Regulation of Dendritic Cell Function by Ermiaosan via the EP4-cAMP-CREB Signaling Pathway
Ermiao San (EMS), a traditional Chinese medicine composed of Atractylodes macrocephala and Cortex Phellodendron, has demonstrated therapeutic efficacy in rheumatoid arthritis (RA). Studies suggest that EMS modulates dendritic cell (DC) maturation in adjuvant arthritis (AA) rats, though the precise mechanisms remain unclear. Prostaglandin receptor 4 (EP4) is critical in inflammation and DC function, while cyclic adenosine monophosphate (cAMP) regulates cellular signaling, potentially influencing RA pathogenesis via protein kinase A (PKA) and cAMP response element-binding protein (CREB) activation. EMS exerts protective effects in RA rats by suppressing DC functions, including reduced EP4 mRNA/protein expression, diminished cAMP levels, and impaired CREB phosphorylation. Additionally, serum from EMS-treated rats inhibited antigen uptake by bone marrow-derived DCs (BMDCs), downregulating CD40, CD80, and CD86 expression and altering pro-inflammatory cytokine secretion. Mechanistically, EMS-treated serum suppressed the EP4-cAMP pathway by decreasing EP4 protein expression and CREB activation, alongside reduced intracellular cAMP and PKA levels in BMDCs co-stimulated with PGE2 and TNF-a. These findings indicate that EMS alleviates RA by inhibiting the EP4-cAMP-CREB signaling axis in DCs, providing a scientific rationale for its clinical application in RA treatment.
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