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<article xml:lang="en" article-type="research-article" xmlns:xlink="http://www.w3.org/1999/xlink">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">IJMM</journal-id>
<journal-title-group>
<journal-title>International Journal of Molecular Medicine</journal-title></journal-title-group>
<issn pub-type="ppub">1107-3756</issn>
<issn pub-type="epub">1791-244X</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/ijmm.2015.2301</article-id>
<article-id pub-id-type="publisher-id">ijmm-36-04-1042</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title><italic>N-trans</italic>-&#x003C1;-caffeoyl tyramine isolated from <italic>Tribulus terrestris</italic> exerts anti-inflammatory effects in lipopolysaccharide-stimulated RAW 264.7 cells</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>KO</surname><given-names>HAN-JIK</given-names></name><xref rid="af1-ijmm-36-04-1042" ref-type="aff">1</xref><xref rid="fn1-ijmm-36-04-1042" ref-type="author-notes">&#x0002A;</xref></contrib>
<contrib contrib-type="author">
<name><surname>AHN</surname><given-names>EUN-KYUNG</given-names></name><xref rid="af2-ijmm-36-04-1042" ref-type="aff">2</xref><xref rid="fn1-ijmm-36-04-1042" ref-type="author-notes">&#x0002A;</xref></contrib>
<contrib contrib-type="author">
<name><surname>OH</surname><given-names>JOA SUB</given-names></name><xref rid="af1-ijmm-36-04-1042" ref-type="aff">1</xref><xref ref-type="corresp" rid="c1-ijmm-36-04-1042"/></contrib></contrib-group>
<aff id="af1-ijmm-36-04-1042">
<label>1</label>College of Pharmacy, Dankook University, Cheonan, Chungnam 330&#x02013;714, Republic of Korea</aff>
<aff id="af2-ijmm-36-04-1042">
<label>2</label>Bio Center, Gyeonggi Institute of Science and Technology Promotion, Yeongtong-gu, Suwon-si, Gyeonggi-do 443&#x02013;270, Republic of Korea</aff>
<author-notes>
<corresp id="c1-ijmm-36-04-1042">Correspondence to: Professor Joa Sub Oh, College of Pharmacy, Dankook University, 119 Dandae-ro, Cheonan, Chungnam 330-714, Republic of Korea, E-mail: <email>jsoh@dankook.ac.kr</email></corresp><fn id="fn1-ijmm-36-04-1042">
<label>&#x0002A;</label>
<p>Contributed equally</p></fn></author-notes>
<pub-date pub-type="ppub">
<month>10</month>
<year>2015</year></pub-date>
<pub-date pub-type="epub">
<day>03</day>
<month>08</month>
<year>2015</year></pub-date>
<volume>36</volume>
<issue>4</issue>
<fpage>1042</fpage>
<lpage>1048</lpage>
<history>
<date date-type="received">
<day>27</day>
<month>02</month>
<year>2015</year></date>
<date date-type="accepted">
<day>09</day>
<month>07</month>
<year>2015</year></date></history>
<permissions>
<copyright-statement>Copyright: &#x000A9; Ko.</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0">
<license-p>This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 4.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.</license-p></license></permissions>
<abstract>
<p>Inflammation is induced by the expression of cyclooxygenase-2 (COX-2), which is an important mediator of chronic inflammatory diseases, such as rheumatoid arthritis, asthma and inflammatory bowel disease. <italic>Tribulus terrestris</italic> (<italic>T. terrestris</italic>) is known to have a beneficial effect on inflammatory diseases. In this study, we investigated the effects of <italic>N-trans</italic>-&#x003C1;-caffeoyl tyramine (CT) isolated from <italic>T. terrestris</italic> on the production of nitric oxide (NO), and the expression of pro-inflammatory cytokines and COX-2 in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. We also aimed to elucidate the molecular mechanisms involved. We found that the ethanolic extract of <italic>T. terrestris</italic> (EETT) and CT inhibited the production of NO, tumor necrosis factor-&#x003B1; (TNF-&#x003B1;), interleukin (IL)-6 and IL-10 in the LPS-stimulated RAW 264.7 cells in a dose-dependent manner. They were determined by reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). In addition, CT markedly suppressed the expression of COX-2 and the production of prostaglandin E<sub>2</sub> (PGE<sub>2</sub>) in response to LPS stimulation. Furthermore, CT markedly decreased p-c-Jun N-terminal kinase (p-JNK) protein expression in LPS-stimulated RAW 264.7 cells. COX-2 and p-JNK were measured by western blot analysis. Taken together, these findings indicate that CT isolated from <italic>T. terrestris</italic> is a novel and potent modulator of inflammatory responses. Thus, it may prove benefiical to further evaluate CT as a possible treatment for chronic inflammatory diseases.</p></abstract>
<kwd-group>
<kwd><italic>N-trans</italic>-&#x003C1;-caffeoyl tyramine</kwd>
<kwd><italic>Tribulus terrestris</italic></kwd>
<kwd>anti-inflammatory effect</kwd>
<kwd>pro-inflammatory cytokines</kwd>
<kwd>cyclooxygenase-2</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p><italic>Tribulus terrestris</italic> (<italic>T. terrestris</italic>) is a herbal remedy that has a variety of uses in folk medicine. In traditional medicine, the extract from <italic>T. terrestris</italic> has been used to treat various diseases including hypertension, coronary heart disease (<xref ref-type="bibr" rid="b1-ijmm-36-04-1042">1</xref>), fungal diseases and infertility in both genders (<xref ref-type="bibr" rid="b2-ijmm-36-04-1042">2</xref>,<xref ref-type="bibr" rid="b3-ijmm-36-04-1042">3</xref>). It has also been described as a highly valuable drug that can help to restore decreased liver function, and it is used in the treatment of diabetes and hyperlipidemia (<xref ref-type="bibr" rid="b4-ijmm-36-04-1042">4</xref>,<xref ref-type="bibr" rid="b5-ijmm-36-04-1042">5</xref>). In traditional Chinese medicine, the fruit of <italic>T. terrestris</italic> has been used to treat pruritus, edema, tracheitis and inflammation (<xref ref-type="bibr" rid="b6-ijmm-36-04-1042">6</xref>). <italic>N-trans</italic>-&#x003C1;-caffeoyl tyramine (CT) is one of the compounds isolated from <italic>T. terres- tris</italic> (<xref ref-type="bibr" rid="b7-ijmm-36-04-1042">7</xref>). A previous study reported that CT acts as an antioxidant and moderately inhibits acetylcholinesterase <italic>in vitro</italic> and <italic>in vivo</italic> (<xref ref-type="bibr" rid="b8-ijmm-36-04-1042">8</xref>). However, the anti-inflammatory effects of CT have not yet been completely elucidated.</p>
<p>Inflammation is a complex pathological process mediated by diverse molecules involving a variety of immune cells, such as leukocytes, macrophages and mast cells (<xref ref-type="bibr" rid="b9-ijmm-36-04-1042">9</xref>). Nitric oxide (NO) and prostaglandin E<sub>2</sub> (PGE<sub>2</sub>) are involved in various pathophysiological processes, including inflammation, and inducible NO synthase (iNOS) and cyclooxygenase-2 (COX-2) are mainly responsible for the production of large quantities of these mediators (<xref ref-type="bibr" rid="b10-ijmm-36-04-1042">10</xref>,<xref ref-type="bibr" rid="b11-ijmm-36-04-1042">11</xref>). NO produced by the constitutive isoform of NO synthase (NOS) is a key regulator of homeostasis; however, the generation of NO by iNOS plays a significant role in inflammation (<xref ref-type="bibr" rid="b12-ijmm-36-04-1042">12</xref>). Activated macrophages play a pivotal role in inflammatory diseases, as they excessively produce pro-inflammatory cytokines, including tumor necrosis factor-&#x003B1; (TNF-&#x003B1;) and inflammatory mediators, such as NO and PGE<sub>2</sub> (<xref ref-type="bibr" rid="b13-ijmm-36-04-1042">13</xref>,<xref ref-type="bibr" rid="b14-ijmm-36-04-1042">14</xref>). PGE<sub>2</sub> is another important inflammatory mediator and is produced from arachidonic acid metabolites by the catalysis of COX-2 (<xref ref-type="bibr" rid="b15-ijmm-36-04-1042">15</xref>). PGE<sub>2</sub> is related to the pathogenesis of acute and chronic inflammatory states (<xref ref-type="bibr" rid="b16-ijmm-36-04-1042">16</xref>), and specific COX-2 inhibitors decrease the symptoms of inflammation (<xref ref-type="bibr" rid="b17-ijmm-36-04-1042">17</xref>).</p>
<p>In the present study, we examined the anti-inflammatory effects of CT isolated from <italic>T. terrestris</italic> on lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. Our findings demonstrated that CT inhibited NO production and suppressed the expression COX-2 and cytokines related to inflammation in LPS-stimulated RAW 264.7 cells.</p></sec>
<sec sec-type="methods">
<title>Materials and methods</title>
<sec>
<title>Preparation of T. terrestris extract</title>
<p>The dried fruit of <italic>T. terrestris</italic> (Fructus <italic>Tribuli</italic>) was purchased from the Gyeongdong oriental Herbal Store, Seoul, Korea, in March 2012 and was formally identified by Professor Joa Sub Oh (College of Pharmacy, Dankook University, Cheonan, Korea). A voucher specimen (G46) was deposited at the Natural Products Research Laboratory, Gyeonggi Institute of Science and Technology Promotion, Suwon, Korea. The air-dried, crushed fruits of <italic>T. terrestris</italic> (10 kg) were pulverized and the extract was removed with 80% ethanol (EtOH; 3&#x000D7;18 liters) at room temperature (twice each day for 2 days).</p></sec>
<sec>
<title>Extraction and isolation of CT</title>
<p>The 80% EtOH extract was filtered and concentrated <italic>in vacuo</italic> at 40&#x000B0;C to yield 673.5 g of residue, and the residue was then suspended in water and partitioned with hexane (3&#x000D7;1.5 liters) to produce a hexane-soluble layer (40 g). The aqueous layer was partitioned with CHCl<sub>3</sub> to provide a CHCl<sub>3</sub>-soluble residue (8.1 g). The CHCl<sub>3</sub> layer was subjected to liquid chromatography &#x0005B;glass column (7&#x000D7;20 cm) packed with silica gel (230&#x02013;400 mesh)&#x0005D; using CHCl<sub>3</sub>:MeOH (100:0, 99:1, 98:2, 97:3, 96:4, 94:6, 92:8, 90:10, 80:20, 70:30, 60:40, 50:50; v/v) gradient mixtures as eluents. The eluent fractions G46-51-(<xref ref-type="bibr" rid="b1-ijmm-36-04-1042">1</xref>&#x02013;<xref ref-type="bibr" rid="b13-ijmm-36-04-1042">13</xref>) were obtained from this initial liquid chromatographic separation. The fractions F001-F011 were subjected to an <italic>in vitro</italic> bioassay to evaluate their NO inhibitory activity. The fraction G46-51-7 exhibited promising inhibitory activity against NO production and was thus selected for further analysis. Column chromatography of the CHCl<sub>3</sub>-soluble layer (8.1 g) on a silica gel using MeOH, with increasing polarity, yielded 13 fractions, G46-51-(<xref ref-type="bibr" rid="b1-ijmm-36-04-1042">1</xref>&#x02013;<xref ref-type="bibr" rid="b13-ijmm-36-04-1042">13</xref>). Fraction G46-51-7 (2.71 g) was further applied to flash column chromatography on a sephadex LH-20 column using CHCl<sub>3</sub>:MeOH (1:1), and 21 fractions were noted: G46-52-(<xref ref-type="bibr" rid="b1-ijmm-36-04-1042">1</xref>&#x02013;<xref ref-type="bibr" rid="b21-ijmm-36-04-1042">21</xref>). Of these 21 fractions, CT (97.5 mg) was isolated from fraction G46-52-12, which was precipitated with CHCl<sub>3</sub>. <sup>1</sup>H- and <sup>13</sup>C-NMR spectra were recorded on a Bruker Ascend 700 MHz spectrometer (Bruker, Billerica, MA, USA) using CDCl3 as a solvent. Electrospray ionization (ESI) mass spectra were obtained on an LTQ Orbitrap XL (Thermo Scientific, Bremen, Germany) mass spectrometer.</p></sec>
<sec>
<title>N-trans-&#x003C1;-caffeoyl tyramine (CT)</title>
<p>Amorphous powder; <sup>1</sup>H-NMR (CD<sub>3</sub>OD, 700 MHz) &#x003B4;: 7.40 (1H, d, <italic>J</italic>=15.4 Hz, H-7&#x02032;), 7.07 (2H, d, <italic>J</italic>=8.4 Hz, H-2, 6), 7.01 (1H, d, <italic>J</italic>=1.4 Hz, H-2&#x02032;), 6.92 (1H, dd, <italic>J</italic>=8.4, 2.1 Hz, H-6&#x02032;), 6.78 (1H, d, <italic>J</italic>=8.4 Hz, H-5&#x02032;), 6.74 (2H, d, <italic>J</italic>=8.4 Hz, H-3, 5), 6.35 (1H, d, <italic>J</italic>=15.4 Hz, H-8&#x02032;), 3.47 (1H, t, <italic>J</italic>=7.0 Hz, H-7), 2.77 (1H, t, <italic>J</italic>=7.0 Hz, H-8); <sup>13</sup>C-NMR (CD<sub>3</sub>OD, 175 MHz) &#x003B4; 167.9 (C-9&#x02032;), 155.5 (C-4), 147.3 (C-4&#x02032;), 145.3 (C-3&#x02032;), 140.8 (C-7&#x02032;), 129.9 (C-1&#x02032;), 129.3 (C-2, 6), 126.9 (C-1), 120.7 (C-6&#x02032;), 117.0 (C-8&#x02032;), 115.0 (C-5&#x02032;), 114.8 (C-3, 5), 113.6 (C-2&#x02032;), 41.1 (C-8), 34.4 (C-7); ESI mass spectrometry (ESIMS; negative) <italic>m/z</italic> 298 &#x0005B;M-H&#x0005D;<sup>&#x02212;</sup> (<xref ref-type="bibr" rid="b18-ijmm-36-04-1042">18</xref>). The structure of CT is presented in <xref rid="f1-ijmm-36-04-1042" ref-type="fig">Fig. 1A</xref>.</p></sec>
<sec>
<title>Reagents</title>
<p>The following pharmacological agents and antibodies were purchased from commercial sources: LPS from <italic>Escherichia coli</italic> serotype 0111:B4, celecoxib, N<sup>G</sup>-monom ethyl-l-arginine (L-NMMA) and dexamethasone (all from Sigma-Aldrich, St. Louis, MO, USA); anti-COX-2 (M-19; sc-1747), anti-&#x003B2;-actin (13E5) and anti-GAPDH antibodies, and goat and mouse IgG-horseradish peroxidase conjugates (all from Santa Cruz Biotechnology, Inc., Santa Cruz, CA, USA); anti-c-Jun N-terminal protein kinase (JNK; #9251) and anti-phospho-JNK (Thr183/Tyr185) antibodies (both from Cell Signaling Technology, Beverly, MA, USA).</p></sec>
<sec>
<title>Cell culture and NO assay</title>
<p>RAW 264.7 murine macrophages (TIB-71) were purchased from the American Type Culture Collection (ATCC, Manassas, VA, USA). The cells were maintained in Dulbecco's modified Eagle's medium (DMEM) supplemented with 10% fetal bovine serum (FBS; both from Gibco<sup>&#x000AE;</sup> Life Technologies, Inc., Grand Island, NY, USA), 100 U/ml penicillin and 0.1 mg/ml streptomycin (both from Gibco<sup>&#x000AE;</sup> Life Technologies, Inc.) in a humidified atmosphere of 95% air with 5% CO<sub>2</sub> at 37&#x000B0;C. On day 0, the cells were seeded in 96 well plates. After 24 h, the cells were stimulated with medium (0.5 <italic>&#x003BC;</italic>g/ml LPS in 10% FBS-DMEM) for 2 h, and then this medium was replaced with maintenance medium (10% FBS-DMEM). The cells were treated with various concentrations of CT (0&#x02013;50 <italic>&#x003BC;</italic>M) for 24 h. We then measured the levels of nitrite, a stable metabolite of NO, using Griess reagent (1% sulfanilamide and 0.1% N-(1-naphthyl) ethylenediamine dihydrochloride in 2.5% phosphoric acid; Sigma-Aldrich). Subsequently, the mixture was incubated at room temperature for 10 min, and the absorbance was measured at 540 nm. The quantity of nitrite was determined from a standard curve for sodium nitrite (Sigma-Aldrich).</p></sec>
<sec>
<title>Cell cytotoxicity assay</title>
<p>The 3-&#x0005B;4,5-dimethylthiazol-2-yl&#x0005D;-2,5-diphenyltetrazolium bromide (MTT; Sigma-Aldrich) assay was used for the determination of cell viability <italic>in vitro</italic> in the RAW 264.7 cells. The cells were plated at a density of 4&#x000D7;10<sup>4</sup> cells/well in 100 <italic>&#x003BC;</italic>l culture medium. One day after plating, a time zero control plate was made. Following stimulation of the cells with LPS for 2 h, CT was applied directly, and the cells were incubated for 24 h in a humidified atmosphere with 5% CO<sub>2</sub> at 37&#x000B0;C. Cell culture was then performed. MTT (5 mg/ml in PBS) was added to each well, followed by incubation for 90 min. The medium was removed from the wells by aspiration; subsequently, 0.1 ml of buffered dimethyl sulfoxide (DMSO; Sigma-Aldrich) was added to each well, and the plates were shaken. The absorbance was measured on a microtiter plate reader at 540 nm.</p></sec>
<sec>
<title>Enzyme-linked immunosorbent assay (ELISA)</title>
<p>ELISA was performed for the determination of the levels of cytokines <italic>in vitro</italic> in the RAW 264.7 cells. The cells were plated at a density of 4&#x000D7;10<sup>4</sup> cells/well in 100 <italic>&#x003BC;</italic>l culture medium. One day after plating, a time zero control plate was made. Following stimulation of the cells with LPS for 2 h, CT was applied directly and the cells were incubated for 24 h in a humidified atmosphere with 5% CO<sub>2</sub> at 37&#x000B0;C. Cell culture was then performed. The supernatants were harvested and assayed for cytokines by ELISA. The concentrations of interleukin (IL)-6, IL-10 and TNF-&#x003B1; in the culture medium were quantified using a platinum ELISA kit (eBioscience, San Diego, CA, USA), and the concentration of PGE<sub>2</sub> in the culture medium was quantified using a competitive enzyme ELISA kit (R&amp;D Systems, Minneapolis, MN, USA) according to the manufacturer's instructions, respectively.</p></sec>
<sec>
<title>RNA extraction and reverse transcription-polymerase chain reaction (RT-PCR)</title>
<p>Total RNA was extracted using a total RNA extraction kit (Ambion, Carlsbad, CA, USA). Five micrograms of RNA were used as a template for each RT-PCR reaction using the SuperScript&#x02122; III One-Step RT-PCR system (Invitrogen, Carlsbad, CA, USA). Newly synthesized cDNA from the RAW 264.7 control cells and CT-treated cells was amplified using specific primers and the Accupower<sup>&#x000AE;</sup> Pfu PCR PreMix (Bioneer, Daejeon, Korea). The sequences of the primers used for RT-PCR are shown in <xref rid="tI-ijmm-36-04-1042" ref-type="table">Table I</xref>.</p></sec>
<sec>
<title>Western blot analysis</title>
<p>The cells were harvested and washed with PBS and then collected by centrifugation at 13,000 rpm for 1 min at 4&#x000B0;C. To obtain the cell lysate, the cells were lysed on ice for 30 min in RIPA buffer &#x0005B;50 mM Tris-HCl, pH 7.5, 0.15 M NaCl, 1% NP-40, 0.1% sodium dodecyl sulfate (SDS), 1 mM dithiothreitol (DTT) and 1 mM phenylmethanesulfonyl fluoride (PMSF)&#x0005D;, which contained protease inhibitors (Roche, Mannheim, Germany). Insoluble materials were removed by centrifugation at 13,000 rpm for 10 min at 4&#x000B0;C. A total of 50 mg of the supernatants was separated using a 10% polyacrylamide gel containing 10% SDS, 1.5 M Tris-HCl, 0.035% <italic>N,N,N&#x02032;,N&#x02032;</italic>-tetramethylenediamine and 7 mg ammonium persulfate. The separated proteins were electrically transferred onto a nitrocellulose membrane (Whatman, Dassel, Germany) at 36 mA in a transfer buffer containing 39 mM glycine, 48 mM Tris base, 0.037% SDS and 20% MeOH. All western blot analyses were performed at least in triplicate, and representative blots are shown.</p></sec>
<sec>
<title>Statistical analysis</title>
<p>Data are expressed as the means &#x000B1; SD. The statistical significance of the experimental results was analyzed (Student's t-test and one-way ANOVA with a subsequent Dunnett's multiple-range test). P-values &lt;0.05 were considered to indicate statistically significant differences.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>Effects of CT on NO production and cytotoxicity in LPS-stimulated RAW 264.7 cells</title>
<p>The chemical structure of CT is illustrated in <xref rid="f1-ijmm-36-04-1042" ref-type="fig">Fig. 1A</xref>. To examine the effects of CT on the inflammatory response, we measured the levels of NO production following treatment of the LPS (0.5 <italic>&#x003BC;</italic>g/ml)- stimulated RAW 264.7 cells with CT (0, 5, 25 or 50 <italic>&#x003BC;</italic>M) for 24 h. Treatment with CT induced a marked decrease in NO levels in the LPS-stimulated cells in a dose-dependent manner. Treatment with 50 <italic>&#x003BC;</italic>M CT induced an 84.07% decrease in NO production. We also confirmed that this result was similar to that achieved by treatment with 100 <italic>&#x003BC;</italic>M L-NMMA (<xref rid="f1-ijmm-36-04-1042" ref-type="fig">Fig. 1B</xref>), as also previously demonstrated (<xref ref-type="bibr" rid="b19-ijmm-36-04-1042">19</xref>). To evaluate the cytotox-icity of CT, we conducted an MTT assay. Treatment with 5, 25 or 50 <italic>&#x003BC;</italic>M CT did not have a marked cytotoxic effect on the LPS-stimulated RAW 264.7 cells (<xref rid="f1-ijmm-36-04-1042" ref-type="fig">Fig. 1C</xref>).</p></sec>
<sec>
<title>Effects of CT on the expression and production of cytokines in LPS-stimulated RAW 264.7 cells</title>
<p>We investigated the effects of CT on the expression of TNF-&#x003B1;, IL-6 and IL-10, which are pro-inflammatory cytokines, in the LPS-stimulated RAW 264.7 cells. Firstly, we measured the mRNA expression levels of TNF-&#x003B1;, IL-6 and IL-10 by RT-PCR following treatment with 5, 25 or 50 <italic>&#x003BC;</italic>M CT. We observed that treastment with CT suppressed the mRNA levels of TNF-&#x003B1;, IL-6 and IL-10 in a dose-dependent manner (<xref rid="f2-ijmm-36-04-1042" ref-type="fig">Fig. 2A</xref>). Treatment with dexamethasone (25 <italic>&#x003BC;</italic>M), which is a potent synthetic member of the glucocorticoid class of steroid drugs, also inhibited the mRNA expression of TNF-&#x003B1;, IL-6 and IL-10 (<xref rid="f2-ijmm-36-04-1042" ref-type="fig">Fig. 2A</xref>). We then confirmed the effects of CT on TNF-&#x003B1;, IL-6 and IL-10 at the protein level by ELISA. The protein levels of TNF-&#x003B1;, IL-6 and IL-10 in the conditioned medium were decreased following treatment with 5, 25 or 50 <italic>&#x003BC;</italic>M CT. In particular, treatment with 50 <italic>&#x003BC;</italic>M CT significantly inhibited the release of TNF-&#x003B1;, IL-6 and IL-10 by up to 44.13, 18.38 and 84.99%, respectively (<xref rid="f2-ijmm-36-04-1042" ref-type="fig">Fig. 2B&#x02013;D</xref>).</p></sec>
<sec>
<title>Effects of CT on COX-2 expression and phosphorylation of mitogen-activated protein kinase (MAPK) in LPS-stimulated RAW 264.7 cells</title>
<p>To determine the effects of CT on COX-2 expression, we examined whether the expression of COX-2 is reduced at both the mRNA and protein level in LPS-stimulated RAW 264.7 cells following treatment with 5, 25 or 50 <italic>&#x003BC;</italic>M of CT. As shown in <xref rid="f3-ijmm-36-04-1042" ref-type="fig">Fig. 3A</xref>, CT significantly inhibited COX-2 mRNA expression in a dose-dependent manner. Treatment with 5 <italic>&#x003BC;</italic>M of celecoxib, a well-known COX-2 inhibitor, significantly inhibited COX-2 expression at the mRNA level. In addition, treatment with 5, 25 or 50 <italic>&#x003BC;</italic>M CT also resulted in the suppression of COX-2 expression at the protein level in a dose-dependent manner, as evidenced by western blot analysis. Treatment with celecoxib also significantly inhibited COX-2 protein expression (<xref rid="f3-ijmm-36-04-1042" ref-type="fig">Fig. 3B</xref>). Studies have demonstrated that the LPS-induced phosphorylation of MAPKs leads to the production of inflammatory cytokines (<xref ref-type="bibr" rid="b20-ijmm-36-04-1042">20</xref>,<xref ref-type="bibr" rid="b21-ijmm-36-04-1042">21</xref>). Thus, to determine whether the activation of the MAPK pathway is regulated by CT, we measured the phosphorylation levels of JNK. Treatment with CT (particularly with 50 <italic>&#x003BC;</italic>M CT) significantly inhibited the LPS-induced phosphorylation of JNK, but did not affect the expression of JNK (<xref rid="f3-ijmm-36-04-1042" ref-type="fig">Fig. 3C</xref>).</p></sec>
<sec>
<title>Effects of CT on the PGE<sub>2</sub> level in LPS-stimulated RAW 264.7 cells</title>
<p>To confirm the effects of CT on PGE<sub>2</sub>, one of the mediators produced by COX-2, we measured the secretion levels of PGE<sub>2</sub> following treatment of the LPS-stimulated RAW 264.7 cells with CT (5, 25 or 50 <italic>&#x003BC;</italic>M) and celecoxib (5 <italic>&#x003BC;</italic>M). The conditioned media were collected and the PGE<sub>2</sub> content was measured by ELISA. As shown in <xref rid="f4-ijmm-36-04-1042" ref-type="fig">Fig. 4</xref>, the levels of PGE<sub>2</sub> in the conditioned media were significantly decreased following treatment with CT (50 <italic>&#x003BC;</italic>M) and celecoxib (5 <italic>&#x003BC;</italic>M).</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>In this study, we demonstrated that CT isolated from <italic>T. terrestris</italic> has a marked effect on the inflammatory response and on the levels of related pro-inflammatory cytokines in LPS-stimulated RAW 264.7 cells. We first examined the effects of an 80% ethanol extract of <italic>T. terrestris</italic> (EETT) on the inflammatory response using an NO assay, and we observed the dose-dependent suppression of NO production in the LPS-stimulated RAW 264.7 cells (data not shown). A previous study demonstrated that <italic>T. terrestris</italic> inhibited COX-2 expression using the promoter assay (<xref ref-type="bibr" rid="b22-ijmm-36-04-1042">22</xref>). In the present study, we isolated CT from the EETT, and we examined its anti-inflammatory effects on RAW 264.7 murine macrophages. We demonstrated that treatment with CT resulted in a decrease in NO production in the LPS-stimulated macrophages and that it did not cause cytotoxicity under our experimental conditions. We also observed that treatment with 100 <italic>&#x003BC;</italic>M L-NMMA, a well-known NOS inhibitor, decreased NO production in the LPS-stimulated macrophages (<xref rid="f1-ijmm-36-04-1042" ref-type="fig">Fig. 1B</xref>).</p>
<p>Macrophages are known to play a key role in the host defense mechanism; they are activated by exposure to interferon-&#x003B3;, pro-inflammatory cytokines and bacterial LPS (<xref ref-type="bibr" rid="b10-ijmm-36-04-1042">10</xref>). NO is endogenously generated from L-NMMA by NOS, and it plays an important role in the regulation of a number of physiological processes (<xref ref-type="bibr" rid="b23-ijmm-36-04-1042">23</xref>). TNF-&#x003B1;, IL-6 and IL-10 are the most important pro-inflammatory cytokines. The cytokines, TNF-&#x003B1;, IL-6 and IL-10, are produced mainly by activated monocytes or macrophages (<xref ref-type="bibr" rid="b24-ijmm-36-04-1042">24</xref>). In the present study, we noted that the LPS-stimulated cells exhibited increased levels of expression and production of pro-inflammatory cytokines compared to the unstimulated cells. Our data indicated that treatment with CT reduced the expression of TNF-&#x003B1;, IL-6 and IL-10 at the mRNA level (<xref rid="f2-ijmm-36-04-1042" ref-type="fig">Fig. 2A</xref>), and it suppressed the secretion of TNF-&#x003B1;, IL-6 and IL-10 at the protein level in the LPS-treated macrophages (<xref rid="f2-ijmm-36-04-1042" ref-type="fig">Fig. 2B</xref>).</p>
<p>Glucocorticoids are a class of steroid hormones with pleiotropic effects. At pharmacological concentrations, glucocorticoids are used to prevent and suppress inflammation and the activation of the immune system. Steroids exert their anti-inflammatory effects mainly by modulating the transcription of a variety of genes involved in controlling inflammatory processes (<xref ref-type="bibr" rid="b25-ijmm-36-04-1042">25</xref>). Our results indicated that treatment with dexamethasone, which is one of the glucocorticoids, induced a decrease in the levels of TNF-&#x003B1;, IL-6 and IL-10 by up to 81.39, 22.19 and 93.13%, respectively (<xref rid="f2-ijmm-36-04-1042" ref-type="fig">Fig. 2B&#x02013;D</xref>). However, glucocorticoids are known to have serious side-effects (<xref ref-type="bibr" rid="b26-ijmm-36-04-1042">26</xref>), and hence it was our aim to obtain a drug from natural sources.</p>
<p>Prostaglandins (PGs) are key inflammatory mediators; they are produced from the conversion of arachidonic acid by COX. There are two isoforms of COX: COX-1 and COX-2 (<xref ref-type="bibr" rid="b27-ijmm-36-04-1042">27</xref>). COX-1 is the constitutively expressed isoform under normal physiological conditions, whereas COX-2 is expressed in response to inflammatory signals, such as cytokines and the bacteria endotoxin LPS. Celecoxib, which is a COX-2 selective inhibitor, is a useful drug for the treatment of acute pain and chronic inflammatory diseases, particularly arthritis (<xref ref-type="bibr" rid="b28-ijmm-36-04-1042">28</xref>); however, it is known to cause various side-effects. In this study, we demonstrated that treatment of the cells with 25 or 50 <italic>&#x003BC;</italic>M of CT, or 5 <italic>&#x003BC;</italic>M celecoxib, inhibited the expression of COX-2 at the mRNA and protein level (<xref rid="f3-ijmm-36-04-1042" ref-type="fig">Fig. 3A and B</xref>). These findings suggest that CT isolated from <italic>T. terrestris</italic> exerts a therapeutic effect and prevents inflammatory responses by acting as a COX-2 selective inhibitor, and may thus be a potentially safe naturally-derived drug which may be used in the treatment of inflammatory diseases. Salvemini <italic>et al</italic> reported that NO modulates the activity of COX-2 and plays a role in the release of PGE<sub>2</sub> by activating COX-2 (<xref ref-type="bibr" rid="b29-ijmm-36-04-1042">29</xref>). COX-2 produces large amounts of PGE<sub>2</sub> that induce an inflammatory response (<xref ref-type="bibr" rid="b17-ijmm-36-04-1042">17</xref>). Therefore, the release of the inflammatory mediator PGE<sub>2</sub> is promoted by COX-2 activation. Our results demonstrated that treatment with CT (50 <italic>&#x003BC;</italic>M) induced a 32.70% decrease in PGE<sub>2</sub> levels (<xref rid="f4-ijmm-36-04-1042" ref-type="fig">Fig. 4</xref>). These results suggest that CT exerts an anti-inflammatory effect by suppressing COX-2 expression, which results in the inhibition of PGE<sub>2</sub> synthesis.</p>
<p>In conclusion, in this study, we demonstrated that CT can markedly inhibited macrophage-mediated inflammatory responses through the suppression of the production of NO and pro-inflammatory cytokines, such as TNF-&#x003B1;, IL-6 and IL-10. Moreover, CT inhibited the expression of COX-2, the phosphorylation of JNK and PGE<sub>2</sub> synthesis. These findings suggest that CT has a therapeutic effect and may be used to prevent inflammatory diseases. Thus, it can be considered as a potential drug candidate for the treatment of arthritis and other inflammatory diseases, functioning as a COX-2-specific inhibitor.</p></sec></body>
<back>
<ack>
<title>Acknowledgments</title>
<p>The present study was conducted by the research fund of Dankook University in 2013.</p></ack>
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<floats-group>
<fig id="f1-ijmm-36-04-1042" position="float">
<label>Figure 1</label>
<caption>
<p>Effects of <italic>N-trans</italic>-&#x003C1;-caffeoyl tyramine (CT) on nitric oxide (NO) production and cytotoxicity in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. (A) Structure of CT. (B) Following stimulation with LPS, the RAW 264.7 cells were treated with 0, 5, 25 or 50 <italic>&#x003BC;</italic>M of CT for 24 h. NO assay was performed using Griess reagent. (C) Cell viability was determined by MTT assay. Results of the experiments are the mean values of 3 independent experiments and are shown as a percentage cell viability compared with the viability of the untreated cells. <sup>&#x0002A;</sup>P&lt;0.05 and <sup>&#x0002A;&#x0002A;</sup>P&lt;0.01, compared with the LPS-treated cells.</p></caption>
<graphic xlink:href="IJMM-36-04-1042-g00.tif"/></fig>
<fig id="f2-ijmm-36-04-1042" position="float">
<label>Figure 2</label>
<caption>
<p>Effects of <italic>N-trans</italic>-&#x003C1;-caffeoyl tyramine (CT) on the expression of inflammatory cytokines in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. Following stimulation, the RAW 264.7 cells were treated with 0, 5, 25 or 50 <italic>&#x003BC;</italic>M of CT for 24 h. (A) The representative mRNA levels of tumor necrosis factor-&#x003B1; (TNF-&#x003B1;), interleukin (IL)-6 and IL-10 were assessed by RT-PCR. Inhibitory effects of CT on the production of (B) TNF-&#x003B1;, (C) IL-6 and (D) IL-10 were assessed by enzyme-linked immunosorbent assay (ELISA). Values represent the means &#x000B1; SD of 3 independent experiments. <sup>&#x0002A;</sup>P&lt;0.05 and <sup>&#x0002A;&#x0002A;</sup>P&lt;0.01, compared with the LPS-treated cells.</p></caption>
<graphic xlink:href="IJMM-36-04-1042-g01.tif"/></fig>
<fig id="f3-ijmm-36-04-1042" position="float">
<label>Figure 3</label>
<caption>
<p>Effect of <italic>N-trans</italic>-&#x003C1;-caffeoyl tyramine (CT) on the expression of the cyclooxygenase-2 (COX)-2 and the phosphorylation of c-Jun N-terminal protein kinase (JNK) in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. Following stimulation, the RAW 264.7 cells were treated with 0, 5, 25 or 50 <italic>&#x003BC;</italic>M of CT for 24 h. The CT-treated cells exhibited a decrease in (A) COX-2 mRNA expression and (B) COX-2 protein expression and (C) phosphorylation of JNK when compared with the untreated cells. We confirmed this effect by using quantitative densitometric analysis. Values represent the means &#x000B1; SD of 3 independent experiments. <sup>&#x0002A;</sup>P&lt;0.05, compared with the LPS-treated cells.</p></caption>
<graphic xlink:href="IJMM-36-04-1042-g02.tif"/></fig>
<fig id="f4-ijmm-36-04-1042" position="float">
<label>Figure 4</label>
<caption>
<p>Effect of <italic>N-trans</italic>-&#x003C1;-caffeoyl tyramine (CT) on the production of prostaglandin E<sub>2</sub> (PGE<sub>2</sub>) in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. Following stimulation, the RAW 264.7 cells were treated with 0, 5, 25 or 50 <italic>&#x003BC;</italic>M CT for 24 h. PGE<sub>2</sub> secretion from the RAW 264.7 cells was determined using an enzyme-linked immunosorbent assay (ELISA). Values represent the means &#x000B1; SD of 3 independent experiments. <sup>&#x0002A;</sup>P&lt;0.05, compared with the LPS-treated cells.</p></caption>
<graphic xlink:href="IJMM-36-04-1042-g03.tif"/></fig>
<table-wrap id="tI-ijmm-36-04-1042" position="float">
<label>Table I</label>
<caption>
<p>The primer sequence used for RT-PCR.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="top" align="left">Target</th>
<th valign="top" align="center">Primer sequence</th>
<th valign="top" align="center">Accession no.</th></tr></thead>
<tbody>
<tr>
<td valign="top" align="left">GAPDH</td>
<td valign="top" align="left">Sense: 5&#x02032;-GTATGACTCCACTCACGGCAAA-3&#x02032;</td>
<td valign="top" align="left"/></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="left">Antisense: 5&#x02032;-GGTCTCGCTCCTGGAGAGATG-3&#x02032;</td>
<td valign="top" align="center">NM_008084</td></tr>
<tr>
<td valign="top" align="left">IL-6</td>
<td valign="top" align="left">Sense: 5&#x02032;-CACTTCACAAGTCGGAGGCTT-3&#x02032;</td>
<td valign="top" align="center"/></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="left">Antisense: 5&#x02032;-GCAAGTGCATCATCGTTGTTC-3&#x02032;</td>
<td valign="top" align="center">NM_031168</td></tr>
<tr>
<td valign="top" align="left">IL-10</td>
<td valign="top" align="left">Sense: 5&#x02032;-CCTGGTAGAAGTGATGCCCCAGGCA-3&#x02032;</td>
<td valign="top" align="center"/></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="left">Antisense: 5&#x02032;-CTATGCAGTTGATGAAGATGTCAAA-3&#x02032;</td>
<td valign="top" align="center">NM_010548</td></tr>
<tr>
<td valign="top" align="left">COX-2</td>
<td valign="top" align="left">Sense: 5&#x02032;-GGAGAGACTATCAAGATAGTGATC-3&#x02032;</td>
<td valign="top" align="center"/></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="left">Antisense: 5&#x02032;-ATGGTCAGTAGACTTTTACAGCTC-3&#x02032;</td>
<td valign="top" align="center">NM_011198</td></tr>
<tr>
<td valign="top" align="left">TNF-&#x003B1;</td>
<td valign="top" align="left">Sense: 5&#x02032;-AGCCTGTAGCCCACGTCGTA-3&#x02032;</td>
<td valign="top" align="center"/></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="left">Antisense: 5&#x02032;-TCTTTGAGATCCATGCCGTTG-3&#x02032;</td>
<td valign="top" align="center">NM_013693</td></tr></tbody></table>
<table-wrap-foot><fn id="tfn1-ijmm-36-04-1042">
<p>IL, interleukin; COX-2, cyclooxygenase-2; TNF-&#x003B1;, tumor necrosis factor-&#x003B1;.</p></fn></table-wrap-foot></table-wrap></floats-group></article>
