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<?release-delay 0|0?>
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">ETM</journal-id>
<journal-title-group>
<journal-title>Experimental and Therapeutic Medicine</journal-title>
</journal-title-group>
<issn pub-type="ppub">1792-0981</issn>
<issn pub-type="epub">1792-1015</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">ETM-28-2-12606</article-id>
<article-id pub-id-type="doi">10.3892/etm.2024.12606</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Articles</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Anti‑inflammatory effects of methanol extract from <italic>Peperomia dindygulensis</italic> Miq. mediated by HO‑1 in LPS‑induced RAW 264.7 cells</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Min</surname><given-names>Won-Hong</given-names></name>
<xref rid="af1-ETM-28-2-12606" ref-type="aff">1</xref>
<xref rid="af2-ETM-28-2-12606" ref-type="aff">2</xref>
<xref rid="fn1-ETM-28-2-12606" ref-type="author-notes">&#x002A;</xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Ko</surname><given-names>Chae-Yeon</given-names></name>
<xref rid="af1-ETM-28-2-12606" ref-type="aff">1</xref>
<xref rid="af2-ETM-28-2-12606" ref-type="aff">2</xref>
<xref rid="fn1-ETM-28-2-12606" ref-type="author-notes">&#x002A;</xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Kim</surname><given-names>Hyemin</given-names></name>
<xref rid="af1-ETM-28-2-12606" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Kwon</surname><given-names>Hyuk-Kwon</given-names></name>
<xref rid="af1-ETM-28-2-12606" ref-type="aff">1</xref>
<xref rid="af2-ETM-28-2-12606" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Jang</surname><given-names>Hyun-Jae</given-names></name>
<xref rid="af3-ETM-28-2-12606" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Bach</surname><given-names>Tran The</given-names></name>
<xref rid="af4-ETM-28-2-12606" ref-type="aff">4</xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Han</surname><given-names>Le Ngoc</given-names></name>
<xref rid="af4-ETM-28-2-12606" ref-type="aff">4</xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Lee</surname><given-names>Jeong-Hyung</given-names></name>
<xref rid="af5-ETM-28-2-12606" ref-type="aff">5</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Kim</surname><given-names>Hyo-Jin</given-names></name>
<xref rid="af1-ETM-28-2-12606" ref-type="aff">1</xref>
<xref rid="af2-ETM-28-2-12606" ref-type="aff">2</xref>
<xref rid="c1-ETM-28-2-12606" ref-type="corresp"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Hwangbo</surname><given-names>Cheol</given-names></name>
<xref rid="af1-ETM-28-2-12606" ref-type="aff">1</xref>
<xref rid="af2-ETM-28-2-12606" ref-type="aff">2</xref>
<xref rid="c1-ETM-28-2-12606" ref-type="corresp"/>
</contrib>
</contrib-group>
<aff id="af1-ETM-28-2-12606"><label>1</label>Division of Life Science, College of Natural Sciences, Gyeongsang National University, Jinju-si, Gyeongsang 52828, Republic of Korea</aff>
<aff id="af2-ETM-28-2-12606"><label>2</label>Division of Applied Life Science (BK21 Four) and Research Institute of Life Sciences, Gyeongsang National University, Jinju-si, Gyeongsang 52828, Republic of Korea</aff>
<aff id="af3-ETM-28-2-12606"><label>3</label>Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheonju-si, Chungcheongbuk-do 28116, Republic of Korea</aff>
<aff id="af4-ETM-28-2-12606"><label>4</label>Institute of Ecology and Biological Resources, Vietnam Academy of Science and Technology, Cau Giay, Hanoi 01211, Vietnam</aff>
<aff id="af5-ETM-28-2-12606"><label>5</label>Department of Biochemistry (BK21 Four), College of Natural Sciences, Kangwon National University, Chuncheon, Gangwon 24414, Republic of Korea</aff>
<author-notes>
<corresp id="c1-ETM-28-2-12606"><italic>Correspondence to:</italic> Dr Hyo-Jin Kim or Professor Cheol Hwangbo, Division of Life Science, College of Natural Sciences, Gyeongsang National University, 501 Jinju-daero, Jinju-si, Gyeongsang 52828, Republic of Korea <email>chwangbo@gnu.ac.kr hjin4477@gnu.ac.kr </email></corresp>
<fn id="fn1-ETM-28-2-12606"><p><sup>&#x002A;</sup>Contributed equally</p></fn>
</author-notes>
<pub-date pub-type="collection">
<month>08</month>
<year>2024</year></pub-date>
<pub-date pub-type="epub">
<day>14</day>
<month>06</month>
<year>2024</year></pub-date>
<volume>28</volume>
<issue>2</issue>
<elocation-id>317</elocation-id>
<history>
<date date-type="received">
<day>08</day>
<month>11</month>
<year>2023</year>
</date>
<date date-type="accepted">
<day>26</day>
<month>04</month>
<year>2024</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright: &#x00A9; 2024 Min et al.</copyright-statement>
<copyright-year>2024</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>Inflammation serves as a multifaceted defense mechanism activated by pathogens, cellular damage and irritants, aiming to eliminate primary causes of injury and promote tissue repair. <italic>Peperomia dindygulensis</italic> Miq<italic>.</italic> (<italic>P. dindygulensis</italic>), prevalent in Vietnam and southern China, has a history of traditional use for treating cough, fever and asthma. Previous studies on its phytochemicals have shown their potential as anti-inflammatory agents, yet underlying mechanisms remain to be elucidated. The present study investigated the regulatory effects of <italic>P. dindygulensis</italic> on the anti-inflammatory pathways. The methanol extracts of <italic>P. dindygulensis</italic> (PDME) were found to inhibit nitric oxide (NO) production and induce heme oxygenase-1 (HO-1) expression in murine macrophages. While MAPKs inhibitors, such as SP600125, SB203580 and U0126 did not regulate HO-1 expression, the treatment of cycloheximide, a translation inhibitor, reduced HO-1. Furthermore, PDME inhibited lipopolysaccharide (LPS)-induced inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) and TNF-&#x03B1; expression at both the mRNA and protein levels. The activity of NOS and the expression of TNF-&#x03B1;, iNOS and COX-2 decreased in LPS-stimulated Raw 264.7 cells treated with PDME and this effect was regulated by inhibition of HO-1 activity. These findings suggested that PDME functions as an HO-1 inducer and serves as an effective natural anti-inflammatory agent in LPS-induced inflammation.</p>
</abstract>
<kwd-group>
<kwd><italic>P. dindygulensis</italic></kwd>
<kwd>anti-inflammatory effect</kwd>
<kwd>nitric oxide</kwd>
<kwd>heme oxygenase-1</kwd>
<kwd>macrophage</kwd>
</kwd-group>
<funding-group>
<funding-statement><bold>Funding:</bold> The present study was funded by grants from the National Research Foundation (NRF) of Korea (grant no. NRF-2021R1C1C1006516). It was supported by the Technology Innovation Program (grant no. 20022828; Research and Development of micronized human acellular dermal matrix preserving collagen and growth factor for soft tissue filling) funded by the Ministry of Trade, Industry &#x0026; Energy (MOTIE, Korea).</funding-statement>
</funding-group>
</article-meta>
</front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Inflammation is a complex biological defense system activated by a pathogen, damaged cells and irritants (<xref rid="b1-ETM-28-2-12606" ref-type="bibr">1</xref>,<xref rid="b2-ETM-28-2-12606" ref-type="bibr">2</xref>). The inflammatory response eliminates the initial cause of cell damage, necrosis of cells and tissues damaged by the inflammatory process and initiates tissue repair (<xref rid="b3-ETM-28-2-12606" ref-type="bibr">3</xref>). The inflammatory process is regulated by various cell types, including macrophages, neutrophils, eosinophils and mononuclear phagocytes (<xref rid="b4-ETM-28-2-12606" ref-type="bibr">4</xref>,<xref rid="b5-ETM-28-2-12606" ref-type="bibr">5</xref>). Macrophages are associated with the initiation and maintenance of inflammation, the presentation of antigens and the production of cytokines and growth factors (<xref rid="b6-ETM-28-2-12606" ref-type="bibr">6</xref>). Therefore, the regulation of macrophages is essential for controlling the overall immune response.</p>
<p>Heme oxygenase 1 (HO-1) is an enzyme responsible for degrading heme into carbon monoxide, biliverdin and iron, playing crucial roles as a tissue homeostatic regulator, immune function regulator and inflammatory attenuator (<xref rid="b7-ETM-28-2-12606 b8-ETM-28-2-12606 b9-ETM-28-2-12606" ref-type="bibr">7-9</xref>). Multiple isozymes of HO-1 and HO-2 have been identified, each encoded by different gene (<xref rid="b10-ETM-28-2-12606" ref-type="bibr">10</xref>). While HO-2 is predominantly expressed in the brain and testicles and remains unstimulated by receptors or metabolism (<xref rid="b10-ETM-28-2-12606 b11-ETM-28-2-12606 b12-ETM-28-2-12606" ref-type="bibr">10-12</xref>), HO-1, characterized by low basal expression levels in most cells and tissues, undergoes marked elevation in response to heme substrate and various stress such as UV light, lipopolysaccharides (LPS) or hydrogen peroxide (<xref rid="b13-ETM-28-2-12606" ref-type="bibr">13</xref>,<xref rid="b14-ETM-28-2-12606" ref-type="bibr">14</xref>). Carbon monoxide produced by HO-1 plays an anti-inflammatory role by inhibiting the secretion of LPS-induced inflammatory cytokines including TNF-&#x03B1;, interleukin (IL)-1&#x03B2; and IL-6. Additionally, it induces IL-10, which is known for its anti-inflammatory properties, in macrophages (<xref rid="b15-ETM-28-2-12606 b16-ETM-28-2-12606 b17-ETM-28-2-12606 b18-ETM-28-2-12606" ref-type="bibr">15-18</xref>). When exposed to damage and injury, tissues activate macrophages and produce prostaglandin E2 (PGE2) via cyclooxygenase-2 (COX-2), and nitric oxide (NO) via inducible nitric oxide synthase (iNOS) (<xref rid="b19-ETM-28-2-12606" ref-type="bibr">19</xref>). Increased HO-1 expression inhibits LPS-mediated expression of COX-2 and iNOS, thereby inhibiting PGE2 and NO production (<xref rid="b20-ETM-28-2-12606" ref-type="bibr">20</xref>,<xref rid="b21-ETM-28-2-12606" ref-type="bibr">21</xref>). Although it has been reported that HO-1 induces NO during cellular senescence, the induction of HO-1 inhibits iNOS to reduce NO by oxidative injury (<xref rid="b22-ETM-28-2-12606" ref-type="bibr">22</xref>). CO and biliverdin, the products of HO-1, are also known to inhibit iNOS (<xref rid="b23-ETM-28-2-12606 b24-ETM-28-2-12606 b25-ETM-28-2-12606" ref-type="bibr">23-25</xref>). Therefore, controlling HO-1 expression is pivotal in modulating anti-inflammatory responses.</p>
<p><italic>Peperomia dindygulensis</italic> Miq<italic>.</italic> (<italic>P. dindygulensis</italic>), a commonly found herb in southern China, has been used in folk medicine to address various ailments, including cough, asthma, phthisis and a range of cancers, such as stomach, lung, breast and liver cancer (<xref rid="b26-ETM-28-2-12606" ref-type="bibr">26</xref>). The ethanol extract of <italic>P. dindygulensis</italic> repressed the growth of the lung cancer cell lines A549 and Lovo (<xref rid="b5-ETM-28-2-12606" ref-type="bibr">5</xref>). Some compounds found in the extract demonstrate activity that hampers the growth of liver cancer cells (<xref rid="b27-ETM-28-2-12606" ref-type="bibr">27</xref>). Moreover, <italic>P. dindygulensis</italic> ethanol extracts have demonstrated the capacity to inhibit cell growth and impede angiogenesis at specific concentrations in human umbilical vein endothelial cells (HUVECs) (<xref rid="b28-ETM-28-2-12606" ref-type="bibr">28</xref>,<xref rid="b29-ETM-28-2-12606" ref-type="bibr">29</xref>). No studies, to the best of the authors&#x0027; knowledge, have explored the regulatory effects of <italic>P. dindygulensis</italic> methanol extract (PDME) on inflammatory responses in raw 264.7 cells.</p>
<p>The present study demonstrated that PDME acts as an anti-inflammatory effector in macrophages. This extract diminished NOS activity and inflammatory factor expression, such as iNOS, Cox-2 and TNF-&#x03B1;, in LPS-induced macrophages. The anti-inflammatory effects of PDME are contingent upon the HO-1 translation level. Based on these results, a new role was identified for PDME in inducing anti-inflammatory reactions through the regulation of the expression of HO-1.</p>
</sec>
<sec sec-type="Materials|methods">
<title>Materials and methods</title>
<sec>
<title/>
<sec>
<title>Cell culture</title>
<p>RAW 264.7 and U937 cells were purchased from the American Type Culture Collection (cat. nos. TIB-71 and CRL-1593.2). RAW 264.7 cells were cultured in Dulbecco&#x0027;s modified Eagle&#x0027;s medium (Welgene, Inc.; cat. no. LM 001-05) containing 10&#x0025; fetal bovine serum (GenDEPOT, LLC; cat. no. F0900-050) and 1&#x0025; penicillin/streptomycin (Lonza Group, Ltd.; cat. no. 17-602E). U937 cells (<xref rid="b30-ETM-28-2-12606" ref-type="bibr">30</xref>,<xref rid="b31-ETM-28-2-12606" ref-type="bibr">31</xref>) were maintained in Dulbecco&#x0027;s modified Eagle&#x0027;s medium (Welgene, Inc.; cat. no. LM 001-05) containing 10&#x0025; fetal bovine serum (GenDEPOT, LLC; cat. no. F0900-050), 1&#x0025; penicillin/streptomycin (Lonza Group, Ltd.; cat. no. 17-602E) and 1&#x0025; beta-mercaptoethanol (cat. no. MER002; BioShop Canada, Inc.). After exposure to 10 ng/ml PMA (MilliporeSigma; cat. no. p8139) for 24 h and the U937 cells underwent differentiation and were washed to eliminate remaining PMA. HUVECs were purchased from PromoCell GmbH. HUVECs were maintained in medium M199 (MilliporeSigma; cat. no. M4530) containing 20&#x0025; fetal bovine serum, 30 &#x00B5;g/ml ECGS (Corning, Inc.; cat. no. 306006) and 100 &#x00B5;g/ml heparin (MilliporeSigma; cat. no. H3149). Cells were incubated in a humidified 5&#x0025; CO<sub>2</sub> atmosphere at 37&#x02DA;C incubator.</p>
</sec>
<sec>
<title>Plant material</title>
<p><italic>P. dindygulensis</italic> was obtained from the Thang Loi community, located in the Ha Lang district of Cao Bang Province, Vietnam, in July 2015. It was identified by Dr Tran The Bach, from the Institute of Ecology and Biological Resources in Hanoi, Vietnam. Voucher specimens labelled as VK 6535 were archived in the herbarium of the Korea Research Institute of Bioscience and Biotechnology. The dried whole plant (50 g) was pulverized and extracted with methanol (500 ml; HPLC grade) using an ultrasonic extractor (SDN-900H; Sungdong Ultrasonic Co., Ltd.). The ultrasonic extraction procedure was systematically conducted over 30 cycles, with each cycle comprising a 15 min extraction phase followed by a 120 min standby period to optimize extraction efficiency and prevent temperature elevation effects. After the <italic>P. dindygulensis</italic> methanol extract was filtered, it was then concentrated under reduced pressure, yielding 2.8 g of extract, which corresponds to a 5.6&#x0025; yield. The methanol extract of <italic>P. dindygulensis</italic> was supplied by the International Biological Material Research Center (cat. no. FBM259-078).</p>
</sec>
<sec>
<title>Reagents</title>
<p>SB203580 (cat. no. 559389), SP600125 (cat. no. 420119), U0126 (cat. no. U120), Cycloheximide (cat. no. 01810) and actinomycin D (cat. no. A1410) were purchased from MilliporeSigma. IX (ZnPP; cat. no. sc-200329) was purchased from Santa Cruz Biotechnology, Inc.</p>
</sec>
<sec>
<title>NOS assay</title>
<p>RAW 264.7 cells were seeded at a density of 1x10<sup>5</sup>/well in a 96-well plate and incubated for 24 h at 37&#x02DA;C. Cells were treated with PDME (10 &#x00B5;g/ml) or ZnPP (10 &#x00B5;M) at the indicated concentration and time, followed by treatment with LPS (1 &#x00B5;g/ml). After a 24 h-incubation at 37&#x02DA;C, 70 &#x00B5;l of the medium from each well was transferred to a new 96-well plate, mixed with 50 &#x00B5;l of Griess reagent (40 &#x00B5;g/&#x00B5;l; MilliporeSigma; cat. no. G4410) and incubated in a foil-wrapped plate for 15 min at room temperature. Absorbance was measured at 540 nm using Spark (Tecan Group, Ltd.). The amount of NO produced was calculated by using a standard curve.</p>
</sec>
<sec>
<title>MTT assay</title>
<p>RAW 264.7 cells were seeded at a density of 1x10<sup>5</sup>/well in a 96-well plate. HUVECs were seeded at a density of 0.5x10<sup>4</sup>/well in a 96-well plate. The cells were incubated for 24 h at 37&#x02DA;C. PDME treatment was administered at the indicated concentrations and times. Then, 20 &#x00B5;l of MTT reagents (Merck KGaA; cat. no. 475989) was added per 96-well plate, with reagents added to designated wells as a blank. After incubation for 3.5 h at 37&#x02DA;C, 100 &#x00B5;l DMSO solvent was added to each well. The foil-wrapped plate was incubated for 15 min at room temperature on the shaker, and then the absorbance was measured at 590 nm using a SPARK microplate reader (Tecan Group, Ltd.).</p>
</sec>
<sec>
<title>Western blot analysis and antibodies</title>
<p>For western blotting, proteins were extracted from cells lysed in lysis buffer &#x005B;50 mM Tris (pH 7.4), 150 nM NaCl, 1&#x0025; NP-40, 1 mM EDTA, protease/phosphatase inhibitor cocktail (Cell Signaling Technology, Inc.; cat. no. 5872S)&#x005D; for 30 min on ice and centrifuged at 21,000 x g for 15 min at 4&#x02DA;C. Protein quantification was performed using the Bradford reagent (Bio-Rad Laboratories, Inc.; cat. no. 5000006) using a microplate reader (Bio-Rad Laboratories, Inc.; model 680) and calculated using standard curves. The cell lysate (25 &#x00B5;g/lane) was loaded onto an 8-12&#x0025; sodium dodecyl sulfate-polyacrylamide gel and transferred to a polyvinylidene fluoride membrane (Bio-Rad Laboratories, Inc.; cat. no. 1620177). The membrane was blocked with a 5&#x0025; blocking reagent (GenomicBase; cat. no. SKI400) for 1 h at room temperature and then incubated with the specific primary antibody overnight at 4&#x02DA;C. The next day, the membrane was washed with PBS-T (0.2&#x0025; Tween 20) and incubated with the secondary antibody for 3 h at room temperature. After incubation, the blot was washed with PBS-T and developed with the Clarity ECL Substrate Kit (Bio-Rad Laboratories, Inc.; cat. no. 1705061) using KwikQuant Pro Imager (Kindle Biosciences, LLC; cat. no. D1010). To western blot using other antibody on the same membrane, the membrane was incubated with stripping buffer &#x005B;2&#x0025; SDS; 50 mM Tris (pH 6.8), 0.7&#x0025; &#x03B2;-mercaptoethanol&#x005D; for 10 min at 55&#x02DA;C. After incubation, the membrane was washed with PBS-T and every step repeated from blocking to detection. Phosphorylated (p-)JNK, p-p38 and p-ERK1/2 levels were semi-quantified using ImageJ software (version 1.53n; National Institutes of Health) and normalized to the intensity of JNK, p38 and ERK1/2.</p>
<p>The antibodies used were: HO-1 (1:500; cat. no. sc-390991), &#x03B2;-actin (1:2,000; cat. no. sc-47778), p-JNK (1:1,000; cat. no. sc-6254), JNK (1:1,000; cat. no. sc-7345), p-p38 (1:1,000; cat. no. sc-166182), p38 (1:1,000; cat. no. sc-7972), p-ERK1/2 (1:1,000; cat. no. sc-7383), ERK1/2 (1:1,000; cat. no. sc-514302), &#x03B1;-tubulin (1:1,000; cat. no. sc-58666), iNOS (1:1,000; cat. no. sc-7271) and COX-2 (1:1,000; cat. no. sc-514489). All antibodies were anti-mouse IgG and purchased from Santa Cruz Biotechnology, Inc. The mouse secondary antibody (HRP-linked antibody) was purchased from Cell Signaling Technology, Inc. (1:2,000; cat. no. 7076S).</p>
</sec>
<sec>
<title>Reverse transcription-quantitative (RT-q) PCR</title>
<p>The cells were seeded at a density of 1x10<sup>4</sup> in a 6-cm plate and incubated for 24 h at 37&#x02DA;C. Cells were treated with PDME (10 &#x00B5;g/ml) or ZnPP (10 &#x00B5;M) for 1 h at 37&#x02DA;C, followed by treatment with LPS (1 &#x00B5;g/ml) for 24 h at 37&#x02DA;C. Total RNA for analysis was obtained using NucleoSpin RNA (Macherey-Nagel; cat. no. 740955.250) according to the manufacturer&#x0027;s instructions. RNA (1 &#x00B5;g) was used for complementary DNA synthesis using an iScript cDNA Synthesis Kit (Bio-Rad Laboratories, Inc.; cat. no. BR-170-8891). The reverse transcription reaction was performed at 37&#x02DA;C for 1 h and then terminated at 95&#x02DA;C for 5 min. RT-PCR analysis was performed with cDNA and specific gene primers using IQ SYBR Green Supermix (Bio-Rad Laboratories, Inc.; cat. no. BR1708882). Primers sequence for RT-qPCR were; HO-1, 5&#x0027;-TGAACACTCTGGAGATGACA-3&#x0027; (sense) and 5&#x0027;-AACAGGAAGCTGAGAGTGAG-3&#x0027; (antisense); TNF-a, 5&#x0027;-CAGGAGGGAGAACAGAAACTCCA-3&#x0027; (sense) and 5&#x0027;-CCTGGTTGGCTGCTTGCTT-3&#x0027; (antisense); iNOS, 5&#x0027;-TGCATGGACCAGTATAAGGCAAGC-3&#x0027; (sense) and 5&#x0027;-CTCCTGCCCACTGAGTTCGTC-3&#x0027; (antisense); COX-2, 5&#x0027;-CCACTTCAAGGGAGTCTGGA-3&#x0027; (sense) and 5&#x0027;-AGTCATCTGCTACGGGAGGA-3&#x0027; (antisense); GAPDH, 5&#x0027;-CATCACTGCCACCCAGAAGACTG-3&#x0027; (sense) and 5&#x0027;-ATGCCAGTGAGCTTCCCGTTCAG-3&#x0027; (antisense). Pre-denaturation step was conducted at 95&#x02DA;C for 3 min, followed by denaturation and extension steps at 95&#x02DA;C for 15 sec and 60&#x02DA;C for 1 min, respectively, repeated for 40 cycles in a Rotor-Gene Q (Qiagen GmbH). RT-qPCR experiments were repeated three times independently. The RNA expression was calculated using the 2<sup>-&#x0394;&#x0394;Cq</sup> method (<xref rid="b32-ETM-28-2-12606" ref-type="bibr">32</xref>).</p>
</sec>
<sec>
<title>TNF-&#x03B1; ELISA</title>
<p>To measure the secretion level of TNF-&#x03B1;, Mouse TNF-&#x03B1; Quantikine ELISA Kit was used (R&#x0026;D Systems, Inc.; cat. no. MTA00B) according to the manufacturer&#x0027;s protocol. First, the standard reagent was prepared and the cultured medium obtained from control, LPS-treatment and LPS with PDME treatment cells. Diluent RD1-63 (50 &#x00B5;l) was added to each well and then 50 &#x00B5;l of standard or sample medium added per well. The plate was gently tapped to mix and incubated at room temperature for 2 h with adhesive strips covering. Each well was washed four times with 400 &#x00B5;l wash buffer. The wash buffer was completely removed and 100 &#x00B5;l Mouse TNF-&#x03B1; conjugate added to each well. The wells were incubated at room temperature for 2 h while covered with adhesive strips. After incubation, each well was washed four times with 400 &#x00B5;l wash buffer. Substrate solution (100 &#x00B5;l) was added to each well and the foil-wrapped plates were incubated for 30 min at room temperature. Stop solution (100 &#x00B5;l) was added to each well and gently tapped to mix thoroughly. Absorbance was measured at 450 nm using Spark (Tecan Group, Ltd.).</p>
</sec>
<sec>
<title>Statistical analysis</title>
<p>Statistical analyses were conducted using GraphPad Prism version 7.04 (Dotmatics). For multiple comparisons, data were subjected to one-way ANOVA followed by the Bonferroni post hoc test to generate adjusted P-values. For comparisons between two groups, data were analyzed using an unpaired two-tailed Student&#x0027;s t-test. Error bars in all graphs represent the means of SEM. P-value was denoted with symbols (<sup>&#x002A;</sup>P&#x003C;0.05, <sup>&#x002A;&#x002A;</sup>P&#x003C;0.005, <sup>&#x002A;&#x002A;&#x002A;</sup>P&#x003C;0.0005 and &#x2018;n.s&#x2019; indicating no significance). All statistical analyses were performed in triplicate. 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>Inhibition of NOS activity by PDME in murine macrophages</title>
<p>To evaluate the anti-inflammatory properties of PDME, the present study conducted a NOS activity assay in Raw264.7 cells. LPS stimulation increased NOS activity. However, the combination of PDME and LPS resulted in a dose-dependent reduction in NOS activity (<xref rid="f1-ETM-28-2-12606" ref-type="fig">Fig. 1A</xref>). Cell viability decreased only in cells treated with 20 &#x00B5;g/ml PDME, with no changes observed at other concentrations (<xref rid="f1-ETM-28-2-12606" ref-type="fig">Fig. 1B</xref>). Cell cytotoxicity was measured in HUVECs following treatment with the PDME, as there have been reports indicating its impact on endothelial cell viability (<xref rid="b29-ETM-28-2-12606" ref-type="bibr">29</xref>). However, it was confirmed that there was no cellular toxicity when treated with a concentration of 10 &#x00B5;g/ml for 24 h, indicating no impairment in endothelial cell function at the concentration demonstrating anti-inflammatory activity (<xref rid="SD1-ETM-28-2-12606" ref-type="supplementary-material">Fig. S1</xref>). Collectively, these findings suggested that PDME exerted anti-inflammatory effects on LPS-stimulated Raw264.7 cells.</p>
</sec>
<sec>
<title>PDME induces HO-1 expression</title>
<p>HO-1 induces anti-inflammatory reactions in macrophages (<xref rid="b21-ETM-28-2-12606" ref-type="bibr">21</xref>). Therefore, the present study tested whether PDME induced HO-1 expression in Raw264.7 cells. The expression of HO-1 gradually increased with increasing treatment doses of PDME from 1-10 &#x00B5;g/ml over 24 h (<xref rid="f2-ETM-28-2-12606" ref-type="fig">Fig. 2A</xref>). Time course experiments conducted with 10 &#x00B5;g/ml PDME showed an increasing HO-1 protein level 1 h post-treatment, followed by a steady increase in expression up to 24 h (<xref rid="f2-ETM-28-2-12606" ref-type="fig">Fig. 2B</xref>). Furthermore, when human monocytic leukemia cells U937 were differentiated and treated with 10 &#x00B5;g/ml of PDME at various time points or with PDME ranging from 1-10 &#x00B5;g/ml for 24 h, the expression of HO-1 increased similarly to the previous results (<xref rid="SD2-ETM-28-2-12606" ref-type="supplementary-material">Fig. S2A</xref> and <xref rid="SD2-ETM-28-2-12606" ref-type="supplementary-material">B</xref>). These results indicated that PDME modulated HO-1 expression in murine macrophages and human monocytic leukemia cells.</p>
</sec>
<sec>
<title>Regulation of HO-1 expression by PDME at the translation level</title>
<p>The expression of HO-1 is primarily controlled at the transcriptional level through the MAPK signaling pathways, including JNK, ERK and p38 kinase (<xref rid="b33-ETM-28-2-12606" ref-type="bibr">33</xref>). Therefore, the present study investigated the mRNA levels of HO-1 in a time- and dose-dependent manner upon PDME treatment in Raw264.7 cells. Notably, PDME treatment did not alter HO-1 mRNA expression (<xref rid="f3-ETM-28-2-12606" ref-type="fig">Fig. 3A</xref> and <xref rid="f3-ETM-28-2-12606" ref-type="fig">B</xref>). To determine whether the inhibition of MAPKs regulates the PDME-induced increase in HO-1 expression, Raw264.7 cells were treated with specific inhibitors: JNK inhibitor SP600125, p38 inhibitor SB203580, or MEK inhibitor U0126 (<xref rid="f3-ETM-28-2-12606" ref-type="fig">Fig. 3C</xref>). Treatment with these inhibitors and PDME partly affected HO-1 expression. In addition, PDME treatment did not affect the expression or activity of JNK, p38 and ERK1/2 (<xref rid="f3-ETM-28-2-12606" ref-type="fig">Fig. 3D</xref> and <xref rid="f3-ETM-28-2-12606" ref-type="fig">E</xref>). Furthermore, the present study examined whether PDME-induced changes in HO-1 expression occurred at the transcriptional or translational level by co-treating cells with actinomycin D (ActD) and cycloheximide (CHX) (<xref rid="f3-ETM-28-2-12606" ref-type="fig">Fig. 3F</xref>). While the expression of HO-1 remained unaffected when the transcription inhibitor ActD was administered, PDME-induced HO-1 expression was diminished when the translation inhibitor CHX was used. Collectively, these findings indicated that PDME specifically regulates HO-1 expression at the translational level.</p>
</sec>
<sec>
<title>PDME suppresses the expression of iNOS, COX-2 and TNF-&#x03B1; induced by LPS</title>
<p>The present study investigated the effect of PDME treatment on the expression levels of iNOS, COX-2 and TNF-&#x03B1; stimulated by LPS. The combination of PDME with LPS for 24 h resulted in a notable decrease in the mRNA expression of iNOS, COX-2 and TNF-&#x03B1; in Raw 264.7 cells (<xref rid="f4-ETM-28-2-12606" ref-type="fig">Fig. 4A</xref>). Furthermore, LPS-induced protein expression of iNOS and COX-2 was attenuated following PDME treatment for either 24 h (<xref rid="f4-ETM-28-2-12606" ref-type="fig">Fig. 4B</xref>) or 6 h (<xref rid="SD3-ETM-28-2-12606" ref-type="supplementary-material">Fig. S3</xref>). In addition, even in U937 cells, the expression of iNOS and COX-2 stimulated by LPS was reduced with PDME treatment (<xref rid="SD2-ETM-28-2-12606" ref-type="supplementary-material">Fig. S2C</xref>). The secretion of TNF-&#x03B1;, which was increased by LPS, is also decreased by treatment with 10 &#x00B5;g/ml PDME for 24 h (<xref rid="f4-ETM-28-2-12606" ref-type="fig">Fig. 4C</xref>). These findings demonstrated that PDME effectively reduced both mRNA and protein expression levels of iNOS, COX-2 and TNF-&#x03B1; induced by LPS treatment.</p>
</sec>
<sec>
<title>Inhibition of HO-1 activity suppresses the anti-inflammatory effect stimulated by PDME</title>
<p>In RAW 264.7, PDME demonstrated its anti-inflammatory effect by upregulating HO-1 expression. To establish whether the anti-inflammatory function induced by PDME was mediated by HO-1, the inflammatory response following treatment with ZnPP, a specific inhibitor of HO-1 was assessed. The increase in NO levels induced by LPS decreased when PDME was administered concurrently, whereas NO levels increased when ZnPP was administered as a pretreatment (<xref rid="f5-ETM-28-2-12606" ref-type="fig">Fig. 5A</xref>). Additionally, the mRNA expression of iNOS, COX-2 and TNF-&#x03B1; was analyzed under identical conditions and it was verified that the inflammatory factors induced by PDME were reduced by the addition of ZnPP (<xref rid="f5-ETM-28-2-12606" ref-type="fig">Fig. 5B</xref>). These findings strongly indicated that the anti-inflammatory response triggered by PDME relies on HO-1 in macrophages.</p>
</sec>
</sec>
</sec>
<sec sec-type="Discussion">
<title>Discussion</title>
<p><italic>P. dindygulensis</italic>, a traditional medicinal herb from southern China, has historically been employed to alleviate conditions such as cough, asthma and pharyngitis (<xref rid="b26-ETM-28-2-12606" ref-type="bibr">26</xref>). Previous reports have highlighted the anticancer properties of compounds extracted from <italic>P. dindygulensis</italic>, particularly against lung and liver cancers (<xref rid="b5-ETM-28-2-12606" ref-type="bibr">5</xref>,<xref rid="b27-ETM-28-2-12606 b28-ETM-28-2-12606 b29-ETM-28-2-12606" ref-type="bibr">27-29</xref>). Despite the close relationship between its anticancer properties and its anti-inflammatory function, there has been limited investigation into the anti-inflammatory effects of natural products derived from <italic>P. dindygulensis</italic>. Traditionally, <italic>P. dindygulensis</italic> has been recognized for its pharmacological effectiveness in diseases associated with inflammation. Studies have indicated that treatment with an ethanol extract of this plant alleviate atherosclerosis by inhibiting the formation of the NOD-like receptor pyrin 3 inflammasome (<xref rid="b26-ETM-28-2-12606" ref-type="bibr">26</xref>,<xref rid="b34-ETM-28-2-12606" ref-type="bibr">34</xref>,<xref rid="b35-ETM-28-2-12606" ref-type="bibr">35</xref>). Furthermore, Lin <italic>et al</italic> (<xref rid="b28-ETM-28-2-12606" ref-type="bibr">28</xref>) demonstrated the potential for the structural constituents of ethanol extracts to act as regulators of the IFN-&#x03B3;/STAT1 and IL-6/STAT3 pathway. Treatment of endothelial cells with the ethanol extract reduced angiogenic ability, such as tube formation (<xref rid="b29-ETM-28-2-12606" ref-type="bibr">29</xref>). However, the efficacy of the methanol extract is unknown and changes in representative factors of the inflammatory response, such as HO-1 and NO, have not yet been studied. Hence, the objective of the present study was to investigate the anti-inflammatory effects and underlying mechanism of action of a methanol extract derived from <italic>P. dindygulensis</italic> against LPS-induced inflammation. While the anticancer effects are closely linked to its anti-inflammatory properties, the extent of the anti-inflammatory effects of PDME remain relatively unexplored.</p>
<p>LPS binds to Toll-like receptor 4, triggering inflammatory signals and inducing the expression and secretion of pro-inflammatory cytokines such as TNF-&#x03B1;, IL-1&#x03B2; and IL-6 (<xref rid="b36-ETM-28-2-12606" ref-type="bibr">36</xref>,<xref rid="b37-ETM-28-2-12606" ref-type="bibr">37</xref>). Upon stimulation by LPS, macrophages activate inflammatory pathways including NF-&#x03BA;B, MAPKs and AKT through Toll-like receptor 4, leading to the secretion of various pro-inflammatory mediators such as NO, PGE2, iNOS and COX-2 (<xref rid="b38-ETM-28-2-12606" ref-type="bibr">38</xref>,<xref rid="b39-ETM-28-2-12606" ref-type="bibr">39</xref>). HO-1, an enzyme that catalyzes heme degradation, is a potent protective enzyme upregulated in response to various cellular stress conditions (<xref rid="b4-ETM-28-2-12606" ref-type="bibr">4</xref>). HO-1 and its by-product, carbon monoxide, both possess anti-inflammatory activity by inhibiting LPS-induced expression of NO, PGE2, iNOS and COX-2 (<xref rid="b20-ETM-28-2-12606" ref-type="bibr">20</xref>,<xref rid="b21-ETM-28-2-12606" ref-type="bibr">21</xref>). Natural extracts exert their anti-inflammatory effects by upregulating HO-1(<xref rid="b40-ETM-28-2-12606" ref-type="bibr">40</xref>).</p>
<p>The present study observed that the treatment of macrophages with PDME reduced LPS-induced NOS activity and increased HO-1 production in RAW 264.7 and U937 cells. HO-1 expression is subjected to regulation at the mRNA level by various transcription factors, including activator protein-1, NF-&#x03BA;B, hypoxia-inducible factor and notably, nuclear factor erythroid 2-related factor 2. Additionally, its regulation extends to the protein level (<xref rid="b41-ETM-28-2-12606" ref-type="bibr">41</xref>,<xref rid="b42-ETM-28-2-12606" ref-type="bibr">42</xref>). No significant changes were observed in HO-1 regulation by PDME at the mRNA level. The upregulation of HO-1 expression is typically associated with the activities of JNK, ERK and p38, which are the three representative kinases of the MAPK pathway. For instance, in mouse hepatocytes, sodium arsenite activates the JNK pathway to modulate HO-1 expression (<xref rid="b43-ETM-28-2-12606" ref-type="bibr">43</xref>). Similarly, HO-1 is upregulated in rat hepatocytes through both the JNK and p38 pathways (<xref rid="b43-ETM-28-2-12606" ref-type="bibr">43</xref>,<xref rid="b44-ETM-28-2-12606" ref-type="bibr">44</xref>). In chicken hepatoma cells, arsenite triggers the ERK and p38 pathways, leading to increased HO-1 expression (<xref rid="b45-ETM-28-2-12606" ref-type="bibr">45</xref>). However, in the present study, no significant changes in HO-1 expression were observed when MAPK inhibitors (JNK, p38 and MEK) were administered. Li <italic>et al</italic> (<xref rid="b46-ETM-28-2-12606" ref-type="bibr">46</xref>) demonstrated that Fucoxanthin, a marine seaweed extract, exhibits anti-inflammatory effects by modulating pro-inflammatory factors and regulating TLR4/MyD88 signaling in RAW264.7 cells. Exposure to NO inhibits the activity of iron regulatory protein 1 and increases the expression of HO-1 in mouse lymphoma cells (<xref rid="b47-ETM-28-2-12606" ref-type="bibr">47</xref>). The increase in the mRNA levels of HO-1 upon complete inhibition of inducible HO-1 expression with NO scavenger treatment demonstrate the presence of a direct regulatory system for HO-1 against NO exposure (<xref rid="b48-ETM-28-2-12606" ref-type="bibr">48</xref>). The present study showed that resistance to LPS-induced inflammatory responses was not influenced by MAPK. These results demonstrated that PDME may trigger anti-inflammatory responses through TLR4 signaling or direct modulation of HO-1 and NO. The translation of HO-1 can be regulated through alternative mechanisms in the 5&#x0027;-untranslated region and HO-1 protein levels may be modulated via proteasomal degradation (<xref rid="b49-ETM-28-2-12606" ref-type="bibr">49</xref>,<xref rid="b50-ETM-28-2-12606" ref-type="bibr">50</xref>). The expression of HO-1 decreased with CHX treatment, a translation inhibitor, while it remained unaffected by ActD, a transcription inhibitor. These results suggested that PDME regulates HO-1 protein expression in macrophages.</p>
<p>Furthermore, PDME treatment exhibited its capacity to inhibit the LPS-induced increase in NO, COX-2 and TNF-&#x03B1;. Notably, the effect of PDME was negated by the administration of ZnPP, an HO-1 inhibitor. Collectively, these results indicated that PDME induces anti-inflammatory effects in macrophages by upregulating HO-1 expression. Additional investigation concentrating on the specific compounds present in PDME is necessary. Nevertheless, the present study highlighted the anti-inflammatory capacity of PDME and could aid in uncovering novel natural therapeutics.</p>
<p>The present study confirmed the anti-inflammatory effects of whole methanol extracts obtained from <italic>P. dindygulensis</italic>. Although this marks the first validation of the anti-inflammatory effect of PDME, to the best of the authors&#x0027; knowledge, this extract comprises various compounds. Therefore, it is necessary to analyze the distribution of individual compounds using experimental methods such as LC/MS and isolate them to ascertain their singular anti-inflammatory effect. The present study verified the anti-inflammatory effect of PDME against LPS-stimulated inflammation in human monocyte leukemia cells U937. PDME increased HO-1 expression and suppressed the upregulation of COX-2 and iNOS induced by LPS-mediated inflammation in U937 cells. However, further studies such as changes in the expression and release of TNF-&#x03B1; by PDME in U937 cells and effects by ZnPP are needed to identify clear efficacy in human cells. In addition, the effectiveness of PDME has not been confirmed in animal models. Verifying the anti-inflammatory effects of natural products in animal models will be an important step in confirming their effectiveness as well as their stability in organisms. These further investigations serve as a foundation for safer and more efficacious utilization of the anti-inflammatory properties of these extracts.</p>
</sec>
<sec sec-type="supplementary-material">
<title>Supplementary Material</title>
<supplementary-material id="SD1-ETM-28-2-12606" content-type="local-data">
<caption>
<title>PDME does not affect the viability of endothelial cells. HUVECs viability was evaluated in PDME-treated cells according to the indicated concentration for 24 h. Data are presented as the mean &#x00B1; SEM and statistically analyzed using t-test; n.s, not significant PDME 10 <italic>&#x03BC;</italic>g/ml vs. PDME 0 <italic>&#x03BC;</italic>g/ml. PDME, <italic>P. dindygulensis</italic> methanol extracts; HUVECs, human umbilical vein endothelial cells.</title>
</caption>
<media mimetype="application" mime-subtype="pdf" xlink:href="Supplementary_Data.pdf"/>
</supplementary-material>
<supplementary-material id="SD2-ETM-28-2-12606" content-type="local-data">
<caption>
<title>PDME induces HO-1 expression and reduces LPS-mediated iNOS and COX-2 expression in U937 cells. (A) Differentiated U937 cells treated with PDME indicated concentration for 24 h and HO-1 protein expression determined using western blotting. (B) The cells were treated with PDME (10 <italic>&#x03BC;</italic>g/ml) for the indicated time and HO-1 protein expression was determined using western blotting. (C) Differentiated U937 cells were pre-treated with PDME (10 <italic>&#x03BC;</italic>g/ml) for 30 min and treated with LPS (1 <italic>&#x03BC;</italic>g/ml) for 24 h. Next, the protein expression of iNOS and COX-2 was determined using western blotting. For control, the solution used for extraction and dilution was treated in equal amounts. PDME, <italic>P. dindygulensis</italic> methanol extracts; HO-1, heme oxygenase 1; LPS, lipopolysaccharides; COX-2, cyclooxygenins-2; iNOS. inducible nitric oxide synthase.</title>
</caption>
<media mimetype="application" mime-subtype="pdf" xlink:href="Supplementary_Data.pdf"/>
</supplementary-material>
<supplementary-material id="SD3-ETM-28-2-12606" content-type="local-data">
<caption>
<title>PDME reduces LPS-mediated iNOS and COX-2 expression. RAW246.7 cells were pre-treated with PDME (10 <italic>&#x03BC;</italic>g/ml) for 30 min and treated with LPS (1 <italic>&#x03BC;</italic>g/ml) for 6 h. For control, the solution used for extraction and dilution was treated in equal amounts. Next, the protein expression of iNOS and COX-2 was determined using western blotting. PDME, <italic>P. dindygulensis</italic> methanol extracts; LPS, lipopolysaccharides; iNOS. inducible nitric oxide synthase; COX-2, cyclooxygenins-2.</title>
</caption>
<media mimetype="application" mime-subtype="pdf" xlink:href="Supplementary_Data.pdf"/>
</supplementary-material>
</sec>
</body>
<back>
<ack>
<title>Acknowledgements</title>
<p>Not applicable.</p>
</ack>
<sec sec-type="data-availability">
<title>Availability of data and materials</title>
<p>The data generated in the present study may be requested from the corresponding author.</p>
</sec>
<sec>
<title>Authors&#x0027; contributions</title>
<p>WHM and CYK conducted the experiments. WHM, CYK and HJK validated and curated the data. HJJ, HJK and CH conceived and designed the study. HK, JHL, HJK and CH conceptualized and supervised the study. HJJ, JHL, HJK and CH wrote the original manuscript. TTB, LNH, HKK and HJK participated in the manuscript modification of the important points and analyzed the data. HJJ, TTB, LNH, HKK, HJK and CH confirm the authenticity of all the raw data. All authors read and approved the final manuscript.</p>
</sec>
<sec>
<title>Ethics approval and consent to participate</title>
<p>Not applicable.</p>
</sec>
<sec>
<title>Patient consent for publication</title>
<p>Not applicable.</p>
</sec>
<sec sec-type="COI-statement">
<title>Competing interests</title>
<p>The authors declare that they have no competing interests.</p>
</sec>
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<floats-group>
<fig id="f1-ETM-28-2-12606" position="float">
<label>Figure 1</label>
<caption><p>PDME reduce NOS activity in Raw246.7 cells. (A) NOS activity was measured in PDME-treated 264.7 cells at concentrations from 0 to 20 &#x00B5;g/ml for 1 h and then LPS (1 &#x00B5;g/ml) treatment for 24 h. For all controls, the solution used for extraction and dilution was treated in equal amounts. Data are presented with the mean &#x00B1; SEM and statistically analyzed using one-way ANOVA; <sup>&#x002A;</sup>P&#x003C;0.05, <sup>&#x002A;&#x002A;</sup>P&#x003C;0.005, <sup>&#x002A;&#x002A;&#x002A;</sup>P&#x003C;0.0005, vs. LPS only treated samples. (B) Cell viability was evaluated in PDME-treated cells at concentrations from 0-10 &#x00B5;g/ml for 24 h. Data are presented as the mean &#x00B1; SEM and statistically analyzed using one-way ANOVA; <sup>&#x002A;&#x002A;&#x002A;</sup>P&#x003C;0.0005, vs. PDME 0 &#x00B5;g/ml. PDME, <italic>P. dindygulensis</italic> methanol extracts; NOS, nitric oxide synthase; LPS, lipopolysaccharides.</p></caption>
<graphic xlink:href="etm-28-02-12606-g00.tif" />
</fig>
<fig id="f2-ETM-28-2-12606" position="float">
<label>Figure 2</label>
<caption><p>PDME induces HO-1 protein expression in dose- and time-dependent manner. (A) RAW264.7 cells were treated with PDME at concentrations ranging from 0-10 &#x00B5;g/ml for 24 h, followed by determination of HO-1 protein expression using western blotting. (B) The cells were treated with PDME (10 &#x00B5;g/ml) for time from 0-24 h. Next, HO-1 protein expression determined using western blotting. For all controls, the solution used for extraction and dilution was treated in equal amounts. PDME, <italic>P. dindygulensis</italic> methanol extracts; HO-1, heme oxygenase 1.</p></caption>
<graphic xlink:href="etm-28-02-12606-g01.tif" />
</fig>
<fig id="f3-ETM-28-2-12606" position="float">
<label>Figure 3</label>
<caption><p>PDME regulate HO-1 expression at the translation level. (A) The RNA expression of HO-1 was evaluated in PDME-treated cells with concentrations from 0-10 &#x00B5;g/ml for 24 h and (B) PDME (10 &#x00B5;g/ml)-treated cells with time from 0-24 h. For all controls, the solution used for extraction and dilution was treated in equal amounts. Data are presented as the mean &#x00B1; SEM and statistically analyzed using one-way ANOVA; n.s, not significant and <sup>&#x002A;</sup>P&#x003C;0.05 vs. control. (C) RAW246.7 cells were pre-treated with SP600125 (JNK inhibitor, 10 &#x00B5;M), SB203580 (p38 inhibitor, 10 &#x00B5;M), or U0126 (MEK inhibitor, 10 &#x00B5;M) for 30 min and treated with PBVN14063 (10 &#x00B5;g/ml) for 24 h. Subsequently, HO-1 protein expression was determined by western blotting using total lysate. (D) The cells were treated with PDME (10 &#x00B5;g/ml) for the indicated time (0-30 min), and the expression and phosphorylation levels of JNK, p38 and ERK1/2 were detected using western blotting. (E) Ratio of phospho-kinase/kinase semi-quantified using ImageJ. All data are presented as the mean &#x00B1; SEM and were statistically analyzed using one-way ANOVA with the Bonferroni post hoc test. (F) The cells were pre-treated with Act. D (50 ng/ml) or CHX (10 &#x00B5;g/ml) for 30 min and treated with PDME (10 &#x00B5;g/ml) for 3 h. Subsequently, HO-1 protein expression was determined by western blotting using total lysate. PDME, <italic>P. dindygulensis</italic> methanol extracts; HO-1, heme oxygenase 1; Act. D, actinomycin D; CHX, cycloheximide; n.s, not significant; p-, phosphorylated.</p></caption>
<graphic xlink:href="etm-28-02-12606-g02.tif" />
</fig>
<fig id="f4-ETM-28-2-12606" position="float">
<label>Figure 4</label>
<caption><p>PDME reduces LPS-mediated iNOS, COX-2 and TNF-&#x03B1; expression. (A) RAW246.7 cells were pre-treated with PDME (10 &#x00B5;g/ml) for 30 min and treated with LPS (1 &#x00B5;g/ml) for 24 h. For all controls, the solution used for extraction and dilution was treated in equal amounts. Next, the mRNA expression of iNOS, COX-2 and TNF-&#x03B1; was determined using RT-qPCR. Columns are presented with the mean &#x00B1; SEM and statistical analysis using one-way ANOVA; <sup>&#x002A;&#x002A;</sup>P&#x003C;0.005, <sup>&#x002A;&#x002A;&#x002A;</sup>P&#x003C;0.0005, Statistical analyses was compared among the columns shown using triplicate results. (B) RAW246.7 cells were pre-treated with PDME (10 &#x00B5;g/ml) for 30 min treated with LPS (1 &#x00B5;g/ml) for 24 h. Next, the protein expression of iNOS and COX-2 was determined using a western blotting. (C) The cells were pre-treated with PDME (10 &#x00B5;g/ml) for 30 min and treated with LPS for 24 h. Next, the incubation medium was obtained from cells and TNF-&#x03B1; secretion was detected using ELISA. Columns are presented with the mean &#x00B1; SEM and statistical analysis using one-way ANOVA. <sup>&#x002A;&#x002A;&#x002A;</sup>P&#x003C;0.0005. PDME, <italic>P. dindygulensis</italic> methanol extracts; LPS, lipopolysaccharides; iNOS. inducible nitric oxide synthase; COX-2, cyclooxygenins-2; RT-qPCR, reverse transcription-quantitative PCR.</p></caption>
<graphic xlink:href="etm-28-02-12606-g03.tif" />
</fig>
<fig id="f5-ETM-28-2-12606" position="float">
<label>Figure 5</label>
<caption><p>Inhibition of HO-1 activity decreases PDME-mediated anti-inflammatory effects in RAW264.7 cells. (A) The RAW264.7 cells were pre-treated with PDME (10 &#x00B5;g/ml) and ZnPP (10 &#x00B5;M) for 1 h. For all controls, the solution used for extraction and dilution was treated in equal amounts. NOS activity was measured in LPS (1 &#x00B5;g/ml) -stimulated cells for 24 h. (B) The cells were pre-treated with PDME (10 &#x00B5;g/ml) and ZnPP (10 &#x00B5;M) for 1 h and then stimulated with LPS (1 &#x00B5;g/ml) for 24 h. Next, the mRNA expression of iNOS, COX-2 and TNF-&#x03B1; were measured using RT-PCR. Data are presented as the mean &#x00B1; SEM and statistically analyzed using one-way ANOVA; <sup>&#x002A;&#x002A;</sup>P&#x003C;0.005, <sup>&#x002A;&#x002A;&#x002A;</sup>P&#x003C;0.0005. Statistical analyses were compared among the bars using triplicate results. HO-1, heme oxygenase 1; PDME, <italic>P. dindygulensis</italic> methanol extracts; NOS, nitric oxide synthase; LPS, lipopolysaccharides; iNOS. inducible nitric oxide synthase; COX-2, cyclooxygenins-2; RT-qPCR, reverse transcription-quantitative PCR.</p></caption>
<graphic xlink:href="etm-28-02-12606-g04.tif" />
</fig>
</floats-group>
</article>
