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<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Molecular Medicine Reports</journal-id>
<journal-title-group>
<journal-title>Molecular Medicine Reports</journal-title></journal-title-group>
<issn pub-type="ppub">1791-2997</issn>
<issn pub-type="epub">1791-3004</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/mmr.2015.4272</article-id>
<article-id pub-id-type="publisher-id">mmr-12-05-6946</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>Ginsenoside Rh2 attenuates allergic airway inflammation by modulating nuclear factor-&#x003BA;B activation in a murine model of asthma</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>LI</surname><given-names>LIANG CHANG</given-names></name><xref rid="af1-mmr-12-05-6946" ref-type="aff">1</xref><xref rid="fn1-mmr-12-05-6946" ref-type="author-notes">&#x0002A;</xref></contrib>
<contrib contrib-type="author">
<name><surname>PIAO</surname><given-names>HONG MEI</given-names></name><xref rid="af2-mmr-12-05-6946" ref-type="aff">2</xref><xref rid="fn1-mmr-12-05-6946" ref-type="author-notes">&#x0002A;</xref></contrib>
<contrib contrib-type="author">
<name><surname>ZHENG</surname><given-names>MING YU</given-names></name><xref rid="af3-mmr-12-05-6946" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author">
<name><surname>LIN</surname><given-names>ZHEN HUA</given-names></name><xref rid="af4-mmr-12-05-6946" ref-type="aff">4</xref></contrib>
<contrib contrib-type="author">
<name><surname>CHOI</surname><given-names>YUN HO</given-names></name><xref rid="af5-mmr-12-05-6946" ref-type="aff">5</xref></contrib>
<contrib contrib-type="author">
<name><surname>YAN</surname><given-names>GUANG HAI</given-names></name><xref rid="af1-mmr-12-05-6946" ref-type="aff">1</xref><xref ref-type="corresp" rid="c1-mmr-12-05-6946"/></contrib></contrib-group>
<aff id="af1-mmr-12-05-6946">
<label>1</label>Department of Anatomy, Histology and Embryology, Yanbian University School of Basic Medical Sciences, Yanbian, Jilin 133002, P.R. China</aff>
<aff id="af2-mmr-12-05-6946">
<label>2</label>Department of Respiratory Medicine, Yanbian University, Yanbian, Jilin 133000, P.R. China</aff>
<aff id="af3-mmr-12-05-6946">
<label>3</label>College of Pharmacy, Yanbian University, Yanbian, Jilin 133002, P.R. China</aff>
<aff id="af4-mmr-12-05-6946">
<label>4</label>Department of Pathology, Yanbian University School of Basic Medical Sciences, Yanbian, Jilin 133000, P.R. China</aff>
<aff id="af5-mmr-12-05-6946">
<label>5</label>Department of Anatomy, Medical School, Institute for Medical Sciences, Chonbuk National University, Jeonju, Jeonbuk 561-756, Republic of Korea</aff>
<author-notes>
<corresp id="c1-mmr-12-05-6946">Correspondence to: Dr Guang Hai Yan, Department of Anatomy, Histology and Embryology, Yanbian University School of Basic Medical Sciences, 977 Gongyuan Road, Yanji, Yanbian, Jilin 133002, P.R. China, E-mail: <email>ghyan@ybu.edu.cn</email></corresp><fn id="fn1-mmr-12-05-6946">
<label>&#x0002A;</label>
<p>Contributed equally</p></fn></author-notes>
<pub-date pub-type="ppub">
<month>11</month>
<year>2015</year></pub-date>
<pub-date pub-type="epub">
<day>28</day>
<month>08</month>
<year>2015</year></pub-date>
<volume>12</volume>
<issue>5</issue>
<fpage>6946</fpage>
<lpage>6954</lpage>
<history>
<date date-type="received">
<day>22</day>
<month>10</month>
<year>2014</year></date>
<date date-type="accepted">
<day>21</day>
<month>07</month>
<year>2015</year></date></history>
<permissions>
<copyright-statement>Copyright: &#x000A9; Li et al.</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access">
<license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivs License</ext-link>, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.</license-p></license></permissions>
<abstract>
<p>Allergic asthma is a chronic inflammatory disease that is regulated by coordination of T-helper type 2 cell cytokines and inflammatory signaling molecules. Ginsenoside Rh2 (G-Rh2) is an active component of ginseng with anti-inflammatory and anti-tumor effects. The aim of the present study was to determine the inhibitory effects of G-Rh2 on allergic airway inflammation in a murine model of asthma, in which mice develop the following pathophysiological features of asthma: Increased abundance of inflammatory cells; increased levels of interleukin-4 (IL-4), IL-5 and IL-13; decreased abundance of interferon gamma in the bronchoalveolar lavage fluid and lung tissue; increased total and ovalbumin (OVA)-specific immunoglobulin E (IgE) levels in the serum; increased airway hyperresponsiveness (AHR); and activation of nuclear factor kappa B (NF-&#x003BA;B) in lung tissue. In the asthmatic mice, administration of G-Rh2 markedly reduced peribronchiolar inflammation, recruitment of airway inflammatory cells, cytokine production, total and OVA-specific IgE levels and AHR. G-Rh2 administration inhibited NF-&#x003BA;B activation and p38 mitogen-activated protein kinase (MAPK) phosphorylation induced by OVA inhalation. These results suggested that G-Rh2 attenuates allergic airway inflammation by regulating NF-&#x003BA;B activation and p38 MAPK phosphorylation. The present study identified the molecular mechanisms of action of G-Rh2, which supported the potential use of G-Rh2 to prevent and/or treat asthma and other airway inflammatory disorders.</p></abstract>
<kwd-group>
<kwd>ginsenoside Rh2</kwd>
<kwd>asthma</kwd>
<kwd>nuclear factor-kappa B</kwd>
<kwd>airway inflammation</kwd>
<kwd>T helper cell type 2 cytokines</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Asthma, one of the most prevalent diseases worldwide, is a chronic inflammatory disease of the airways that is characterized by airway inflammation, airway hyperresponsiveness (AHR) and reversible airway obstruction. The pathological features of allergic asthma include inflammatory cell infiltration, edema, mast cell activation, denudation of the airway epithelium and collagen deposition (<xref rid="b1-mmr-12-05-6946" ref-type="bibr">1</xref>). Asthma is closely associated with imbalances in T-helper cell type 1 (Th1)/Th2 abundance due to their distinct cytokine profiles (<xref rid="b2-mmr-12-05-6946" ref-type="bibr">2</xref>,<xref rid="b3-mmr-12-05-6946" ref-type="bibr">3</xref>). Th2-specific cytokines, including interleukin (IL)-4, IL-5 and IL-13, are important mediators of humoral immune responses that induce immunoglobulin (Ig)E production and recruit eosinophils to the airways. Furthermore, Th2 cytokines that induce histamine and leukotriene release are associated with AHR (<xref rid="b4-mmr-12-05-6946" ref-type="bibr">4</xref>,<xref rid="b5-mmr-12-05-6946" ref-type="bibr">5</xref>). Th1 cytokines, including interferon gamma (IFN-&#x003B3;) and IL-12, are involved in the mediation of the cellular immune response, and these cytokines restrain the development of asthma by acting in opposition to Th2-mediated immune responses and reducing IgE synthesis (<xref rid="b6-mmr-12-05-6946" ref-type="bibr">6</xref>). Disease states occur when the dynamic balance of Th1/Th2 cell abundance and activation is disturbed. In recent years, increasing research interest has been focused on the inhibition of Th2 cell activation and the modulation of the Th1/Th2 equilibrium to prevent and treat asthma (<xref rid="b7-mmr-12-05-6946" ref-type="bibr">7</xref>).</p>
<p>Nuclear factor kappa B (NF-&#x003BA;B), a well-studied transcriptional factor that has numerous important functions in cell signaling, also has a pivotal role in airway remodeling in asthma (<xref rid="b8-mmr-12-05-6946" ref-type="bibr">8</xref>,<xref rid="b9-mmr-12-05-6946" ref-type="bibr">9</xref>). Cytokines and other factors that are triggered as part of inflammatory processes activate NF-&#x003BA;B via several signaling pathways, leading to a signaling cascade that amplifies inflammation. (<xref rid="b8-mmr-12-05-6946" ref-type="bibr">8</xref>) Several studies have associated NF-&#x003BA;B overactivation with airway remodeling (<xref rid="b10-mmr-12-05-6946" ref-type="bibr">10</xref>). The p38 mitogen-activated protein kinases (MAPKs) represent a point of convergence for multiple signaling processes that are activated in inflammation and that affect a diverse range of signaling events that mediate inflammatory processes (<xref rid="b11-mmr-12-05-6946" ref-type="bibr">11</xref>,<xref rid="b12-mmr-12-05-6946" ref-type="bibr">12</xref>). Signaling via the p38 MAPK pathway regulates numerous pro-inflammatory transcription factors, such as activator protein 1 and NF-&#x003BA;B (<xref rid="b13-mmr-12-05-6946" ref-type="bibr">13</xref>&#x02013;<xref rid="b15-mmr-12-05-6946" ref-type="bibr">15</xref>).</p>
<p>Ginseng, the root of <italic>Panax ginseng</italic> C.A. Meyer, has been used for millennia in traditional Asian medicine for preventive and therapeutic purposes due to its diverse biological effects (<xref rid="b16-mmr-12-05-6946" ref-type="bibr">16</xref>,<xref rid="b17-mmr-12-05-6946" ref-type="bibr">17</xref>). Ginsenosides are the major bioactive constituents of ginseng (<xref rid="b18-mmr-12-05-6946" ref-type="bibr">18</xref>&#x02013;<xref rid="b20-mmr-12-05-6946" ref-type="bibr">20</xref>). Ginsenoside Rh2 (G-Rh2) is a rare ginsenoside with a dammarane skeleton that is found only in red ginseng; however, G-Rh2 can be synthesized from easily available protopanaxadiol-type ginsenosides, which are similar to G-Rh2, with the exception of an additional glucose molecule at the C-3 position (<xref rid="b21-mmr-12-05-6946" ref-type="bibr">21</xref>). G-Rh2 produces remarkable anti-proliferative (<xref rid="b22-mmr-12-05-6946" ref-type="bibr">22</xref>) and pro-apoptotic effects (<xref rid="b23-mmr-12-05-6946" ref-type="bibr">23</xref>), and prevents metabolic disorders, including obesity, via the 5&#x02032; adenosine monophosphate-activated protein kinase (AMPK) signaling pathway. Furthermore, total saponins and G-Rh2 showed a potential therapeutic effect against inflammation-mediated neuronal degeneration (<xref rid="b24-mmr-12-05-6946" ref-type="bibr">24</xref>). Although numerous studies have investigated the underlying mechanisms of the anti-cancer activity of G-Rh2, the anti-inflammatory potential of G-Rh2 has not been well established, and the involvement of MAPK signaling and NF-&#x003BA;B in its effects have not been fully elucidated. Therefore, the present study investigated the mechanism of action of G-Rh2 in the context of MAPK and NF-&#x003BA;B signaling, which are known to regulate the inflammatory response, using an <italic>in vivo</italic> mouse model of allergic airway inflammation in asthma. The results of the present study provided insight into asthma prevention and treatment.</p></sec>
<sec sec-type="methods">
<title>Materials and methods</title>
<sec>
<title>Animals and experimental protocols</title>
<p>Forty-two specific pathogen-free (SPF), inbred, female BALB/c mice (age, seven weeks; weight, 20&#x02013;30 g) were obtained from the in-house animal production facility of the Yanbian University Health Science Center (Yanji, China). The mice were maintained in an animal facility under a 12-h light/dark cycle at 22&#x000B0;C in standard laboratory conditions for one week prior to the experiments. Water and a standard diet were provided <italic>ad libitum</italic>. The experiments were performed in compliance with the guidelines approved by the Institutional Animal Care and Use Committee of the Yanbian University School of Medical Sciences (Yanji, China). Mice were immunized intraperitoneally with 10 <italic>&#x000B5;</italic>g ovalbumin (OVA; chicken egg albumin; Sigma-Aldrich, St. Louis, MO, USA) with 1.0 mg aluminum hydroxide adjuvant (Imject<sup>&#x000AE;</sup> Alum; Pierce, Rockford, IL, USA). A booster injection of 10 <italic>&#x000B5;</italic>g OVA plus 1.0 mg aluminum hydroxide adjuvant was given 10 days after the initial OVA/adjuvant treatment. From days 17&#x02013;19, the immunized mice were challenged by exposure to an aerosol of 1% OVA in phosphate-buffered saline (PBS) for 20 min. Bronchoprovocation was performed in a vented plastic chamber (18&#x000D7;14&#x000D7;8 cm) that was adapted for mice. Aerosol particles of 3&#x02013;5 mm in diameter were created using an ultrasonic nebulizer (NE-U12; Omron, Tokyo, Japan), directed into the plastic chamber and vented to a fume hood. Each group consisted of seven animals. The saline-treated mice that served as controls were exposed to aerosolized saline. G-Rh2 (98% purity) was purchased from the National Institute for the Control of Pharmaceutical and Biological Products (Beijing, China) and dissolved in 0.1% dimethyl sulfoxide (DMSO). The animals received G-Rh2 (50 or 100 mg/kg) or dexamethasone (DXM; 0.5 mg/kg) by oral gavage at 24-h intervals, beginning 1 h prior to the first provocation (challenge), on days 17&#x02013;19.</p></sec>
<sec>
<title>Harvest of bronchoalveolar lavage (BAL) fluids and cytospin preparations</title>
<p>Immediately following the assessment of airway responsiveness, mice were anesthetized by intra-peritoneal injection of pentobarbital (50 mg/kg; Wuhan Boster Biological Technology, Ltd., Wuhan, China) and the trachea was cannulated while gently massaging the thorax, after which the lungs were lavaged with 0.7 ml PBS. BAL fluid samples were collected and the number of cells in a 0.05-ml aliquot was counted using a hemocytometer. The remaining samples were centrifuged at 200 x g for 10 min at 4&#x000B0;C (model 5424R centrifuge, Eppendorf-Netheler, Hamburg, Germany) and the supernatants were stored at &#x02212;70&#x000B0;C for analyses of IL-4, IL-5, IL-13 and IFN-&#x003B3; levels. Cell pellets were re-suspended in PBS and cytospin preparations (Cytospin 3; Shandon Life Sciences, Astmor, UK) of the BAL cells were stained with Diff-Quik solution (International Reagents, Kobe, Japan). Two independent, blinded investigators counted the cells using a microscope. Approximately 400 cells were counted in each of four different random fields of view (CX31 microscope; Olympus Corporation, Tokyo, Japan). Inter-investigator variation was &lt;5%. The results were expressed as the mean value of the cell counts determined by the two investigators.</p></sec>
<sec>
<title>Determination of cytokines in BAL fluids</title>
<p>IL-4, IL-5, IL-13 and IFN-&#x003B3; levels in BAL and IgE in serum were determined using ELISA kits for mice. The IL-4 kit was obtained from Invitrogen Life Technologies (Carlsbad, CA, USA) and IL-5, IL-13, IFN-&#x003B3; and IgE kits were obtained from R&amp;D Systems Inc. (Minneapolis, MN, USA). The enzyme immunoassays were performed according to the manufacturer's instructions.</p></sec>
<sec>
<title>Determination of total IgE and OVA-specific IgE in serum</title>
<p>Total IgE and OVA-specific IgE were measured by ELISA. Briefly, 96-well microtiter plates were coated overnight with an isotype-specific coating (total IgE) and 10 mg/ml OVA in PBS-Tween 20 (OVA-specific IgE). After washing and blocking of the plates, the samples were incubated for 2 h. Subsequently, the plates were washed and horseradish peroxidase-conjugated goat anti-mouse total IgE and OVA-specific IgE were added. After washing the samples four times in PBS-Tween-20 solution, 200 <italic>&#x000B5;</italic>l <italic>o</italic>-phenylenediamine dihydro-chloride (Sigma-Aldrich) was added to each well. The plates were incubated for 10 min in the dark and absorbance was determined at 450 nm using a Bio-Rad 680 microplate ELISA reader (Bio-Rad Laboratories, Hercules, CA, USA). Total IgE and OVA-specific IgE concentrations were calculated from a standard curve that was generated using 250 ng/ml recombinant IgE.</p></sec>
<sec>
<title>Histological examination of murine lung tissue</title>
<p>After BAL preparation, the lungs were resected, fixed with 4% paraformaldehyde and embedded in paraffin. Specimens were cut into 4-<italic>&#x000B5;</italic>m sections using a Leica model 2165 rotary microtome (Leica Microsystems, Wetzlar, Germany). The microsections were stained with hematoxylin and eosin (Richard-Allan Scientific, Kalamazoo, MI, USA) and examined under the CX31 microscope (magnification, &#x000D7;100).</p></sec>
<sec>
<title>Nuclear protein extractions for analysis of NF-&#x003BA;B</title>
<p>Freshly isolated lung tissue samples were washed and lysed in two volumes of lysis buffer A (50 mM Tris-HCl, pH 7.5, 1 M EDTA, 10% glycerol, 0.5 mM dithiothreitol, 5 mM MgCl<sub>2</sub>, 1 mM phenylmethanesulfonylfluoride (PMSF) and protease inhibitor cocktails) for 5 min at 4&#x000B0;C. The resulting suspension was centrifuged at 1,000 xg for 15 min at 4&#x000B0;C. The supernatant fraction was incubated on ice for 10 min and centrifuged at 100,000 x g for 1 h at 4&#x000B0;C to obtain cytosolic protein extracts. The pelleted nuclei were re-suspended in buffer B (1.3 M sucrose, 1.0 mM MgCl<sub>2</sub>, 10 mM potassium phosphate buffer, pH 6.8) and centrifuged at 1,000 xg for 15 min. The pellets were suspended in buffer B with a final sucrose concentration of 2.2 M and centrifuged at 100,000 xg for 1 h. The resulting nuclear pellets were washed once with a solution containing 0.25 M sucrose, 0.5 mM MgCl<sub>2</sub> and 20 mM Tris-HCl (pH 7.2), and centrifuged at 1,000 xg for 10 min. The nuclear pellets were solubilized with a solution of 50 mM Tris-HCl (pH 7.2), 0.3 M sucrose, 150 mM NaCl, 2 mM EDTA, 20% glycerol, 2% Triton X-100, 2 mM PMSF and protease inhibitor cocktails, and the resulting mixture was kept on ice for 1 h with gentle stirring, after which it was centrifuged at 12,000 x g for 30 min. The resulting soluble nuclear protein supernatant samples were used for western blot analysis.</p></sec>
<sec>
<title>Western blot analysis</title>
<p>Lung tissue samples were homogenized in the presence of protease inhibitors and protein concentrations were determined using the Bradford reagent (Bio-Rad Laboratories). Samples of protein from the lung homogenates (30 <italic>&#x000B5;</italic>g per lane) were subjected to 12% SDS-PAGE and transferred onto nitrocellulose membranes. Western blot analysis was performed using the following antibodies at a dilution of 1:1,000: Rabbit anti-mouse polyclonal antibodies against IL-5 (cat. no. sc-7887), p38 MAPK (cat. no. sc-535), phospho-p38 MAPK (cat. no. sc-101759), poly(adenosinediphosphate) ribose polymerase (PARP) (cat. no. sc-25780), NF-&#x003BA;B p65 (cat. no. sc-109), nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor, alpha (I&#x003BA;B-&#x003B1;) (cat. no. sc-847) and &#x003B2;-actin (cat. no. sc-130656) (all from Santa Cruz Biotechnology, Inc., Dallas, TX, USA) as well as IL-13 (cat. no. AF-413-NA; R&amp;D Systems) or IL-4 (cat. no. AAM36; Serotec, Oxford, UK), or the goat anti-mouse polyclonal antibody IFN-&#x003B3; (cat. no. sc-9344; Calbiochem, San Diego, CA, USA). The binding of all the antibodies was detected using an ECL detection system (Amersham, Arlington Heights, IL, USA) according to the manufacturer's instructions.</p></sec>
<sec>
<title>Assessment of AHR</title>
<p>Airway responsiveness was measured two days after the last OVA challenge according to the method of Choi <italic>et al</italic> (<xref rid="b25-mmr-12-05-6946" ref-type="bibr">25</xref>). Conscious unrestrained mice were placed in a barometric plethysmographic chamber (OCP3000; All Medicus, Seoul, Korea), and baseline readings were collected and averaged for 3 min. Aerosolized methacholine (Mch; All Medicus) at increasing concentrations (from 2.5 to 50 mg/ml) was nebulized through an inlet of the main chamber for 3 min, and readings were taken and averaged for 3 min after each nebulization. The bronchopulmonary resistance was determined by calculating enhanced pauses (Penh) according to the manufacturer's protocol with the following equation:
<disp-formula id="fd1-mmr-12-05-6946">
<mml:math id="mm1" display='block'>
<mml:mrow>
<mml:mtext>Penh</mml:mtext>
<mml:mo>=</mml:mo>
<mml:mo stretchy='false'>(</mml:mo>
<mml:mi>T</mml:mi>
<mml:mi>e</mml:mi>
<mml:mo>/</mml:mo>
<mml:mi>R</mml:mi>
<mml:mi>T</mml:mi>
<mml:mo>&#x02212;</mml:mo>
<mml:mn>1</mml:mn>
<mml:mo stretchy='false'>)</mml:mo>
<mml:mo>&#x000D7;</mml:mo>
<mml:mo stretchy='false'>(</mml:mo>
<mml:mi>P</mml:mi>
<mml:mi>E</mml:mi>
<mml:mi>F</mml:mi>
<mml:mo>/</mml:mo>
<mml:mi>P</mml:mi>
<mml:mi>I</mml:mi>
<mml:mi>F</mml:mi>
<mml:mo stretchy='false'>)</mml:mo></mml:mrow></mml:math></disp-formula>where <italic>Te</italic> was the expiratory time, <italic>RT</italic> was the relaxation time, <italic>PEF</italic> was the peak expiratory flow and <italic>PIF</italic> was the peak inspiratory flow. The results are expressed as the percentage increase in Penh over the baseline value after PBS challenge (taken as 100%) following a challenge performed with each concentration of Mch.</p></sec>
<sec>
<title>Statistical analysis</title>
<p>Values are expressed as the mean &#x000B1; standard error of the mean. Statistical evaluation of the data was performed using analysis of variance, followed by Dunnett's <italic>post-hoc</italic> test. SPSS 13.0 software (SPSS, Inc., Chicago, IL, USA) was used to perform analyses and P&lt;0.05 was considered to indicate a statistically significant difference.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>G-Rh2 attenuates cellular changes in BAL fluids of OVA-induced asthmatic mice</title>
<p>In BAL fluid, the total cell number and the numbers of eosinophils, lymphocytes and neutrophils were significantly increased 24 h after OVA inhalation in comparison with those measured 24 h after saline inhalation (<xref rid="f1-mmr-12-05-6946" ref-type="fig">Fig. 1A</xref>). Of note, these effects of OVA inhalation were significantly reduced by administration of G-Rh2 or positive control DXM.</p></sec>
<sec>
<title>G-Rh2 attenuates pathological changes associated with OVA-induced asthma</title>
<p>Histological analyses revealed widespread perivascular and peribronchiolar inflammatory cell infiltrates, which are typical pathological features of asthma, in OVA-challenged mice, but these features were not found in control mice. OVA-exposed mice treated with G-Rh2 or DXM (<xref rid="f1-mmr-12-05-6946" ref-type="fig">Fig. 1B</xref>) showed significantly reduced inflammatory-cell infiltration in the peribronchiolar and perivascular regions in comparison with that in mice exposed to OVA only. These results suggested that G-Rh2 inhibits inflammatory-cell infiltration and attenuates antigen-induced airway inflammation.</p></sec>
<sec>
<title>G-Rh2 attenuates OVA-induced increases in IL-4, IL-5 and IL-13 protein levels in lung tissue and BAL fluid of mice</title>
<p>Western blot analysis revealed that IL-4, IL-5 and IL-13 protein levels in lung tissue were significantly increased 24 h after OVA inhalation in comparison with levels measured 24 h after saline inhalation. The OVA-induced increases in IL-4, IL-5 and IL-13 protein levels were significantly inhibited by administration of G-Rh2 or DXM (<xref rid="f2-mmr-12-05-6946" ref-type="fig">Fig. 2A</xref>). Consistent with these results, ELISAs revealed that protein levels of IL-4, IL-5 and IL-13 in BAL fluid were also significantly increased 24 h after OVA inhalation in comparison with levels measured 24 h after saline inhalation (<xref rid="f2-mmr-12-05-6946" ref-type="fig">Fig. 2B</xref>), and these changes in protein abundance were also significantly inhibited by administration of G-Rh2 or DXM.</p></sec>
<sec>
<title>G-Rh2 attenuates decreases in IFN-&#x003B3; protein levels in lung tissue and BAL fluid from mice with OVA-induced asthma</title>
<p>To determine the effect of G-Rh2 on the Th1 response, IFN-&#x003B3; abundance in lung tissue was assessed using western blot analysis. IFN-&#x003B3; abundance in OVA-challenged mice was reduced in comparison with that in control mice (<xref rid="f3-mmr-12-05-6946" ref-type="fig">Fig. 3A</xref>). However, administration of G-Rh2 or DXM inhibited OVA-induced reductions in IFN-&#x003B3; abundance. Similarly, ELISAs of BAL fluid showed that IFN-&#x003B3; protein abundance was significantly reduced in OVA-challenged mice in comparison with that of control mice (<xref rid="f3-mmr-12-05-6946" ref-type="fig">Fig. 3A</xref>), and pre-treatment with G-Rh2 or DXM inhibited this change in expression.</p></sec>
<sec>
<title>G-Rh2 attenuates increases in total IgE and OVA-specific IgE levels in serum of mice with OVA-induced asthma</title>
<p>The total IgE and OVA-specific IgE levels in each experimental group were determined by ELISA 24 h after the final OVA challenge. Total IgE and OVA-specific IgE levels in serum were significantly increased 24 h after OVA inhalation in comparison with levels measured 24 h after saline inhalation (<xref rid="f4-mmr-12-05-6946" ref-type="fig">Fig. 4</xref>). In comparison with the OVA-challenged group, increased total IgE and OVA-specific IgE levels in serum were significantly reduced in the groups treated with G-Rh2 or DXM.</p></sec>
<sec>
<title>G-Rh2 prevents OVA-induced NF-&#x003BA;B p65 translocation in lung tissue of mice by blocking of phosphorylation and degradation of I&#x003BA;B-&#x003B1;</title>
<p>Western blot analysis revealed that nuclear NF-&#x003BA;B p65 abundance in the lung was increased 24 h after OVA inhalation in comparison with that in the control mice, and this effect was inhibited by administration of G-Rh2 or DXM. By contrast, cytosolic NF-&#x003BA;B p65 abundance was reduced 24 h after OVA inhalation in comparison with that of the control mice (<xref rid="f5-mmr-12-05-6946" ref-type="fig">Fig. 5A and B</xref>), and this effect was also inhibited by administration of G-Rh2 or DXM. The effect of G-Rh2 on OVA-induced phosphorylation and degradation of I&#x003BA;B-&#x003B1; was studied to examine the molecular mechanisms by which G-Rh2 inhibits NF-&#x003BA;B transcriptional activity. G-Rh2 significantly blocked OVA-induced phosphorylation and degradation of I&#x003BA;B-&#x003B1; (<xref rid="f6-mmr-12-05-6946" ref-type="fig">Fig. 6A and B</xref>). These results indicated that G-Rh2 prevents NF-&#x003BA;B translocation in OVA-challenged mice by blocking phosphorylation and degradation of I&#x003BA;B-&#x003B1;.</p></sec>
<sec>
<title>G-Rh2 inhibits OVA-induced p38 MAPK phosphorylation in lung tissue of mice</title>
<p>Western blot analysis was used to determine the phosphorylation/activation status of p38 MAPK, which is an upstream mediator of NF-&#x003BA;B activation. Phospho-p38 protein abundance in the lung was increased 24 h after OVA inhalation in comparison with that of the control mice, and this effect was inhibited by administration of G-Rh2 or DXM (<xref rid="f7-mmr-12-05-6946" ref-type="fig">Fig. 7A and B</xref>). However, no significant changes in p38 MAPK protein abundance were observed in any group.</p></sec>
<sec>
<title>G-Rh2 reduces methacholine-induced AHR in mice with OVA-induced asthma</title>
<p>The present study investigated the effect of G-Rh2 on the development of AHR in mice. Airway responsiveness (determined by calculating Penh) induced by methacholine inhalation was increased in OVA-challenged mice in comparison with that in control mice, and this effect was inhibited by administration of G-Rh2 or DXM, as shown in <xref rid="f8-mmr-12-05-6946" ref-type="fig">Fig. 8</xref>.</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>Asthma is a chronic inflammatory disease of the airways that is characterized by infiltration of airway inflammatory cells and AHR to inhaled allergens and non-specific stimuli (<xref rid="b26-mmr-12-05-6946" ref-type="bibr">26</xref>). Inflammatory cells, including Th2 cells, mast cells, macrophages, lymphocytes, eosinophils and neutrophils, as well as cytokines, particularly IL-4, IL-5 and IL-13, are involved in asthma (<xref rid="b27-mmr-12-05-6946" ref-type="bibr">27</xref>,<xref rid="b28-mmr-12-05-6946" ref-type="bibr">28</xref>). The results of the present study revealed that G-Rh2 reverses or prevents several characteristic effects of asthma in model mice. In comparison with OVA-challenged mice, counts of total cells, eosinophils, lymphocytes and neutrophils in BALF were significantly decreased in OVA-challenged mice that were pre-treated with G-Rh2. In patients with asthma, expression levels of Th2 cytokines, including IL-4, IL-5 and IL-13, are increased, and the expression of Th1 cytokines, such as IFN-&#x003B3;, is decreased (<xref rid="b3-mmr-12-05-6946" ref-type="bibr">3</xref>). In BAL fluid and lung tissue, G-Rh2 significantly inhibited OVA-induced upregulation of IL-4, IL-5 and IL-13 expression, and inhibited OVA-induced down-regulation of IFN-&#x003B3; expression. Consistent with these biochemical findings, staining with hematoxylin and eosin showed that G-Rh2 treatment ameliorated airway inflammation.</p>
<p>Airway inflammation is regulated by complex interconnected signaling networks, and the precise molecular mechanisms involved in airway inflammation associated with asthma have largely remained to be elucidated. NF-&#x003BA;B is present in most cell types and is known to have a critical role in immune and inflammatory responses, including asthma (<xref rid="b29-mmr-12-05-6946" ref-type="bibr">29</xref>&#x02013;<xref rid="b32-mmr-12-05-6946" ref-type="bibr">32</xref>). In unstimulated cells, NF-&#x003BA;B is sequestered in the cytoplasm by I&#x003BA;B&#x003B1;. However, phosphorylation and degradation of I&#x003BA;B&#x003B1; allows translocation of NF-&#x003BA;B into the nucleus, where it regulates transcription of target genes that encode numerous inflammatory proteins (<xref rid="b33-mmr-12-05-6946" ref-type="bibr">33</xref>), including the cytokines IL-4, IL-5 and IL-13, all of which are closely implicated in the pathogenesis of asthma (<xref rid="b34-mmr-12-05-6946" ref-type="bibr">34</xref>). The role of NF-&#x003BA;B in inflammation associated with asthma is corroborated by the present observation that NF-&#x003BA;B abundance in nuclear protein extracts from lung tissue was substantially increased in mice exposed to an OVA challenge to induce allergic airway disease. G-Rh2 significantly reduced I&#x003BA;B&#x003B1; degradation and translocation of the p65 subunit of NF-&#x003BA;B into the nucleus, as well as levels of Th2 cytokines (IL-4, IL-5 and IL-13), in the lungs of OVA-challenged mice. These results indicated that G-Rh2 ameliorated asthmatic symptoms by inhibiting NF-&#x003BA;B activation.</p>
<p>MAPKs are a group of serine/threonine kinases that include extracellular signal-regulated kinases (ERKs), c-Jun N-terminal kinases (JNKs) and p38 MAPK. MAPKs relay signals generated by exogenous and endogenous stimuli to the intracellular space via protein phosphorylation (<xref rid="b35-mmr-12-05-6946" ref-type="bibr">35</xref>&#x02013;<xref rid="b37-mmr-12-05-6946" ref-type="bibr">37</xref>). The phosphorylation states and/or activities of the ERKs, JNKs and p38 MAPK are upregulated in animal models of asthma (<xref rid="b38-mmr-12-05-6946" ref-type="bibr">38</xref>,<xref rid="b39-mmr-12-05-6946" ref-type="bibr">39</xref>). In addition, recent studies have shown that SB 239063, a potent and selective p38 MAPK inhibitor, significantly inhibited antigen-induced eosinophilia, promoted apoptosis of eosinophils in BAL fluid (<xref rid="b40-mmr-12-05-6946" ref-type="bibr">40</xref>), and reduced antigen-induced airway inflammatory cell infiltration, levels of IL-4, IL-5 and IL-13, mucus hypersecretion and airway AHR (<xref rid="b41-mmr-12-05-6946" ref-type="bibr">41</xref>). Sulfated 20(S)-ginsenoside Rh2 inhibited the release of lipopolysaccharide-induced pro-inflammatory mediators by blocking signaling through MAPKs and NF-&#x003BA;B in RAW 264.7 cells (<xref rid="b42-mmr-12-05-6946" ref-type="bibr">42</xref>). Consistent with these data, the present study found that phosphorylation of p38 MAPK was markedly increased after OVA inhalation and that G-Rh2 significantly decreased phospho-p38 MAPK abundance in lung tissue from OVA-challenged mice. In addition, the results of the present study showed that G-Rh2 reduced allergen-induced airway inflammation, airway AHR, I&#x003BA;B&#x003B1; degradation and NF-&#x003BA;B p65 nuclear translocation in OVA-challenged mice. These findings suggested that the modulation of p38 MAPK signaling involving I&#x003BA;B and NF-&#x003BA;B are among the underlying molecular mechanisms of the beneficial effects of G-Rh2 in patients with allergic airway disease.</p>
<p>In conclusion, the present study examined the effects of G-Rh2 on allergen-induced airway inflammation and AHR and investigated the roles of p38 MAPK and NF-&#x003BA;B in these inflammatory processes. In OVA-challenged mice, p38 MAPK phosphorylation, NF-&#x003BA;B activation, Th2 cytokine levels, airway inflammation and AHR were inhibited by pre-treatment with G-Rh2. Therefore, the inhibitory effects of G-Rh2 on OVA-induced allergic airway inflammation are mediated, at least in part, by its regulation of p38 MAPK/NF-&#x003BA;B signaling. The present study provided empirical evidence for the molecular basis for the preventive effects of G-Rh2 against allergic airway diseases.</p></sec></body>
<back>
<ack>
<title>Acknowledgments</title>
<p>The present study was supported by the Natural Science Foundation of China (nos. 81260665 and 81160176), the Project of Research &amp; Innovation of Jilin Youth Leader and Team (no. 20140519013JH) and the Natural Science Research Foundation of Jilin Province for Sciences and Technology (no. 201215235).</p></ack>
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<floats-group>
<fig id="f1-mmr-12-05-6946" position="float">
<label>Figure 1</label>
<caption>
<p>Effect of G-Rh2 on immune cell counts in BAL and pathological changes in the lung tissues of OVA-challenged mice. (A) Numbers of each counted cell type in BAL. Mice were orally administered G-Rh2 or DXM (positive control) daily for three consecutive days after the first OVA challenge. The effects of G-Rh2 and DXM on OVA challenge-induced changes in cell counts in BAL fluid were analyzed 24 h after the last OVA challenge. Results of five independent experiments (7 mice/group) are expressed as the mean &#x000B1; standard error of the mean. <sup>#</sup>P&lt;0.05 vs. control group; <sup>&#x0002A;</sup>P&lt;0.05 vs. OVA-challenged group. (B) Hematoxylin and eosin-stained sections of lung tissue (magnification, &#x000D7;200; scale bar, 50 <italic>&#x000B5;</italic>m). Paraffin-embedded lung sections were prepared 24 h after the last OVA challenge and stained with hematoxylin and eosin. Images are representative of five independent experiments. Groups: CON, saline-treated mice; OVA, OVA-challenged mice; OVA+VEH, OVA-challenged mice treated with the drug vehicle; G-Rh2 50, OVA-challenged mice treated with 50 mg/kg G-Rh2; G-Rh2 100, OVA-challenged mice treated with 100 mg/kg G-Rh2; DXM, OVA-challenged mice treated with 0.5 mg/kg DXM. EOS, eosinophil; NEU, neutrophil; MAC, macrophage; LYM, lymphocyte; G-Rh2, ginsenoside Rh2; BAL, bronchoalveolar lavage fluid; OVA, ovalbumin; VEH, vehicle; DXM, dexamethasone.</p></caption>
<graphic xlink:href="MMR-12-05-6946-g00.jpg"/></fig>
<fig id="f2-mmr-12-05-6946" position="float">
<label>Figure 2</label>
<caption>
<p>Assessment of T-helper type 2 cell cytokines in BAL fluid and lung tissue from OVA-challenged mice treated with ginsenoside Rh2. (A) Lung tissue was collected 24 h after the last OVA challenge and levels of IL-4, IL-5 and IL-13 were determined by western blot analysis. A representative immunoblot of five independent experiments is shown. (B) BAL fluid was collected 24 h after the last OVA challenge and levels of IL-4, IL-5 and IL-13 were quantified by ELISA. Results from five independent experiments (7 mice/group) are expressed as the mean &#x000B1; standard error of the mean. <sup>#</sup>P&lt;0.05 vs. control group; <sup>&#x0002A;</sup>P&lt;0.05 vs. OVA-challenged group. Groups: CON, saline-treated mice; OVA, OVA-challenged mice; OVA+VEH, OVA-challenged mice treated with the drug vehicle; G-Rh2 50, OVA-challenged mice treated with 50 mg/kg G-Rh2; G-Rh2 100, OVA-challenged mice treated with 100 mg/kg G-Rh2; DXM, OVA-challenged mice treated with 0.5 mg/kg DXM. BAL, bronchoalveolar lavage; IL, interleukin; OVA, ovalbumin; VEH, vehicle; DXM, dexamethasone; G, ginsenoside.</p></caption>
<graphic xlink:href="MMR-12-05-6946-g01.jpg"/></fig>
<fig id="f3-mmr-12-05-6946" position="float">
<label>Figure 3</label>
<caption>
<p>Assessment of T-helper type 1 cell cytokines in BAL fluid and lung tissues from OVA-challenged mice treated with ginsenoside Rh2. (A) Lung tissue was collected 24 h after the last OVA challenge and the abundance of IFN-&#x003B3; was measured by western blot analysis. A representative immunoblot of five independent experiments is shown. (B) BAL fluid was collected 24 h after the last OVA challenge and the abundance of IFN-&#x003B3; was quantified by ELISA. Results from five independent experiments (7 mice/group) are expressed as the mean &#x000B1; standard error of the mean. <sup>#</sup>P&lt;0.05 vs. control group; <sup>&#x0002A;</sup>P&lt;0.05 vs. OVA-challenged group. Groups: CON, saline-treated mice; OVA, OVA-challenged mice; OVA+VEH, OVA-challenged mice treated with the drug vehicle; G-Rh2 50, OVA-challenged mice treated with 50 mg/kg G-Rh2; G-Rh2 100, OVA-challenged mice treated with 100 mg/kg G-Rh2; DXM, OVA-challenged mice treated with 0.5 mg/kg dexamethasone. BAL, bronchoalveolar lavage; IL, interleukin; OVA, ovalbumin; VEH, vehicle; DXM, dexamethasone; IFN, interferon; G, ginsenoside.</p></caption>
<graphic xlink:href="MMR-12-05-6946-g02.jpg"/></fig>
<fig id="f4-mmr-12-05-6946" position="float">
<label>Figure 4</label>
<caption>
<p>Effect of ginsenoside Rh2 on total IgE and OVA-specific IgE levels in serum from mice with OVA-induced asthma. (A) Total IgE abundance. (B) OVA-specific IgE abundance. Serum was collected 24 h after the last OVA challenge and IgE was quantified by ELISA. Results of five independent experiments(7 mice/group) are expressed as the mean &#x000B1; standard error of the mean. <sup>#</sup>P&lt;0.05 vs. control group; <sup>&#x0002A;</sup>P&lt;0.05 vs. OVA-challenged group. Groups: CON, saline-treated mice; OVA, OVA-challenged mice; OVA+VEH, OVA-challenged mice treated with the drug vehicle; G-Rh2 50, OVA-challenged mice treated with 50 mg/kg G-Rh2; G-Rh2 100, OVA-challenged mice treated with 100 mg/kg G-Rh2; DXM, OVA-challenged mice treated with 0.5 mg/kg dexamethasone. IgE, immunoglobulin E; OVA, ovalbumin; VEH, vehicle; DXM, dexamethasone; G, ginsenoside.</p></caption>
<graphic xlink:href="MMR-12-05-6946-g03.jpg"/></fig>
<fig id="f5-mmr-12-05-6946" position="float">
<label>Figure 5</label>
<caption>
<p>Effect of ginsenoside Rh2 on OVA challenge-induced NF-&#x003BA;B activation. Mice were orally administered ginsenoside Rh2 or DXM daily for three consecutive days after the first OVA challenge. Lung homogenates were prepared 24 h after the last OVA challenge. Translocation of p65 to the nucleus was assessed by western blot. &#x003B2;-actin and PARP were used as internal controls. (A) An immunoblot representative of five independent experiments is shown. (B) Bands were quantified by densitometric analysis relative to &#x003B2;-actin or PARP. Results from five independent experiments (7 mice/group) are expressed as the mean &#x000B1; standard error of the mean. <sup>#</sup>P&lt;0.05 vs. control group; <sup>&#x0002A;</sup>P&lt;0.05 vs. OVA-challenged group. Groups: CON, saline-treated mice; OVA, OVA-challenged mice; OVA+VEH, OVA-challenged mice treated with the drug vehicle; G-Rh2 50, OVA-challenged mice treated with 50 mg/kg G-Rh2; G-Rh2 100, OVA-challenged mice treated with 100 mg/kg G-Rh2; DXM, OVA-challenged mice treated with 0.5 mg/kg DXM. NF, nuclear factor; PARP, poly(adenosine diphosphate ribose) polymerase; OVA, ovalbumin; VEH, vehicle; DXM, dexamethasone; G, ginsenoside.</p></caption>
<graphic xlink:href="MMR-12-05-6946-g04.jpg"/></fig>
<fig id="f6-mmr-12-05-6946" position="float">
<label>Figure 6</label>
<caption>
<p>Effect of ginsenoside Rh2 on OVA challenge-induced phosphorylation of I&#x003BA;B-&#x003B1; in the cytoplasm. Mice were orally administered ginsenoside Rh2 or DXM daily for three consecutive days after the first OVA challenge. Lung homogenates were prepared 24 h after the last OVA challenge. I&#x003BA;B-&#x003B1; phosphorylation and degradation in the cytoplasm were assessed by western blot analysis. &#x003B2;-actin was used as an internal control. (A) An immunoblot representative of five independent experiments is shown. (B) Bands were quantified by densitometric analysis compared to &#x003B2;-actin. Results from five independent experiments (7 mice/group) are expressed as the mean &#x000B1; standard error of the mean. <sup>#</sup>P&lt;0.05 vs. control group; <sup>&#x0002A;</sup>P&lt;0.05 vs. OVA-challenged group. Groups: CON, saline-treated mice; OVA, OVA-challenged mice; OVA+VEH, OVA-challenged mice treated with the drug vehicle; G-Rh2 50, OVA-challenged mice treated with 50 mg/kg G-Rh2; G-Rh2 100, OVA-challenged mice treated with 100 mg/kg G-Rh2; DXM, OVA-challenged mice treated with 0.5 mg/kg DXM. p-I&#x003BA;B-&#x003B1;, phosphorylated inhibitor of nuclear factor &#x003BA;B, alpha; OVA, ovalbumin; VEH, vehicle; DXM, dexamethasone; G, ginsenoside.</p></caption>
<graphic xlink:href="MMR-12-05-6946-g05.jpg"/></fig>
<fig id="f7-mmr-12-05-6946" position="float">
<label>Figure 7</label>
<caption>
<p>Effect of ginsenoside Rh2 on OVA challenge-induced p38 activation. Mice were orally administered ginsenoside Rh2 or DXM daily for three consecutive days after the first OVA challenge. Lung homogenates were prepared 24 h after the last OVA challenge and p38 phosphorylation was assessed by western blot. Total p38 was used as an internal control. (A) An immunoblot representative of five independent experiments is shown. (B) p-p38 bands were quantified by densitometric analysis compared to total p38. Results from five independent experiments (7 mice/group) are expressed as the mean &#x000B1; standard error of the mean. <sup>#</sup>P&lt;0.05 vs. control group; <sup>&#x0002A;</sup>P&lt;0.05 vs. OVA-challenged group. Groups: CON, saline-treated mice; OVA, OVA-challenged mice; OVA+VEH, OVA-challenged mice treated with the drug vehicle; G-Rh2 50, OVA-challenged mice treated with 50 mg/kg G-Rh2; G-Rh2 100, OVA-challenged mice treated with 100 mg/kg G-Rh2; DXM, OVA-challenged mice treated with 0.5 mg/kg DXM. OVA, ovalbumin; VEH, vehicle; DXM, dexamethasone; G, ginsenoside; p, phosphorylated.</p></caption>
<graphic xlink:href="MMR-12-05-6946-g06.jpg"/></fig>
<fig id="f8-mmr-12-05-6946" position="float">
<label>Figure 8</label>
<caption>
<p>Effect of ginsenoside Rh2 on OVA challenge-induced airway hyperresponsiveness. All animals were nebulized with various concentrations of methacholine (2.5, 5, 10, 25 or 50 mg/ml) as a bronchoconstrictor. Values are expressed as the percentage increase in Penh over that of the saline-treated control group (which was set as 100%). Results of five independent experiments (7 mice/group) are expressed as the mean &#x000B1; standard error of the mean. <sup>#</sup>P&lt;0.05 vs. control group; <sup>&#x0002A;</sup>P&lt;0.05 vs. OVA-challenged group. Groups: CON, saline-treated mice; OVA, OVA-challenged mice; OVA+VEH, OVA-challenged mice treated with the drug vehicle; G-Rh2 50, OVA-challenged mice treated with 50 mg/kg G-Rh2; G-Rh2 100, OVA-challenged mice treated with 100 mg/kg G-Rh2; DXM, OVA-challenged mice treated with 0.5 mg/kg DXM. OVA, ovalbumin; VEH, vehicle; DXM, dexamethasone; G, ginsenoside; Penh, enhanced pauses.</p></caption>
<graphic xlink:href="MMR-12-05-6946-g07.jpg"/></fig></floats-group></article>
