Emodin protects against severe acute pancreatitis-associated acute lung injury by activating Nrf2/HO-1/GPX4 signal and inhibiting ferroptosis in vivo and in vitro

Abstract Background Severe acute pancreatitis (SAP) has high morbidity, a complicated and dangerous course, and many complications, including severe pulmonary complications. SAP-associated acute lung injury (SAP-ALI) is still a significant challenge for surgeons because of its high mortality. Theref...

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Main Authors: Gang Shen, Haiyun Wen, Huijuan Li, Xuetao Zhang, Bowen Lan, Xuanchi Dong, Peng Ge, Yalan Luo, Hailong Chen
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-03660-1
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author Gang Shen
Haiyun Wen
Huijuan Li
Xuetao Zhang
Bowen Lan
Xuanchi Dong
Peng Ge
Yalan Luo
Hailong Chen
author_facet Gang Shen
Haiyun Wen
Huijuan Li
Xuetao Zhang
Bowen Lan
Xuanchi Dong
Peng Ge
Yalan Luo
Hailong Chen
author_sort Gang Shen
collection DOAJ
description Abstract Background Severe acute pancreatitis (SAP) has high morbidity, a complicated and dangerous course, and many complications, including severe pulmonary complications. SAP-associated acute lung injury (SAP-ALI) is still a significant challenge for surgeons because of its high mortality. Therefore, more effective treatment methods are urgently needed. Emodin (EMO) has shown tremendous potential in treating many refractory diseases. However, its protection mechanism in SAP-ALI needs to be further clarified. This study was undertaken to investigate the protective effects of EMO against lung injury in SAP rats and alveolar epithelial cells, with a particular focus on the classical ferroptosis pathway. Methods In an in vivo study, forty SD rats were evenly split into five groups: sham operation (SO) group, the biliopancreatic duct was retrogradely injected with 5% sodium taurocholate (STC) to create the SAP group, SAP + EMO group was administered EMO via gavage to the rats following the modeling, SAP + ML385 group (a given inhibitor of nuclear factor erythroid 2-related factor 2 (Nrf2)), SAP + ML385 + EMO group. In an in vitro study, alveolar epithelial A549 cell lines were exposed to lipopolysaccharide (LPS) and treated with EMO. ML385 was also used to inhibit the expression of Nrf2. Pancreatic and lung tissue damage was evaluated using histological examination and molecular experiments. Enzyme-linked immunosorbent assays (ELISA) were used to assess the levels of pro-inflammatory cytokines, Fe2+, and associated oxidative stress indicators in the serum and cell supernatant. Real-time polymerase chain reaction (PCR), Western blot (WB), and immunofluorescence were used to find the expressions of related mRNAs and proteins in the lung tissue or A549 cells. Results The findings demonstrated that suppressing Nrf2 expression exacerbated the inflammatory response brought on by SAP and the pathological alterations of SAP-ALI. Emodin treatment reversed this pathological change by activating the Nrf2/Heme Oxygenase-1 (HO-1)/glutathione peroxidase 4 (GPX4) signal path. Moreover, these results also showed that EMO, contrary to the effects of ML385, suppressed the ferroptosis response, which manifested as up-regulated glutathione (GSH) and GPX4 levels in vivo and in vitro and down-regulated malondialdehyde (MDA), superoxide dismutase (SOD), Fe2+, and reactive oxygen species (ROS) levels. Conclusions Our results demonstrated that EMO effectively inhibited ferroptosis both in vivo and in vitro, while also modulating the Nrf2/HO-1/GPX4 signaling pathway to provide protection against SAP-ALI.
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spelling doaj-art-ba82dc0e6a9f452a8ec2c63da04b2fd72025-02-09T12:39:40ZengBMCBMC Gastroenterology1471-230X2025-02-0125111510.1186/s12876-025-03660-1Emodin protects against severe acute pancreatitis-associated acute lung injury by activating Nrf2/HO-1/GPX4 signal and inhibiting ferroptosis in vivo and in vitroGang Shen0Haiyun Wen1Huijuan Li2Xuetao Zhang3Bowen Lan4Xuanchi Dong5Peng Ge6Yalan Luo7Hailong Chen8Department of General Surgery, Pancreatic-Biliary Center, The First Affiliated Hospital of Dalian Medical UniversityDepartment of General Surgery, Pancreatic-Biliary Center, The First Affiliated Hospital of Dalian Medical UniversityLaboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical UniversityDepartment of General Surgery, Pancreatic-Biliary Center, The First Affiliated Hospital of Dalian Medical UniversityDepartment of General Surgery, Pancreatic-Biliary Center, The First Affiliated Hospital of Dalian Medical UniversityDepartment of General Surgery, Pancreatic-Biliary Center, The First Affiliated Hospital of Dalian Medical UniversityDepartment of General Surgery, Pancreatic-Biliary Center, The First Affiliated Hospital of Dalian Medical UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Dalian Medical UniversityDepartment of General Surgery, Pancreatic-Biliary Center, The First Affiliated Hospital of Dalian Medical UniversityAbstract Background Severe acute pancreatitis (SAP) has high morbidity, a complicated and dangerous course, and many complications, including severe pulmonary complications. SAP-associated acute lung injury (SAP-ALI) is still a significant challenge for surgeons because of its high mortality. Therefore, more effective treatment methods are urgently needed. Emodin (EMO) has shown tremendous potential in treating many refractory diseases. However, its protection mechanism in SAP-ALI needs to be further clarified. This study was undertaken to investigate the protective effects of EMO against lung injury in SAP rats and alveolar epithelial cells, with a particular focus on the classical ferroptosis pathway. Methods In an in vivo study, forty SD rats were evenly split into five groups: sham operation (SO) group, the biliopancreatic duct was retrogradely injected with 5% sodium taurocholate (STC) to create the SAP group, SAP + EMO group was administered EMO via gavage to the rats following the modeling, SAP + ML385 group (a given inhibitor of nuclear factor erythroid 2-related factor 2 (Nrf2)), SAP + ML385 + EMO group. In an in vitro study, alveolar epithelial A549 cell lines were exposed to lipopolysaccharide (LPS) and treated with EMO. ML385 was also used to inhibit the expression of Nrf2. Pancreatic and lung tissue damage was evaluated using histological examination and molecular experiments. Enzyme-linked immunosorbent assays (ELISA) were used to assess the levels of pro-inflammatory cytokines, Fe2+, and associated oxidative stress indicators in the serum and cell supernatant. Real-time polymerase chain reaction (PCR), Western blot (WB), and immunofluorescence were used to find the expressions of related mRNAs and proteins in the lung tissue or A549 cells. Results The findings demonstrated that suppressing Nrf2 expression exacerbated the inflammatory response brought on by SAP and the pathological alterations of SAP-ALI. Emodin treatment reversed this pathological change by activating the Nrf2/Heme Oxygenase-1 (HO-1)/glutathione peroxidase 4 (GPX4) signal path. Moreover, these results also showed that EMO, contrary to the effects of ML385, suppressed the ferroptosis response, which manifested as up-regulated glutathione (GSH) and GPX4 levels in vivo and in vitro and down-regulated malondialdehyde (MDA), superoxide dismutase (SOD), Fe2+, and reactive oxygen species (ROS) levels. Conclusions Our results demonstrated that EMO effectively inhibited ferroptosis both in vivo and in vitro, while also modulating the Nrf2/HO-1/GPX4 signaling pathway to provide protection against SAP-ALI.https://doi.org/10.1186/s12876-025-03660-1FerroptosisSAP-ALIEmodinNrf2GPX4HO-1
spellingShingle Gang Shen
Haiyun Wen
Huijuan Li
Xuetao Zhang
Bowen Lan
Xuanchi Dong
Peng Ge
Yalan Luo
Hailong Chen
Emodin protects against severe acute pancreatitis-associated acute lung injury by activating Nrf2/HO-1/GPX4 signal and inhibiting ferroptosis in vivo and in vitro
BMC Gastroenterology
Ferroptosis
SAP-ALI
Emodin
Nrf2
GPX4
HO-1
title Emodin protects against severe acute pancreatitis-associated acute lung injury by activating Nrf2/HO-1/GPX4 signal and inhibiting ferroptosis in vivo and in vitro
title_full Emodin protects against severe acute pancreatitis-associated acute lung injury by activating Nrf2/HO-1/GPX4 signal and inhibiting ferroptosis in vivo and in vitro
title_fullStr Emodin protects against severe acute pancreatitis-associated acute lung injury by activating Nrf2/HO-1/GPX4 signal and inhibiting ferroptosis in vivo and in vitro
title_full_unstemmed Emodin protects against severe acute pancreatitis-associated acute lung injury by activating Nrf2/HO-1/GPX4 signal and inhibiting ferroptosis in vivo and in vitro
title_short Emodin protects against severe acute pancreatitis-associated acute lung injury by activating Nrf2/HO-1/GPX4 signal and inhibiting ferroptosis in vivo and in vitro
title_sort emodin protects against severe acute pancreatitis associated acute lung injury by activating nrf2 ho 1 gpx4 signal and inhibiting ferroptosis in vivo and in vitro
topic Ferroptosis
SAP-ALI
Emodin
Nrf2
GPX4
HO-1
url https://doi.org/10.1186/s12876-025-03660-1
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