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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Pharmacol.</journal-id>
<journal-title>Frontiers in Pharmacology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Pharmacol.</abbrev-journal-title>
<issn pub-type="epub">1663-9812</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">639558</article-id>
<article-id pub-id-type="doi">10.3389/fphar.2021.639558</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Pharmacology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Berberine Regulated miR150-5p to Inhibit P2X7 Receptor, EMMPRIN and MMP-9 Expression in oxLDL Induced Macrophages</article-title>
<alt-title alt-title-type="left-running-head">Lu et&#x20;al.</alt-title>
<alt-title alt-title-type="right-running-head">Berberine Inhibited P2X7R by miR150-5p </alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Lu</surname>
<given-names>Lin</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="fn" rid="fn1">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/358172/overview" />
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Huang</surname>
<given-names>Jianjian</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="fn" rid="fn1">
<sup>&#x2020;</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Xue</surname>
<given-names>Xia</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Ting</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Huang</surname>
<given-names>Zhouqing</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/776006/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Li</surname>
<given-names>Jianmin</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1181209/overview"/>
</contrib>
</contrib-group>
<aff id="aff1">
<label>
<sup>1</sup>
</label>The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of WenZhou Medical University, <addr-line>Wenzhou</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<label>
<sup>2</sup>
</label>Department of Anesthesiology, Wenzhou Medical University, <addr-line>Wenzhou</addr-line>, <country>China</country>
</aff>
<aff id="aff3">
<label>
<sup>3</sup>
</label>Department of Pathology, The First Affiliated Hospital of WenZhou Medical University, <addr-line>Wenzhou</addr-line>, <country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/11437/overview">Belton Orina</ext-link>, University College Dublin, Ireland</p>
</fn>
<fn fn-type="edited-by">
<p>
<bold>Reviewed by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/32300/overview">Kuhn Hartmut</ext-link>, Charit&#xe9;&#x2013;Universit&#xe4;tsmedizin Berlin, Germany</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1080551/overview">Chung Ching-Hu</ext-link>, Mackay Medical College, Taiwan</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Zhouqing Huang, <email>susiehzq@126.com</email>; Jianmin Li, <email>wzyxyljmin@163.com</email>
</corresp>
<fn fn-type="other">
<p>This article was submitted to Inflammation Pharmacology, a section of the journal Frontiers in Pharmacology</p>
</fn>
<fn fn-type="equal" id="fn1">
<label>
<sup>&#x2020;</sup>
</label>
<p>These authors have contributed equally to this work</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>20</day>
<month>04</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="collection">
<year>2021</year>
</pub-date>
<volume>12</volume>
<elocation-id>639558</elocation-id>
<history>
<date date-type="received">
<day>09</day>
<month>12</month>
<year>2020</year>
</date>
<date date-type="accepted">
<day>25</day>
<month>03</month>
<year>2021</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2021 Lu, Huang, Xue, Wang, Huang and Li.</copyright-statement>
<copyright-year>2021</copyright-year>
<copyright-holder>Lu, Huang, Xue, Wang, Huang and Li</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these&#x20;terms.</p>
</license>
</permissions>
<abstract>
<p>Elevated extracellular matrix metalloproteinase inducer (EMMPRIN) and matrix metalloproteinase-9 (MMP-9) in oxidized low density lipoprotein (oxLDL)-induced macrophages leads to the progression of vulnerable plaques by degradation of the extracellular matrix. Our previous report showed that berberine regulates the expression of both EMMPRIN and MMP-9. In addition, P2X7 receptor (P2X7R) upregulation plays a crucial role in the development of atherosclerosis. However, it is unclear whether berberine regulated P2X7R level to inhibit both EMMPRIN and MMP-9 expession in macrophages. In the present study, we investigated the impact of berberine on P2X7R expression and the regulation of P2X7R in the expression of EMMPRIN and MMP-9 in oxLDL-induced macrophages. We found that P2X7R expression was increased, miR150-5p was reduced in oxLDL-induced macrophages, relatively. And A-438079 (a P2X7R inhibitor) or miR150-5p mimic treatment greatly reversed the upregulation of EMMPRIN and MMP-9 expression. Moreover, A-438079 significantly reduced oxLDL-induced AMP-activated protein kinase-&#x3b1; (AMPK-&#x3b1;) phosphorylation and reversed the activation of mitogen-activated protein kinase (MAPK), which in turn decreased the expression of EMMPRIN and MMP-9. These findings illustrate that P2X7R suppresses EMMPRIN and MMP-9 expression by inhibiting the AMPK-&#x3b1;/MAPK pathway in oxLDL-induced macrophages. Accordingly, exposure to berberine markedly upregulated miR150-5p, decreased P2X7R expression and downregulated MMP-9 and EMMPRIN levels in oxLDL-induced macrophages, resulting in AMPK-&#x3b1;/MAPK (JNK, p38, and ERK) inactivation. Overall, these results indicate that berberine increased miR150-5p level, subsequently inhibits P2X7R-mediated EMMPRIN and MMP-9 expression by suppressing AMPK-&#x3b1; and MAPK signaling in oxLDL-induced macrophages.</p>
</abstract>
<kwd-group>
<kwd>berberine</kwd>
<kwd>P2X7 receptor</kwd>
<kwd>EMMPRIN (extracellular matrix metalloproteinase inducer)</kwd>
<kwd>MMP-9</kwd>
<kwd>oxLDL</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec id="s1">
<title>Introduction</title>
<p>Atherosclerosis is a chronic and progressive inflammatory disease and is closely correlated with oxLDL-activated macrophages, which release many inflammatory factors that affect atherosclerotic plaque stability (<xref ref-type="bibr" rid="B11">Galis et&#x20;al., 1995</xref>; <xref ref-type="bibr" rid="B9">Di Pietro et&#x20;al., 2016</xref>; <xref ref-type="bibr" rid="B40">Tabas and Bornfeldt, 2016</xref>). Of particular note, the stability of atherosclerotic plaques determines whether a patient will experience cardiac events, such as acute myocardial infarction and unstable angina (<xref ref-type="bibr" rid="B36">Shin et&#x20;al., 2003</xref>). Mounting evidence has suggested that elevated EMMPRIN and MMP-9 expression in atherosclerotic plaques (<xref ref-type="bibr" rid="B34">Schmidt et&#x20;al., 2006</xref>) or in atherosclerosis-related cells (such as oxLDL-stimulated monocytes/macrophages and coronary smooth muscle cells) (<xref ref-type="bibr" rid="B27">Major et&#x20;al., 2002</xref>) contributes to extracellular matrix degradation and promotes plaque rupture (<xref ref-type="bibr" rid="B45">Yoon et&#x20;al., 2005</xref>; <xref ref-type="bibr" rid="B22">Joghetaei et&#x20;al., 2013</xref>), which indicates that EMMPRIN and MMP-9 play important regulatory roles in the progression of atherosclerosis.</p>
<p>P2X purinergic receptors are adenosine triphosphate (ATP)-dependent ligand gated ion channels (<xref ref-type="bibr" rid="B39">Surprenant et&#x20;al., 1996</xref>). Among the purinergic receptor family, P2X7 receptor (P2X7R) has a unique phenotype and is widely expressed in cardiomyocytes, monocytes, macrophages and other cells. Numerous reports have revealed that P2X7R plays an important role in different disease models, such as nervous system diseases, inflammatory bowel disease and the immune response (<xref ref-type="bibr" rid="B37">Stachon et&#x20;al., 2017</xref>). In addition, emerging evidence indicates that P2X7R is also associated with cardiovascular disease (<xref ref-type="bibr" rid="B7">Chen et&#x20;al., 2018</xref>). For instance, activation of P2X7R is responsible for attenuating myocardial ischemia-reperfusion injury (<xref ref-type="bibr" rid="B42">Vessey, et&#x20;al., 2011</xref>; <xref ref-type="bibr" rid="B8">Chen et&#x20;al., 2016</xref>). P2X7R inhibition ameliorates hypertension by reducing the inflammatory response (<xref ref-type="bibr" rid="B21">Ji et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B7">Chen et&#x20;al., 2018</xref>). In atherosclerosis, P2X7R is expressed in endothelial cells and macrophages, which infiltrate the atherosclerotic plaques in human carotid arteries (<xref ref-type="bibr" rid="B2">Burnstock and Knight, 2004</xref>). Mantione et&#x20;al. showed that P2X7R is a modulator of MMP9 secretion by primary human vascular smooth muscle-like cells and contributes to the development of atherosclerosis (<xref ref-type="bibr" rid="B29">Mantione et&#x20;al., 2019</xref>). In addition, P2X7 deficiency attenuates atherosclerosis in LDLR&#x2212;/&#x2212;mice by blocking activation of NLRP3 and decreasing the release of IL-1 <italic>&#x3b2;</italic> (<xref ref-type="bibr" rid="B33">Peng et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B37">Stachon et&#x20;al., 2017</xref>). However, whether P2X7R regulates EMMPRIN and MMP-9 expression in oxLDL-stimulated macrophages remains unclear.</p>
<p>Berberine is a natural compound that can be extracted from several medicinal herbs, such as <italic>Cortex phellodendri</italic> (Huangbai), <italic>Hydrastis canadensis</italic> and <italic>Rhizoma coptidis</italic> (Huanglian) (<xref ref-type="bibr" rid="B20">Ikram, 1975</xref>). Berberine has been extensively used in traditional Chinese medicine for many years as an anti-infectious diarrhea agent (<xref ref-type="bibr" rid="B38">Stermitz et&#x20;al., 2000</xref>). Recently, mounting evidence has shown that berberine has pleiotropic effects in cardiovascular diseases. For example, berberine reduces plasma glucose (<xref ref-type="bibr" rid="B46">Zhang et&#x20;al., 2018</xref>; <xref ref-type="bibr" rid="B31">Mi et&#x20;al., 2019</xref>) and cholesterol levels (<xref ref-type="bibr" rid="B23">Kong et&#x20;al., 2004</xref>; <xref ref-type="bibr" rid="B6">Cao et&#x20;al., 2018</xref>). In addition, berberine inhibits excessive autophagy to alleviate cardiac ischemia-reperfusion injury in cardiomyocytes (<xref ref-type="bibr" rid="B16">Huang et&#x20;al., 2015</xref>). Moreover, berberine exerts antiatherogenic effects by decreasing EMMPRIN and MMP-9 expression (<xref ref-type="bibr" rid="B19">Huang et&#x20;al., 2011</xref>). However, the potential mechanisms involved in its regulation of the expression of these proteins remain elusive. Therefore, in the present study, we investigated the effects of berberine on the expression of P2X7R and the relative underlying mechanism in oxLDL-induced macrophages.</p>
</sec>
<sec sec-type="materials|methods" id="s2">
<title>Materials and Methods</title>
<sec id="s2-1">
<title>Cell Culture and Treatment</title>
<p>The human monocytic cell line THP-1 and Raw264.7 murine macrophage-like cell line was obtained from American Type Culture Collection (Rockville, MD). And THP-1 cells was maintained at a density of 10<sup>6</sup>/ml in RPMI 1640 medium, Raw264.7 cells were cultured in DMEM medium, containing 10% FBS, 10&#xa0;mM HEPES (Sigma, United&#x20;States) and 1% pen/strep solution at 37&#xb0;C in a 5% CO<sub>2</sub> incubator. THP-1cells were cultured in six-well plates for 48&#xa0;h in the presence of 100&#xa0;nM PMA, which induced differentiation into adherent macrophages (<xref ref-type="bibr" rid="B41">Tsuchiya et&#x20;al., 1982</xref>). Then, the cells were pretreated with berberine (0&#x2013;50&#xa0;&#x3bc;M) or 100&#xa0;&#x3bc;M A-438079 (a P2X7R inhibitor, Selleck, United&#x20;States) and 10&#xa0;&#x3bc;M compound C (AMPK inhibitor), PD98059 (a MAPK/ERK inhibitor), SB203580 (a p38 MAPK inhibitor), and SP600125 (a JNK inhibitor), which are MAP kinase inhibitors (Sigma, United&#x20;States), for 1&#xa0;h prior to incubation with oxLDL (50&#xa0;&#x3bc;g/ml) for 24&#xa0;h.</p>
</sec>
<sec id="s2-2">
<title>MicroRNA Transfection</title>
<p>Cells in exponential phase of growth were plated in six-well plates at 3&#x20;&#x2a; 10<sup>5</sup> cells/plate and cultured overnight. Then, the cells were transfected with the miR-150 precursor (50&#xa0;nM) or a negative control RNA (50&#xa0;nM) using riboFECTTM CP Reagent and Buffer (RiboBio, Guangzhou, China). According to the manufacturer&#x2019;s protocol of transfection reagent, the miRNAs was diluted with riboFECTTM CP buffer at 37&#xb0;C for 10&#xa0;min. The diluent was mixed with riboFECTTM CP Reagent and incubated for 10&#xa0;min at 37&#xb0;C. Then, the riboFECTTMCP-miRNA mixture was added to the cells together with 1.8&#xa0;ml DMEM and incubated at 37&#xb0;C for 48&#xa0;h.</p>
</sec>
<sec id="s2-3">
<title>Protein Isolation and Western Blot Analysis</title>
<p>Protein isolation and Western blot analysis of cell lysates were performed as previously described (<xref ref-type="bibr" rid="B5">Cao et&#x20;al., 2017</xref>), except that the membranes were probed with the primary antibodies rabbit anti-GAPDH, anti-P2X7R, anti-MMP-9, anti-AMPK&#x3b1;, anti-phospho-AMPK&#x3b1;, anti-p38, anti-phospho-p38, anti-JNK, anti-phospho-JNK (Cell Signaling Technology, Boston, MA) (1:1,000 dilution in TBST), anti-EMMPRIN (Abcam, United&#x20;States) (1:1,000 dilution in TBST), anti-ERK, and anti-phospho-ERK (Santa Cruz) (diluted 1:300 in TBST) at 4&#xb0;C overnight. Next, the membranes were incubated with HRP-conjugated secondary antibody (1:1,000) for 1&#xa0;h. Proteins were visualized by the ECL procedure (Bio-Rad, United&#x20;States). The results were analyzed with Quantity One (Bio-Rad) software.</p>
</sec>
<sec id="s2-4">
<title>RNA Isolation, cDNA Synthesis and Real-Time PCR</title>
<p>Total RNA from cells that were treated with the indicated conditions was extracted using TRIzol reagent (Invitrogen) according to the instructions. cDNA was synthesized using a cDNA transcription kit (Thermo) before real-time polymerase chain reaction (PCR) was performed using the SYBR Premix Ex Taq Kit (TaKaRa Code DRR041) as previously described (<xref ref-type="bibr" rid="B30">Meng et al., 2012</xref>). Real-time PCR was performed to determine the gene expression of MMP-9 and EMMPRIN. The PCR products were detected by an ABI-7500 sequence detection system (United States). The primer sequences used in the study are as follows: MMP-9 (NM_004994.2), F: TGA&#x200b;CGC&#x200b;CGC&#x200b;TCA&#x200b;CCT&#x200b;TCA&#x200b;CT, R: CGC&#x200b;GCC&#x200b;ATC&#x200b;TGC&#x200b;GTT&#x200b;TCC&#x200b;AA; EMMPRIN (NM_001728.3), Forward: TTG&#x200b;GAG&#x200b;GTT&#x200b;GTA&#x200b;GGA&#x200b;CCG&#x200b;GCG&#x200b;A, R: TGGGACCCTGCCCTTCA- AACCA; and GAPDH (NM_001256799.2), Forward: CCG&#x200b;CAT&#x200b;CTT&#x200b;CTT&#x200b;TTG&#x200b;CGT&#x200b;CGC&#x200b;C, R: TCT&#x200b;CAG&#x200b;CCT&#x200b;TGA&#x200b;CGG&#x200b;TGC&#x200b;CA; miR-150-5p (NC_000073.7), F: TCT&#x200b;CCC&#x200b;AAC&#x200b;CCT&#x200b;TGT&#x200b;ACC&#x200b;AGT&#x200b;G, R: CAGTGCGTGTCGTGGAGT (where F is forward and R is reverse). All results were normalized to the GAPDH level.</p>
</sec>
<sec id="s2-5">
<title>Gelatin Zymography</title>
<p>MMP activity was determined by gelatin zymography. Cells were seeded in 6-wellplates at a density of 3&#x20;&#xd7; 10<sup>5</sup> cells per well. After incubation in serum-free medium with or without A-438079 for 1&#xa0;h, the cells were incubated with 100&#xa0;&#x3bc;M PMA for another 48&#xa0;h. Culture supernatants were collected, and 10&#xa0;&#x3bc;L aliquots of the culture supernatant were loaded onto a 10% polyacrylamide gel containing 1&#xa0;mg/ml gelatin. After electrophoresis, the gels were washed twice with 2.5% Triton X-100 (37&#xb0;C, 30&#xa0;min), and then the gels were incubated at 37&#xb0;C for 11&#xa0;h in developing buffer (10&#xa0;mM Tris base, 40&#xa0;mM Tris&#x2013;HCl, 200&#xa0;mM NaCl, 10&#xa0;mM CaCl<sub>2</sub>, and 0.02% Brij 35). The gels were subsequently stained with 0.5% (w/v) Coomassie Blue R-250 for 2&#xa0;h and then destained in the appropriate solution (50% methanol, 10% glacial acetic acid, and 40% water). MMP-9-digested regions were visualized as light bands against a dark background. An image of each gel was detected by an Odyssey imaging system (Li-cor, United&#x20;States).</p>
</sec>
<sec id="s2-6">
<title>Statistical Analysis</title>
<p>Three or more groups were compared using one-way ANOVA with Student-Newman-Keuls and Dunnett&#x2019;s post hoc analysis if the ANOVA result was significant. The data are presented as the mean&#x20;&#xb1; SD and were analyzed using SPSS 18 software (SPSS Inc: Chicago, IL, United&#x20;States). Statistical significance was defined as <italic>p</italic>&#x20;&#x3c; 0.05. All experiments were performed at least three&#x20;times.</p>
</sec>
</sec>
<sec sec-type="results" id="s3">
<title>Results</title>
<sec id="s3-1">
<title>P2X7R Expression Was Upregulated in a Time-dependent Manner in Ox-LDL-Induced Macrophages</title>
<p>PMA-induced macrophages were treated with ox-LDL (50&#xa0;&#x3bc;g/ml) for different times ranging from 1 to 48&#xa0;h. The protein level of P2X7R was measured by Western blot analysis. We found that P2X7R expression was markedly increased by incubation with ox-LDL in a time-dependent manner (<xref ref-type="fig" rid="F1">Figure&#x20;1A</xref>), and the highest level occurred at 24&#xa0;h of treatment with oxLDL. Therefore, the cells were treated with 50&#xa0;&#x3bc;g/ml ox-LDL for 24&#xa0;h in subsequent experiments.</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>Expression of P2X7R and the effect of A-438079 on EMMPRIN and MMP-9 levels in oxLDL-induced macrophages. EMMPRIN and MMP-9 protein and mRNA levels were measured by Western blot and real-time PCR, respectively. MMP-9 activity was tested by gelatin zymography. Representative real-time PCR, Western blot and zymography results of MMP-9 or EMMPRIN expression are shown. <bold>(A)</bold> oxLDL induced P2X7R in a time-dependent manner in macrophages. C. Effect of A-438079 on EMMPRIN and MMP-9 levels in THP-1 cells. <bold>(B,D,F,G)</bold> Representative real-time PCR results of MMP-9 mRNA analysis and densitometric measurement results of EMMPRIN and MMP-9 protein levels. <bold>(E)</bold> Densitometric measurement results of MMP-9 activity. H and I. EMMPRIN and MMP-9 expression by A-438079 in RAW264.7 murine cells. The band densities were measured by Quantity One 1D analysis software. The data represent the mean&#x20;&#xb1; S.D. &#x2a;<italic>p</italic>&#x20;&#x3c; 0.05, &#x2a;&#x2a;<italic>p</italic>&#x20;&#x3c; 0.01 compared with the PMA or control, &#x23;&#x23;<italic>p</italic>&#x20;&#x3c; 0.01 compared with the oxLDL&#x20;group.</p>
</caption>
<graphic xlink:href="fphar-12-639558-g001.tif"/>
</fig>
</sec>
<sec id="s3-2">
<title>Inhibition of P2X7R Reversed MMP-9 and EMMPRIN Expression and Decreased MMP-9 Activity in Ox-LDL-Induced Macrophages</title>
<p>To determine the effect of P2X7R on the expression of EMMPRIN and MMP-9, macrophages were pretreated with A-438079 for 1&#xa0;h and then incubated with 50&#xa0;&#x3bc;g/ml ox-LDL for 24&#xa0;h. We showed that EMMPRIN and MMP-9 expression obviously increased after stimulation with ox-LDL, and suppression of P2X7R expression by A-438079 significantly inhibited the ox-LDL-induced upregulation of MMP-9 and EMMPRIN (<xref ref-type="fig" rid="F1">Figures 1C,H</xref>), and their relative mRNA level represented the same tendency (<xref ref-type="fig" rid="F1">Figures 1F,G</xref>). In addition, MMP-9 is reported to greatly enhance elastin degradation <italic>in&#x20;vitro</italic> and induce plaque rupture <italic>in vivo</italic> (<xref ref-type="bibr" rid="B12">Galis et&#x20;al., 1994</xref>; <xref ref-type="bibr" rid="B14">Gough et&#x20;al., 2006</xref>), and we further investigated the effect of A-438079 on MMP-9 enzymatic activity. We also observed that the elevated MMP-9 activity was abolished by A-438079 (<xref ref-type="fig" rid="F1">Figures 1C,E</xref>). These data indicate that P2X7R inhibition decreases EMMPRIN and MMP-9 levels and reduces MMP-9 activity in ox-LDL-stimulated macrophages.</p>
</sec>
<sec id="s3-3">
<title>P2X7R Inhibition Suppressed Activation of AMPK and MAPK Pathways Induced by Ox-LDL in Macrophages</title>
<p>We previously reported (<xref ref-type="bibr" rid="B4">Cao et&#x20;al., 2014</xref>; <xref ref-type="bibr" rid="B5">Cao et&#x20;al., 2017</xref>) that activation of the MAPK (including ERK, p38 and JNK) or AMPK pathway is involved in the regulation of EMMPRIN and MMP-9 expression in PMA- or oxLDL-induced macrophages. In the present study, we reconfirmed the results of MAPK pathway activation in oxLDL-induced macrophages using ERK-, p38- or JNK-related inhibitors (<xref ref-type="fig" rid="F2">Figure&#x20;2A</xref>). Then, to further elucidate whether AMPK has an effect on the MAPK pathway after cells are exposed to oxLDL, we used compound C to inhibit the AMPK pathway. As shown in <xref ref-type="fig" rid="F2">Figure&#x20;2C</xref>, we found that compound C suppressed the phosphorylation of ERK, p38, and JNK and dramatically reduced the expression of EMMPRIN and MMP-9 in macrophages, suggesting that the AMPK inhibitor diminished activation of the p38, JNK, and ERK pathways. Thus, AMPK activation, as an upstream pathway of MAPK, is important for oxLDL-induced MMP-9 and EMMPRIN expression in macrophages.</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>oxLDL-induced EMMPRIN and MMP-9 expression in macrophages is abolished by specific ERK, JNK, and p38 inhibitors or compound C. EMMPRIN and MMP-9 protein levels or phosphorylation of ERK1/2, p38, and JNK were measured by Western blotting. Densitometry measurements of phosphorylated ERK1/2, p38, and JNK were normalized to total ERK1/2, p38, and JNK, respectively. The band densities were measured by Quantity One 1D analysis software. The Data (means&#x20;&#xb1; SD) were obtained from three independent experiments. &#x2a;&#x2a;<italic>p</italic>&#x20;&#x3c; 0.01 compared with PMA, &#x23;<italic>p</italic>&#x20;&#x3c; 0.05, &#x23;&#x23;: <italic>p</italic>&#x20;&#x3c; 0.01 compared with the oxLDL&#x20;group.</p>
</caption>
<graphic xlink:href="fphar-12-639558-g002.tif"/>
</fig>
<p>In addition, to investigate the role of P2X7R in the activation of AMPK and the MAPK pathway, we pretreated macrophages with A-438079 for 1&#xa0;h and then induced them with ox-LDL for another 24&#xa0;h. The phosphorylation and total protein levels of AMPK-&#x3b1;, ERK1/2, p38 MAPK, and JNK were examined by Western blot analysis. As shown in <xref ref-type="fig" rid="F3">Figure&#x20;3</xref>, ox-LDL induced sustained activation of AMPK&#x3b1; and increased phosphorylation of ERK, p38, and JNK in macrophages, and these effects were markedly abolished by A-438079. Taken together, we concluded that P2X7R inhibition remarkably abolished AMPK-&#x3b1; phosphorylation through MAPK pathway activation, which led to decreased EMMPRIN and MMP-9 expression in oxLDL-induced macrophages.</p>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption>
<p>Effect of A-438079 on the phosphorylation of AMPK&#x3b1;, ERK1/2, p38, and JNK. The phosphorylation of AMPK&#x3b1;, ERK1/2, p38, and JNK was measured by Western blotting. Densitometry measurements of phosphorylated AMPK&#x3b1;, ERK1/2, p38, and JNK were normalized to total AMPK&#x3b1;, ERK1/2, p38, and JNK, respectively. The band densities were measured by Quantity One 1D analysis software. The data (means&#x20;&#xb1; SD) were obtained from three independent experiments. &#x2a;&#x2a;<italic>p</italic>&#x20;&#x3c;&#x20;0.01 compared with PMA, &#x23;&#x23;: <italic>p</italic>&#x20;&#x3c; 0.01 compared with the oxLDL&#x20;group.</p>
</caption>
<graphic xlink:href="fphar-12-639558-g003.tif"/>
</fig>
</sec>
<sec id="s3-4">
<title>Berberine Reduced P2X7R Expression and Decreased EMMPRIN and MMP-9 in a Dose-dependent Manner by Inhibiting AMPK-&#x3b1; Though the MAPK Pathway in oxLDL-Induced Macrophages</title>
<p>Elevated MMP-9 and EMMPRIN expression is reduced by berberine in PMA- or oxLDL-induced macrophages (<xref ref-type="bibr" rid="B19">Huang et&#x20;al., 2011</xref>; <xref ref-type="bibr" rid="B17">Huang et&#x20;al., 2012</xref>), and P2X7R inhibition decreased MMP-9 and EMMPRIN expression in this study. We next tested whether the inhibitory effect of berberine on EMMPRIN and MMP-9 expression was due to P2X7R suppression in oxLDL-induced macrophages (THP-1 cells and RAW264.7). As expected, berberine reduced P2X7R levels in a dose-dependent manner while also reducing EMMPRIN and MMP-9 expression (<xref ref-type="fig" rid="F4">Figure&#x20;4</xref>). Thus, downregulation of P2X7R by berberine is responsible for the reduction in EMMPRIN and MMP-9 expression in oxLDL-induced macrophages. Notably, berberine also obviously inhibited the activation of AMPK&#x3b1; and reduced the phosphorylation of ERK, p38 and JNK in macrophages (<xref ref-type="fig" rid="F5">Figure&#x20;5</xref>), suggesting that the AMPK&#x3b1; and MAPK pathways induced by berberine contribute to the downregulation of P2X7R, EMMPRIN, and MMP-9 expression in oxLDL-induced macrophages.</p>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption>
<p>Effect of berberine (5&#x2013;50&#xa0;&#x3bc;M) on P2X7R, EMMPRIN, and MMP-9 expression <bold>(A)</bold> and <bold>(B)</bold> in THP-1 cells, <bold>(C)</bold> and <bold>(D)</bold> in RAW264.7 cells). Densitometry measurements of P2X7R, EMMPRIN, and MMP-9 were normalized to GAPDH. The band densities were measured by Quantity One 1D analysis software. The data (means&#x20;&#xb1; SD) were obtained from three independent experiments. &#x2a;&#x2a;<italic>p</italic>&#x20;&#x3c; 0.01 compared with PMA or control, &#x23;: <italic>p</italic>&#x20;&#x3c; 0.05, &#x23;&#x23;: <italic>p</italic>&#x20;&#x3c; 0.01 compared with the oxLDL&#x20;group.</p>
</caption>
<graphic xlink:href="fphar-12-639558-g004.tif"/>
</fig>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption>
<p>Berberine inhibited the phosphorylation of AMPK&#x3b1;, ERK1/2, p38, and JNK in oxLDL-induced macrophages. The densitometry measurements of phosphorylated AMPK&#x3b1;, ERK1/2, p38, and JNK were normalized to total AMPK&#x3b1;, ERK1/2, p38, and JNK, respectively. The band densities were measured by Quantity One 1D analysis software. The data (means&#x20;&#xb1; SD) were obtained from three independent experiments. &#x2a;&#x2a;<italic>p</italic>&#x20;&#x3c; 0.01 compared with PMA, &#x23;&#x23;: <italic>p</italic>&#x20;&#x3c; 0.01 compared with the oxLDL&#x20;group.</p>
</caption>
<graphic xlink:href="fphar-12-639558-g005.tif"/>
</fig>
</sec>
<sec id="s4">
<title>Berberine Increased miR-150-5p, Subsequently Repressed P2X7R Expression as Well as EMMPRIN and MMP-9 in oxLDL-Induced Macrophages</title>
<p>To investigate the underlying mechaniam of berberine on P2X7R.</p>
<p>
<xref ref-type="fig" rid="F6">Figure&#x20;6A</xref> depicted the change of miR-150-5p (mature of miR-150) after oxLDL stimulation in macrophages. We observed that miR-150-5p was reduced in oxLDL-induced macrophages, and abolished by berberine. In order to identify the relationship between miR-150 and P2X7R, we used several prediction algorithms including miRDB and Targetscan, which indicated that P2X7R is a candidate target of miR-150. The binding sites of miR-150-5p were well conserved between P2X7R mRNAs from mouse and human. As showed in <xref ref-type="fig" rid="F6">Figure&#x20;6B</xref>, P2X7R has strong miR-150 binding sites at the 3&#x2032;-UTR. In addition, P2X7R as well as EMMPRIN and MMP-9 were inhibited with miR-150-5p overexpression (<xref ref-type="fig" rid="F6">Figure&#x20;6C</xref>).</p>
<fig id="F6" position="float">
<label>FIGURE 6</label>
<caption>
<p>Berbeine upregulated miR-150-5p expression <bold>(A)</bold>; P2X7R and miR-150 have strong binding sites at their 3&#x2032;-UTRs. MiR-150 seed pairing in the target regions P2X7R is shown as red vertical lines <bold>(B)</bold>; <bold>(C)</bold> overexpression miR-150-5p repressed P2X7R as well as EMMPRIN, MMP-9. Densitometry measurements of P2X7R, EMMPRIN, and MMP-9 were normalized to GAPDH. The band densities were measured by Quantity One 1D analysis software. The data (means&#x20;&#xb1; SD) were obtained from three independent experiments. &#x2a;&#x2a;<italic>p</italic>&#x20;&#x3c; 0.01 compared with Control, &#x23;: <italic>p</italic>&#x20;&#x3c; 0.05, &#x23;&#x23;: <italic>p</italic>&#x20;&#x3c; 0.01 compared with the oxLDL&#x20;group.</p>
</caption>
<graphic xlink:href="fphar-12-639558-g006.tif"/>
</fig>
</sec>
</sec>
<sec sec-type="discussion" id="s5">
<title>Discussion</title>
<p>In the present study, we first revealed that P2X7R expression was markedly increased in oxLDL-stimulated macrophages, and the upregulation of EMMPRIN and MMP-9 was greatly reversed by A-438079 to inhibit P2X7R. In addition, exposure to berberine markedly increased miR-150-5p, decreased P2X7R expression and downregulated the expression of MMP-9 and EMMPRIN in oxLDL-stimulated macrophages. And miR-150-5p overexpression also directly inhibited all of P2X7R, EMMPRIN, and MMP-9, suggesting that berberine inhibited P2X7R by upregulating miR-150-5p to reduce EMMPRIN and MMP9 expression in oxLDL-stimulated macrophages.</p>
<p>It has been recognized that the primary cause of acute myocardial syndromes is coronary artery plaque vulnerability and rupture, which lacks a collagen extracellular matrix. A growing body of evidence now indicates that overproduction of EMMPRIN and MMP-9 is critical in the degradation of the extracellular matrix (<xref ref-type="bibr" rid="B32">Newby, 2008</xref>; <xref ref-type="bibr" rid="B35">Seizer et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B3">Canyelles et&#x20;al., 2018</xref>). MMP-9 yields caspase-1-independent activation of the proinflammatory cytokine interleukin 1 beta (IL-1&#x3b2;) (<xref ref-type="bibr" rid="B28">Mandal et&#x20;al., 2003</xref>), which is a gatekeeper of inflammation; in turn, IL-1&#x3b2; produced by plaque endothelium, smooth muscle cells, and monocytes/macrophages increased the expression and activity of MMP 9 (<xref ref-type="bibr" rid="B10">Du et&#x20;al., 2019</xref>). As an upstream regulator of MMP-9, EMMPRIN is also closely correlated with the progression of atherosclerosis (<xref ref-type="bibr" rid="B34">Schmidt et&#x20;al., 2006</xref>). Consequently, inhibiting EMMPRIN and MMP-9 levels can be beneficial for the stability of atherosclerotic plaques. Notably, we previously revealed that P2X7R effectively regulates both EMMPRIN and MMP-9 during monocyte differentiation into macrophages (<xref ref-type="bibr" rid="B25">Lin et&#x20;al., 2018</xref>). In this study, we demonstrated that P2X7R was upregulated under oxLDL stimulation in macrophages and that its inhibition significantly reduced EMMPRIN and MMP-9 expression, which indicates that P2X7R is a regulator of EMMPRIN and MMP-9 and could be a potential therapeutic target for inhibiting plaque rupture or retarding atherosclerosis. As was previously reported, the common P2X7R missense variant reduces the risk of atherosclerosis (<xref ref-type="bibr" rid="B13">Gidlof et&#x20;al., 2012</xref>). In addition, P2X7R activation is strongly correlated with lipid accumulation in high-fat diet mice (<xref ref-type="bibr" rid="B1">Asatryan et&#x20;al., 2015</xref>). Apart from this, atherosclerotic lesional macrophages are the major source of P2X7 receptors, and activation of P2X7R triggers an inflammatory response by activating NLRP3 and increasing IL-1&#x3b2; and MMP-9 (<xref ref-type="bibr" rid="B26">Lombardi et&#x20;al., 2017</xref>; <xref ref-type="bibr" rid="B29">Mantione et&#x20;al., 2019</xref>). These results support the concept that P2X7R plays a critical role in atherosclerosis. Accordingly, knockout of P2X7R decreases the number of lesional macrophages, resulting in a smaller atherosclerotic lesion (<xref ref-type="bibr" rid="B37">Stachon et&#x20;al., 2017</xref>), and inhibition of P2X7R may reduce lipid oxidation, leading to the improvement of atherosclerosis (<xref ref-type="bibr" rid="B15">Guha et&#x20;al., 2013</xref>). Thus, P2X7R is involved in the atherosclerotic process through different mechanisms, and P2X7R inhibition is beneficial for retarding the progression of atherosclerosis.</p>
<p>Interestingly, berberine effectively reduced the expression of P2X7R and decreased both EMMPRIN and MMP-9 in a dose-dependent manner in oxLDL-induced macrophages, suggesting that berberine inhibits EMMPRIN and MMP-9 levels by downregulating P2X7R. It is notably, the potential mechanism of how berberine regulates P2X7R in oxLDL-macrophages remains unclear. According to the data of candidate prediction and previous evidences indicated P2X7R was found to be regulated by miR-150 in pulmonary cells and HL-1 cells (<xref ref-type="bibr" rid="B47">Zhou et&#x20;al., 2008</xref>; <xref ref-type="bibr" rid="B43">Weng et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B44">Yao et&#x20;al., 2015</xref>), we tested the miR-150-5p level in oxLDL-macrophages. As expected, we observed that miR-150-5p was reduced by oxLDL and reversed by berberine. Apart from this, miR-150-5p overexpression greatly repressed P2X7R, EMMPRIN and MMP-9 expression. Collectively, the data supported that berberine suppressed P2X7R by upregulating miR-150-5p in oxLDL-macrophages.</p>
<p>Previous studies (<xref ref-type="bibr" rid="B18">Huang et&#x20;al., 2008</xref>; <xref ref-type="bibr" rid="B19">Huang et&#x20;al., 2011</xref>; <xref ref-type="bibr" rid="B4">Cao et&#x20;al., 2014</xref>; <xref ref-type="bibr" rid="B24">Liang et&#x20;al., 2016</xref>) reported that activation of AMPK and MAPK cascades (p38, ERK1/2, and JNK) are implicated in inducing the expression of EMMPRIN and MMP-9 in PMA-induced THP-1 cells. Here, we also tested both the AMPK and MAPK pathways in macrophages under oxLDL stimulation. As expected, oxLDL induced activation of AMPK&#x3b1; and increased the phosphorylation of p38, ERK1/2, and JNK in macrophages. Moreover, P2X7R inhibition using A-438079 obviously abolished both activation of AMPK&#x3b1; and the MAPK pathway. In addition, compound C also diminished the phosphorylation of MAPK signaling (ERK, JNK, and p38), suggesting that AMPK&#x3b1; is an upstream gene of MAPK activation and regulates EMMPRIN and MMP-9 expression in oxLDL-induced macrophages. Taken together, P2X7R inhibition reduced EMMPRIN and MMP-9 by reducing AMPK&#x3b1; inactivation through suppressing MAPK pathways. In addition, we observed the same trend in the effect of berberine on AMPK&#x3b1; and MAPK activation by oxLDL. These findings revealed that berberine decreases P2X7R levels, which inhibits MMP-9 and EMMPRIN expression by inhibiting AMPK&#x3b1; though MAPK in oxLDL-induced macrophages.</p>
</sec>
</body>
<back>
<sec id="s6">
<title>Data Availability Statement</title>
<p>The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding authors.</p>
</sec>
<sec id="s7">
<title>Author Contributions</title>
<p>LL and JH: experiments participation and paper writing and revised ZH and JL: experiments design and participation, paper writing; XX and TW: technical support, cells treatment and collection; All authors read and approved the final manuscript.</p>
</sec>
<sec id="s8">
<title>Funding</title>
<p>This study was supported by the National Natural Science Foundation of China (Grant No. 81670227 and 82070446) and the Wenzhou Science and Technology Bureau (Grant No. Y20180099 and Y2020242), and the key specialty of traditional Chinese Medicine of Zhejiang Provincial in the 13th Five-Year Plan period (Emergency Department).</p>
</sec>
<sec sec-type="COI-statement" id="s9">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
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