Chronic liver damage of diverse etiologies can lead to hepatic fibrosis, a condition that, untreated, may escalate to cirrhosis and hepatocellular carcinoma. Presently, the therapeutic armamentarium lacks a specific medication for hepatic fibrosis, with a plethora of candidate drugs in various stages of research and development. As such, an unmet clinical demand persists for a potent pharmaceutical agent capable of effectively addressing liver fibrosis [20, 21]. Interestingly, KA, as a lavandulyl flavonoid compound isolated from the traditional Chinese medicine Sophora flavescens, have showned a hepatoprotective effect on CCl4-induced acute liver injury in mice through its antioxidant and anti-inflammatory activities [16]. Hepatic disorders exhibit a spectrum of progressive stages, ranging from initial liver injury to fibrosis, cirrhosis, and, in severe cases, hepatocellular carcinoma. The gradation of severity and the underlying pathophysiological mechanisms vary significantly across the different phases of liver disease [22]. Therefore, it is not clear whether KA can reduce liver fibrosis. Interestingly, this study found that KA can inhibit the excessive accumulation of liver fibrosis markers (α-SMA, fibronectin and collagen I) in activated LX-2 cells and improve liver fibrosis by regulating the TGF-β/Smads signaling pathway.(Fig. 6).
Central to the pathogenesis of liver fibrosis is the activation and subsequent proliferation of hepatic stellate cells (HSCs), which are considered a key factor. The present study is designed to assess the efficacy of KA in ameliorating liver fibrosis potentially by inhibiting these cellular activities [23, 24]. Initially, a cell model of liver fibrosis was successfully established by TGF-β1-induced LX-2 cells. Subsequently, the results showed that a total of 11 compounds had a significant inhibitory effect on the proliferation of LX-2 cells and their IC50 was between 4–40 µM by MTS assay. Among them, three compounds (Xanthohumol (8), Isoliquiritigenin (9) and Luteolin (24)) have been reported to have anti-hepatic fibrosis activity [25–27], and KA, as a new structural compound with anti-hepatic injury effect isolated from Sophora flavescens, has been focused on and studied in depth from two aspects of inhibiting the proliferation and activation of HSCs.
Upon activation, HSCs demonstrate the capacity for proliferation and migration, and are responsible for the biosynthesis of key ECM proteins such as fibronectin and collagen I, in conjunction with the secretion of the contractile protein α-SMA. The presence of α-SMA is widely regarded as a diagnostic marker for HSCs activation. The synthesis and secretion of collagen I and fibronectin by fibroblasts, when in excessive amounts, typify the pathological alterations associated with the development of liver fibrosis [28]. In the current study, cell scratch, RT-qPCR and Western blotting results showed that KA could inhibit the migration of activated LX-2 cells and the mRNA and protein levels of Fibronectin, Collagen I and α-SMA in a dose-dependent manner. These results indicate that KA can directly act on activated HSCs, thereby reducing liver fibrosis in vivo. In pursuit of a more profound understanding of the mechanisms by which KA suppresses the activation of LX-2 cells, the investigators have harnessed the power of transcriptomic technologies. This approach aims to uncover the molecular targets and biological pathways that are implicated in KA's therapeutic efficacy against hepatic fibrosis. Finally, it was found that the mechanism of KA against liver fibrosis was closely related to TGF-β/Smads signaling pathway. The TGF-β1/Smads signaling pathway is pivotal in the activation of HSCs and is central to the pathogenesis of liver fibrosis, characterized by the aberrant deposition of ECM components. TGF-β is acknowledged as a key cytokine that orchestrates the transition of HSCs into a more fibrogenic state. Activation of TGF-β1 triggers the phosphorylation of Smad2/3, resulting in the formation of phosphorylated Smad2/3 (p-Smad2/3). This active form then complexes with Smad4, leading to nuclear translocation and subsequent activation of gene transcription for ECM proteins [29, 30]. Therefore, exogenous molecules that disrupt TGF-β/Smads signaling to inhibit HSCs activation may be potential anti-hepatic fibrosis drugs. The study conducted by the research team has provided evidence that KA exerts an inhibitory effect on the protein levels of TGF-β1 and Smad4, and alters the ratio of phosphorylated to total Smad2/3 within LX-2 cells. This suggests a potential mechanism by which KA could suppress the activation of HSCs, specifically LX-2 cells, by impeding the TGF-β1/Smads signaling pathway. Consequently, this intervention may lead to an improvement in the condition of liver fibrosis.
In summary, this study explored the effect of KA on LX-2 cells activation and proliferation through a preliminary in vitro experiment. This pioneering work has, for the first time, established that KA can attenuate the activation of LX-2 cells and curb the unwarranted buildup of ECM by interfering with the TGF-β/Smads signaling pathways, thereby potentially ameliorating liver fibrosis. The implications of these results are that KA may be a promising candidate for the therapeutic intervention of liver fibrosis. Consequently, the study contributes novel and scientifically rigorous insights, providing a foundation and catalyst for future research into the anti-fibrotic properties of KA.
Ackonwledgments This research was funded by Guizhou Provincial Science and Technology [NO. ZK (2022)-362; NO. ZK (2024)-047; [NO.2024-023]. The Innovation and Entrepreneurship Training Program for Undergraduates from China [NO.202210660131, 202310660082], Science Foundation of Guizhou Education Technology [NO.2022-064], University Engineering Research Center for the Prevention and Treatment of Chronic Diseases by Authentic Medicinal Materials in Guizhou Province ([2023]035).
Auther’s contribution CXJ, Investigation, Data Curation, Writing-Original Draft, WritingReview & Editing, Validation; TB, Validation, Formal analysis, Investigation; HMH, Validation, Investigation, Visualization; ZX, Methodology, Investigation; LSG, Project administration, Funding Acquisition; LZ, Methodology, Visualization; ZZ, Methodology, Investigation; LQD, Methodology, Project administration, Writing-Review & Editing; LY, Supervision, Conceptualization, Writing-Review & Editing, Funding acquisition. All authors reviewed the manuscript.