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Targeting Nrf2 with the triterpenoid CDDO-imidazolide attenuates cigarette smoke-induced emphysema and cardiac dysfunction in mice.

Abstract
Chronic obstructive pulmonary disease (COPD), which comprises emphysema and chronic bronchitis resulting from prolonged exposure to cigarette smoke (CS), is a major public health burden with no effective treatment. Emphysema is also associated with pulmonary hypertension, which can progress to right ventricular failure, an important cause of morbidity and mortality among patients with COPD. Nuclear erythroid 2 p45 related factor-2 (Nrf2) is a redox-sensitive transcription factor that up-regulates a battery of antioxidative genes and cytoprotective enzymes that constitute the defense against oxidative stress. Recently, it has been shown that patients with advanced COPD have a decline in expression of the Nrf2 pathway in lungs, suggesting that loss of this antioxidative protective response is a key factor in the pathophysiological progression of emphysema. Furthermore, genetic disruption of Nrf2 in mice causes early-onset and severe emphysema. The present study evaluated whether the strategy of activation of Nrf2 and its downstream network of cytoprotective genes with a small molecule would attenuate CS-induced oxidative stress and emphysema. Nrf2(+/+) and Nrf2(-/-) mice were fed a diet containing the potent Nrf2 activator, 1-[2-cyano-3-,12-dioxooleana-1,9(11)-dien-28-oyl]imidazole (CDDO-Im), while being exposed to CS for 6 months. CDDO-Im significantly reduced lung oxidative stress, alveolar cell apoptosis, alveolar destruction, and pulmonary hypertension in Nrf2(+/+) mice caused by chronic exposure to CS. This protection from CS-induced emphysema depended on Nrf2, as Nrf2(-/-) mice failed to show significant reduction in alveolar cell apoptosis and alveolar destruction after treatment with CDDO-Im. These results suggest that targeting the Nrf2 pathway during the etiopathogenesis of emphysema may represent an important approach for prophylaxis against COPD.
AuthorsThomas E Sussan, Tirumalai Rangasamy, David J Blake, Deepti Malhotra, Hazim El-Haddad, Djahida Bedja, Melinda S Yates, Ponvijay Kombairaju, Masayuki Yamamoto, Karen T Liby, Michael B Sporn, Kathleen L Gabrielson, Hunter C Champion, Rubin M Tuder, Thomas W Kensler, Shyam Biswal
JournalProceedings of the National Academy of Sciences of the United States of America (Proc Natl Acad Sci U S A) Vol. 106 Issue 1 Pg. 250-5 (Jan 06 2009) ISSN: 1091-6490 [Electronic] United States
PMID19104057 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Chemical References
  • 2-cyano-3,12-dioxoolean-1,9-dien-28-oic acid
  • Imidazoles
  • NF-E2-Related Factor 2
  • Nfe2l2 protein, mouse
  • Smoke
  • Nitric Oxide
  • Oleanolic Acid
Topics
  • Animals
  • Apoptosis
  • Drug Delivery Systems
  • Heart Diseases (drug therapy, prevention & control)
  • Hypertension, Pulmonary
  • Imidazoles
  • Mice
  • Mice, Knockout
  • NF-E2-Related Factor 2 (genetics, physiology)
  • Nitric Oxide (antagonists & inhibitors)
  • Oleanolic Acid (analogs & derivatives, pharmacology, therapeutic use)
  • Oxidative Stress (drug effects)
  • Pulmonary Alveoli (pathology)
  • Pulmonary Disease, Chronic Obstructive (drug therapy, etiology)
  • Pulmonary Emphysema (drug therapy, prevention & control)
  • Smoke (adverse effects)

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