A Flavonoid-Rich Extract from Bergamot Juice, Alone Or In
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pharmaceuticals Article A Flavonoid-Rich Extract from Bergamot Juice, Alone or in Association with Curcumin and Resveratrol, Shows Protective Effects in a Murine Model of Cadmium-Induced Testicular Injury Nadia Ferlazzo 1, Antonio Micali 1, Herbert Ryan Marini 2 , Josè Freni 1, Giuseppe Santoro 1 , Domenico Puzzolo 1, Francesco Squadrito 2 , Giovanni Pallio 2 , Michele Navarra 3 , Santa Cirmi 3,4,* and Letteria Minutoli 2 1 Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy; [email protected] (N.F.); [email protected] (A.M.); [email protected] (J.F.); [email protected] (G.S.); [email protected] (D.P.) 2 Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; [email protected] (H.R.M.); [email protected] (F.S.); [email protected] (G.P.); [email protected] (L.M.) 3 Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy; [email protected] 4 Department of Pharmacy-Drug Sciences, University of Bari “Aldo Moro”, 70125 Bari, Italy * Correspondence: [email protected] Citation: Ferlazzo, N.; Micali, A.; Marini, H.R.; Freni, J.; Santoro, G.; Abstract: It is known that cadmium damages testis structure and functionality. We examined the Puzzolo, D.; Squadrito, F.; Pallio, G.; effects of nutraceuticals such as a flavonoid-rich extract of bergamot juice (BJe), alone or in association Navarra, M.; Cirmi, S.; et al. A with curcumin (Cur) and resveratrol (Re), on mice testicular dysfunction caused by cadmium chloride Flavonoid-Rich Extract from (CdCl2). Controversial data on the protective effects of Cur and Re are available, while no evidence Bergamot Juice, Alone or in on the possible role of BJe exists. Adult male C57 BL/6J mice were administered with CdCl2 and Association with Curcumin and treated with Cur, Re, or BJe alone or in combination for 14 days. Then, testes were removed and Resveratrol, Shows Protective Effects processed for molecular, structural, and immunohistochemical analyses. CdCl2 increased the mRNA in a Murine Model of of IL-1β, TNF-α, p53, and BAX while reduced that of Bcl-2 and induced tubular lesions and apoptosis Cadmium-Induced Testicular Injury. of germinal cells. Cur, Re, and BJe at 40 mg/kg significantly improved all of these parameters and Pharmaceuticals 2021, 14, 386. events, although BJe at 20 mg/kg showed a lower protective effect. The association of Cur, Re, and https://doi.org/10.3390/ph14050386 BJe at both doses of 50/20/20 and 100/20/40 mg/kg brought each parameter close to those of the Academic Editor: Daniela De Vita control. Our results indicate that the nutraceuticals employed in this study and their associations exert a positive action against Cd-induced testicular injury, suggesting a possible protection of testis Received: 6 April 2021 functionality in subjects exposed to environmental toxicants. Accepted: 19 April 2021 Published: 21 April 2021 Keywords: cadmium; oxidative stress; apoptosis; flavonoids; bergamot juice; curcumin; resveratrol; testis; nutraceuticals; functional food Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. 1. Introduction Cadmium (Cd) is a nonessential transition metal without any physiological function in the human body, often considered a ubiquitous toxicant with carcinogenic activity. Cd, alongside arsenic, lead, mercury, and chromium, poses health risks [1,2]. Human exposure Copyright: © 2021 by the authors. to Cd occurs either in the workplace or through inhalation or ingestion of Cd-contaminated Licensee MDPI, Basel, Switzerland. materials [3]. Occupational exposure is typical of subjects working with pigments, glass, This article is an open access article plastics, metal alloys, and nickel-Cd batteries [4], while the main sources of exposure for distributed under the terms and the general population are cigarette smoke and foods [5]. In humans, Cd induces toxic conditions of the Creative Commons effects in various organs, including the testes [6]. In fact, male infertility with lower semen Attribution (CC BY) license (https:// quality [7] and postponed puberty with reduced gonadal growth [8] were observed. creativecommons.org/licenses/by/ 4.0/). Pharmaceuticals 2021, 14, 386. https://doi.org/10.3390/ph14050386 https://www.mdpi.com/journal/pharmaceuticals Pharmaceuticals 2021, 14, 386 2 of 14 In animals, and particularly in rodents [9], after experimental Cd exposure, testicular lesions were observed, such as a significant reduction in testis weight and testosterone levels, and structural changes in both seminiferous tubules and Leydig cells [10–13]. Both oxidative stress and inflammation are key events involved in the toxic action of Cd [14]. Cd-induced inflammatory cascade is triggered by tumor necrosis factor (TNF)-α, a proinflammatory cytokine [13,15] that amplifies phlogistic response by stimulating the release of reactive oxygen species (ROS). These are extremely toxic to spermatozoa because of their high content of polyunsaturated fatty acids along with their limited ability to repair DNA [16]. In addition to directly inducing structural damage in the testis, oxidative stress is also capable of stimulating apoptosis both in vitro [17] and in vivo [12,18]. In fact, Cd has been shown to increase the expression of proapoptotic factors such B cell-lymphoma (Bcl)-2-associated X protein (Bax), of the key regulatory protein p53, and of caspase-3 as well as to reduce that of the antiapoptotic Bcl-2 [11,18–21]. It was also observed that germ cell apoptosis might be the consequence of a Cd-induced reduction in testosterone level [22] with detachment of immature germ cells from the seminiferous epithelium [23]. In recent years, several therapeutical approaches have been proposed to retrieve the toxic effects of Cd on male genital apparatus [6]. Among them, the role of antioxidants on the restoration of the seminiferous epithelium was evaluated. In this field, the phenolic compound curcumin (Cur), a major component of Curcuma longa L., showed protective effects against oxidative damage by inhibiting the production of TNF-α [24] and by scav- enging ROS [25]. In this regard, in rodents challenged with Cd, Cur improved seminiferous tubules morphology [26,27] and significantly decreased the number of apoptotic germi- nal cells [28,29]. Additionally, resveratrol (Re), a polyphenol present in many plants and especially in red wine, showed antioxidant properties [30] as well a positive regulation of apoptosis and other zonula occludens protein expression, such as occludin [31,32]. In the testis, Re protected from oxidative stress [33], partially reversed the dysregulation of the apoptotic pathways [20], and improved sperm parameters and histopathological dam- age [34]. Recently, bergamot juice (BJ), obtained from the endocarp of Citrus bergamia Risso et Poiteau (bergamot) fruits, gained the attention of pharmaceutical companies interested in natural products and antioxidant bioactive compounds from dietary sources [35–37]. Indeed, it has been shown that BJ and its flavonoid-rich fraction (BJe) exert hypolipemic and hypoglycemic activity [38], and anticancer [39], anti-infective [40,41], neuroprotec- tive [42], antioxidant, and anti-inflammatory effects [43–46]. However, no data are currently available on the potential role of BJe during Cd challenge. In light of this background, the present study was designed to examine the effects of the nutraceuticals BJe, Cur, and Re, alone or in association, in a murine model of Cd-induced testicular damage. 2. Results 2.1. Testes and Body Weight along with Their Ratio Mice testes and body weight (TW and BW, respectively) as well as their ratio (TW/BW) are shown in Table1. As expected, CdCl 2-challenged mice showed TW, BW, and TW/BW ratio significantly lower than the control (Table1). Both doses of Cur slightly increased these parameters with respect to those found in CdCl2-injured mice that, however, remained significantly lower than the controls (Table1 ). Conversely, in CdCl2 + Re treated mice, all parameters considered in this task showed a significant improvement in comparison to those assessed in CdCl2-subjected mice (p < 0.05) as occurs with BJe 40 mg/kg (p < 0.05 vs. CdCl2), whilst BJe 20 mg/kg did not significantly increase TW, BW, or their ratio (Table1) . Of note, the associations between BJe, Cur, and Re (Cur 50 mg/kg + Re 20 mg/kg + BJe 20 mg/kg as well as Cur 100 mg/kg + Re 20 mg/kg + BJe 40 mg/kg) significantly improved all parameters almost up to those of the controls (p < 0.05 vs. CdCl2), thus protecting mice and their testes from cadmium toxicity. Pharmaceuticals 2021, 14, x FOR PEER REVIEW 3 of 15 significantly improved all parameters almost up to those of the controls (p < 0.05 vs. Pharmaceuticals 2021, 14, 386 CdCl2), thus protecting mice and their testes from cadmium toxicity. 3 of 14 Table 1. Cur, Re, BJe, and their combinations improved BW, TW, and TW/BW in mice exposed to CdCl2. All values are expressed as mean ± SEM; n = 7 animals for each group. Table 1. Cur, Re, BJe, and their combinations improved BW, TW, and TW/BW in mice exposed to CdCl . All values are expressed as mean ± SEM; n = 7 animals for each group. TW/BW 2 BW (g) TW (mg) Ratio TW/BW BW (g) TW (mg) Controls 30.2 ± 1.8 108.2 ± 9.4 Ratio3.59 CdCl2 + vehicle 24.3 ± 1.5 a 71.2 ± 5.4 a 2.93 a Controls 30.2 ± 1.8 108.2 ± 9.4 3.59 CdCl2 + Cur 50 mg/kg 27.1a ± 1.4 a,b 83.2a ± 5.9 a,b 3.07a a,b CdCl2 + vehicle