Atlanta Veterans Affairs Medical Center, Decatur, GA, USA.
Am J Respir Cell Mol Biol. 2013 Apr;48(4):511-7. doi: 10.1165/rcmb.2012-0334OC.
Excessive alcohol use increases the risk of acute lung injury and pneumonia. Chronic alcohol ingestion causes oxidative stress within the alveolar space, including near depletion of glutathione (GSH), which impairs alveolar epithelial and macrophage function, in experimental animals and human subjects. However, the fundamental mechanism(s) by which alcohol induces such profound lung oxidative stress is unknown. Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is a redox-sensitive master transcription factor that regulates activation of the antioxidant response element (ARE). As the alveolar epithelium controls GSH levels within the alveolar space, we hypothesized that alcohol also decreases Nrf2 expression and/or activation within the alveolar epithelium. In this study, we determined that alcohol ingestion in vivo or direct alcohol exposure in vitro down-regulated the Nrf2-ARE pathway in lung epithelial cells, decreased the expression of antioxidant genes, and lowered intracellular GSH levels. RNA silencing of Nrf2 gene expression in alveolar epithelial cells in vitro decreased expression of these same antioxidant genes, and likewise lowered intracellular GSH levels, findings that mirrored the effects of alcohol. In contrast, treating alcohol-exposed alveolar epithelial cells in vitro with the Nrf2 activator, sulforaphane, preserved Nrf2 expression, ARE activation, intracellular GSH levels, and epithelial barrier function. These new experimental findings implicate down-regulation of the Nrf2-ARE signaling pathway as a fundamental mechanism by which alcohol causes profound oxidative stress and alveolar epithelial dysfunction, and suggest that treatments, such as sulforaphane, that activate this pathway could mitigate the pathophysiological consequences of alcohol on the lung and other organs.
过量饮酒会增加急性肺损伤和肺炎的风险。慢性饮酒会导致肺泡内氧化应激,包括谷胱甘肽 (GSH) 的几乎耗尽,这会损害肺泡上皮细胞和巨噬细胞的功能,在实验动物和人类中都是如此。然而,酒精引起如此严重的肺部氧化应激的基本机制尚不清楚。核因子 (红系衍生 2)-样 2 (Nrf2) 是一种氧化还原敏感的主转录因子,可调节抗氧化反应元件 (ARE) 的激活。由于肺泡上皮细胞控制肺泡腔内的 GSH 水平,我们假设酒精也会降低肺泡上皮细胞内的 Nrf2 表达和/或激活。在这项研究中,我们确定体内饮酒或体外直接酒精暴露会下调肺上皮细胞中的 Nrf2-ARE 途径,降低抗氧化基因的表达,并降低细胞内 GSH 水平。体外肺泡上皮细胞中 Nrf2 基因表达的 RNA 沉默会降低这些相同的抗氧化基因的表达,并同样降低细胞内 GSH 水平,这与酒精的作用相吻合。相比之下,体外用 Nrf2 激活剂萝卜硫素处理酒精暴露的肺泡上皮细胞可维持 Nrf2 表达、ARE 激活、细胞内 GSH 水平和上皮屏障功能。这些新的实验发现表明,Nrf2-ARE 信号通路的下调是酒精引起严重氧化应激和肺泡上皮功能障碍的基本机制,并表明激活该通路的治疗方法,如萝卜硫素,可能减轻酒精对肺和其他器官的病理生理后果。