Activation of NRF2 by epiberberine improves oxidative stress and insulin resistance in T2DM mice and IR-HepG2 cells in an AMPK dependent manner

Ethnopharmacological relevance: Phytochemical compounds offer a distinctive edge in diabetes management, attributed to their multifaceted target mechanisms and minimal toxicological profiles. Epiberberine (EPI), an alkaloid derived from Plants of the Rhizoma Coptidis, has been reported to have antidiabetic effects. However, the underlying molecular mechanism of EPI are not fully elucidated.

Aim of the study: This study explored the anti-diabetic effects of EPI and the role of the NRF2/AMPK signaling pathway in improving Insulin resistance.

Materials and methods: We utilized two distinct models: in vivo, we employed mice with type 2 diabetes mellitus (T2DM) induced by high-fat diet (HFD) and streptozotocin (STZ) to conduct a range of assessments including measuring physical parameters, conducting biochemical analyses, examining histopathology, and performing Western blot tests. In parallel, in vitro experiments were carried out using Insulin resistance (IR)-HepG2 cells, through which we conducted a CCK8 assay, glucose uptake tests, Western blot analyses, and flow cytometry studies.

Results: In the EPI-treated group of T2DM mice, there was a significant reduction in hyperglycemia, IR, and hyperlipidemia, accompanied by beneficial changes in the liver and pancreas, as well as enhanced glucose uptake in IR-HepG2 cells. Herein, our finding also provided evidence that EPI could increase the expression of GLUT4 and activated the IRS-1/PI3K/AKT Insulin signaling pathway to improve IR in vitro and in vivo. Moreover, EPI alleviated oxidative stress by enhancing SOD and GPX-px activity, decreasing Reactive Oxygen Species (ROS) and malondialdehyde (MDA) content, and promoting nuclear factor (erythroid-derived 2)-like 2 (NRF2), total NRF2, NAD(P)H-quinone oxidoreductase (NQO1) and heme oxygenase-1 (HO-1) expression in the liver tissue of T2DM mice and IR-HepG2 cells. Furthermore, EPI decreased oxidative stress and improved IR, but these benefits were nullified by siNRF2 transfection. In particular, AMP-activated protein kinase (AMPK) deficiency by short-hairpin RNA (shRNA) partially reversed the effects of EPI on nuclear transcription, oxidative stress, and IR of NRF2 in IR-HepG2 cells.

Conclusions: Taken together, EPI activated NRF2-dependent AMPK cascade to protect T2DM from oxidative stress, thereby alleviating IR.

AMPK; Epiberberine; Insulin resistance; NRF2; Type 2 diabetes mellitus.