High mobility group box 1 (
HMGB1) is recognized as a late mediator of
sepsis, and the inhibition of
HMGB1 release and recovery of vascular barrier integrity have emerged as attractive therapeutic strategies for the management of
sepsis. We tested the hypothesis that
aloin induces
sirtuin 1 (
SIRT1) and
heme oxygenase (HO)-1, which inhibit
HMGB1 release in
lipopolysaccharide (LPS)-stimulated cells, thereby inhibiting HMGB1-induced hyperpermeability and increasing the survival of septic mice.
Aloin was administered after LPS or
HMGB1 challenge, and the
antiseptic activity of
aloin was determined from measurements of permeability, activation of pro-inflammatory
proteins and production of markers for tissue injury in HMGB1-activated human umbilical vein endothelial cells (HUVECs) and a cecal
ligation and
puncture (CLP)-induced
sepsis mouse model.
Aloin significantly reduced
HMGB1 release in LPS-activated HUVECs via SIRT1-mediated
HMGB1 deacetylation and the PI3K/Nrf2/
heme oxygenase (HO)-1 signaling axis.
Aloin also suppressed the production of
tumor necrosis factor (TNF)- α and
interleukin (IL)-6, as well as the activation of nuclear factor (NF)- κ B and
extracellular signal-regulated kinase 1/2 (ERK 1/2) by
HMGB1. Moreover,
aloin restored HMGB1-mediated vascular disruption and inhibited vascular hyperpermeability in mice. In addition, treatment with
aloin reduced the CLP-induced release of
HMGB1,
sepsis-related mortality and tissue injury in vivo. Our results suggest that
aloin reduces
HMGB1 release and
sepsis-related mortality by activating
SIRT1 and PI3K/Nrf2/HO-1 signals, indicating that
aloin has potential for the treatment of
sepsis.