Curcumin induces human cathelicidin antimicrobial peptide gene expression through a
vitamin D receptor-independent pathway
Chunxiao Guoa,b, Elena Rosohaa,b, Malcolm B. Lowrya,c, Niels Borregaardd, Adrian F.
aLinus Pauling Institute, bDepartment of Biochemistry and Biophysics, cDepartment of
Microbiology, Oregon State University, Corvallis, OR 97331
dThe Granulocyte Research Laboratory, Department of Hematology, National University
Hospital, Copenhagen, Denmark
*Corresponding author: Adrian F. Gombart, Linus Pauling Institute, Department of Biochemistry
and Biophysics, Oregon State University, 307 Linus Pauling Science Center, Corvallis, OR
97331, tel. 541-737-8018, fax 541-737-5077
This study was supported by NIH grant 5R01AI65604 (A.F.G.).
innate immunity, vitamin D receptor, curcumin, poly-unsaturated fatty acid, cathelicidin
The vitamin D receptor (VDR) mediates the pleiotropic biologic effects of 1,25 dihydroxy-
vitamin D3. Recent in vitro studies suggested that curcumin and poly-unsaturated fatty acids
(PUFAs) also bind to VDR with low affinity. As potential ligands for the VDR, we hypothesized
that curcumin and PUFAs would induce expression of known VDR target genes in cells. In this
study, we tested whether these compounds regulated two important VDR target genes - human
cathelicidin antimicrobial peptide (CAMP) and 1,25-dihydroxyvitamin D3 24-hydroxylase
(CYP24A1)- in human monocytic cell line U937, colon cancer cell line HT-29 and keratinocyte
cell line HaCaT. We demonstrated that PUFAs failed to induce CAMP or CYP24A1 mRNA
expression in all three cell lines, but curcumin up-regulated CAMP mRNA and protein levels in
U937 cells. Curcumin treatment induced CAMP promoter activity from a luciferase reporter
construct lacking the VDR binding site and did not increase binding of the VDR to the CAMP
promoter as determined by chromatin immunoprecipitation assays. These findings indicate that
induction of CAMP by curcumin occurs through a vitamin D receptor-independent manner. We
conclude that PUFAs and curcumin do not function as ligands for the VDR.
The nuclear receptor superfamily is divided into four groups based on whether the receptor forms
a homo- or heterodimer complex and what class of ligand is bound . The endocrine receptors
form homodimers and bind steroid hormones produced by endocrine tissues. The xenobiotic
receptors function as heterodimers with retinoid-X-receptor (RXR) and bind to xenobiotic
compounds, dietary lipids and cholesterol metabolites. The third group forms heterodimers with
RXR and binds to thyroid hormone and vitamins A and D while the orphan receptor group lacks
known ligands . The vitamin D receptor (VDR, NR1I1) is widely expressed in most, if not all,
human tissues and possesses characteristics of both the second and third groups . It serves as
the receptor for 1, 25-dihydroxyvitamin D3 [1,25(OH)2D3] which binds with high affinity and
for the secondary bile acid lithocholic acid (LCA) that binds with low affinity . Vitamin D is
obtained either from food, supplementation or synthesized in the skin by UVB irradiation of 7-
dehydrocholesterol . LCA is a secondary bile acid converted from primary bile acids by gut
microbiota . Upon engagement of a ligand, VDR forms a heterodimer with RXR and binds to
vitamin D response elements (VDREs) present in about 2000 genomic locations and directly
regulates approximately 200 genes [6, 7]. Target genes of the VDR contribute to bone mineral
homeostasis, detoxification of exogenous and endogenous compounds, cancer prevention,
mammalian hair cycling and immune function .
The ability of the VDR to bind LCA suggests that it may interact with other novel ligands. To
identify additional VDR ligands, Jurutka and colleagues used a mammalian two-hybrid system to
test high concentrations of curcumin (CM) and the polyunsaturated fats (PUFAs)
docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), arachidonic acid (AA), and
linolenic acid (LA) . These compounds promoted the dimerization of VDR and RXR
suggesting that they may function as novel low-affinity ligands for the VDR . More recently,
curcumin was shown to induce expression of the VDR target genes CYP24A1, CYP3A4, TRPV6
and CDKN1A in the human colon cancer cell line Caco-2 .
The human cathelicidin antimicrobial peptide (CAMP) gene encodes the hCAP18 pro-protein
that is cleaved to release the active peptide LL-37. The CAMP gene is directly regulated by
binding of the VDR to a VDRE located in its promoter region . Expression of the human
CAMP mRNA and hCAP18 is strongly induced by both 1,25(OH)2D3 and LCA in keratinocytes
and myeloid leukemia cell lines [11, 12]. Induction of the CAMP gene by LCA requires a 1000-
fold higher concentration of LCA than 1,25(OH)2D3 (1 x 10-5 versus 1 x 10-9 M, respectively) as
it is a low-affinity ligand for the VDR . We hypothesized that if CM and PUFAs are low-affinity
ligands for the VDR then at high concentrations they may induce the human CAMP gene in cells
via activation of the VDR. In this study, we showed that PUFAs did not act as VDR ligands and
were unable to increase expression of the CAMP gene in keratinocyte, colon and myeloid cell
lines, but CM acted through a VDR-independent pathway to increase CAMP expression.
2. Material and methods
Curcumin (C7727-500MG), cis-4,7,10,13,16,19-docosahexaenoic acid (D2534), cis-
5,8,11,14,17-eicosapentaenoic acid (E2011), arachidonic acid (A9673), linolenic acid (L2376),
were purchased from Sigma Aldrich (St. Louis, MO, USA).
2.2. Cell culture
Colonic epithelial cell line HT-29 was kindly provided by Dr. Rod Dashwood (Oregon State
University, Corvallis, OR). The human monocytic U937 and the keratinocyte HaCaT cell lines
were a generous gift from Dr. H. Phillip Koeffler (Cedars-Sinai Medical Center, Los Angeles,
CA). U937 cells were maintained in RPMI 1640 medium and HT-29 and HaCaT cells were
maintained in DMEM medium (Mediatech Inc., Manassas, VA, USA). All media were
supplemented with 10% (v/v) heat-inactivated FBS, 2 mM L-glutamine, and 1% Pen/Strep
(Invitrogen Corporation, Carlsbad, CA, USA). Cell cultures were incubated at 37°C in a
humidified 5% CO2 incubator.
2.3. Quantitative real-time PCR (qRT-PCR)
U937, HaCaT and HT-29 cells were treated with compounds as described in the figure legends.
Total RNA was isolated using the SV Total RNA Isolation System according to the
manufacturer’s protocol (Promega Corporation, Madison, WI, USA). RNA (1-2 g) was
converted to cDNA using SuperScript III reverse transcriptase and random hexamer primers
(Invitrogen Corporation) according to the manufacturer’s recommendations. PCR reactions were
set up as described previously . PCR was performed on a Bio-Rad iCycler iQ5 or CFX-96
QPCR system (Bio-Rad Laboratories, Hercules, CA, USA). All the threshold cycle (Ct) numbers
were normalized to 18S rRNA. The probes and primers for the human CAMP, CYP24A1,
FABP4 and RN18S1 genes used for qRT-PCR are described in Table 1.
2.4. Intracellular staining, fluorescence activated cell sorting and enzyme-linked
U937 cells were treated as indicated in the figure legends. Cells were fixed, permeabilized and
blocked using the eBioscience™ Fixation and Permeabilization Kit as described by the
manufacturer (eBioscience, Inc., San Diego, CA, USA). Cells were incubated with a rabbit, anti-
hCAP18 polyclonal antibody  and a Dylight 649 Fab’ 2 donkey anti-rabbit antibody (Jackson
Immunoresearch, Pike West Grove, PA, USA). Fluorescence activated cell sorting (FACS) was
performed on a BD FACSCalibur flow cytometer (BD Biosciences, San Jose, CA, USA) and the
results were analyzed by BD CellQuest™ Pro software (BD Biosciences). The enzyme-linked
immunosorbent assay (ELISA) was performed as described previously .
2.5 CAMP promoter luciferase reporter assay
U937 cells were electroporated using a NEONTM transfection system (Life Technologies, Grand
Island, NY, USA) in Tip100 tips at 5×107 cells/mL. Electroporation conditions were 1400 mV,
30ms, 1 pulse. A total of 10 µg plasmid was used per electroporation. After transfection, cells
were treated with CM or 1,25(OH)2D3 or vehicle as indicated in the figure legends. Cells were
lysed and dual luciferase assays were performed as described by the manufacturer (Promega,
Madison, WI, USA). The human CAMP promoter (nucleotides –693 to 14) containing the
VDRE and a 5’ deletion of the promoter (ΔHindIII, nucleotides –497 to 14) lacking the VDRE
were subcloned into a pXP2 firefly luciferase reporter plasmid previously . A renilla
luciferase reporter (phTKRL, Promega) was co-transfected to normalize firefly luciferase
activities in all experiments.
2.6. Chromatin-Immunoprecipitation Assay
Chromatin-immunoprecipitation (ChIP) experiments were performed as described previously
. Briefly, U937 cells (107 cells/IP) were treated with compounds as specified in the figure
legend for 24 hours. Cells then were fixed with 1% (v/v) formaldehyde for 10 minutes at room
temperature and quenched by 0.1 M glycine for 5 minutes. Fixed chromatin was sheared to 200-
1000 bp fragments by a bath sonicator (BioruptorTM XL, Diagenode Inc. Denville, NJ) following
the manufacturer’s recommendations. Anti-VDR antibodies (2 μg C-20 VDR antibody, sc-1008;
2 μg N-20 VDR antibody, sc-1009, Santa Cruz Biotechnology, Santa Cruz, CA) were incubated
with sheared chromatin for 16 hours at 4°C. Immunocomplexes were pulled down by Protein
A/G Plus Agrose beads (sc-2003, Santa Cruz Biotechnology, Santa Cruz, CA) and DNA was
recovered using Chelex® 100 resin (Bio-Rad, Hercules, CA). To evaluate the VDR occupancy
at the human CAMP gene promoter, quantitative PCR was performed as described in section 2.3.
Occupancy by VDR was normalized with respect to chromatin input used for
immunoprecipitation. Primers and probe are listed in Table 1.
2.7. Data analysis
All qRT-PCR and ELISA experiments were performed in triplicate or duplicate and results were
represented as mean value with SD. Student’s t-test was performed using Sigma Plot (Systat
Software, San Jose, CA) and Microsoft Excel (Microsoft Corporation, Redmond, WA).
3.1. CAMP gene expression is induced by curcumin but not PUFAs
The human CAMP and CYP24A1 are known target genes of the VDR and induced by
1,25(OH)2D3 and LCA [16, 17]. We predicted that compounds that function as low-affinity
ligands for the VDR would induce expression of these two genes. To test this, we treated U937
(Fig. 1 A & B), HT-29 (Fig. 1 C & D) and HaCaT (Fig. 1 E & F) cells with CM, DHA, EPA, AA
and LA for 24 hours. 1,25(OH)2D3 and LCA were included as positive controls and vehicle
(ethanol or DMSO) was used for the untreated control. Because 1,25(OH)2D3 does not induce
CAMP strongly in HT-29 cells, sodium butyrate (NaB), a known inducer of CAMP in colon
cancer cell lines, was included for experiments with HT-29 (Fig. 1 C & D). 1,25(OH)2D3
and LCA strongly induced expression of both the CAMP (Fig. 1 A & E) and CYP24A1 (Fig. 1 B
& F) genes in U937 and HaCaT cells. In HT-29 cells CAMP was not strongly induced by
1,25(OH)2D3 or LCA, but was induced about four-fold by NaB (Fig. 1 C). CYP24A1 expression
was induced by LCA and 1,25(OH)2D3 in all cells tested (Fig. 1 B, D & F). The PUFAs (DHA,
EPA, AA and LA) did not induce human CAMP or CYP24A1 expression in U937, HaCaT or
HT-29 cells (Fig. 1 A-F). CM consistently induced expression of human CAMP by about 3-fold
(n=3, P<0.05) in U937 and HT-29 cells (Fig. 1 A & C) but not in HaCaT cells (Fig. 1 E). In all
three cell lines, CM did not induce CYP24A1 (Fig. 1 B, D & F). To demonstrate that the PUFAs
used in this study were active, we examined expression of FABP4, a gene induced by PUFAs
binding the PPAR receptor in monocytes . FABP4 expression was induced in U937 cells
demonstrating that the compounds were functional (Fig. 2). To ensure that induction of CAMP
or CYP24A1 did not peak prior to 24 hours, we tested CM and DHA in a time course experiment
(0, 3, 6, 12 and 24 hours) and observed maximal induction of CAMP by CM at 24 hours and no
induction by DHA (data not shown). Collectively, these data indicate that PUFAs do not act as
low-affinity agonists for the VDR and that CM induces CAMP, but not CYP24A1.
3.2. CM elevates hCAP18 levels
Treatment of U937 cells with 10 nM 1,25(OH)2D3 increases levels of hCAP18 (the protein
encoded by the human CAMP gene) secreted into the medium . We monitored secreted
levels of hCAP18 in the medium by ELISA . As expected, 10 nM 1,25(OH)2D3 increased
secretion of hCAP18 into the medium; however, treatment with 100 µM LCA and 1 nM
1,25(OH)2D3, which induce CAMP mRNA expression to similar levels, did not enhance hCAP18
secretion and neither did CM nor the PUFAs (Fig. 3). These results suggest that modest
increases in CAMP mRNA levels may not lead to secretion of hCAP18 proteins in U937 cells.
To determine if induction of CAMP mRNA by CM would increase intracellular hCAP18
expression, U937 cells were treated with either 15 M CM, 100 M DHA, 100 M EPA, 100
M AA, 100 M LA, 100 M LCA or 10 nM 1,25(OH)2D3 for 24 hours. The hCAP18 levels
were measured by intracellular staining and FACS. The PUFAs did not increase hCAP18 levels
(data not shown). CM increased the intracellular hCAP18 levels, however, they were lower than
those induced by LCA and 1,25(OH)2D3 (Fig. 4).
3.3. CM does not enhance 1,25(OH)2D3 induction of CAMP expression
It was shown previously that treatment of Caco-2 cells with CM and 1,25(OH)2D3 resulted in a
combinatorial activation of a transfected VDRE-Luc reporter construct [9, 10]. To determine if
CM plus 1,25(OH)2D3 would activate the CAMP gene better than either compound alone, we
treated U937 cells with 15 M CM and increasing doses of 1,25(OH)2D3. The CAMP mRNA
levels were evaluated by qRT-PCR (Fig. 5). CM increased CAMP mRNA levels by 2.6-fold
while 0.1 nM vitamin D induced CAMP by 6.5-fold. The combination induced CAMP by 5.5-
fold indicating no combinatorial activation of the gene. This lack of combinatorial activation
was observed with 1 nM and 10 nM 1,25(OH)2D3, as well (Fig. 5).
3.4 Induction of the CAMP gene by CM does not require the VDRE in the CAMP promoter.
We predicted that if CM induced CAMP through the VDR, then deletion of the VDRE in the
CAMP promoter should abrogate the induction. We transfected CAMP promoter firefly
luciferase reporters with or without the presence of the VDRE (pXP2-CAMP-luc and pXP2-
CAMP-ΔHindIII-luc, respectively, Fig. 6 A) into U937 cells. Consistent with our previous report
, deletion of the VDRE in the CAMP promoter almost completely abolished induction of
luciferase activity by 10 nM 1,25(OH)2D3 (Fig. 6 B). On the other hand, CM was still capable of
increasing CAMP promoter activity in the absence of the VDRE in the promoter (Fig. 6 B). 10
M CM induced the luciferase activities by about two-fold regardless of the presence or absence
of the VDRE. From these experiments, we concluded that induction of the CAMP gene by CM
does require the VDRE.
3.5 CM does not increase VDR binding to the CAMP gene promoter
CM does not appear to function as a ligand for the VDR, thus we predicted that it would not
increase VDR binding to the human CAMP gene promoter. To test this, we performed ChIP for
VDR in U937 cells treated with CM, LCA and1,25(OH)2D3 (Fig. 7). We found that VDR
binding to the CAMP promoter was increased with 1,25(OH)2D3, and LCA treatment and not by
CM (Fig. 7), strongly suggesting that CM-induced human CAMP expression occurs through a
VDR- independent mechanism.
VDR agonists are of great interest because of their potential therapeutic benefits in treating
cancer, psoriasis and other diseases [20-24]. Thousands of analogs have been synthesized
around the vitamin D backbone to reduce or eliminate its hypercalcemic side effects .
Another class of VDR agonists is secondary bile acid LCA and its analogs  that activate
VDR target genes without inducing hypercalcemia . The identification of new agonists
increases the toolbox of backbones upon which additional analogs can be developed. To this end,
we tested a group of potential VDR ligands identified by a mammalian two hybrid system .
We showed that CM modestly induced CAMP, but not CYP24A1 expression and that PUFAs
did not induce the mRNA levels these two VDR target genes in human monocyte (U937),
keratinocyte (HaCaT) or colon cancer (HT-29) cell lines. These results suggest these compounds
are not functional VDR agonists. On the other hand, the known ligands, LCA and 1,25(OH)2D3
strongly induced both genes. Of the putative ligands tested, only CM increased intracellular
levels of hCAP18. This induction was observed in three of four experiments and was less than
either LCA or 1,25(OH)2D3. The modest induction of CAMP by CM did not appear to occur
through the VDR. ChIP experiments showed that VDR binding to the CAMP promoter was not
increased by CM as it is by both LCA and 1,25(OH)2D3. Furthermore, we demonstrated by
reporter assays that CM activated the CAMP promoter in the absence of the VDRE.
CM at the concentration we used can elicit ER stress  and a recent study showed ER stress
induces human CAMP expression in keratinocytes . We tested whether ER stress induced
CAMP in our cell lines and were unable to demonstrate a role for this mechanism (data not
shown); therefore, ER stress elicited by CM is not a likely mechanism for induction of human
CAMP gene expression in our study. Collectively, these data argue that CM and PUFAs are not
low affinity ligands for the VDR and CM activates CAMP expression by a currently unknown
The discrepancy between our work and the previous study  could be attributed to several
factors. First, recent molecular docking studies proposed that two ligand binding pockets exist in
the VDR ligand binding domain: the genomic and alternative pockets. Vitamin D and its
metabolites are ligands of the genomic pocket while CM is proposed to mainly bind to the
alternative pocket . Therefore, in the mammalian two hybrid system, the possible binding of
CM to the alternative pocket may have increased VDR/RXR dimerization; however, since CM
was a weak ligand of the genomic pocket, it did not activate transcription of VDR target genes in
our cell culture experiments. Second, prior studies demonstrated that CM regulated the VDR
target gene CYP24A1 in Caco-2 cells . We did not observe this in U937, HaCaT or HT-29
cells, suggesting that modulation of VDR target genes by CM could be specific to the type of cell
Future experiments determining the crystal structure of the VDR/CM complex may further
define the role of CM as a VDR alternative pocket ligand. Also, additional studies in other cell
lines may be required to comprehensively understand the possible function of CM and PUFAs as
We thank Mary Fantacone for critically reviewing the manuscript and Charlotte Horn for
technical assistance. In addition, we are grateful to Brian Sinnott, Yan Campbell and Jesse
Rushen for their help in completing this project.
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Figure 1. Alternative VDR ligands fail to activate the human CAMP gene. U937 cells (A, B),
HT-29 cells (C, D) and HaCaT cells (E, F) were treated with 10 M curcumin (CM), 100M
docosahexaenoic acid (DHA), 100 M eicosapentaenoic acid (EPA), 100 M arachidonic acid
(AA) , 100 M linolenic Acid (LA), 100 M lithocholic acid (LCA) and 1 nM 1,25(OH)2D3 for
24 hours. For HT-29 cells, 2 mM sodium butyrate (NaB) was used as positive control since
1,25(OH)2D3 is not a potent inducer of CAMP in these cells. qRT-PCR analysis of human
CAMP (A, C, and E) and CYP24A1 (B, D and F) mRNA levels were normalized to 18S rRNA.
Each panel is from one experiment, but is representative of three independent experiments.
*Significant (P < 0.05) difference compared with untreated control.
Figure 2. PUFAs and CM induced FABP4 expression in U937 cells. U937 cells were treated
with 10 M CM, 100 M DHA, 100 M EPA, 100 M AA and 100 M LA for 24 hours.
FABP4 mRNA levels were measured by qRT-PCR using primers and probe as described in
Table 1. *Significant (P < 0.05) difference compared with untreated control.
Figure 3. Curcumin and PUFAs do not increase levels of secreted hCAP18. U937 cells
were treated with 10 M CM, 100 M DHA, 100 M EPA, 100 M AA, 100 M LA, 100 M
LCA or 1,25(OH)2D3 (1 nM and 10 nM) for 24 hours. Culture medium was collected and
subjected to ELISA to measure extracellular hCAP18 protein levels. *Significant (P < 0.01)
difference compared with untreated control.
Figure 4. CM increases intracellular levels of hCAP18. U937 cells were treated with 10 M
CM, 100 M LCA and 1 nM 1,25(OH)2D3 for 24 hours. Intracellular hCAP18 levels were
assessed by flow cytometry. This panel is from one experiment, but is representative of four
Figure 5. CM does not cooperatively increase CAMP expression by 1,25(OH)2D3. U937
cells were treated with 15 µM CM in the absence or presence of increasing concentrations of
1,25(OH)2D3 for 24 hours. This data are representative of two independent experiments. Levels
of CAMP expression were measured by qRT-PCR using primers and probe as described in Table
Figure 6. CM induces CAMP promoter activity in absence of VDRE. A) Schematic
diagrams show the structures of the two CAMP promoter-luciferase reporter constructs used in
this study. Solid filled black box indicates the location of the VDRE in the CAMP promoter. B)
U937 cells were electroporated with pXP2-CAMP-luc or pXP2-CAMP-ΔHindIII-luc plasmid
and then treated with 10 M CM, 10 nM 1,25(OH)2D3 or vehicle for 20 hours. Data were
presented as fold changes over the corresponding untreated control. *Significant (P < 0.05, n=3)
difference compared with untreated control. This bar chart summarizes three independent
Figure 7. CM does not enhance VDR binding to the human CAMP promoter. U937 cells
were treated with 10 M CM, 100 M LCA and 10 nM 1,25(OH)2D3 for 24 hours. Chromatin-IP
was performed as described in section 2.5. The panel represents two independent experiments.
*Significant (P < 0.05) difference compared with untreated control.
Table 1. Primers and probes used for qRT-PCR
Gene Primer Sequence Probe Sequence
F 5'-GCTAACCTCTACCGCCTCCT -3'
R 5'-GGTCACTGTCCCCATACACC -3'
F 5’-GAACGTTGGCTTCAGGAGAA -3’
R 5’-TATTTGCGGACAATCCAACA -3’
F 5’-AGCACCATAACCTTAGATGGGG -3’
F 5’- CGTGGAAGTGACGCCTTTCA -3’
F 5'-AAACGGCTACCACATCCAAG -3'
R 5'-CCTCCAATGGATCCTCGTTA -3'
CAMP ΔHindIII Luciferase
CAMP promoter Luciferase