Chemotherapy-induced phlebitis via the GBP5/NLRP3 inflammasome axis and the therapeutic effect of aescin

Br J Pharmacol. 2023 Apr;180(8):1132-1147. doi: 10.1111/bph.16002. Epub 2022 Dec 26.

Abstract

Background and purpose: Intravenous infusion of chemotherapy drugs can cause severe chemotherapy-induced phlebitis (CIP) in patients. However, the underlying mechanism of CIP development remains unclear.

Experimental approach: RNA-sequencing analysis was used to identify potential disease targets in CIP. Guanylate binding protein-5 (GBP5) genetic deletion approaches also were used to investigate the role of GBP5 in NLR family pyrin domain containing 3 (NLRP3) inflammasome activation in lipopolysaccharide (LPS) primed murine bone-marrow-derived macrophages (BMDMs) induced by vinorelbine (VIN) in vitro and in mouse models of VIN-induced CIP in vivo. The anti-CIP effect of aescin was evaluated, both in vivo and in vivo.

Key results: Here, we show that the expression of GBP5 was upregulated in human peripheral blood mononuclear cells from CIP patients. Genetic ablation of GBP5 in murine macrophages significantly alleviated VIN-induced CIP in the experimental mouse model. Mechanistically, GBP5 contributed to the inflammatory responses through activating NLRP3 inflammasome and driving the production of the inflammatory cytokine IL-1β. Moreover, aescin, a mixture of triterpene saponins extracted from horse chestnut seed, can alleviate CIP by inhibiting the GBP5/NLRP3 axis.

Conclusion and implications: These findings suggest that GBP5 is an important regulator of NLRP3 inflammasome in CIP mouse model. Our work further reveals that aescin may serve as a promising candidate in the clinical treatment of CIP.

Keywords: GBP5; NLRP3 inflammasome; aescin; phlebitis; vinorelbine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Agents*
  • Escin
  • GTP-Binding Proteins / metabolism
  • Humans
  • Inflammasomes / metabolism
  • Interleukin-1beta / metabolism
  • Leukocytes, Mononuclear / metabolism
  • Lipopolysaccharides / pharmacology
  • Mice
  • NLR Family, Pyrin Domain-Containing 3 Protein / metabolism
  • Phlebitis*

Substances

  • Inflammasomes
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • Escin
  • Antineoplastic Agents
  • Lipopolysaccharides
  • Interleukin-1beta
  • GBP5 protein, human
  • GTP-Binding Proteins
  • Gbp5 protein, mouse
  • Nlrp3 protein, mouse