Abstract

Objective: Idiopathic pulmonary fibrosis is an irreversible and progressive fibrotic lung disease that leads to declines in pulmonary function and, eventually, respiratory failure and has no effective treatment. Gly-His-Lys (GHK) is a tripeptide involved in the processes of tissue regeneration and wound healing and has significant inhibitory effects on transforming growth factor (TGF)-β1 secretion. The effect of GHK on fibrogenesis in pulmonary fibrosis and the exact underlying mechanism have not been studied previously. Thus, this study investigated the effects of GHK on bleomycin (BLM)-induced fibrosis and identified the pathway that is potentially responsible for these effects.Methods: Intratracheal injections of 3 mg/kg BLM were administered to induce pulmonary fibrosis in C57BL/6 mice. GHK was administered intraperitoneally at doses of 2.6, 26, and 260 μg/ml/day every other day from the 4th to the 21st day after BLM instillation. Three weeks after BLM instillation, pulmonary injury and pulmonary fibrosis was evaluated by the hematoxylin-eosin (HE) and Masson’s trichrome (MT) staining. Chronic inflammation index was used for the histological assessments by two pathologists blindly to each other. Tumor necrosis factor (TNF)-α and IL-6 levels in BALF and myeloperoxidase (MPO) activity in lung extracts were measured. For the pulmonary fibrosis evaluation, the fibrosis index calculated based on MT staining, collagen deposition and active TGF-β1 expression detected by ELISA, and the expression of TGF-β1, α-smooth muscle actin (SMA), fibronectin, MMP-9, and TIMP-1 by western blotting. The epithelial mesenchymal transition index, E-cadherin, and vimentin was also detected by western blot. The statistical analysis was performed by one-way ANOVA and the comparison between different groups were performed.Results: Treatment with GHK at all three doses reduced inflammatory cell infiltration and interstitial thickness and attenuated BLM-induced pulmonary fibrosis in mice. GHK treatment significantly improved collagen deposition, and MMP-9/TIMP-1 imbalances in lung tissue and also reduced TNF-α, IL-6 expression in bronchoalveolar lavage fluid (BALF) and MPO in lung extracts. Furthermore, GHK reversed BLM-induced increases in TGF-β1, p-Smad2, p-Smad-3 and insulin-like growth factor-1 (IGF-1) expression.Conclusion: GHK inhibits BLM-induced fibrosis progression, the inflammatory response and EMT via the TGF-β1/Smad 2/3 and IGF-1 pathway. Thus, GHK may be a potential treatment for pulmonary fibrosis.

Highlights

  • Idiopathic pulmonary fibrosis (IPF) is a severe respiratory disease characterized by progressive and diffuse pulmonary fibrosis and restrictive ventilation dysfunction that eventually leads to respiratory failure

  • For the pulmonary fibrosis evaluation, the fibrosis index calculated based on Masson’s trichrome (MT) staining, collagen deposition and active transforming growth factor (TGF)-β1 expression detected by Enzyme-Linked Immunosorbent Assay (ELISA), and the expression of TGF-β1, α-smooth muscle actin (SMA), fibronectin, MMP-9, and TIMP-1 by western blotting

  • Consistent with the findings of other studies, we found that GHK protected the lungs from BLM-induced fibrosis, inflammation and epithelial mesenchymal transition (EMT) through the insulin-like growth factor-1 (IGF-1) and TGFβ/Smad2/3 signaling pathways

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Summary

Introduction

Idiopathic pulmonary fibrosis (IPF) is a severe respiratory disease characterized by progressive and diffuse pulmonary fibrosis and restrictive ventilation dysfunction that eventually leads to respiratory failure. Given that pulmonary fibrosis is characterized by a progressive pulmonary functional decline (Behr, 2013), studies seeking safe and effective treatments for pulmonary fibrosis are a crucial priority. GHK levels reflect regenerative capacity, and GHK plays an important role in tissue remodeling processes (Pickart, 2008)—wound healing and skin remodeling—induced by the stimulation of collagen and glycosaminoglycan synthesis and breakdown (Wegrowski et al, 1992). GHK was reported to decrease the gene expression of IGF-1 (Pickart et al, 2014), which stimulates TGF-β1 transcription and protein expression in dermal fibroblasts in vitro (Ghahary et al, 1998). To test the above hypothesis, we established a pulmonary fibrosis mouse model through BLM instillation and explored the therapeutic effects of GHK on BLM-induced pulmonary fibrosis in the mouse model.

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