Abstract
DL-3-n-Butylphthalide (DL-NBP), a small molecular compound extracted from the seeds of Apium graveolens Linn (Chinese celery), has been shown to exert neuroprotective effects due to its anti-inflammatory, anti-oxidative and anti-apoptotic activities. DL-NBP not only protects against ischemic cerebral injury, but also ameliorates vascular cognitive impairment in dementia patients including AD and PD. In the current study, we investigated whether and how DL-NBP exerted a neuroprotective effect against diabetes-associated cognitive decline (DACD) in db/db mice, a model of type-2 diabetes. db/db mice were orally administered DL-NBP (20, 60, 120 mg· kg−1· d−1) for 8 weeks. Then the mice were subjected to behavioral test, their brain tissue was collected for morphological and biochemical analyses. We showed that oral administration of DL-NBP significantly ameliorated the cognitive decline with improved learning and memory function in Morris water maze testing. Furthermore, DL-NBP administration attenuated diabetes-induced morphological alterations and increased neuronal survival and restored the levels of synaptic protein PSD95, synaptophysin and synapsin-1 as well as dendritic density in the hippocampus, especially at a dose of 60 mg/kg. Moreover, we revealed that DL-NBP administration suppressed oxidative stress by upregulating Nrf2/HO-1 signaling, and increased brain-derived neurotrophic factor (BDNF) expression by activating PI3K/Akt/CREB signaling in the hippocampus. These beneficial effects of DL-NBP were observed in high glucose-treated PC12 cells. Our results suggest that DL-NBP may be a potential pharmacologic agent for the treatment of DACD.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Enomoto M, Yoshii H, Mita T, Sanke H, Yokota A, Yamashiro K, et al. Relationship between dietary pattern and cognitive function in elderly patients with type 2 diabetes mellitus. J Int Med Res. 2015;43:506–17.
Cooray GK, Maurex L, Brismar T. Cognitive impairment correlates to low auditory event-related potential amplitudes in type 1 diabetes. Psychoneuroendocrinology. 2008;33:942–50.
Plastino M, Fava A, Pirritano D, Cotronei P, Sacco N, Sperli T, et al. Effects of insulinic therapy on cognitive impairment in patients with Alzheimer disease and diabetes mellitus type-2. J Neurol Sci. 2010;288:112–6.
Koekkoek PS, Ruis C, van den Donk M, Biessels GJ, Gorter KJ, Kappelle LJ, et al. Intensive multifactorial treatment and cognitive functioning in screen-detected type 2 diabetes-the addition-netherlands study: a cluster-randomized trial. J Neurol Sci. 2012;314:71–7.
Aly HF, Mantawy MM. Comparative effects of zinc, selenium and vitamin E or their combination on carbohydrate metabolizing enzymes and oxidative stress in streptozotocin induced-diabetic rats. Eur Rev Med Pharmacol Sci. 2012;16:66–78.
Reddy PH. Amyloid precursor protein-mediated free radicals and oxidative damage: implications for the development and progression of Alzheimer’s disease. J Neurochem. 2006;96:1–13.
Fukui K, Onodera K, Shinkai T, Suzuki S, Urano S. Impairment of learning and memory in rats caused by oxidative stress and aging, and changes in antioxidative defense systems. Ann Ny Acad Sci. 2001;928:168–75.
Ansari MA, Scheff SW. Oxidative stress in the progression of Alzheimer disease in the frontal cortex. J Neuropathol Exp Neurol. 2010;69:155–67.
Peng Y, Hu Y, Xu S, Li P, Li J, Lu L, et al. L-3-n-butylphthalide reduces tau phosphorylation and improves cognitive deficits in AbetaPP/PS1-Alzheimer’s transgenic mice. J Alzheimers Dis. 2012;29:379–91.
Baydas G, Donder E, Kiliboz M, Sonkaya E, Tuzcu M, Yasar A, et al. Neuroprotection by alpha-lipoic acid in streptozotocin-induced diabetes. Biochemistry (Mosc). 2004;69:1001–5.
Li W, Jain MR, Chen C, Yue X, Hebbar V, Zhou R, et al. Nrf2 possesses a redox-insensitive nuclear export signal overlapping with the leucine zipper motif. J Biol Chem. 2005;280:28430–8.
Gong W, Li J, Zhu G, Wang Y, Zheng G, Kan Q. Chlorogenic acid relieved oxidative stress injury in retinal ganglion cells through IncRNA-TUG1/Nrf2. Cell Cycle. 2019;18:1549–59.
Singh N, Vijayanti S, Saha L, Bhatia A, Banerjee D, Chakrabarti A. Neuroprotective effect of Nrf2 activator dimethyl fumarate, on the hippocampal neurons in chemical kindling model in rat. Epilepsy Res. 2018;143:98–104.
Shi Y, Miao W, Teng J, Zhang L. Ginsenoside Rb1 protects the brain from damage induced by epileptic seizure via Nrf2/ARE signaling. Cell Physiol Biochem. 2018;45:212–25.
Zhang Y, Liu B, Chen X, Zhang N, Li G, Zhang LH, et al. Naringenin ameliorates behavioral dysfunction and neurological deficits in a D-galactose-induced aging mouse model through activation of PI3K/Akt/Nrf2 pathway. Rejuvenation Res. 2017;20:462–72.
Frebel K, Wiese S. Signalling molecules essential for neuronal survival and differentiation. Biochem Soc Trans. 2006;34:1287–90.
Ali T, Kim T, Rehman SU, Khan MS, Amin FU, Khan M, et al. Natural dietary supplementation of anthocyanins via PI3K/Akt/Nrf2/HO-1 pathways mitigate oxidative stress, neurodegeneration, and memory impairment in a mouse model of Alzheimer’s disease. Mol Neurobiol. 2018;55:6076–93.
Nakaso K, Yano H, Fukuhara Y, Takeshima T, Wada-Isoe K, Nakashima K. PI3K is a key molecule in the Nrf2-mediated regulation of antioxidative proteins by hemin in human neuroblastoma cells. FEBS Lett. 2003;546:181–4.
Wang L, Chen Y, Sternberg P, Cai J. Essential roles of the PI3 kinase/Akt pathway in regulating Nrf2-dependent antioxidant functions in the RPE. Invest Ophthalmol Vis Sci. 2008;49:1671–8.
Wen Z, Hou W, Wu W, Zhao Y, Dong X, Bai X, et al. 6’-O-Galloylpaeoniflorin attenuates cerebral ischemia reperfusion-induced neuroinflammation and oxidative stress via PI3K/Akt/Nrf2 activation. Oxid Med Cell Longev. 2018;2018:8678267.
Lopez de Armentia M, Jancic D, Olivares R, Alarcon JM, Kandel ER, Barco A. cAMP response element-binding protein-mediated gene expression increases the intrinsic excitability of CA1 pyramidal neurons. J Neurosci. 2007;27:13909–18.
AM L, NY I, MM P. Potentiation of developing neuromuscular synapses by the neurotrophins NT-3 and BDNF. Nature. 1993;363:350–3.
Figurov A, Pozzo-Miller LD, Olafsson P, Wang T, Lu B. Regulation of synaptic responses to high-frequency stimulation and LTP by neurotrophins in the hippocampus. Nature. 1996;381:706–9.
Phillips HS, Hains JM, Armanini M, Laramee GR, Johnson SA, Winslow JW. BDNF mRNA is decreased in the hippocampus of individuals with Alzheimer’s disease. Neuron. 1991;7:695–702.
Li G, Peskind ER, Millard SP, Chi P, Sokal I, Yu CE, et al. Cerebrospinal fluid concentration of brain-derived neurotrophic factor and cognitive function in non-demented subjects. PLoS One. 2009;4:e5424.
Kariharan T, Nanayakkara G, Parameshwaran K, Bagasrawala I, Ahuja M, Abdel-Rahman E, et al. Central activation of PPAR-gamma ameliorates diabetes induced cognitive dysfunction and improves BDNF expression. Neurobiol Aging. 2015;36:1451–61.
Chen J, Liang L, Zhan LB, Zhou Y, Zheng LP, Sun XX, et al. ZiBuPiYin recipe protects db/db mice from diabetes-associated cognitive decline through improving multiple pathological changes. PLoS One. 2014;9:e91680.
Carvalho C, Machado N, Mota PC, Correia SC, Cardoso S, Santos RX, et al. Type 2 diabetic and Alzheimer’s disease mice present similar behavioral, cognitive, and vascular anomalies. J Alzheimers Dis. 2013;35:623–35.
Peng B, Cui LY. Treatment for acute ischemic stroke: new evidence from China. Chin Med J (Engl). 2013;126:3403–4.
Hu JY, Wen QP, Wu Y, Li BZ, Gao P. The effect of butylphthalide on the brain edema, blood-brain barrier of rats after focal cerebral infarction and the expression of Rho A. Cell Biochem Biophys. 2014;69:363–8.
Jia JP, Wei CB, Liang JH, Zhou AH, Zuo XM, Song HG, et al. The effects of DL-3-n-butylphthalide in patients with vascular cognitive impairment without dementia caused by subcortical ischemic small vessel disease: a multicentre, randomized, double-blind, placebo-controlled trial. Alzheimers Dement. 2016;12:89–99.
Xiong NA, Huang JS, Chen CN, Zhao Y, Zhang ZW, Jia M, et al. DL-3-n-butylphthalide, a natural antioxidant, protects dopamine neurons in rotenone models for Parkinson’s disease. Neurobiol Aging. 2012;33:1777–91.
Yang LC, Li J, Xu SF, Cai J, Lei H, Liu DM, et al. L-3-n-butylphthalide promotes neurogenesis and neuroplasticity in cerebral ischemic rats. CNS Neurosci Ther. 2015;21:733–41.
Wang CY, Wang ZY, Xie JW, Wang T, Wang X, Xu Y, et al. DL-3-n-butylphthalide-induced upregulation of antioxidant defense is involved in the enhancement of cross talk between CREB and Nrf2 in an Alzheimer’s disease mouse model. Neurobiol Aging. 2016;38:32–46.
Abdoulaye IA, Guo YJ. A review of recent advances in neuroprotective potential of 3-n-butylphthalide and its derivatives. Biomed Res Int. 2016;2016:5012341.
Peng Y, Xu SF, Chen GQ, Wang L, Feng YP, Wang XL. L-3-n-butylphthalide improves cognitive impairment induced by chronic cerebral hypoperfusion in rats. J Pharmacol Exp Ther. 2007;321:902–10.
Nicholas A, Munhoz CD, Ferguson D, Campbell L, Sapolsky R. Enhancing cognition after stress with gene therapy. J Neurosci. 2006;26:11637–43.
Xu Y, Pan J, Sun J, Ding L, Ruan L, Reed M, et al. Inhibition of phosphodiesterase 2 reverses impaired cognition and neuronal remodeling caused by chronic stress. Neurobiol Aging. 2015;36:955–70.
Chien T, Weng YT, Chang SY, Lai HL, Chiu FL, Kuo HC, et al. GSK3beta negatively regulates TRAX, a scaffold protein implicated in mental disorders, for NHEJ-mediated DNA repair in neurons. Mol Psychiatry. 2018;23:2375–90.
Meng L, Chen R, Jiang A, Wang L, Wang P, Li CZ, et al. Short multiwall carbon nanotubes promote neuronal differentiation of PC12 cells via up-regulation of the neurotrophin signaling pathway. Small. 2013;9:1786–98.
Danielyan L, Schafer R, Schulz A, Ladewig T, Lourhmati A, Buadze M, et al. Survival, neuron-like differentiation and functionality of mesenchymal stem cells in neurotoxic environment: the critical role of erythropoietin. Cell Death Differ. 2009;16:1599–614.
Li M, Yu HB, Pan HY, Zhou XQ, Ruan QF, Kong DL, et al. Nrf2 suppression delays diabetic wound healing through sustained oxidative stress and inflammation. Front Pharmacol. 2019;10:1099.
Wang ZG, Zhang HY, Xu XL, Shi HX, Yu XC, Wang XJ, et al. bFGF inhibits ER stress induced by ischemic oxidative injury via activation of the PI3K/Akt and ERK1/2 pathways. Toxicol Lett. 2012;212:137–46.
Li L, Li T, Zhang Y, Pan Z, Wu B, Huang X, et al. Peroxisome proliferator-activated receptorbeta/delta activation is essential for modulating p-Foxo1/Foxo1 status in functional insulin-positive cell differentiation. Cell Death Dis. 2015;6:e1715.
Hu X, Shi Q, Zhou X, He W, Yi H, Yin X, et al. Transgenic mice overexpressing reticulon 3 develop neuritic abnormalities. EMBO J. 2007;26:2755–67.
Sairanen M, O’Leary OF, Knuuttila JE, Castren E. Chronic antidepressant treatment selectively increases expression of plasticity-related proteins in the hippocampus and medial prefrontal cortex of the rat. Neuroscience. 2007;144:368–74.
Li ZG, Zhang W, Sima AA. C-peptide enhances insulin-mediated cell growth and protection against high glucose-induced apoptosis in SH-SY5Y cells. Diabetes Metab Res Rev. 2003;19:375–85.
Sale P, De Pandis MF, Vimercati SL, Sova I, Foti C, Tenore N, et al. The relation between Parkinson’s disease and ageing comparison of the gait patterns of young Parkinson’s disease subjects with healthy elderly subjects. Eur J Phys Rehab Med. 2013;49:161–7.
Sun YF, Cheng X, Wang HB, Mu XP, Liang YF, Luo YJ, et al. DL-3-n-butylphthalide promotes neuroplasticity and motor recovery in stroke rats. Behav Brain Res. 2017;329:67–74.
Li JM, Li Y, Ogle M, Zhou X, Song MK, Yu SP, et al. DL-3-n-Butylphthalide prevents neuronal cell death after focal cerebral ischemia in mice via the JNK pathway. Brain Res. 2010;1359:216–26.
Ye XW, Rong ZY, Li YF, Wang XT, Cheng BY, Cheng YY, et al. Protective role of L-3-n-butylphthalide in cognitive function and dysthymic disorders in mouse with chronic epilepsy. Front Pharmacol. 2018;9:734.
Xu J, Huai YP, Meng N, Dong YH, Liu ZJ, Qi QQ, et al. L-3-n-butylphthalide activates Akt/mTOR signaling, inhibits neuronal apoptosis and autophagy and improves cognitive impairment in mice with repeated cerebral ischemia-reperfusion injury. Neurochem Res. 2017;42:2968–81.
Gao M, Ji S, Li J, Zhang S. DL-3-n-butylphthalide (NBP) ameliorates cognitive deficits and CaMKII-mediated long-term potentiation impairment in the hippocampus of diabetic db/db mice. Neurol Res. 2019;41:1024–33.
Di Mario U, Morano S, Valle E, Pozzessere G. Electrophysiological alterations of the central nervous system in diabetes mellitus. Diabetes Metab Rev. 1995;11:259–77.
Xiang Q, Zhang J, Li CY, Wang Y, Zeng MJ, Cai ZX, et al. Insulin resistance-induced hyperglycemia decreased the activation of Akt/CREB in hippocampus neurons: Molecular evidence for mechanism of diabetes-induced cognitive dysfunction. Neuropeptides. 2015;54:9–15.
Bliss TV, Collingridge GL. A synaptic model of memory: long-term potentiation in the hippocampus. Nature. 1993;361:31–9.
Dagon Y, Avraham Y, Link G, Zolotarev O, Mechoulam R, Berry EM. The synthetic cannabinoid HU-210 attenuates neural damage in diabetic mice and hyperglycemic pheochromocytoma PC12 cells. Neurobiol Dis. 2007;27:174–81.
Song Y, Ding W, Bei Y, Xiao Y, Tong HD, Wang LB, et al. Insulin is a potential antioxidant for diabetes-associated cognitive decline via regulating Nrf2 dependent antioxidant enzymes. Biomed Pharmacother. 2018;104:474–84.
Qi QQ, Xu J, Lv PY, Dong YH, Liu ZJ, Hu M, et al. DL-3-n-butylphthalide alleviates vascular cognitive impairment induced by chronic cerebral hypoperfusion by activating the Akt/Nrf2 signaling pathway in the hippocampus of rats. Neurosci Lett. 2018;672:59–64.
Zhang C, Li C, Chen S, Li Z, Jia X, Wang K, et al. Berberine protects against 6-OHDA-induced neurotoxicity in PC12 cells and zebrafish through hormetic mechanisms involving PI3K/AKT/Bcl-2 and Nrf2/HO-1 pathways. Redox Biol. 2017;11:1–11.
Zhao M, Tang X, Gong D, Xia P, Wang F, Xu S. Bungeanum improves cognitive dysfunction and neurological deficits in D-galactose-induced aging mice via activating PI3K/Akt/Nrf2 signaling pathway. Front Pharmacol. 2020;11:71.
Mu YL, Gage FH. Adult hippocampal neurogenesis and its role in Alzheimer’s disease. Mol Neurodegener. 2011;6:85. https://doi.org/10.1186/1750-1326-6-85.
Tatebayashi Y, Lee MH, Li L, Iqbal K, Grundke-Iqbal I. The dentate gyrus neurogenesis: a therapeutic target for Alzheimer’s disease. Acta Neuropathol. 2003;105:225–32.
Agrimi J, Spalletti C, Baroni C, Keceli G, Zhu GS, Caragnano A, et al. Obese mice exposed to psychosocial stress display cardiac and hippocampal dysfunction associated with local brain-derived neurotrophic factor depletion. Ebiomedicine. 2019;47:384–401.
Belgacem YH, Borodinsky LN. CREB at the crossroads of activity-dependent regulation of nervous system development and function. Adv Exp Med Biol. 2017;1015:19–39.
Gite S, Ross RP, Kirke D, Guiheneuf F, Aussant J, Stengel DB, et al. Nutraceuticals to promote neuronal plasticity in response to corticosterone-induced stress in human neuroblastoma cells. Nutr Neurosci. 2019;22:551–68.
de la Monte SM, Wands JR. Alzheimer’s disease is type 3 diabetes-evidence reviewed. J Diabetes Sci Technol. 2008;2:1101–13.
Lee HK, Kumar P, Fu Q, Rosen KM, Querfurth HW. The insulin/Akt signaling pathway is targeted by intracellular beta-amyloid. Mol Biol Cell. 2009;20:1533–44.
Sun B, Feng MJ, Tian XY, Lu XW, Zhang YY, Ke XJ, et al. DL-3-n-butylphthalide protects rat bone marrow stem cells against hydrogen peroxide-induced cell death through antioxidation and activation of PI3K-Akt pathway. Neurosci Lett. 2012;516:247–52.
Chen Y, Cao CP, Li CR, Wang W, Zhang D, Han LL, et al. Ghrelin modulates insulin sensitivity and tau phosphorylation in high glucose-induced hippocampal neurons. Biol Pharm Bull. 2010;33:1165–9.
ZZ C, YP F. DL-3-n-butylphthalide attenuates reperfusion-induced blood-brain barrier damage after focal cerebral ischemia in rats. Zhongguo Yao Li Xue Bao. 1999;20:696–700.
Wu FF, Xu K, Xu KB, Teng CH, Zhang M, Xia LL, et al. DL-3n-butylphthalide improves traumatic brain injury recovery via inhibiting autophagy-induced blood-brain barrier disruption and cell apoptosis. J Cell Mol Med. 2020;24:1220–32.
Acknowledgements
This study is supported by the research grants from the National Natural Science Foundation of China (81801233, 81870842, 81801245, 81802238) and Natural Science Foundation of Zhejiang Province (LQ18H090011 and LGD21H070001).
Author information
Authors and Affiliations
Contributions
BNW, CBW and YQW did the research and wrote the paper. ZMC participated in data analysis and writing the paper. PPZ, YQL, JX, JYX, PFL, AAM, LBY and ZLZ researched data. JX and JW conceived the project, designed the experiments, and wrote the paper. All authors have approved the final version of the paper.
Corresponding authors
Ethics declarations
Competing interests
The authors declare no competing interests.
Supplementary information
Rights and permissions
About this article
Cite this article
Wang, Bn., Wu, Cb., Chen, Zm. et al. DL-3-n-butylphthalide ameliorates diabetes-associated cognitive decline by enhancing PI3K/Akt signaling and suppressing oxidative stress. Acta Pharmacol Sin 42, 347–360 (2021). https://doi.org/10.1038/s41401-020-00583-3
Received:
Accepted:
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41401-020-00583-3
Keywords
This article is cited by
-
3-n-Butylphthalide Protects SH-SY5Y Cells from Ferroptosis by Inhibiting ACSL4-Mediated Lipid Peroxidation
Molecular Neurobiology (2026)
-
Artemisinin ameliorates cognitive decline by inhibiting hippocampal neuronal ferroptosis via Nrf2 activation in T2DM mice
Molecular Medicine (2024)
-
Unveiling the therapeutic potential of Dl-3-n-butylphthalide in NTG-induced migraine mouse: activating the Nrf2 pathway to alleviate oxidative stress and neuroinflammation
The Journal of Headache and Pain (2024)
-
Transcriptomics reveals dynamic changes in the “gene profiles” of rat supraspinatus tendon at three different time points after diabetes induction
BMC Medical Genomics (2024)
-
Mechanistic Insights and Potential Therapeutic Implications of NRF2 in Diabetic Encephalopathy
Molecular Neurobiology (2024)


