Misoprostol modulates cytokine expression through a cAMP pathway: Potential therapeutic implication for liver disease

Clin Immunol. 2015 Dec;161(2):291-9. doi: 10.1016/j.clim.2015.09.008. Epub 2015 Sep 25.

Abstract

Dysregulated cytokine metabolism plays a critical role in the pathogenesis of many forms of liver disease, including alcoholic and non-alcoholic liver disease. In this study we examined the efficacy of Misoprostol in modulating LPS-inducible TNFα and IL-10 expression in healthy human subjects and evaluated molecular mechanisms for Misoprostol modulation of cytokines in vitro. Healthy subjects were given 14day courses of Misoprostol at doses of 100, 200, and 300μg four times a day, in random order. Baseline and LPS-inducible cytokine levels were examined ex vivo in whole blood at the beginning and the end of the study. Additionally, in vitro studies were performed using primary human PBMCs and the murine macrophage cell line, RAW 264.7, to investigate underlying mechanisms of misoprostol on cytokine production. Administration of Misoprostol reduced LPS inducible TNF production by 29%, while increasing IL-10 production by 79% in human subjects with no significant dose effect on ex vivo cytokine activity; In vitro, the effect of Misoprostol was largely mediated by increased cAMP levels and consequent changes in CRE and NFκB activity, which are critical for regulating IL-10 and TNF expression. Additionally, chromatin immunoprecipitation (ChIP) studies demonstrated that Misoprostol treatment led to changes in transcription factor and RNA Polymerase II binding, resulting in changes in mRNA levels. In summary, Misoprostol was effective at beneficially modulating TNF and IL-10 levels both in vivo and in vitro; these studies suggest a potential rationale for Misoprostol use in ALD, NASH and other liver diseases where inflammation plays an etiologic role.

Keywords: CREB; ChIP; Inflammation; Liver disease; NFκB; cAMP.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Abdominal Pain / chemically induced
  • Animals
  • Anti-Ulcer Agents / adverse effects
  • Anti-Ulcer Agents / pharmacology
  • Cell Line
  • Cells, Cultured
  • Cyclic AMP / metabolism*
  • Cytokines / blood
  • Cytokines / genetics
  • Cytokines / metabolism*
  • Diarrhea / chemically induced
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Gene Expression / drug effects
  • Humans
  • Interleukin-10 / genetics
  • Interleukin-10 / metabolism
  • Leukocytes, Mononuclear / drug effects
  • Leukocytes, Mononuclear / metabolism
  • Lipopolysaccharides / pharmacology
  • Liver Diseases / drug therapy
  • Liver Diseases / genetics
  • Liver Diseases / metabolism
  • Macrophages / drug effects
  • Macrophages / metabolism
  • Male
  • Mice
  • Misoprostol / adverse effects
  • Misoprostol / pharmacology*
  • Nausea / chemically induced
  • Signal Transduction / drug effects*
  • Tumor Necrosis Factor-alpha / genetics
  • Tumor Necrosis Factor-alpha / metabolism

Substances

  • Anti-Ulcer Agents
  • Cytokines
  • Lipopolysaccharides
  • Tumor Necrosis Factor-alpha
  • Misoprostol
  • Interleukin-10
  • Cyclic AMP