#3839 therapeutic targets of arsenic trioxide in lupus nephritis – data from bioinformatics analysis and in vitro studies

Abstract Background and Aims Patients with systemic lupus erythematosus (SLE) are at an increased risk of developing lupus nephritis (LN), which results in high morbidity and mortality. There is preliminary data showing the efficacy of low dose of Arsenic Trioxide (ATO) in reducing renal flares amongst LN patients, but the underlying mechanism for such benefit remains unclear. Method We performed bioinformatic analysis and network pharmacology to elucidate the potential targets from differentially expressed genes (DEGs) of human SLE and LN peripheral blood mononuclear cells (PBMCs) datasets and pharmacological databases. The relationship between the potential targets and immune cells was further analyzed. Results Twelve intersection genes of DEGs in SLE, predicting targets of ATO and immune related genes were identified. KEGG pathway analysis suggested that the mechanisms of ATO in SLE were associated with IL-17 signalling pathway (p = 1.67E-18), TNF signalling pathway (p = 5.77E-11) and NOD-like receptor signalling pathway (p = 1.93E-09). Ten types of immune cells showed significant difference with intersection genes expression in SLE using ssGSEA approach. MMP9 was the most significantly associated with immune cells and showed positive correlations with macrophages and neutrophils. A significant TF-MMP9-miRNA regulatory network was constructed using cytoscape software. Pilot data from our in vitro studies suggested that ATO might downregulate MMP9 expression in PBMCs obtained from LN patients during disease remission (n = 3). Conclusion ATO interacts with immune cells in LN patients via different inflammatory pathways and may downregulate MMP9 expression in PBMCs.