Autoimmune disease Like many stress and heat shock proteins, BiP has potent immunological activity when released from the internal environment of the cell into the extracellular space. Specifically, it feeds anti-inflammatory and pro-resolutory signals into immune networks, thus helping to resolve
inflammation. The mechanisms underlying BiP's immunological activity are incompletely understood. Nonetheless, it has been shown to induce anti-inflammatory cytokine secretion by binding to a receptor on the surface of
monocytes, downregulate critical molecules involved in
T-lymphocyte activation, and modulate the differentiation pathway of monocytes into
dendritic cells. The potent immunomodulatory activities of BiP/GRP78 have also been demonstrated in animal models of autoimmune disease including
collagen-induced arthritis, a murine disease that resembles human rheumatoid arthritis. Prophylactic or therapeutic parenteral delivery of BiP has been shown to ameliorate clinical and histological signs of inflammatory arthritis.
Cardiovascular disease Upregulation of BiP has been associated with ER stress-induced cardiac dysfunction and
dilated cardiomyopathy. BiP also has been proposed to suppress the development of
atherosclerosis through alleviating
homocysteine-induced ER stress, preventing apoptosis of
vascular endothelial cells, inhibiting the activation of genes responsible for
cholesterol/
triglyceride biosynthesis, and suppressing tissue factor
procoagulant activity, all of which can contribute to the buildup of
atherosclerotic plaques. Some
anticancer drugs, such as
proteasome inhibitors, have been associated with heart failure complications. In rat
neonatal cardiomyocytes, overexpression of BiP attenuates cardiomyocyte death induced by proteasome inhibition.
Neurodegenerative disease As an ER chaperone protein, BiP prevents
neuronal cell death induced by ER stress by correcting misfolded proteins. Moreover, a chemical inducer of BiP, named BIX, reduced cerebral infarction in cerebral
ischemic mice. Conversely, enhanced BiP chaperone function has been strongly implicated in
Alzheimer's disease.
Metabolic disease BiP
heterozygosity is proposed to protect against high fat diet-induced
obesity,
type 2 diabetes, and
pancreatitis by upregulating protective ER stress pathways. BiP is also necessary for
adipogenesis and
glucose homeostasis in
adipose tissues.
Infectious disease Prokaryotic BiP
orthologs were found to interact with key proteins such as
RecA, which is vital to bacterial
DNA replication. As a result, these bacterial Hsp70 chaperones represent a promising set of targets for antibiotic development. Notably, the anticancer drug OSU-03012 re-sensitized
superbug strains of
Neisseria gonorrhoeae to several standard-of-care
antibiotics. == Notes ==