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二甲双胍通过激活 SIRT1 抑制巨噬细胞介导的炎症反应预防创伤性异位骨化。

Pharmacological activation of SIRT1 by metformin prevented trauma-induced heterotopic ossification through inhibiting macrophage mediated inflammation.

机构信息

Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, PR China; Shanghai Engineering Research Center for Orthopaedic Material Innovation and Tissue Regeneration, Shanghai, 201306, PR China.

Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, PR China; Shanghai Engineering Research Center for Orthopaedic Material Innovation and Tissue Regeneration, Shanghai, 201306, PR China.

出版信息

Eur J Pharmacol. 2021 Oct 15;909:174386. doi: 10.1016/j.ejphar.2021.174386. Epub 2021 Jul 29.

Abstract

Trauma-induced heterotopic ossification (HO) is the aberrant extra-skeletal bone formation that severely incapacitates patient's daily life. Inflammation is the first stage of this progression, becoming an appealing target of early therapeutic intervention. Metformin, a widely used antidiabetic drug, also poses the therapeutic potential to modulate various inflammatory-related diseases. Therefore, this study aimed to investigate the preventive effect of metformin on trauma-induced HO progression, and unveil the underlying molecular mechanisms. A murine burn/tenotomy model was established to mimic trauma-induced HO in vivo. The anti-inflammation and anti-ossification effects of metformin were evaluated by histological staining and micro-CT. The inhibitory effects of metformin on macrophages activation in vitro were examined by ELISA and qRT-PCR. The underlying molecular mechanisms were further explored by immunofluorescence staining and western-blotting in vivo. Increased macrophages infiltration and inflammatory responses were found at early stage during HO progression. However, metformin dose-dependently attenuated the macrophage-mediated inflammatory responses both in vivo and vitro, which might account for the inhibitory effect of metformin on chondrogenesis and HO formation after trauma. Furthermore, elevated SIRT1 expression and decreased NF-κB p65 acetylation were found in the beneficial effects of metformin. Moreover, similar preventive effects were also found in SRT1720 HCI, a specific SIRT1 activator, while were remarkably reversed after the administration of EX527 (a specific SIRT1 inhibitor) with metformin. Taken together, our results provide a novel evidence that metformin can effectively attenuate trauma-induced HO by mitigating macrophage inflammatory responses through inhibiting NF-κB signaling via SIRT1-dependent mechanisms, which favors future therapeutic investigations for trauma-related disease.

摘要

创伤性异位骨化(HO)是一种异常的骨骼外骨形成,严重影响患者的日常生活。炎症是这一进展的第一阶段,成为早期治疗干预的一个有吸引力的靶点。二甲双胍是一种广泛使用的抗糖尿病药物,也具有调节各种炎症相关疾病的治疗潜力。因此,本研究旨在探讨二甲双胍对创伤性 HO 进展的预防作用,并揭示其潜在的分子机制。建立了一种烧伤/肌腱切断的小鼠模型,以模拟体内创伤性 HO。通过组织学染色和 micro-CT 评估二甲双胍的抗炎和抗骨化作用。通过 ELISA 和 qRT-PCR 检测二甲双胍在体外对巨噬细胞激活的抑制作用。通过免疫荧光染色和体内 Western-blotting 进一步探讨其潜在的分子机制。在 HO 进展的早期阶段发现巨噬细胞浸润和炎症反应增加。然而,二甲双胍剂量依赖性地减弱了体内和体外的巨噬细胞介导的炎症反应,这可能是二甲双胍抑制创伤后软骨生成和 HO 形成的原因。此外,在二甲双胍的有益作用中发现 SIRT1 表达升高和 NF-κB p65 乙酰化降低。此外,在 SRT1720 HCI(一种特异性 SIRT1 激活剂)中也发现了类似的预防作用,而在用二甲双胍联合 EX527(一种特异性 SIRT1 抑制剂)后,这种作用则明显逆转。总之,我们的研究结果提供了新的证据,表明二甲双胍可以通过抑制 NF-κB 信号通路通过 SIRT1 依赖性机制减轻巨噬细胞炎症反应,从而有效抑制创伤性 HO,这有利于创伤相关疾病的未来治疗研究。

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