Background/Aims: The objective of this study was to elucidate the underlying antioxidant mechanism of aqueous extract of Piper betle (PB) in aging rats. The nuclear factor erythroid 2-related factor 2 (Nrf2)/ARE pathway involving phase II detoxifying and antioxidant enzymes plays an important role in the antioxidant system by reducing electrophiles and reactive oxygen species through induction of phase II enzymes and proteins. Methods: Genes and proteins of phase II detoxifying antioxidant enzymes were analyzed by QuantiGenePlex 2.0 Assay and Western blot analysis. Results: PB significantly induced genes and proteins of phase II and antioxidant enzymes, NAD(P)H quinone oxidoreductase 1, and catalase in aging mice (p < 0.05). The expression of these enzymes were stimulated via translocation of Nrf2 into the nucleus, indicating the involvement of ARE, a cis-acting motif located in the promoter region of nearly all phase II genes. Conclusions: PB was testified for the first time to induce cytoprotective genes through the Nrf2/ARE signaling pathway, thus unraveling the antioxidant mechanism of PB during the aging process.

1.
Allen RG: Oxidative stress and superoxide dismutase in development, aging and gene regulation. Age 1998;21:47-76.
2.
Harman D: Free radical theory of aging. Mutat Res 1992;275:257-266.
3.
Shin D-h, Park H-M, Jung K-A, Choi H-G, Kim J, Kim D-D, Kim SG, Kang KW, Ku SK, Kensler TW: The NRF2 - heme oxygenase-1 system modulates cyclosporin A-induced epithelial - mesenchymal transition and renal fibrosis. Free Radic Bio Med 2010;48:1051-1063.
4.
Itoh K, Wakabayashi N, Katoh Y, Ishii T, Igarashi K, Engel JD, Yamamoto M: Keap1 represses nuclear activation of antioxidant responsive elements by Nrf2 through binding to the amino-terminal Neh2 domain. Genes Dev 1999;13:76-86.
5.
Nguyen T, Sherratt PJ, Pickett CB: Regulatory mechanisms controlling gene expression mediated by the antioxidant response element. Annu Rev Pharmacol Toxicol 2003;43:233-260.
6.
Kwak M-K, Kensler TW: Targeting Nrf2 signaling for cancer chemoprevention. Toxicol Appl Pharmacol 2010;244:66-76.
7.
Tanigawa S, Fujii M, Hou D-X: Action of Nrf2 and Keap1 in ARE-mediated NQO1 expression by quercetin. Free Radic Biol Med 2007;42:1690-1703.
8.
Lamartiniere CA, Cotroneo MS, Fritz WA, Wang J, Mentor-Marcel R, Elgavish A: Genistein chemoprevention: timing and mechanisms of action in murine mammary and prostate. J Nutr 2002;132:552S-558S.
9.
Na H-K, Surh Y-J: Modulation of Nrf2-mediated antioxidant and detoxifying enzyme induction by the green tea polyphenol EGCG. Food Chem Toxicol 2008;46:1271-1278.
10.
Balogun E, Hoque M, Gong P, Killeen E, Green C, Foresti R, Alam J, Motterlini R: Curcumin activates the haem oxygenase-1 gene via regulation of Nrf2 and the antioxidant-responsive element. Biochem J 2003;371:887-895.
11.
Pradhan D, Suri K, Pradhan D, Biswasroy P: Golden heart of the nature: Piper betle L. J Pharmacogn Phytochem 2013;1:147-167.
12.
Bhattacharya S, Subramanian M, Roychowdhury S, Bauri AK, Kamat JP, Chattopadhyay S, Bandyopadhyay SK: Radioprotective property of the ethanolic extract of piper betel leaf. J Radiat Res 2005;46:165-171.
13.
Bajpai V, Sharma D, Kumar B, Madhusudanan KP: Profiling of Piper betle Linn. Cultivars by direct analysis in real time mass spectrometric technique. Biomed Chromatogr 2010;24:1283-1286.
14.
Kumar N, Misra P, Dube A, Bhattacharya S, Dikshit M, Ranade S: Piper betle Linn. A maligned pan-asiatic plant with an array of pharmacological activities and prospects for drug discovery. Curr Sci 2010;99:922-933.
15.
Paranjpe R, Gundala SR, Lakshminarayana N, Sagwal A, Asif G, Pandey A, Aneja R: Piper betel leaf extract: anticancer benefits and bio-guided fractionation to identify active principles for prostate cancer management. Carcinogenesis 2013:bgt066.
16.
Aliahmat NS, Noor MRM, Yusof WJW, Makpol S, Ngah WZW, Yusof YAM: Antioxidant enzyme activity and malondialdehyde levels can be modulated by piper betle, tocotrienol rich fraction and Chlorella vulgaris in aging c57bl/6 mice. Clinics 2012;67:1447-1454.
18.
Choudhary D, Kale RK: Antioxidant and non‐toxic properties of Piper betle leaf extract: in vitro and in vivo studies. Phytother Res 2002;16:461-466.
19.
Al-Adhroey AH, Nor ZM, Al-Mekhlafi HM, Amran AA, Mahmud R: Antimalarial activity of methanolic leaf extract of Piper betle L. Molecules 2010;16:107-118.
20.
Miller CJ, Gounder SS, Kannan S, Goutam K, Muthusamy VR, Firpo MA, Symons JD, Paine R, Hoidal JR, Rajasekaran NS: Disruption of Nrf2/ARE signaling impairs antioxidant mechanisms and promotes cell degradation pathways in aged skeletal muscle. Biochim Biophys Acta 2012;1822:1038-1050.
21.
Pin K, Ilicali C, Luqman Chuah A, Choong T, Shahrul M, Rasadah M, Law C: Modelling of freezing kinetics of extract of betel leaves (Piper betle L.). Int J Food Eng 2011, Volume 7, Article 15 (DOI:10.2202/1556-3758.1692)
22.
Ryan MJ, Dudash HJ, Docherty M, Geronilla KB, Baker BA, Haff GG, Cutlip RG, Alway SE: Aging-dependent regulation of antioxidant enzymes and redox status in chronically loaded rat dorsiflex or muscles. J Gerontol A Biol Sci Med Sci 2008;63:1015-1026.
23.
Willcox JK, Ash SL, Catignani GL: Antioxidants and prevention of chronic disease. Crit Rev Food Sci 2004;44:275-295.
24.
Bruns DR, Drake JC, Biela LM, Peelor F 3rd, Miller BF, Hamilton KL: Nrf2 signaling and the slowed aging phenotype: evidence from long-lived models. Oxid Med Cell Longev 2015;732596.
25.
Kasapoglu M, Özben T: Alterations of antioxidant enzymes and oxidative stress markers in aging. Exp Gerontol 2001;36:209-220.
26.
Kwak M-K, Wakabayashi N, Kensler TW: Chemoprevention through the Keap1-Nrf2 signaling pathway by phase 2 enzyme inducers. Mutat Res 2004;555:133-148.
27.
Pin K, Chuah AL, Rashih AA, Mazura M, Fadzureena J, Vimala S, Rasadah M: Antioxidant and anti-inflammatory activities of extracts of betel leaves (Piper betle) from solvents with different polarities. J Trop For Sci 2010:448-455.
28.
Sharma S, Khan IA, Ali I, Ali F, Kumar M, Kumar A, Johri RK, Abdullah ST, Bani S, Pandey A: Evaluation of the antimicrobial, antioxidant, and anti-inflammatory activities of hydroxychavicol for its potential use as an oral care agent. Antimicrob Agents Chemother 2009;53:216-222.
29.
Rai MP, Thilakchand KR, Palatty PL, Rao P, Rao S, Bhat HP, Baliga MS: Piper betel Linn (betel vine), the maligned southeast Asian medicinal plant possesses cancer preventive effects: time to reconsider the wronged opinion. Asian Pac J Cancer Prev 2011;12:2149-2156.
30.
Lee J-S, Surh Y-J: Nrf2 as a novel molecular target for chemoprevention. Cancer Lett 2005;224:171-184.
31.
Dinkova-Kostova AT, Holtzclaw WD, Kensler TW: The role of Keap1 in cellular protective responses. Chem Res Toxicol 2005;18:1779-1791.
32.
Miller CJ, Gounder SS, Kannan S, Goutam K, Muthusamy VR, Firpo MA, Symons JD, Paine R III, Hoidal JR, Rajasekaran NS: Disruption of Nrf2/are signaling impairs antioxidant mechanisms and promotes cell degradation pathways in aged skeletal muscle. Biochim Biophys Acta 2012;1822:1038-1050.
33.
Suh JH, Shenvi SV, Dixon BM, Liu H, Jaiswal AK, Liu R-M, Hagen TM: Decline in transcriptional activity of Nrf2 causes age-related loss of glutathione synthesis, which is reversible with lipoic acid. Proc Natl Acad Sci USA 2004;101:3381-3386.
34.
Gounder SS, Kannan S, Devadoss D, Miller CJ, Whitehead KS, Odelberg SJ, Firpo MA, Paine R III, Hoidal JR, Abel ED: Impaired transcriptional activity of Nrf2 in age-related myocardial oxidative stress is reversible by moderate exercise training. PLoS One 2012;7:e45697.
35.
Warabi E, Takabe W, Minami T, Inoue K, Itoh K, Yamamoto M, Ishii T, Kodama T, Noguchi N: Shear stress stabilizes NF-E2-related factor 2 and induces antioxidant genes in endothelial cells: Role of reactive oxygen/nitrogen species. Free Radic Biol Med 2007;42:260-269.
36.
Zhou S, Sun W, Zhang Z, Zheng Y: The role of Nrf2-mediated pathway in cardiac remodeling and heart failure. Oxid Med Cell Longev 2014;2014:260429.
37.
Miller CJ, Gounder SS, Kannan S, Goutam K, Muthusamy VR, Firpo MA, Symons JD, Paine III R, Hoidal JR, Rajasekaran NS: Disruption of Nrf2/are signaling impairs antioxidant mechanisms and promotes cell degradation pathways in aged skeletal muscle. Biochim Biophys Acta 2012;1822:1038-1050.
38.
Lavrovsky Y, Song CS, Chatterjee B, Roy AK: Age-dependent increase of heme oxygenase-1 gene expression in the liver mediated by NFkappaB. Mech Ageing Dev 2000;114:49-60.
39.
Lim JH, Kim K-M, Kim SW, Hwang O, Choi HJ: Bromocriptine activates NQO1 via Nrf2-PI3K/Akt signaling: Novel cytoprotective mechanism against oxidative damage. Pharmacol Res 2008;57:325-331.
40.
Sun J, Tower J: FLP recombinase-mediated induction of Cu/Zn-superoxide dismutase transgene expression can extend the life span of adult drosophila melanogaster flies. Mol Cell Biol 1999;19:216-228.
41.
Sun J, Molitor J, Tower J: Effects of simultaneous over-expression of Cu/ZnSOD and MnSOD on Drosophila melanogaster life span. Mech Ageing Dev 2004;125:341-349.
42.
Schipper H: Heme oxygenase-1: Role in brain aging and neurodegeneration. Exp Gerontol 2000;35:821-830.
43.
SantaCruz KS, Yazlovitskaya E, Collins J, Johnson J, DeCarli C: Regional NAD(P)H:quinone oxidoreductase activity in Alzheimer's disease. Neurobiol Aging 2004;25:63-69.
44.
Melov S, Ravenscroft J, Malik S, Gill MS, Walker DW, Clayton PE, Wallace DC, Malfroy B, Doctrow SR, Lithgow GJ: Extension of life-span with superoxide dismutase/catalase mimetics. Science 2000;289:1567-1569.
45.
Ren J, Li Q, Wu S, Li S-Y, Babcock SA: Cardiac overexpression of antioxidant catalase attenuates aging-induced cardiomyocyte relaxation dysfunction. Mech Ageing Dev 2007;128:276-285.
46.
Zhao X, Zou Y, Xu H, Fan L, Guo H, Li X, Li G, Zhang X, Dong M: Gastrodin protect primary cultured rat hippocampal neurons against amyloid-beta peptide-induced neurotoxicity via ERK1/2-Nrf2 pathway. Brain Res 2012;1482:13-21.
47.
Kwak M-K, Itoh K, Yamamoto M, Sutter TR, Kensler TW: Role of transcription factor Nrf2 in the induction of hepatic phase 2 and antioxidative enzymes in vivo by the cancer chemoprotective agent, 3H-1, 2-dimethiole-3-thione. Mol Med 2001;7:135.
48.
Kwak M-K, Wakabayashi N, Greenlaw JL, Yamamoto M, Kensler TW: Antioxidants enhance mammalian proteasome expression through the Keap1-Nrf2 signaling pathway. Mol Cell Biol 2003;23:8786-8794.
49.
Hasan WN, Kwak M-K, Makpol S, Ngah WZ, Yusof YA: Piper betle induces phase I & II genes through Nrf2/are signaling pathway in mouse embryonic fibroblasts derived from wild type and Nrf2 knockout cells. BMC Complement Altern Med 2014;14:72.
50.
Gonzalez-Burgos E, Carretero M, Gomez-Serranillos M: Involvement of Nrf2 signaling pathway in the neuroprotective activity of natural kaurane diterpenes. J Neurosci 2013;231:400-412.
51.
Zhu H, Itoh K, Yamamoto M, Zweier JL, Li Y: Role of Nrf2 signaling in regulation of antioxidants and phase 2 enzymes in cardiac fibroblasts: protection against reactive oxygen and nitrogen species-induced cell injury. FEBS Lett 2005;579:3029-3036.
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