IPSE, a urogenital parasite-derived immunomodulatory protein, ameliorates ifosfamide-induced hemorrhagic cystitis through downregulation of pro-inflammatory pathways

Sci Rep. 2019 Feb 7;9(1):1586. doi: 10.1038/s41598-018-38274-z.

Abstract

Ifosfamide and other oxazaphosphorines can result in hemorrhagic cystitis, a constellation of complications caused by acrolein metabolites. We previously showed that a single dose of IPSE (Interleukin-4-inducing principle from Schistosoma eggs), a schistosome-derived host modulatory protein, can ameliorate ifosfamide-related cystitis; however, the mechanisms underlying this urotoxicity and its prevention are not fully understood. To provide insights into IPSE's protective mechanism, we undertook transcriptional profiling of bladders from ifosfamide-treated mice, with or without pretreatment with IPSE or IPSE-NLS (a mutant of IPSE lacking nuclear localization sequence). Ifosfamide treatment upregulated a range of proinflammatory genes. The IL-1β-TNFα-IL-6 proinflammatory cascade via NFκB and STAT3 pathways was identified as the key driver of inflammation. The NRF2-mediated oxidative stress response pathway, which regulates heme homoeostasis and expression of antioxidant enzymes, was highly activated. Anti-inflammatory cascades, namely Wnt, Hedgehog and PPAR pathways, were downregulated. IPSE drove significant downregulation of major proinflammatory pathways including the IL-1β-TNFα-IL-6 pathways, interferon signaling, and reduction in oxidative stress. IPSE-NLS reduced inflammation but not oxidative stress. Taken together, we have identified signatures of acute-phase inflammation and oxidative stress in ifosfamide-injured bladder, which are reversed by pretreatment with IPSE. This work revealed several pathways that could be therapeutically targeted to prevent ifosfamide-induced hemorrhagic cystitis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents, Alkylating / adverse effects*
  • Cystitis / diagnosis
  • Cystitis / etiology*
  • Cystitis / metabolism*
  • Cytokines / metabolism
  • Egg Proteins / immunology*
  • Gene Expression Profiling
  • Helminth Proteins / immunology*
  • Hemorrhage / diagnosis
  • Hemorrhage / etiology*
  • Hemorrhage / metabolism*
  • Ifosfamide / adverse effects*
  • Inflammation Mediators / metabolism
  • Oxidative Stress
  • Signal Transduction / drug effects*
  • Transcriptome

Substances

  • Antineoplastic Agents, Alkylating
  • Cytokines
  • Egg Proteins
  • Helminth Proteins
  • IPSE protein, Schistosoma mansoni
  • Inflammation Mediators
  • Ifosfamide