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J. Biol. Chem., Vol. 280, Issue 10, 9409-9415, March 11, 2005
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From the Department of Physiology, Indian Institute of Chemical Biology, 4, Raja S.C. Mullick Road, Jadavpur, Kolkata-700032, India
Received for publication, November 29, 2004
| ABSTRACT |
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| INTRODUCTION |
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Indomethacin, a NSAID, causes gastric lesions through a number of mechanisms including inhibition of prostaglandin synthesis, increased expression of interleukin-1 (IL-1), generation of reactive oxygen species (ROS), and induction of apoptosis (710). Increased lipid peroxidation, protein oxidation, and depletion of glutathione are the major indications of the oxidative damage of the gastric mucosal cells by indomethacin (8, 11). However, very little is known about the involvement of MMP and TIMP expression in NSAID-induced gastric ulcer (1215). MMP-1 concentration is found to be significantly higher in H. pylori-induced ulcer compared with that of NSAIDs ulcer (12). The roles for ECM proteins and ECM degrading enzymes (i.e. MMPs) in gastric ulceration have been implicated in few reports during the last few years (15, 16), but the mechanistic basis is not very clear today. MMP-2 has been suggested to participate in the physiological turnover of the gastric ECM, whereas MMP-9 may be important in the early phase of indomethacin-induced chronic gastric ulcers (13). Very recently, Mori et al. (17) reported MMP-9 induction through activation of NF-
B in H. pylori-infected cultured gastric mucosal cells. Literature is also very scanty regarding the role of MMPs and TIMPs during the healing process of the gastric ulcer (18). The roles of MMPs in ulcer development and healing have been demonstrated only in the acetic acid-induced gastric ulcer model (18). The objective of the present study is to investigate in detail the expression and activities of MMP-9 and -2 during indomethacin-induced gastric ulceration and its healing by curcumin.
Although the efficacy and safety of omeprazole used for the healing of gastroduodenal ulcers caused by NSAIDs are well established (19). Some shortcomings have also been reported (20, 21). The quality of healing remains crucial for preventing recurrence (22) because ulcer recurs with various adverse side effects when common antiulcer drugs, such as omeprazole, ranitidine, famotidine, etc. are used. Considering these limitations, a search for an alternative nontoxic antiulcer compound is always welcome. Curcumin (diferuloylmethane), a bioactive constituent from Curcuma longa possesses remarkable anti-inflammatory, antioxidant, and anticarcinogenic properties (23, 24). This compound has been shown to inhibit the expression of a sequence of inflammatory cytokines such as tumor necrosis factor-
, IL-1, or IL-8 (24). Curcumin is a potential scavenger of oxidized free radicals, and it also increases the level of glutathione during apoptosis (25). Because pro-inflammatory and pro-oxidant states are closely linked to ulcer development, a polyphenolic compound like curcumin having potent anti-inflammatory and antioxidant activities is anticipated to exert an antiulcer effect. Based on its ethnopharmacological studies and medicinal use in traditional practice (24), the present study is undertaken to examine the gastroprotective and ulcer healing effect of curcumin in indomethacin-induced gastric ulcer and its healing process with special emphasis on the regulation of MMP-9 and -2 activities. Evidence has been presented to show that curcumin not only protects gastric mucosal cell damage and oxidative insult, but it also regulates expression and activities of MMPs during protection and healing of indomethacin-induced gastric damage. Our studies have revealed for the first time the antiulcer activity of curcumin and its mechanism of action that blocks gastric damage by inhibiting the up-regulation of MMP-9 and down-regulation of MMP-2. Furthermore, characterization of ulcer prevention by omeprazole showed its properties to be distinct from curcumin and to involve the MMP-9-independent pathway. This finding identifies the MMP-9-dependent pathway in addition to the MMP-independent pathway for ulceration.
| MATERIALS AND METHODS |
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Animals UsedMale Sprague-Dawley rats (180220 g) bred inhouse with free access to food and water were used for all of the experiments. All of the rats were kept in 12-h light/dark cycles and housed at 25 °C room temperature. All of the experiments were designed to minimize animal suffering and to use the minimum number associated with valid statistical evaluation. The animals were anesthetized by ketamine (12 mg kg-1 body weight) followed by cervical dislocation for killing. The animal experiments (n = 12) were conducted in accordance to the guidelines of the animal ethics committee of the Indian Institute of Chemical Biology.
Indomethacin-induced Gastric Ulceration and Its Protection StudiesBefore ulcer induction animals of both control and experimental groups kept separately in standard controlled conditions were fasted for 24 h with free access to water. Acute gastric ulcers were induced by oral administration of indomethacin at a dose of 48 mg kg-1 body weight and rats were sacrificed after 4 h of indomethacin treatment. The control group received the vehicle only, whereas the experimental group received indomethacin for gastric ulceration. After 4 h, the animals were sacrificed, and gastric lesions in the fundic stomach were scored and expressed as ulcer index (26) as follows: 0 = no pathology; 1 = a small pinhead ulcer spot; and 25 = a bandlike lesion of 25 mm length (26). The sum of the total scores divided by the number of animals is expressed as the mean ulcer index. Curcumin was administered intraperitoneally or orally 30 min prior to indomethacin treatment to see the gastroprotective effect. Omeprazole and Me2SO were administered intraperitoneally at a dose of 15 mg kg-1 body weight and 3 ml kg-1 body weight, respectively.
Histological AnalysisAfter scoring the ulcer index, the fundic stomach was sectioned for histological studies. The tissue samples were fixed in 10% formalin and embedded in paraffin. The sections (5 µm) were cut using microtome, stained with hematoxylin and eosin (27), and assessed under an Olympus microscope (1 x 70). Images were captured using Camedia software (E-20P 5.0 Megapixel) and processed using Adobe Photoshop version 6.0.
Measurement of GSH LevelFundic stomach homogenate was made in 0.2 M Tris, pH 8.2, containing 20 mM EDTA and centrifuged. An aliquot of 1.0 ml of homogenate was precipitated with 10% trichloroacetic acid and centrifuged. The supernatant (1.0 ml) was added to 2.0 ml of 0.8 M Tris-HCl, pH 9.0, containing 20 mM EDTA (28) and mixed with 0.1 ml of 10 mM 5,5'-dithiobis-2-nitrobenzoic acid. The intense yellow color of nitromercaptobenzoate was read at 412 nm. For calibration, a standard curve was prepared treating varied concentrations of reduced glutathione with 5,5'-dithiobis-2-nitrobenzoic acid under identical conditions.
Measurement of Lipid PeroxidationThe mitochondrial membrane fraction from the fundic stomach homogenate was used for measurement of lipid peroxide content as thiobarbituric acid reactive species (29). Briefly, 1 ml of the membrane fraction was allowed to react with 2 ml of 15% trichloroacetic acid, 0.375% thiobarbituric acid, 0.25 N HCl reagent, heated in a boiling water bath for 15 min, cooled, and centrifuged. The absorbance of the supernatant was measured at 535 nm, and the number of nmol of thiobarbituric acid reactive species produced was determined from a standard curve using tetraethoxypropane as standard.
Measurement of Protein Carbonyl ContentProtein oxidation was measured as carbonyl content in the low speed supernatant of the fundic stomach homogenate (26). The fundic stomach from control, ulcerated, and curcumin-pretreated (40 mg kg-1) indomethacin-treated rats were homogenized in 50 mM sodium phosphate buffer, pH 7.4, in a Potter-Elvehjem glass homogenizer for 2 min to get 20% homogenate. After centrifugation at 600 x g for 10 min, the proteins from 1.0 ml of the supernatant were precipitated with 10% trichloroacetic acid and allowed to react with 0.5 ml of 10 mM 2,4-dinitrophenylhydrazine for 1 h. After precipitation with 20% trichloroacetic acid, the protein was washed thrice with a mixture of ethanol-ethyl acetate (1:1), dissolved in 1.0 ml of a solution containing 6 M guanidine HCl in 20 mM potassium phosphate adjusted to pH 2.3 with trifluroacetic acid, and centrifuged, and the supernatant was read for carbonyl content at 362 nm (e = 22,000 M-1 cm-1).
Tissue Extraction and Gelatin ZymographyThe fundic part of the gastric mucosa was suspended in phosphate-buffered saline containing protease inhibitors, minced, and incubated for 10 min at 4 °C. After centrifugation at 12,000 x g for 15 min, the supernatant was discarded. The pellet was extracted in the lysis buffer (10 mM Tris-HCl pH 8.0, 150 mM NaCl, 1% Triton X-100 plus protease inhibitors) and centrifuged at 12,000 x g for 15 min to obtain TX extract. Tissue extracts were preserved at -70 °C and used in future studies. MMP activity was significantly decreased within a short period of time if the mucosa was processed in the absence of protease inhibitors. For assay of MMP-2 and MMP-9 activity, mucosal extracts were electrophoresed in SDS-poly-acrylamide gel containing 1 mg ml-1 gelatin under nonreducing conditions. The gels were washed in 2.5% Triton-X-100 and incubated in CAB buffer (40 mM Tris-HCl, pH 7.4, 0.2 M NaCl, 10 mM CaCl2) for 18 h at 37 °C and stained with 0.1% Coomassie Blue followed by destaining (18). The zones of gelatinolytic activity came as negative staining. Enzymatic activity was determined by scanning bands using a scanner (HP Scanjet Scanner 5550C) connected to a computer linked to proper software (Image QUANT) to measure the area produced by each peak.
Western BlottingProteins (120 µg) were resolved by 8% nonreducing SDS-polyacrylamide gel electrophoresis and transferred to nitrocellulose membranes (30). The membrane was blocked for 2 h at room temperature in 20 mM Tris-HCl, pH 7.4, 150 mM NaCl, 0.02% Tween 20 (TBST) containing 7% nonfat dry milk followed by overnight incubation at 4 °C in 1:500 dilution of polyclonal goat antihuman MMP-9 antibody in TBST. The membrane was washed three times with TBST and incubated with alkaline phosphatase-conjugated secondary antibody, and the bands were visualized using 5-bromo-4-chloro-3-indolyl phosphate/nitro blue tetrazolium substrate solution from Sigma. The blots shown in this study are representative replicates selected from at least three experiments.
Healing of Indomethacin-induced Gastric UlcerIndomethacin-induced gastric ulcer was developed in a group of animals under the conditions described above. One group served as control for autohealing, whereas the other groups were treated intraperitoneally with 40 mg kg-1 body weight curcumin or 15 mg kg-1 body weight omeprazole after 4 h of administration of indomethacin. Healing was monitored after sacrificing animals at different time points (n = 12), and the ulcer index was scored as described above. The activity profile of MMP-9 and -2 during ulcer healing was determined as described before.
Statistical AnalysisThe ulcer index data were fitted using a Sigma plot. The data were presented as the means ± S.E. Significance was calculated from Student's t test.
| RESULTS |
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1012-fold at 34 h after indomethacin administration (Fig. 4), with respect to the earlier time points.
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90% protection of ulcer occurred with an intraperitoneal dose of 40 mg kg-1 body weight curcumin (Fig. 5A). Curcumin dose-dependently blocked indomethacin-induced gastric lesions (Fig. 5A) through reduction of MMP-9 activity and enhancement of total MMP-2 (both pro and active forms) activity (Fig. 5B). This down-regulation of MMP-9 activity was due to attenuation of MMP-9 at protein level as judged by Western blot probed with anti-MMP-9 antibody (Fig. 5C). Based on prophylactic data we asked whether curcumin might be applicable for therapeutic purposes. As shown in Fig. 6 oral administration of curcumin was also highly effective in protecting ulcer through reduction of MMP-9 activity and enhancement of total MMP-2 (both pro and active forms) activity. At an oral dose of 60 mg kg-1 body weight, curcumin exhibited 85% inhibition of ulcer index (Fig. 6A). It is interesting to note that only a 1.5 times higher dose of curcumin was required to block ulcer when given orally (Fig. 6A) compared with that done intraperitoneally (Fig. 5A). In addition, oral administration of curcumin dose-dependently blocked indomethacin-induced gastric lesions (Fig. 6A) and a exerted significant inhibitory role on MMP-9 activity (Fig. 6B). The 12-fold up-regulation of MMP-9 activity caused by indo-methacin treatment (i.e. zero dose of curcumin) almost completely disappeared (Fig. 6A) at the oral dose of 60 mg kg-1 body weight where ulcer was inhibited by 85%.
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80%) antiulcer effect (Fig. 8B). Ulcer inhibition by curcumin and Me2SO were associated with attenuation of pro-MMP-9 activity. In contrast, omeprazole protected ulcers with-out inhibiting MMP-9 activity (Fig. 8B).
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| DISCUSSION |
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(7, 8, 9, 31). The mechanisms of diminishment of prostaglandin E production and the increment of cytokine expression are mediated through generation of ROS (8). In several systems, indomethacin-induced suppression of endogenous prostaglandin E production is associated with the inhibition of pro-MMP-9 and the decrease of MMP-9 activity (31, 32). Evidence has also been provided to show that IL-1-mediated pro-MMP-9 production is enhanced by indomethacin and that tumor necrosis factor-
induces the expression of MMP-9 via the NF-
B-mediated pathway (33, 34). Nevertheless it is clear from various studies that indo-methacin increases MMP-9 activity either by prostaglandin-dependent or -independent pathways (3236). Various combinations of cytokines present at inflammatory sites as well as their balance during different stages of inflammation may provide the signals for induction of MMP-9 activity. The up- and down-regulation of MMPs at the gene and protein levels are thought to be some of the underlying mechanisms for damage and regeneration of ECM during ulceration and healing processes, respectively. Our studies indicate that ulcerated gastric mucosal tissue of rat stomach exhibited significant increase of MMP-9 activity and decreased MMP-2 activity more than that of normal tissue. In addition, gastric lesions caused by indomethacin are due to overexpression of MMP-9 protein in damaged tissue. Lempinen et al. (13) showed that indomethacin causes enhancement of MMP-9 as well as MMP-2 activity in chronic gastric ulcers in the rat model. In contrast we have consistently seen decreased MMP-2 activity and increased MMP-9 activity by indomethacin in a time- and dose-dependent manner in the acute ulcer model. Our data are supported by the findings of Pan and Hung (37) that NSAIDs suppress the constitutive activity of MMP-2 gene expression by inhibiting its transcription. Nevertheless, it is clear from all the studies that changes of total MMP-2 (pro and active) activity signify involvement of MMP-2 in the ulceration of NSAID. One interpretation of these opposite expression patterns of MMP-2 and MMP-9 is that they are regulated by distinct mechanisms. In agreement with this, it is reported that MMP-2 and MMP-9 promoters differ markedly; MMP-9 but not MMP-2 promoters contain several putative AP-1 and NF-
B binding sites (3638). Omeprazole (a substituted benzimidazole derivative) is widely used to control gastric damage by stress and NSAIDs and is believed to offer its antiulcer activity through acid suppression, scavenging of ·OH radical, and blocking apoptotic cell death (26). Although omeprazole is extensively used, it has some side effects like neutrophil adherence, diarrhea, and recurrence of ulcers (22). Considering the disadvantages of this well established drug, an alternative antiulcer agent is necessary at this junction. It is now generally agreed that among various mechanisms, oxidative damage of the mucosa by reactive oxygen species and by apoptotic cell death are the major causative factors for gastric ulceration (10, 11). Increased lipid peroxidation and protein oxidation along with the depletion of thiols are the major indications of ROS generation in gastric mucosa (8). Because ROS generation plays a major role in all types of gastric ulcer, the possible role of them in the regulation of MMPs and the effect of curcumin thereon is an interesting aspect for investigation. Because ROS are involved in the formation of indomethacin-induced gastric ulcer, polyphenolic substances like curcumin having potent anti-inflammatory and/or antioxidant properties are anticipated to exert protective effects on ulceration (8, 23, 24). Interestingly, our data document that curcumin offers gastroprotection by preventing oxidative damage caused by glutathione depletion, lipid peroxidation, and protein oxidation. It is evident from our histological studies that curcumin can completely reverse the damage of the surface epithelial cells and the mucosal layer of gastric lumen caused by indomethacin. However, the biochemical mechanism underlying the regulation of MMP activity and the manner in which ECM remodeling occurs by curcumin during healing process are yet unknown.
The present study first establishes the antiulcer activity of curcumin in indomethacin-induced gastric ulcer and its association with down-regulation of MMP-9 activity and up-regulation of MMP-2 activity. Attenuation of MMP-9 activity is due to the block of overexpression of this protein. In the present study we have found the ability of curcumin to protect gastric ulcer in a dose-dependent manner even when administered orally. The result shows that oral dose of curcumin (60 mg kg-1) blocks 85% of gastric damage caused by indomethacin. Thus, it may be a promising alternative therapeutic agent for offering protection and healing of NSAIDs-induced gastric ulcer. Support for this idea is provided by the findings that curcumin is nontoxic to human up to 8 gm day-1 when taken orally for 3 months (39). The other important finding is that healing of indomethacin-induced ulcer is greatly accelerated by curcumin through an MMP-dependent process. Autohealing of indomethacin-induced ulcer was achieved progressively with time and correlates well with the gradual attenuation of MMP-9 activity and increment of MMP-2 activity. Similarly, curcumin not only attenuates MMP-9 but also ameliorates MMP-2 activity while accelerating the healing process. It is probable that curcumin down-regulates MMP-9 via diminished transactivation because the 5'-flanking region of rat MMP-9 gene contains binding sequences for transacting molecule like Ets and NF-
B (36). We are interested to explore whether NF-
B is playing a role in the induction of MMP-9 gene during gastric ulceration or suppression of MMP-9 gene during protection or healing by curcumin. On the other hand, curcumin may up-regulate MMP-2 expression in a cytokine-mediated process during healing of gastric damage. Further studies will be required to test these possibilities. Because the inhibitory effect of indomethacin on angiogenesis via suppression of MMP-2 has been reported (40, 41), it is interesting to explore the plausible role of curcumin in the protection and healing of gastric lesions by regulating angiogenesis through MMP-2. Finally, the above results raise the important question of whether MMP-9 inhibition necessarily means ulcer healing. Or, in other words, is MMP-9 alone diagnostic for ulcer healing? To prove the hypothesis, we used different antioxidants and an established drug, omeprazole, for blocking indomethacin-induced ulcer and looked for the MMP-9 profile. Surprisingly, omeprazole protects gastric ulcers without affecting MMP-9 activity. On the other hand, Me2SO as well as curcumin caused significant MMP-9 inhibition during protection of ulcers. One interpretation of these data is that ulcer healing is associated with MMP-9-dependent as well as MMP-9-independent pathways. Additionally, autohealing data suggests that the MMP-9-mediated pathway for ulcer healing is the physiologically relevant one, and curcumin exerts accelerated healing with comparable efficiency like omeprazole in a MMP-9-dependent pathway. The possibility of recurrence of ulcer may be avoided by targeting the MMP-9-dependent pathway during the healing process.
In summary, the results of this study demonstrate that up-regulation of MMP-9 (
12-fold) in indomethacin-induced gastric ulcer is due to overexpression of this protein. The novel antiulcer activity of curcumin causes reversal of indomethacin-induced epithelial cell damage and the oxidative insult of the gastric lumen by preventing lipid peroxidation and protein oxidation. Furthermore, curcumin protects ulcer and stimulates the healing process by inhibiting MMP-9 activity and by increasing MMP-2 activity. Gastric ulcer healing is a multifaceted processes and action of curcumin in arresting the MMP-dependent pathway in ulcer wound healing may lead to better healing therapeutics. More studies are anticipated showing that curcumin is of particular clinical significance for the healing of ulcer disease.
| FOOTNOTES |
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Recipients of a Junior Research Fellowship from the Council of Scientific and Industrial Research (New Delhi, India). ![]()
¶ Recipient of Research Associateship from Council of Scientific and Industrial Research (New Delhi, India). ![]()
To whom correspondence should be addressed. Tel.: 91-33-2473-0492 (ext. 224); Fax: 91-33-2473-5197; E-mail: snehasiktas{at}hotmail.com.
1 The abbreviations used are: NSAID, nonsteroidal anti-inflammatory drug; MMP, matrix metalloproteinase; ECM, extracellular matrix; ROS, reactive oxygen species; TIMP, tissue inhibitors of metalloproteinase; IL, interleukin; TX, Triton X-100. ![]()
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