Abstract

Chinese herbal medicines used in combination have long-term been shown to be mild remedies with “integrated effects.” However, our study provides the first demonstration that M1, an active metabolite of ginsenoside, exerted its dramatic therapeutic effects on accelerated and severe lupus nephritis (ASLN) mice, featuring acute renal function impairment, heavy proteinuria, high serum levels of anti-dsDNA, and high-grade, diffuse proliferative renal lesions. In the present study, NZB/WF1 mice were given injections of lipopolysaccharide to induce the ASLN model. M1 (30 mg/kg) was then administered to the mice by gavage daily, and the mice were sacrificed on week 3 and week 5 after the induction of disease. To identify the potential mechanism of action for the pure compound, levels of NLRP3 inflammasome activation in bone marrow-derived dendritic cells (BMDCs), podocytes and macrophages, and antigen-specific T cell activation in BMDCs were determined in addition to mechanistic experiments in vivo. Treatment with M1 dramatically improved renal function, albuminuria and renal lesions and reduced serum levels of anti-dsDNA in the ASLN mice. These beneficial effects with M1 treatment involved the following cellular and molecular mechanistic events: [1] inhibition of NLRP3 inflammasome associated with autophagy induction, [2] modulation of T help cell activation, and [3] induction of regulatory T cell differentiation. M1 improved the ASLN mice by blunting NLRP3 inflammasome activation and differentially regulating T cell functions, and the results support M1 as a new therapeutic candidate for LN patients with a status of abrupt transformation of lower-grade (mesangial) to higher-grade (diffuse proliferative) nephritis.

Highlights

  • Lupus nephritis (LN) has six classes according to the level of severity of the renal pathology [1], and there is frequent transformation between the classes [2, 3]

  • We first demonstrated that M1 exerted its dramatic therapeutic effects in ASLN mice, characterized by acute renal function impairment, heavy proteinuria, high serum levels of anti-dsDNA, and high-grade, diffuse proliferative renal lesions

  • We showed these beneficial effects of M1 clearly correlated with the following: [1] inhibition of NOD-like receptor family-pyrin domain containing 3 (NLRP3) inflammasome associated with autophagy induction in renal tissues, bone marrow-derived dendritic cells (BMDCs) or podocytes, [2] modulation of Th cell activation, and [3] induction of Treg cell differentiation in ASLN (Figure 7)

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Summary

Introduction

Lupus nephritis (LN) has six classes according to the level of severity of the renal pathology [1], and there is frequent transformation between the classes [2, 3]. We found that the uncontrolled production of IL-1β, IL-18, and ROS, and T cell activation are implicated in the activation of the NLRP3 inflammasome in a mouse model of accelerated and severe LN (ASLN) [8, 9, 11]. Autophagy exerts an inhibitory effect on the NLRP3 inflammasome and can negatively regulate the innate immune response and inflammation [23, 33], for which various studies suggest that autophagy serves as a negative regulator of the NLRP3 inflammasome in the restoration of tissue homeostasis after damage in autoimmune diseases, including LN [34,35,36]. Several studies revealed that autophagy can protect against damage to podocytes [37,38,39]

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