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Victor Tseng, MD. Division of Pulmonary, Allergy, and Critical Care Medicine. Mentors : Viranuj Sueblinvong , MD and David M. Guidot, MD. TRANSCRIPTIONAL REGULATION OF OXIDATIVE STRESS IN THE ALCOHOLIC LUNG. Keywords: Alcohol, Oxidative Stess, ATF-3, NRF-2, TGF- β. CLINICAL PROBLEM.
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Victor Tseng, MD Division of Pulmonary, Allergy, and Critical Care Medicine Mentors: ViranujSueblinvong, MD and David M. Guidot, MD TRANSCRIPTIONAL REGULATION OF OXIDATIVE STRESS IN THE ALCOHOLIC LUNG Keywords: Alcohol, Oxidative Stess, ATF-3, NRF-2, TGF-β
CLINICAL PROBLEM • Alcohol results in severe lung derangements at the cellular level1-3 • Decreased alveolar macrophage viability • Decreased neutrophil chemotaxis • Increased permeability of alveolar epithelium • Oxidized intracellular state (low GSH) • Alcohol renders the lung more susceptible to the following acute disease processes4,5 • ALI/ARDS • Bacterial Pneumonia • Pulmonary TB (Primary Infection, Reactivation)
OXIDATIVE STRESS PATHWAY Oxidative Stress6 Proteasome ACUTE Sepsis VILI Pneumonia Hyperoxia CHRONIC Alcohol HIV Cigarettes Aging ROS● Keap1 GSH Glutathione Nrf2 Cytosol Nucleus 5’ GCLC GST NADH-q 3’ Nrf2 binds the Anti-Oxidant Response Element (ARE)
ALCOHOL HOW? • Decreased Transcription? • Epigenetic • Repression • Decreased Protein Synthesis? • RNA interference • Post-Transcriptional Increases TGFβ17 Increases Nuclear Translocation of Nrf2 Decreases Nrf2 Expression Causes Profound Glutathione Depletion
TGFβ1 ATF3 Ubiquitous transcription factor known to be upregulated8 by TGFβ1 and then to suppress Nrf2-ARE activity in airway smooth muscle cells9, whole mouse lung10 and pulmonary fibrosis models11. ATF3 Nrf2
QUESTION 1 What transcriptional changes are seen in acute and chronic phenotypes of alcohol-induced stress? QUESTION 2 More specifically, is ATF3 involved in this process?
METHODS (CELLS) • NIH 3T3 (Mouse Lung Fibroblasts) • Grown to 80% confluent monolayer with standard tissue culture flask Incubated for 72 hours with 60 mM ethanol • Whole-cell lysate purified • Total mRNA extracted by Qiagen kit • Total protein isolated by RIPA buffer Quantified by RT-qPCR Normalized to 18S rRNA ATF3, Nrf2, and TGFβ1 cDNA created Nrf2 probed on Western blot TGFβ1 by flow cytometry Quantified by CCD Normalized to β-actin
METHODS (MICE) 3-month old C57 BL/6 mouse colony, approved by Emory IACUC Fed EtOH in water, increased by +5%/wk until final concentration 20% v/V. Standard chow Lungs harvested at 8 weeks and prepared for nucleic acid/protein analysis
RESULTS (Cells, Part 1) Downregulated Nrf2 For mRNA, alcohol treatment in vitro was associated with… Upregulated Tgfβ-1 Upregulated Atf3
RESULTS (Cells, Part 2) For protein, alcohol treatment in vitro was associated with… Downregulated GSTT2 Decreased NRF2
RESULTS (Mouse Lung) DownregulatedNrf2 For mRNA, alcohol treatment in vivo was associated with… Decreased NRF2 Downregulated Atf3
RESULTS SUMMARY EFFECTS OF ALCOHOL TREATMENT a Data not shown b n = 2 – 4, so unable to determine statistical significance
LIMITATIONS • Temporal alcohol exposure is difficult to model • No good model of chronic alcohol exposure in vitro • No good model of acute alcohol exposure in vivo • Variation in ATF3 expression can be explained by myriad factors • Genetic regulation of redox homeostasis is pleiotropic • More experiments are needed to confirm trend seen in ATF3
CONCLUSION • Alcohol exposure generates oxidative stress via an array of transcriptional changes • TGFβ1 expression is upregulated in both 3T3 cells and whole mouse lung • ATF3 expression is upregulated in 3T3 cells, but not in whole mouse lung • As a result, Nrf2-ARE activity and NRF2 protein levels are reduced • These changes may suggest potential therapeutic targets in alcohol-mediated ARDS
ACKNOWLEDGEMENTS RESIDENCY PROGRAM Dominique Cosco, MD Daniel Dressler, MD Megan DeMoss, MD FUNDING NIH K08 AA021404-01 NIH P50 AA013757 NIH R01 AA 017627 MENTORS: Viranuj Sueblinvong, MD David Guidot, MD • GUIDOT LAB • David Guidot, MD • Stephen Mills, MS • Bashar Staitieh, MD • Xian Fan, MD • Wendy Neveu, MD PhD
REFERENCES Brown et al. Glutathione availability modulates alveolar macrophage function in the chronic ethanol-fed rat. Am J Physiol Lung Cell Mol Physiol. 2007 Apr;292(4):L824-32. Jensen et al. Alcohol causes alveolar epithelial oxidative stress by inhibiting the nuclear factor (erythroid-derived 2)-like 2-antioxidant response element signaling pathway. Am J Respir Cell Mol Biol. 2013 Apr;48(4):511-7. Sueblinbvong et al. Chronic alcohol ingestion primes the lung for bleomycin-induced fibrosis in mice. Alcohol Clin Exp Res. 2014 Feb;38(2):336-43. Joshi and Guidot. The alcoholic lung: epidemiology, pathophysiology, and potential therapies. Am J Physiol Lung Cell Mol Physiol. 2007 Apr;292(4):L813-23. Moss et al. The role of chronic alcohol abuse in the development of acute respiratory distress syndrome in adults. JAMA. 1996 Jan 3;275(1):50-4. Itoh et al. Molecular mechanism activating Nrf2-Keap1 pathway in regulation of adaptive response to electrophiles. Free Radic Biol Med. 2004 May 15;36(10):1208-13 Bechara et al. Transforming growth factor beta1 expression and activation is increased in the alcoholic rat lung. Am J Respir Crit Care Med. 2004 Jul 15;170(2):188-94. Brown et al. Cancer Res. Activating transcription factor 3 is a novel repressor of the nuclear factor erythroid-derived 2-related factor 2 (Nrf2)-regulated stress pathway.2008 Jan 15;68(2):364-8. Michaeloudes et al. Transforming growth factor-β and nuclear factor E2–related factor 2 regulate antioxidant responses in airway smooth muscle cells: role in asthma. Am J Respir Crit Care Med. 2011 Oct 15;184(8):894-903. Liu et al. Transforming growth factor β suppresses glutamate-cysteine ligase gene expression and induces oxidative stress in a lung fibrosis model. Free Radic Biol Med. 2012 Aug 1;53(3):554-63. Hoetzenecker et al. ROS-induced ATF3 causes susceptibility to secondary infections during sepsis-associated immunosuppression. Nature. 2011 Dec 18;18(1):128-34. doi: 10.1038/nm.2557.