Although many factors have been identified to contribute to RILI, evidence suggests that additional undiscovered processes are involved. Therefore, we utilized mass spectrometry to identify proteins that changed in abundance in the irradiated rat lung over a time course from one day to 20 weeks post-irradiation. The lung samples were obtained from a previous study that documented physiological and histological changes after radiation (
2) permitting functional correlations between protein levels and physiological outcomes. From silver staining of total lung homogenates, it was clear that the abundance of several proteins dramatically decreased between 6 and 20 weeks post-irradiation (). Although it was not possible to identify all of the down-regulated proteins due to the complex nature of the samples, the most prominent proteins were identified. These proteins are involved in processes ranging from cellular architecture to cell signaling () and have not yet been reported to undergo radiation-induced changes in the lung. One protein that underwent a dramatic change is filamin, whose protein level dropped precipitously at 6 weeks post-IR and remained low throughout the remainder of the time course. Filamin is a large scaffolding protein involved in cross-linking actin filaments and organization of the cytoskeleton (
23). Interestingly, filamin-A knock-out mice show vascular defects with abnormal epithelial and endothelial organization and aberrant adherens junctions in developing blood vessels (
24). Thus, loss of filamin A may contribute to vascular damage and subsequent hypoxia in the lung. Another protein identified to be down regulated was talin which plays a critical role in integrin activation and actin cytoskeleton dynamics (
25).
Other proteins down-regulated between 8 and 20 weeks post-IR were biliverdin reductase and peroxiredoxin II. Both biliverdin reductase and peroxiredoxin II contribute to antioxidant defense by production of bilirubin (
26) and reduction of hydrogen peroxide to water respectively. The decrease in the level of these enzymes correlates with a steep increase in oxidative stress in rat lungs as measured by 8-OHdG staining between 6 and 10 weeks post-radiation (
2). Thus, loss of biliverdin reductase and peroxiredoxin II may be one mechanism by which radiation contributes to establishment of chronic oxidative stress. In agreement with our results, biliverdin reductase and peroxiredoxin II were previously shown to be down regulated in abundance in mouse lungs 5 weeks after treatment with 12 Gy (
27).
In addition to the proteins mentioned above, we found that Rho-GDI and annexin II were down regulated in abundance. Rho-GDI inhibits GDP dissociation from Rho GTPases, keeping the latter in an inactive state (
28). The Rho GTPases are involved in the regulation of a diverse array of cellular processes including actin dynamics, gene transcription, and motility (
29). Thus, alteration of their activity could potentially impact a large number of processes in the lung including cell migration. Annexin II was shown to undergo a dramatic reduction in apparent molecular weight at 10 weeks post-irradiation. Since the newly generated species reacted with the annexin II antibody, one possibility is limited proteolysis. Annexin II has been shown to be cleaved by proteases into a 33 kDa C-terminal core domain and a 3 kDa N-terminal domain of 30 amino acids (
30) and Annexin II forms in the 32-36 kDa range were identified by mass spectrometry (
31). Interestingly, antibodies to annexin were detected in the sera and bronchoalveolar lavage fluid from patients with idiopathic pulmonary fibrosis (
32).
In contrast to the proteins identified by mass spectrometry, we found that the HO-1 expression was upregulated by radiation. HO-1 is a low molecular weight stress protein that catalyzes the oxidative degradation of heme to biliverdin, carbon monoxide and iron and is induced by a wide variety of stress signals (
26). Previous studies of HO-1 and radiation have shown increases in HO-1 in response to ionizing radiation in rat liver (
33), intestine (
34) and mouse lung (
20,
21). However, the studies of mouse lung only showed mRNA changes for HO-1 (
20,
21). We have shown for the first time that HO-1 protein expression is increased after irradiation of the lung and that in addition to the first induction, a second induction of HO-1 protein expression occurs at 6-8 weeks post-irradiation suggesting the onset of a second wave of cellular stress.
Previous studies have shown that MnSOD mimetics have the ability to reduce RILI in animal models (
9-
13). Although they are capable of reducing RILI, the mechanisms underlying their protective effects are not fully elucidated. Therefore, we analyzed protein expression changes in the irradiated rat lung from animals treated with the MnSOD mimetic, MnTE-2-PyP
5+ at 6 weeks post-radiation, a time corresponding to macrophage and other inflammatory cell infiltration (
2). Treatment of rats with MnTE-2-PyP
5+ did not result in a reduction in the amount of HO-1 expression at 6 weeks post-IR. This result may be due to the fact that many different types of signals, other than ROS/RNS, induce HO-1 expression (
26) or because MnTE-2-PyP
5+ does not completely eliminate lung injury (
2). However, MnTE-2-PyP
5+ treatment did reduce the apparent degradation of filamin as shown by a decrease in the amount of a ~250 kDa band which reacts with the filamin antibody and was identified as filamin by mass spectrometry ( and , ID #3). Therefore, one mechanism of MnSOD mimetics may be to reduce levels of protein proteolysis.
β-catenin protein levels were significantly down regulated in abundance beginning at ~4-6 weeks post-irradiation and remained diminished until the end of the study (). MnTE-2-PyP
5+ treatment significantly increased β-catenin protein levels at 6 weeks post-radiation compared to radiation alone (). β-catenin is an integral part of the Wnt signaling pathway and irradiation has been shown to inhibit β-catenin signaling in epithelial cells (
35). Moreover, activation of β-catenin in epithelial cells improves cell survival after irradiation (
36). However, there are also studies that show that aberrant Wnt signaling may contribute to pulmonary fibrosis (
22).
Treatment with MnTE-2-PyP
5+ also increased the level of phosphorylated Akt in the irradiated rat lung. Activation of Akt in normal tissues is generally thought to promote cell survival and proliferation and exposure of normal cells to a variety of forms of stress, including ionizing radiation, reduces Akt activation (
37). In agreement with these findings, we found that irradiation decreased Akt phosphorylation at 6 weeks post-IR. Therefore, the increased level of Akt phosphorylation observed after MnTE-2-PyP
5+ treatment may reflect an increase in cell survival signaling. In support of this, treatment with MnTE-2-PyP
5+ produced a corresponding decrease in the amount of cleaved caspase 3. This is in agreement with a previous study that found that a MnSOD mimetic reduced irradiation-induced caspase 3 activation in U937 cells (
13). Taken together, these data suggest that one mechanism by which the MnSOD mimetics act to reduce RILI is to reduce the level of cell death.
In summary, we have identified novel protein changes occurring both during the early response and during the progression and development of RILI at 6-20 weeks after irradiation. It is not yet determined if the changes in protein levels are due to differential protein expression, protein turnover, or from reorganization/remodeling of lung tissue. A model summarizing a potential mechanism for the protective effects of MnSOD mimetics is shown in . In this model, radiation induces lung injury in part through the generation of ROS/RNS, which in turn, can induce significant protein down regulation. The loss of proteins involved in oxidative stress metabolism may further contribute to the generation of ROS/RNS. Alternatively, the loss of cytoskeletal proteins could disrupt connections to the extracellular matrix and induce apoptotic processes. Increased cell death may then stimulate the recruitment of macrophages and other inflammatory cells that can further increase levels of ROS/RNS creating a cycle of chronic inflammation. To maintain structural integrity of the lung, dead cells are replaced by myofibroblasts that ultimately can contribute to the fibrotic process (
18). Thus, MnSOD mimetics may function to reduce radiation-induced lung injury by interrupting the cycle of chronic inflammation through reduction of ROS/RNS and by reducing the level of protein down regulation and apoptosis to preserve structural integrity of the lung.