Background
Diabetes mellitus (DM) is a common metabolic disorder, affecting 382 million people worldwide as of 2013 [
1]. DM is characterized by high blood glucose levels due to impaired insulin action and secretion, and is classified into two major categories, types 1 and 2 [
2]. Type 1 DM (T1DM) results from autoimmune destruction of β-cells in the pancreas [
3], usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Patients with T1DM must live in compliance with daily vigilance of blood glucose and insulin injections. Hyperglycemia is the hallmark of T1DM, inducing chronic generation of reactive oxygen species (ROS), consequently resulting in diabetic liver injury [
4]. Patients with T1DM have a considerably worse long-term prognosis than individuals without diabetes, due to the high incidence of cardiovascular disease and end-stage renal disease (ESRD). Diabetic nephropathy (DN), the leading cause of chronic kidney disease in the United States, is responsible for up to 40% of all ESRD cases [
5]. Since conventional and recently proposed therapies for DN lack major efficacy or are still under investigation, the search for novel targets involved in diabetes-induced renal damage is of primary importance.
Ginger is a commonly used spice or food supplement. This edible plant has been equally reputed for its medicinal function for centuries [
6,
7]. The pleasant aroma of ginger comes from the constituents present in its volatile oil, while its non-volatile pungent phytochemicals, consisting of gingerols, shogaols, and paradols, give ginger its warm pungent sensation and are reported to account for most of its pharmacological effects [
8,
9]. Among identified components, 6-gingerol was reported as the most abundant bioactive compound in ginger with various pharmacological effects, including antioxidant, analgesic, anti-inflammatory, and antipyretic properties [
10‐
12]. Recent studies have shown that 6-shogaol, with the lowest concentration in ginger, is more biologically active than 6-gingerol [
13‐
15]; it has also been reported as a potent anti-inflammatory and antioxidant compound [
16].
In recent years, ginger has received extensive attention as a botanical dietary supplement in the United States and Europe because of its anti-inflammatory, anti-oxidative, and antitumor activities [
17,
18]. A number of studies have examined the effects of ginger in hyperglycemia. Ginger (800 mg/kg) significantly decreased fasting blood glucose levels following 1-h treatment in an streptozotocin (STZ)-induced type 1 diabetic rat model [
19] and prevented 5-hydroxytryptamine (5-HT)—induced acute hyperglycemia. Long-term treatment with ginger not only affected blood glucose levels, but also decreased serum triglyceride and total cholesterol, increased insulin, and effectively prevented liver and kidney damage in STZ-induced diabetic rats [
20]. Of the several bioactive compounds identified in ginger, including gingerols, shogaols, paradols, and zingerones [
21‐
23], 6-shogaol has recently been studied for its antioxidant and antitumor activities, as well as its activity in diclofenac sodium-induced liver injury [
16,
24‐
26].
In the present study, we evaluated the effects of 6-shogaol on serum levels of blood glucose, body weight, and pathological changes in an STZ-induced mouse model. We also investigated the effect of 6-shogaol on cell proliferation and apoptosis in diabetic pancreas, kidney, and liver. We analyzed that 6-shogaol’s preventive effects of oxidative stress in STZ-induced mouse kidney, inhibitory effects of alanine transaminase (ALT) and aspirate aminotransferase (AST) levels, which are indicative of liver damage, and tumor necrosis factor (TNF)-α and transforming growth factor (TGF)-β1 mRNA expression levels in STZ-induced mouse liver. We verified that STZ-induced central areas of necrosis, fatty change, and inflamed liver sinusoids following treatment with 6-shogaol. We also analyzed expression levels of Ki-67 and other proteins related to cell proliferation in various tissues.
Materials and methods
Animal treatment
Male C57BL/6J (8-week-old) mice were purchased from Harlan Korea Laboratories. All mice were housed in the Experiment Animal Center of Kyungpook National University at 22 °C with a 12:12-h light/dark cycle and free access to rodent chow and tap water.
The animals were randomly divided into four experimental groups: control group mice (n = 3) were given an IP injection of STZ vehicle (1 mL citrate buffer/100 g body weight) at day 1 and received an IP injection of 6-shogaol vehicle [1 mL buffer (0.5% DMSO, 10% Tween 20, and 89.5% PBS)/100 g body weight] every other day for 4 consecutive days; STZ group mice (n = 3) were given a single IP injection of STZ (50 mg/kg body weight) at day 1, and a daily IP injection of sodium citrate vehicle for 4 consecutive days; Sho group mice (n = 4) received a single IP injection of cisplatin vehicle at day 0 (10 mg/kg body weight), and a daily IP injection of 6-shogaol for 4 days; and STZ + Sho group mice (n = 6) received a single IP injection of STZ at day 1 (50 mg/kg body weight), followed by daily IP injections of 6-shogaol solution (5 or 10 mg/kg body weight) for 4 days. 6-Shogaol (purity > 96%) was purchased from Chengdu Push Biotechnology (Cat No: PS1753). This experiments were continued check the glucose level and body weight until 2 weeks.
Biochemical assays
Following STZ treatment, on the day of sacrifice, mice were euthanized by intraperitoneal injection of a cocktail of xylazine, tiletamine and zolazepam (Rompun, Bayer and Zoletil, Virbac). After achieving deep anaesthesia, the subjects were exsanguinated by cardiac puncture using a heparinized syringe. The collected blood samples were centrifuged at 5000 rpm for 10 min at 4 °C, and the separated sera were stored at − 80 °C until analysis. Serum samples were used for the biochemical analysis of ALT and AST levels. Measurements were performed using an auto-analyzer.
Histopathological studies
For preparation of pancreas, kidney and liver tissues we had to CO
2-euthanized all mice in the current study. Pancreas, kidney, and liver tissues were formalin-fixed after isolation, embedded in paraffin after dehydration (2 h in PBS, 2.5 h in 50% ethanol, 2.5 h in 70% ethanol, 2.5 h in 80% ethanol, overnight in 90% ethanol, 2.5 h in 95% ethanol, 2.5 h in 100% ethanol, 5 min in xylene twice, 30 min in xylene/paraffin, and 30 min in paraffin three times), and cut into 4-µm sections. The 4-µm thick sections were rehydrated (30 s in 100% ethanol, 30 s in 90% ethanol, 30 s in 80% ethanol, and 30 s in 70% ethanol), dried overnight, and stained with hematoxylin and eosin (3 min rinse in distilled water, 1 min 30 s stain in Gill’s hematoxylin V, 3 min rinse in running tap water, 30 s counterstain in eosin, and 5 s rinse in tap water), then dehydrated (10× dipping in 80% ethanol, 90% ethanol, 100% ethanol, and 100% ethanol, followed by 5 min each in xylene I, II, and III) [
27].
Immunohistochemistry studies
The immunohistochemistry studies were performed as previously described [
27]. Pancreas, kidney, and liver tissue slices from the different experimental groups were immersed in 10% formalin at room temperature overnight. The tissues were then embedded in paraffin, and the paraffin sections were cut. After deparaffinization, some sections were used for routine hematoxylin–eosin staining, while others were incubated with blocking serum for 30 min followed by noncommercial rabbit polyclonal antibody against rat caspase-3 (1:300; Cell Signaling, #9661S) and Ki-67 (1:200; Abcam, AB92742) overnight at 4 °C. The sections were rinsed with Tris-buffered saline containing 1% Tween (TBST), then immediately incubated with horseradish peroxidase (HRP)-conjugated secondary antibody against rabbit immunoglobulin for 1 h. To detect HRP labeling, a peroxidase substrate solution with diaminobenzidine (0.05% diaminobenzidine in TBST with 0.05% H
2O
2) was used. The sections were counterstained with hematoxylin before examination under a light microscope.
Real-time PCR
On the day of sacrifice, mice were euthanized by CO2 chamber. After opening the abdominal wall, the intestinal tract was removed and cut according to the different anatomic regions. The content of the fresh kidney and liver tissues was separately collected in microtubes and quickly frozen and homogenize in liquid nitrogen. Total RNA was prepared from frozen tissues using TRIzol Reagent (Thermo Fisher Scientific) according to the manufacturer’s instructions. cDNA was synthesized using a Veriti 96-Well Fast Thermal Cycler (5 min at 65 °C, 1 h at 42 °C, 5 min at 95 °C, followed by 4 °C overnight). Gene expression levels were determined by real-time PCR using the StepOnePlus Real-Time PCR System (Applied Biosystems) with Power SYBR Green PCR Master Mix (Applied Biosystems) and the following primers: nuclear factor E2-related factor (Nrf)-2 forward: 5′-CTC GCT GGA AAA AGA AGT GG-3′ and reverse: 5′-GGA GAG GAT GCT GCT GAA AG-3′; TNF-α forward: 5′-GCT GAG CTC AAA CCC TGG TA-3′ and reverse: 5′-CGG ACT CCG CAA AGT CTA AG-3′; TGF-β1 forward: 5′-TGA GTG GCT GTC TTT TGA CG-3′ and reverse: 5′-AGC CCT GTA TTC CGT CTC CT-3′; and β-actin forward: 5′-GCG CAA GTA CTC TGT GTG GA-3′ and reverse: 5′-ACA TCT GCT GGA AGG TGG AC-3′. Reactions were performed according to the manufacturer’s instructions and analyzed following geometric normalization.
Statistical analysis
All quantitative results are expressed as mean ± standard deviation. Statistically significant differences were obtained using Student’s t-test or one-way analysis of variance. p < 0.05 was considered to indicate statistical significance.
Discussion
Diabetic patient increased fastly in the world and this disorder increased heterogeneity, so more appropriate application need for therapy [
28]. Recently, therapeutic drug has some drawbacks such as hepatotoxicity, vascular complications, neuronal and cardiotoxicity side effect. Chemotherapeutic drug still have a challenge for management of diabetes in medical system. This has led to an increase in the demand for natural products with anti-hyperglycemic activity and fewer side effects. Traditional plant medicines are used in the world wide for diabetic disease. The study of medicines field might offer a new key to unlock a diabetic pharmacy for the future.
Streptozotocin injection resulted in diabetes mellitus, which may be due to destruction of beta cells of Islets of Langerhans as proposed by others. Diabetes arises from irreversible destruction of pancreatic beta cells, causing degranulation and reduction of insulin secretion. STZ-induced diabetes is characterized by a severe loss in body weight and may exhibit most of the diabetic complications such as, myocardial, cardiovascular, nervous, kidney and urinary bladder dysfunction through oxidative stress [
29]. After 30 days supplementation of ethanolic extract of ginger to diabetic rats, resulted significant diminution of fasting blood glucose level in respect to diabetic control rats, but no significant alteration of fasting blood glucose level to the control, which further strengthen the antidiabetogenic action of ginger extract. Many investigators reported that phenols, polyphenolic compounds and flavonoids of ginger are responsible for hypoglycemic and other pharmacological activities [
30]. The decrease in body weight in diabetic rats shows that the loss or degradation of structural proteins is due to diabetes, and structural proteins are known to contribute to the body weight. The present study demonstrated that ginger treatment, ALT and AST levels were significantly increased in STZ-induced diabetic group. 6-Shogaol inhibits ALT (alanine transaminase), AST (aspirate aminotransferase) level which indicate liver damage and down regulates TNF-α, TGF-β1 mRNA expression in STZ-induced mice liver. And we identify STZ-induced central area necrosis, fatty change, sinusoids with inflammatory cell display nearly normal appearance by 6-shogaol treatment in various tissue. Also 6-shogaol decrease expression of ki-67, cell proliferation related protein, in addition proapoptotic protein caspase3 expression reverse normal condition level.
In our study, dramatic changes in insulin content, islet morphology and b-cell structure were evident after 2 weeks with STZ group compared with control group. There was a marked reduction in islet cells staining for insulin. Whereas, STZ + Sho group indicate that maintain of insulin immunolabelling and structure of b-cell mass after 2 weeks compared with control group. This is clear from the fact that many b-cells and insulin granules are observed at the structural level. The morphology of these b-cells also confirms they are undergoing apoptosis in various tissues. Nevertheless, ki-67 positive cell no such a difference were recognized within and between the groups in pancreas and kidney. We also found no change in proliferation. Thus, our data argue that the marked maintain in insulin staining we observe by immunohistochemistry is not primarily due to b-cell increase but rather to a increase in insulin gene expression and insulin granule density. The idea that increase insulin content can give rise to the fallacious impression of b-cell production has also been suggested for islets from patients with diabetes [
31] and rodent models of diabetes [
32].
DM is a global health problem due to its serious complications. Among diabetic complications, nephropathy probably is one of the major complications to increase the mortality of diabetic patients or impact their life quality. Although mechanisms by which diabetes induces the development of nephropathy are multiple, excessive production of reactive oxygen species (ROS) diabetic condition seems the primary factor [
33‐
35]. Nuclear factor E2-related factor-2 (Nrf2) is a key transcription factor in regulating intracellular redox balance and a sensor of oxidative and electrophilic stress. Nrf2 regulates intracellular antioxidants, phase II detoxifying enzymes, and many other proteins that detoxify xenobiotics and neutralize ROS and/or RNS to maintain cellular redox homeostasis. NAD(P)H quinone oxidoreductase (NQO1), heme oxygenase-1 (HO-1), and glutathione S-transferase are among the well-studied Nrf2 target genes that are upregulated through the antioxidant response element regulatory element in response to oxidative stress [
36‐
38]. The important role of Nrf2 in combating oxidative stress induced by diabetes has been demonstrated by the increased cardiac and renal sensitivity of Nrf2
−/− mice to diabetes [
38‐
40].
Liver is a major target of insulin action, the onset of diabetes is accompanied by development biochemical and functional abnormalities in the liver including alteration in carbohydrate, lipid, protein metabolism, and change in antioxidant status [
41‐
44]. In a research recently published, it is demonstrated that the diabetic state induces an increase of TNF-α and of its receptor TNF-R1 in the liver [
45]. Also hyperglycemia induces apoptosis in streptozotocin (STZ)-induced diabetic rat liver through the increase of hydroxyl radical, and consequent activation caspase-3 [
46]. STZ-induced animal models have been widely used in medical research to understand the pathophysiology of T1D based on the ability of STZ to disrupt pancreatic β-cells [
47]. Aseer et al. [
48] found that SPARC was significantly up-regulated in the liver while down-regulated in the pancreas of STZ-induced diabetic rats and significant up-regulation of TGF-β1, TNF-α in diabetic liver.
Conclusion
Our study suggest that 6-shogaol has an effect against damage of pancreas, kidney, and liver in the diabetic mice. Since, 6-shogaol prevent the damage for STZ induced stress. 6-shogaol will applicate the diabetic therapy as a pharmatheuticals or combination drug with herbal plant or others. 6-shogaol may be a good therapeutic drug because it covers not only pancreatic β-cell but also liver and kidney. In the future Ginger may be ideal because they contain a variety of pharmacological compounds with different known pharmacological actions. However, further study will be needed, for the better understanding of the mechanism of action of ginger by which it modulates liver and kidney damage in diabetic condition.
Authors’ contributions
JK and ZY performed the majority of experiments, analyzed the data, and wrote the manuscript; JJ participated in animal experiments; DY assisted with data analysis and edited the manuscript, MO designed and SH coordinated the research. All authors ensure that this is the case. All authors read and approved the final manuscript.