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Zhao S, Li Y, Kong H, Zhou Y, Zhou W, Zheng J, Gong Q, Cao C, Ding J, Zhou X. Bioinformatic features and immunological response of recombinant antigen CTLA4-IgV-EgG1Y162 against Echinococcus granulosus. Braz J Med Biol Res 2024; 57:e13139. [PMID: 39607201 DOI: 10.1590/1414-431x2024e13139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 10/15/2024] [Indexed: 11/29/2024] Open
Abstract
Cystic echinococcosis (CE) is a zoonotic disease caused by the infection of Echinococcus granulosus (E. granulosus) larva. Currently, blocking the pathogenic cycle chain through immunoprophylaxis has become the main research direction. EgG1Y162 protein has good antigenicity and immunogenicity and is therefore a good candidate molecule for E. granulosus vaccine. Mature T cells express CTLA-4 on their surface, and its extracellular IgV region binds efficiently to the B7 molecules on antigen-presenting cells to deliver negative signals. We designed and prepared a recombinant vaccine by fusing CTLA-4IgV to the EgG1Y162 protein to exploit its binding properties. Bioinformatic methods were used to analyze the structure and epitopes of the proposed recombinant vaccine. The placement of 16 amino acids (GTDDDDKAMADIGSEF) between the CTLA-4IgV and EgG1Y162 using the skeleton structure of pET30a plasmid did not affect the correct folding of the proteins. When the recombinant proteins were co-cultured with bone marrow-induced dendritic cells (DC), the protein CTLA-4IgV-EgG1Y162 promoted its binding to DC and increased the percentage of DC maturation compared with protein EgG1Y162 in vitro and in vivo. Compared to EgG1Y162, CTLA-4IgV-EgG1Y162 promoted the proliferation of lymphocytes in spleen and the release of interferon (IFN)-γ and interleukin (IL)-4 by those lymphocytes in vitro, while it also promoted the release of protective antibodies in the serum of immunized mice in vivo. These findings indicated that the designed recombinant vaccine, CTLA-4IgV-EgG1Y162, can provide new ideas for the optimization and improvement of vaccines against E. granulosus.
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Affiliation(s)
- Shangqi Zhao
- Department of Immunology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Molecular Biology for Endemic Diseases, Urumqi, Xinjiang, China
| | - Yanmin Li
- Department of Immunology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Molecular Biology for Endemic Diseases, Urumqi, Xinjiang, China
| | - Huifang Kong
- Department of Immunology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yanxia Zhou
- Department of Immunology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Wentao Zhou
- The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Jia Zheng
- Department of Immunology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Molecular Biology for Endemic Diseases, Urumqi, Xinjiang, China
| | - Qiaoqiao Gong
- Department of Immunology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Chunbao Cao
- Department of Immunology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Jianbing Ding
- Department of Immunology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xiaotao Zhou
- Department of Immunology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Molecular Biology for Endemic Diseases, Urumqi, Xinjiang, China
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Frazaei MH, Nouri R, Arefnezhad R, Pour PM, Naseri M, Assar S. A Review of Medicinal Plants and Phytochemicals for the Management of Gout. Curr Rheumatol Rev 2024; 20:223-240. [PMID: 37828678 DOI: 10.2174/0115733971268037230920072503] [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: 06/19/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 10/14/2023]
Abstract
Gout, characterized by elevated uric acid levels, is a common inflammatory joint disease associated with pain, joint swelling, and bone erosion. Existing treatments for gout often result in undesirable side effects, highlighting the need for new, safe, and cost-effective anti-gout drugs. Natural products, including medicinal plants and phytochemicals, have gained attention as potential sources of anti-gout compounds. In this review, we examined articles from 2000 to 2020 using PubMed and Google Scholar, focusing on the effectiveness of medicinal plants and phyto-chemicals in managing gout. Our findings identified 14 plants and nine phytochemicals with anti-gout properties. Notably, Teucrium polium, Prunus avium, Smilax riparia, Rhus coriaria, Foenic-ulum vulgare, Allium cepa, Camellia japonica, and Helianthus annuus exhibited the highest xa-thine oxidase inhibitory activity, attributed to their unique natural bioactive compounds such as phenolics, tannins, coumarins, terpenoids, and alkaloids. Herbal plants and their phytochemicals have demonstrated promising effects in reducing serum urate and inhibiting xanthine. This review aims to report recent studies on plants/phytochemicals derived from herbs beneficial in gout and their different mechanisms.
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Affiliation(s)
- Mohammad Hosein Frazaei
- Department of Pharmacology, Medical Technology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roghayeh Nouri
- Department of Pharmacology, Medical Technology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Arefnezhad
- Anatomical Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pardis Mohammadi Pour
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Naseri
- Department of Pharmacology, Medical Technology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shirin Assar
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Lee JY, Son HG, Koo Y, Jung SH, Park SD, Shim JJ, Lee JL, Lee YH. Protective Effects of Cudrania tricuspidata Against Helicobacter pylori-Induced Inflammation in C57BL/6 Mice. J Med Food 2023; 26:224-231. [PMID: 36862521 DOI: 10.1089/jmf.2022.k.0133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Helicobacter pylori modulates the host inflammatory response, resulting in chronic gastritis, which contributes to gastric cancer pathogenesis. We verified the effect of Cudrania tricuspidata on H. pylori infection by inhibiting H. pylori-induced inflammatory activity. Five-week-old C57BL/6 mice (n = 8) were administered C. tricuspidata leaf extract (10 or 20 mg/kg per day) for 6 weeks. An invasive test (campylobacter-like organism [CLO]) and noninvasive tests (stool antigen test [SAT] and H. pylori antibody enzyme-linked immunosorbent assay) were performed to confirm the eradication of H. pylori. To evaluate the anti-inflammatory effect of C. tricuspidata, pro-inflammatory cytokines levels and inflammation scores were measured in mouse gastric tissue. C. tricuspidata significantly decreased the CLO score and H. pylori immunoglobulin G antibody optical density levels at both 10 and 20 mg/kg per day doses (P < .05). C. tricuspidata decreased the H. pylori antibody levels in a concentration-dependent manner, increased negative responses to SAT by up to 37.5%, and inhibited the pro-inflammatory cytokines interleukin (IL; IL-1β, IL-6, 1L-8, and tumor necrosis factor alpha). C. tricuspidata also relieved gastric erosions and ulcers and significantly reduced the inflammation score (P < .05). We measured rutin in C. tricuspidata extract as a standard for high-performance liquid chromatography. C. tricuspidata leaf extract showed anti-H. pylori activity through the inhibition of inflammation. Our findings suggest that C. tricuspidata leaf extract is potentially an effective functional food material against H. pylori.
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Affiliation(s)
- Jeong Yoon Lee
- Department of Food and Nutrition, University of Suwon, Hwasung, South Korea
| | - Hyung Gu Son
- Department of Food and Nutrition, University of Suwon, Hwasung, South Korea
| | - Yejin Koo
- Department of Food and Nutrition, University of Suwon, Hwasung, South Korea
| | | | | | | | | | - Yoo-Hyun Lee
- Department of Food and Nutrition, University of Suwon, Hwasung, South Korea
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Identification of Novel Parishin Compounds from the Twig of Maclura tricuspidata and Comparative Analysis of Parishin Derivatives in Different Parts. Molecules 2022; 28:molecules28010007. [PMID: 36615203 PMCID: PMC9822251 DOI: 10.3390/molecules28010007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Parishin compounds are rare polyphenolic glucosides mainly found in the rhizome of the traditional Chinese medicinal plant, Gastrodia elata. These constituents are reported to have several biological and pharmacological activities. In the present study, two novel parishin derivatives not previously reported as plant-based phytochemicals were identified from a twig of Maclura tricuspidata (MT) and two new compounds were elucidated as 1-(4-(β-d-glucopyranosyloxy)benzyl)-3-hydroxy-3-methylpentane-1,5-dioate (named macluraparishin E) and 1,3-bis(4-(β-d-glucopyranosyloxy)benzyl)-3-hydroxy-3-methylpentane- 1,5-dioate (macluraparishin C), based on the experimental data obtained by UV-Visible (UV-Vis) spectroscopy, high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (HPLC-QTOF-MS) and nuclear magnetic resonance (NMR) spectroscopy. Additionally, gastrodin, parishin A and parishin B were positively identified by spectroscopic evidence and the comparison of HPLC retention time with the corresponding authentic standards. Gastrodin, parishin A and parishin B, macluraparishin E and macluraparishin C were found to be the most abundant constituents in the MT twig. The compositions and contents of these constituents were found to vary depending on the different parts of the MT plant. In particular, the contents of parishin A, parishin B, macluraparishin C and macluraparishin E were higher in the twig, bark and root than in the leaves, xylem and fruit.
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Jo YH, Lee S, Yeon SW, Turk A, Lee JH, Hong SM, Han YK, Lee KY, Hwang BY, Kim SY, Lee MK. Anti-diabetic potential of Masclura tricuspidata leaves: Prenylated isoflavonoids with α-glucosidase inhibitory and anti-glycation activity. Bioorg Chem 2021; 114:105098. [PMID: 34153812 DOI: 10.1016/j.bioorg.2021.105098] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/10/2021] [Accepted: 06/12/2021] [Indexed: 01/20/2023]
Abstract
Investigation of chemical constituents of Masclura tricuspidata leaves resulted in the isolation of 47 isoflavonoids possessing prenyl groups with different numbers and structures. Among them, sixteen compounds named cudracusisoflavones A-P (1-16) were first isolated from nature. The isoflavonoids isolated from M. tricuspidata leaves showed anti-diabetic effects as measured by inhibition on α-glucosidase activity and advanced glycation end-products (AGEs) formations. Especially, cudracusisoflavone L (12), a new compound, together with gancaonin M (27), erysenegalensein E (41) and millewanin G (44) showed strong α-glucosidase inhibition with IC50 values <10.0 μM. In addition, cudracusisoflavones A (1), D (4), M (13) and N (14), together with known prenylated isoflavonoids efficiently inhibited methylglyoxal (MGO)- or glyoxal (GO)-induced AGE formations. Structure activity relationship together with molecular docking analysis suggested the importance of hydroxy group and linear type of prenyl moiety for α-glucosidase inhibition. Conclusively, diverse prenylated isoflavonoids in M. tricuspidata leaves might ameliorate glycotoxicity-induced metabolic diseases.
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Affiliation(s)
- Yang Hee Jo
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea
| | - Solip Lee
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea
| | - Sang Won Yeon
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea
| | - Ayman Turk
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea
| | - Jae Hyuk Lee
- College of Pharmacy, Gachon University, Incheon 21936, Republic of Korea
| | - Seong-Min Hong
- College of Pharmacy, Gachon University, Incheon 21936, Republic of Korea
| | - Yoo Kyong Han
- College of Pharmacy, Korea University, Sejong 47236, Republic of Korea
| | - Ki Yong Lee
- College of Pharmacy, Korea University, Sejong 47236, Republic of Korea
| | - Bang Yeon Hwang
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea
| | - Sun Yeou Kim
- College of Pharmacy, Gachon University, Incheon 21936, Republic of Korea
| | - Mi Kyeong Lee
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea.
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Lu Q, Harmalkar DS, Quan G, Kwon H, Cho J, Choi Y, Lee D, Lee K. Total Synthesis of the Neuroprotective Agent Cudraisoflavone J. JOURNAL OF NATURAL PRODUCTS 2021; 84:1359-1365. [PMID: 33826847 DOI: 10.1021/acs.jnatprod.1c00121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Cudraisoflavone J (1), isolated from Cudrania tricuspidata, is a potent neuroprotective compound with a chiral center. Herein, we report the first total synthesis of racemic cudraisoflavone J (1) using a Claisen rearrangement and a Suzuki coupling reaction as the key steps. Racemic secondary alcohol was kinetically resolved to give (+)- and (-)-cudraisoflavone J with up to 97 and 88% enantiomeric excess, respectively. The modified Mosher's method was used to elucidate the absolute configuration of naturally occurring cudraisoflavone J.
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Affiliation(s)
- Qili Lu
- College of Pharmacy, Dongguk University-Seoul, Goyang 10326, Republic of Korea
| | - Dipesh S Harmalkar
- College of Pharmacy, Dongguk University-Seoul, Goyang 10326, Republic of Korea
- Department of Biotechnology, Korea University, Seoul 02841, Republic of Korea
| | - Guofeng Quan
- College of Pharmacy, Dongguk University-Seoul, Goyang 10326, Republic of Korea
| | - Haeun Kwon
- Department of Plant Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul 02841, Republic of Korea
| | - Jungsook Cho
- College of Pharmacy, Dongguk University-Seoul, Goyang 10326, Republic of Korea
| | - Yongseok Choi
- Department of Biotechnology, Korea University, Seoul 02841, Republic of Korea
| | - Dongho Lee
- Department of Plant Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul 02841, Republic of Korea
| | - Kyeong Lee
- College of Pharmacy, Dongguk University-Seoul, Goyang 10326, Republic of Korea
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Kim GD, Park S. Effects of Cudrania tricuspidata on anti-senescence in high glucose-treated endothelial cells via the Akt/p53/p21 pathway. Food Sci Nutr 2020; 8:5999-6006. [PMID: 33282251 PMCID: PMC7684615 DOI: 10.1002/fsn3.1885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 08/19/2020] [Accepted: 08/23/2020] [Indexed: 01/08/2023] Open
Abstract
The roles of Cudrania tricuspidata (CT) in the prevention of senescence and the underlying mechanisms have not been elucidated. In a high glucose (HG)-induced senescent endothelial cell (EC) culture, CT (20 µg/ml) reduced the number of senescence-associated β-galactosidase-positive cells by 8.3% compared with the control group and increased the expression of p-Sirt1 by more than twofold compared with the control group. Moreover, 20 μg/ml CT treatment doubled the activity of p-Akt, which was inhibited by HG, compared with the control group. In addition, CT treatment decreased the expression of p53, p21, and Rb, which was increased by HG. Overall, CT delays HG-induced senescence via the Akt/p53/p21 pathway, suggesting its potential as a functional agent for the protection of ECs.
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Affiliation(s)
- Gi Dae Kim
- Department of Food and NutritionKyungnam UniversityChangwon‐siRepublic of Korea
| | - Seonghee Park
- Department of Biological ScienceSookmyung Women's UniversitySeoulRepublic of Korea
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Ko W, Kim KW, Quang TH, Yoon CS, Kim N, Lee H, Kim SC, Woo ER, Kim YC, Oh H, Lee DS. Cudraflavanone B Isolated from the Root Bark of Cudrania tricuspidata Alleviates Lipopolysaccharide-Induced Inflammatory Responses by Downregulating NF-κB and ERK MAPK Signaling Pathways in RAW264.7 Macrophages and BV2 Microglia. Inflammation 2020; 44:104-115. [PMID: 32766955 DOI: 10.1007/s10753-020-01312-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A prenylated flavonoid, cudraflavanone B, is isolated from Cudrania tricuspidata. In this study, we investigated its anti-inflammatory and anti-neuroinflammatory effects in lipopolysaccharide (LPS)-induced RAW264.7 and BV2 cells. In our initial study of the anti-inflammatory effects of cudraflavanone B the production of nitric oxide and prostaglandin E2 was attenuated in LPS-stimulated RAW264.7 and BV2 cells. These inhibitory effects were related to the downregulation of inducible nitric oxide synthase and cyclooxygenase-2. In addition, cudraflavanone B suppressed the production of pro-inflammatory cytokines such as interleukin-6 and tumor necrosis factor-α in LPS-induced RAW264.7 and BV2 cells. Moreover, the evaluation of the molecular mechanisms underlying the anti-inflammatory effects of cudraflavanone B revealed that the compound attenuated the nuclear factor-kappa B signaling pathway in LPS-induced RAW264.7 and BV2 cells. In addition, cudraflavanone B inhibited the phosphorylation of extracellular signal-regulated kinase mitogen-activated protein kinase signaling pathways in these LPS-stimulated cells. Thus, cudraflavanone B suppressed nuclear factor-κB, and extracellular signal-regulated kinase mitogen-activated protein kinase mediated inflammatory pathways, demonstrating its potential in the treatment of neuroinflammatory conditions.
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Affiliation(s)
- Wonmin Ko
- College of Pharmacy, Chosun University, Dong-gu, Gwangju, 61452, Republic of Korea
| | - Kwan-Woo Kim
- College of Pharmacy, Wonkwang University, Iksan, 54538, Republic of Korea
| | - Tran Hong Quang
- Institute of Marine Biochemistry, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi, Vietnam
| | - Chi-Su Yoon
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju-si, 28116, Republic of Korea
| | - Nayeon Kim
- College of Pharmacy, Chosun University, Dong-gu, Gwangju, 61452, Republic of Korea
| | - Hwan Lee
- College of Pharmacy, Chosun University, Dong-gu, Gwangju, 61452, Republic of Korea
| | - Sam-Cheol Kim
- Department of Family Practice and Community Medicine, Chosun University College of Medicine, Dong-gu, Gwangju, 61452, Republic of Korea
| | - Eun-Rhan Woo
- College of Pharmacy, Chosun University, Dong-gu, Gwangju, 61452, Republic of Korea
| | - Youn-Chul Kim
- College of Pharmacy, Wonkwang University, Iksan, 54538, Republic of Korea
| | - Hyuncheol Oh
- College of Pharmacy, Wonkwang University, Iksan, 54538, Republic of Korea
| | - Dong-Sung Lee
- College of Pharmacy, Chosun University, Dong-gu, Gwangju, 61452, Republic of Korea.
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Kim EN, Kwon J, Lee HS, Lee S, Lee D, Jeong GS. Inhibitory Effect of Cudratrixanthone U on RANKL-Induced Osteoclast Differentiation and Function in Macrophages and BMM Cells. Front Pharmacol 2020; 11:1048. [PMID: 32848726 PMCID: PMC7419678 DOI: 10.3389/fphar.2020.01048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/26/2020] [Indexed: 12/19/2022] Open
Abstract
Cudratrixanthone U (CTU) is a prenylated xanthone compound isolated from Maclura tricuspidata Bureau (Moraceae). Prenylated xanthones have been reported to exhibit a variety of biological activities. However, the effects of prenylated xanthone on osteoclast differentiation and function are still unclear. Excessive bone resorption by osteoclasts is considered a major cause of diseases such as osteoporosis. Accordingly, suppression of excessive osteoclast formation and function is one of strategies for treating osteoclast related bone diseases. In this study, CTU inhibited osteoclast differentiation and function in RAW264.7 macrophages and BMM cells induced by receptor activator of nuclear factor-κB ligand (RANKL). CTU regulated the formation of TRAF6-TAK1 complex in RANKL-induced RAW264.7 macrophages and BMM cells. Osteoclast-specific genes including those encoding matrix metallopeptidase 9 (MMP-9), dendritic cell-specific transmembrane proteins (DC-STAMP), cathepsin K (CTSK) and chemokine CC motif ligand 4 (CCL4) play an important role in bone resorption and migration, and were effectively regulated by CTU. These results suggest that CTU is a potential therapeutic agent in osteoporosis.
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Affiliation(s)
- Eun-Nam Kim
- College of Pharmacy, Keimyung University, Daegu, South Korea
| | - Jaeyoung Kwon
- Natural Constituents Research Center, Korea Institute of Science and Technology (KIST), Gangneung, South Korea
| | - Hyun-Su Lee
- College of Pharmacy, Keimyung University, Daegu, South Korea
| | - Sooyeun Lee
- College of Pharmacy, Keimyung University, Daegu, South Korea
| | - Dongho Lee
- Department of Biosystems and Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, South Korea
| | - Gil-Saeng Jeong
- College of Pharmacy, Keimyung University, Daegu, South Korea
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Chemical Composition and Antioxidant Activity of Steam-Distilled Essential Oil and Glycosidically Bound Volatiles from Maclura Tricuspidata Fruit. Foods 2019; 8:foods8120659. [PMID: 31835417 PMCID: PMC6963948 DOI: 10.3390/foods8120659] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/02/2019] [Accepted: 12/05/2019] [Indexed: 02/06/2023] Open
Abstract
Essential oil obtained from Maclura triscuspidata fruit has been reported to have functional properties. This study aimed at determining chemical compositions and antioxidant activities of steam-distilled essential oil (SDEO) and glycosidically bound aglycone fraction (GBAF) isolated from fully ripe M. triscuspidata fruit. SDEO was isolated by simultaneous steam distillation and extraction (SDE). GBAF was prepared by Amberlite XAD-2 adsorption of methanol extract, followed by methanol elution and enzymatic hydrolysis. Both fractions were analyzed by gas chromatography–mass spectrometry (GC–MS). A total of 76 constituents were identified from both oils. Apart from fatty acids and their esters, the SDEO contained p-cresol in the highest concentration (383.5 ± 17.7), followed by δ-cadinene (147.7 ± 7.7), β-caryophyllene (145.7 ± 10.5), β-ionone (141.0 ± 4.5), n-nonanal (140.3 ± 20.5), theaspirane A (121.3 ± 4.5) and theaspirane B (99.67 ± 9.05 µg/g). Thirteen carotenoid-derived compounds identified in the SDEO are being isolated from M. triscuspidata fruit for the first time. Out of the 22 components identified in GBAF, 14 were present only in the glycosidically bound volatiles. Antioxidant activity of the GBAF was higher than that of SDEO. These results suggest that glycosidically bound volatiles of M. triscuspidata fruit have a good potential as natural antioxidants.
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Oh HN, Park DH, Park JY, Song SY, Lee SH, Yoon G, Moon HS, Oh DS, Rhee SH, Im EO, Yoon IS, Shim JH, Cho SS. Tyrosinase Inhibition Antioxidant Effect and Cytotoxicity Studies of the Extracts of Cudrania tricuspidata Fruit Standardized in Chlorogenic Acid. Molecules 2019; 24:molecules24183266. [PMID: 31500323 PMCID: PMC6767289 DOI: 10.3390/molecules24183266] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 08/30/2019] [Accepted: 09/06/2019] [Indexed: 11/22/2022] Open
Abstract
In the present study, various extracts of C. tricuspidata fruit were prepared with varying ethanol contents and evaluated for their biomarker and biological properties. The 80% ethanolic extract showed the best tyrosinase inhibitory activity, while the 100% ethanolic extract showed the best total phenolics and flavonoids contents. The HPLC method was applied to analyze the chlorogenic acid in C. tricuspidata fruit extracts. The results suggest that the observed antioxidant and tyrosinase inhibitory activity of C. tricuspidata fruit extract could partially be attributed to the presence of marker compounds in the extract. In this study, we present an analytical method for standardization and optimization of C. tricuspidata fruit preparations. Further investigations are warranted to confirm the in vivo pharmacological activity of C. tricuspidata fruit extract and its active constituents and assess the safe use of the plant for the potential development of the extract as a skin depigmentation agent.
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Affiliation(s)
- Ha-Na Oh
- College of Pharmacy, Mokpo National University, Muan-gun, Jeonnam 58554, Korea.
| | - Dae-Hun Park
- Department of Nursing, Dongshin University, Naju-si, Jeonnam 58245, Korea.
| | - Ji-Yeon Park
- College of Pharmacy, Mokpo National University, Muan-gun, Jeonnam 58554, Korea.
| | - Seung-Yub Song
- College of Pharmacy, Mokpo National University, Muan-gun, Jeonnam 58554, Korea.
| | - Sung-Ho Lee
- College of Pharmacy, Mokpo National University, Muan-gun, Jeonnam 58554, Korea.
| | - Goo Yoon
- College of Pharmacy, Mokpo National University, Muan-gun, Jeonnam 58554, Korea.
| | - Hong-Seop Moon
- College of Pharmacy, Mokpo National University, Muan-gun, Jeonnam 58554, Korea.
| | - Deuk-Sil Oh
- Jeollanam-do Forest Resource Research Institute, Naju, Jeonnam 58213, South Korea.
| | - Sang-Hoon Rhee
- Department of Biological Sciences, Oakland University, Rochester, MI 48309, USA.
| | - Eun-Ok Im
- Department of Pharmacy, College of Pharmacy, Pusan National University, Busan 46241, Korea.
| | - In-Soo Yoon
- Department of Pharmacy, College of Pharmacy, Pusan National University, Busan 46241, Korea.
| | - Jung-Hyun Shim
- College of Pharmacy, Mokpo National University, Muan-gun, Jeonnam 58554, Korea.
| | - Seung-Sik Cho
- College of Pharmacy, Mokpo National University, Muan-gun, Jeonnam 58554, Korea.
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Comparison of Bioactive Compounds and Antioxidant Activities of Maclura tricuspidata Fruit Extracts at Different Maturity Stages. Molecules 2019; 24:molecules24030567. [PMID: 30720740 PMCID: PMC6384656 DOI: 10.3390/molecules24030567] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 01/22/2019] [Accepted: 02/01/2019] [Indexed: 11/17/2022] Open
Abstract
Maclura tricuspidata fruit contains various bioactive compounds and has traditionally been used in folk medicine and as valuable food material in Korea. The composition and contents of bioactive compounds in the fruit can be influenced by its maturity stages. In this study, total phenol, total flavonoid, individual polyphenolic compounds, total carotenoids and antioxidant activities at four maturity stages of the fruit were determined. Polyphenolic compounds were analyzed using high-pressure liquid chromatography-quadrupole time-of-flight mass spectrometry (HPLC-QTOF-MS) and HPLC. Among 18 polyphenolic compounds identified in this study, five parishin derivatives (gastrodin, parishin A, B, C, E) were positively identified for the first time in this plant. These compounds were also validated and quantified using authentic standards. Parishin A was the most abundant component, followed by chlorogenic acid, gastrodin, eriodictyol glucoside, parishin C, parishin E and parishin B. The contents of all the polyphenolic compounds were higher at the immature and premature stages than at fully mature and overmature stages, while total carotenoid was found to be higher in the mature and overmature stages. Overall antioxidant activities by three different assays (DPPH, ABTS, FRAP) decreased as maturation progressed. Antioxidant properties of the fruit extract are suggested to be attributed to the polyphenols.
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Ethanol Extract of Cudrania tricuspidata Leaf Ameliorates Hyperuricemia in Mice via Inhibition of Hepatic and Serum Xanthine Oxidase Activity. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:8037925. [PMID: 30622611 PMCID: PMC6304516 DOI: 10.1155/2018/8037925] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 11/08/2018] [Indexed: 01/13/2023]
Abstract
Cudrania tricuspidata Bureau (Moraceae) (CT) is a dietary and medicinal plant distributed widely in Northeast Asia. There have been no studies on the effect of CT and/or its active constituents on in vivo xanthine oxidase (XO) activity, hyperuricemia, and gout. The aim of this study was to investigate XO inhibitory and antihyperuricemic effects of the ethanol extract of CT leaf (CTLE) and its active constituents in vitro and in vivo. Gas chromatography-mass spectrometry (GC-MS) and high-performance liquid chromatography (HPLC) analyses were used to determine a chemical profile of CTLE. XO inhibitory and antihyperuricemic effects of CTLE given orally (30 and 100 mg/kg per day for 1 week) were examined in potassium oxonate-induced hyperuricemic ICR mice. CTLE exhibited XO inhibitory activity in vitro with an IC50 of 368.2 μg/mL, significantly reduced serum uric acid levels by approximately 2-fold (7.9 nM in normal mice; 3.8 nM in 30 mg/kg CTLE; 3.9 nM in 100 mg/kg CTLE), and significantly alleviated hyperuricemia by reducing hepatic (by 39.1 and 41.8% in 30 and 100 mg/kg, respectively) and serum XO activity (by 30.7 and 50.1% in 30 and 100 mg/kg, respectively) in hyperuricemic mice. Moreover, several XO inhibitory and/or antihyperuricemic phytochemicals, such as stigmasterol, β-sitosterol, vitamin E, rutin, and kaempferol, were identified from CTLE. Compared with rutin, kaempferol showed markedly higher XO inhibitory activity in vitro. Our present results demonstrate that CTLE may offer a promising alternative to allopurinol for the treatment of hyperuricemia and gout.
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Song SH, Ki SH, Park DH, Moon HS, Lee CD, Yoon IS, Cho SS. Quantitative Analysis, Extraction Optimization, and Biological Evaluation of Cudrania tricuspidata Leaf and Fruit Extracts. Molecules 2017; 22:molecules22091489. [PMID: 28880226 PMCID: PMC6151595 DOI: 10.3390/molecules22091489] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 09/05/2017] [Indexed: 01/20/2023] Open
Abstract
Cudrania tricuspidata Bureau (Moraceae) shows numerous pharmacological effects and has been used in traditional herbal remedies for inflammation, gastritis, tumors, and liver diseases. However, no validated analytical method for the standardization and optimization of the biological properties of C. tricuspidata preparations has been reported. We developed and validated a reverse-phase high-performance liquid chromatography (HPLC) method for the separation and quantification of active markers. Ethanolic extracts of C. tricuspidata leaves were prepared and evaluated for chemical profiles and biological activities. The 80% ethanolic extract demonstrated the greatest antioxidant activity and phenolic content, while the 100% ethanolic extract had the greatest total flavonoid content and xanthine oxidase (XO) inhibitory activity. The validated HPLC method confirmed that chlorogenic acid, rutin, and kaempferol were present in C. tricuspidata leaf extracts. We postulated that the antioxidant and anti-hyperuricemic/gout effects of C. tricuspidata extract could be attributed to these marker compounds. Our results suggested that the flavonoid-rich fraction of the leaf extract may be utilized for the treatment and prevention of hyperuricemia-related diseases, and the validated method and marker compounds could be applied for the quality control of C. tricuspidata preparations.
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Affiliation(s)
- Seung-Hui Song
- Department of Pharmacy, College of Pharmacy, Mokpo National University, Muan-gun, Jeonnam 58554, Korea.
| | - Sung Hwan Ki
- Laboratory of Toxicology, College of Pharmacy, Chosun University, Dong-gu, Gwangju 61452, Korea.
| | - Dae-Hun Park
- Department of Nursing, Dongshin University, Naju-si, Jeonnam 58245, Korea.
| | - Hong-Seop Moon
- Department of Pharmacy, College of Pharmacy, Mokpo National University, Muan-gun, Jeonnam 58554, Korea.
| | - Chang-Dai Lee
- Department of Business Administration, Mokpo National University, Muan-gun, Jeonnam 58554, Korea.
| | - In-Soo Yoon
- Department of Manufacturing Pharmacy, College of Pharmacy, Pusan National University, Geumjeong-gu, Busan 46241, Korea.
| | - Seung-Sik Cho
- Department of Pharmacy, College of Pharmacy, Mokpo National University, Muan-gun, Jeonnam 58554, Korea.
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Xin LT, Yue SJ, Fan YC, Wu JS, Yan D, Guan HS, Wang CY. Cudrania tricuspidata: an updated review on ethnomedicine, phytochemistry and pharmacology. RSC Adv 2017. [DOI: 10.1039/c7ra04322h] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This review summarized the botany, traditional uses, phytochemistry and pharmacology ofCudrania tricuspidata, and the limitations of the studies on this species were also discussed so as to serve as the basis for further research and development of this medicinal plant.
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Affiliation(s)
- Lan-Ting Xin
- Key Laboratory of Marine Drugs
- The Ministry of Education of China
- School of Medicine and Pharmacy
- Ocean University of China
- Qingdao 266003
| | - Shi-Jun Yue
- Key Laboratory of Marine Drugs
- The Ministry of Education of China
- School of Medicine and Pharmacy
- Ocean University of China
- Qingdao 266003
| | - Ya-Chu Fan
- Key Laboratory of Marine Drugs
- The Ministry of Education of China
- School of Medicine and Pharmacy
- Ocean University of China
- Qingdao 266003
| | - Jing-Shuai Wu
- Key Laboratory of Marine Drugs
- The Ministry of Education of China
- School of Medicine and Pharmacy
- Ocean University of China
- Qingdao 266003
| | - Dan Yan
- Beijing Shijitan Hospital
- Capital Medical University
- Beijing 100038
- P. R. China
| | - Hua-Shi Guan
- Key Laboratory of Marine Drugs
- The Ministry of Education of China
- School of Medicine and Pharmacy
- Ocean University of China
- Qingdao 266003
| | - Chang-Yun Wang
- Key Laboratory of Marine Drugs
- The Ministry of Education of China
- School of Medicine and Pharmacy
- Ocean University of China
- Qingdao 266003
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Lactic acid bacteria-mediated fermentation of Cudrania tricuspidata leaf extract improves its antioxidative activity, osteogenic effects, and anti-adipogenic effects. BIOTECHNOL BIOPROC E 2015. [DOI: 10.1007/s12257-015-0302-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kim OK, Nam DE, Jun W, Lee J. Anti-Inflammatory and Gastroprotective Activities of C
udrania Tricuspidata
Leaf Extract Against Acute HCl/Ethanol-Induced Gastric Mucosal Injury in Sprague-Dawley Rats. J Food Biochem 2015. [DOI: 10.1111/jfbc.12149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ok-Kyung Kim
- Department of Medical Nutrition; Kyung Hee University; Yongin 446-701 Korea
| | - Da-Eun Nam
- Department of Medical Nutrition; Kyung Hee University; Yongin 446-701 Korea
| | - Woojin Jun
- Department of Food and Nutrition; Chonnam National University; Gwangju Korea
| | - Jeongmin Lee
- Department of Medical Nutrition; Kyung Hee University; Yongin 446-701 Korea
- Research Institute of Clinical Nutrition; Kyung Hee University; Seoul 130-701 Korea
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Son HU, Lee SH. Comparison of α-glucosidase inhibition by Cudrania tricuspidata according to harvesting time. Biomed Rep 2013; 1:624-628. [PMID: 24648998 DOI: 10.3892/br.2013.111] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 05/01/2013] [Indexed: 11/06/2022] Open
Abstract
Cudrania tricuspidata (CT) is a type of add-value beneficial plant. The aim of the present study was to determine the components of CT that inhibit α-glucosidase activity. Roots, leaves and stems of the plants were obtained and several subgroups were created according to harvesting time. Root extracts exhibited a 77% velocity inhibition at a concentration of 300 μg/ml and an inhibitory constant of 41.6 μg/ml. The inhibitory percentage of the positive control at 1 mM was ∼67% of the enzymatic velocity with acarbose. According to the Michaelis-Menten equation, the type of inhibitory mechanism underlying the effects of the stem and root samples according to climate was competitive or non-competitive inhibition, suggesting that the extracts contain additional antidiabetic compounds produced during the growth period. Collectively, the results from our study suggested that stem and root extracts of CT serve as an antidiabetic biomaterial and contain a variety of antidiabetic compounds.
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Affiliation(s)
- Hyeong-U Son
- Department of Food Science and Biotechnology, Kyungpook National University, Daegu 702-701, Republic of Korea
| | - Sang-Han Lee
- Department of Food Science and Biotechnology, Kyungpook National University, Daegu 702-701, Republic of Korea ; Food and Bio-Industry Research Institute, Kyungpook National University, Daegu 702-701, Republic of Korea
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Yang G, Lee K, Lee M, Ham I, Choi HY. Inhibition of lipopolysaccharide-induced nitric oxide and prostaglandin E2 production by chloroform fraction of Cudrania tricuspidata in RAW 264.7 macrophages. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 12:250. [PMID: 23228109 PMCID: PMC3575384 DOI: 10.1186/1472-6882-12-250] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 11/24/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cudrania tricuspidata extract is an important traditional herbal remedy for tumors, inflammation, gastritis, and liver damage and is predominantly used in Korea, China, and Japan. However, the anti-inflammatory effects of the extract have not yet been conclusively proved. METHODS In this study, we investigated the effects of the CHCl3 fraction (CTC) of a methanol extract of C. tricuspidata on the lipopolysaccharide (LPS)-induced nitric oxide (NO) and prostaglandin E2 (PGE2) production in RAW 264.7 macrophage cells and mouse peritoneal macrophages, and the levels of pro-inflammatory cytokines tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-6 in RAW 264.7 macrophage cells. RESULTS We observed that the protein expression levels of inducible NO synthase and COX-2 enzymes were markedly inhibited by CTC in a concentration-dependent manner. In addition, CTC reduced the production of TNF-α, IL-1β, and IL-6 in the LPS-stimulated RAW 264.7 macrophage cells. CONCLUSIONS Our results show that the C. tricuspidata extract could modulate macrophage-mediated inflammatory functions such as the overproduction of cytokines, NO, and PGE2. The CTC was found to be the active fraction in this context.
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Siripong P, Rassamee K, Piyaviriyakul S, Yahuafai J, Kanokmedhakul K. Anti-metastatic Effects on B16F10 Melanoma Cells of Extracts and Two Prenylated Xanthones Isolated from Maclura amboinensis Bl. Roots. Asian Pac J Cancer Prev 2012; 13:3519-28. [DOI: 10.7314/apjcp.2012.13.7.3519] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Quercetin Inhibits IL-1β-Induced Proliferation and Production of MMPs, COX-2, and PGE2 by Rheumatoid Synovial Fibroblast. Inflammation 2012; 35:1585-94. [DOI: 10.1007/s10753-012-9473-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lee H, Ha H, Lee JK, Seo CS, Lee NH, Jung DY, Park SJ, Shin HK. The fruits of Cudrania tricuspidata suppress development of atopic dermatitis in NC/Nga mice. Phytother Res 2011; 26:594-9. [PMID: 21972057 DOI: 10.1002/ptr.3577] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2010] [Accepted: 05/08/2011] [Indexed: 11/07/2022]
Abstract
The fruits of Cudrania tricuspidata are a medicinal herb in Korea, known for its antiatherosclerotic and antiinflammatory effects. Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by the influx of lymphocytes into the dermis. Using an animal model of AD, we assessed whether C. tricuspidata suppresses the development of AD-like skin lesions. Cudrania tricuspidata was administered orally to NC/Nga mice with Dermatophagoides-farinae-induced AD-like lesions for 49 days. The effects of C. tricuspidata were assessed by measuring clinical symptoms, swelling of the skin on the back and ears, and plasma concentrations of mTARC (mouse thymus and activation regulated chemokine), histamine and immunoglobulin E (IgE). We found that C. tricuspidata (60 mg/kg/day) inhibited the development of AD-like skin lesions, reduced skin dermatitis scores and inhibited the histological changes induced by repeated application of D. farinae. In addition, C. tricuspidata inhibited the increases in plasma concentrations of mTARC, histamine and IgE induced by D. farinae. These findings indicate that C. tricuspidata inhibits the development of AD-like skin lesions induced by repeated applications of D. farinae in sensitized NC/Nga by suppressing plasma concentrations of mTARC, histamine and IgE.
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Affiliation(s)
- Hoyoung Lee
- Herbal Medicine EBM Research Center, Korea Institute of Oriental Medicine, Daejeon 305-811, Korea
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Lee EG, Yun HJ, Lee SI, Yoo WH. Ethyl acetate fraction from Cudrania tricuspidata inhibits IL-1beta-stimulated osteoclast differentiation through downregulation of MAPKs, c-Fos and NFATc1. Korean J Intern Med 2010; 25:93-100. [PMID: 20195410 PMCID: PMC2829423 DOI: 10.3904/kjim.2010.25.1.93] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Accepted: 08/20/2009] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND/AIMS The present study was performed to determine the effects of the ethyl acetate extract of Cudrania tricuspidata (EACT) on interleukin (IL)-1beta-stimulated receptor activator of NF-kappaB ligand (RANKL)-mediated osteoclast differentiation. METHODS Bone marrow cells were harvested from 6-week-old male imprinting control region mice, and the differentiation of osteoclasts from these cells was evaluated by tartrate-resistant acid phosphatase and resorption pit formation assay. Phosphorylated extracellular signal regulated kinase (p-ERK), phosphorylated p38, phosphorylated c-Jun amino-terminal kinase, NF-kappaB (p65), IkappaBalpha, c-Fos, and nuclear factor of activated T-cells c1 (NFATc1) expression was examined by immunoblotting and quantitative reverse transcription-polymerase chain reaction. RESULTS EACT inhibits IL-1beta-stimulated RANKL-mediated osteoclast differentiation. EACT also inhibits IL-1beta-stimulated RANKL-mediated phosphorylation of ERK 1/2, p38 mitogen activated protein kinase, and expression of c-Fos and NFATc1. CONCLUSIONS These results suggest that EACT may be involved in the inhibition of bone loss by preventing osteoclast formation and may be used to manage bone destruction in inflammatory diseases, such as rheumatoid arthritis.
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Affiliation(s)
- Eun-Gyeong Lee
- Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Jeonju, Korea
| | - Hee-Jin Yun
- Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Jeonju, Korea
| | - Sang-Il Lee
- Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Wan-Hee Yoo
- Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Jeonju, Korea
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