Glycyrrhizin attenuates myocardial ischemia reperfusion injury by suppressing Inflammation, oxidative stress, and ferroptosis via the HMGB1-TLR4-GPX4 pathway

Exp Cell Res. 2024 Feb 1;435(1):113912. doi: 10.1016/j.yexcr.2024.113912. Epub 2024 Jan 2.

Abstract

Ferroptosis, a form of regulated cell death process, play an important role in myocardial ischemia‒reperfusion (I/R) injury. Glycyrrhizin (GL), a natural glycoconjugate triterpene, has the property to improve growth rate, immune regulation, antioxidant, anti-inflammatory. However, whether GL can attenuate myocardial I/R injury by modulating ferroptosis or other mechanisms are still unclear. In this study, SD rats underwent in vivo myocardial ischemia/reperfusion (I/R) surgery, while H9C2 cells were subjected to the hypoxia/reoxygenation (H/R) model for in vitro experiments. In addition, TAK-242, a TLR4-specific antagonist, and GL were also used to evaluate the effect and mechanisms of GL on the cardiac function and expression of ferroptosis-related gene and protein in vivo and vitro. The results show that GL decreased not only the expression of the inflammation-related factors (HMGB1, TNF-α, IL-6, IL-18 and IL-1β), but also reduced the number of TUNEL-positive cardiomyocytes, and mitigated pathological alterations in I/R injury. In addition, GL decreased the levels of MDA, promoted antioxidant capacity such as GSH, CAT, Cu/Zn-SOD, Mn-SOD, and SOD in vivo and vitro. More importantly, GL and TAK-242 regulate ferroptosis-related protein and gene expression in I/R and H/R model. Surprisingly, GL may ameliorate cardiomyocyte ferroptosis and ultimately improves cardiac function induced by H/R via the HMGB1-TLR4-GPX4 axis. Therefore, we have highlighted a novel mechanism by which GL regulates inflammation, oxidative stress, and ferroptosis via the HMGB1-TLR4-GPX4 pathway to prevent myocardial I/R injury. GL appears to be a potentially applicable drug for the treatment of myocardial I/R injury.

Keywords: Ferroptosis; Glycyrrhizin; Inflammation; Myocardial ischemia‒reperfusion injury; Oxidative stress.

MeSH terms

  • Animals
  • Antioxidants / metabolism
  • Antioxidants / pharmacology
  • Apoptosis
  • Ferroptosis*
  • Glycyrrhizic Acid / pharmacology
  • HMGB1 Protein* / metabolism
  • Inflammation / drug therapy
  • Inflammation / pathology
  • Myocardial Reperfusion Injury* / metabolism
  • Oxidative Stress
  • Rats
  • Rats, Sprague-Dawley
  • Reperfusion Injury* / pathology
  • Sulfonamides*
  • Superoxide Dismutase / metabolism
  • Toll-Like Receptor 4 / metabolism

Substances

  • Glycyrrhizic Acid
  • ethyl 6-(N-(2-chloro-4-fluorophenyl)sulfamoyl)cyclohex-1-ene-1-carboxylate
  • Toll-Like Receptor 4
  • Antioxidants
  • HMGB1 Protein
  • Superoxide Dismutase
  • Sulfonamides