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Zhou D, Jang JM, Yang G, Ha HC, Fu Z, Kim DK. A Novel Role of Hyaluronic Acid and Proteoglycan Link Protein 1 (HAPLN1) in Delaying Vascular Endothelial Cell Senescence. Biomol Ther (Seoul) 2023; 31:629-639. [PMID: 37551651 PMCID: PMC10616520 DOI: 10.4062/biomolther.2023.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/18/2023] [Accepted: 06/23/2023] [Indexed: 08/09/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the most common cardiovascular system disorders. Cellular senescence is a key mechanism associated with dysfunction of aged vascular endothelium. Hyaluronic acid and proteoglycan link protein 1 (HAPLN1) has been known to non-covalently link hyaluronic acid (HA) and proteoglycans (PGs), and forms and stabilizes HAPLN1-containing aggregates as a major component of extracellular matrix. Our previous study showed that serum levels of HAPLN1 decrease with aging. Here, we found that the HAPLN1 gene expression was reduced in senescent human umbilical vein endothelial cells (HUVECs). Moreover, a recombinant human HAPLN1 (rhHAPLN1) decreased the activity of senescence-associated β-gal and inhibited the production of senescence-associated secretory phenotypes, including IL-1β, CCL2, and IL-6. rhHAPLN1 also down-regulated IL-17A levels, which is known to play a key role in vascular endothelial senescence. In addition, rhHAPLN1 protected senescent HUVECs from oxidative stress by reducing cellular reactive oxygen species levels, thus promoting the function and survival of HUVECs and leading to cellular proliferation, migration, and angiogenesis. We also found that rhHAPLN1 not only increases the sirtuin 1 (SIRT1) levels, but also reduces the cellular senescence markers levels, such as p53, p21, and p16. Taken together, our data indicate that rhHAPLN1 delays or inhibits the endothelial senescence induced by various aging factors, such as replicative, IL-17A, and oxidative stress-induced senescence, thus suggesting that rhHAPLN1 may be a promising therapeutic for CVD and atherosclerosis.
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Affiliation(s)
- Dan Zhou
- Department of Environmental & Health Chemistry, College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
- HaplnScience Research Institute, HaplnScience Inc., Seongnam 13494, Republic of Korea
| | - Ji Min Jang
- Department of Environmental & Health Chemistry, College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
- HaplnScience Research Institute, HaplnScience Inc., Seongnam 13494, Republic of Korea
| | - Goowon Yang
- HaplnScience Research Institute, HaplnScience Inc., Seongnam 13494, Republic of Korea
| | - Hae Chan Ha
- Department of Environmental & Health Chemistry, College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Zhicheng Fu
- Department of Environmental & Health Chemistry, College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
- HaplnScience Research Institute, HaplnScience Inc., Seongnam 13494, Republic of Korea
| | - Dae Kyong Kim
- Department of Environmental & Health Chemistry, College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
- HaplnScience Research Institute, HaplnScience Inc., Seongnam 13494, Republic of Korea
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Gong Z, Da W, Tian Y, Zhao R, Qiu S, Wu Q, Wen K, Shen L, Zhou R, Tao L, Zhu Y. Exogenous melatonin prevents type 1 diabetes mellitus-induced bone loss, probably by inhibiting senescence. Osteoporos Int 2022; 33:453-466. [PMID: 34519833 PMCID: PMC8813725 DOI: 10.1007/s00198-021-06061-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 06/30/2021] [Indexed: 12/31/2022]
Abstract
UNLABELLED Exogenous melatonin inhibited the senescence of preosteoblast cells in type 1 diabetic (T1D) mice and those cultured in high glucose (HG) by multiple regulations. Exogenous melatonin had a protective effect on diabetic osteoporosis, which may depend on the inhibition of senescence. INTRODUCTION Senescence is thought to play an important role in the pathophysiological mechanisms underlying diabetic bone loss. Increasing evidence has shown that melatonin exerts anti-senescence effects. In this study, we investigated whether melatonin can inhibit senescence and prevent diabetic bone loss. METHODS C57BL/6 mice received a single intraperitoneal injection of 160 mg/kg streptozotocin, followed by the oral administration of melatonin or vehicle for 2 months. Then, tissues were harvested and subsequently examined. MC3T3-E1 cells were cultured under HG conditions for 7 days and then treated with melatonin or not for 24 h. Sirt1-specific siRNAs and MT1- or MT2-specific shRNA plasmids were transfected into MC3T3-E1 cells for mechanistic study. RESULTS The total protein extracted from mouse femurs revealed that melatonin prevented senescence in T1D mice. The micro-CT results indicated that melatonin prevented bone loss in T1D mice. Cellular experiments indicated that melatonin administration prevented HG-induced senescence, whereas knockdown of the melatonin receptors MT1 or MT2 abolished these effects. Sirt1 expression was upregulated by melatonin administration but significantly reduced after MT1 or MT2 was knocked down. Knockdown of Sirt1 blocked the anti-senescence effects of melatonin. Additionally, melatonin promoted the expression of CDK2, CDK4, and CyclinD1, while knockdown of MT1 or MT2 abolished these effects. Furthermore, melatonin increased the expression of the polycomb repressive complex (PRC), but knockdown of MT1 or MT2 abolished these effects. Furthermore, melatonin increased the protein levels of Sirt1, PRC1/2 complex-, and cell cycle-related proteins. CONCLUSION This work shows that melatonin protects against T1D-induced bone loss, probably by inhibiting senescence. Targeting senescence in the investigation of diabetic osteoporosis may lead to novel discoveries.
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Affiliation(s)
- Z Gong
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, 110001, China
| | - W Da
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Y Tian
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, 110001, China
| | - R Zhao
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, 110001, China
| | - S Qiu
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Q Wu
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, 110001, China
| | - K Wen
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, 110001, China
| | - L Shen
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, 110001, China
| | - R Zhou
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, 110001, China
| | - L Tao
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, 110001, China.
| | - Y Zhu
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, 110001, China.
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Adipose-Derived Stem Cell Features and MCF-7. Cells 2021; 10:cells10071754. [PMID: 34359925 PMCID: PMC8307920 DOI: 10.3390/cells10071754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 01/04/2023] Open
Abstract
Human adipose tissue-derived stem cells (hADSCs) are highly suitable for regeneration therapies being easily collected and propagated in vitro. The effects of different external factors and culturing conditions are able to affect hADSC proliferation, senescence, differentiation, and migration, even at the molecular level. In the present paper, we exposed hADSCs to an exhausted medium from the breast cancer cell line (MCF-7) to evaluate whether the soluble factors released by these cells may be able to induce changes in stem cell behavior. In particular, we investigated the expression of stemness-related genes (OCT4; Sox 2; Nanog), the cell-cycle regulators p21 (WAF1/CIP1) p53, epigenetic markers (DNMT1 and Sirt1), and autophagy-related proteins. From our results, we can infer that the exhausted medium from MCF-7 is able to influence the hADSCs behavior increasing the expression of stemness-related genes, cell proliferation, and autophagy. Polyamines detectable in MCF-7 exhausted medium could be related to the higher proliferation capability observed in hADSCs, suggesting direct crosstalk between these molecules and the observed changes in stem cell potency.
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He L, Wang X, Cheng D, Xiong Z, Liu X. Ginsenoside Rg1 improves pathological damages by activating the p21‑p53‑STK pathway in ovary and Bax‑Bcl2 in the uterus in premature ovarian insufficiency mouse models. Mol Med Rep 2020; 23:37. [PMID: 33179093 PMCID: PMC7684879 DOI: 10.3892/mmr.2020.11675] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/25/2020] [Indexed: 01/02/2023] Open
Abstract
The aim of the present study was to investigate the effects of the ginsenoside Rg1 on D-galactose (D-gal)-induced mouse models of premature ovarian insufficiency (POI) and the related mechanisms. C57BL/6 female mice were randomly grouped into the following: i) D-gal [subcutaneously (s.c.) 200 mg/kg/d D-gal for 42 days]; ii) Rg1 [intraperitoneally (i.p.) 20 mg/kg/d Rg1 for 28 days]; iii) D-gal + Rg1 (s.c. 200 mg/kg/d D-gal for 42 days followed by i.p. 20 mg/kg/d Rg1 for 28 days); and iv) saline groups (equivalent volume of saline s.c. and i.p.). Hematoxylin and eosin staining and electron microscopy were used to analyze uterine and ovarian morphology. Expression levels of senescence factors (p21, p53 and serine/threonine kinase), secretion of pro-inflammatory cytokines [interleukin (IL)-6, tumor necrosis factor (TNF)-α and IL-1β] and the activities of oxidation biomarkers [superoxide dismutase (T-SOD), malondialdehyde (MDA) and glutathione peroxidase (GSH-px)] were analyzed. The results showed that mice in the Rg1 + D-gal group had significantly higher uterine and ovarian weight compared with those in the D-gal group. Uterus morphology was also improved, based on the comparison between the D-gal group and the Rg1 + D-gal group. In addition, the Rg1 treatment after D-gal administration significantly decreased the expression of senescence-associated factors, enhanced the activities of anti-oxidant enzymes total T-SOD and GSH-px in addition to reducing TNF-α, IL-1β, MDA and IL-6 (based on the comparison between the D-gal group and the Rg1 + D-gal group). In conclusion, the present study suggested that the ginsenoside Rg1 improved pathological damages in the ovary and uterus by increasing anti-oxidant and anti-inflammatory abilities whilst reducing the expression of senescence signaling pathways in POI mouse models.
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Affiliation(s)
- Lianli He
- Department of Gynecology and Obstetrics, The First People's Hospital of Zunyi and Third Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Xiaojuan Wang
- Department of Gynecology and Obstetrics, The First People's Hospital of Zunyi and Third Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Daigang Cheng
- Department of Gynecology and Obstetrics, The First People's Hospital of Zunyi and Third Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Zhengai Xiong
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, P.R. China
| | - Xiaoyun Liu
- Department of Gynecology and Obstetrics, The First People's Hospital of Zunyi and Third Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
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Sutula GI, Alhasan BA, Vorobev ML, Guzhova IV, Suvorova II. Inducible Ulk1 expression activates the p53 protein in mouse embryonic stem cells. Biochem Biophys Res Commun 2020; 532:280-284. [DOI: 10.1016/j.bbrc.2020.07.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 07/29/2020] [Indexed: 01/12/2023]
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Behavioral Changes in Stem-Cell Potency by HepG2-Exhausted Medium. Cells 2020; 9:cells9081890. [PMID: 32806709 PMCID: PMC7547384 DOI: 10.3390/cells9081890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/05/2020] [Accepted: 08/09/2020] [Indexed: 12/16/2022] Open
Abstract
Wharton jelly mesenchymal stem cells (WJ-MSCs) are able to differentiate into different cell lineages upon stimulation. This ability is closely related to the perfect balance between the pluripotency-related genes, which control stem-cell proliferation, and genes able to orchestrate the appearance of a specific phenotype. Here we studied the expression of stemness-related genes, epigenetic regulators (DNMT1, SIRT1), miRNAs (miR-145, miR-148, and miR-185) related to stemness, exosomes, the cell-cycle regulators p21 (WAF1/CIP1) and p53, and the senescence-associated genes (p16, p19, and hTERT). Cells were cultured in the presence or absence of the human hepatocarcinoma cell line HepG2-exhausted medium, to evaluate changes in stemness, differentiation capability, and senescence sensibility. Our results showed the overexpression of SIRT1 and reduced levels of p21 mRNA. Moreover, we observed a downregulation of DNMT1, and a simultaneous overexpression of Oct-4 and c-Myc. These findings suggest that WJ-MSCs are more likely to retain a stem phenotype and sometimes to switch to a highly undifferentiable proliferative-like behavior if treated with medium exhausted by human HepG2 cell lines.
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Wang Y, Zhong B, Wu Q, Tong J, Zhu T, Zhang M. Effect of Aldosterone on Senescence and Proliferation Inhibition of Endothelial Progenitor Cells Induced by Sirtuin 1 (SIRT1) in Pulmonary Arterial Hypertension. Med Sci Monit 2020; 26:e920678. [PMID: 32303670 PMCID: PMC7191948 DOI: 10.12659/msm.920678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Background Pulmonary arterial hypertension (PAH) is characterized by a progressive increase in pulmonary circulatory resistance. Pulmonary vascular endothelial dysfunction is one of the main causes of primary PAH. Endothelial progenitor cells (EPCs) can proliferate and differentiate into vascular endothelial cells and play an important role in maintaining normal endothelial function. Mineralocorticoid receptor inhibitor has been reported to be used in the treatment of PAH. However, the role and the underlying mechanism of aldosterone (ALDO) in PAH remains unclear. Material/Methods Rats were divided to 4 groups (n=10 per group) and treated with 0.9% normal saline, monocrotaline (MCT), spironolactone (SP), or MCT combined with SP. After the rats were sacrificed with an overdose of pentobarbital sodium, hematoxylin and eosin staining was performed to observe the pulmonary artery pathology section. Sirtuin 1 (SIRT1), p53, and p21 protein expression was detect by western blot. Immunofluorescence staining was performed to verify EPCs. EPCs were treated with different concentrations of ALDO. MTT assay and senescence-associated β-galactosidase staining were used to measure cell viability and senescence. Results MCT increased the vascular arterial wall thickness and wall area, inhibited SIRT1 protein expression and increased p53 and p21 protein expression in the lung tissue of rats, while SP partially reversed this effect. In addition, ALDO inhibited EPCs viability and induced senescence. The expression of p53 and p21 proteins in the EPCs were upregulated and the senescence was accelerated when EPCs were transfected with SIRT1 siRNA. Conclusions ALDO promoted EPCs senescence and inhibited EPCs proliferation by downregulating SIRT1, which regulates the p53/p21 pathway, thus promoting PAH.
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Affiliation(s)
- Yue Wang
- School of Pharmaceutical Engineering and Life Science and School of Nursing, Changzhou University, Changzhou, Jiangsu, China (mainland)
| | - Bin Zhong
- Department of Thoracic and Cardiovascular Surgery, Changzhou No. 2 People's Hospital, Affiliated to Nanjing Medical University, Changzhou, Jiangsu, China (mainland)
| | - Qiyong Wu
- Department of Thoracic and Cardiovascular Surgery, Changzhou No. 2 People's Hospital, Affiliated to Nanjing Medical University, Changzhou, Jiangsu, China (mainland)
| | - Jichun Tong
- Department of Thoracic and Cardiovascular Surgery, Changzhou No. 2 People's Hospital, Affiliated to Nanjing Medical University, Changzhou, Jiangsu, China (mainland)
| | - Tao Zhu
- Department of Thoracic and Cardiovascular Surgery, Changzhou No. 2 People's Hospital, Affiliated to Nanjing Medical University, Changzhou, Jiangsu, China (mainland)
| | - Ming Zhang
- Department of Thoracic and Cardiovascular Surgery, Changzhou No. 2 People's Hospital, Affiliated to Nanjing Medical University, Changzhou, Jiangsu, China (mainland)
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Nan P, Niu Y, Wang X, Li Q. MiR-29a function as tumor suppressor in cervical cancer by targeting SIRT1 and predict patient prognosis. Onco Targets Ther 2019; 12:6917-6925. [PMID: 31692593 PMCID: PMC6717154 DOI: 10.2147/ott.s218043] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 07/31/2019] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Cervical cancer is the second most frequently malignant tumors in females and metastasis is a challenge of the treatment of cervical cancer. MiR-29a is usually low expressed in several tumors and its functions in cervical cancer remain unclear. PATIENTS AND METHODS The quantitative real-time polymerase chain reaction was employed to assess the expression of miR-29a and the Sirtuin-1 (SIRT1). Cell metastatic ability was assessed using Transwell and Western blot assays. The dual-luciferase reporter assay was performed to verify that miR-29a targeted to the 3'-untranslated region (UTR) of SIRT1 mRNA. RESULTS MiR-29a was low expressed in cervical cancer and downregulation of miR-29a was associated with poor outcome. MiR-29a regulated the expression of SIRT1 by targeting to its 3'-UTR of mRNA in HeLa cells. SIRT1 was upregulated in cervical cancer tissues and cells in comparison with the non-tumor tissues and normal cells. Upregulation of SIRT1 predicted worse outcome of cervical cancer patients. MiR-29a was participated in the migration, invasion and epithelial-mesenchymal transition (EMT) in cervical cancer through directly targeting to the 3'-UTR of SIRT1 mRNA. SIRT1 reversed partial roles of miR-29a on metastasis in cervical cancer. CONCLUSION miR-29a suppressed migration, invasion and EMT by directly targeting to SIRT1 in cervical cancer. The newly identified miR-29a/SIRT1 axis provides novel insight into the pathogenesis of cervical cancer.
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Affiliation(s)
- Ping Nan
- Department of Gynaecology, Shengli Oil Centre Hospital, Dongying, People’s Republic of China
| | - Yugui Niu
- Department of Joint Surgery, Shengli Oil Center Hospital, Dongying, People’s Republic of China
| | - Xiuhua Wang
- Department of Gynecology, Dongying District People’s Hospital, Dongying, People’s Republic of China
| | - Qiang Li
- Department of Gynaecology, Shengli Oil Centre Hospital, Dongying, People’s Republic of China
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Mechanism of Action for HDAC Inhibitors-Insights from Omics Approaches. Int J Mol Sci 2019; 20:ijms20071616. [PMID: 30939743 PMCID: PMC6480157 DOI: 10.3390/ijms20071616] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 01/01/2023] Open
Abstract
Histone deacetylase inhibitors (HDIs) are a class of prominent epigenetic drugs that are currently being tested in hundreds of clinical trials against a variety of diseases. A few compounds have already been approved for treating lymphoma or myeloma. HDIs bind to the zinc-containing catalytic domain of the histone deacetylase (HDACs) and they repress the deacetylase enzymatic activity. The broad therapeutic effect of HDIs with seemingly low toxicity is somewhat puzzling when considering that most HDIs lack strict specificity toward any individual HDAC and, even if they do, each individual HDAC has diverse functions under different physiology scenarios. Here, we review recent mechanistic studies using omics approaches, including epigenomics, transcriptomics, proteomics, metabolomics, and chemoproteomics, methods. These omics studies provide non-biased insights into the mechanism of action for HDIs.
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Cai L, Zhang Y, Zhang Y, Chen H, Hu J. Effect of Th9/IL-9 on the growth of gastric cancer in nude mice. Onco Targets Ther 2019; 12:2225-2234. [PMID: 30988627 PMCID: PMC6441462 DOI: 10.2147/ott.s197816] [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] [Indexed: 12/25/2022] Open
Abstract
Objective By neutralizing IL-9 in a nude mouse model, the study aimed to investigate the role of Th9/IL-9 on the growth of gastric cancer in mice. Materials and methods Male BALB/c nude mice were randomly divided into three groups: a normal control group (Control), an SGC-7901 xenografted nude mice model group (Model), and a rIL-9 treatment group (Treat). The weight of the tumors was recorded to calculate the tumor inhibition rate. Flow cytometry was used to detect the cell frequency of Th9, Th17, and Treg in peripheral blood. The IL-4, IL-9, IL-10, IL-25, VEGF, and TGF-β levels in serum were determined by ELISA. The cellular migration and invasion were investigated by transwell assay. Immunohistochemical and Western blot were used to detect the expression of IL-9, CD34, PU.1, p53, and p21 proteins in gastric cancer tissue. The mRNA expression levels of IL-9, IL-21, and PU.1 in gastric cancer tissue were determined by qRT-PCR. Result rIL-9 can significantly inhibit the growth of gastric cancer. The frequency of Th9, Th17, and Treg in peripheral blood was decreased upon treatment. The levels of IL-4, IL-9, IL-10, IL-25, VEGF, and TGF-β in serum were significantly reduced in the Treat group compared with the Model group (P<0.05). rIL-9 can inhibit cellular migration and invasion and reduce the mRNA level of IL-9, IL-21, and PU.1. Meanwhile, in the Treat group, the expression of IL-9, CD34, and PU.1 was significantly reduced, whereas the expression of p53 and p21 was significantly increased compared with the Model group (P<0.05). Conclusion This study suggested that Th9/IL-9 has a deleterious role in gastric cancer.
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Affiliation(s)
- Li Cai
- Department of Pathology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, People's Republic of China
| | - Yue Zhang
- Department of Gastrointestinal Surgery, Laizhou People's Hospital, Yantai 264000, People's Republic of China
| | - Yifei Zhang
- Department of Gastrointestinal Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, People's Republic of China,
| | - Hongbing Chen
- Department of Gastrointestinal Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, People's Republic of China,
| | - Jinchen Hu
- Department of Gastrointestinal Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, People's Republic of China,
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