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Wang M, Cao L. Hydrolysable tannins as a potential therapeutic drug for the human fibrosis-associated disease. Drug Dev Res 2023; 84:1096-1113. [PMID: 37386756 DOI: 10.1002/ddr.22089] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/22/2023] [Accepted: 06/06/2023] [Indexed: 07/01/2023]
Abstract
Fibrosis is a pathological change with abnormal tissue regeneration due to a response to persistent injury, which is extensively related to organ damage and failure, leading to high morbidity and mortality worldwide. Although the pathogenesis of fibrosis has been comprehensively elucidated, there are few effective therapies for treating fibrotic diseases. Natural products are increasingly regarded as an effective strategy for fibrosis with numerous favorable functions. Hydrolysable tannins (HT) are a type of natural products that have the potential to treat the fibrotic disease. In this review, we describe some biological activities and the therapeutic prospects of HT in organ fibrosis. Furthermore, the underlying mechanisms of inhibition of HT on fibrotic organs in relation to inflammation, oxidative stress, epithelial-mesenchymal transition, fibroblast activation and proliferation, and extracellular matrix accumulation are discussed. Understanding the mechanism of HT against fibrotic diseases will provide a new strategy for the prevention and attenuation of fibrosis progression.
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Affiliation(s)
- Meiwei Wang
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, China
| | - Linghui Cao
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, China
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2
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TRIB3 promotes pulmonary fibrosis through inhibiting SLUG degradation by physically interacting with MDM2. Acta Pharm Sin B 2023; 13:1631-1647. [PMID: 37139431 PMCID: PMC10150180 DOI: 10.1016/j.apsb.2023.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 01/12/2023] Open
Abstract
Pulmonary fibrosis (PF) is the pathological structure of incurable fibroproliferative lung diseases that are attributed to the repeated lung injury-caused failure of lung alveolar regeneration (LAR). Here, we report that repetitive lung damage results in a progressive accumulation of the transcriptional repressor SLUG in alveolar epithelial type II cells (AEC2s). The abnormal increased SLUG inhibits AEC2s from self-renewal and differentiation into alveolar epithelial type I cells (AEC1s). We found that the elevated SLUG represses the expression of the phosphate transporter SLC34A2 in AEC2s, which reduces intracellular phosphate and represses the phosphorylation of JNK and P38 MAPK, two critical kinases supporting LAR, leading to LAR failure. TRIB3, a stress sensor, interacts with the E3 ligase MDM2 to suppress SLUG degradation in AEC2s by impeding MDM2-catalyzed SLUG ubiquitination. Targeting SLUG degradation by disturbing the TRIB3/MDM2 interaction using a new synthetic staple peptide restores LAR capacity and exhibits potent therapeutic efficacy against experimental PF. Our study reveals a mechanism of the TRIB3-MDM2-SLUG-SLC34A2 axis causing the LAR failure in PF, which confers a potential strategy for treating patients with fibroproliferative lung diseases.
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Vincenzi E, Fantazzini A, Basso C, Barla A, Odone F, Leo L, Mecozzi L, Mambrini M, Ferrini E, Sverzellati N, Stellari FF. A fully automated deep learning pipeline for micro-CT-imaging-based densitometry of lung fibrosis murine models. Respir Res 2022; 23:308. [DOI: 10.1186/s12931-022-02236-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/15/2022] [Indexed: 11/13/2022] Open
Abstract
AbstractIdiopathic pulmonary fibrosis, the archetype of pulmonary fibrosis (PF), is a chronic lung disease of a poor prognosis, characterized by progressively worsening of lung function. Although histology is still the gold standard for PF assessment in preclinical practice, histological data typically involve less than 1% of total lung volume and are not amenable to longitudinal studies. A miniaturized version of computed tomography (µCT) has been introduced to radiologically examine lung in preclinical murine models of PF. The linear relationship between X-ray attenuation and tissue density allows lung densitometry on total lung volume. However, the huge density changes caused by PF usually require manual segmentation by trained operators, limiting µCT deployment in preclinical routine. Deep learning approaches have achieved state-of-the-art performance in medical image segmentation. In this work, we propose a fully automated deep learning approach to segment right and left lung on µCT imaging and subsequently derive lung densitometry. Our pipeline first employs a convolutional network (CNN) for pre-processing at low-resolution and then a 2.5D CNN for higher-resolution segmentation, combining computational advantage of 2D and ability to address 3D spatial coherence without compromising accuracy. Finally, lungs are divided into compartments based on air content assessed by density. We validated this pipeline on 72 mice with different grades of PF, achieving a Dice score of 0.967 on test set. Our tests demonstrate that this automated tool allows for rapid and comprehensive analysis of µCT scans of PF murine models, thus laying the ground for its wider exploitation in preclinical settings.
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Beck H, Thaler T, Meibom D, Meininghaus M, Jörißen H, Dietz L, Terjung C, Bairlein M, von Bühler CJ, Anlauf S, Fürstner C, Stellfeld T, Schneider D, Gericke KM, Buyck T, Lovis K, Münster U, Anlahr J, Kersten E, Levilain G, Marossek V, Kast R. Potent and Selective Human Prostaglandin F (FP) Receptor Antagonist (BAY-6672) for the Treatment of Idiopathic Pulmonary Fibrosis (IPF). J Med Chem 2020; 63:11639-11662. [PMID: 32969660 DOI: 10.1021/acs.jmedchem.0c00834] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Idiopathic pulmonary fibrosis (IPF) is a rare and devastating chronic lung disease of unknown etiology. Despite the approved treatment options nintedanib and pirfenidone, the medical need for a safe and well-tolerated antifibrotic treatment of IPF remains high. The human prostaglandin F receptor (hFP-R) is widely expressed in the lung tissue and constitutes an attractive target for the treatment of fibrotic lung diseases. Herein, we present our research toward novel quinoline-based hFP-R antagonists, including synthesis and detailed structure-activity relationship (SAR). Starting from a high-throughput screening (HTS) hit of our corporate compound library, multiple parameter improvements-including increase of the relative oral bioavailability Frel from 3 to ≥100%-led to a highly potent and selective hFP-R antagonist with complete oral absorption from suspension. BAY-6672 (46) represents-to the best of our knowledge-the first reported FP-R antagonist to demonstrate in vivo efficacy in a preclinical animal model of lung fibrosis, thus paving the way for a new treatment option in IPF.
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Affiliation(s)
- Hartmut Beck
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Tobias Thaler
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Daniel Meibom
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Mark Meininghaus
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Hannah Jörißen
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Lisa Dietz
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Carsten Terjung
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Michaela Bairlein
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | | | - Sonja Anlauf
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Chantal Fürstner
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Timo Stellfeld
- Research & Development, Pharmaceuticals, Bayer AG, 13353 Berlin, Germany
| | - Dirk Schneider
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Kersten M Gericke
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Thomas Buyck
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Kai Lovis
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Uwe Münster
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Johanna Anlahr
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Elisabeth Kersten
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Guillaume Levilain
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Virginia Marossek
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
| | - Raimund Kast
- Research & Development, Pharmaceuticals, Bayer AG, 42096 Wuppertal, Germany
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5
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Ruscitti F, Ravanetti F, Bertani V, Ragionieri L, Mecozzi L, Sverzellati N, Silva M, Ruffini L, Menozzi V, Civelli M, Villetti G, Stellari FF. Quantification of Lung Fibrosis in IPF-Like Mouse Model and Pharmacological Response to Treatment by Micro-Computed Tomography. Front Pharmacol 2020; 11:1117. [PMID: 32792953 PMCID: PMC7385278 DOI: 10.3389/fphar.2020.01117] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 07/09/2020] [Indexed: 12/19/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive degenerative lung disease leading to respiratory failure and death. Although anti-fibrotic drugs are now available for treating IPF, their clinical efficacy is limited and lung transplantation remains the only modality to prolong survival of IPF patients. Despite its limitations, the bleomycin (BLM) animal model remains the best characterized experimental tool for studying disease pathogenesis and assessing efficacy of novel potential drugs. In the present study, the effects of oropharyngeal (OA) and intratracheal (IT) administration of BLM were compared in C57BL/6 mice. The development of lung fibrosis was followed in vivo for 28 days after BLM administration by micro-computed tomography and ex vivo by histological analyses (bronchoalveolar lavage, histology in the left lung to stage fibrosis severity and hydroxyproline determination in the right lung). In a separate study, the antifibrotic effect of Nintedanib was investigated after oral administration (60 mg/kg for two weeks) in the OA BLM model. Lung fibrosis severity and duration after BLM OA and IT administration was comparable. However, a more homogeneous distribution of fibrotic lesions among lung lobes was apparent after OA administration. Quantification of fibrosis by micro-CT based on % of poorly aerated tissue revealed that this readout correlated significantly with the standard histological methods in the OA model. These findings were further confirmed in a second study in the OA model, evaluating Nintedanib anti-fibrotic effects. Indeed, compared to the BLM group, Nintedanib inhibited significantly the increase in % of poorly aerated areas (26%) and reduced ex vivo histological lesions and hydroxyproline levels by 49 and 41%, respectively. This study indicated that micro-computed tomography is a valuable in vivo technology for lung fibrosis quantification, which will be very helpful in the future to better evaluate new anti-fibrotic drug candidates.
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Affiliation(s)
| | | | - Valeria Bertani
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - Luisa Ragionieri
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - Laura Mecozzi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Mario Silva
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Livia Ruffini
- Department Nuclear Medicine, Academic Hospital of Parma, Parma, Italy
| | | | - Maurizio Civelli
- Corporate Pre-Clinical R&D, Chiesi Farmaceutici S.p.A., Parma, Italy
| | - Gino Villetti
- Corporate Pre-Clinical R&D, Chiesi Farmaceutici S.p.A., Parma, Italy
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VKORC1 and CYP2C9 Polymorphisms: A Case Report in a Dutch Family with Pulmonary Fibrosis. Int J Mol Sci 2019; 20:ijms20051160. [PMID: 30866412 PMCID: PMC6429271 DOI: 10.3390/ijms20051160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/21/2019] [Accepted: 03/03/2019] [Indexed: 12/16/2022] Open
Abstract
Here, we describe a Dutch family with idiopathic pulmonary fibrosis (IPF). We hypothesized that there might be an association between the presence of Vitamin K epoxide reductase complex 1 (VKORC1) and/or cytochrome P450 2C9 (CYP2C9) variant alleles and the early onset of IPF in the members of this family. VKORC1 (rs9923231 and rs9934438) and CYP2C9 (rs1799853 and rs1057910) were genotyped in this family, which includes a significant number of pulmonary fibrosis patients. In all family members, at least one of the variant alleles tested was present. The presence of the VKORC1 variant alleles in all of the IPF cases and CYP2C9 variants in all but one, which likely leads to a phenotype that is characterized by the early onset and progressive course of IPF. Our findings indicate a role of these allelic variants in (familial) IPF. Therefore, we suggest that the presence of these variants, in association with other pathogenic mutations, should be evaluated during genetic counselling. Our findings might have consequences for the lifestyle of patients with familial IPF in order to prevent the disease from becoming manifest.
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Huang X, Li L, Ammar R, Zhang Y, Wang Y, Ravi K, Thompson J, Jarai G. Molecular characterization of a precision-cut rat lung slice model for the evaluation of antifibrotic drugs. Am J Physiol Lung Cell Mol Physiol 2019; 316:L348-L357. [DOI: 10.1152/ajplung.00339.2018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The translation of novel pulmonary fibrosis therapies from preclinical models into the clinic represents a major challenge demonstrated by the high attrition rate of compounds that showed efficacy in preclinical models but demonstrated no significant beneficial effects in clinical trials. A precision-cut lung tissue slice (PCLS) contains all major cell types of the lung and preserves the original cell-cell and cell-matrix contacts. It represents a promising ex vivo model to study pulmonary fibrosis. In this study, using RNA sequencing, we demonstrated that transforming growth factor-β1 (TGFβ1) induced robust fibrotic responses in the rat PCLS model, as it changed the expression of genes functionally related to extracellular matrix remodeling, cell adhesion, epithelial-to-mesenchymal transition, and various immune responses. Nintedanib, pirfenidone, and sorafenib each reversed a subset of genes modulated by TGFβ1, and of those genes we identified 229 whose expression was reversed by all three drugs. These genes define a molecular signature characterizing many aspects of pulmonary fibrosis pathology and its attenuation in the rat PCLS fibrosis model. A panel of 12 genes and three secreted biomarkers, including procollagen I, hyaluronic acid, and WNT1-inducible signaling pathway protein 1 were validated as efficacy end points for the evaluation of antifibrotic activity of experimental compounds. Finally, we showed that blockade of αV-integrins suppressed TGFβ1-induced fibrotic responses in the rat PCLS fibrosis model. Overall, our results suggest that the TGFβ1-induced rat PCLS fibrosis model may represent a valuable system for target validation and to determine the efficacy of experimental compounds.
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Affiliation(s)
- Xinqiang Huang
- Department of Cardiovascular and Fibrotic Diseases Drug Discovery, Bristol-Myers Squibb, Pennington, New Jersey
| | - Li Li
- Department of Cardiovascular and Fibrotic Diseases Drug Discovery, Bristol-Myers Squibb, Pennington, New Jersey
| | - Ron Ammar
- Department of Cardiovascular and Fibrotic Diseases Drug Discovery, Bristol-Myers Squibb, Pennington, New Jersey
| | - Yan Zhang
- Department of Cardiovascular and Fibrotic Diseases Drug Discovery, Bristol-Myers Squibb, Pennington, New Jersey
| | - Yihe Wang
- Department of Cardiovascular and Fibrotic Diseases Drug Discovery, Bristol-Myers Squibb, Pennington, New Jersey
| | - Kandasamy Ravi
- Department of Cardiovascular and Fibrotic Diseases Drug Discovery, Bristol-Myers Squibb, Pennington, New Jersey
| | - John Thompson
- Department of Cardiovascular and Fibrotic Diseases Drug Discovery, Bristol-Myers Squibb, Pennington, New Jersey
| | - Gabor Jarai
- Department of Cardiovascular and Fibrotic Diseases Drug Discovery, Bristol-Myers Squibb, Pennington, New Jersey
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8
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Nawroth JC, Barrile R, Conegliano D, van Riet S, Hiemstra PS, Villenave R. Stem cell-based Lung-on-Chips: The best of both worlds? Adv Drug Deliv Rev 2019; 140:12-32. [PMID: 30009883 PMCID: PMC7172977 DOI: 10.1016/j.addr.2018.07.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/06/2018] [Accepted: 07/06/2018] [Indexed: 02/07/2023]
Abstract
Pathologies of the respiratory system such as lung infections, chronic inflammatory lung diseases, and lung cancer are among the leading causes of morbidity and mortality, killing one in six people worldwide. Development of more effective treatments is hindered by the lack of preclinical models of the human lung that can capture the disease complexity, highly heterogeneous disease phenotypes, and pharmacokinetics and pharmacodynamics observed in patients. The merger of two novel technologies, Organs-on-Chips and human stem cell engineering, has the potential to deliver such urgently needed models. Organs-on-Chips, which are microengineered bioinspired tissue systems, recapitulate the mechanochemical environment and physiological functions of human organs while concurrent advances in generating and differentiating human stem cells promise a renewable supply of patient-specific cells for personalized and precision medicine. Here, we discuss the challenges of modeling human lung pathophysiology in vitro, evaluate past and current models including Organs-on-Chips, review the current status of lung tissue modeling using human pluripotent stem cells, explore in depth how stem-cell based Lung-on-Chips may advance disease modeling and drug testing, and summarize practical consideration for the design of Lung-on-Chips for academic and industry applications.
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Affiliation(s)
| | | | | | - Sander van Riet
- Department of Pulmonology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
| | - Pieter S Hiemstra
- Department of Pulmonology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
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9
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Richeldi L, Fletcher S, Adamali H, Chaudhuri N, Wiebe S, Wind S, Hohl K, Baker A, Schlenker-Herceg R, Stowasser S, Maher TM. No relevant pharmacokinetic drug-drug interaction between nintedanib and pirfenidone. Eur Respir J 2019; 53:13993003.01060-2018. [PMID: 30442716 DOI: 10.1183/13993003.01060-2018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 10/28/2018] [Indexed: 01/08/2023]
Abstract
Nintedanib and pirfenidone are approved treatments for idiopathic pulmonary fibrosis (IPF). This open-label, two-group trial investigated the pharmacokinetic drug-drug interaction between these two drugs in patients with IPF.Subjects not treated with antifibrotics at screening (group 1, n=20) received a single nintedanib dose (150 mg) followed by pirfenidone (titrated to 801 mg thrice daily) for 3 weeks, with a further single nintedanib dose (150 mg) on the last day (day 23). Subjects treated with pirfenidone at screening (group 2, n=17) continued to receive pirfenidone alone (801 mg thrice daily) for 7 days, then co-administered with nintedanib (150 mg twice daily) for a further 7 days, before single doses of both treatments on day 16.In group 1, adjusted geometric mean (gMean) ratios (with/without pirfenidone) were 88.6% and 80.6% for nintedanib area under the plasma concentration-time curve (AUC) and maximum plasma concentration (Cmax), respectively. In group 2, gMean ratios (with/without nintedanib) were 97.2% and 99.5% for pirfenidone AUC and Cmax, respectively. For all parameters, the 90% confidence intervals included 100%, suggesting similar exposure for administration alone and when co-administered. Both treatments were well tolerated.These data indicate there is no relevant pharmacokinetic drug-drug interaction between nintedanib and pirfenidone when co-administered in IPF patients.
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Affiliation(s)
- Luca Richeldi
- Università Cattolica del Sacro Cuore, Fondazione Policlinico A. Gemelli, Rome, Italy.,Dept of Respiratory Medicine, University Hospital Southampton and Southampton NIHR Respiratory Biomedical Research Unit, University Hospital Southampton, Southampton, UK
| | - Sophie Fletcher
- Dept of Respiratory Medicine, University Hospital Southampton and Southampton NIHR Respiratory Biomedical Research Unit, University Hospital Southampton, Southampton, UK.,Translational Research Collaboration - Inflammatory Respiratory Disease Centre, Manchester, UK
| | - Huzaifa Adamali
- Bristol Interstitial Lung Disease Service, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - Nazia Chaudhuri
- Translational Research Collaboration - Inflammatory Respiratory Disease Centre, Manchester, UK.,North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Sven Wind
- Boehringer Ingelheim Pharma, Biberach, Germany
| | | | | | | | | | - Toby M Maher
- Translational Research Collaboration - Inflammatory Respiratory Disease Centre, Manchester, UK.,National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, and Fibrosis Research group, National Heart and Lung Institute, Imperial College, London, UK
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10
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Juillerat-Jeanneret L, Aubert JD, Mikulic J, Golshayan D. Fibrogenic Disorders in Human Diseases: From Inflammation to Organ Dysfunction. J Med Chem 2018; 61:9811-9840. [DOI: 10.1021/acs.jmedchem.8b00294] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Lucienne Juillerat-Jeanneret
- Transplantation Center and Transplantation Immunopathology Laboratory, Department of Medicine, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - John-David Aubert
- Pneumology Division and Transplantation Center, Centre Hospitalier Universitaire Vaudois (CHUV), CH1011 Lausanne, Switzerland
| | - Josip Mikulic
- Transplantation Center and Transplantation Immunopathology Laboratory, Department of Medicine, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Dela Golshayan
- Transplantation Center and Transplantation Immunopathology Laboratory, Department of Medicine, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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12
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Arora A, Bhuria V, Hazari PP, Pathak U, Mathur S, Roy BG, Sandhir R, Soni R, Dwarakanath BS, Bhatt AN. Amifostine Analog, DRDE-30, Attenuates Bleomycin-Induced Pulmonary Fibrosis in Mice. Front Pharmacol 2018; 9:394. [PMID: 29740320 PMCID: PMC5928292 DOI: 10.3389/fphar.2018.00394] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 04/05/2018] [Indexed: 12/15/2022] Open
Abstract
Bleomycin (BLM) is an effective curative option in the management of several malignancies including pleural effusions; but pulmonary toxicity, comprising of pneumonitis and fibrosis, poses challenge in its use as a front-line chemotherapeutic. Although Amifostine has been found to protect lungs from the toxic effects of radiation and BLM, its application is limited due to associated toxicity and unfavorable route of administration. Therefore, there is a need for selective, potent, and safe anti-fibrotic drugs. The current study was undertaken to assess the protective effects of DRDE-30, an analog of Amifostine, on BLM-induced lung injury in C57BL/6 mice. Whole body micro- computed tomography (CT) was used to non-invasively observe tissue damage, while broncheo-alveolar lavage fluid (BALF) and lung tissues were assessed for oxidative damage, inflammation and fibrosis. Changes in the lung density revealed by micro-CT suggested protection against BLM-induced lung injury by DRDE-30, which correlated well with changes in lung morphology and histopathology. DRDE-30 significantly blunted BLM-induced oxidative stress, inflammation and fibrosis in the lungs evidenced by reduced oxidative damage, endothelial barrier dysfunction, Myeloperoxidase (MPO) activity, pro-inflammatory cytokine release and protection of tissue architecture, that could be linked to enhanced anti-oxidant defense system and suppression of redox-sensitive pro-inflammatory signaling cascades. DRDE-30 decreased the BLM-induced augmentation in BALF TGF-β and lung hydroxyproline levels, as well as reduced the expression of the mesenchymal marker α-smooth muscle actin (α-SMA), suggesting the suppression of epithelial to mesenchymal transition (EMT) as one of its anti-fibrotic effects. The results demonstrate that the Amifostine analog, DRDE-30, ameliorates the oxidative injury and lung fibrosis induced by BLM and strengthen its potential use as an adjuvant in alleviating the side effects of BLM.
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Affiliation(s)
- Aastha Arora
- Institute of Nuclear Medicine & Allied Sciences, New Delhi, India.,Department of Biochemistry, Panjab University, Chandigarh, India
| | | | - Puja P Hazari
- Institute of Nuclear Medicine & Allied Sciences, New Delhi, India
| | - Uma Pathak
- Synthetic Chemistry Division, Defence Research and Development Establishment, Gwalior, India
| | - Sweta Mathur
- Synthetic Chemistry Division, Defence Research and Development Establishment, Gwalior, India
| | - Bal G Roy
- Institute of Nuclear Medicine & Allied Sciences, New Delhi, India
| | - Rajat Sandhir
- Department of Biochemistry, Panjab University, Chandigarh, India
| | - Ravi Soni
- Institute of Nuclear Medicine & Allied Sciences, New Delhi, India
| | | | - Anant N Bhatt
- Institute of Nuclear Medicine & Allied Sciences, New Delhi, India
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13
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Sgalla G, Iovene B, Calvello M, Ori M, Varone F, Richeldi L. Idiopathic pulmonary fibrosis: pathogenesis and management. Respir Res 2018; 19:32. [PMID: 29471816 PMCID: PMC5824456 DOI: 10.1186/s12931-018-0730-2] [Citation(s) in RCA: 309] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/28/2018] [Indexed: 12/21/2022] Open
Abstract
Background Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive disease characterized by the aberrant accumulation of fibrotic tissue in the lungs parenchyma, associated with significant morbidity and poor prognosis. This review will present the substantial advances achieved in the understanding of IPF pathogenesis and in the therapeutic options that can be offered to patients, and will address the issues regarding diagnosis and management that are still open. Main body Over the last two decades much has been clarified about the pathogenic pathways underlying the development and progression of the lung scarring in IPF. Sustained alveolar epithelial micro-injury and activation has been recognised as the trigger of several biological events of disordered repair occurring in genetically susceptible ageing individuals. Despite multidisciplinary team discussion has demonstrated to increase diagnostic accuracy, patients can still remain unclassified when the current diagnostic criteria are strictly applied, requiring the identification of a Usual Interstitial Pattern either on high-resolution computed tomography scan or lung biopsy. Outstanding achievements have been made in the management of these patients, as nintedanib and pirfenidone consistently proved to reduce the rate of progression of the fibrotic process. However, many uncertainties still lie in the correct use of these drugs, ranging from the initial choice of the drug, the appropriate timing for treatment and the benefit-risk ratio of a combined treatment regimen. Several novel compounds are being developed in the perspective of a more targeted therapeutic approach; in the meantime, the supportive care of these patients and their carers should be appropriately prioritized, and greater efforts should be made toward the prompt identification and management of relevant comorbidities. Conclusions Building on the advances in the understanding of IPF pathobiology, the further investigation of the role of gene variants, epigenetic alterations and other molecular biomarkers reflecting disease activity and behaviour will hopefully enable earlier and more confident diagnosis, improve disease phenotyping and support the development of novel agents for personalized treatment of IPF.
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Affiliation(s)
- Giacomo Sgalla
- Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Unità Operativa Complessa di Pneumologia, Largo A. Gemelli, 8 -00168, Rome, Italy.
| | - Bruno Iovene
- Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Unità Operativa Complessa di Pneumologia, Largo A. Gemelli, 8 -00168, Rome, Italy
| | - Mariarosaria Calvello
- Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Unità Operativa Complessa di Pneumologia, Largo A. Gemelli, 8 -00168, Rome, Italy
| | - Margherita Ori
- Dipartimento di Scienze Mediche e Chirurgiche, Azienda Ospedaliero-Universitaria di Modena, Università di Modena e Reggio Emilia, Struttura Complessa di Malattie dell'Apparato respiratorio , Via Del Pozzo, 71-41124, Modena, Italy
| | - Francesco Varone
- Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Unità Operativa Complessa di Pneumologia, Largo A. Gemelli, 8 -00168, Rome, Italy
| | - Luca Richeldi
- Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Unità Operativa Complessa di Pneumologia, Largo A. Gemelli, 8 -00168, Rome, Italy
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