Jihan Youssef

Role of Peroxisome Proliferator-Activated Receptors in Inflammation Control

Peroxisome proliferator-activated receptors (PPARs) were discovered over a decade ago, and were classified as orphan members of the nuclear receptor superfamily. To date, three PPAR subtypes have been discovered and characterized (PPARα, β/δ, γ). Different PPAR subtypes have been shown to play crucial roles in important diseases and conditions such as obesity, diabetes, atherosclerosis, cancer, and fertility. Among the most studied roles of PPARs is their involvement in inflammatory processes. Numerous studies have revealed that agonists of PPARα and PPARγ exert anti-inflammatory effects both in vitro and in vivo. Using the carrageenan-induced paw edema model of inflammation, a recent study in our laboratories showed that these agonists hinder the initiation phase, but not the late phase of the inflammatory process. Furthermore, in the same experimental model, we recently also observed that activation of PPARδ exerted an anti-inflammatory effect. Despite the fact that exclusive dependence of these effects on PPARs has been questioned, the bulk of evidence suggests that all three PPAR subtypes, PPARα, δ, γ, play a significant role in controlling inflammatory responses. Whether these subtypes act via a common mechanism or are independent of each other remains to be elucidated. However, due to the intensity of research efforts in this area, it is anticipated that these efforts will result in the development of PPAR ligands as therapeutic agents for the treatment of inflammatory diseases.

Peroxisome proliferator-activated receptors and cancer: challenges and opportunities

Peroxisome proliferator‐activated receptors (PPARs), members of the nuclear hormone receptor superfamily, function as transcription factors and modulators of gene expression. These actions allow PPARs to regulate a variety of biological processes and to play a significant role in several diseases and conditions. The current literature describes frequently opposing and paradoxical roles for the three PPAR isotypes, PPARα, PPARβ/δ and PPARγ, in cancer. While some studies have implicated PPARs in the promotion and development of cancer, others, in contrast, have presented evidence for a protective role for these receptors against cancer. In some tissues, the expression level of these receptors and/or their activation correlates with a positive outcome against cancer, while, in other tissue types, their expression and activation have the opposite effect. These disparate findings raise the possibility of (i) PPAR receptor‐independent effects, including effects on receptors other than PPARs by the utilized ligands; (ii) cancer stage‐specific effect; and/or (iii) differences in essential ligand‐related pharmacokinetic considerations. In this review, we highlight the latest available studies on the role of the various PPAR isotypes in cancer in several major organs and present challenges as well as promising opportunities in the field.

Age-dependent effects of nongenotoxic hepatocarcinogens on liver apoptosis in vivo.

Aging sensitizes the liver to the hepatocarcinogenic effect of PPARalpha agonists via unknown mechanisms. This study was designed to investigate whether aging enhances the susceptibility of the liver to the anti-apoptotic effect of these chemicals. Since apoptosis serves to purge the liver of transformed cells, exaggerated inhibition of this process in aged livers may facilitate the progress of these cells to cancer. We quantified the effect of the PPARalpha agonists, clofibrate and Wy-14643, on the mRNA levels of various elements of the apoptotic machinery in male Fisher-344 rats ranging in age from immaturity (4-week-old), young adulthood (10-week-old), middle age (50-week-old), to senescence (100-week-old). Clofibrate and Wy-14643 either significantly diminished or exerted no effect on hepatic mRNA levels of several pro-apoptotic factors in immature, middle age and senescent animals. Unexpectedly, however, these PPARalpha agonists caused a remarkable 2- to 45-fold augmentation in the levels of the mRNA of Bax, caspase-2, and Fas mRNA in the young adult 10-week-old rats. A 47-75% decrease in the percent of apoptotic hepatocytes was observed only in 50- and 100-week-old rats treated with Wy-14643. Data suggest that activation of PPARalpha alters the balance between pro- and anti-apoptotic genes most significantly in livers of 50- and 100-week-old rats. Since suppression of apoptosis in the senescent liver is expected to diminish its ability to purge itself of already transformed cells, which may then progress to malignancy, exposure of senescent animals to PPARalpha agonists may be crucial to the ultimate outcome of liver cancer later in their life-span.

Senescence-associated decline in hepatic peroxisomal enzyme activities corresponds with diminished levels of retinoid X receptor alpha, but not peroxisome proliferator-activated receptor alpha☆

Aging is associated with alterations in hepatic peroxisomal metabolism and susceptibility to hepatocarcinogenicity produced by agonists of peroxisome proliferator-activated receptor alpha (PPAR alpha). Mechanisms involved in these effects are not well understood. However, as a heterodimer with retinoid X receptor alpha (RXR alpha), PPAR alpha regulates transcription of genes involved in oxidative stress, cell proliferation and apoptosis. Modulating these important cell functions as a result of aging may be responsible for altered hepatic peroxisomal responses in the senescent liver. Therefore, we investigated hepatic apoptosis, and peroxisomal beta-oxidation activity, a major source of H(2)O(2), as well as the activity of the peroxisomal anti-oxidant enzyme catalase, in male Fischer-344 rats of four age groups (4, 10, 50 and 100 week old). We further quantified protein levels of both PPAR alpha and RXR alpha in these animals. Data show that peroxisomal beta-oxidation and catalase activities were significantly lower in livers of the 100 week old animals compared with other age groups, while percentage of apoptotic hepatocytes were identical in all animal age groups. However, aging had no effect on hepatic PPAR alpha protein levels. In the senescent group, the level of decline in both peroxisomal enzyme activities of 30% was surprisingly similar to the decline observed in the hepatic expression of the RXR alpha protein. Results from this study suggest that alterations in peroxisomal metabolism observed in the senescent liver may be a result of the decline in the availability of RXR alpha receptor, and not the primary PPAR alpha receptor. On the other hand, PPAR alpha-independent mechanisms appear to play a role in controlling apoptosis in the senescent liver.

High-dose inhaled nitric oxide and hyperoxia increases lung collagen accumulation in piglets

Nitric oxide (NO), a pro-oxidant gas, is used with hyperoxia (O2) to treat neonatal pulmonary hypertension and recently bronchopulmonary dysplasia, but great concerns remain regarding NO’s potential toxicity. Based on reports that exposure to oxidant gases results in pulmonary extracellular matrix injury associated with elevated lavage fluid levels of extracellular matrix components, we hypothesized that inhaled NO with or without hyperoxia will have the same effect. We measured alveolar septal width, lung collagen content, lavage fluid hydroxyproline, hyaluronan and laminin levels in neonatal piglets after 5 days’ exposure to room air (RA), RA + 50 ppm NO (RA + NO), O2 (FiO2 > 0.96) or O2 + NO. Matrix metalloproteinase (MMP) activity and MMP-2 mRNA were also measured. In recovery experiments, we measured lung collagen content in piglets exposed to RA + NO or O2 + NO and then allowed to recover for 3 days. The results show that lung collagen increased 4-fold in the RA + NO piglets, the O2 and O2 + NO groups had only a 2-fold elevation relative to RA controls. Unlike the RA + NO piglets, the O2 and O2 + NO groups had more than 20-fold elevation in lung lavage fluid hydroxyproline compared to the RA group. O2 and O2 + NO also had increased lung MMP activity, extravascular water, and lavage fluid proteins. MMP-2 mRNA levels were unchanged. After 3 days’ recovery in room air, the RA + NO groups’ lung collagen had declined from 4-fold to 2-fold above the RA group values. The O2 + NO group did not decline. Alveolar septal width increased significantly only in the O2 and O2 + NO groups. We conclude that 5 days’ exposure to NO does not result in pulmonary matrix degradation but instead significantly increases lung collagen content. This effect appears potentially reversible. In contrast, hyperoxia exposure with or without NO results in pulmonary matrix degradation and increased lung collagen content. The observation that NO increased lung collagen content represents a new finding and suggests NO could potentially induce pulmonary fibrosis.

Age-independent, gray matter-localized, brain-enhanced oxidative stress in male fischer 344 rats: brain levels of F2-isoprostanes and F4-neuroprostanes

While studies showed that aging is accompanied by increased exposure of the brain to oxidative stress, others have not detected any age-correlated differences in levels of markers of oxidative stress. Use of conventional markers of oxidative damage in vivo, which may be formed ex vivo and/or eliminated by endogenous metabolism, may explain these conflicting results. Recently, F(2)-isoprostanes and F(4)-neuroprostanes, peroxidation products of arachidonic acid and docosahexaenoic acid, respectively, have been identified as sensitive and reliable markers of oxidative injury. Therefore, this study was designed to quantify brain levels of F(2)-isoprostanes and F(4)-neuroprostanes and their precursors in 4, 10, 50, and 100 week old male Fischer 344 rats. Data show that levels of F(2)-isoprostanes and F(4)-neuroprostanes were comparable in all animal age groups. However, levels of F(4)-neuroprostanes were approximately 20-fold higher than those of F(2)-isoprostanes in all age groups, despite the fact that brain levels of docosahexaenoic acid were only twice as high as those of arachidonic acid. Based on our findings, it is concluded that aging is not accompanied by enhanced brain susceptibility to oxidative stress. Furthermore, the metabolically active gray matter of the brain, where docosahexaenoic acid is abundant, appears more susceptible to oxidative stress than the white matter.

Aging and enhanced hepatocarcinogenicity by peroxisome proliferator-activated receptor alpha agonists.

The hepatocarcinogenic effect of PPARalpha agonists is enhanced by aging. Exposure to these chemicals produces a five- to seven-fold higher yield of grossly visible hepatic tumors in old relative to young animals. This review presents current experimental evidence, which supports a mechanism involving enhanced exposure to oxidative stress, and diminished apoptosis in this age-related difference in sensitivity. In the aged liver, a decrease in hepatic antioxidant activity, coupled with a PPARalpha agonist-induced increase in the activities of various oxidases, may expose these livers to oxidative stress. Additionally, livers of senescent animals appeared more sensitive to the anti-apoptotic effect of PPARalpha agonists. Since apoptosis safeguards cells with damaged DNA from progressing to the point of tumor formation, inhibition of hepatocellular apoptosis by PPARalpha agonists could well lead to the formation of focal lesions in the aged liver. Although PPARalpha-dependent alterations in cell cycle regulatory proteins have been reported, the correlation between hepatocellular DNA replication and liver cancer caused by PPARalpha agonists is a weak one. These findings have implications for human susceptibility to these chemicals.

Enhanced Hepatocarcinogenicity Due to Agonists of Peroxisome Proliferator-Activated Receptors in Senescent Rats: Role of Peroxisome Proliferation, Cell Proliferation, and Apoptosis

Exposure to agonists of peroxisome proliferator-activated receptor alpha (PPARα) causes liver cancer in rodents, with aged animals being more susceptible than their younger counterparts to this effect. Treatment with these chemicals produced a five- to sevenfold higher yield of grossly visible hepatic tumors in old rats compared to young animals. The enhanced susceptibility of the aged livers to the carcinogenic effect of PPAR agonists could not be explained by differences in levels of peroxisomal and/or cell proliferation between young and old animals, as neither of these responses was exaggerated with aging. Reported studies have shown that activating PPARa results in the suppression of hepatic apoptosis. This effect is expected to diminish the ability of the liver to purge itself of pre-existing neoplastic cells, allowing them to progress to tumors. New findings from our laboratories show that the aged liver is exceedingly sensitive to the antiapoptotic effect of PPAR agonists. In addition, aged livers showed remarkably higher levels of the antiapoptotic protein Bcl-2 than livers of young, adult, and middle-aged animals. Interestingly, the PPARa agonist Wy-14,643 significantly diminished elements of the proapoptotic machinery (e.g., Bax, caspases, and fas) in the aged liver, while remarkably increasing elements of this machinery in younger animals. Taken together, while activation of PPARs appears to inhibit apoptosis in livers of senescent animals, activating these receptors seems to stimulate the apoptotic machinery in young animals. This paradoxical effect may be responsible for the exaggerated sensitivity of the aged liver to the carcinogenic effect of agents that activate PPARs.

Disruption of mitochondrial energetics and DNA synthesis by the anti-AIDS drug dideoxyinosine

The purpose of this study was to clarify the role of the mitochondria as a site for the reported hepatotoxic effects of the anti-AIDS drug dideoxyinosine (ddI). Data show that ddI interfered with the mitochondrial redox state in perfused livers leading to more oxidized mitochondria. This effect was reflected by a significant decrease in the mitochondrial NADH/NAD+ ratios from basal values of 0.40 +/- 0.04 to 0.28 +/- 0.02 within 10 min following the infusion of ddI. In suspensions of isolated mitochondria utilizing succinate as a substrate, ddI diminished state 3 and stimulated state 4 respiration significantly, suggesting an uncoupling effect by ddI. Incubation of mitochondria with ddI resulted in a significant decrease in the mitochondrial respiratory control ratios (state 3/state 4 respiration) to 0.8 +/- 0.02 from corresponding control values of 6.0 +/- 0.40 Data also show that ddI inhibited mitochondrial DNA synthesis as evidenced by the decrease in [3H]thymidine incorporation into mitochondrial DNA. This study confirms the need for a close monitoring of patients receiving the dideoxyinosine anti-AIDS drugs and for prompt discontinuation of these drugs before potential irreversible liver damage occurs.

Diminished energy metabolism and enhanced apoptosis in livers of B6C3F1 mice treated with the antihepatocarcinogen rotenone

Rotenone decreases the incidence of hepatocellular carcinoma and lowers rates of hepatocellular proliferation. In an effort to delineate mechanisms involved, the in vivo effect of rotenone on liver mitochondrial metabolism, apoptotic machinery as well as elements of the hepatic signal transduction pathways were investigated. Mitochondria from livers of male B6C3F1 mice fed a standard diet containing 600 ppm rotenone for 7 days were uncoupled or inhibited when succinate or glutamate plus malate were used as the substrate, respectively. These livers also showed a significant increase in apoptosis compared with control livers. Furthermore, rotenone increased the expression of c-myc mRNA to 5-fold of control values within 3 days, an effect which was still observed (3-fold) after 7 days. Levels of p53 mRNA were also increased 3-fold after 1 day, but declined to control levels by 7 days. Rotenone also caused a transient, yet marked increase in liver particulate glyceraldehyde phosphate dehydrogenase (GAPDH) protein expression, while it did not alter the expression of the cytosolic form of the enzyme. Conversely, mRNA of the proto-oncogene H-ras showed a decline of 35% after 3 days of rotenone treatment, and remained diminished for the duration of the experiment. These data suggest that rotenone may act as an anticancer agent by diminishing mitochondrial bioenergetics which prevents basal hepatocyte proliferation and lowers the threshold for liver cells with DNA damage to undergo apoptosis.