Therapeutic Potential of Dihydroartemisinin in Mitigating
Radiation-Induced Lung Injury: Inhibition of Ferroptosis through
Nrf2/HO-1 Pathways in Mice
Abstract
Background: Radiation-induced lung injury (RILI) is a common consequence
of thoracic radiation therapy that lacks effective preventative and
treatment strategies. Dihydroartemisinin (DHA), a derivative of
artemisinin, affects oxidative stress, immunomodulation, and
inflammation. It’s uncertain, nevertheless, whether DHA reduces RILI. In
this work, we looked into the specific mechanisms of action of DHA in
RILI. Methods: The mice were irradiated with 20 Gy 6 MV irradiation dose
followed by administration of DHA and Brusatol for 30 days. Pathologic
changes in the lungs were observed thereafter. TNF-α, TGF-β, glutathione
peroxidase (GPX4), Nuclear factor erythroid 2-related factor 2 (NRF2),
and heme oxygenase-1 (HO-1) expression in lung tissues were detected. In
addition, mitochondrial ultrastructural changes in lung tissues were
also observed, and the GSH content in lung tissues was assessed.
Results: DHA attenuated radiation-induced pathological lung injury and
inflammatory cell infiltration. Additionally, it decreased the synthesis
of inflammatory substances like TNF-α and TGF-β. DHA additionally
stimulated the Nrf2/HO-1 pathway. DHA inhibited cellular ferroptosis and
upregulated GPX4 and GSH levels. The Nrf2 inhibitor Brusatol reduced
DHA’s inhibitory effect on ferroptosis. Conclusion: DHA modulated the
Nrf2/HO-1 pathway to prevent cellular ferroptosis, hence reducing RILI.
Therefore, DHA could be a potential drug for the treatment of RILI.