Abstract
Background:
Liver fibrosis is a chronic pathological condition with a leading cause of liver-related mortality worldwide. In the present study, we have evaluated the antifibrotic effect of crocin, a carotenoid present in the stigma of
Methods:
Liver fibrosis was induced by intraperitoneal administration of 30% carbon tetrachloride (CCl4). The crocin was administered orally at 20, 40 and 80 mg/kg body weight along with CCl4 up to 8 weeks.
Results:
Chronic exposure to CCl4 resulted in elevated levels of liver enzymes and reduced cytochrome P450 2E1 (CYP2E1) activity in the liver. The liver tissue showed cellular swelling, vacuolization, necrosis, infiltration of inflammatory cells and fibrotic changes. The crocin treatment significantly lowered the levels of liver enzymes in serum and improved the liver CYP2E1 mRNA levels. The pathological changes in the liver were also lowered by crocin treatment. The level of pro-inflammatory cytokines, nuclear factor-kappa B, interleukin-6 and tumor necrosis factor α and fibrogenic factor, transforming growth factor β, and α-smooth muscle actin were elevated by the CCl4 in the liver tissue. However, crocin treatment at different doses significantly reduced the expression of these factors. The increased caspase 3/7 activity was also lowered by crocin. CCl4 administration decreased the expression of peroxisome proliferator-activated receptor γ (PPAR-γ) in liver tissue. The improved PPAR-γ expression in the liver by crocin treatment indicates its role in the therapeutic effect of crocin.
Conclusions:
Crocin attenuated the various events in the progression of liver fibrosis via PPAR-γ mediated modulation of inflammatory and fibrogenic pathways.
Introduction
Liver fibrosis, a typical pathological process in chronic liver diseases, is becoming an increasing health burden worldwide. With the leading causes of liver-related morbidity and mortality, liver cirrhosis causes about 1.16 million deaths per year globally, making it the 11th most common causes of death with the growth of 10.3% from 2005. 1 Most common causes of liver fibrosis include viral infections, alcohol consumption, metabolic disorders and chemical/drug toxicities. 2 Liver fibrosis may further progress to cirrhosis, hepatocellular carcinoma and end-stage liver disease in untreated cases. It is characterized by progressive deposition of extracellular matrix (ECM) proteins in response to chronic liver injury. The pathogenic cascade of liver fibrosis begins with oxidative stress leading to hepatocyte injury, which further releases various inflammatory cytokines, chemokines and adhesion molecules were leading to activation of hepatic stellate cells (HSCs). 2 Stimulation of transforming growth factor (TGF)-β signalling and proliferation of HSCs are mainly responsible for excessive accumulation and deposition of ECM, resulting in liver fibrosis. 3
Peroxisome proliferator-activated receptor γ (PPAR-γ) is a ligand-activated transcription factor of the nuclear receptor superfamily. It regulates the gene expression of various proteins involved in a wide variety of biological functions, including lipid and glucose metabolism, adipogenesis, cell growth and differentiation and immunity. 4 These receptors are highly expressed in the adipose tissue, but other tissues like liver, skeletal muscles, pancreatic β cells, macrophages, and myeloid dendritic cells also express these receptors for their essential functions. 5 In recent years, a close interlay of PPAR-γ was studied in the pathogenesis of liver fibrosis. PPAR-γ agonists were reported to have an important role in preventing liver fibrosis by inhibiting TGF-β signalling, HSC activation, lowering of α-smooth muscle actin (α-SMA) and collagen expression as well as cell proliferation. 3,6
Carbon tetrachloride (CCl4)-induced fibrosis model is extensively used to study the underlying mechanism of liver fibrosis and the effect of various molecules on its development. The mixed-function cytochrome P450 oxygenase system of the liver converts CCl4 to trichloromethyl free radical (CCl3) or trichloroperoxyl radical (CCl3O2−), which leads to oxidative stress, membrane damage, hepatocellular necrosis, inflammation and fibrosis. 7
Materials and methods
Chemicals
The CCl4 was purchased from Ranbaxy Fine Chemicals Ltd (Chandigarh, Punjab, India). Crocin, sirius red, anti-α-SMA and anti-nuclear factor-kappa B (NF-κB) antibodies were obtained from Sigma-Aldrich (St Louis, Missouri, USA). Anti-TGF-β and anti-PPAR-γ antibodies were procured from Santa Cruz Biotechnology Inc. (Dallas, Texas, USA). Serum biochemical analysis kits were purchased from ERBA Diagnostics (Mannheim GmbH, Germany). The kits for immunohistochemistry (IHC) and quantitative real-time polymerase chain reaction (qRT-PCR) were purchased from Vector Labs (Burlingame, California, USA) and Thermo Fisher Scientific (Waltham, Massachusetts, USA), respectively. Apo-ONE homogenous caspase 3/7 assay kit from Promega (Madison, Wisconsin, USA) was used in the study.
Animals
Adult 6-week-old male Wistar rats were acquired from CSIR-Institute of Himalayan Bioresource Technology, Palampur, India, animal house facility. The animals were kept at standard room temperature (23 ± 2°C) and humidity (45–50%). The pellet rodent diet and water were provided to rats ad libitum. Animal handling and experimental protocols were performed as per the Committee for the Purpose of Control and Supervision of Experiments on Animals (CPCSEA) guidelines and were approved by the Institutional Animal Ethical Committee.
Experimental protocol
Rats were divided into five groups, with six rats in each group. Group I served as normal control (CNT) and received corn oil in equivalent doses. Groups II to V were administered with 30% CCl4 (0.3 ml/kg body weight) in corn oil, intraperitoneally thrice a week for 8 weeks. The dose of CCl4 was selected based on previous reports. 15 Groups III, IV, and V received crocin treatment at 20, 40 and 80 mg/kg body weight dose, respectively, from the day 1 onward up to eighth week. Group II served as a vehicle control (VC) group. After 8 weeks, the blood was collected through retro-orbital plexus and serum was separated for further biochemical analysis. The animals were euthanized by carbon dioxide asphyxiation and the liver tissues were collected and stored at −80°C for protein expression studies and in 10% neutral buffered formalin for histopathology studies.
Serum biochemistry
Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were analyzed by serum biochemical kits (ERBA, Transasia, India), using fully automated biochemistry analyzer (ERBA).
Histopathology
After proper fixation, the liver tissues collected in 10% neutral buffered formalin were subjected to processing following overnight washing under running water. Tissues then dehydrated with increasing grades of alcohol, cleared using xylene, and embedded in liquid paraffin. The paraffin-embedded tissues were sectioned at 4–5 µm and stained with hematoxylin and eosin stain. The stained tissue sections were analyzed using Olympus BX53F microscope (DSS IMAGETECH Pvt. Ltd., India) . 16
Picrosirius stain
The fibrous tissue deposition in the liver was evaluated using picrosirius staining. The liver sections were first stained with Weigert’s hematoxylin and then incubated with picrosirius red. The sections were dehydrated after removing the excess stain with acidified water, cleared in xylene, and mounted with dibutylphthalate polystyrene xylene (DPX) for observation. The sections were analyzed using a bright-field microscope, and the quantification of fibrous tissue was done with ImageJ software (ImageJ 1.52j) . 16
Immunohistochemistry
IHC was performed to analyze the expression of various factors in the liver tissues. Deparaffinized and hydrated tissue sections were boiled with sodium citrate buffer (pH 6.0) for the retrieval of antigens. The IHC was performed using ImmPRESS Excel staining kit, as per the prescribed protocol. The antibodies of α-SMA, TGF-β, NF-κB and PPAR-γ were used for the study (1:50–1:100 dilutions). The stained slides were evaluated under microscope and quantification of the expression was done using ImageJ software. 16
Total RNA isolation and RT-qPCR
Total RNA was isolated using trizol reagent from the liver tissues stored at −80°C. Liver tissues were (100 mg) homogenized in 1 ml of trizol reagent. Chloroform (0.2 ml) per ml of trizol was added and centrifuged (12,000 ×
For RT-qPCR, complementary DNA synthesized from 2 µg of RNA as per the manufacturer’s instructions (Applied Biosystems, Foster City, California, USA) and specific primers sequences for target genes have been given in Table 1.
Specific primers sequences for target genes.
CYP2E1: cytochrome P450 2E1; TGF-β: transforming growth factor-β; α-SMA: α-smooth muscle actin; IL-6: interleukin-6; TNF-α: tumor necrosis factor-α.
Caspase 3/7 assay
The liver tissue (50 mg) was homogenized in 1 ml of chilled phosphate-buffered saline. The samples were then centrifuged at 12,000 r/min for 15 min to collect the supernatant. The 100 µl of supernatant from each sample was taken in a black-walled 96-well plate and 100 µl of caspase 3/7 reaction mixture was added to it, followed by 30 min of incubation at room temperature, as per the manufacturer’s protocol. The fluorescence was measured at an excitation/emission wavelength of 480/560 nm in an ELISA plate reader. The formula (Net relative fluorescence unit (RFU) = Assay RFU − Blank RFU) was used to calculate the net RFU.
Western blotting
The liver tissues were micronized by hand homogenizer in a modified radioimmunoprecipitationassay buffer (RIPA) lysis buffer. The samples were then sonicated, and the protein was extracted by centrifugation at 14,000 r/min for 15 min at 4°C. The protein was quantified using Bradford reagent colorimetric assay at a wavelength of 595 nm in an ELISA plate reader. Western blotting was performed as per earlier reported method and quantification of blots was done using ImageJ software. 17
Statistical analysis
The results expressed as mean ± standard error of the mean. The statistical significance was carried out using one-way analysis of variance among all groups followed by Tukey’s post hoc test. The significance level was considered at
Results
Effect of crocin on cytochrome P450 (CYP2E1) activity
Cytochrome P450 2E1 (CYP2E1) earlier marked as ethanol degradation enzyme but later also identified for its active role in the biotransformation of many xenobiotics. The mRNA levels of CYP2E1 in the CCl4 group found significantly (

(a) Liver CYP2E1 mRNA levels, (b) serum ALT and (c) AST activity in different groups. *
Effect of crocin on liver injury markers
The serum levels of ALT and AST enzymes are the markers of liver injury. The CCl4 treatment significantly (
Effect of crocin on liver histopathology
The control group showed typical liver architecture with well-arranged hepatocytes and associated structures with no degenerative changes. The CCl4 administration caused ballooning of hepatocytes in the centrilobular area and bridging necrosis. The infiltration of the mononuclear cells was also evident. Crocin treatment at 40 and 80 mg/kg body weight significantly (

Liver tissue in (a) control group showing normal lobular arrangement of hepatocytes around blood vessel (arrow); (b) vehicle control group showing bridging necrosis with ballooning degeneration (arrows) and inflammatory cells (arrowhead) around centrilobular area; (c–e) liver tissue in 20, 40, and 80 mg/kg dose groups showing reduced intensity of pathological lesions, respectively; (f) mean lesion score of degenerative changes in various groups. *
Effect of crocin on fibrous tissue deposition in the liver
The fibrous tissue deposition in the liver was evaluated by picrosirius staining. The control group showed the normal presence of fibrous tissue around vessels. The VC group showed significantly (

Fibrous tissue deposition (a) CNT showing minimal fibrous tissue around blood vessels; (b) vehicle control group showing increased deposition of fibrous tissue (arrow) around blood vessels as well as in liver parenchyma (arrowhead); (c–e) 20, 40, and 80 mg/kg dose groups, respectively, showing the effect of crocin in reducing fibrous tissue deposition; (f) mean percentage of fibrous tissue deposition in different groups. *
Effect of crocin on liver inflammation
The level of pro-inflammatory cytokines is the indicator of an inflammatory response in the tissue. The gene expression studies revealed that CCl4 treatment significantly (

Immunohistochemical expression of various markers in the liver tissue of different group. (a–f) TGF-β expression in different groups, (g–l) NF-κB expression in different groups and (m–r) α-SMA expression in different groups. *

mRNA levels of various genes in different groups. (a) TGF-β, (b) α-SMA, (c) IL-6 and (d) TNF-α. *
Effect of crocin on fibrogenic factors
TGF-β and α-SMA are considered to be the prominent markers in the progression of fibrosis. The expressions of TGF-β and α-SMA in liver were studied by IHC. The tissue expression of TGF-β and α-SMA found significantly (
Effect of crocin on apoptosis
Caspase-3/7 are the key enzymes of the apoptotic pathway, and their elevated levels are an indicator of apoptosis. The level of caspase-3/7 activity found significantly (

Caspase 3/7 activity in different groups. *
Effect of crocin on PPAR-γ induction
The ligand-dependent transcription factor, PPAR-γ, plays a major role in liver fibrosis by regulating the activation and differentiation of stellate cells. The expression of PPAR-γ in liver tissues was evaluated by IHC. The VC group showed significantly (

PPAR-γ expression in the liver of different groups (a) Normal control group; (b) vehicle control group showing reduced expression; (c–e) 20, 40 and 80 mg/kg dose groups showing improved expression respectively; (f) comparative expression in liver tissue of different groups; (g, h) protein expression of PPAR-γ in different groups. *
Discussion
The demand for traditional medicines and nutraceuticals of natural origin has increased many folds over the years due to their therapeutic value without any side effect.
Liver fibrosis is a common response to chronic toxin-mediated liver injury. CYP2E1-dependent metabolism of CCl4 generates toxic metabolites and reactive oxygen species, leading to hepatocellular necrosis and subsequent fibrosis in the liver. 18 CCl4 metabolites reduce the CYP2E1 activity in the liver tissue in a phosphorylation-dependent manner, and a resistance to CCL4 toxicity was reported in CYP2E1 knockout mice. 18,19 In the present study, we observed a significant reduction in CYP2E1 activity in the CCl4-treated group. However, crocin in all the treatment groups restored the activity of CYP2E1 by maintaining its level to sustain the detoxifying capacity of the liver.
Hepatocyte injury leaks certain transaminases in the circulation as a valid indicator of liver damage. The elevated serum ALT and AST levels reported to being associated with hepatocyte injury and seepage of these enzymes from cell cytosol into circulation. 20 In the current study, these biochemical markers were noted to be significantly elevated after CCl4 exposure. However, improved levels of liver injury marker enzymes by crocin treatment might be due to its potent antioxidant effect, maintaining the integrity of the hepatic cellular membrane and preventing the transfusion of these cellular enzymes into serum. 12,21 Similarly, the hepatoprotective effect of crocin on liver transaminases has been well reported against amiodarone-induced liver damage, respectively. 22
The histopathology of liver supported the serum biochemistry findings, where CCl4 administration completely altered the liver histology leading to cellular swelling, necrosis, infiltration of mononuclear inflammatory cells and fibrous tissue deposition. The main pathological alterations after CCl4 administration were observed in the centrilobular area as the CYP2E1 is mainly expressed in the endoplasmic reticulum of centrilobular hepatocytes, which is primarily responsible for toxin metabolism. 23 Crocin treatment eminently improved the microscopic liver pathology by reducing these degenerative changes. In the previous report also, crocin administration showed a protective effect in CCl4-induced liver damage model by improving the liver pathology. 21 CCl4 induces fibrotic changes in the liver, which were well evident after 8 weeks of its repeated administration in the present study. The fibrous tissue deposition induced by CCl4 was substantially lowered by crocin in all the treatment groups. Recently, a study also supported the antifibrotic potential of crocin along with the reduction of liver damage in the mice model. 12
CCl4 metabolism in the liver results in the free-radical generation and induce oxidative stress, lipid peroxidation and alteration of membrane permeability. The oxidative stress-induced cellular injury triggers the production of a variety of cytokines that are capable of modulating various cellular events, such as necrosis, inflammation, apoptosis and fibrosis. 24,25 NF-κB signalling has been reported as one of the most crucial pathways involved in inflammatory diseases like liver fibrosis. Chronic administration of CCl4 is believed to prolong hepatic inflammation through the NF-κB signalling pathway, resulting in the production and secretion of TNF-α and IL-6 that are actively involved in the progression of fibrosis. 26 Our study demonstrated that CCl4-induced oxidative stress resulted in inflammatory response and activation of HSC, eventually leading to the progression of fibrosis. Moreover, evaluation of different inflammatory markers disclosed that CCl4-induced injury caused an inflammatory response in liver tissue with a substantial rise in hepatic NF-κB expressions along with a considerable increase in TNF-α and IL-6 mRNA. 27 The crocin treatment offered beneficial effect against CCl4-induced liver inflammation by significantly reducing the levels of NF-κB, TNF-α and IL-6. The earlier study also reported the anti-inflammatory effect of crocin by preventing NF-κB pathway activation and lowering the levels of pro-inflammatory cytokines TNF-α and IL-6. 28
Persistent inflammation may trigger fibrotic/cirrhotic response causing irreversible damage to hepatocytes and decline in liver function. Chronic liver injury leads to HSC activation and their transformation into myofibroblast-like cells with elevated α-SMA expression and increased synthesis of collagen and ECM. 29 TGF-β and α-SMA are considered to be the most prominent markers of fibrosis progression. Studies have confirmed that TGF-β contributes to HSC activation, which produces a number of profibrotic cytokines and growth factors, thus contributing to the progression of fibrosis both by autocrine and paracrine mechanism. 30 TGF- β/Smad pathway activates underlying cellular mechanisms, such as cell survival and proliferation. This further initiates the induction of pro-inflammatory cytokines, such as IL-1β and TNF-α along with other profibrotic factors to trigger fibrosis and tumorigenesis. 30,31 In our study, an elevated level of profibrotic markers, TGF-β and α-SMA, in liver tissues confirmed the fibrotic effect of CCl4. However, crocin treatment considerably abrogated the liver tissue expression of TGF-β and α-SMA. Similar reports have suggested by Algandaby, where crocin administration at 100 mg/kg dose weakened the expression of TGF-β and α-SMA against thioacetamide-induced liver fibrosis. 12
Apoptosis is considered to be a pivotal event in toxin-induced hepatotoxicity. It has reported that inflammatory cytokines possibly induce the activation of caspases and initiate cell apoptosis. 32 CCl4-induced apoptotic cell death is said to be mediated through the activation of caspase-3/7. 33 In our study, crocin administration ameliorated the CCl4-induced liver cells apoptosis by inhibiting the caspase-3/7-dependent apoptotic signalling pathway. Similarly, Sun et al. have suggested the role of crocin in reducing cisplatin-induced liver injury via inhibiting p38 mitogen-activated protein kinase (MAPK) and caspase-3 activity. 34
PPAR-γ is a nuclear family receptor and transcription factor that helps to maintain the quiescent stage of HSC by transcriptional regulation of multiple genes, including TNF-α, platelet-derived growth factor (PDGF)-β and TGF-β1. 35 The role of PPAR-γ has widely accepted in liver fibrosis, and its signalling pathway has a direct link to HSC activation. Rosiglitazone, a PPAR-γ agonist, has been found to inhibit HSC activation by suppressing inflammatory mediators, such as NF-κB, IL-6 and TNF-α. 36 Also, a PPAR-γ agonist was found to be capable of inhibiting oxidative stress and apoptosis in rat astrocyte cell line. 37 In our study, IHC and Western blot analysis have revealed that there was a substantial decrease in PPAR-γ expression in CCl4-administered rats. Nevertheless, there was a significant upregulation of PPAR-γ in crocin-treated groups, suggesting its potential role in preventing liver fibrosis by activating PPAR-γ signalling.
Conclusion
In conclusion, the present study speculates that the protective effect of crocin on CCl4-induced liver fibrosis was probably mediated through the PPAR-γ activation, leading to the suppression of oxidative stress and inhibition of apoptosis. Furthermore, crocin effectively reduced the course of fibrosis progression by inhibiting inflammatory and fibrogenic factors in the liver. However, further studies in this direction suggested that our results project crocin as a future therapeutic agent involving PPAR-γ mediated efficacy.
Footnotes
Acknowledgements
The authors would like to thank the Director, CSIR-IHBT, Palampur, India, for providing all the necessary facilities. We also acknowledge CSIR, India, for providing financial support in the form of a project (MLP0204). The CSIR-IHBT communication number is 4455.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The authors received financial support from CSIR, India.
