Molecular Medicine

, Volume 19, Issue 1, pp 203–211 | Cite as

Carbenoxolone Blocks Endotoxin-Induced Protein Kinase R (PKR) Activation and High Mobility Group Box 1 (HMGB1) Release

  • Wei Li
  • Jianhua Li
  • Andrew E. Sama
  • Haichao Wang
Research Article


The pathogen- and damage-associated molecular patterns (for example, bacterial endotoxin and adenosine 5′-triphosphate (ATP)) activate the double-stranded RNA-activated protein kinase R (PKR) to trigger the inflammasome-dependent high mobility group box 1 (HMGB1) release. Extracellular ATP contributes to the inflammasome activation through binding to the plasma membrane purinergic P2X7 receptor (P2X7R), triggering the opening of P2X7R channels and the pannexin-1 (panx-1) hemichannels permeable for larger molecules up to 900 daltons. It was previously unknown whether panx-1 channel blockers can abrogate lipopolysaccharide (LPS)-induced PKR activation and HMGB1 release in innate immune cells. Here we demonstrated that a major gancao (licorice) component (glycyrrhizin, or glycyrrhizic acid) derivative, carbenoxolone (CBX), dose dependently abrogated LPS-induced HMGB1 release in macrophage cultures with an estimated IC50 ≈ 5 µmol/L. In an animal model of polymicrobial sepsis (induced by cecal ligation and puncture (CLP)), repetitive CBX administration beginning 24 h after CLP led to a significant reduction of circulating and peritoneal HMGB1 levels, and promoted a significant increase in animal survival rates. As did P2X7R antagonists (for example, oxidized ATP, oATP), CBX also effectively attenuated LPS-induced P2X7R/panx-1 channel activation (as judged by Lucifer Yellow dye uptake) and PKR phosphorylation in primary peritoneal macrophages. Collectively, these results suggested that CBX blocks LPS-induced HMGB1 release possibly through impairing PKR activation, supporting the involvement of PKR in the regulation of HMGB1 release.



We thank Mala Ashok for assistance with animal experiments, Arvin Jundoria for critical reading of the manuscript, and Kevin J Tracey and Ben Lu for helpful discussions. This work was supported by the National Center of Complementary and Alternative Medicine (NCCAM, R01AT05076) and the National Institute of General Medical Sciences (NIGMS, R01GM063075).


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Authors and Affiliations

  • Wei Li
    • 1
    • 2
  • Jianhua Li
    • 1
  • Andrew E. Sama
    • 2
  • Haichao Wang
    • 1
    • 2
  1. 1.The Feinstein Institute for Medical ResearchManhassetUSA
  2. 2.Department of Emergency MedicineNorth Shore University HospitalManhassetUSA

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