DOI QR코드

DOI QR Code

Combination of EHE and Silymarin ameliorates liver fibrosis by inhibiting TGF-β/Smad pathway in LX-2 cells

마황(麻黃)과 Silymarin의 병용이 TGF-β/Smad 경로 억제를 통한 간섬유화 억제효능

  • Sang Mi Park (College of Korean Medicine, Daegu Haany University) ;
  • Hyo Jeong Jin (College of Korean Medicine, Daegu Haany University) ;
  • Ye Lim Kim (College of Korean Medicine, Daegu Haany University) ;
  • Sook Jahr Park (Department of Pharmaceutical Engineering, Daegu Haany University) ;
  • Sang Chan Kim (College of Korean Medicine, Daegu Haany University)
  • 박상미 (대구한의대학교 한의과대학) ;
  • 진효정 (대구한의대학교 한의과대학) ;
  • 김예림 (대구한의대학교 한의과대학) ;
  • 박숙자 (대구한의대학교 제약공학과) ;
  • 김상찬 (대구한의대학교 한의과대학)
  • Received : 2024.06.10
  • Accepted : 2024.07.25
  • Published : 2024.07.30

Abstract

Objectives : Ephedrae Herba has been used in the East Asian traditional medicine, for treatment of asthma, cold and influenza. Silymarin is an effective antioxidant and its anti-fibrogenic, anti-inflammatory, and hepatoprotective properties have been reported. This study was performed to explore an anti-fibrogenic potential of Ephedrae Herba extract (EHE) + silymarin on immortalized human hepatic stellate cell line, LX-2 cells. Methods : We studied the anti-fibrogenic effects of EHE + silymarin on transforming growth factor β1 (TGF-β1) signaling pathway in LX-2 cells. Cell viability was measured using the MTT assay. mRNA levels were detected by real-time PCR. TGF-β1 signaling-related proteins expression were detected by Western blot. Results : Silymarin 30 ㎍/mL and EHE 100 ㎍/mL showed cytotoxicity on LX-2 cells. Therefore, the concentrations of silymarin and EHE were studied at 10 ㎍/mL, respectively. Silymarin significantly reduced PAI-1 protein expression, Smad binding element (SBE) luciferase activity, and mRNA (PAI-1, MMP2 and 9) expression compared to TGF-β1. EHE significantly reduced SBE luciferase activity and mRNA (PAI-1, MMP2 and 9) expression compared to TGF-β1. More importantly, EHE + silymarin significantly reduced all parameters compared to TGF-β1, and also significantly reduced compared to EHE alone and silymarin alone. Conclusion : The results indicate that EHE + silymarin has anti-fibrogenic effect in LX-2 cells induced by TGF-β1. Additionally, EHE + silymarin shows more effective anti-fibrogenic effect than EHE alone and silymarin alone.

Keywords

Acknowledgement

This study was supported by the National Research Foundation of Korea funded by Korea government (MSIP) (Grant No.2018R1A5A2025272)

References

  1. Shin MK. Clinical herbology. Seoul:Younglimsa. 1997:322-3. 
  2. Park BR, Lee SH, Han KM, Hwang JW, Kim HI, Baek SY. Development and Utilization of KASP Markers for the Identification of Three Types of Ephedra Herbs. Kor. J. Pharmacogn. 2022;53(4):226-33.  https://doi.org/10.22889/KJP.2022.53.4.226
  3. Lee GS. The Anatomical Identification-key of Ephedrae Herba and its adulterant. Kor. J. Herbol. 2019;34(6):25-32.  https://doi.org/10.6116/KJH.2019.34.6.25.
  4. Ha TH, Kwon TW, Kim YK. Effects of Ephedra Herba ethyl-acetate fraction on high fat diet induced hyperlipidemic mice. Journal of Society of Preventive Korean Medicine 2014;18(2):101-13. 
  5. Kim HJ, Kim EJ, Han YH. The Effect of Ephedra sinica Pharmacopuncture on Lipid Metabolism in an Experimental Mouse Model of Obesity. J. Int. Korean Med. 2016;37(4):579-90.  https://doi.org/10.22246/jikm.2016.37.4.579
  6. Jeong JJ, Kim BW. The Effect of Ephedrae Herba Pharmacopuncture on Adipocyte Metabolism. Korean J. Orient. int. Med. 2008;29(1):80-9. 
  7. Won CW, Jung YS, Yoon KH, Lee HY, Yoon MC, Kim BK, Park SD, Shin SS. Herba Ephedrae and Rhizoma Amorphophalli modulates visceral obesity in micro-CT of high fat induced obese male mice. Herb. Formula Sci. 2008;16(2):205-17. 
  8. Oh MJ, Lee CH, Kim HJ, Kim HR, Kim MS, Lee DY, Oh CH, Kim MS, Kim JS. The comparative studies on anti-obesity effects of Ephedrae Herba and Cyperi rhizoma in high fat diet fed mice. Herb. Formula Sci. 2016;24(2):108-23.  https://doi.org/10.14374/HFS.2016.24.2.108
  9. Jo EH, Jo IJ, Park SJ, Jo SH, Park MC. Effects of Ephedra sinica (ES) Extract on the Ovalbumin-Induced Allergid Asthma in Mice. J Korean Med Ophthalmol Otolaryngol Dermatol. 2014;27(3):84-95.  https://doi.org/10.6114/jkood.2014.27.3.084
  10. Ryu HC, Shin JG. A study on proper dosage of Ma-huang. J of KMediACS. 2013;5(1):101-11. 
  11. Lee TH, Hsing LC, Yang CS, Kim LH, Seo ES, Jang IS. Adverse Effects of Ephedra According to Sasang Typology in Healthy Adults : A Double-Blind Randomized Controlled Trial. Korean J. Orient. Int. Med. 2009;30(1):144-52. 
  12. Kim JR, Yun SJ, Lee YK, Lee HJ, Kim JS. A Review on Safety of Herbal Medicines for Doping. J Korean Med. 2019;40(3):139-76.  https://doi.org/10.13048/jkm.19032
  13. Jo GW, Ok JM, Kim SY, Lim YW. Review on the Efficacy and Safety of Mahuang and Ephedrine in the Treatment of Obesity -Focused on RCT-. J Korean Med. 2017;38(3):170-84.  https://doi.org/10.13048/jkm.17034
  14. Chang MS, Shim KJ, Oh JH, Yoon JW, Choi MJ, Kim DR, Yang WM, Lim HH, Lee MJ, Park SK. Acute Oral Toxicity of Ephedrae Herba in SD Rats. Korean J. Oriental Physiology & Pathology. 2008;22(4):762-75. 
  15. Choi DG, Shim KJ, Choi BJ, Park SY, Chang MS, Park SK. Subacute Oral Toxicity of Ephedrae Herba Extract in SD Rats. Kor. J. Herbology 2008;23(4):1-7. 
  16. Yoo JH, Park SM, Jung DH, Kim SC. Ephedra has anti-fibrogenic effects by inhibiting the TGFβ/Smad pathway in LX-2 cells. Herb. Formula Sci. 2024;32(2):141-53.  https://doi.org/10.14374/HFS.2024.32.2.141
  17. Aghemo A, Alekseeva OP, Angelico F, Bakulin IG, Bakulina NV, Bordin D, Bueverov AO, Drapkina OM, Gillessen A, Kagarmanova EM, Korochanskaya NV, Kucheryavii UA, Lazebnik LB, Livzan MA, Maev IV, Martynov AI, Osipenko MF, Sas EI, Starodubova A, Uspensky YP, Vinnitskaya EV, Yakovenko EP, Yakovlev AA. Role of silymarin as antioxidant in clinical management of chronic liver diseases: a narrative review. Ann Med. 2022;54(1):1548-60.  https://doi.org/10.1080/07853890.2022.2069854
  18. Zhao XA, Chen GM, Liu Y, Chen YX, Wu HY, Chen J, Xiong YL, Tian C, Wang GY, Jia B, Xia J, Wang J, Yan XM, Zhang ZP, Huang R, Wu C. Inhibitory effect of silymarin on CCl(4)-induced liver fibrosis by reducing Ly6C(hi) monocytes infiltration. Int J Clin Exp Pathol. 2017;10(12):11941-51. 
  19. Saller R, Meier R, Brignoli R. The use of silymarin in the treatment of liver diseases. Drugs. 2001;61(14):2035-63.  https://doi.org/10.2165/00003495-200161140-00003
  20. Gillessen A, Schmidt HH. Silymarin as Supportive Treatment in Liver Diseases: A Narrative Review. Adv Ther. 2020;37(4):1279-301.  https://doi.org/10.1007/s12325-020-01251-y
  21. Balta C, Herman H, Boldura OM, Gasca I, Rosu M, Ardelean A, Hermenean A. Chrysin attenuates liver fibrosis and hepatic stellate cell activation through TGF-beta/Smad signaling pathway. Chem Biol Interact. 2015;240:94-101.  https://doi.org/10.1016/j.cbi.2015.08.013
  22. Bai Y, Wang L, TingYang, Wang L, Ge W. Silymarin ameliorates peritoneal fibrosis by inhibiting the TGF-beta/Smad signaling pathway. Naunyn Schmiedebergs Arch Pharmacol. 2023;396(10):2379-91  https://doi.org/10.1007/s00210-023-02450-4
  23. Eraky SM, El-Mesery M, El-Karef A, Eissa LA, El-Gayar AM. Silymarin and caffeine combination ameliorates experimentally-induced hepatic fibrosis through down-regulation of LPAR1 expression. Biomed Pharmacother. 2018;101:49-57.  https://doi.org/10.1016/j.biopha.2018.02.064
  24. Sokar SS, El-Sayad ME, Ghoneim ME, Shebl AM. Combination of Sitagliptin and Silymarin ameliorates liver fibrosis induced by carbon tetrachloride in rats. Biomed Pharmacother. 2017;89:98-107.  https://doi.org/10.1016/j.biopha.2017.02.010
  25. Okda TM, Abd-Alhaseeb MM, Barka K, Ragab NM. Ginger potentiates the effects of silymarin on liver fibrosis induced by CCL4: the role of galectin-8. Eur Rev Med Pharmacol Sci. 2019;23(2):885-91. 
  26. Lee JA, Shin MR, Choi J, Kim M, Park HJ, Roh SS. Co-Treatments of Gardeniae Fructus and Silymarin Ameliorates Excessive Oxidative Stress-Driven Liver Fibrosis by Regulation of Hepatic Sirtuin1 Activities Using Thioacetamide-Induced Mice Model. Antioxidants (Basel). 2022;12(1):97. 
  27. Kim WH, Choi DY. Jangbubyeonjeungnonchi <7th Ed>. Seoul:Seongbosa. 2004:153-166. 
  28. Byun SH, Park SM, Kim SC, Cho IJ. Anti-fibrotic Effect of Mori Folium Extract in Hepatic Stellate Cells. Kor. J. Herbology. 2013;28(4):49-55.  https://doi.org/10.6116/kjh.2013.28.4.49
  29. Kutz SM, Hordines J, McKeown-Longo PJ, Higgins PJ. TGF-β1-induced PAI-1 gene expression requires MEK activity and cell-to-substrate adhesion. J Cell Sci. 2001;114:3905-14  https://doi.org/10.1242/jcs.114.21.3905
  30. Allen RR, Higgins PJ. Plasminogen activator inhibitor type-1 expression and the pathophysiology of TGF-β1-induced epithelial-to-mesenchymal transition. Recent Res Devel Physiol. 2004;2:355-66. 
  31. Desmouliere A, Geiniz A, Gabbiani F, Gabbiani G. Transforming growth factor-β1 induces α-Smooth muscle actin expression in granulation tissue myofibroblasts and in quiescent and growing cultured fibroblasts. J Cell Biol. 1993;122:103-11.  https://doi.org/10.1083/jcb.122.1.103
  32. Chung JY, Chan MK, Li JS, Chan AS, Tang PC, Leung K, To K, Lan H, Tang PM. TGF-β Signaling: From Tissue Fibrosis to Tumor Microenvironment. Int J Mol Sci. 2021;22(14):7575. 
  33. Lee SI. Herbology. Seoul:Suseowon. 1981:189-90. 
  34. Zhai HQ, Zhang SF, Gao MC, Liu Y, Ou M, Meng FY, Wang YY. Effects of Herba Ephedra Sinicae and Fructus Schisandrae Chinensis on pathology of rats with bleomycin A(5)-induced idiopathic pulmonary fibrosis. Zhong Xi Yi Jie He Xue Bao. 2011;9(5):553-7.  https://doi.org/10.3736/jcim20110514
  35. Kim KH, Kang GH, Lee YU, Kang S, Ji SH, Song JH, Kim CH, Lee SK. Treating COVID-19 with Qingfei Paidu Decoction with and without Ephedra Herba: A Retrospective Case Series. J. Int. Korean Med. 2022;43(2):264-73.  https://doi.org/10.22246/jikm.2022.43.2.264
  36. Yoon KH, Lee HY, Jung YS, Seo BI, Park GY, Yoon MC, Shin SS. Modulation of obesity by Gyeongshingangjeehwan18 in ob/ob mice. Kor. J. Herbology 2010;25(3):1-9.  https://doi.org/10.6116/KJH.2010.25.3.001
  37. Lee HY, Yoon KH, Seo BI, Park GY, Yoon MC, Shen ZB, Cui HH, Shin SS, Molecular biologic mechanism of obesity by GGEx18. Kor. J. Herbology 2011; 26(1):65-74.  https://doi.org/10.6116/KJH.2011.26.1.065
  38. Kim HJ, Kim JB. Effects of Mahwangimun-tang in Cholesterol Diet and Triton WR-1339-induced Hyperlipidemic Rat. Korean J. Oriental Physiology & Pathology. 2010;24(1):102-10. 
  39. Ki YB, Kim DH, Kang DH, Kim SJ, Choi JB, Yang MS. Effect of Mixed Extract of Ephedrae Sinica and Fibrosum Gypsum on Differentiation of Preadipocytes and Obesity of Rats. Journal of Korean Medicine Rehabilitation. 2014;24(3):11-27. 
  40. Kang HJ, Ku TH, Kim GC. Hemodynamic Effects of Herbal Prescription Containing Ephedra on Weight Loss: A 3-Dimensional Radial Pulse Tonometry Device Study. J Korean Med Obes Res. 2023;23(1):28-41.  https://doi.org/10.15429/jkomor.2023.23.1.28
  41. Park JE, Hwang HS, Kim TY. Studies on Anti-inflammatory Effects of Mahwanghangingamchosukgo-tang Extracts. Korean J. Oriental Physiology & Pathology. 2020;34(6):319-25.  https://doi.org/10.15188/kjopp.2020.12.34.6.319
  42. Jang HK, Heo DS. Anti-OsteoArthritic effects of Mahwangbuja-tang(Mahuangfuzi-tang) on Papain-Induced Osteo Arthritic mice model. J Oriental Rehab Med. 2012;22(4):59-77. 
  43. Bae JY, Jo EH, Kim HY, Park MC. Inhibitory Effect of Ten Kinds of Herbal Medicine Including Ephedrae Herba on Nitric Oxide in LPS-induced Murine Peritoneal Macrophage. The Journal of Korean Oriental Medical Ophthalmology & Otolaryngology & Dermatology. 2009;22(2):19-38. 
  44. Wang H, Sun R, Yang S, Ma X, Yu C. Association between serum ferritin level and the various stages of non-alcoholic fatty liver disease: A systematic review. Front Med (Lausanne). 2022;9:934989. 
  45. Tsochatzis EA, Bosch J, Burroughs AK. Liver cirrhosis. Lancet. 2014;383(9930):1749-61.  https://doi.org/10.1016/S0140-6736(14)60121-5
  46. Bataller R, Brenner DA. Liver fibrosis. J Clin Invest. 2005;115:209-18.  https://doi.org/10.1172/JCI24282
  47. Fabregat I, Caballero-Diaz D. Transforming Growth Factor-β-Induced Cell Plasticity in Liver Fibrosis and Hepatocarcinogenesis. Front Oncol. 2018;8:357. 
  48. Pellicoro A, Ramachandran P, Iredale JP, Fallowfield JA. Liver fibrosis and repair: immune regulation of wound healing in a solid organ. Nat Rev Immunol. 2014;14(3):181-94.  https://doi.org/10.1038/nri3623
  49. Puche JE, Saiman Y, Friedman SL. Hepatic stellate cells and liver fibrosis. Compr Physiol. 2013;3: 1473-92.  https://doi.org/10.1002/cphy.c120035
  50. Ren Y, Chen Y, Tang EH, Hu Y, Niu B, Liang H, Xi C, Zhao F, Cao Z. Arbidol attenuates liver fibrosis and activation of hepatic stellate cells by blocking TGF-beta1 signaling. Eur J Pharmacol. 2024;967:176367. 
  51. Huang SJ, Chen SQ, Lin Y, Yang HY, Ran J, Yan FF, Huang M, Liu XL, Hong LC, Zhang XD. Maternal nicotine exposure aggravates metabolic associated fatty liver disease via PI3K/Akt signaling in adult offspring mice. Liver Int. 2021;41(8):1867-78.  https://doi.org/10.1111/liv.14902
  52. Dewidar B, Meyer C, Dooley S, Meindl-Beinker N. TGF-in Hepatic Stellate Cell Activation and Liver Fibrogenesis-Updated 2019. Cells. 2019;8(11):1419. 
  53. Chen G, Xia B, Fu Q, Huang X, Wang F, Chen Z, Lv Y. Matrix Mechanics as Regulatory Factors and Therapeutic Targets in Hepatic Fibrosis. Int J Biol Sci. 2019;15(12):2509-21.  https://doi.org/10.7150/ijbs.37500