Punicalagin protects bovine endometrial epithelial cells against lipopolysaccharide-induced inflammatory injury

Punicalagin protects bovine endometrial epithelial cells against lipopolysaccharide-induced inflammatory injury 安石榴苷对脂多糖诱导奶牛子宫内膜上皮细胞炎症损伤的保护作用 first-author corresp ‡Corresponding Authors ‡Corresponding Authors †E-mail:jls@bac.edu.cnliufenghuabua@126.com †E-mail:jls@bac.edu.cnliufenghuabua@126.com jls@bac.edu.cn corresp ‡Corresponding Authors ‡Corresponding Authors †E-mail:jls@bac.edu.cnliufenghuabua@126.com †E-mail:jls@bac.edu.cnliufenghuabua@126.com jls@bac.edu.cn Beijing Key Laboratory for Dairy Cow Nutrition, College of Animal Science and Technology, Beijing University of Agriculture, Beijing 102206, China Beijing Key Laboratory for Dairy Cow Nutrition, College of Animal Science and Technology, Beijing University of Agriculture, Beijing 102206, China Objective: 2 Bovine endometritis is one of the most common reproductive disorders in cattle. The aim of this study was to investigate the anti-inflammation potential of punicalagin in lipopolysaccharide (LPS)-induced bovine endometrial epithelial cells (bEECs) and to uncover the underlying mechanisms. Methods: 2 bEECs were stimulated with different concentrations (1, 10, 30, 50, and 100 μg/ml) of LPS for 3, 6, 9, 12, and 18 h. MTT assay was used to assess cell viability and to identify the conditions for inflammatory injury and effective concentrations of punicalagin. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to assess gene expression of pro-inflammatory cytokines. Western blotting was used to assess levels of inflammation-related proteins. Results: 2 Treatment of bEECs with 30 µg/ml LPS for 12 h induced cell injury and reduced cell viability. Punicalagin (5, 10, or 20 µg/ml) pretreatment significantly decreased LPS-induced productions of interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-α (TNF-α) in bEECs. Molecular research showed that punicalagin inhibited the activation of the upstream mediator nuclear factor-κB (NF-κB) by suppressing the production of inhibitor κBα (IκBα) and phosphorylation of p65. Results also indicated that punicalagin can suppress the phosphorylation of mitogen-activated protein kinases (MAPKs) including p38, c-Jun N-terminal kinase (JNK), and extracellular signal-regulated kinase (ERK). Conclusions: 2 Punicalagin may attenuate LPS-induced inflammatory injury and provide a potential option for the treatment of dairy cows with Escherichia coli endometritis. 目的 2 评估安石榴苷对脂多糖诱导奶牛子宫内膜上皮细胞炎症损伤的保护作用，并初步探讨其作用机制。 创新点 2 首次证明安石榴苷对脂多糖诱导奶牛子宫内膜上皮细胞炎症损伤具有保护作用，且此作用与核转录因子κB（NF-κB）和丝裂原活化蛋白激酶（MAPK）信号通路的抑制相关。 方法 2 用不同浓度的脂多糖（1、10、30、50和100 µg/ml）刺激奶牛子宫内膜上皮细胞3、6、9、12和18 h，筛选出建立炎症损伤的最佳作用浓度和时间。安石榴苷预处理细胞2 h后用脂多糖刺激12 h，用逆转录聚合酶链式反应（RT-PCR）检测炎症因子白细胞介素1β（IL-1β）、白细胞介素6（IL-6）、白细胞介素8（IL-8）及肿瘤坏死因子α（TNF-α）的表达。用蛋白质免疫印迹试验（Western blotting）的方法检测核因子κB抑制蛋白α（IκBα）、磷酸化的p65、p38、c-Jun氨基末端激酶（JNK）和细胞外调节蛋白激酶（ERK）的表达水平。 结论 2 MTT结果显示，30 µg/ml 脂多糖刺激奶牛子宫内膜上皮细胞12 h能够造成细胞活力下降和形态改变（图2和3）。RT-PCR结果显示，安石榴苷预处理后炎症因子显著降低（图4）。Western blotting结果显示，安石榴苷预处理能显著抑制IκBα降解以及p65、p38、JNK和ERK的磷酸化表达水平（图5和6）。综上所述，安石榴苷对脂多糖诱导奶牛子宫内膜上皮细胞炎症损伤具有保护作用，在治疗奶牛子宫内膜炎中具有重要价值。 Bovine endometrial epithelial cell Cytokine Inflammatory injury Punicalagin 奶牛子宫内膜上皮细胞 炎症因子 炎性损伤 安石榴苷 Introduction 1 Endometritis is one of the most common reproductive disorders caused by bacteria in cattle throughout the world. It damages the endometrium, delaying the onset of the ovarian cycle activity after calving, extending luteal phases, reducing fertility, and causing significant economic losses (Sheldon et al., 2006 2006 ; Azawi, 2008 2008 ; Kasimanickam et al., 2013 2013 ). Therefore, methods are needed to eradicate the causative bacteria earlier and control inflammation. Although antibiotics have been effective, increasing drug resistance and concerns about food safety limit their use (Malinowski et al., 2011 2011 ; Zhao et al., 2014 2014 ; Mackeen et al., 2015 2015 ; Ward and Duff, 2016 2016 ). Escherichia coli and other Gram-negative bacteria are the major pathogens associated with endometritis (Janowski et al., 2013 2013 ; Sens and Heuwieser, 2013 2013 ; Brodzki et al., 2014 2014 ; Wagener et al., 2014 2014 ). Lipopolysaccharides (LPSs) are the major structural components of the cell wall of Gram-negative bacteria. LPS can be transferred to cluster of differentiation 14 (CD14) by LPS-binding protein (LBP) and is recognized by Toll-like receptor 4 (TLR4) on the cell surface (Shimada et al., 2005 2005 ; Khan et al., 2009 2009 ; Wu et al., 2016 2016 ). The interaction between LPS and TLR4 results in the activation of intracellular signaling through myeloid differentiation factor 88 (MyD88) and TIR-domain-containing adapter-inducing interferon-β (TRIF) pathways, leading to the activation of major mitogen-activated protein kinases (MAPKs) and translocation of nuclear transcription factor-κB (NF-κB) (Sheldon and Roberts, 2010 2010 ; Kawai and Akira, 2011 2011 ; Huang et al., 2016 2016 ). NF-κB regulates the expression of cytokines, including interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-α (TNF-α), which are essential mediators of the inflammation response (Wang et al., 2012 2012 ; Liu et al., 2014 2014 ; Huang et al., 2016 2016 ). The endometrium is the first line of defense against microbial invasion, and endometrial epithelial cells are thought to play a key role in local innate immunity (Herath et al., 2006 2006 ; Soboll et al., 2006 2006 ; Turner et al., 2014 2014 ). Endometrial epithelial cells line the uterine mucosal surface, forming a physical barrier to protect the host from pathogen invasion (Wira et al., 2005 2005 ). Endometrial epithelial cells in the bovine uterus were found to recognize and respond to pathogens via surface receptors such as TLRs (Chapwanya et al., 2013 2013 ; Turner et al., 2014 2014 ). Punicalagin, a hydrolysable tannin of pomegranate juice, is a powerful nutrient that promotes overall health (Yaidikar et al., 2014 2014 ). Punicalagin exhibits multiple biological effects, including antioxidant, antiproliferative, antiviral, and antimicrobial activities (Taguri et al., 2004 2004 ; Aqil et al., 2012 2012 ; Yang et al., 2012 2012 ; Xu et al., 2016 2016 ). Moreover, it has shown anti-inflammatory properties both in vitro and in vivo (Jean-Gilles et al., 2013 2013 ; Olajide et al., 2014 2014 ; Xu et al., 2014 2014 ). However, the effects of punicalagin on endometritis have not been investigated. This study was therefore designed to investigate whether punicalagin could protect against LPS-induced inflammatory injury in bovine endometrial epithelial cells (bEECs) and to clarify its possible mechanisms of action. Materials and methods 1 Reagents 2 Punicalagin ( > 98% high-performance liquid chromatography (HPLC) purity) was purchased from Tauto Biotech (Shanghai, China). LPS ( E . coli O55:B5), 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT), trypsin, collagenase II, bovine serum albumin (BSA), and DNase I were purchased from Sigma-Aldrich Chemical Company (St. Louis, MO, USA). Dulbecco’s modified Eagle’s medium/Ham’s F-12 nutrient mixture (DMEM/F12), fetal bovine serum (FBS), antibiotic, and TRIzol reagent were purchased from Gibco (Grand Island, NY, USA). A bicinchoninic acid (BCA) protein assay kit was purchased from Pierce (Rockford, IL, USA). Antibodies against β-actin, inhibitor κBα (IκBα), phosphorylated p65 (p-p65), phosphorylated p38 (p-p38), phosphorylated c-Jun N-terminal kinase (p-JNK), and phosphorylated extracellular signal-regulated kinase (p-ERK) were purchased from Cell Signaling Technology (Danvers, MA, USA). Goat anti-mouse antibody was purchased from Li-CDR Odyssey (Lincoln, NE, USA). Cell culture and treatment 2 Uteruses from five non-pregnant Holstein cows were obtained from a local abattoir immediately after slaughter and kept on ice until further processing in the laboratory. The animals had no evidence of genital disease based on visual inspection and the uteruses were obtained in accordance with protocols approved by the local Institutional Animal Care and Use Committee. Primary bEECs were isolated from the endometrium as described previously (Chapwanya et al., 2013 2013 ). In brief, the endometrium was sliced into small pieces measuring about 3–5 mm 3 and digested with sterile filtered digestive solution (50 mg trypsin, 50 mg collagenase II, 100 mg BSA, and 10 mg DNase I) for 1 h in a gently agitating water bath at 37 °C. Cells were resuspended in DMEM/F12 containing 10% FBS and antibiotics (100 U/ml penicillin and 100 U/ml streptomycin) at 37 °C in a humidified incubator with 5% CO 2 . Cell viability assay 2 The bEECs were seeded in 96-well plates at 1×10 4 cells per well and allowed to grow to 90% confluence in complete medium. After 24 h, cells were washed twice with phosphate-buffered saline (PBS) and incubated with serum-free medium for 1 h at 37 °C in 5% CO 2 . Cells were then treated with different concentrations of LPS (0, 1, 10, 30, 50, and 100 µg/ml) for 3, 6, 9, 12, or 18 h in the incubator. Cell viability was measured by the MTT assay. To examine the cytotoxicity of punicalagin in bEECs, cells were treated with different concentrations of punicalagin (5, 10, 20, 25, 30, and 50 µg/ml) for 24 h. The medium was then removed and DMEM/F12 containing 10% MTT was added to each well. Formazan complex was dissolved in 100 µl dimethyl sulfoxide (DMSO) after 4 h of incubation. The optical density was measured using a microplate reader (Bio-Rad, USA) at 490 nm. Quantitative real-time PCR analysis 2 To detect the effects of punicalagin on gene expression in LPS-stimulated cells, bEECs were pre-incubated in six-well plates (1×10 6 cells/well) and pretreated with punicalagin (5, 10, and 20 µg/ml) for 2 h prior to LPS (30 µg/ml) treatment in an incubator at 37 °C and 5% CO 2 for 3, 6, 9, or 12 h. Total RNA was isolated using a phenol and guanidine isothiocyanate-based TRIzol reagent according to the manufacturer’s instructions. The concentration and integrity of total RNA were measured at a 260/280 nm ratio. Quantitative polymerase chain reaction (PCR) analysis was performed using the DNA Engine Mx3000P ® (Agilent, Santa Clara, CA, USA) fluorescence detection system against a double-stranded DNA-specific fluorescent dye (Stratagene, La Jolla, CA, USA) according to optimized PCR protocols. β-Actin was amplified in parallel with the target genes and used as a normalization control. The cycling conditions were as follows: 95 °C for 10 min, followed by 40 cycles of 95 °C for 30 s, 60 °C for 60 s, and 72 °C for 60 s. Expression levels were determined using the relative threshold cycle (Ct) method as described by the manufacturer (Stratagene). The PCR reaction system (25 µl in total) contained 12.5 µl of SYBR Green PCR mix, 0.375 µl of reference dye, 1 µl of each primer (both, 10 μmol/L), 1 µl of complementary DNA (cDNA) template, and 9.125 µl of diethyl phosphorocyanidate (DEPC)-treated water. Table 1 1 lists the gene-specific oligonucleotide primers used for real-time PCR (RT-PCR). Primers were designed from the sequences published in the GenBank database under the indicated accession numbers. F: forward primer; R: reverse primer Gene Accession number 1 1 Primer sequence (5'→3') Product (bp)   β-actin NM_173979.3 F: CAGAAGGACTCGTACGTGGG R: TTGGCCTTGGGGTTCAGGG 199   TNF-α NM_173966.3 F: CTTCATTGCCAGGTTTCTG R: CAGGTGTTGGATGCAGCTCT 141   IL-1β NM_174093.1 F: ATGACTTCTGCTTTCCCTACCC R: GCTGCTTTCACACTCATCATTC 179   IL-6 NM_173923.2 F: GCAFFTATTTGTGAAGAGAGCTG R: CACAGAACATGAGGCACTGAA 148   IL-8 NM_173925.2 F: ACGGGCTTTACCTCATCTACTC R: GCTCTTGATGGCAGACAGG 140 Western blot analysis 2 The bEECs cultured in tissue culture flasks for 24 h were pretreated with punicalagin for 2 h prior to treatment with LPS (30 µg/ml) for 15, 45, or 90 min in an incubator at 37 °C and 5% CO 2 . Cells were then harvested on ice, washed twice using ice-cold PBS, and suspended in 500 µl lysis buffer supplemented with protease inhibitor. After incubating on ice for 30 min, cell extracts were subjected to centrifugation (12 000 g ) at 4 °C for 15 min and proteins were quantified using a BCA protein assay kit. Proteins were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and electro-transferred to nitrocellulose membranes (Pierce Biotechnology Inc.), which were then hybridized with the specific antibodies. β-Actin was used to correct for protein loading. Densitometric values of immunoblot signals were obtained from three separate experiments using Image J software (National Institutes of Health, USA). Statistical analysis 2 The results are expressed as mean±the standard error of the mean (SEM) and differences between mean values of normally distributed data were assessed by one-way analysis of variance (ANOVA) multiple comparisons. A P -value of 0.05 or less was regarded as significant. Results 1 Effect of punicalagin on cell viability 2 We first examined the cytotoxicity of different concentrations of punicalagin (5, 10, 20, 25, 30, and 50 µg/ml) on bEECs by evaluating cell viability using the MTT assay. The results showed that punicalagin in concentrations from 0 to 30 µg/ml had no cytotoxic effect on bEECs (Fig. 1 1 ), suggesting that the inhibitory effect of punicalagin on LPS-induced inflammation was not a result of cytotoxicity caused by a reduction in cell viability. Cells were treated with different concentrations (5, 10, 20, 25, 30, and 50 µg/ml) of punicalagin for 24 h. Cell viability was evaluated by MTT assay. Data represent the mean±SEM of three independent experiments. * P < 0.05 vs. the control group Inhibition of LPS-induced pro-inflammatory cytokine production by punicalagin 2 To determine the appropriate LPS concentration and time for stimulation, cell viability was tested after LPS treatment with different concentrations (0, 1, 10, 30, 50, and 100 µg/ml) for 3, 6, 9, 12, and 18 h. Cell viability was not altered by the treatment with 1 and 10 µg/ml of LPS before 12 h (Fig. 2 2 ). However, stimulation of cells with 30 µg/ml LPS for 12 h significantly reduced cell vitality ( P < 0.05), and compared with the control group (Figs. 3a–3c 3a–3c ), the treated cells showed obvious floating, rounding, and nuclear pycnosis (Figs. 3d–3f 3d–3f ). The effects of 50 and 100 µg/ml LPS on cell viability after 12 h were more pronounced ( P < 0.01 each). Therefore, we selected cell stimulation with 30 µg/ml LPS for 12 h for our experimental analyses. Cells were incubated with different concentrations (1, 10, 30, 50, and 100 µg/ml) of LPS for 3, 6, 9, 12, and 18 h. Cell viability was significantly reduced by 30 µg/ml of LPS at 12 h ( * P < 0.05). Data represent the mean±SEM of three independent experiments. * P < 0.05, ** P < 0.01 vs. the control (Con) group Cells were incubated with or without 30 µg/ml LPS for 12 h and cell morphology was observed using an inverted microscope. (a–c) Control group: the distribution of bEECs was compact and regular. (d–f) Model group: bEECs exposed to 30 µg/ml LPS for 12 h became enlarged, lost their cuboidal shape, and showed disrupted cell-cell contacts (arrowheads). (a, d) 4× microscope; (b, e) 10× microscope; (c, f) 20× microscope To determine the effect of punicalagin on LPS-induced pro-inflammatory cytokine expression, total RNA was extracted and examined by RT-PCR. The expression levels of IL-1β, IL-6, IL-8, and TNF-α induced by LPS were significantly ( P < 0.001) upregulated at indicated time points (Fig. 4 4 ). This effect was markedly inhibited by punicalagin in a dose-dependent manner, confirming that punicalagin had anti-inflammatory effects. Cells were pretreated with punicalagin (5, 10, and 20 µg/ml) for 2 h and exposed to 30 µg/ml LPS for 3, 6, 9, and 12 h. The levels of IL-1β (a), IL-6 (b), IL-8 (c), and TNF-α (d) mRNAs were quantified using RT-PCR analysis. Data represent the mean±SEM of three independent experiments. ## P < 0.01, ### P < 0.001 vs. the control (Con) group. * P < 0.05, ** P < 0.01, *** P < 0.001 vs. the model (Mod) group. Con: control; Mod: treated with LPS (30 µg/ml) only; Low: punicalagin (5 µg/ml)+LPS (30 µg/ml); Mid: punicalagin (10 µg/ml)+LPS (30 µg/ml); High: punicalagin (20 µg/ml)+LPS (30 µg/ml) Inhibition of LPS-induced NF-κB activation by punicalagin 2 NF-κB is an important transcription factor that induces cytokine mRNA after stimulation by LPS. Therefore, critical proteins involved in NF-κB signaling pathway were examined by Western blotting. The results showed an almost complete degradation of IκBα and a significant increase in phosphorylation of p65 after cells were treated with LPS for 15 min (Figs. 5a and 5b 5a and 5b ), indicating an increase in NF-κB activity. The degradation of IκBα and phosphorylation of p65 induced by LPS were partially inhibited by punicalagin, which indicated a weakening activity of NF-κB. After 45 min, the degradation of IκBα and phosphorylation of p65 had decreased in all groups. These results show that NF-κB activity in bEECs induced by LPS was significantly inhibited by punicalagin. Cells were pretreated with punicalagin (5, 10, and 20 µg/ml) for 2 h, exposed to 30 µg/ml LPS for 15, 45, and 90 min, and analyzed by Western blotting. IκBα (a) and phosphorylated p65 (b) were analyzed using anti-IκBα and phosphor-specific anti-p65 antibodies. Data represent the mean±SEM of three independent experiments. # P < 0.05, ### P < 0.001 vs. the control (Con) group. * P < 0.05, ** P < 0.01, *** P < 0.001 vs. the model (Mod) group. Con: control; Mod: treated with LPS (30 µg/ml) only; Low: punicalagin (5 µg/ml)+LPS (30 µg/ml); Mid: punicalagin (10 µg/ml)+LPS (30 µg/ml); High: punicalagin (20 µg/ml)+LPS (30 µg/ml) Inhibition of LPS-induced MAPK activation by punicalagin 2 To further expound the mechanism of the inhibitory effect on LPS-induced pro-inflammatory cytokine expression by punicalagin, we then investigated the effect of punicalagin on LPS-induced activation via the MAPK signaling pathway by assessing the phosphorylation of p38, JNK, and ERK (Fig. 6 6 ). Treatment of bEECs with LPS significantly ( P < 0.001) increased the activation of MAPKs by strengthening the phosphorylation of p38, JNK, and ERK. However, the phosphorylation levels were attenuated to some degree in punicalagin-pretreated cells compared with LPS-treated cells. Cells were pretreated with punicalagin (5, 10, and 20 µg/ml) for 2 h, exposed to 30 µg/ml LPS for 15, 45, and 90 min, and analyzed by Western blotting. Phosphorylation levels of p38 (a), JNK (b), and ERK (c) were analyzed using phospho-specific anti-p38, phospho-specific anti-JNK, and phospho-specific anti-ERK antibodies. Data represent the mean±SEM of three independent experiments. ### P < 0.001 vs. the control (Con) group. * P < 0.05, *** P < 0.001 vs. the model (Mod) group. Con: control; Mod: treated with LPS (30 µg/ml) only; Low: punicalagin (5 µg/ml)+LPS (30 µg/ml); Mid: punicalagin (10 µg/ml)+LPS (30 µg/ml); High: punicalagin (20 µg/ml)+LPS (30 µg/ml) 4 Discussion 2 LPS, a cell wall component of Gram-negative bacteria, is a well-known inducer of inflammation, and exposure of cells to LPS has been shown to promote the release of pro-inflammatory cytokines (Lim et al., 2012 2012 ; Fu et al., 2013 2013 ; Wang et al., 2013 2013 ), making LPS a good stimulant of inflammation. In many previous reports, the concentrations of LPS used in vitro were less than 1 µg/ml (Choi et al., 2007 2007 ; Wang et al., 2012 2012 ; Qi et al., 2016 2016 ). However, in our study, the treatment with LPS up to 30 µg/ml for 3, 6, or 9 h did not inhibit cell viability. This may have been because of the high tolerance of primary cells to LPS and species specificity. However, incubation of cells with 30 µg/ml LPS for 12 h significantly reduced cell vitality and induced modality change, and therefore we selected this concentration and time as the experimental conditions in this study. Clinical treatment of inflammation caused by bacterial infection and its associated symptoms involves the use of antibiotic drugs (Ugurlu et al., 2010 2010 ; Pandrea et al., 2016 2016 ). However, the use of these drugs is associated with severe side effects (Kumar et al., 2016 2016 ; Yoon et al., 2016 2016 ), indicating the need for natural methods of inflammation control. Punicalagin, a large natural polyphenolic compound found in pomegranates, is a traditional medicine reported to exhibit anti-inflammatory activity (Jean-Gilles et al., 2013 2013 ; Olajide et al., 2014 2014 ; Peng et al., 2015 2015 ; Yaidikar and Thakur, 2015 2015 ). Jean-Gilles et al. ( 2013 2013 ) showed that punicalagin may be toxic to cattle and rats in vivo. In this study, punicalagin did not have toxic effects on bEECs at concentrations of 0–30 µg/ml. These results are consistent with those of Kulkarni et al. ( 2007 2007 ) showing that punicalagin is toxic only at higher concentrations in cells of Vero (a normal African green monkey kidney cell line), Hep-2 (a human larynx epithelial cancer cell line), and A-549 (a human small cell lung carcinoma cell line). This indicates that the inhibition of LPS-induced inflammatory injury in bEECs was not a result of toxicity. E. coli induces a rapid inflammation response in endometrial epithelial cells, which release a large number of pro-inflammatory cytokines, including IL-1β, IL-6, IL-8, and TNF-α (Chapwanya et al., 2013 2013 ; Huang et al., 2016 2016 ). These cytokines attract immune effector cells to fight infection; however, excessive expression of these cytokines injures the cells. In this study, the potential effect of punicalagin on the expression of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, and TNF-α) was analyzed by RT-PCR. As expected, the expression of IL-1β, IL-6, IL-8, and TNF-α was upregulated at all time points after LPS stimulation. Punicalagin inhibited the expression of IL-1β, IL-6, IL-8, and TNF-α in a dose-dependent manner, which protected bEECs from LPS. NF-κB plays a central role in regulating immune and inflammatory processes, and thus is a target in developing novel treatments for inflammatory diseases (Checker et al., 2012 2012 ; Ling et al., 2012 2012 ). Before activation, NF-κB is bound in the cytoplasm by IκBα, an inhibitory protein that keeps NF-κB in an inactive state. When activated by various stimulants such as LPS, IκBα is phosphorylated by IκB kinase (IKK) and is separated from NF-κB. Free NF-κB then translocates from the cytoplasm into the nucleus, where it binds specifically to certain DNA sequences, promoting the expression of specific target genes (Corbetta et al., 2005 2005 ; Gu et al., 2012 2012 ). Previous studies reported that treatments of BV2 and THP1 cells with LPS greatly upregulated the phosphorylation level of NF-κB p65, indicating activation of the NF-κB signal pathway (Lim et al., 2012 2012 ; Wang et al., 2013 2013 ). To confirm the specific effect of punicalagin on NF-κB activity in bEECs, Western blotting was performed to detect levels of IκBα and phosphorylated p65. Punicalagin significantly inhibited LPS-induced NF-κB signaling in bEECs by suppressing the degradation of IκBα and the phosphorylation of p65 within 15, 45, and 90 min of LPS stimulation. We therefore propose that punicalagin prevented inflammation in the LPS-activated bEECs through the NF-κB pathway. The TLR-4-mediated NF-κB pathway is well established as a signaling pathway responsible for inflammatory responses. In addition to NF-κB activation, TLR-4 can initiate MAPK signaling (Risco et al., 2012 2012 ; Hines et al., 2013 2013 ). Phosphorylation of MAPK family members including ERK, p38, and JNK activates a series of transcription factors, such as activator protein 1 (AP-1), cAMP-response element binding protein (CREB), and signal transducers and activators of transcription (STAT), and subsequently promotes transcription of cytokines (Morimoto et al., 2009 2009 ; Ruimi et al., 2010 2010 ). Punicalagin has been shown to inhibit the expression of pro-inflammatory genes by regulating the phosphorylation of proteins of the MAPK pathway (Olajide et al., 2014 2014 ; Xu et al., 2014 2014 ). However, whether the MAPK signaling pathway undergoes any changes in bEECs had not been determined. In the current study, LPS enhanced the phosphorylation levels of p38, JNK, and ERK in bEECs, but these effects were markedly downregulated by punicalagin in a dose-and time-dependent manner. These results indicate that attenuation of p38, JNK, and ERK activation may be involved in the reduction of cytokine production by punicalagin. 5 Conclusions 1 This study demonstrated the protective effect of punicalagin on LPS-induced inflammatory injury in bEECs. This effect was at least partly achieved by the decreased production of pro-inflammatory cytokines mediated by reducing the degradation of IκBα and phosphorylation of p65, p38, JNK, and ERK in the NF-κB and MAPK pathways. However, other possible pathways and targets related to the anti-inflammatory effect of punicalagin in bEECs need to be researched in the future. References F Aqil , R Munagala , MV Vadhanam , 等 . Anti-proliferative activity and protection against oxidative DNA damage by punicalagin isolated from pomegranate husk . Food Res Int , 2012 . 49 ( 1 ): 345 - 353 . 23493479 DOI: 10.1016/j.foodres.2012.07.059 http://doi.org/10.1016/j.foodres.2012.07.059 . Anti-proliferative activity and protection against oxidative DNA damage by punicalagin isolated from pomegranate husk OI Azawi . Postpartum uterine infection in cattle . Anim Reprod Sci , 2008 . 105 ( 3-4 ): 187 - 208 . 18280065 DOI: 10.1016/j.anireprosci.2008.01.010 http://doi.org/10.1016/j.anireprosci.2008.01.010 . Postpartum uterine infection in cattle P Brodzki , M Bochniarz , A Brodzki , 等 . Trueperella pyogenes and Escherichia coli as an etiological factor of endometritis in cows and the susceptibility of these bacteria to selected antibiotics . Pol J Vet Sci , 2014 . 17 ( 4 ): 657 - 664 . 25638979 . Trueperella pyogenes and Escherichia coli as an etiological factor of endometritis in cows and the susceptibility of these bacteria to selected antibiotics A Chapwanya , KG Meade , ML Doherty , 等 . Endometrial epithelial cells are potent producers of tracheal antimicrobial peptide and serum amyloid A3 gene expression in response to E. coli stimulation . Vet Immunol Immunopathol , 2013 . 151 ( 1-2 ): 157 - 162 . 23200820 DOI: 10.1016/j.vetimm.2012.09.042 http://doi.org/10.1016/j.vetimm.2012.09.042 . Endometrial epithelial cells are potent producers of tracheal antimicrobial peptide and serum amyloid A3 gene expression in response to E. coli stimulation R Checker , RS Patwardhan , D Sharma , 等 . Schisandrin B exhibits anti-inflammatory activity through modulation of the redox-sensitive transcription factors Nrf2 and NF-κB . Free Radic Biol Med , 2012 . 53 ( 7 ): 1421 - 1430 . 22917978 DOI: 10.1016/j.freeradbiomed.2012.08.006 http://doi.org/10.1016/j.freeradbiomed.2012.08.006 . Schisandrin B exhibits anti-inflammatory activity through modulation of the redox-sensitive transcription factors Nrf2 and NF-κB HJ Choi , OH Kang , PS Park , 等 . Mume fructus water extract inhibits pro-inflammatory mediators in lipopolysaccharide-stimulated macrophages . J Med Food , 2007 . 10 ( 3 ): 460 - 466 . 17887939 DOI: 10.1089/jmf.2006.198 http://doi.org/10.1089/jmf.2006.198 . Mume fructus water extract inhibits pro-inflammatory mediators in lipopolysaccharide-stimulated macrophages S Corbetta , L Vicentini , S Ferrero , 等 . Activity and function of the nuclear factor kappaB pathway in human parathyroid tumors . Endocr Relat Cancer , 2005 . 12 ( 4 ): 929 - 937 . 16322332 DOI: 10.1677/erc.1.00970 http://doi.org/10.1677/erc.1.00970 . Activity and function of the nuclear factor kappaB pathway in human parathyroid tumors Y Fu , B Liu , X Feng , 等 . Lipopolysaccharide increases Toll-like receptor 4 and downstream Toll-like receptor signaling molecules expression in bovine endometrial epithelial cells . Vet Immunol Immunopathol , 2013 . 151 ( 1-2 ): 20 - 27 . 23218938 DOI: 10.1016/j.vetimm.2012.09.039 http://doi.org/10.1016/j.vetimm.2012.09.039 . Lipopolysaccharide increases Toll-like receptor 4 and downstream Toll-like receptor signaling molecules expression in bovine endometrial epithelial cells JH Gu , JB Ge , M Li , 等 . Inhibition of NF-κB activation is associated with anti-inflammatory and anti-apoptotic effects of Ginkgolide B in a mouse model of cerebral ischemia/reperfusion injury . Eur J Pharm Sci , 2012 . 47 ( 4 ): 652 - 660 . 22850444 DOI: 10.1016/j.ejps.2012.07.016 http://doi.org/10.1016/j.ejps.2012.07.016 . Inhibition of NF-κB activation is associated with anti-inflammatory and anti-apoptotic effects of Ginkgolide B in a mouse model of cerebral ischemia/reperfusion injury S Herath , DP Fischer , D Werling , 等 . Expression and function of Toll-like receptor 4 in the endometrial cells of the uterus . Endocrinology , 2006 . 147 ( 1 ): 562 - 570 . 16223858 DOI: 10.1210/en.2005-1113 http://doi.org/10.1210/en.2005-1113 . Expression and function of Toll-like receptor 4 in the endometrial cells of the uterus DJ Hines , HB Choi , RM Hines , 等 . Prevention of LPS-induced microglia activation, cytokine production and sickness behavior with TLR4 receptor interfering peptides . PLoS ONE , 2013 . 8 ( 3 ): e60388 23555964 DOI: 10.1371/journal.pone.0060388 http://doi.org/10.1371/journal.pone.0060388 . Prevention of LPS-induced microglia activation, cytokine production and sickness behavior with TLR4 receptor interfering peptides B Huang , D Xiao , B Tan , 等 . Chitosan oligosaccharide reduces intestinal inflammation that involves calcium-sensing receptor (CaSR) activation in lipopolysaccharide (LPS)-challenged piglets . J Agric Food Chem , 2016 . 64 ( 1 ): 245 - 252 . 26654156 DOI: 10.1021/acs.jafc.5b05195 http://doi.org/10.1021/acs.jafc.5b05195 . Chitosan oligosaccharide reduces intestinal inflammation that involves calcium-sensing receptor (CaSR) activation in lipopolysaccharide (LPS)-challenged piglets T Janowski , W Barański , K Łukasik , 等 . Prevalence of subclinical endometritis in repeat breeding cows and mRNA expression of tumor necrosis factor α and inducible nitric oxide synthase in the endometrium of repeat breeding cows with and without subclinical endometritis . Pol J Vet Sci , 2013 . 16 ( 4 ): 693 - 699 . 24597304 DOI: 10.2478/pjvs-2013-0098 http://doi.org/10.2478/pjvs-2013-0098 . Prevalence of subclinical endometritis in repeat breeding cows and mRNA expression of tumor necrosis factor α and inducible nitric oxide synthase in the endometrium of repeat breeding cows with and without subclinical endometritis D Jean-Gilles , L Li , VG Vaidyanathan , 等 . Inhibitory effects of polyphenol punicalagin on type-II collagen degradation in vitro and inflammation in vivo . Chem Biol Interact , 2013 . 205 ( 2 ): 90 - 99 . 23830812 DOI: 10.1016/j.cbi.2013.06.018 http://doi.org/10.1016/j.cbi.2013.06.018 . Inhibitory effects of polyphenol punicalagin on type-II collagen degradation in vitro and inflammation in vivo RK Kasimanickam , VR Kasimanickam , JR Olsen , 等 . Associations among serum pro- and anti-inflammatory cytokines, metabolic mediators, body condition, and uterine disease in postpartum dairy cows . Reprod Biol Endocrinol , 2013 . 11 ( 1 ): 103 24209779 DOI: 10.1186/1477-7827-11-103 http://doi.org/10.1186/1477-7827-11-103 . Associations among serum pro- and anti-inflammatory cytokines, metabolic mediators, body condition, and uterine disease in postpartum dairy cows T Kawai , S Akira . Toll-like receptors and their crosstalk with other innate receptors in infection and immunity . Immunity , 2011 . 34 ( 5 ): 637 - 650 . 21616434 DOI: 10.1016/j.immuni.2011.05.006 http://doi.org/10.1016/j.immuni.2011.05.006 . Toll-like receptors and their crosstalk with other innate receptors in infection and immunity KN Khan , M Kitajima , K Hiraki , 等 . Toll-like receptors in innate immunity: role of bacterial endotoxin and Toll-like receptor 4 in endometrium and endometriosis . Gynecol Obstet Invest , 2009 . 68 ( 1 ): 40 - 52 . 19365133 DOI: 10.1159/000212061 http://doi.org/10.1159/000212061 . Toll-like receptors in innate immunity: role of bacterial endotoxin and Toll-like receptor 4 in endometrium and endometriosis AP Kulkarni , HS Mahal , S Kapoor , 等 . In vitro studies on the binding, antioxidant, and cytotoxic actions of punicalagin . J Agric Food Chem , 2007 . 55 ( 4 ): 1491 - 1500 . 17243704 DOI: 10.1021/jf0626720 http://doi.org/10.1021/jf0626720 . In vitro studies on the binding, antioxidant, and cytotoxic actions of punicalagin H Kumar , A Kaur , N Kishor , 等 . Prevalence of multiple antibiotic resistant nasal carriage MRSA among healthy population of border villages in Amritsar Region, Punjab, India . J Clin Diagn Res , 2016 . 10 ( 5 ): DL01 - DL02 . DOI: 10.7860/JCDR/2016/16131.7781 http://doi.org/10.7860/JCDR/2016/16131.7781 . Prevalence of multiple antibiotic resistant nasal carriage MRSA among healthy population of border villages in Amritsar Region, Punjab, India JY Lim , BY Hwang , KW Hwang , 等 . Methylalpinumisoflavone inhibits lipopolysaccharide-induced inflammation in microglial cells by the NF-kappaB and MAPK signaling pathway . Phytother Res , 2012 . 26 ( 12 ): 1948 - 1956 . 22899404 DOI: 10.1002/ptr.4810 http://doi.org/10.1002/ptr.4810 . Methylalpinumisoflavone inhibits lipopolysaccharide-induced inflammation in microglial cells by the NF-kappaB and MAPK signaling pathway M Ling , Y Li , Y Xu , 等 . Regulation of miRNA-21 by reactive oxygen species-activated ERK/NF-κB in arsenite-induced cell transformation . Free Radic Biol Med , 2012 . 52 ( 9 ): 1508 - 1518 . 22387281 DOI: 10.1016/j.freeradbiomed.2012.02.020 http://doi.org/10.1016/j.freeradbiomed.2012.02.020 . Regulation of miRNA-21 by reactive oxygen species-activated ERK/NF-κB in arsenite-induced cell transformation M Liu , S Song , H Li , 等 . The protective effect of caffeic acid against inflammation injury of primary bovine mammary epithelial cells induced by lipopolysaccharide . J Dairy Sci , 2014 . 97 ( 5 ): 2856 - 2865 . 24612802 DOI: 10.3168/jds.2013-7600 http://doi.org/10.3168/jds.2013-7600 . The protective effect of caffeic acid against inflammation injury of primary bovine mammary epithelial cells induced by lipopolysaccharide AD Mackeen , RE Packard , E Ota , 等 . Antibiotic regimens for postpartum endometritis . Cochrane Database Syst Rev , 2015 . ( 2 ): CD001067 25922861 DOI: 10.1002/14651858.CD001067.pub3 http://doi.org/10.1002/14651858.CD001067.pub3 . Antibiotic regimens for postpartum endometritis E Malinowski , H Lassa , H Markiewicz , 等 . Sensitivity to antibiotics of Arcanobacterium pyogenes and Escherichia coli from the uteri of cows with metritis/endometritis . Vet J , 2011 . 187 ( 2 ): 234 - 238 . 20129803 DOI: 10.1016/j.tvjl.2009.12.010 http://doi.org/10.1016/j.tvjl.2009.12.010 . Sensitivity to antibiotics of Arcanobacterium pyogenes and Escherichia coli from the uteri of cows with metritis/endometritis Y Morimoto , K Kikuchi , T Ito , 等 . MK615 attenuates Porphyromonas gingivalis lipopolysaccharide-induced pro-inflammatory cytokine release via MAPK inactivation in murine macrophage-like RAW264.7 cells . Biochem Biophys Res Commun , 2009 . 389 ( 1 ): 90 - 94 . 19706286 DOI: 10.1016/j.bbrc.2009.08.103 http://doi.org/10.1016/j.bbrc.2009.08.103 . MK615 attenuates Porphyromonas gingivalis lipopolysaccharide-induced pro-inflammatory cytokine release via MAPK inactivation in murine macrophage-like RAW264.7 cells OA Olajide , A Kumar , R Velagapudi , 等 . Punicalagin inhibits neuroinflammation in LPS-activated rat primary microglia . Mol Nutr Food Res , 2014 . 58 ( 9 ): 1843 - 1851 . 25066095 DOI: 10.1002/mnfr.201400163 http://doi.org/10.1002/mnfr.201400163 . Punicalagin inhibits neuroinflammation in LPS-activated rat primary microglia I Pandrea , C Xu , JL Stock , 等 . Antibiotic and antiinflammatory therapy transiently reduces inflammation and hypercoagulation in acutely SIV-infected pigtailed macaques . PLoS Pathog , 2016 . 12 ( 1 ): e1005384 26764484 DOI: 10.1371/journal.ppat.1005384 http://doi.org/10.1371/journal.ppat.1005384 . Antibiotic and antiinflammatory therapy transiently reduces inflammation and hypercoagulation in acutely SIV-infected pigtailed macaques J Peng , D Wei , Z Fu , 等 . Punicalagin ameliorates lipopolysaccharide-induced acute respiratory distress syndrome in mice . Inflammation , 2015 . 38 ( 2 ): 493 - 499 . 25005005 DOI: 10.1007/s10753-014-9955-5 http://doi.org/10.1007/s10753-014-9955-5 . Punicalagin ameliorates lipopolysaccharide-induced acute respiratory distress syndrome in mice Z Qi , S Qi , L Ling , 等 . Salidroside attenuates inflammatory response via suppressing JAK2-STAT3 pathway activation and preventing STAT3 transfer into nucleus . Int Immunopharmacol , 2016 . 35 265 - 271 . 27085677 DOI: 10.1016/j.intimp.2016.04.004 http://doi.org/10.1016/j.intimp.2016.04.004 . Salidroside attenuates inflammatory response via suppressing JAK2-STAT3 pathway activation and preventing STAT3 transfer into nucleus A Risco , C del Fresno , A Mambol , 等 . p38γ and p38δ kinases regulate the Toll-like receptor 4 (TLR4)-induced cytokine production by controlling ERK1/2 protein kinase pathway activation . Proc Natl Acad Sci USA , 2012 . 109 ( 28 ): 11200 - 11205 . DOI: 10.1073/pnas.1207290109 http://doi.org/10.1073/pnas.1207290109 . p38γ and p38δ kinases regulate the Toll-like receptor 4 (TLR4)-induced cytokine production by controlling ERK1/2 protein kinase pathway activation N Ruimi , H Rwashdeh , S Wasser , 等 . Daedalea gibbosa substances inhibit LPS-induced expression of iNOS by suppression of NF-κB and MAPK activities in RAW 264.7 macrophage cells . Int J Mol Med , 2010 . 25 ( 3 ): 421 - 432 . 20127048 . Daedalea gibbosa substances inhibit LPS-induced expression of iNOS by suppression of NF-κB and MAPK activities in RAW 264.7 macrophage cells A Sens , W Heuwieser . Presence of Escherichia coli , Trueperella pyogenes , α-hemolytic streptococci, and coagulase-negative staphylococci and prevalence of subclinical endometritis . J Dairy Sci , 2013 . 96 ( 10 ): 6347 - 6354 . 23910551 DOI: 10.3168/jds.2013-6646 http://doi.org/10.3168/jds.2013-6646 . Presence of Escherichia coli, Trueperella pyogenes, α-hemolytic streptococci, and coagulase-negative staphylococci and prevalence of subclinical endometritis IM Sheldon , MH Roberts . Toll-like receptor 4 mediates the response of epithelial and stromal cells to lipopolysaccharide in the endometrium . PLoS ONE , 2010 . 5 ( 9 ): e12906 20877575 DOI: 10.1371/journal.pone.0012906 http://doi.org/10.1371/journal.pone.0012906 . Toll-like receptor 4 mediates the response of epithelial and stromal cells to lipopolysaccharide in the endometrium IM Sheldon , GS Lewis , S LeBlanc , 等 . Defining postpartum uterine disease in cattle . Theriogenology , 2006 . 65 ( 8 ): 1516 - 1530 . 16226305 DOI: 10.1016/j.theriogenology.2005.08.021 http://doi.org/10.1016/j.theriogenology.2005.08.021 . Defining postpartum uterine disease in cattle K Shimada , H Daida , W Ma-Krupa , 等 . Lipopolysaccharide, CD14 and Toll-like receptors: an emerging link between innate immunity and atherosclerotic disease . Future Cardiol , 2005 . 1 ( 5 ): 657 - 674 . 19804106 DOI: 10.2217/14796678.1.5.657 http://doi.org/10.2217/14796678.1.5.657 . Lipopolysaccharide, CD14 and Toll-like receptors: an emerging link between innate immunity and atherosclerotic disease G Soboll , TM Schaefer , CR Wira . Effect of Toll-like receptor (TLR) agonists on TLR and microbicide expression in uterine and vaginal tissues of the mouse . Am J Reprod Immunol , 2006 . 55 ( 6 ): 434 - 446 . 16674601 DOI: 10.1111/j.1600-0897.2006.00381.x http://doi.org/10.1111/j.1600-0897.2006.00381.x . Effect of Toll-like receptor (TLR) agonists on TLR and microbicide expression in uterine and vaginal tissues of the mouse T Taguri , T Tanaka , I Kouno . Antimicrobial activity of 10 different plant polyphenols against bacteria causing food-borne disease . Biol Pharm Bull , 2004 . 27 ( 12 ): 1965 - 1969 . 15577214 DOI: 10.1248/bpb.27.1965 http://doi.org/10.1248/bpb.27.1965 . Antimicrobial activity of 10 different plant polyphenols against bacteria causing food-borne disease ML Turner , JG Cronin , GD Healey , 等 . Epithelial and stromal cells of bovine endometrium have roles in innate immunity and initiate inflammatory responses to bacterial lipopeptides in vitro via Toll-like receptors TLR2, TLR1, and TLR6 . Endocrinology , 2014 . 155 ( 4 ): 1453 - 1465 . 24437488 DOI: 10.1210/en.2013-1822 http://doi.org/10.1210/en.2013-1822 . Epithelial and stromal cells of bovine endometrium have roles in innate immunity and initiate inflammatory responses to bacterial lipopeptides in vitro via Toll-like receptors TLR2, TLR1, and TLR6 O Ugurlu , M Yaris , CV Oztekin , 等 . Impacts of antibiotic and anti-inflammatory therapies on serum prostate-specific antigen levels in the presence of prostatic inflammation: a prospective randomized controlled trial . Urol Int , 2010 . 84 ( 2 ): 185 - 190 . 20215823 DOI: 10.1159/000277596 http://doi.org/10.1159/000277596 . Impacts of antibiotic and anti-inflammatory therapies on serum prostate-specific antigen levels in the presence of prostatic inflammation: a prospective randomized controlled trial K Wagener , T Grunert , I Prunner , 等 . Dynamics of uterine infections with Escherichia coli , Streptococcus uberis and Trueperella pyogenes in post-partum dairy cows and their association with clinical endometritis . Vet J , 2014 . 202 ( 3 ): 527 - 532 . 25439441 DOI: 10.1016/j.tvjl.2014.08.023 http://doi.org/10.1016/j.tvjl.2014.08.023 . Dynamics of uterine infections with Escherichia coli, Streptococcus uberis and Trueperella pyogenes in post-partum dairy cows and their association with clinical endometritis HW Wang , T Wu , JY Qi , 等 . Salidroside attenuates LPS-stimulated activation of THP-1 cell-derived macrophages through down-regulation of MAPK/NF-κB signaling pathways . J Huazhong Univ Sci Technol Med Sci , 2013 . 33 ( 4 ): 463 - 469 . 23904362 DOI: 10.1007/s11596-013-1143-6 http://doi.org/10.1007/s11596-013-1143-6 . Salidroside attenuates LPS-stimulated activation of THP-1 cell-derived macrophages through down-regulation of MAPK/NF-κB signaling pathways Z Wang , W Jiang , Z Zhang , 等 . Nitidine chloride inhibits LPS-induced inflammatory cytokines production via MAPK and NF-kappaB pathway in RAW 264.7 cells . J Ethnopharmacol , 2012 . 144 ( 1 ): 145 - 150 . 22971898 DOI: 10.1016/j.jep.2012.08.041 http://doi.org/10.1016/j.jep.2012.08.041 . Nitidine chloride inhibits LPS-induced inflammatory cytokines production via MAPK and NF-kappaB pathway in RAW 264.7 cells E Ward , P Duff . A comparison of 3 antibiotic regimens for prevention of postcesarean endometritis: an historical cohort study . Am J Obstet Gynecol , 2016 . 214 ( 6 ): 751.e1 - 751e4 . DOI: 10.1016/j.ajog.2016.02.037 http://doi.org/10.1016/j.ajog.2016.02.037 . A comparison of 3 antibiotic regimens for prevention of postcesarean endometritis: an historical cohort study CR Wira , KS Grant-Tschudy , MA Crane-Godreau . Epithelial cells in the female reproductive tract: a central role as sentinels of immune protection . Am J Reprod Immunol , 2005 . 53 ( 2 ): 65 - 76 . 15790340 DOI: 10.1111/j.1600-0897.2004.00248.x http://doi.org/10.1111/j.1600-0897.2004.00248.x . Epithelial cells in the female reproductive tract: a central role as sentinels of immune protection H Wu , G Zhao , K Jiang , 等 . Engeletin alleviates lipopolysaccharide-induced endometritis in mice by inhibiting TLR4-mediated NF-κB activation . J Agric Food Chem , 2016 . 64 ( 31 ): 6171 - 6178 . 27411287 DOI: 10.1021/acs.jafc.6b02304 http://doi.org/10.1021/acs.jafc.6b02304 . Engeletin alleviates lipopolysaccharide-induced endometritis in mice by inhibiting TLR4-mediated NF-κB activation L Xu , S He , P Yin , 等 . Punicalagin induces Nrf2 translocation and HO-1 expression via PI3K/Akt, protecting rat intestinal epithelial cells from oxidative stress . Int J Hyperthermia , 2016 . 32 ( 5 ): 465 - 473 . 27055862 DOI: 10.3109/02656736.2016.1155762 http://doi.org/10.3109/02656736.2016.1155762 . Punicalagin induces Nrf2 translocation and HO-1 expression via PI3K/Akt, protecting rat intestinal epithelial cells from oxidative stress X Xu , P Yin , C Wan , 等 . Punicalagin inhibits inflammation in LPS-induced RAW264.7 macrophages via the suppression of TLR4-mediated MAPKs and NF-κB activation . Inflammation , 2014 . 37 ( 3 ): 956 - 965 . 24473904 DOI: 10.1007/s10753-014-9816-2 http://doi.org/10.1007/s10753-014-9816-2 . Punicalagin inhibits inflammation in LPS-induced RAW264.7 macrophages via the suppression of TLR4-mediated MAPKs and NF-κB activation L Yaidikar , S Thakur . Punicalagin attenuated cerebral ischemia-reperfusion insult via inhibition of proinflammatory cytokines, up-regulation of Bcl-2, down-regulation of Bax, and caspase-3 . Mol Cell Biochem , 2015 . 402 ( 1-2 ): 141 - 148 . 25555468 DOI: 10.1007/s11010-014-2321-y http://doi.org/10.1007/s11010-014-2321-y . Punicalagin attenuated cerebral ischemia-reperfusion insult via inhibition of proinflammatory cytokines, up-regulation of Bcl-2, down-regulation of Bax, and caspase-3 L Yaidikar , B Byna , SR Thakur . Neuroprotective effect of punicalagin against cerebral ischemia reperfusion-induced oxidative brain injury in rats . J Stroke Cerebrovasc Dis , 2014 . 23 ( 10 ): 2869 - 2878 . 25282190 DOI: 10.1016/j.jstrokecerebrovasdis.2014.07.020 http://doi.org/10.1016/j.jstrokecerebrovasdis.2014.07.020 . Neuroprotective effect of punicalagin against cerebral ischemia reperfusion-induced oxidative brain injury in rats Y Yang , J Xiu , L Zhang , 等 . Antiviral activity of punicalagin toward human enterovirus 71 in vitro and in vivo . Phytomedicine , 2012 . 20 ( 1 ): 67 - 70 . 23146421 DOI: 10.1016/j.phymed.2012.08.012 http://doi.org/10.1016/j.phymed.2012.08.012 . Antiviral activity of punicalagin toward human enterovirus 71 in vitro and in vivo YK Yoon , DW Park , JW Sohn , 等 . Effects of inappropriate empirical antibiotic therapy on mortality in patients with healthcare-associated methicillin-resistant Staphylococcus aureus bacteremia: a propensity-matched analysis . BMC Infect Dis , 2016 . 16 ( 1 ): 331 27418274 DOI: 10.1186/s12879-016-1650-8 http://doi.org/10.1186/s12879-016-1650-8 . Effects of inappropriate empirical antibiotic therapy on mortality in patients with healthcare-associated methicillin-resistant Staphylococcus aureus bacteremia: a propensity-matched analysis HX Zhao , JL Zhao , JZ Shen , 等 . Prevalence and molecular characterization of fluoroquinolone resistance in Escherichia coli isolates from dairy cattle with endometritis in China . Microb Drug Resist , 2014 . 20 ( 2 ): 162 - 169 . 24224497 DOI: 10.1089/mdr.2013.0073 http://doi.org/10.1089/mdr.2013.0073 . Prevalence and molecular characterization of fluoroquinolone resistance in Escherichia coli isolates from dairy cattle with endometritis in China We are thankful for help from the members of China Agricultural University-Beijing University of Agriculture Traditional Chinese Veterinary Medicine (CAU-BUA TCVM) teaching and research team. Compliance with ethics guidelines An LYU, Jia-jia CHEN, Hui-chuan WANG, Xiao-hong YU, Zhi-cong ZHANG, Ping GONG, Lin-shu JIANG, and Feng-hua LIU declare that they have no conflict of interest. All institutional and national guidelines for the care and use of laboratory animals were followed. 10.1631/jzus.B1600224 Project supported by the National Key Technology R & D Program of China (No. 2013BAD10B04) and the Importation and Development of High-Caliber Talents Project of Beijing Municipal Institutions (No. CIT&TCD20130324), China 2016-05-17 2017-05-08 2016-08-17 2022-01-05 Copyright © Zhejiang University and Springer-Verlag Berlin Heidelberg 2017 2017 Journal of Zhejiang University-SCIENCE B (Biomedicine and Biotechnology) 06 18