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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="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.2017.8242</article-id>
<article-id pub-id-type="publisher-id">mmr-17-02-3267</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Protective effect of gigantol against hydrogen peroxide-induced apoptosis in rat bone marrow mesenchymal stem cells through the PI3K/Akt pathway</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author"><name><surname>Chen</surname><given-names>Huanhuan</given-names></name>
<xref rid="af1-mmr-17-02-3267" ref-type="aff">1</xref>
<xref rid="fn1-mmr-17-02-3267" ref-type="author-notes">&#x002A;</xref></contrib>
<contrib contrib-type="author"><name><surname>Huang</surname><given-names>Yuechun</given-names></name>
<xref rid="af2-mmr-17-02-3267" ref-type="aff">2</xref>
<xref rid="fn1-mmr-17-02-3267" ref-type="author-notes">&#x002A;</xref></contrib>
<contrib contrib-type="author"><name><surname>Huang</surname><given-names>Dandan</given-names></name>
<xref rid="af1-mmr-17-02-3267" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author"><name><surname>Wu</surname><given-names>Zhifang</given-names></name>
<xref rid="af3-mmr-17-02-3267" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author"><name><surname>Li</surname><given-names>Yunrong</given-names></name>
<xref rid="af1-mmr-17-02-3267" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author"><name><surname>Zhou</surname><given-names>Chunhua</given-names></name>
<xref rid="af1-mmr-17-02-3267" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author"><name><surname>Wei</surname><given-names>Gang</given-names></name>
<xref rid="af1-mmr-17-02-3267" ref-type="aff">1</xref>
<xref rid="c1-mmr-17-02-3267" ref-type="corresp"/></contrib>
</contrib-group>
<aff id="af1-mmr-17-02-3267"><label>1</label>School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, P.R. China</aff>
<aff id="af2-mmr-17-02-3267"><label>2</label>Department of Pharmacy, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China</aff>
<aff id="af3-mmr-17-02-3267"><label>3</label>Department of Trauma Orthopedics, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510360, P.R. China</aff>
<author-notes>
<corresp id="c1-mmr-17-02-3267"><italic>Correspondence to</italic>: Professor Gang Wei, School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, 232 East Waihuan Road, Higher Education Mega Center, Guangzhou, Guangdong 510006, P.R. China, E-mail: <email>weigang021@outlook.com</email></corresp>
<fn id="fn1-mmr-17-02-3267"><label>&#x002A;</label><p>Contributed equally</p></fn>
</author-notes>
<pub-date pub-type="ppub"><month>02</month><year>2018</year></pub-date>
<pub-date pub-type="epub"><day>11</day><month>12</month><year>2017</year></pub-date>
<volume>17</volume>
<issue>2</issue>
<fpage>3267</fpage>
<lpage>3273</lpage>
<history>
<date date-type="received"><day>05</day><month>07</month><year>2017</year></date>
<date date-type="accepted"><day>24</day><month>10</month><year>2017</year></date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2018, Spandidos Publications</copyright-statement>
<copyright-year>2018</copyright-year>
</permissions>
<abstract>
<p>Bone marrow mesenchymal stem cell (BMSC) transplants are promising for the treatment of certain central nervous system diseases. However, oxidative stress is one of the major factors that may limit the survival of the transplanted BMSCs. The present study investigated the effect of pretreatment with gigantol on hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>)-induced apoptosis in rat BMSCs (rBMSCs) and the potential underlying mechanisms. The results demonstrated that gigantol pretreatment significantly inhibited H<sub>2</sub>O<sub>2</sub>-induced apoptosis of rBMSCs. rBMSCs were incubated with 600 &#x00B5;M H<sub>2</sub>O<sub>2</sub> in the absence or presence of different doses of gigantol (1&#x2013;100 &#x00B5;M). Cell viability and apoptosis ratios were assessed by MTT assays and flow cytometry, respectively. Morphological alterations and reactive oxygen species were measured by the fluorescent-based methods of Hoechst staining and dichlorodihydrofluorescein diacetate, respectively. Furthermore, the protein levels of phosphorylated-protein kinase B (Akt), B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X (Bax), caspase-3 and caspase-9 were investigated by western blotting. Following incubation with H<sub>2</sub>O<sub>2</sub> for 2 h, gigantol significantly inhibited the H<sub>2</sub>O<sub>2</sub>-induced reductions in the cell viability of rBMSCs in a dose-dependent manner. Furthermore, gigantol upregulated Akt phosphorylation and Bcl-2 expression, downregulated Bax expression, and reduced the expression of caspase-3 and caspase-9 in H<sub>2</sub>O<sub>2</sub>-treated rBMSCs, whereas an opposite effect was detected when LY294002, an inhibitor of phosphatidylinositol 3-kinase, was administered in combination with gigantol. These results indicate that gigantol may be developed as a promising neuroprotective agent for successful MSC transplantation in ischemic diseases.</p>
</abstract>
<kwd-group>
<kwd>gigantol</kwd>
<kwd>mesenchymal stem cells</kwd>
<kwd>oxidative stress</kwd>
<kwd>apoptosis</kwd>
<kwd>phosphatidylinositol 3-kinase/Akt pathway</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Diseases associated with cerebral ischemia are a major cause of mortality in developing countries. Ischemic stroke is associated with the acute loss of neurons, astroglia and oligodendroglia, in addition to disruption to synaptic architecture, as a result of cerebral artery occlusion (<xref rid="b1-mmr-17-02-3267" ref-type="bibr">1</xref>). Certain studies have focused on the potential use of mesenchymal stem cell (MSC) transplantation in the treatment of central nervous system (CNS) diseases and injures, such as cerebral ischemia (<xref rid="b2-mmr-17-02-3267" ref-type="bibr">2</xref>,<xref rid="b3-mmr-17-02-3267" ref-type="bibr">3</xref>). MSC therapy is considered a novel and promising strategy for the treatment of ischemic stroke, and may exert neuroprotective effects and promote the repair of neurons by secreting various neural trophic factors and replacing damaged neurons (<xref rid="b4-mmr-17-02-3267" ref-type="bibr">4</xref>). However, the ischemic microenvironment negatively influences the survival rate of transplanted MSCs in injured CNS conditions due to oxidative stress (<xref rid="b5-mmr-17-02-3267" ref-type="bibr">5</xref>,<xref rid="b6-mmr-17-02-3267" ref-type="bibr">6</xref>). Thus, improving the survival of MSCs during oxidative stress may improve the efficacy of MSC-based therapies.</p>
<p>Gigantol is a biphenolic compound that is primarily extracted from the stem of <italic>Dendrobium aurantiacum</italic> (<xref rid="b7-mmr-17-02-3267" ref-type="bibr">7</xref>). Phenols derived from natural plants contain numerous antioxidants and therefore are typically used to study antioxidative activities (<xref rid="b8-mmr-17-02-3267" ref-type="bibr">8</xref>&#x2013;<xref rid="b11-mmr-17-02-3267" ref-type="bibr">11</xref>). Furthermore, gigantol is reported to exhibit numerous biological functions, including anti-osmosis effects (<xref rid="b12-mmr-17-02-3267" ref-type="bibr">12</xref>), antitumor effects in human liver (<xref rid="b13-mmr-17-02-3267" ref-type="bibr">13</xref>) and lung (<xref rid="b14-mmr-17-02-3267" ref-type="bibr">14</xref>) cancer, antimutagenic effects (<xref rid="b15-mmr-17-02-3267" ref-type="bibr">15</xref>) and immunomodulatory activities (<xref rid="b16-mmr-17-02-3267" ref-type="bibr">16</xref>). Additionally, gigantol was reported to be a potent compound for restoring sight in diabetics with cataracts (<xref rid="b17-mmr-17-02-3267" ref-type="bibr">17</xref>). However, to the best of our knowledge, no previous studies have investigated the protective effect of gigantol on hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>)-induced oxidative stress in rat bone marrow MSCs (rBMSCs). Therefore, the present study investigated whether gigantol protects against H<sub>2</sub>O<sub>2</sub>-induced oxidative stress in rBMSCs and whether the antioxidant mechanism of gigantol involves the phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt) pathway.</p>
</sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec>
<title/>
<sec>
<title>Chemicals and materials</title>
<p>Male 4-week-old Sprague-Dawley rats (n=10) weighing 80&#x2013;100 g were used in the present study and were obtained from Guangzhou Laboratory Animal Center, Guangzhou University of Chinese Medicine (Guangzhou, China). Low glucose Dulbecco&#x0027;s modified Eagle&#x0027;s medium (DMEM) and PBS were acquired from Gibco (Thermo Fisher Scientific, Inc., Waltham, MA, USA). H<sub>2</sub>O<sub>2</sub> was purchased from Guangzhou Chemical Reagent Factory (Guangzhou, China). Basal medium of Sprague-Dawley rat MSCs, fetal bovine serum (FBS), glutamine, penicillin-streptomycin and trypsin were purchased from Cyagen Biosciences, Inc. (Guangzhou, China). MTT and dimethyl sulfoxide were acquired from Sigma-Aldrich (Merck KGaA, Darmstadt, Germany). Gigantol was purchased from the National Institute for Food and Drug Control (cat. no. 111875; Beijing, China). The chemical structure of gigantol is presented in <xref rid="f1-mmr-17-02-3267" ref-type="fig">Fig. 1A</xref>. Annexin V-fluorescein isothiocyanate (FITC) apoptosis, Hoechst 33258 and reactive oxygen species (ROS) assay kits were provided by Nanjing KeyGen Biotech Co., Ltd. (Nanjing, China). The PI3K/Akt inhibitor LY294002 was purchased from Selleck Chemicals (Houston, TX, USA). All other chemicals were of analytical grade.</p>
</sec>
<sec>
<title>Isolation and culture of rBMSCs</title>
<p>MSCs were immediately isolated from the Sprague-Dawley rats as previously described, with minor modifications (<xref rid="b18-mmr-17-02-3267" ref-type="bibr">18</xref>). Briefly, Sprague-Dawley rats were sacrificed by cervical dislocation. The experimental procedures were approved by the Laboratory Animal Committee of Guangdong Province (Guangzhou, China). All treatments on animals were performed in accordance with the Guide for the Care and Use of Laboratory Animals (<xref rid="b19-mmr-17-02-3267" ref-type="bibr">19</xref>). The femurs and tibias of rats were carefully cleaned of adherent soft tissue, the marrow was harvested and flushed with serum-free DMEM with 1&#x0025; penicillin-streptomycin until the bone washed pale. Cells were resuspended in DMEM medium with 10&#x0025; FBS and 1&#x0025; penicillin -streptomycin of Sprague-Dawley rBMSCs at 37&#x00B0;C with 5&#x0025; CO<sub>2</sub> After being allowed to attach for 24 h, hematopoietic and non-adherent cells were removed by changing the medium. Subsequently, rBMSCs were harvested for the experiments described below between the second and third passage. Cells were pretreated with gigantol for 12 h followed by treatment with H<sub>2</sub>O<sub>2</sub> for 2 h, both at room temperature. To determine the effect of LY294002, cells were pretreated with LY294002 (25 &#x00B5;mol/l) for 1 h at room temperature, followed by the treatments with gigantol and H<sub>2</sub>O<sub>2</sub>.</p>
</sec>
<sec>
<title>Cell viability assay</title>
<p>Cells were seeded in 96-well plates (1&#x00D7;10<sup>5</sup> cells/ml) for 24 h at room temperature. To determine the effects of gigantol and H<sub>2</sub>O<sub>2</sub> on rBMSC viability, cells were treated with 1, 10, 40, 80 and 100 &#x00B5;M gigantol for 12 h, or 400, 500, 600, 700, 800 and 900 &#x00B5;M H<sub>2</sub>O<sub>2</sub> for 2 h, respectively. As a control, cells were treated with DMEM medium only. Furthermore, in another cell viability assay, cells were pretreated with different concentrations of gigantol (1, 10, 40, 80 and 100 &#x00B5;M) for 12 h followed by treatment with 600 &#x00B5;M H<sub>2</sub>O<sub>2</sub> for 2 h, both at room temperature. Subsequently, 20 &#x00B5;l MTT was added to each well and incubated at 37&#x00B0;C for 4 h prior to removal and addition of 100 &#x00B5;l dimethyl sulfoxide. The absorbance value was measured in a microplate reader (Bio-Rad Laboratories, Inc., Hercules, CA, USA) at 490 nm. Statistical analysis was performed on absorbance value readings.</p>
</sec>
<sec>
<title>Assessment of morphological changes</title>
<p>Cells were cultured in 24-well plates (5&#x00D7;10<sup>5</sup> cells/well) and treated with 80 &#x00B5;M gigantol for 12 h followed by the addition of 600 &#x00B5;M H<sub>2</sub>O<sub>2</sub> for 2 h. Cells in the H<sub>2</sub>O<sub>2</sub> group were treated with 600 &#x00B5;M H<sub>2</sub>O<sub>2</sub> only. Cells were fixed with 4&#x0025; paraformaldehyde for 10 min and washed with PBS twice prior to staining with Hoechst 33258 for 5 min at 4&#x00B0;C in the dark. Condensed nuclei and cell shrinkage were observed using an inverted and fluorescence microscope (Leica Microsystems GmbH, Wetzlar, Germany). A bright blue stain indicated apoptotic cell nuclei.</p>
</sec>
<sec>
<title>Measurement of ROS</title>
<p>Cells were cultured in 6-well plates (1&#x00D7;10<sup>6</sup> cells/well) and treated with 80 &#x00B5;M gigantol for 12 h followed by the addition of 600 &#x00B5;M H<sub>2</sub>O<sub>2</sub> for 2 h, both at room temperature. Cells in the H<sub>2</sub>O<sub>2</sub> group were treated with 600 &#x00B5;M H<sub>2</sub>O<sub>2</sub> only. Cells were stained with 10 &#x00B5;M 2&#x2032;7&#x2032;-dichlorofluorescin diacetate (DCFH-DA) diluted with serum-free medium at 37&#x00B0;C for 20 min and later washed with serum-free medium three times. Fluorescence intensity was analyzed using a microplate reader (Bio-Rad Laboratories, Inc.) at excitation and emission wavelengths of 488 and 525 nm, respectively. Images were captured using a fluorescence microscope (Leica Microsystems GmbH). The absorbance values were obtained for statistical analysis.</p>
</sec>
<sec>
<title>Flow cytometric analysis of cell apoptosis</title>
<p>Cells were seeded in 6-well plates (1&#x00D7;10<sup>6</sup> cells/well) for 24 h and and treated with 80 &#x00B5;M gigantol for 12 h followed by the addition of 600 &#x00B5;M H<sub>2</sub>O<sub>2</sub> for 2 h. Cells in the H<sub>2</sub>O<sub>2</sub> group were treated with 600 &#x00B5;M H<sub>2</sub>O<sub>2</sub> only. Subsequently, cells were harvested and washed twice using PBS, and were resuspended in 500 &#x00B5;l binding buffer. Annexin V-FITC stock (5 &#x00B5;l) and propidium iodide solution (5 &#x00B5;l) was added to the cells and incubated for 10 min at room temperature in the dark, and immediately analyzed using flow cytometer (BD FACSCanto II). The percentage of apoptotic cells was obtained for statistical analysis.</p>
</sec>
<sec>
<title>Protein extraction and western blot analysis</title>
<p>Cells were seeded in 6-well plates (1&#x00D7;10<sup>6</sup> cells/well) for 24 h and treated with 80 &#x00B5;M gigantol for 12 h followed by the addition of 600 &#x00B5;M H<sub>2</sub>O<sub>2</sub> for 2 h, both at room temperature. Cells in the H<sub>2</sub>O<sub>2</sub> group were treated with 600 &#x00B5;M H<sub>2</sub>O<sub>2</sub> only. Cells in the gigantol &#x002B; H<sub>2</sub>O<sub>2</sub> &#x002B; LY294002 group were pretreated with LY294002 (25 &#x00B5;mol/l) for 1 h prior to gigantol with H<sub>2</sub>O<sub>2</sub> treatment. Subsequently, cells were washed with PBS and lysed in cold radioimmunoprecipitation assay lysis buffer (Beyotime Institute of Biotechnology, Haimen, China) with protein inhibitor. Cellular proteins were collected and their concentrations were determined using a Bradford assay. Equal amounts of protein (40 &#x00B5;g/lane) were separated on 15&#x0025; SDS-polyacrylamide gels and transferred onto polyvinylidene difluoride membranes via electrophoresis. After blocking with tris-buffered saline (TBS) containing 5&#x0025; skimmed milk and 0.05&#x0025; Tween-20 for 1 h at room temperature, the membranes were incubated with the following primary antibodies: p-Akt (ser 473; cat. no. Sc7985r; 1:100; Santa Cruz Biotechnology, Inc., Dallas, TX, USA), Akt (ser 473; cat. no. Sc8312; 1:200; Santa Cruz Biotechnology, Inc.), B-cell lymphoma-2 (Bcl-2)-associated X (Bax; cat. no. 2772; 1:1,000; CST Biological Reagents Co., Ltd., Shanghai, China), Bcl-2 (cat. no. 2872; 1:1,000; CST Biological Reagents Co., Ltd.), Caspase-3 (cat. no. 9662; 1:1,000; CST Biological Reagents Co., Ltd.), Caspase-9 (cat. no. 9504; 1;1,000; CST Biological Reagents Co., Ltd.) and &#x03B2;-actin (cat. no. sc58673; Santa Cruz Biotechnology, Inc.) at 4&#x00B0;C overnight. After washing with TBS three times, the membranes were incubated with goat anti-rabbit immunoglobulin G antibodies conjugated with horseradish peroxidase (cat. no. 111-035-003; 1:1,000; Jackson Immuno Research Laboratories, Inc., West Grove, PA, USA) for 1 h at room temperature. Following three washes with TBS-Tween-20, the intensity of bands was visualized using an enhanced chemiluminescence western blotting kit (Merck KGaA) and quantified by densitometric analysis with ImageJ software (version 3.0; National Institutes of Health, Bethesda, MD, USA).</p>
</sec>
<sec>
<title>Statistical analysis</title>
<p>All experiments were conducted at least three times. Data are presented as the mean &#x002B; standard error of the mean. Differences among groups were analyzed by one-way analysis of variance, followed by Dunnett&#x0027;s post-hoc test, using SPSS version 20 (IBM Corp., Armonk, NY, USA). P&#x003C;0.05 was considered to indicate a statistically significant difference.</p>
</sec>
</sec>
</sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title/>
<sec>
<title>Gigantol inhibits H<sub>2</sub>O<sub>2</sub>-induced inhibition of cell viability in rBMSCs</title>
<p>To determine an appropriate concentration of gigantol, cells were treated with gigantol (1, 10, 40, 80 and 100 &#x00B5;M), and the results indicated that none of these concentrations exhibited a damaging effect on cell viability (<xref rid="f1-mmr-17-02-3267" ref-type="fig">Fig. 1B</xref>). Cell viability was reduced in a dose-dependent manner when treated with 400, 500, 600, 700 and 800 &#x00B5;M H<sub>2</sub>O<sub>2</sub> for 2 h, compared with the control group. H<sub>2</sub>O<sub>2</sub> at the concentration of 600 &#x00B5;M significantly reduced cell viability compared with the control by 51.6&#x00B1;3.2&#x0025; (<xref rid="f1-mmr-17-02-3267" ref-type="fig">Fig. 1C</xref>). In addition, results in <xref rid="f1-mmr-17-02-3267" ref-type="fig">Fig. 1D</xref> demonstrated that gigantol significantly increased the cell viability of rBMSCs in a dose-dependent manner compared with cells treated with H<sub>2</sub>O<sub>2</sub> only. Furthermore, pretreatment with 80 &#x00B5;M gigantol significantly enhanced cell viability compared with the H<sub>2</sub>O<sub>2</sub> only group (<xref rid="f1-mmr-17-02-3267" ref-type="fig">Fig. 1D</xref>). Concentrations of gigantol &#x003E;80 &#x00B5;M reduced the stimulatory effect. Therefore, 600 &#x00B5;M H<sub>2</sub>O<sub>2</sub> and 80 &#x00B5;M gigantol were selected for the following experiments.</p>
</sec>
<sec>
<title>Assessment of morphological changes</title>
<p>Following treatment with H<sub>2</sub>O<sub>2</sub>, apoptosis-associated morphology was observed in rBMSCs, including detachment, irregular shape and nuclear shrinkage. However, the number of apoptosis-like cells decreased in the group pretreated with gigantol, which indicated a potential protective effect of gigantol from apoptosis induction (<xref rid="f2-mmr-17-02-3267" ref-type="fig">Fig. 2A and B</xref>).</p>
</sec>
<sec>
<title>Detection of ROS</title>
<p>Cellular oxidative stress was examined by a DCFH-DA assay. The results demonstrated that, in the H<sub>2</sub>O<sub>2</sub>-treated group, a significant increase in 2&#x2032;,7&#x2032;-dichlorofluorescein fluorescence was observed (<xref rid="f2-mmr-17-02-3267" ref-type="fig">Fig. 2C and D</xref>). However, pretreatment with gigantol significantly reduced the intracellular production of ROS compared with the H<sub>2</sub>O<sub>2</sub>-treated group (<xref rid="f2-mmr-17-02-3267" ref-type="fig">Fig. 2C and D</xref>).</p>
</sec>
<sec>
<title>Analysis of cell apoptosis</title>
<p>Cell apoptosis was analyzed using an Annexin V and propidium iodide double-staining assay by flow cytometry. The percentage of apoptotic cells in Q2 and Q4 increased from 0.5&#x00B1;0.45&#x0025; in the control group to 49.5&#x00B1;3.30&#x0025; in the H<sub>2</sub>O<sub>2</sub> group, while apoptosis was significantly reduced to 23.4&#x00B1;2.06&#x0025; in the gigantol &#x002B; H<sub>2</sub>O<sub>2</sub> group, compared with the H<sub>2</sub>O<sub>2</sub> only group (<xref rid="f3-mmr-17-02-3267" ref-type="fig">Fig. 3</xref>).</p>
</sec>
<sec>
<title>Gigantol activates the PI3K/Akt pathway</title>
<p>The results of western blot analysis demonstrated that H<sub>2</sub>O<sub>2</sub> treatment reduced the protein levels of phosphorylated (p)-Akt and the antiapoptotic protein Bcl-2 (<xref rid="f4-mmr-17-02-3267" ref-type="fig">Fig. 4A and B</xref>), and increased the levels of the proapoptotic proteins Bax, caspase-3 and caspase-9 (<xref rid="f4-mmr-17-02-3267" ref-type="fig">Fig. 4B-D</xref>). However, gigantol pretreatment lowered the caspase-3, caspase-9 and Bax levels, and increased the levels of p-Akt and Bcl-2, compared with the H<sub>2</sub>O<sub>2</sub> only group (<xref rid="f4-mmr-17-02-3267" ref-type="fig">Fig. 4</xref>). Furthermore, LY294002 (a PI3K inhibitor) significantly inhibited the protective effect of gigantol against H<sub>2</sub>O<sub>2</sub>-induced apoptosis by increasing the levels of caspase-3, caspase-9 and the ratio of Bax/Bcl-2, and decreasing the ratio of p-Akt/Akt (<xref rid="f4-mmr-17-02-3267" ref-type="fig">Fig. 4</xref>).</p>
</sec>
</sec>
</sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>Previous studies have reported that the transplantation of human or rat MSCs led to a substantial functional improvement in stroke treatment (<xref rid="b20-mmr-17-02-3267" ref-type="bibr">20</xref>&#x2013;<xref rid="b22-mmr-17-02-3267" ref-type="bibr">22</xref>). However, the low survival rate of MSCs that are transplanted for the treatment of an ischemic myocardium indicates that the hypoxic microenvironment may impair the survival of MSCs. H<sub>2</sub>O<sub>2</sub> has successfully been used to induce oxidative stress, which led to cell apoptosis and mimicked the hypoxic microenvironment of the ischemic brain (<xref rid="b23-mmr-17-02-3267" ref-type="bibr">23</xref>&#x2013;<xref rid="b25-mmr-17-02-3267" ref-type="bibr">25</xref>). In addition, Sun <italic>et al</italic> (<xref rid="b26-mmr-17-02-3267" ref-type="bibr">26</xref>) employed a H<sub>2</sub>O<sub>2</sub>-induced cytotoxicity model of BMSCs to investigate damage induced by oxidative stress.</p>
<p>We previously reported that gigantol is abundant in <italic>Dendrobium aurantiacum</italic> among the herbal medicines grouped as Huangcao Shihu, which includes <italic>Dendrobium nobile</italic>, <italic>Dendrobium fimbriatum</italic> and <italic>Dendrobium aurantiacum</italic> (<xref rid="b27-mmr-17-02-3267" ref-type="bibr">27</xref>). It is uncommon for such high concentrations of active compounds to occur naturally within plants; therefore, gigantol may be of clinical value if beneficial effects are observed. The present study, to the best of our knowledge, is the first to indicate that gigantol may have protective activities against ischemic diseases, as MTT and flow cytometry results demonstrated that gigantol inhibited H<sub>2</sub>O<sub>2</sub>-induced cell apoptosis in rBMSCs. Furthermore, gigantol reduced the generation of ROS in H<sub>2</sub>O<sub>2</sub>-treated rBMSCs, which indicates that gigantol may exhibit beneficial antiapoptotic activities through inhibition of ROS generation.</p>
<p>A previous report demonstrated that extracellular H<sub>2</sub>O<sub>2</sub> enhanced intracellular concentrations of ROS, which subsequently inactivated p-Akt (<xref rid="b28-mmr-17-02-3267" ref-type="bibr">28</xref>). In the present study, treatment of MSCs with H<sub>2</sub>O<sub>2</sub> led to decreased levels of p-Akt, indicating that the PI3K/Akt signaling pathway may be inhibited in MSCs following exposure to H<sub>2</sub>O<sub>2</sub>. In the present study, treatment with gigantol activated the expression of p-Akt in H<sub>2</sub>O<sub>2</sub>-induced rBMSCs. Previous studies have demonstrated that the PI3K/Akt pathway is involved in various biological processes, including cell growth, survival and apoptosis, and also has roles in cell metabolism, proliferation and migration (<xref rid="b29-mmr-17-02-3267" ref-type="bibr">29</xref>&#x2013;<xref rid="b31-mmr-17-02-3267" ref-type="bibr">31</xref>).</p>
<p>PI3K/Akt is reported to prevent cell apoptosis by reducing the expression of various proapoptotic proteins, including caspase-3, caspase-9 and Bax, and by elevating the levels of the antiapoptotic protein Bcl-2 (<xref rid="b32-mmr-17-02-3267" ref-type="bibr">32</xref>). These results are consistent with those of an earlier report, which indicated that PI3K-Akt signaling increased the intracellular levels of ROS and activated the proapoptotic proteins caspase-3, caspase-9 and Bax, and inhibited the expression of Bcl-2 (<xref rid="b33-mmr-17-02-3267" ref-type="bibr">33</xref>). The results of the current study demonstrated that H<sub>2</sub>O<sub>2</sub> treatment increased the Bax/Bcl-2 ratio, and caspase-3 and caspase-9 protein expression, in rBMSCs. However, pretreatment with gigantol suppressed the Bax/Bcl-2 ratio, and caspase-3 and caspase-9 levels, which indicates that gigantol may protect against rBMSC apoptosis via the PI3K/Akt signaling pathway. Furthermore, LY294002, a specific PI3K/Akt inhibitor, blocked the protective effects of gigantol. These results confirmed that PI3K/Akt may be activated by gigantol to protect rBMSCs from H<sub>2</sub>O<sub>2</sub>-induced apoptosis.</p>
<p>In conclusion, the present study demonstrated that gigantol significantly inhibited H<sub>2</sub>O<sub>2</sub>-induced apoptosis in rBMSCs. The protective effect of gigantol was accompanied by reductions in intracellular ROS generation, the expression ratio of Bax/Bcl-2, and caspase-3 and caspase-9 protein expression, in addition to increases in the ratio of p-Akt/Akt and Bcl-2 expression. Therefore, gigantol may have the potential to be developed as a protective agent for the clinical treatment of patients with ischemic diseases. Regarding the utilization of gigantol in ischemic stroke, however, further <italic>in vitro</italic> and <italic>in vivo</italic> experiments are required to investigate the effect of gigantol on transport and differentiation in rBMSCs.</p>
</sec>
</body>
<back>
<ack>
<title>Acknowledgements</title>
<p>The present study was financially supported by the Special Foundation of 2015 High Level University Construction (grant no. 2050205), the Special Foundation of High Level University Construction of Guang Zhou University of Chinese Medicine (grant no. A1-AFD018171Z11024) and the Science and Technology Planning Project of Guangdong Province (grant no. 2013B060400022).</p>
</ack>
<glossary>
<def-list>
<title>Abbreviations</title>
<def-item><term>rBMSCs</term><def><p>rat bone marrow mesenchymal stem cells</p></def></def-item>
<def-item><term>Bcl-2</term><def><p>B-cell lymphoma-2</p></def></def-item>
<def-item><term>Bax</term><def><p>Bcl-2-associated X</p></def></def-item>
<def-item><term>H<sub>2</sub>O<sub>2</sub></term><def><p>hydrogen peroxide</p></def></def-item>
<def-item><term>PI3K</term><def><p>phosphatidylinositol 3-kinase</p></def></def-item>
<def-item><term>Akt</term><def><p>protein kinase B</p></def></def-item>
<def-item><term>ROS</term><def><p>reactive oxygen species</p></def></def-item>
</def-list>
</glossary>
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<floats-group>
<fig id="f1-mmr-17-02-3267" position="float">
<label>Figure 1.</label>
<caption><p>Effect of gigantol on the cell viability of rat bone marrow mesenchymal stem cells, as determined by MTT assays. (A) Chemical structure of gigantol. (B) Cells were cultured with various concentrations of gigantol for 12 h. (C) Cell viability was reduced dose-dependently following treatment of cells with 400, 500, 600, 700, 800 and 900 &#x00B5;M H<sub>2</sub>O<sub>2</sub>. (D) Cell viability was increased dose-dependently in cells that were pretreated with various concentrations of gigantol followed by 600 &#x00B5;M H<sub>2</sub>O<sub>2</sub> treatment. &#x002A;P&#x003C;0.05 and &#x002A;&#x002A;P&#x003C;0.01 vs. control group. <sup>#</sup>P&#x003C;0.05 and <sup>##</sup>P&#x003C;0.01 vs. H<sub>2</sub>O<sub>2</sub> only group. H<sub>2</sub>O<sub>2</sub>, hydrogen peroxide.</p></caption>
<graphic xlink:href="MMR-17-02-3267-g00.tif"/>
</fig>
<fig id="f2-mmr-17-02-3267" position="float">
<label>Figure 2.</label>
<caption><p>Effect of gigantol on apoptosis-associated morphology in rBMSCs. (A) Gigantol markedly decreased the amount of rBMSCs with apoptosis-associated morphologies induced by H<sub>2</sub>O<sub>2</sub>, as observed using an inverted microscope. (B) Gigantol protected rBMSCs from H<sub>2</sub>O<sub>2</sub>-induced morphological alterations, as observed by fluorescence microscopy using Hoechst 33258 staining. (C) Gigantol decreased the ROS levels in rBMSCs treated with H<sub>2</sub>O<sub>2</sub>, as determined by observing dichlorofluorescein fluorescence using fluorescence microscopy. (D) ROS levels were quantified in rBMSCs treated with H<sub>2</sub>O<sub>2</sub> with or without gigantol by analyzing the fluorescence intensity with a microplate reader. Magnification, 640x. &#x002A;&#x002A;P&#x003C;0.01 vs. control group. <sup>#</sup>P&#x003C;0.05, as indicated. rBMSCs, rat bone marrow mesenchymal stem cells; H<sub>2</sub>O<sub>2</sub>, hydrogen peroxide; ROS, reactive oxygen species.</p></caption>
<graphic xlink:href="MMR-17-02-3267-g01.tif"/>
</fig>
<fig id="f3-mmr-17-02-3267" position="float">
<label>Figure 3.</label>
<caption><p>The effect of gigantol on rat bone marrow mesenchymal stem cell apoptosis was determined by Annexin V/PI staining. (A) Representative flow cytometry plots following Annexin V/PI staining in control, H<sub>2</sub>O<sub>2</sub> and gigantol &#x002B; H<sub>2</sub>O<sub>2</sub> groups. (B) Apoptosis rates were statistically analyzed. The percentage of apoptotic cells in the H<sub>2</sub>O<sub>2</sub> only group was 49.5&#x00B1;3.30&#x0025;, while gigantol significantly reduced the percentage to 23.4&#x00B1;2.06&#x0025; in Q2 and Q4. &#x002A;&#x002A;P&#x003C;0.01 vs. control group. <sup>##</sup>P&#x003C;0.01, as indicated. PI, propidium iodide; H<sub>2</sub>O<sub>2</sub>, hydrogen peroxide.</p></caption>
<graphic xlink:href="MMR-17-02-3267-g02.tif"/>
</fig>
<fig id="f4-mmr-17-02-3267" position="float">
<label>Figure 4.</label>
<caption><p>The effect of gigantol and LY294002 on the expression of apoptosis-associated proteins was investigated by western blot analysis. (A) Exposure of rBMSCs to 80 &#x00B5;M gigantol significantly increased the expression of p-Akt compared with the H<sub>2</sub>O<sub>2</sub> only group, while LY294002 reduced the increase in p-Akt. Akt was used as an internal control and densitometric analysis indicates the p-Akt/Akt ratio. (B) Gigantol pretreatment attenuated H<sub>2</sub>O<sub>2</sub>-induced upregulation of Bax and downregulation of Bcl-2, and these effects were reversed by the application of LY294002. &#x03B2;-actin was used as an internal control and densitometric analysis indicates the Bax/Bcl-2 ratio. (C) Gigantol inhibited the protein expression of caspase-3 in H<sub>2</sub>O<sub>2</sub>-induced rBMSCs and LY294002 reversed this inhibition partially. &#x03B2;-actin was used as an internal control. (D) Gigantol suppressed the expression of caspase-9 in H<sub>2</sub>O<sub>2</sub>-induced rBMSCs, while LY294002 reversed the inhibition partially. &#x03B2;-actin was used as an internal control. &#x002A;&#x002A;P&#x003C;0.01 vs. H<sub>2</sub>O<sub>2</sub> group; <sup>#</sup>P&#x003C;0.05 and <sup>##</sup>P&#x003C;0.01, as indicated. rBMSCs, rat bone marrow mesenchymal stem cells; p-, phosphorylated-; Akt, protein kinase B; H<sub>2</sub>O<sub>2</sub>, hydrogen peroxide; Bcl-2, B-cell lymphoma-2; Bax, Bcl-2-associated X; actin, &#x03B2;-actin.</p></caption>
<graphic xlink:href="MMR-17-02-3267-g03.tif"/>
</fig>
</floats-group>
</article>