Pharmacological preconditioning with vitamin C attenuates intestinal injury via the induction of heme oxygenase-1 after hemorrhagic shock in rats

PLoS One. 2014 Jun 13;9(6):e99134. doi: 10.1371/journal.pone.0099134. eCollection 2014.

Abstract

Pre-induction of heme oxygenase (HO)-1, which is regarded as an effective method of "organ preconditioning", exerts beneficial effects during hemorrhagic shock (HS). However, the available HO-1 inducers exhibit disadvantages such as toxicity or complex technical requirements. Therefore, a safe and convenient HO-1 inducer would be promising and could be exploited in the treatment of foreseeable hemorrhaging, such as prior to major surgery. Here we investigated the effect of vitamin C (VitC), a common antioxidant, on intestinal HO-1 expression and examined whether VitC pretreatment prevented HS related intestinal tissue injuries after HO-1 induction. First, we conducted an in vitro study and found that HO-1 expression in rat intestinal epithelial cells (IEC-6) was induced by non-toxic VitC in a time and concentration dependent manner, and the mechanism was related to the activation of extracellular signal-regulated kinase 1/2 (ERK1/2). Next, we conducted an in vivo study and found that VitC induced intestinal HO-1 protein expression (mainly observed in the intestinal epithelial cells) and HO-1 activity in normal SD rats, and that these HO-1 levels were further enhanced by VitC in a rat model of HS. The HS related intestinal injuries, including histological damage, pro-inflammatory cytokine levels (tumor necrosis factor and interleukin-6), neutrophil infiltration and apoptosis decreased after VitC pretreatment, and this alleviating of organ injuries was abrogated after the inhibition of HO-1 activity by zinc protoporphyrin-IX. It was of note that VitC did little histological damage to the intestine of the sham rats. These data suggested that VitC might be applied as a safe inducer of intestinal HO-1 and that VitC pretreatment attenuated HS related intestinal injuries via the induction of HO-1.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antioxidants / administration & dosage
  • Antioxidants / pharmacology*
  • Apoptosis / drug effects
  • Ascorbic Acid / administration & dosage
  • Ascorbic Acid / pharmacology*
  • Cells, Cultured
  • Disease Models, Animal
  • Gene Expression Regulation / drug effects
  • Heme Oxygenase-1 / metabolism*
  • Intestinal Diseases / enzymology
  • Intestinal Diseases / prevention & control*
  • Intestines / drug effects
  • Intestines / enzymology
  • Intestines / injuries*
  • MAP Kinase Signaling System / drug effects
  • Rats
  • Rats, Sprague-Dawley
  • Shock, Hemorrhagic / complications*
  • Shock, Hemorrhagic / enzymology
  • Shock, Hemorrhagic / pathology

Substances

  • Antioxidants
  • Heme Oxygenase-1
  • Ascorbic Acid

Grants and funding

This work is supported by National Natural Science Foundation of China projects 81171789 (to En-Qiang Mao) and the Science and Technology Commission of Shanghai Municipality 124119a4600 (to Jian Fei). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.