Chlorogenic Acid Promotes the Nrf2/HO-1 Anti-oxidative Pathway by Activating P21 to Resist Dexamethasone-induced Apoptosis in Osteoblastic Cells

In a previous study, p21 (p21) promoted activation of the nuclear factor E2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) pathway, which has an important role in regulating apoptosis triggered by oxidative stress and inhibiting development of osteoporosis. Chlorogenic acid (CGA) has a strong protective effect on osteoporosis, closely related to activating the Nrf2/HO-1 pathway. However, whether CGA can resist apoptosis by regulating p21 and consequently promote activation of the Nrf2/HO-1 pathway needs further investigation. MC3T3-E1 cells were treated with dexamethasone (Dex), with or without CGA pre-treatment. Cell proliferation and cytotoxicity were measured using MTT assay and LDH release assay, respectively, and apoptosis assessed by flow cytometry. CGA significantly attenuated mitochondrial apoptosis and reversed down-regulation of p21 in osteoblastic MC3T3-E1 cells exposed to Dex. Additionally, CGA decreased Keap1 expression and promoted activation of the Nrf2/HO-1 pathway, quenching intracellular reactive oxygen species (ROS), hydrogen peroxide (HO) and mitochondrial superoxide overproduction boosted by Dex. Importantly, depletion of p21 by siRNA blocked activation of the Nrf2/HO-1 pathway, enhanced oxidative stress and increased apoptosis induced by CGA in MC3T3-E1 cells challenged with Dex. Therefore, CGA promoted the Nrf2/HO-1 anti-oxidative pathway by activating p21 to prevent Dex-induced mitochondrial apoptosis in osteoblastic cells. This pathway has potential as a therapeutic target for prevention and treatment of osteoporosis.