Activation of NRF2 induces the transcription of genes encoding
cytoprotective proteins. These include: • NAD(P)H quinone oxidoreductase 1 (
Nqo1) is a prototypical NRF2 target protein which catalyzes the reduction and detoxification of highly reactive
quinones that can cause
redox cycling and
oxidative stress. •
Glutamate-cysteine ligase catalytic subunit (
GCLC) and glutamate-cysteine ligase regulatory subunit (
GCLM) form a heterodimer, which is the rate-limiting step in the synthesis of
glutathione (GSH), a very powerful endogenous
antioxidant. Both Gclc and Gclm are characteristic NRF2 target genes, which establish NRF2 as a regulator of glutathione, one of the most important antioxidants in the body. •
Sulfiredoxin 1 (
SRXN1) and
Thioredoxin reductase 1 (
TXNRD1) support the reduction and recovery of
peroxiredoxins, proteins important in the detoxification of highly reactive peroxides, including
hydrogen peroxide and
peroxynitrite. • Heme oxygenase-1 (
HMOX1,
HO-1) is an enzyme that catalyzes the breakdown of
heme into the antioxidant
biliverdin, the anti-inflammatory agent
carbon monoxide, and iron. HO-1 is a NRF2 target gene that has been shown to protect from a variety of pathologies, including
sepsis,
hypertension,
atherosclerosis, acute lung injury, kidney injury, and pain. Conversely, induction of HO-1 has been shown to exacerbate early brain injury after
intracerebral hemorrhage. • The
glutathione S-transferase (GST) family includes cytosolic,
mitochondrial, and
microsomal enzymes that catalyze the conjugation of GSH with endogenous and
xenobiotic electrophiles. After detoxification by
glutathione (GSH) conjugation catalyzed by GSTs, the body can eliminate potentially harmful and toxic compounds. GSTs are induced by NRF2 activation and represent an important route of detoxification. • The UDP-
glucuronosyltransferase (UGT) family catalyze the conjugation of a
glucuronic acid moiety to a variety of endogenous and exogenous substances, making them more water-soluble and readily excreted. Important substrates for
glucuronidation include
bilirubin and
acetaminophen. NRF2 has been shown to induce
UGT1A1 and
UGT1A6. •
Multidrug resistance-associated proteins (Mrps) are important
membrane transporters that efflux various compounds from various organs and into
bile or plasma, with subsequent excretion in the feces or urine, respectively. Mrps have been shown to be upregulated by NRF2 and alteration in their expression can dramatically alter the
pharmacokinetics and toxicity of compounds. •
Kelch-like ECH-associated protein 1 is also a primary target of NFE2L2. Several interesting studies have also identified this hidden circuit in NRF2 regulations. An AREs located on a negative strand of the murine Keap1 (INrf2) gene can subtly connect Nrf2 activation to Keap1 transcription. Regarding NRF2 occupancies in human lymphocytes, an approximately 700 bp locus within the KEAP1 promoter region was consistently top rank enriched, even at the whole-genome scale. These basic findings have depicted a mutually influenced pattern between NRF2 and KEAP1. NRF2-driven KEAP1 expression characterized in human cancer contexts, especially in human squamous cell cancers, implicated a new perspective in understanding NRF2 signaling regulation. == Clinical relevance ==