. BMJ Open 2022; 12:e055469. [PMID: 35440453 PMCID: PMC9020313 DOI: 10.1136/bmjopen-2021-055469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Aspirin combined with edaravone is more effective than aspirin or edaravone alone in the treatment of ischaemic stroke. Aspirin is defined as a nephrotoxic drug while the renal safety of edaravone is controversial. We aimed to evaluate whether edaravone will increase the nephrotoxicity of aspirin in patients with ischaemic stroke. DESIGN A propensity score-matched retrospective cohort study. SETTING A tertiary hospital in China. PARTICIPANTS Patients with ischaemic stroke were treated with aspirin from February 2007 to May 2018. PRIMARY AND SECONDARY OUTCOME MEASURES Acute kidney injury (AKI, diagnosed by the Acute Kidney Injury Network), decreased estimated glomerular filtration rate (eGFR,>10%), gastrointestinal bleeding and in-hospital adverse outcomes (defined as dying or giving up treatment in our hospital). RESULTS We included 3061 patients, and 986 pairs were successfully matched. Of the 986 pairs of patients included, the incidence of AKI between the aspirin group and the combination group showed no significant difference (7.71% vs 6.29%, p=0.217). While the incidence of eGFR decline (24.75% vs 16.94%, p<0.001) was significantly lower in the combination group. The protective effect was significant in patients with baseline eGFR >30 mL/min/1.73 m2, especially in eGFR 60-90 mL/min/1.73 m2. In patients with different complications, the incidence of AKI showed no significant differences in patients with chronic kidney injury, hypertension, anaemia, age above 75 years, except in patients with cardiovascular disease (OR, 2.82; 95% CI 1.50 to 5.29; p<0.001). However, the incidence of gastrointestinal bleeding (1.22% vs 2.84%, p=0.011) and in-hospital adverse outcomes (3.25% vs 7.00%, p<0.001) were significantly higher in the combination group. CONCLUSIONS Our study indicated that edaravone in patients with ischaemic stroke didn't increase the nephrotoxicity of aspirin, and even had a protective effect on mild renal deterioration. Nevertheless, there is a need to be cautious when patients are in bad pathophysiological conditions and at high risk of bleeding.
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Affiliation(s)
- Hui-Qin Yang
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Wen-Jun Yin
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Kun Liu
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Man-Cang Liu
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiao-Cong Zuo
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
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9
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Xu F, Liu C, Zhou Q, Ma F. Effects of sequential blood purification on the organ function and lethality in patients with paraquat-induced multiple organ dysfunction syndrome. Am J Transl Res 2022; 14:1818-1825. [PMID: 35422907 PMCID: PMC8991169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the efficacy of sequential blood purification in paraquat (PQ) poisoning-induced multiple organ dysfunction syndrome (MODS). METHODS Forty-six patients with MODS caused by PQ poisoning admitted to our hospital during January 2016-December 2020 were retrospectively enrolled. The patients were allocated into the experimental group (n = 20) and the control group (n = 26) in accordance with the different treatment methods of blood purification. The experimental group was given sequential blood purification, and the control group was given separate blood purification. The two groups were compared in terms of blood biochemical indices, inflammatory factor levels, level of organ injury and treatment efficiency. RESULTS The blood biochemical indices and inflammatory factor levels after treatment were noticeably reduced in both groups (P < 0.05), and the experimental group exhibited lower alanine aminotransferase, MB isoenzyme of creatine kinase, creatinine and blood urea nitrogen than the control group at 3 and 5 days after treatment (P < 0.05). The experimental group exhibited remarkably lower aspartate aminotransferase, lactate dehydrogenase, interleukin-6 and tumor necrosis factor-α levels, and noticeably higher interleukin-10 levels than the control group at 5 days after treatment (P < 0.05). After treatment, the experimental group showed remarkably lower overall organ damage rate (10%) than the control group (58.69%). After treatment, the two groups exhibited remarkably lower disease severity than that before treatment (P < 0.05). At 5 days after treatment, the experimental group showed remarkably lower Acute Physiology and Chronic Health Evaluation II score than the control group (P < 0.05). The experimental group showed noticeably shorter duration of mechanical ventilation, length of coma, intensive care unit stay and hospital stay than the control group after treatment (P < 0.05). The experimental group showed a remarkably higher overall efficiency of treatment (90%) than the control group (76.92%). CONCLUSION Compared with blood purification therapy alone, sequential blood purification therapy can improve the indices of liver function and coma status, suppress the inflammatory response, reduce the APACHE II score, and shorten the overall duration of treatment of patients with PQ poisoning-induced MODS.
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Affiliation(s)
- Fei Xu
- Department of Emergency, 3201 Hospital of Xi’an Jiaotong University Health Science CenterHanzhong 723000, Shaanxi Province, China
| | - Chao Liu
- Department of Emergency, 3201 Hospital of Xi’an Jiaotong University Health Science CenterHanzhong 723000, Shaanxi Province, China
| | - Qiaozhi Zhou
- Department of Emergency, 3201 Hospital of Xi’an Jiaotong University Health Science CenterHanzhong 723000, Shaanxi Province, China
| | - Fei Ma
- Department of Emergency, Hanzhong Center HospitalHanzhong 723000, Shaanxi Province, China
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10
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Ren W, Chen Y, Wang Y, Wang C, Tian M, Gu X, Lv W. Inhibitory effect of pirfenidone on pulmonary fibrosis in patients with acute paraquat poisoning. Am J Transl Res 2021; 13:13192-13199. [PMID: 34956540 PMCID: PMC8661212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/27/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To study the efficacy of pirfenidone (PFD) on patients with pulmonary fibrosis caused by acute paraquat (PQ) poisoning. METHODS A total of 86 patients with pulmonary fibrosis caused by acute PQ poisoning admitted to our hospital were analyzed retrospectively. All of them successfully received the standard 21-day treatment based on "Taishan Consensus", and they were assigned to the PFD group or the NO-PFD group according to whether they received PFD treatment (at 200 mg/time, 3 times/day) for 6 months after discharge. The two groups were compared in effective treatment rate, mortality and incidence of adverse reactions such as liver and kidney function damage, pulmonary fibrosis-associated indexes, pulmonary function-associated indexes, and arterial blood gas indexes before and after therapy. RESULTS The PFD group showed a notably higher effective treatment rate than the NO-PFD group (P<0.05). Additionally, the PFD group showed notably lower levels of serum hyaluronic acid (HA), laminin (LN), type IV collagen (CIV), and type III procollagen (PCIII), and notably higher levels of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC than the NO-PFD group (all P<0.001), and the PFD group also showed significantly higher levels of arterial blood gas indexes including arterial partial pressure of oxygen (PaO2) and PaO2/inspired oxygen (FIO2) than the NO-PFD group (both P<0.001). Moreover, the Kaplan-Meier survival curves showed that the survival rate of the patients in PFD group was significantly higher than that in the NO-PFD group (P<0.05). CONCLUSION With a high safety, PFD can effectively improve the treatment efficacy in patients with pulmonary fibrosis caused by acute PQ poisoning. PFD can improve the pulmonary function and arterial blood gas status of patients, without causing obvious liver and kidney damage.
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Affiliation(s)
- Wenbin Ren
- Department of Emergency, The Fourth Hospital of Shijiazhuang (Shijiazhuang Obstetrics and Gynecology Hospital)Shijiazhuang 050011, Hebei Province, China
| | - Yongqiang Chen
- Department of Emergency Medicine, Lanling County People’s HospitalLinyi 277700, Shandong Province, China
| | - Yuantao Wang
- Clinical Skills Center, Shandong First Medical UniversityJi’nan 271016, Shandong Province, China
| | - Chunbao Wang
- Department of Emergency, Hengshui Eighth People’s HospitalHengshui 053500, Hebei Province, China
| | - Mimi Tian
- Department of Respiratory Medicine, Gaoqing People’s HospitalZibo 256300, Shandong Province, China
| | - Xiaoxu Gu
- Department of Emergency, The Fourth Hospital of Shijiazhuang (Shijiazhuang Obstetrics and Gynecology Hospital)Shijiazhuang 050011, Hebei Province, China
| | - Weiguo Lv
- Department of Nephrology, Laiyang Central HospitalYantai 265200, Shandong Province, China
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11
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Chandra A, Shah KA, Mahato S, Bhattacharjee MS, Mandal T. Paraquat poisoning. BMJ Case Rep 2021; 14:e246585. [PMID: 34764128 PMCID: PMC8587599 DOI: 10.1136/bcr-2021-246585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Atanu Chandra
- Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
| | - Koustav Ali Shah
- Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
| | - Shubhashis Mahato
- Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
| | | | - Tanuka Mandal
- Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
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12
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Hu Y, Qian C, Sun H, Li Q, Wang J, Hua H, Dai Z, Li J, Li T, Ding Y, Yang X, Zhang W. Differences in epithelial-mesenchymal-transition in paraquat-induced pulmonary fibrosis in BALB/C and BALB/C (nu/nu) nude mice. Biomed Pharmacother 2021; 143:112153. [PMID: 34507117 DOI: 10.1016/j.biopha.2021.112153] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022] Open
Abstract
Exposure to the toxic herbicide paraquat (PQ) can lead to the active absorption and enrichment of alveolar epithelial cells, resulting in pulmonary fibrosis and respiratory failure. At present, no effective clinical treatment is available. Notably, however, patients infected with human acquired immunodeficiency virus (HIV) (with T lymphocyte deficiency) do not show pulmonary fibrosis after PQ poisoning, suggesting that T lymphocytes may be involved in the occurrence and pathological development of lung fibers following PQ exposure, although relevant studies remain limited. Here, we found that the degree of pulmonary fibrosis induced by intragastric administration of PQ in congenital immunodeficiency BALB/C (nu/nu) nude (T lymphocyte loss) mice was lower than that in normal mice. However, pulmonary fibrosis was aggravated after transplantation of BALB/C (nu/nu) T lymphocytes into congenital immunodeficiency mice. This study is the first to report on the involvement of T lymphocytes in the occurrence and pathological development of lung fibers induced by PQ exposure. Thus, T cells may be an important cellular target for the clinical treatment of pulmonary fibrosis caused by PQ.
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Affiliation(s)
- Yegang Hu
- Emergency Department, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, 650032 Kunming, Yunnan, China
| | - Chuanyun Qian
- Emergency Department, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, 650032 Kunming, Yunnan, China
| | - Huiling Sun
- Department of Anatomy and Histology & Embryology, Faculty of Basic Medical Science, Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Qiankui Li
- School of Food and Drug, Shandong Institute of Commerce and Technology, 250014 Jinan, Shandong, China
| | - Jinde Wang
- Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Hairong Hua
- Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Zichao Dai
- Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Jintao Li
- Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Tao Li
- Department of Critical Care Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 250014 Jinan, Shandong, China
| | - Yi Ding
- Department of Pathophysiology, Weifang Medical University, 261000 Weifang, Shandong, China
| | - Xinwang Yang
- Department of Anatomy and Histology & Embryology, Faculty of Basic Medical Science, Kunming Medical University, 650500 Kunming, Yunnan, China.
| | - Wei Zhang
- Emergency Department, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, 650032 Kunming, Yunnan, China.
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Yen JS, Wang IK, Liang CC, Fu JF, Hou YC, Chang CC, Gu PW, Tsai KF, Weng CH, Huang WH, Hsu CW, Yen TH. Cytokine changes in fatal cases of paraquat poisoning. Am J Transl Res 2021; 13:11571-11584. [PMID: 34786083 PMCID: PMC8581908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/21/2021] [Indexed: 06/13/2023]
Abstract
Cytokine-mediated inflammation is involved in the pathophysiology of paraquat toxicity. Nevertheless, few human studies have examined fluctuations in circulating cytokine levels. Blood samples were obtained from 21 patients with paraquat poisoning and compared to those of 18 healthy controls. All paraquat patients received a standard detoxification protocol composed of hemoperfusion, pulse therapies of methylprednisolone and cyclophosphamide, followed by dexamethasone therapy. Nonsurvivors not only had higher scores for the severity index of paraquat poisoning (P=0.004) but also presented with higher white blood cell counts (P=0.046) than survivors. Multiplex immunoassays revealed higher circulating levels of interleukin 2 (IL-2), interleukin 9 (IL-9), interleukin 10 (IL-10) and macrophage inflammatory protein-1 beta (MIP-1β) in survivors than in healthy controls. Furthermore, the circulating levels of interleukin 1 beta (IL-1β), IL-2, interleukin 5 (IL-5), interleukin 8 (IL-8), IL-9, IL-10, interleukin 12 (IL-12 p70), interleukin 17A (IL-17A), eotaxin, granulocyte colony-stimulating factor (G-CSF), monocyte chemoattractant protein-1 (MCP-1), interferon gamma-induced protein 10 (IP-10) and MIP-1β were higher in nonsurvivors than in healthy controls. Finally, the circulating levels of IL-1β and MCP-1 were higher in nonsurvivors than in survivors. Therefore, the observation of cytokine-mediated inflammation is in line with the detoxification protocol because glucocorticoids and cyclophosphamide are potent anti-inflammatory agents. Additionally, circulating levels of IL-1β and MCP-1 could serve as promising prognostic markers for patients with paraquat poisoning.
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Affiliation(s)
- Ju-Shao Yen
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial HospitalLinkou 333, Taiwan
| | - I-Kuan Wang
- Department of Nephrology, China Medical University HospitalTaichung 404, Taiwan
- College of Medicine, China Medical UniversityTaichung 406, Taiwan
| | - Chih-Chia Liang
- Department of Nephrology, China Medical University HospitalTaichung 404, Taiwan
- College of Medicine, China Medical UniversityTaichung 406, Taiwan
| | - Jen-Fen Fu
- Department of Medical Research, Chang Gung Memorial HospitalLinkou 333, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan 333, Taiwan
| | - Yi-Chou Hou
- Division of Nephrology, Department of Internal Medicine, Cardinal Tien HospitalNew Taipei City 231, Taiwan
- Fu-Jen Catholic UniversityNew Taipei City 242, Taiwan
| | - Chih-Chun Chang
- Department of Clinical Pathology, Far Eastern Memorial HospitalNew Taipei City 220, Taiwan
| | - Po-Wen Gu
- College of Medicine, Chang Gung UniversityTaoyuan 333, Taiwan
- Department of Laboratory Medicine, Chang Gung Memorial HospitalLinkou 333, Taiwan
| | - Kai-Fan Tsai
- Department of Nephrology, Chang Gung Memorial HospitalKaohsiung 833, Taiwan
| | - Cheng-Hao Weng
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial HospitalLinkou 333, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan 333, Taiwan
| | - Wen-Hung Huang
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial HospitalLinkou 333, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan 333, Taiwan
| | - Ching-Wei Hsu
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial HospitalLinkou 333, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan 333, Taiwan
| | - Tzung-Hai Yen
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial HospitalLinkou 333, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan 333, Taiwan
- Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial HospitalLinkou 333, Taiwan
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Khorashadizadeh N, Neamati A, Moshiri M, Etemad L. Verbascoside inhibits paraquate-induced pulmonary toxicity via modulating oxidative stress, inflammation, apoptosis and DNA damage in A549 cell. Drug Chem Toxicol 2021; 45:2212-2220. [PMID: 34607471 DOI: 10.1080/01480545.2021.1917467] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Paraquat (PQ), one of the most frequently used herbicides, can cause serious health problems in an exposed individual. In the present study, we investigated the protective effect of verbascoside (VB), a phenylpropanoid glycoside from lemon verbena, against PQ-induced A549 cell injury with a particular focus on the possible molecular pathways involved. A549 cells were exposed to PQ (300 µM) and different concentrations of VB (12.5, 25, and 50 µM). Cell viability, ROS content, the level of antioxidant enzymes (SOD, CAT and GPx) and inflammatory markers (IL-6 and TNF-α), as well as 8-OHdG, were detected using MTT assay and an ELISA kit. Western blotting and qRT-PCR were performed to measure the levels of caspase3 and NF-κB mRNA and protein expression. Exposure of cells to PQ caused viability loss and ROS increase. PQ also increased the levels of IL-6, TNF-α and 8-OHdG and decreased the antioxidant enzymes content. PQ treatment resulted in cell death by increasing the gene and protein expression level of caspase 3 and NF-κB. Treatment with VB notably increased cell survival, antioxidant enzymes activity, which concomitantly attenuated ROS, NF-κB and inflammatory mediator production. VB also inhibited apoptosis expression markers. These results indicated that VB could protect A549 cells against PQ induced cell injury by attenuation of ROS and inflammatory marker production and modulation of antioxidant enzymes. VB efficiently suppressed increased NF-κB and caspase-3 activity and formation of 8-OHdG and ultimately improved cell viability. Therefore, VB may be useful in the development of a new therapy for PQ-induced pulmonary toxicity.
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Affiliation(s)
| | - Ali Neamati
- Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Mohammad Moshiri
- Medical Toxicology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Clinical Toxicology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leila Etemad
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
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15
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Xiao C, Yu Y, Liu Y, Yang J. Aerosol inhalation of edaravone can improve inflammation, oxidative stress and pulmonary function of rats with smoke inhalation injury by down-regulating miR-320. Am J Transl Res 2021; 13:2563-2570. [PMID: 34017415 PMCID: PMC8129403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the protective effects and related mechanism of aerosol inhalation of edaravone on inflammation, oxidative stress and pulmonary function (PF) in rats with smoke inhalation injury. METHODS Twenty-four rats were stochastically and equally divided into four groups: group A (edaravone-preventing group), group B (model group), group C (low-dose group) and group D (high-dose group). The serum of rats was collected to determine the expression of miR-320, inflammatory mediators (TNF-α, IL-6, IL-10), oxidative stress indexes (MDA, SOD, MPO) and oxygenation index (OI). Pulmonary tissues of rats were collected to determine the total lung water (TLW), wet-to-dry ratio (W/D) and other parameters. HE staining was adopted for pathological evaluation. RESULTS Compared with group B, the levels of miR-320, TNF-α, IL-6, MDA, MPO, TLW and W/D in group A were significantly down-regulated, while IL-10, SOD and OI levels were significantly up-regulated, and the trend of this change was more obvious than that in group C and group D, with notably better improvement degree in group D than group C. In HE staining, the pulmonary tissue structure was basically normal in group A, and was better than that of the other three groups. In group B, the pulmonary tissue was seriously damaged, accompanied by a large number of inflammatory cells infiltration and alveolar wall thickening. The pathological condition of group C was notably ameliorated, the extent of this improvement was more pronounced in group D, and the degree of pathological improvement in group D was superior to that in group C. CONCLUSION Aerosol inhalation of edaravone in advance can reduce the levels of inflammatory factors and oxidative stress indexes in serum of smoke inhalation injury rats, thus protecting PF, which may be related to the down-regulation of miR-320 by edaravone.
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Affiliation(s)
- Changshuan Xiao
- Department of Burn Plastic Surgery, Affiliated Hospital of Chengde Medical UniversityChengde 067000, Hebei Province, China
| | - Yue Yu
- Department of Burn Plastic Surgery, Affiliated Hospital of Chengde Medical UniversityChengde 067000, Hebei Province, China
| | - Yaping Liu
- Department of Gynaecology, Affiliated Hospital of Chengde Medical UniversityChengde 067000, Hebei Province, China
| | - Jingzhe Yang
- Department of Burn Plastic Surgery, Affiliated Hospital of Chengde Medical UniversityChengde 067000, Hebei Province, China
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16
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Lin CC, Hsu KH, Shih CP, Chang GJ. Hemodynamic and electromechanical effects of paraquat in rat heart. PLoS One 2021; 16:e0234591. [PMID: 33793552 PMCID: PMC8016255 DOI: 10.1371/journal.pone.0234591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 03/18/2021] [Indexed: 01/04/2023] Open
Abstract
Paraquat (PQ) is a highly lethal herbicide. Ingestion of large quantities of PQ usually results in cardiovascular collapse and eventual mortality. Recent pieces of evidence indicate possible involvement of oxidative stress- and inflammation-related factors in PQ-induced cardiac toxicity. However, little information exists on the relationship between hemodynamic and cardiac electromechanical effects involved in acute PQ poisoning. The present study investigated the effects of acute PQ exposure on hemodynamics and electrocardiogram (ECG) in vivo, left ventricular (LV) pressure in isolated hearts, as well as contractile and intracellular Ca2+ properties and ionic currents in ventricular myocytes in a rat model. In anesthetized rats, intravenous PQ administration (100 or 180 mg/kg) induced dose-dependent decreases in heart rate, blood pressure, and cardiac contractility (LV +dP/dtmax). Furthermore, PQ administration prolonged the PR, QRS, QT, and rate-corrected QT (QTc) intervals. In Langendorff-perfused isolated hearts, PQ (33 or 60 μM) decreased LV pressure and contractility (LV +dP/dtmax). PQ (10-60 μM) reduced the amplitudes of Ca2+ transients and fractional cell shortening in a concentration-dependent manner in isolated ventricular myocytes. Moreover, whole-cell patch-clamp experiments demonstrated that PQ decreased the current amplitude and availability of the transient outward K+ channel (Ito) and altered its gating kinetics. These results suggest that PQ-induced cardiotoxicity results mainly from diminished Ca2+ transients and inhibited K+ channels in cardiomyocytes, which lead to LV contractile force suppression and QTc interval prolongation. These findings should provide novel cues to understand PQ-induced cardiac suppression and electrical disturbances and may aid in the development of new treatment modalities.
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Affiliation(s)
- Chih-Chuan Lin
- Department of Emergency Medicine, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Kuang-Hung Hsu
- Laboratory for Epidemiology, Department of Health Care Management, and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan
| | - Chia-Pang Shih
- Department of Nursing, Yuanpei University of Medical Technology, Hsin-Chu, Taiwan
| | - Gwo-Jyh Chang
- Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
- Cardiovascular Division of Medicine, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
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17
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Subbiah R, Tiwari RR. The herbicide paraquat-induced molecular mechanisms in the development of acute lung injury and lung fibrosis. Crit Rev Toxicol 2021; 51:36-64. [PMID: 33528289 DOI: 10.1080/10408444.2020.1864721] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The herbicide paraquat (PQ; 1,1'-dimethyl-4,4'-bipyridylium dichloride) is a highly toxic organic heterocyclic herbicide that has been widely used in agricultural settings. Since its commercial introduction in the early 1960s, numerous cases of fatal PQ poisonings attributed to accidental and/or intentional ingestion of PQ concentrated formulations have been reported. The clinical manifestations of the respiratory system during the acute phase of PQ poisoning mainly include acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), followed by pulmonary fibrosis in a later phase. The focus of this review is to summarize the most recent publications related to PQ-induced lung toxicity as well as the underlying molecular mechanisms for PQ-mediated pathologic processes. Growing sets of data from in vitro and in vivo models have demonstrated the involvement of the PQ in regulating lung oxidative stress, inflammatory response, epigenetics, apoptosis, autophagy, and the progression of lung fibrosis. The article also summarizes novel therapeutic avenues based on a literature review, which can be explored as potential means to combat PQ-induced lung toxicity. Finally, we also presented clinical studies on the association of PQ exposure with the incidence of lung injury and pulmonary fibrosis.
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Affiliation(s)
- Rajasekaran Subbiah
- Department of Biochemistry, ICMR-National Institute for Research in Environmental Health, Bhopal, India
| | - Rajnarayan R Tiwari
- Department of Biochemistry, ICMR-National Institute for Research in Environmental Health, Bhopal, India
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18
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Demir F, Demir M, Aygun H. Evaluation of the protective effect of edaravone on doxorubicin nephrotoxicity by [ 99mTc]DMSA renal scintigraphy and biochemical methods. Naunyn Schmiedebergs Arch Pharmacol 2020; 393:1383-1390. [PMID: 32036411 DOI: 10.1007/s00210-020-01832-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/23/2020] [Indexed: 12/14/2022]
Abstract
To evaluate the nephroprotective effect of edaravone on doxorubicin-induced nephrotoxicity. In this experimental study, twenty-eight Wistar male rats were used. The rats were separated into 4 groups (n = 7); group І (control), rats were treated with saline (4 ml/kg) and group ІІ (doxorubicin), nephrotoxicity was induced by three doses of 18 mg/kg/i.p. doxorubicin, at a 24-h interval on the 12th, 13th, and 14th days. Group ІІІ (edaravone), rats were treated with edaravone (30 mg/kg/for 14 days), and group ІV (edaravone + doxorubicin), rats were treated with edaravone (30 mg/kg/for 14 days) and doxorubicin were injected (18 mg/kg/for 3 days; at a 24-h interval on the 12th, 13th, and 14th days). On the 15th day of the experiment, technetium-99m-labeled dimercaptosuccinic acid ([99mTc]DMSA) uptake was obtained in both kidneys and biochemical parameters from serum and kidney tissue were measured. Doxorubicin led to nephrotoxicity through elevation of serum blood urea nitrogen (BUN), creatinine and tumor necrosis factor-α (TNF-α), nitric oxide (NO), and interleukin-6 (IL-6) in kidney tissue and decreased [99mTc]DMSA uptake level in the kidney when compared with control group (p < 0.01). Pretreatment edaravone significantly decreased BUN and creatinine, also kidney tissue TNF-α, IL-6, NO, and increased [99mTc]DMSA uptake level compared with the doxorubicin. Edaravone has a significant nephroprotective effect through the attenuation of oxidative stress and inflammatory markers during doxorubicin-induced nephrotoxicity in rats.
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Affiliation(s)
- Fadime Demir
- Department of Nuclear Medicine, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Mustafa Demir
- Department of Nephrology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Hatice Aygun
- Department of Physiology, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey.
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Abstract
Paraquat is a commonly used herbicide in India that has lethal consequences even on minimal consumption. The case fatality rate for this poisoning is high and there is dearth of evidence-based recommendation for the treatment of this poison. This review article explores the diagnosis and management of paraquat poisoning with an emphasis on recent advances in treatment. Though immunosuppressants and antioxidants are conventionally used, there is a gap in evidence to prove survival benefit of these treatment regimens. There are also some data showing the use of hemoperfusion (with toxin-specific cartridges) as an early intervention, i.e., within 4 hours of exposure to the poison. The recent drug, Edaravone, has also shown promise in the prevention of renal and hepatic injury in paraquat poisoning. Though it did not reduce pulmonary fibrosis in patients with paraquat poisoning, it delays the generation and development of pulmonary fibrosis. However, there is a need for more clinical and experimental studies to validate its use in paraquat poisoning. HOW TO CITE THIS ARTICLE Sukumar CA, Shanbhag V, Shastry AB. Paraquat: The Poison Potion. Indian J Crit Care Med 2019;23(Suppl 4):S263-S266.
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Affiliation(s)
- Cynthia A Sukumar
- Department of General Medicine, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vishal Shanbhag
- Department of Critical Care Medicine, Manipal Academy of Higher Education, Manipal, Karnataka, India
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20
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Potential use of edaravone to reduce specific side effects of chemo-, radio- and immuno-therapy of cancers. Int Immunopharmacol 2019; 77:105967. [DOI: 10.1016/j.intimp.2019.105967] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 09/30/2019] [Accepted: 10/07/2019] [Indexed: 02/06/2023]
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