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Published ahead of print on October 1, 2009, doi:10.1164/rccm.200903-0324OC

Am. J. Respir. Crit. Care Med., Volume 180, Number 12, December 2009, 1196-1207

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Submitted on March 2, 2009
Accepted on September 30, 2009

Heightened Endoplasmic Reticulum Stress in COPD Lungs: The Role of Nrf2-Regulated Proteasomal Activity

Deepti Malhotra1, Rajesh Thimmulappa1, Neeraj Vij2, Ana Navas-Acien1, Thomas Sussan1, Salim Merali3, Li Zhang4, Steven G Kelsen3, Allen Myers5, Robert Wise6, Rubin Tuder4, and Shyam Biswal7*

1 Environmental Health Sciences, Johns Hopkins School of Public Health, Baltimore, Maryland, United States, 2 Department of Pediatrics and Division of Pulmonary Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States, 3 Department of Biochemistry and Department of Medicine, Division of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, United States, 4 Division of Pulmonary and Critical Care Medicine, University of Colorado Denver, Aurora, Colorado, United States, 5 The Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland, United States, 6 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States, 7 Environmental Health Science, Johns Hopkins University, 615, North Wolfe Street, Baltimore, Maryland, 21205, United States; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States; Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States

* To whom correspondence should be addressed. E-mail: sbiswal{at}jhsph.edu.

Rationale: Nrf2, an important regulator of lung anti-oxidant defenses, declines in COPD. However, Nrf2 also regulates the proteasome system that degrades damaged and misfolded proteins. Since accumulation of misfolded proteins in the endoplasmic reticulum (ER) causes ER stress and ER stress-induced apoptosis, Nrf2 may potentially prevent ER stress-mediated apoptosis in COPD. Objective: To determine whether Nrf2-regulated proteasome function affects ER stress-mediated apoptosis in COPD. Methods: We assessed the expression of Nrf2, Nrf2-dependent proteasomal subunits, proteasomal activity, markers of ER stress and apoptosis in emphysematous lungs of mice exposed to cigarette smoke (CS) as well as peripheral lung tissues from normal controls and COPD patients. Measurements and Main Results: Compared to wild-type mice, emphysematous lungs of CS-exposed Nrf2-deficient mice exhibited markedly lower proteasomal activity and elevated markers of ER stress and apoptosis. Further, compared to normal controls, lungs of patients with mild and advanced COPD showed a marked decrease in the expression of Nrf2-regulated proteasomal subunits and total proteasomal activity. However, they were associated with greater levels of ER stress and apoptosis markers. In vitro studies have demonstrated that enhancing proteasomal activity in Beas2B cells either by sulforaphane, an activator of Nrf2 or overexpression of Nrf2-regulated proteasomal subunit PSMB6, significantly inhibited cigarette smoke condensate (CSC)-induced ER stress and cell death. Conclusions: Impaired Nrf2 signaling causes significant decline in proteasomal activity and heightens ER stress response in lungs of patients with COPD and CS-exposed mice. Accordingly, pharmacological approaches, which augment Nrf2 activity may protect against COPD progression by both up-regulating antioxidant defenses and relieving ER stress.


Key words: Nrf2 • Proteasome system • Endoplasmic reticulum stress • Unfolded protein response • COPD lungs







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