The present study aimed at investigating the neuroprotective actions of EA on ROT-induced DA neuronal damage and the underlying mechanisms as well. Results demonstrated that EA conferred neuroprotection against ROT-induced DA neurotoxicity. Activation of astroglial Nrf2 signaling was involved in EA-mediated DA neuroprotection, as evidenced by the following observations. First, EA activated Nrf2 signaling pathway in ROT-induced DA neuronal damage. Second, EA generated neuroprotection with the presence of astroglia and silence of Nrf2 in astroglia abolished EA-mediated neuroprotection. Third, EA failed to produce DA neuroprotection in Nrf2 knockout mice. Together, these results suggested EA-generated DA neuroprotection might be attributable to the activation of Nrf2 signaling in astroglia.
Oxidative stress has been considered as the central pathological event in the development of PD [19, 20]. For survival and development of neurons, the maintenance of redox homeostasis in the CNS was indispensable [21]. Nrf2 was an oxidative defense transcription factor which mitigated the toxic neuronal effects of parkinsonian agents, such as ROT, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and 6-hydroxydopamine (6-OHDA) in vivo and in vitro [22]. Here, this study found that EA protected DA neurons, activated Nrf2 signaling pathway and initiated the Nrf2 stressor mechanism for its transfer from cytosol to the nucleus (Figs. 1 and 2). Further study indicated that EA-elicited neuroprotection were abolished in Nrf2 knockout mice (Fig. 6). These results suggested that EA-enhanced DA neuronal survival was dependent on Nrf2 activation.
Encouraged by the activation of Nrf2 signaling by EA, we further investigated Nrf2 signaling in which cell type participated in EA-mediated neuroprotection. It is interesting to note that EA targeted astroglia to produce neuroprotection since this protection was just indicated in the presence of astroglia (Fig. 3). Astroglia is the most abundant cell type in the brain [23]. They interacted with neurons in various aspects of signaling transmission, immune and oxidative defense, ion and water homeostasis, metabolite supply and neuroprotection [24]. In neurological disorders, astroglia themselves formed a defense barrier and promoted neuroprotection by producing anti-oxidants against inflammation, especially for excessive extracellular release of the excitatory neurotransmitter glutamate [25]. Stimulation of sulforaphane also prolonged Nrf2-mediated gene expression in astrocytes and prevented neuronal damage caused by superoxide [26]. In addition, besides anti-oxidants, astrocytes could release neurotrophic factors, such as BDNF and GDNF-mediated activation of the Nrf2 pathway in astrocytes, which increased the survival of DA neurons [27]. Recent research indicated that Nrf2-ARE pathway was preferentially activated in astrocytes, HO-1 and NQO1were strongly expressed in astrocytes, sometime microglia, with more infrequent expression in neurons [28, 29]. Nevertheless, Pharmacological activation and overexpression of Nrf2 in astrocytes also clearly demonstrated its therapeutic potential for PD. In the mouse model of α-synuclein mutation, the specific overexpression of astrocyte Nrf2 was regulated, which improved the movement and non-motor dysfunction of the whole CNS, and delayed the process of α-synuclein aggregation [30]. Also, Nrf2 overexpressed in astrocytes kept mice from mutated α-synuclein to protect DA neurons [31]. Additionally, transplantation of astrocytes overexpressing Nrf2 into mouse striatum protected from DA neuronal loss [32]. Therefore, this was an important strategy for the support of neuroprotective functions of astrocytes to enhance neuronal survival and improve PD symptoms.
A large amount of evidence suggested Nrf2 activators could protect neurons and decrease the accumulation of aberrant proteins in vitro and in vivo in different neurodegenerative mouse models. In clinic, melatonin was found to activate Nrf2 to rescue hippocampal bioenergetics and improve cognitive function [33]. At present, the clinical trials on Nrf2 activators for the treatment of neurodegenerative diseases were increasing [34]. For example, pinostrobin could release HO-1 through Nrf2 activation to alleviate MPTP-induced neuronal loss in SN, and relieved zebra fish behavioral deficit disorder, and provided potential neuroprotective effects in vivo [25]. Moreover, Glaucocalyxin B was discerned to inhibit TLR/NF-κB pathway activation and induce Nrf2/HO-1 activation and further produce neuroprotection [35]. Also, dimethyl fumarate enhanced Nrf2 activation, thereby playing an important role in the defense of MPTP-induced loss of DA neurons in the SN [36]. In short, new Nrf2-based treatments might be considered as a viable strategy for future potential. Thus, this study found EA exhibited a promising therapeutic efficacy for PD via activating Nrf2 signaling pathway. These findings suggested that modulation of Nrf2 signaling by potential candidates, such as EA, might be beneficial for PD treatment. Despite this optimistic perspective for future administration of EA potential treatment for PD, most of the findings were derived from experimental models and in vitro data and therefore need be rigorously corroborated in clinical trials in future.