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Downregulation of miR-146a-5p Promotes Acute Pancreatitis through Activating the TLR9/NLRP3 Signaling Pathway by Targeting TRAF6 In Vitro Rat Model

Acute pancreatitis (AP) is mainly caused by acinar cells releasing various inflammatory factors, causing inflammatory storms and leading to severe pancreatitis. Detection methods and treatment targets for pancreatitis are lacking, raising the urgency of identifying diagnostic markers and therapeutic targets for AP. MicroRNAs (miRNAs) have recently been identified as molecular markers for various biological processes such as tumors, immunity, and metabolism, and the involvement of miRNAs in inflammatory responses has been increasingly studied. To explore the role of miRNAs in AP is the primary objective of this study. By using qPCR on our cerulein-induced pancreatitis cell model, it is worth noting that the change of miR-146a-5p expression in inflammation-related miRNAs in AP was predominant. Next, ELISA, CCK8, and flow cytometry were used to inspect the impact of miR-146a-5p on pancreatitis. BiBiServ bioinformatics anticipated binding ability of miR-146a-5p and 3′-untranslated region (3′UTR) of TNF receptor-associated factor 6 (TRAF6), and the dual-luciferase assay verified the combination of the two. TRAF6 knockdown verified the effect of TRAF6 on the progression of pancreatitis. Finally, rescue experiments verified the capability of miR-146a-5p and TRAF6 interaction on the Toll-like receptor 9 (TLR9)/NOD-like receptor protein 3 (NLRP3) signaling pathway and cell function. The expression of miR-146a-5p decreased in cerulein-induced AR42J pancreatic acinar cells. Functional experiments verified that miR-146a-5p facilitated the proliferation of AR42J pancreatic acinar cells and inhibited their apoptosis. Bioinformatic predictions and dual-luciferase experiments verified the actual binding efficiency between miR-146a-5p and 3′UTR of TRAF6. Our study confirmed that knockdown of TRAF6 restrained the progression of pancreatitis, and knockdown of TRAF6 rescued pancreatitis caused by miR-146a-5p downregulation by the TLR9/NLRP3 signaling pathway. Therefore, downregulation of miR-146a-5p in the induced pancreatitis cell model promotes the progression of pancreatitis via the TLR9/TRAF6/NLRP3 signaling pathway. There is potential for miR-146a-5p to serve as a diagnostic marker and therapeutic nucleic acid drug for AP.


Introduction
Acute pancreatitis (AP) is a common acute abdominal condition in gastroenterology. It is characterized by rapid onset, severe illness, and rapid change. If not actively treated, it can be life-threatening [1]. Pancreatitis is mainly diagnosed by detecting serum amylase and lipase. However, this diagnosis is often missed, especially if the patient has this triglyceride [2]. Therefore, there is an urgent need to identify more accurate pancreatitis-related molecular markers.
Recently, continuously increasing researches have expounded that microRNAs (miRNAs) play important roles in acinar cell damage and inflammation [3]. Hu et al. found that microRNA-19b (miR-19b) mimic inhibited the survival rate of AR42J cells and increased their expression in AP tissues [4]. Zhang et al. showed that miR-216a activates phosphoinositide-3-kinase (PI3K)/AKT signaling via the target phosphatase-and-tensin homolog to cause pancreatic tissue damage and inflammation [5]. By constructing an miR-21 knockout mouse model, Ma    Computational and Mathematical Methods in Medicine miR-21 deletion repressed pancreatic injury and inflammation [6]. TNF receptor-associated factor 6 (TRAF6) belongs to the TNF receptor-associated factor family. It can activate the NF-κB signaling pathway and is also an E3 ligase. Therefore, TRAF6 as a signal pathway regulator refer to miscellaneous biological processes such as ubiquitination, autophagy, and inflammation [7,8]. Ellipticine can treat acute pancreatitis by inhibiting the expression of TRAF6 [9]. It is well known that lipopolysaccharide (LPS) can bind to the TLR4 receptor on the cell membrane, recruiting myeloid differentiation factor 88 (MyD88) and TRAF6, activating a series of signaling pathways, and including inflammation [10].
Inflammasomes are a type of macromolecular complex in cells, mainly composed of the NLR protein family, associated speck-like protein containing a CARD (ASC), and downstream protein caspase-1 [11]. NLRP3 inflammasome refers to various inflammatory bowel diseases, inflammatory nephropathy, and autoimmune diseases [12][13][14]. Hoque et al. found that the NLRP3 inflammasome is highly correlated with the occurrence of AP [15]. At the same time, many studies have shown that TRAF6 regulates the activity of NLRP3 inflammasome to regulate neuroinflammation, gouty arthritis, and other inflammatory responses [16][17][18]. However, the relationship between TRAF6 and NLRP3 inflammasome in pancreatitis has not yet been studied.
In light of the existing state of knowledge, the present study elucidated that miR-146a-5p regulates the NLRP3 signaling pathway through the target TRAF6 to stimulate the development of pancreatitis.

Materials and Methods
2.1. Cell Culture and Transfection. AR42J rat acinar cells (purchased from ATCC) and 293T cell lines (from own laboratory) were preserved in DMEM medium, and AR42J pancreatic cells were treated with 0 nM, 2.5 nM, 5 nM, and 10 nM cerulein (Solarbio, C6660) to construct a pancreatitis model. 50 nM of miR-146a-5p mimic or inhibitor and si-TRAF6 were transfected into AR42J acinar cells using Lipofectamine 2000 (Invitrogen). See Supplementary Table I     2.3. RT-qPCR. The total RNA of cerulein-treated AR42J acinar cells was extracted with TRIzol reagent. The extracted RNA was reverse-transcribed into cDNA using Random Primer (hexadeoxyribonucleotide mix: pd(N)6; Takara Bio, Japan). PCR experiments were carried out under the following conditions: 95°C for 10 min, 55°C for 2 min, 72°C for 2 min, followed by 40 cycles of 95°C for 15 s and 60°C for Relative luciferase activity  (e, f) qPCR and WB inspection of the expression of TRAF6 in AR42J cells treated with 0, 2.5, 5, and 10 nM cerulein. Band analysis software is ImageJ (version 1.8.0_172). * p < 0:05, * * p < 0:01, and * * * p < 0:001. The experiments were repeated three times, the statistical test was a two-tailed test, and errors bars in the figures represent standard deviation (SD). 4 Computational and Mathematical Methods in Medicine Cerulein si-con siRNA-2 siRNA-3 Cerulein si-con siRNA-2 siRNA-3    Supplementary Table II for PCR primer. The expression levels of TRAF6 and microRNA were calculated using the 2 -ΔΔCt method. GAPDH and 18sRNA are internal controls for mRNA and microRNAs, respectively.

Statistical
Analysis. Data are expressed as the mean ± standard deviation. Where there were more than two groups of data, statistical analysis was performed using one-way analysis of variance (ANOVA) and Dunnett's post hoc test, and Student's t-test was used to analyze the means of two groups. All experiments were repeated three times.

miR-146a-5p Suppresses the Development of Pancreatitis.
To explore the effect of miR-146a-5p on the progression of pancreatitis, we transfected mimics NC and miR-146a-5p mimics into AR42J acinar cells treated with 10 nM cerulein.
3.3. The miR-146a-5p miRNA Targets TRAF6. Next, we needed to study the mechanism by which miR-146a-5p inhibits pancreatitis. It is known that the mechanism of LPS-induced acute inflammation is mainly through the activation of the inflammatory pathway by TRAF6 protein to release inflammatory factors [19]. Therefore, we supposed that TRAF6 was activated in cerulein-induced pancreatitis. The BiBiServ biological analysis software results exhibited miR-146a-5p binding to the TRAF6 protein 3 ′ UTR, and RNAfold software predicted the secondary structure of the miR-146a-5p binding TRAF6 (Figure 2(a)). Dual-luciferase experiment certified the binding site of miR-146a-5p to TRAF6 3 ′ UTR (Figure 2(b)). The results of qPCR and WB presented that miR-146a-5p can effectively subside the expression of TRAF6, and miR-146a-5p inhibitor can significantly increase the expression of TRAF6 (Figures 2(c) and 2(d)). At the same time, we tested the expression of TRAF6 in the cerulein induction model, and the results showed that TRAF6 increased with an increase in treatment concentration (Figures 2(e) and 2(f)), which was negatively correlated with the previous expression of miR-146a-5p.

TRAF6 Knockdown Inhibits the Development of
Pancreatitis. To verify that TRAF6 knockdown can inhibit the development of pancreatitis, we designed three siRNAs and transfected them into cerulein-induced AR42J acinar cells. qPCR and WB detection results showed three siR-NAs had knockdown effects on TRAF6, and the knockdown effects of siRNA2 and siRNA3 were more significant (Figures 3(a) and 3(b)). Therefore, we chose siRNA2 and siRNA3 for the follow-up experiments. ELISA   -  TRAF6, TLR9, ASC, NLRP3, pro-caspase-1, cleaved-caspase-1 and GSDMD. Band analysis software is ImageJ (version 1.8.0_172). * p < 0:05, * * p < 0:01, and * * * p < 0:001. The experiments were repeated three times, the statistical test was a two-tailed test, and errors bars in the figures represent standard deviation (SD). 8 Computational and Mathematical Methods in Medicine results showed that TRAF6 knockdown inhibited the expression of IL-1β, IL-18, and TNF-α inflammatory factors in AR42J acinar cells induced by cerulein (Figures 3(c)-3(e)). The results of CCK8 showed that TRAF6 knockdown could promote the proliferation of cerulein-induced AR42J acinar cells (Figure 3(f)). The results of apoptosis experiments exhibited that knockdown of TRAF6 inhibited the apoptosis of AR42J acinar cells induced by cerulein (Figure 3(g)). In summary, TRAF6 knockdown inhibited the development of pancreatitis.
3.5. Downregulation of miR-146a-5p Promotes the Progression of Pancreatitis via the TLR9/TRAF6/NLRP3 Signaling Pathway. To confirm that TRAF6 advanced the progression of pancreatitis, we designed a rescue experiment. In the AR42J acinar cells induced by cerulein, the miR-146a-5p antagonist was transfected, and TRAF6 was knocked down on this basis. The function of the miR-146a-5p/TRAF6 axis on apoptosis was verified by ELISA, CCK8, and cell apoptosis experiments. Knockdown of TRAF6 restored that miR-146a-5p suppressed the release of IL-1β, IL-18, and TNF-α inflammatory factor in AR42J acinar cells with cerulein (Figures 4(a)-4(e)). Therefore, we deduced that miR-146a-5p downregulation could accelerate the progression of pancreatitis through the target TRAF6. Furthermore, we wanted to identify the signaling pathway by which miR-146a-5p/TRAF6 regulates pancreatitis. Hoque et al. found that acute pancreatitis and pancreatic acinar cell death are related to TLR9 and NLRP3 inflammasomes [15]. Therefore, in the rescue experiment, we used WB to detect the expression of the TLR9 and NLRP3 inflammasome-associated proteins (NLRP3, ASC, GSDMD, pro-caspase-1, and cleaved-caspase-1). Knockdown of TRAF6 restored the miR-146a-5p inhibitor to the NLRP3 signaling pathway in ceruleininduced AR42J acinar cells (Figure 4(f)). Our observations therefore confirmed that the missing miR-146a-5p pushed the progression of pancreatitis via the TLR9/TRAF6/ NLRP3 signaling pathway ( Figure 5(a)).

Discussion
AP is characterized by the destruction of acinar cells, which contributes to the release of several inflammatory factors [20]. Inflammatory cells are then recruited to the pancreas, activating digestive proteases prematurely and triggering a systemic inflammatory response and, potentially, lifethreatening multiple organ failure [13]. Pancreatic acinar cell damage may be caused by the programmed death of acinar cells, including apoptosis, autophagy, pyroptosis, and necrosis [20][21][22]. Pyroptosis is highly related to the inflammatory response. Therefore, pancreatic acinar cell pyroptosis may be a key factor in the pathogenesis of AP.
In our study, we first constructed a model of ceruleininduced acinar cell pyroptosis. The upregulated expression of TNF-α, IL-18, and IL-1β indicated that cerulein successfully induced acinar cell pyroptosis. Given that microRNAs are involved in multiple inflammations as a regulator, we selected 4 miRNAs related to pancreatitis and relatively conservative sequences based on literature reports-comprising miR-34a-5p, miR-146a-5p, miR-150-5p, and miR-181b-5p, which were induced by cerulein detection in AR42J cells [23,24]. miR-146a-5p is obviously repressing in the pancreatitis group, and subsequent functional experiments have testified that miR-146a-5p can inhibit the progression of pancreatitis. This is consistent with our results. Stem cellderived exosomal miR-146a-5p reduces microglialmediated neuroinflammation via suppression of the IRAK1/TRAF6 signaling pathway after ischemic stroke [25].
The function of miRNA is to pair the target mRNA-3 ′ UTR through base complementation and form a silencing to degrade mRNA [26]. Bioinformatics is a reliable method for candidate gene analysis. Wenjie et al. utilized computer algorithms to discover that sensory ion channels TRPC3 and TRPC7 could be the potential therapeutic targets in pancreatic cancer [27]. So, we used biological analysis prediction software, BiBiServ, to predict that miR-146a-5p can bind to TRAF6 and that miR-146a-5p can significantly downregulate the expression of TRAF6. At the same time, we utilized RNAfold software to predict the secondary structure of TRAF6 mRNA and illustrated the binding sites of miR-146a-5p and TRAF6 in the structure. Furthermore, we confirmed that downregulation of TRAF6 can inhibit the progression of pancreatitis. Similarly, Chen et al. also unearthed that TRAF6 expedites the development of pancreatitis [28]. Xing et al. confirmed that TRAF6 can mediate the initiation of the NLRP3 inflammasome [18]. Sensory ion channels TRPC3 and TRPC7 could be the potential Studies have shown that acinar cell apoptosis does not lead to pancreatitis, whereas acinar cell pyroptosis or necrosis can induce pancreatitis [29,30]. Our results also show that the process of cerulein-induced pancreatitis mainly activates the NLRP3 inflammasome, cleaves caspase-1, activates GSDMD, and leads to the development of pancreatitis. Gao et al. confirmed that the activation of NLRP3 inflammasome and GSDMD in acinar cells triggers acute pancreatitis and systemic inflammation [31]. Our rescue experiment testified that miR-146a-5p downregulation can activate the further exacerbation of pancreatitis and activate the NLRP3 signaling pathway through the target TRAF6. Other studies have also confirmed that downregulation of TRAF6 by miR-146a-5p regulates pyroptosis and autophagy [17,32,33]. Therefore, miR-146a-5p may become a nucleic acid drug for inhibiting acute pancreatitis, which requires us to further conduct animal experiments and clinical trials.
Meanwhile, our study also revealed that the expression of TLR9 was upregulated in cerulein-induced pancreatitis. Zhao et al. also found that TLR9 can activate the NLRP3 inflammasome in mice with allergic airway inflammation [34]. However, how TLR9 and inflammasomes are activated in AP requires further study.

Data Availability
The data used to support the findings of this study are included within the article.