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Kong J, Deng Y. Pirfenidone alleviates vascular intima injury caused by hyperhomocysteinemia. Rev Port Cardiol 2022; 41:813-819. [DOI: 10.1016/j.repc.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/15/2021] [Accepted: 12/18/2021] [Indexed: 10/17/2022] Open
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Gan D, Cheng W, Ke L, Sun AR, Jia Q, Chen J, Xu Z, Xu J, Zhang P. Biphasic Effect of Pirfenidone on Angiogenesis. Front Pharmacol 2022; 12:804327. [PMID: 35069215 PMCID: PMC8766764 DOI: 10.3389/fphar.2021.804327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/20/2021] [Indexed: 12/19/2022] Open
Abstract
Pirfenidone (PFD), a synthetic arsenic compound, has been found to inhibit angiogenesis at high concentrations. However, the biphasic effects of different PFD concentrations on angiogenesis have not yet been elucidated, and the present study used an in vitro model to explore the mechanisms underlying this biphasic response. The effect of PFD on the initial angiogenesis of vascular endothelial cells was investigated through a Matrigel tube formation assay, and the impact of PFD on endothelial cell migration was evaluated through scratch and transwell migration experiments. Moreover, the expression of key migration cytokines, matrix metalloproteinase (MMP)-2 and MMP-9, was examined. Finally, the biphasic mechanism of PFD on angiogenesis was explored through cell signaling and apoptosis analyses. The results showed that 10–100 μM PFD has a significant and dose-dependent inhibitory effect on tube formation and migration, while 10 nM–1 μM PFD significantly promoted tube formation and migration, with 100 nM PFD having the strongest effect. Additionally, we found that a high concentration of PFD could significantly inhibit MMP-2 and MMP-9 expression, while low concentrations of PFD significantly promoted their expression. Finally, we found that high concentrations of PFD inhibited EA.hy926 cell tube formation by promoting apoptosis, while low concentrations of PFD promoted tube formation by increasing MMP-2 and MMP-9 protein expression predominantly via the EGFR/p-p38 pathway. Overall, PFD elicits a biphasic effect on angiogenesis through different mechanisms, could be used as a new potential drug for the treatment of vascular diseases.
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Affiliation(s)
- Donghao Gan
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,School of Medicine, The Southern University of Science and Technology, Shenzhen, China
| | - Wenxiang Cheng
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Liqing Ke
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Antonia RuJia Sun
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Qingyun Jia
- Second Ward of Trauma Surgery Department, Linyi People's Hospital, Linyi, China
| | - Jianhai Chen
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Zhanwang Xu
- Department of Orthopedics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Juan Xu
- Department of Stomatology, SijingHospital, Shanghai, China
| | - Peng Zhang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen Engineering Research Center for Medical Bioactive Materials, Shenzhen, China.,University of Chinese Academy of Sciences, Beijing, China
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Vu TN, Chen X, Foda HD, Smaldone GC, Hasaneen NA. Interferon-γ enhances the antifibrotic effects of pirfenidone by attenuating IPF lung fibroblast activation and differentiation. Respir Res 2019; 20:206. [PMID: 31511015 PMCID: PMC6737625 DOI: 10.1186/s12931-019-1171-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 08/23/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) pathogenesis involves multiple pathways, and combined antifibrotic therapy is needed for future IPF therapy. Inhaled interferon-γ (IFN-γ) was recently shown to be safe and without systemic effects in patients with IPF. AIM To examine the in vitro effects of individual and combined treatment with IFN-γ and pirfenidone (PFD) on normal and IPF fibroblast activation and extracellular matrix remodeling after TGF-β1 and PDGF-BB stimulation. METHODS IPF and normal human lung fibroblasts (NHLF) were treated with IFN-γ, PFD or a combination of both drugs in the presence of either TGF-β1 or PDGF-BB. The effects of TGF-β1 and PDGF-BB treatment on cell viability, proliferation, differentiation and migration were examined. The expression of collagen 1, matrix metalloproteinases (MMPs) and tissue inhibitors of MMP (TIMPs) was analyzed using qPCR, Western blotting and gelatin zymography. Total collagen content in conditioned media was also measured using a Sircol assay. RESULTS Compared to that of PFD, the effect of IFN-γ in downregulating normal and IPF lung fibroblast differentiation to myofibroblasts in response to TGF-β1 was more potent. Importantly, the combination of IFN-γ and PFD had a possibly synergistic/additive effect in inhibiting the TGF-β1- and PDGF-BB-induced proliferation, migration and differentiation of normal and IPF lung fibroblasts. Furthermore, both drugs reversed TGF-β1-induced effects on MMP-1, - 2, - 3, - 7, and - 9, while only PFD promoted TIMP-1 and-2 expression and release. CONCLUSIONS Our findings demonstrate that the antifibrotic effects of IFN-γ and PFD on normal and IPF lung fibroblasts are different and complementary. Combination therapy with inhaled IFN-γ and PFD in IPF is promising and should be further explored in IPF clinical trials.
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Affiliation(s)
- Tuong N Vu
- Pulmonary, Critical Care and Sleep Division, Department of Medicine, Stony Brook Medicine, Health Science Center, State University of New York at Stony Brook, HSC T17 Room 040, Stony Brook, NY, 11794-8172, USA
| | - Xuesong Chen
- Pulmonary, Critical Care and Sleep Division, Department of Medicine, Stony Brook Medicine, Health Science Center, State University of New York at Stony Brook, HSC T17 Room 040, Stony Brook, NY, 11794-8172, USA
| | - Hussein D Foda
- Pulmonary, Critical Care and Sleep Division, Department of Medicine, Stony Brook Medicine, Health Science Center, State University of New York at Stony Brook, HSC T17 Room 040, Stony Brook, NY, 11794-8172, USA.,Department of Medicine and Research, VAMC Northport, Stony Brook, NY, USA
| | - Gerald C Smaldone
- Pulmonary, Critical Care and Sleep Division, Department of Medicine, Stony Brook Medicine, Health Science Center, State University of New York at Stony Brook, HSC T17 Room 040, Stony Brook, NY, 11794-8172, USA
| | - Nadia A Hasaneen
- Pulmonary, Critical Care and Sleep Division, Department of Medicine, Stony Brook Medicine, Health Science Center, State University of New York at Stony Brook, HSC T17 Room 040, Stony Brook, NY, 11794-8172, USA. .,Department of Medicine and Research, VAMC Northport, Stony Brook, NY, USA.
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Inhibition of Matrix Deposition: A New Strategy for Prevention of Restenosis After Balloon Angioplasty. J Cardiovasc Pharmacol 2010; 55:213-8. [DOI: 10.1097/fjc.0b013e3181ce97f6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhou H, Latham CW, Zander DS, Margolin SB, Visner GA. Pirfenidone inhibits obliterative airway disease in mouse tracheal allografts. J Heart Lung Transplant 2006; 24:1577-85. [PMID: 16210133 DOI: 10.1016/j.healun.2004.11.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2004] [Revised: 10/29/2004] [Accepted: 11/12/2004] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Obliterative bronchiolitis (OB) is the histologic correlate of chronic airway rejection, which remains the most significant cause of death in long-term survivors of lung transplantation. Using an established murine heterotopic tracheal transplant model of chronic airway rejection, the effects of the oral anti-fibrotic agent pirfenidone on development of the OB-like lesion were evaluated. METHODS Tracheas from BALB/c mice were implanted into the sub-cutaneous tissue of C57BL/6 mice, and the allografts were evaluated morphologically for airway rejection changes and immunohistochemically for transforming growth factor (TGF)-beta at 16 or 28 days after transplantation. In addition, the potential additive effects of pirfenidone in combination with 2 immunosuppressive agents, cyclosporine or rapamycin, was evaluated. RESULTS Compared with untreated controls, pirfenidone-fed mice showed less epithelial cell injury and luminal granulation tissue and fibrosis. Plasma TGF-beta levels and local TGF-beta expression based on immunohistochemistry were decreased in the pirfenidone-treated animals. Pirfenidone given on Day 9 or 16 post-transplant through Day 28 resulted in no significant improvement compared with controls. There was no significant additive effect of pirfenidone in combination with cyclosporine, whereas pirfenidone plus rapamycin demonstrated additive protection against the development of the obstructive airway lesion. CONCLUSIONS In aggregate, these results show that the anti-fibrotic agent pirfenidone inhibits the development of the OB-like lesion in this mouse model of human chronic airway rejection, and that these effects may be mediated by TGF-beta. The results also suggest that pirfenidone may be worthy of investigation in human lung transplant recipients at high risk of developing OB.
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Affiliation(s)
- Hailan Zhou
- Department of Pediatrics, University of Florida, Gainesville, Florida 32610, USA
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Brook NR, Waller JR, Bicknell GR, Nicholson ML. The novel antifibrotic agent pirfenidone attenuates the profibrotic environment generated by calcineurin inhibitors in the rat salt-depletion model. Transplant Proc 2005; 37:130-3. [PMID: 15808571 DOI: 10.1016/j.transproceed.2004.12.150] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Calcineurin inhibitors (CNIs) promote fibrosis in renal allografts by altering the dynamics of extracellular matrix (ECM) turnover. Graft structure is changed and functional disturbance may follow. This study examined the effects of an antifibrotic agent, pirfenidone, on functional, structural, and molecular markers of fibrosis in a rat model. Cyclosporine or tacrolimus were administered to salt-depleted rats, with or without varying doses of pirfenidone. Both CNIs increased serum creatinine, and pirfenidone attenuated this functional disturbance. No changes in urinary protein excretion or graft histology were observed, suggesting structural and functional alterations can be dissociated. Messenger RNA expression of pro- and antifibrotic genes affecting ECM was estimated with semiquantitative RT-PCR. Cyclosporine-induced increases in collagen III mRNA expression were attenuated by pirfenidone (500 mg/kg/d), and increases in TIMP-1 expression were reversed by all doses of pirfenidone. Matrix metalloproteinase-2 expression was decreased by cyclosporine; all doses of pirfenidone significantly reversed this effect. Tacrolimus alone decreased TGF-beta and TIMP-1 expression, suggesting some antifibrotic action; addition of pirfenidone had no further effect. The mechanism of action of pirfenidone is reversal of some CNI-induced changes in fibrotic gene expression. It also attenuates creatinine rise in salt-depleted rats in this model of CNI-induced nephrotoxicity.
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Affiliation(s)
- N R Brook
- Transplant Surgery Group, University of Leicester, Leicester, UK
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Brook NR, Waller JR, Bicknell GR, Nicholson ML. The Experimental Agent Pirfenidone Reduces Pro-Fibrotic Gene Expression in a Model of Tacrolimus-Induced Nephrotoxicity. J Surg Res 2005; 125:137-43. [PMID: 15854665 DOI: 10.1016/j.jss.2004.12.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2004] [Revised: 09/06/2004] [Accepted: 12/09/2004] [Indexed: 10/25/2022]
Abstract
BACKGROUND Tacrolimus nephrotoxicity is thought to contribute to renal allograft dysfunction and subsequent failure, a process that is underpinned by alterations in mRNA expression of genes involved in matrix metabolism. The new anti-fibrotic pirfenidone was tested for its potential to reverse markers of renal dysfunction. MATERIALS AND METHODS Rats were salt-depleted before tacrolimus and pirfenidone treatment. Serum creatinine, urinary protein/creatinine ratio, extracellular matrix deposition (ECM), and mRNA expression of genes involved in matrix turnover were assessed. RESULTS Tacrolimus reduced TGF-beta mRNA expression below control levels and treatment with pirfenidone at all doses did not alter this effect. Likewise, TIMP-1 mRNA expression was depressed by the addition of tacrolimus and pirfenidone caused a further decrease in expression. Collagen III, MMP-2, and MMP-9 expression was unchanged by tacrolimus, but pirfenidone reduced collagen III below control levels. ECM was slight (1-4%) and not significantly different between groups. CONCLUSIONS These findings suggest that pirfenidone can attenuate the limited fibrotic potential of tacrolimus.
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Bowen JD, Maravilla K, Margolin SB. Open-label study of pirfenidone in patients with progressive forms of multiple sclerosis. Mult Scler 2003; 9:280-3. [PMID: 12814175 DOI: 10.1191/1352458503ms907oa] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pirfenidone is an oral medication with a number of actions affecting the immune system. It has been proposed as a possible treatment for multiple sclerosis (MS). METHODS An early-phase study of progressive forms of MS was conducted. Pirfenidone was slowly titrated to 2400 mg/day. Safety, clinical, quality-of-life, and magnetic resonance image (MRI) outcomes were measured. RESULTS Twenty people were enrolled (13 with secondary progressive and seven with primary progressive MS). The mean age was 47.7 years; the mean Expanded Disability Status Scale (EDSS) was 5.15; 75% were female. Eighteen patients achieved the full dose, although five additional patients eventually had to decrease the dose, primarily because of nausea. The Neurologic Rating Scale showed a slight worsening, from 69.8+/-8.4 at baseline to 71.8+/-8.9 at one year (P = 0.03). Other clinical outcomes remained stable, including the EDSS, ambulation index, and nine-hole peg test. The Short-Form Health Survey (SF-36) quality-of-life measure remained unchanged. Comparisons of MRI scans at baseline and one year found that 715 plaques were unchanged, six were better, and 10 were worse. Three patients had plaques that improved and two patients had plaques that were worse. There were eight gadolinium-enhancing lesions on the baseline scans and 14 on the one-year scans. CONCLUSIONS Pirfenidone was well tolerated in patients with MS. Patients with primary progressive or secondary progressive MS tolerated the medication and remained clinically stable during the one year of follow up. Placebo-controlled blinded studies are needed to determine clinical effectiveness.
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Affiliation(s)
- James D Bowen
- Department of Neurology, University of Washington, Seattle, Washington, USA.
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