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Targeting NOX enzymes in pulmonary fibrosis

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Abstract

Oxidative stress has been associated with a number of human fibrotic diseases, including idiopathic pulmonary fibrosis (IPF). Oxidative stress is most often defined as an imbalance between the generation of reactive oxygen species (ROS) in excess of the capacity of cells/tissues to detoxify or scavenge them. Additionally, the regulated production of ROS participates in cellular signaling. Therapeutic strategies to treat IPF have, thus far, focused on augmenting anti-oxidant capacity. Recent studies have demonstrated a critical role for ROS-generating enzymatic systems, specifically, NADPH oxidase (NOX) family oxidoreductases in fibrotic processes. In this review, we examine the evidence for NOX isoforms in the generation and perpetuation of fibrosis, and the potential to target this gene family for the treatment of IPF and related fibrotic disorders.

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References:

  1. American Thoracic Society (2000) Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. American Thoracic Society (ATS), and the European Respiratory Society (ERS). Am J Respir Crit Care Med 161:646–664

    Google Scholar 

  2. Akasaki T, Ohya Y, Kuroda J, Eto K, Abe I, Sumimoto H, Iida M (2006) Increased expression of gp91phox homologues of NAD(P)H oxidase in the aortic media during chronic hypertension: involvement of the renin-angiotensin system. Hypertens Res 29:813–820

    Article  PubMed  CAS  Google Scholar 

  3. Alder JK, Chen JJ, Lancaster L, Danoff S, Su SC, Cogan JD, Vulto I, Xie M, Qi X, Tuder RM, Phillips JA 3rd, Lansdorp PM, Loyd JE, Armanios MY (2008) Short telomeres are a risk factor for idiopathic pulmonary fibrosis. Proc Natl Acad Sci USA 105:13051–13056

    Article  PubMed  CAS  Google Scholar 

  4. Amara N, Goven D, Prost F, Muloway R, Crestani B, Boczkowski J (2010) NOX4/NADPH oxidase expression is increased in pulmonary fibroblasts from patients with idiopathic pulmonary fibrosis and mediates TGFbeta1-induced fibroblast differentiation into myofibroblasts. Thorax 65:733–738

    Article  PubMed  Google Scholar 

  5. Block K, Eid A, Griendling KK, Lee DY, Wittrant Y, Gorin Y (2008) Nox4 NAD(P)H oxidase mediates Src-dependent tyrosine phosphorylation of PDK-1 in response to angiotensin II: role in mesangial cell hypertrophy and fibronectin expression. J Biol Chem 283:24061–24076

    Article  PubMed  CAS  Google Scholar 

  6. Borbely G, Szabadkai I, Horvath Z, Marko P, Varga Z, Breza N, Baska F, Vantus T, Huszar M, Geiszt M, Hunyady L, Buday L, Orfi L, Keri G (2010) Small-molecule inhibitors of NADPH oxidase 4. J Med Chem 53:6758–6762

    Article  PubMed  CAS  Google Scholar 

  7. Cannito S, Novo E, di Bonzo LV, Busletta C, Colombatto S, Parola M (2010) Epithelial-mesenchymal transition: from molecular mechanisms, redox regulation to implications in human health and disease. Antioxid Redox Signal 12:1383–1430

    Article  PubMed  CAS  Google Scholar 

  8. Cantin AM, North SL, Fells GA, Hubbard RC, Crystal RG (1987) Oxidant-mediated epithelial cell injury in idiopathic pulmonary fibrosis. J Clin Invest 79:1665–1673

    Article  PubMed  CAS  Google Scholar 

  9. Carnesecchi S, Deffert C, Donati Y, Basset O, Hinz B, Preynat-Seauve O, Guichard C, Arbiser JL, Banfi B, Pache JC, Barazzone-Argiroffo C, Krause KH (2011) A Key Role for NOX4 in Epithelial Cell Death During Development of Lung Fibrosis. Antioxid Redox Signal 15:607–619

    Article  PubMed  CAS  Google Scholar 

  10. Carnesecchi S, Deffert C, Pagano A, Garrido-Urbani S, Metrailler-Ruchonnet I, Schappi M, Donati Y, Matthay MA, Krause KH, Barazzone Argiroffo C (2009) NADPH oxidase-1 plays a crucial role in hyperoxia-induced acute lung injury in mice. Am J Respir Crit Care Med 180:972–981

    Article  PubMed  CAS  Google Scholar 

  11. Chen QM, Bartholomew JC, Campisi J, Acosta M, Reagan JD, Ames BN (1998) Molecular analysis of H2O2-induced senescent-like growth arrest in normal human fibroblasts: p53 and Rb control G1 arrest but not cell replication. Biochem J 332(Pt 1):43–50

    PubMed  CAS  Google Scholar 

  12. Colombat M, Mal H, Groussard O, Capron F, Thabut G, Jebrak G, Brugiere O, Dauriat G, Castier Y, Leseche G, Fournier M (2007) Pulmonary vascular lesions in end-stage idiopathic pulmonary fibrosis: histopathologic study on lung explant specimens and correlations with pulmonary hemodynamics. Hum Pathol 38:60–65

    Article  PubMed  CAS  Google Scholar 

  13. Cronkhite JT, Xing C, Raghu G, Chin KM, Torres F, Rosenblatt RL, Garcia CK (2008) Telomere shortening in familial and sporadic pulmonary fibrosis. Am J Respir Crit Care Med 178:729–737

    Article  PubMed  CAS  Google Scholar 

  14. Crystal RG (1991) Oxidants and respiratory tract epithelial injury: pathogenesis and strategies for therapeutic intervention. Am J Med 91:39S–44S

    Article  PubMed  CAS  Google Scholar 

  15. Demedts M, Behr J, Buhl R, Costabel U, Dekhuijzen R, Jansen HM, MacNee W, Thomeer M, Wallaert B, Laurent F, Nicholson AG, Verbeken EK, Verschakelen J, Flower CD, Capron F, Petruzzelli S, De Vuyst P, van den Bosch JM, Rodriguez-Becerra E, Corvasce G, Lankhorst I, Sardina M, Montanari M (2005) High-dose acetylcysteine in idiopathic pulmonary fibrosis. N Engl J Med 353:2229–2242

    Article  PubMed  CAS  Google Scholar 

  16. Ding Q, Luckhardt T, Hecker L, Zhou Y, Liu G, Antony VB, de Andrade J, Thannickal VJ (2011) New insights into the pathogenesis and treatment of idiopathic pulmonary fibrosis. Drugs 71:981–1001

    Article  PubMed  CAS  Google Scholar 

  17. Giri SN, Hyde DM, Schiedt MJ (1988) Effects of repeated administration of N-acetyl-l-cysteine on sulfhydryl levels of different tissues and bleomycin-induced lung fibrosis in hamsters. J Lab Clin Med 111:715–724

    PubMed  CAS  Google Scholar 

  18. Hagiwara SI, Ishii Y, Kitamura S (2000) Aerosolized administration of N-acetylcysteine attenuates lung fibrosis induced by bleomycin in mice. Am J Respir Crit Care Med 162:225–231

    PubMed  CAS  Google Scholar 

  19. Hampel B, Malisan F, Niederegger H, Testi R, Jansen-Durr P (2004) Differential regulation of apoptotic cell death in senescent human cells. Exp Gerontol 39:1713–1721

    Article  PubMed  CAS  Google Scholar 

  20. Hampel B, Wagner M, Teis D, Zwerschke W, Huber LA, Jansen-Durr P (2005) Apoptosis resistance of senescent human fibroblasts is correlated with the absence of nuclear IGFBP-3. Aging Cell 4:325–330

    Article  PubMed  CAS  Google Scholar 

  21. Hecker L, Vittal R, Jones T, Jagirdar R, Luckhardt TR, Horowitz JC, Pennathur S, Martinez FJ, Thannickal VJ (2009) NADPH oxidase-4 mediates myofibroblast activation and fibrogenic responses to lung injury. Nat Med 15:1077–1081

    Article  PubMed  CAS  Google Scholar 

  22. Henderson BC, Sen U, Reynolds C, Moshal KS, Ovechkin A, Tyagi N, Kartha GK, Rodriguez WE, Tyagi SC (2007) Reversal of systemic hypertension-associated cardiac remodeling in chronic pressure overload myocardium by ciglitazone. Int J Biol Sci 3:385–392

    Article  PubMed  CAS  Google Scholar 

  23. Kim KK, Kugler MC, Wolters PJ, Robillard L, Galvez MG, Brumwell AN, Sheppard D, Chapman HA (2006) Alveolar epithelial cell mesenchymal transition develops in vivo during pulmonary fibrosis and is regulated by the extracellular matrix. Proc Natl Acad Sci USA 103:13180–13185

    Article  PubMed  CAS  Google Scholar 

  24. King TE Jr, Schwarz MI, Brown K, Tooze JA, Colby TV, Waldron JA Jr, Flint A, Thurlbeck W, Cherniack RM (2001) Idiopathic pulmonary fibrosis: relationship between histopathologic features and mortality. Am J Respir Crit Care Med 164:1025–1032

    PubMed  Google Scholar 

  25. Kinnula VL, Fattman CL, Tan RJ, Oury TD (2005) Oxidative stress in pulmonary fibrosis: a possible role for redox modulatory therapy. Am J Respir Crit Care Med 172:417–422

    Article  PubMed  Google Scholar 

  26. Kuroda J, Ago T, Matsushima S, Zhai P, Schneider MD, Sadoshima J (2010) NADPH oxidase 4 (Nox4) is a major source of oxidative stress in the failing heart. Proc Natl Acad Sci USA 107:15565–15570

    Article  PubMed  CAS  Google Scholar 

  27. Kuwano K, Hagimoto N, Maeyama T, Fujita M, Yoshimi M, Inoshima I, Nakashima N, Hamada N, Watanabe K, Hara N (2002) Mitochondria-mediated apoptosis of lung epithelial cells in idiopathic interstitial pneumonias. Lab Invest 82:1695–1706

    PubMed  CAS  Google Scholar 

  28. Kuwano K, Kunitake R, Kawasaki M, Nomoto Y, Hagimoto N, Nakanishi Y, Hara N (1996) P21Waf1/Cip1/Sdi1 and p53 expression in association with DNA strand breaks in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 154:477–483

    PubMed  CAS  Google Scholar 

  29. Kuwano K, Nakashima N, Inoshima I, Hagimoto N, Fujita M, Yoshimi M, Maeyama T, Hamada N, Watanabe K, Hara N (2003) Oxidative stress in lung epithelial cells from patients with idiopathic interstitial pneumonias. Eur Respir J 21:232–240

    Article  PubMed  CAS  Google Scholar 

  30. Laleu B, Gaggini F, Orchard M, Fioraso-Cartier L, Cagnon L, Houngninou-Molango S, Gradia A, Duboux G, Merlot C, Heitz F, Szyndralewiez C, Page P (2010) First in class, potent, and orally bioavailable NADPH oxidase isoform 4 (Nox4) inhibitors for the treatment of idiopathic pulmonary fibrosis. J Med Chem 53:7715–7730

    Article  PubMed  CAS  Google Scholar 

  31. Larios JM, Budhiraja R, Fanburg BL, Thannickal VJ (2001) Oxidative protein cross-linking reactions involving l-tyrosine in transforming growth factor-beta1-stimulated fibroblasts. J Biol Chem 276:17437–17441

    Article  PubMed  CAS  Google Scholar 

  32. Lenz AG, Costabel U, Maier KL (1996) Oxidized BAL fluid proteins in patients with interstitial lung diseases. Eur Respir J 9:307–312

    Article  PubMed  CAS  Google Scholar 

  33. Looi YH, Grieve DJ, Siva A, Walker SJ, Anilkumar N, Cave AC, Marber M, Monaghan MJ, Shah AM (2008) Involvement of Nox2 NADPH oxidase in adverse cardiac remodeling after myocardial infarction. Hypertension 51:319–325

    Article  PubMed  CAS  Google Scholar 

  34. Macip S, Igarashi M, Fang L, Chen A, Pan ZQ, Lee SW, Aaronson SA (2002) Inhibition of p21-mediated ROS accumulation can rescue p21-induced senescence. EMBO J 21:2180–2188

    Article  PubMed  CAS  Google Scholar 

  35. Maier K, Leuschel L, Costabel U (1991) Increased levels of oxidized methionine residues in bronchoalveolar lavage fluid proteins from patients with idiopathic pulmonary fibrosis. Am Rev Respir Dis 143:271–274

    PubMed  CAS  Google Scholar 

  36. Manoury B, Nenan S, Leclerc O, Guenon I, Boichot E, Planquois JM, Bertrand CP, Lagente V (2005) The absence of reactive oxygen species production protects mice against bleomycin-induced pulmonary fibrosis. Respir Res 6:11

    Article  PubMed  Google Scholar 

  37. Masamune A, Watanabe T, Kikuta K, Satoh K, Shimosegawa T (2008) NADPH oxidase plays a crucial role in the activation of pancreatic stellate cells. Am J Physiol Gastrointest Liver Physiol 294:G99–G108

    Article  PubMed  CAS  Google Scholar 

  38. Meng QR, Gideon KM, Harbo SJ, Renne RA, Lee MK, Brys AM, Jones R (2006) Gene expression profiling in lung tissues from mice exposed to cigarette smoke, lipopolysaccharide, or smoke plus lipopolysaccharide by inhalation. Inhal Toxicol 18:555–568

    Article  PubMed  CAS  Google Scholar 

  39. Mitchell C, Robin MA, Mayeuf A, Mahrouf-Yorgov M, Mansouri A, Hamard M, Couton D, Fromenty B, Gilgenkrantz H (2009) Protection against hepatocyte mitochondrial dysfunction delays fibrosis progression in mice. Am J Pathol 175:1929–1937

    Article  PubMed  CAS  Google Scholar 

  40. Mittal M, Roth M, Konig P, Hofmann S, Dony E, Goyal P, Selbitz AC, Schermuly RT, Ghofrani HA, Kwapiszewska G, Kummer W, Klepetko W, Hoda MA, Fink L, Hanze J, Seeger W, Grimminger F, Schmidt HH, Weissmann N (2007) Hypoxia-dependent regulation of nonphagocytic NADPH oxidase subunit NOX4 in the pulmonary vasculature. Circ Res 101:258–267

    Article  PubMed  CAS  Google Scholar 

  41. Ohshiro Y, Ma RC, Yasuda Y, Hiraoka-Yamamoto J, Clermont AC, Isshiki K, Yagi K, Arikawa E, Kern TS, King GL (2006) Reduction of diabetes-induced oxidative stress, fibrotic cytokine expression, and renal dysfunction in protein kinase Cbeta-null mice. Diabetes 55:3112–3120

    Article  PubMed  CAS  Google Scholar 

  42. Pache JC, Carnesecchi S, Deffert C, Donati Y, Herrmann FR, Barazzone-Argiroffo C, Krause KH (2011) NOX-4 is expressed in thickened pulmonary arteries in idiopathic pulmonary fibrosis. Nat Med 17:31–32 (author reply 32-33)

    Article  PubMed  CAS  Google Scholar 

  43. Patel NM, Lederer DJ, Borczuk AC, Kawut SM (2007) Pulmonary hypertension in idiopathic pulmonary fibrosis. Chest 132:998–1006

    Article  PubMed  Google Scholar 

  44. Radisky DC, Levy DD, Littlepage LE, Liu H, Nelson CM, Fata JE, Leake D, Godden EL, Albertson DG, Nieto MA, Werb Z, Bissell MJ (2005) Rac1b and reactive oxygen species mediate MMP-3-induced EMT and genomic instability. Nature 436:123–127

    Article  PubMed  CAS  Google Scholar 

  45. Selman M, King TE, Pardo A (2001) Idiopathic pulmonary fibrosis: prevailing and evolving hypotheses about its pathogenesis and implications for therapy. Ann Intern Med 134:136–151

    PubMed  CAS  Google Scholar 

  46. Shahzeidi S, Sarnstrand B, Jeffery PK, McAnulty RJ, Laurent GJ (1991) Oral N-acetylcysteine reduces bleomycin-induced collagen deposition in the lungs of mice. Eur Respir J 4:845–852

    PubMed  CAS  Google Scholar 

  47. Shvedova AA, Kisin ER, Murray AR, Kommineni C, Castranova V, Fadeel B, Kagan VE (2008) Increased accumulation of neutrophils and decreased fibrosis in the lung of NADPH oxidase-deficient C57BL/6 mice exposed to carbon nanotubes. Toxicol Appl Pharmacol 231:235–240

    Article  PubMed  CAS  Google Scholar 

  48. Stas S, Whaley-Connell A, Habibi J, Appesh L, Hayden MR, Karuparthi PR, Qazi M, Morris EM, Cooper SA, Link CD, Stump C, Hay M, Ferrario C, Sowers JR (2007) Mineralocorticoid receptor blockade attenuates chronic overexpression of the renin-angiotensin-aldosterone system stimulation of reduced nicotinamide adenine dinucleotide phosphate oxidase and cardiac remodeling. Endocrinology 148:3773–3780

    Article  PubMed  CAS  Google Scholar 

  49. Strausz J, Muller-Quernheim J, Steppling H, Ferlinz R (1990) Oxygen radical production by alveolar inflammatory cells in idiopathic pulmonary fibrosis. Am Rev Respir Dis 141:124–128

    PubMed  CAS  Google Scholar 

  50. Taira M, Toba H, Murakami M, Iga I, Serizawa R, Murata S, Kobara M, Nakata T (2008) Spironolactone exhibits direct renoprotective effects and inhibits renal renin-angiotensin-aldosterone system in diabetic rats. Eur J Pharmacol 589:264–271

    Article  PubMed  CAS  Google Scholar 

  51. Tanjore H, Xu XC, Polosukhin VV, Degryse AL, Li B, Han W, Sherrill TP, Plieth D, Neilson EG, Blackwell TS, Lawson WE (2009) Contribution of epithelial-derived fibroblasts to bleomycin-induced lung fibrosis. Am J Respir Crit Care Med 180:657–665

    Article  PubMed  CAS  Google Scholar 

  52. Thannickal VJ, Horowitz JC (2006) Evolving concepts of apoptosis in idiopathic pulmonary fibrosis. Proc Am Thorac Soc 3:350–356

    Article  PubMed  CAS  Google Scholar 

  53. Thannickal VJ, Loyd JE (2008) Idiopathic pulmonary fibrosis: a disorder of lung regeneration? Am J Respir Crit Care Med 178:663–665

    Article  PubMed  Google Scholar 

  54. Toussaint O, Medrano EE, von Zglinicki T (2000) Cellular and molecular mechanisms of stress-induced premature senescence (SIPS) of human diploid fibroblasts and melanocytes. Exp Gerontol 35:927–945

    Article  PubMed  CAS  Google Scholar 

  55. Tsakiri KD, Cronkhite JT, Kuan PJ, Xing C, Raghu G, Weissler JC, Rosenblatt RL, Shay JW, Garcia CK (2007) Adult-onset pulmonary fibrosis caused by mutations in telomerase. Proc Natl Acad Sci U S A 104:7552–7557

    Article  PubMed  CAS  Google Scholar 

  56. Uhal BD, Kim JK, Li X, Molina–Molina M (2007) Angiotensin-TGF-beta 1 crosstalk in human idiopathic pulmonary fibrosis: autocrine mechanisms in myofibroblasts and macrophages. Curr Pharm Des 13:1247–1256

    Article  PubMed  CAS  Google Scholar 

  57. Waghray M, Cui Z, Horowitz JC, Subramanian IM, Martinez FJ, Toews GB, Thannickal VJ (2005) Hydrogen peroxide is a diffusible paracrine signal for the induction of epithelial cell death by activated myofibroblasts. FASEB J 19:854–856

    PubMed  CAS  Google Scholar 

  58. Wang CL, Kang J, Li ZH (2007) Increased expression of NADPH oxidase p47-PHOX and p67-PHOX factor in idiopathic pulmonary fibrosis. Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chin J Tuberc Respir Dis 30:265–268

    Google Scholar 

  59. Wang P, Tang F, Li R, Zhang H, Chen S, Liu P, Huang H (2007) Contribution of different Nox homologues to cardiac remodeling in two-kidney two-clip renovascular hypertensive rats: effect of valsartan. Pharmacol Res 55:408–417

    Article  PubMed  CAS  Google Scholar 

  60. Whaley-Connell A, Habibi J, Nistala R, Cooper SA, Karuparthi PR, Hayden MR, Rehmer N, DeMarco VG, Andresen BT, Wei Y, Ferrario C, Sowers JR (2008) Attenuation of NADPH oxidase activation and glomerular filtration barrier remodeling with statin treatment. Hypertension 51:474–480

    Article  PubMed  CAS  Google Scholar 

  61. Wynn TA (2008) Cellular and molecular mechanisms of fibrosis. J Pathol 214:199–210

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This work was supported by U.S. National Institutes of Health grants, R01 HL067967 (VJT), R01 HL094230 (VJT), and R01 HL086836 (JC).

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Correspondence to Louise Hecker.

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Hecker, L., Cheng, J. & Thannickal, V.J. Targeting NOX enzymes in pulmonary fibrosis. Cell. Mol. Life Sci. 69, 2365–2371 (2012). https://doi.org/10.1007/s00018-012-1012-7

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