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Ni Y, Zhu D, Chen C, Wang F, Miu Y, Zhang W. (+)-Catechins Play a Protective Role in Diabetic Kidney Disease by Alleviating EMT through Multiple Pathways. Mol Nutr Food Res 2024:e2400387. [PMID: 39121356 DOI: 10.1002/mnfr.202400387] [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: 05/23/2024] [Revised: 06/30/2024] [Indexed: 08/11/2024]
Abstract
SCOPE Diabetic nephropathy (DN), a complication of diabetes mellitus, is becoming a significant global health concern, with no complete cure currently available. Tea is regarded as an essential component of a balanced diet and contains (+)-Catechin (CE), which exert a range of pharmacological effects. Consequently, CE may be a potential treatment for DN. The objective of this study is to examine the protective effects and underlying mechanisms of CE on DN, with a particular focus on the epithelial-mesenchymal transition (EMT) process, which plays a pivotal role in regulating DN. METHODS AND RESULTS In this study db/db mice are treated with catechins. The results demonstrate that CE reduces obesity and hyperglycemia, improves renal dysfunction and morphological changes in diabetic mice, and inhibits the development of DN through the RAGE/NF-κB signaling pathway. Among them differentially expressed messenger RNA (mRNA) results, those related to EMT, including Cav1, grem2, macrod2, and kap, are identified. To further validate the results, the same experiments are performed on HK-2 cells. CONCLUSIONS The research results offer novel perspectives by emphasizing the anti-inflammatory properties of CE and their potential role in mitigating DN through the regulation of EMT-related genes such as RAGE, Cav1, grem2, macrod2, and kap.
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Affiliation(s)
- Ying Ni
- Engineering Research Center of Natural Medicine, Ministry of Education, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
- Beijing Key Laboratory of Traditional Chinese Medicine Protection and Utilization, Faculty of Geographical, Science, Beijing Normal University, Beijing, 100875, China
- Zhuhai Branch of State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
| | - Dina Zhu
- Engineering Research Center of Natural Medicine, Ministry of Education, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
- Beijing Key Laboratory of Traditional Chinese Medicine Protection and Utilization, Faculty of Geographical, Science, Beijing Normal University, Beijing, 100875, China
- Zhuhai Branch of State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
| | - Chao Chen
- Engineering Research Center of Natural Medicine, Ministry of Education, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
- Beijing Key Laboratory of Traditional Chinese Medicine Protection and Utilization, Faculty of Geographical, Science, Beijing Normal University, Beijing, 100875, China
- Zhuhai Branch of State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
| | - Fan Wang
- Engineering Research Center of Natural Medicine, Ministry of Education, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
- Beijing Key Laboratory of Traditional Chinese Medicine Protection and Utilization, Faculty of Geographical, Science, Beijing Normal University, Beijing, 100875, China
- Zhuhai Branch of State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
| | - Yanyan Miu
- Engineering Research Center of Natural Medicine, Ministry of Education, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
- Beijing Key Laboratory of Traditional Chinese Medicine Protection and Utilization, Faculty of Geographical, Science, Beijing Normal University, Beijing, 100875, China
- Zhuhai Branch of State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
| | - Wensheng Zhang
- Engineering Research Center of Natural Medicine, Ministry of Education, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
- Beijing Key Laboratory of Traditional Chinese Medicine Protection and Utilization, Faculty of Geographical, Science, Beijing Normal University, Beijing, 100875, China
- Zhuhai Branch of State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
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Huang S, Lu H, Chen J, Jiang C, Jiang G, Maduraiveeran G, Pan Y, Liu J, Deng LE. Advances in drug delivery-based therapeutic strategies for renal fibrosis treatment. J Mater Chem B 2024; 12:6532-6549. [PMID: 38913013 DOI: 10.1039/d4tb00737a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Renal fibrosis is the result of all chronic kidney diseases and is becoming a major global health hazard. Currently, traditional treatments for renal fibrosis are difficult to meet clinical needs due to shortcomings such as poor efficacy or highly toxic side effects. Therefore, therapeutic strategies that target the kidneys are needed to overcome these shortcomings. Drug delivery can be attained by improving drug stability and addressing controlled release and targeted delivery of drugs in the delivery category. By combining drug delivery technology with nanosystems, controlled drug release and biodistribution can be achieved, enhancing therapeutic efficacy and reducing toxic cross-wise effects. This review discusses nanomaterial drug delivery strategies reported in recent years. Firstly, the present review describes the mechanisms of renal fibrosis and anti-renal fibrosis drug delivery. Secondly, different nanomaterial drug delivery strategies for the treatment of renal injury and fibrosis are highlighted. Finally, the limitations of these strategies are also discussed. Investigating various anti-renal fibrosis drug delivery strategies reveals the characteristics and therapeutic effects of various novel nanosystem-derived drug delivery approaches. This will serve as a reference for future research on drug delivery strategies for renal fibrosis treatment.
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Affiliation(s)
- Sida Huang
- Dongguan Key Laboratory of Drug Design and Formulation Technology, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, 523808, China.
| | - Hanqi Lu
- Department of Nephrology, Dongguan Hospital of Guangzhou University of Traditional Chinese Medicine, Dongguan, Guangdong 523000, China.
| | - Jin Chen
- Department of Nephrology, Dongguan Hospital of Guangzhou University of Traditional Chinese Medicine, Dongguan, Guangdong 523000, China.
| | - Chengyi Jiang
- Dongguan Key Laboratory of Drug Design and Formulation Technology, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, 523808, China.
| | - Guanmin Jiang
- Department of Oncology, Affiliated Dongguan Hospital, Southern Medical University (Dongguan people's hospital), 78 Wandao Road South, Dongguan, 523059 Guangdong, China.
| | - Govindhan Maduraiveeran
- Materials Electrochemistry Laboratory, Department of Chemistry, SRM Institute of Science and Technology, Kattankulathur - 603 203, Chengalpattu, Tamil Nadu, India.
| | - Ying Pan
- Dongguan Key Laboratory of Drug Design and Formulation Technology, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, 523808, China.
| | - Jianqiang Liu
- Dongguan Key Laboratory of Drug Design and Formulation Technology, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, 523808, China.
| | - Li-Er Deng
- Department of Nephrology, Dongguan Hospital of Guangzhou University of Traditional Chinese Medicine, Dongguan, Guangdong 523000, China.
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Park JH, Kwon S, Choi SY, Kim B, Oh J. Optimizing the Amino Acid Sequence Enhances the Productivity and Bioefficacy of the RBP-Albumin Fusion Protein. Bioengineering (Basel) 2024; 11:617. [PMID: 38927853 PMCID: PMC11200973 DOI: 10.3390/bioengineering11060617] [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: 05/31/2024] [Revised: 06/12/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
The significant growth of the global protein drug market, including fusion proteins, emphasizes the crucial role of optimizing amino acid sequences to enhance the productivity and bioefficacy. Among these fusion proteins, RBP-IIIA-IB, comprising retinol-binding protein in conjunction with the albumin domains, IIIA and IB, has displayed efficacy in alleviating liver fibrosis by inhibiting the activation of hepatic stellate cells (HSCs). This study aimed to address the issue of the low productivity in RBP-IIIA-IB. To induce structural changes, the linking sequence, EVDD, between domain IIIA and IB in RBP-IIIA-IB was modified to DGPG, AAAA, and GGPA. Among these, RBP-IIIA-AAAA-IB demonstrated an increase in yield (>4-fold) and a heightened inhibition of HSC activation. Furthermore, we identified amino acid residues that could form disulfide bonds when substituted with cysteine. Through the mutation of N453S-V480S in RBP-IIIA-AAAA-IB, the productivity further increased by over 9-fold, accompanied by an increase in anti-fibrotic activity. Overall, there was a more than 30-fold increase in the fusion protein's yield. These findings demonstrate the effectiveness of modifying linker sequences and introducing extra disulfide bonds to improve both the production yield and biological efficacy of fusion proteins.
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Affiliation(s)
- Ji Hoon Park
- New Drug Development Center, Osong Medical Innovation Foundation, Osong 28160, Republic of Korea; (J.H.P.); (S.-Y.C.)
| | - Sohyun Kwon
- Department of Biomedical Sciences, College of Medicine, Korea University, Seoul 02841, Republic of Korea;
| | - So-Young Choi
- New Drug Development Center, Osong Medical Innovation Foundation, Osong 28160, Republic of Korea; (J.H.P.); (S.-Y.C.)
| | - Bongcheol Kim
- Senelix Co. Ltd., 25, Beobwon-ro 11-gil, Songpa-gu, Seoul 05836, Republic of Korea;
| | - Junseo Oh
- Department of Biomedical Sciences, College of Medicine, Korea University, Seoul 02841, Republic of Korea;
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Martínez-Hernández SL, Muñoz-Ortega MH, Ávila-Blanco ME, Medina-Pizaño MY, Ventura-Juárez J. Novel Approaches in Chronic Renal Failure without Renal Replacement Therapy: A Review. Biomedicines 2023; 11:2828. [PMID: 37893201 PMCID: PMC10604533 DOI: 10.3390/biomedicines11102828] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/28/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Chronic kidney disease (CKD) is characterized by renal parenchymal damage leading to a reduction in the glomerular filtration rate. The inflammatory response plays a pivotal role in the tissue damage contributing to renal failure. Current therapeutic options encompass dietary control, mineral salt regulation, and management of blood pressure, blood glucose, and fatty acid levels. However, they do not effectively halt the progression of renal damage. This review critically examines novel therapeutic avenues aimed at ameliorating inflammation, mitigating extracellular matrix accumulation, and fostering renal tissue regeneration in the context of CKD. Understanding the mechanisms sustaining a proinflammatory and profibrotic state may offer the potential for targeted pharmacological interventions. This, in turn, could pave the way for combination therapies capable of reversing renal damage in CKD. The non-replacement phase of CKD currently faces a dearth of efficacious therapeutic options. Future directions encompass exploring vaptans as diuretics to inhibit water absorption, investigating antifibrotic agents, antioxidants, and exploring regenerative treatment modalities, such as stem cell therapy and novel probiotics. Moreover, this review identifies pharmaceutical agents capable of mitigating renal parenchymal damage attributed to CKD, targeting molecular-level signaling pathways (TGF-β, Smad, and Nrf2) that predominate in the inflammatory processes of renal fibrogenic cells.
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Affiliation(s)
- Sandra Luz Martínez-Hernández
- Departamento de Microbiología, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes 20100, Ags, Mexico
| | - Martín Humberto Muñoz-Ortega
- Departamento de Química, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes 20100, Ags, Mexico
| | - Manuel Enrique Ávila-Blanco
- Departamento de Morfología, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes 20100, Ags, Mexico
| | - Mariana Yazmin Medina-Pizaño
- Departamento de Morfología, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes 20100, Ags, Mexico
| | - Javier Ventura-Juárez
- Departamento de Morfología, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes 20100, Ags, Mexico
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Choi J, Son Y, Moon JW, Park DW, Kim YS, Oh J. Fusion Protein of RBP and Albumin Domain III Reduces Lung Fibrosis by Inactivating Lung Stellate Cells. Biomedicines 2023; 11:2007. [PMID: 37509646 PMCID: PMC10377390 DOI: 10.3390/biomedicines11072007] [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: 06/23/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Activated stellate cells play a role in fibrosis development in the liver, pancreas, and kidneys. The fusion protein R-III, which consists of retinol-binding protein and albumin domain III, has been demonstrated to attenuate liver and renal fibrosis by suppressing stellate cell activation. In this study, we investigated the efficacy of R-III against bleomycin-induced lung fibrosis in mice. R-III reduced lung fibrosis and primarily localized in autofluorescent cells in the lung tissue. Furthermore, we isolated lung stellate cells (LSCs) from rat lungs using the isolation protocol employed for hepatic stellate cells (HSCs). LSCs shared many characteristics with HSCs, including the presence of vitamin A-containing lipid droplets and the expression of alpha-smooth muscle actin and collagen type I, markers for activated HSCs/myofibroblasts. LSCs spontaneously transdifferentiated into myofibroblasts in in vitro culture, which was inhibited by R-III. These findings suggest that R-III may reduce lung fibrosis by inactivating LSCs and could be a promising treatment for extrahepatic fibrosis.
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Affiliation(s)
- Jaeho Choi
- Department of Anatomy, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Yuna Son
- Department of Anatomy, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Ji Wook Moon
- Department of Anatomy, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Dae Won Park
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Republic of Korea
| | - Young-Sik Kim
- Department of Pathology, Korea University Ansan Hospital, Ansan 15355, Republic of Korea
| | - Junseo Oh
- Department of Anatomy, College of Medicine, Korea University, Seoul 02841, Republic of Korea
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Kang MJ, Lee S, Jung U, Mandal C, Park H, Stetler-Stevenson WG, Kim YS, Moon JW, Park SH, Oh J. Inhibition of Hepatic Stellate Cell Activation Suppresses Tumorigenicity of Hepatocellular Carcinoma in Mice. THE AMERICAN JOURNAL OF PATHOLOGY 2021; 191:2219-2230. [PMID: 34428424 PMCID: PMC8747013 DOI: 10.1016/j.ajpath.2021.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/27/2021] [Accepted: 08/06/2021] [Indexed: 12/18/2022]
Abstract
Transdifferentiation (or activation) of hepatic stellate cells (HSCs) to myofibroblasts is a key event in liver fibrosis. Activated HSCs in the tumor microenvironment reportedly promote tumor progression. This study analyzed the effect of an inhibitor of HSC activation, retinol-binding protein–albumin domain III fusion protein (R-III), on protumorigenic functions of HSCs. Although conditioned medium collected from activated HSCs enhanced the migration, invasion, and proliferation of the hepatocellular carcinoma cell line Hepa-1c1c7, this effect was not observed in Hepa-1c1c7 cells treated with conditioned medium from R-III–exposed HSCs. In a subcutaneous tumor model, larger tumors with increased vascular density were formed in mice transplanted with Hepa-1c1c7+HSC than in mice transplanted with Hepa-1c1c7 cells alone. Intriguingly, when Hepa-1c1c7+HSC–transplanted mice were injected intravenously with R-III, a reduction in vascular density and extended tumor necrosis were observed. In an orthotopic tumor model, co-transplantation of HSCs enhanced tumor growth, angiogenesis, and regional metastasis accompanied by increased peritumoral lymphatic vessel density, which was abolished by R-III. In vitro study showed that R-III treatment affected the synthesis of pro-angiogenic and anti-angiogenic factors in activated HSCs, which might be the potential mechanism underlying the R-III effect. These findings suggest that the inhibition of HSC activation abrogates HSC-induced tumor angiogenesis and growth, which represents an attractive therapeutic strategy.
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Affiliation(s)
- Min-Jung Kang
- Department of Biomedical Science, Korea University Graduate School, Seoul, Korea
| | - Soovin Lee
- Laboratory Animal Research Center, College of Medicine, Korea University, Seoul, Korea
| | - Usuk Jung
- Department of Biomedical Science, Korea University Graduate School, Seoul, Korea
| | - Chanchal Mandal
- Department of Biomedical Science, Korea University Graduate School, Seoul, Korea
| | - Heekyung Park
- Department of Biomedical Science, Korea University Graduate School, Seoul, Korea
| | - William G Stetler-Stevenson
- Extracellular Matrix Pathology Section, Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Young-Sik Kim
- Department of Pathology, College of Medicine, Korea University, Seoul, Korea
| | - Ji Wook Moon
- Department of Anatomy, College of Medicine, Korea University, Seoul, Korea
| | - Sun-Hwa Park
- Department of Anatomy, College of Medicine, Korea University, Seoul, Korea
| | - Junseo Oh
- Department of Biomedical Science, Korea University Graduate School, Seoul, Korea; Department of Anatomy, College of Medicine, Korea University, Seoul, Korea.
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7
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Li A, Yuan JF, Gong Q, Zhang N, Chen LY, Luo YY, Cui YR, Wang HL, Liu RH. Effects of Eucommia ulmoides extract against renal injury caused by long-term high purine diets in rats. Food Funct 2021; 12:5607-5620. [PMID: 34018492 DOI: 10.1039/d0fo02802a] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Diets of overloaded purine-rich foods for a long time are one of the important reasons to cause renal lesions. Eucommia ulmoides is one of the traditional Chinese medicine herbs, which has been used to recover functions of the kidney. However, its mechanism remains unclear. The aim of this study was to explore the effects and protective mechanism of Eucommia ulmoides extract on renal injury caused by long-term high purine diets in rats. SD rats underwent an intragastric adenine (200 mg kg-1 d-1) administration for 9 weeks and were treated for 15 weeks. The results demonstrated that Eucommia ulmoides extract significantly reduced serum Cre and BUN levels in rats. H&E and Masson's trichrome stains showed notable lowering of the infiltration of inflammatory cells, the formation of fibrous tissues and collagen fibers, and improvement in the pathological morphology of kidneys. It also suppressed the protein and mRNA expressions of TGF-β1 and α-SMA and enhanced E-cadherin expression. Meanwhile, Eucommia ulmoides extract prominently inhibited the mRNA expression of Col I, Col III, Col IV, TIMP-1, and TIMP-2 and promoted expressions of MMP-1, MMP-2 and MMP-9. Through our study, it is the first time to prove that Eucommia ulmoides extract could ameliorate renal interstitial fibrosis and may involve in the regulation of the extracellular matrix (ECM) degradation enzyme (MMPs/TIMPs) system, promotion of the expression of E-cadherin, and suppression of expressions of TGF-β1 and α-SMA. The results provide a significant implication for the utilization of Eunomia Ulmoides extract as functional foods to enhance renal functions and improve renal injury caused by high purine diets.
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Affiliation(s)
- An Li
- National Pharmaceutical Engineering Center for Solid Preparation of Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China.
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Park JH, Kim J, Choi SY, Lee B, Lee JE, Park H, Moon JW, Park SH, Lee JM, Lee HS, Oh J. Albumin inhibits the nuclear translocation of Smad3 via interleukin-1beta signaling in hepatic stellate cells. Sci Rep 2021; 11:3196. [PMID: 33542418 PMCID: PMC7862402 DOI: 10.1038/s41598-021-82758-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 01/25/2021] [Indexed: 12/11/2022] Open
Abstract
Activation of quiescent hepatic stellate cells (HSCs) to myofibroblasts plays a key role in liver fibrosis. We had previously shown that albumin and its derivative, R-III (a retinol-binding protein—albumin domain III fusion protein), inhibited HSC activation by sequestering retinoic acid (RA) and that R-III administration reduced carbon tetrachloride (CCl4)-induced liver fibrosis. In this study, we aimed to elucidate the mechanism of action of albumin downstream of RA sequestration. Nuclear factor-κB p65 was evenly distributed in the cytoplasm in activated mouse HSCs, whereas albumin expression or R-III treatment (albumin/R-III) caused the nuclear translocation of p65, probably via RA sequestration, resulting in a dramatic increase in interleukin-1beta (IL-1β) expression. Albumin/R-III in turn induced the phosphorylation of Smad3 at the linker region, inhibiting its nuclear import in an IL-1β-dependent manner. Consistent with the in vitro results, the level of IL-1β mRNA expression was higher in CCl4/R-III-treated livers than in CCl4-treated livers. These findings reveal that albumin/R-III inhibits the transforming growth factor-β-Smad3 signaling as well as the retinoic acid receptor-mediated pathway, which probably contributes to the inhibition of HSC activation, and suggest that R-III may be an anti-fibrotic drug candidate.
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Affiliation(s)
- Ji Hoon Park
- Protein Drug Team at New Drug Development Center, Osong Medical Innovation Foundation, Osong, 28160, Korea
| | - Janghyun Kim
- Department of Anatomy, Korea University College of Medicine, Seoul, 02841, Korea
| | - So-Young Choi
- Protein Drug Team at New Drug Development Center, Osong Medical Innovation Foundation, Osong, 28160, Korea
| | - Boram Lee
- Department of Anatomy, Korea University College of Medicine, Seoul, 02841, Korea
| | - Jung-Eun Lee
- Department of Anatomy, Korea University College of Medicine, Seoul, 02841, Korea
| | - Heekyung Park
- Department of Anatomy, Korea University College of Medicine, Seoul, 02841, Korea
| | - Ji Wook Moon
- Department of Anatomy, Korea University College of Medicine, Seoul, 02841, Korea
| | - Sun-Hwa Park
- Department of Anatomy, Korea University College of Medicine, Seoul, 02841, Korea
| | - Jae Min Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, 02841, Korea
| | - Hong Sik Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, 02841, Korea
| | - Junseo Oh
- Department of Anatomy, Korea University College of Medicine, Seoul, 02841, Korea. .,Department of Biomedical Science, Korea University Graduate School, Seoul, 02841, Korea.
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