Zhou Fan, Yao Lan, Lu Xiaoqing, Li Yubao, Han Xingmin, Wang Pei
Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Henan Medical Key Laboratory of Molecular Imaging, Zhengzhou, China.
Front Med (Lausanne). 2022 Mar 7;9:804899. doi: 10.3389/fmed.2022.804899. eCollection 2022.
Peritoneal fibrosis is a devastating complication in patients undergoing peritoneal dialysis, with no definite therapy yet available. and its major active component Salvianolic acid A (Sal A) have demonstrated a beneficial effect in myriad diseases. However, their effect on peritoneal fibrosis is unknown. In murine models of peritoneal dialysis, daily Sal A treatment substantially improved the peritoneal dialysis fluid (PDF) elicited peritoneal fibrosis, marked by thickening of the submesothelial compact zone, accumulation of extracellular matrix and increased expression of vimentin and PAI-1, concomitant with attenuation of GSK3β hyperactivity. This coincided with diminished nitrotyrosine in peritoneal tissues and increased Nrf2 nuclear translocation, entailing a lessened oxidative injury and reinforced Nrf2 antioxidant response. Meanwhile, inflammatory infiltration and maladaptive angiogenesis in peritoneal tissues provoked by PDF injury were also mitigated by Sal A, associated with a suppressed NFκB activation. Mechanistically, ectopic expression of the constitutively active GSK3β blunted the NFκB-suppressing and Nrf2-activating efficacy of Sal A in peritoneal mesothelial cells exposed to hypertonic dextrose, suggesting that GSK3β inhibition mediates the protective effect of Sal A. Collectively, our findings may open the avenue for developing a novel therapy based on Sal A for preventing peritoneal fibrosis in peritoneal dialysis.
腹膜纤维化是接受腹膜透析患者的一种严重并发症,目前尚无确切的治疗方法。其主要活性成分丹参酸A(Sal A)已在多种疾病中显示出有益作用。然而,它们对腹膜纤维化的影响尚不清楚。在腹膜透析的小鼠模型中,每日给予Sal A治疗可显著改善腹膜透析液(PDF)引起的腹膜纤维化,表现为间皮下致密区增厚、细胞外基质积聚以及波形蛋白和纤溶酶原激活物抑制剂-1(PAI-1)表达增加,同时伴有糖原合成酶激酶3β(GSK3β)过度活性的减弱。这与腹膜组织中硝基酪氨酸减少和核因子E2相关因子2(Nrf2)核转位增加相一致,意味着氧化损伤减轻和Nrf2抗氧化反应增强。同时,Sal A还减轻了PDF损伤引起的腹膜组织炎症浸润和适应性不良的血管生成,这与核因子κB(NFκB)激活受到抑制有关。从机制上讲,组成型活性GSK3β的异位表达削弱了Sal A对暴露于高渗葡萄糖的腹膜间皮细胞中NFκB的抑制作用和Nrf2的激活作用,表明GSK3β抑制介导了Sal A的保护作用。总的来说,我们的研究结果可能为开发基于Sal A的新型疗法以预防腹膜透析中的腹膜纤维化开辟道路。