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Fintha A, Gasparics Á, Rosivall L, Sebe A. Therapeutic Targeting of Fibrotic Epithelial-Mesenchymal Transition-An Outstanding Challenge. Front Pharmacol 2019; 10:388. [PMID: 31057405 PMCID: PMC6482168 DOI: 10.3389/fphar.2019.00388] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/29/2019] [Indexed: 12/11/2022] Open
Abstract
Back in 1995, a landmark paper was published, which shaped the fibrosis literature for many years to come. During the characterization of a fibroblast-specific marker (FSP1) in the kidneys, an observation was made, which gave rise to the hypothesis that “fibroblasts in some cases arise from the local conversion of epithelium.” In the following years, epithelial-mesenchymal transition was in the spotlight of fibrosis research, especially in the kidney. However, the hypothesis came under scrutiny following some discouraging findings from lineage tracing experiments and clinical observations. In this review, we provide a timely overview of the current position of the epithelial-mesenchymal transition hypothesis in the context of fibrosis (with a certain focus on renal fibrosis) and highlight some of the potential hurdles and pitfalls preventing therapeutic breakthroughs targeting fibrotic epithelial-mesenchymal transition.
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Affiliation(s)
- Attila Fintha
- 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Ákos Gasparics
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - László Rosivall
- Department of Pathophysiology, International Nephrology Research and Training Center, Semmelweis University, Budapest, Hungary
| | - Attila Sebe
- Department of Pathophysiology, International Nephrology Research and Training Center, Semmelweis University, Budapest, Hungary.,Division of Medical Biotechnology, Paul Ehrlich Institute, Langen, Germany
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Ebrahimpour A, Shrestha S, Bonnen MD, Eissa NT, Raghu G, Ghebre YT. Nicotine Modulates Growth Factors and MicroRNA to Promote Inflammatory and Fibrotic Processes. J Pharmacol Exp Ther 2019; 368:169-178. [PMID: 30446578 PMCID: PMC6323623 DOI: 10.1124/jpet.118.252650] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 11/01/2018] [Indexed: 02/06/2023] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a fatal disease that destroys the structure and function of the lungs. Risk factors include advanced age and genetic predisposition. However, tobacco use is the chief modifiable risk factor. The prevalence of tobacco use in IPF reaches up to 80%. Although tobacco smoke contains over 5000 chemicals, nicotine is a major component. Nicotine is a bioactive molecule that acts upon nicotinic acetylcholine receptors expressed on neuronal and non-neuronal cells including endothelial cells. Accordingly, it has a pleiotropic effect on cell proliferation and angiogenesis. The angiogenic effect is partly mediated by stimulation of growth factors including fibroblast, platelet-derived, and vascular endothelial growth factors. Nintedanib, a Food and Drug Administration-approved drug for IPF, works by inhibiting receptors for these growth factors, suggesting a pathobiologic role of the growth factors in IPF and a potential mechanism by which tobacco use may exacerbate the disease process; additionally, nicotine downregulates anti-inflammatory microRNAs (miRs) in lung cells. Here, we profiled the expression of miRs in lung tissues explanted from a lung injury model and examined the effect of nicotine on one of the identified miRs (miR-24) and its downstream targets. Our data show that miR-24 is downregulated during lung injury and is suppressed by nicotine. We also found that nicotine upregulates the expression of inflammatory cytokines targeted by miR-24. Finally, nicotine stimulated growth factors, fibroblast proliferation, collagen release, and expression of myofibroblast markers. Taken together, nicotine, alone or as a component of tobacco smoke, may accelerate the disease process in IPF through stimulation of growth factors and downregulation of anti-inflammatory miRs.
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Affiliation(s)
- Afshin Ebrahimpour
- Departments of Radiation Oncology (A.E., S.S., M.D.B., Y.T.G.) and Medicine, Section on Pulmonary and Critical Care Medicine (N.T.E., Y.T.G.), Baylor College of Medicine, Houston, Texas; and Division of Pulmonary and Critical Care Medicine, Center for Interstitial Lung Disease, University of Washington, Seattle, Washington (G.R.)
| | - Samana Shrestha
- Departments of Radiation Oncology (A.E., S.S., M.D.B., Y.T.G.) and Medicine, Section on Pulmonary and Critical Care Medicine (N.T.E., Y.T.G.), Baylor College of Medicine, Houston, Texas; and Division of Pulmonary and Critical Care Medicine, Center for Interstitial Lung Disease, University of Washington, Seattle, Washington (G.R.)
| | - Mark D Bonnen
- Departments of Radiation Oncology (A.E., S.S., M.D.B., Y.T.G.) and Medicine, Section on Pulmonary and Critical Care Medicine (N.T.E., Y.T.G.), Baylor College of Medicine, Houston, Texas; and Division of Pulmonary and Critical Care Medicine, Center for Interstitial Lung Disease, University of Washington, Seattle, Washington (G.R.)
| | - N Tony Eissa
- Departments of Radiation Oncology (A.E., S.S., M.D.B., Y.T.G.) and Medicine, Section on Pulmonary and Critical Care Medicine (N.T.E., Y.T.G.), Baylor College of Medicine, Houston, Texas; and Division of Pulmonary and Critical Care Medicine, Center for Interstitial Lung Disease, University of Washington, Seattle, Washington (G.R.)
| | - Ganesh Raghu
- Departments of Radiation Oncology (A.E., S.S., M.D.B., Y.T.G.) and Medicine, Section on Pulmonary and Critical Care Medicine (N.T.E., Y.T.G.), Baylor College of Medicine, Houston, Texas; and Division of Pulmonary and Critical Care Medicine, Center for Interstitial Lung Disease, University of Washington, Seattle, Washington (G.R.)
| | - Yohannes T Ghebre
- Departments of Radiation Oncology (A.E., S.S., M.D.B., Y.T.G.) and Medicine, Section on Pulmonary and Critical Care Medicine (N.T.E., Y.T.G.), Baylor College of Medicine, Houston, Texas; and Division of Pulmonary and Critical Care Medicine, Center for Interstitial Lung Disease, University of Washington, Seattle, Washington (G.R.)
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Bartis D, Crowley LE, D'Souza VK, Borthwick L, Fisher AJ, Croft AP, Pongrácz JE, Thompson R, Langman G, Buckley CD, Thickett DR. Role of CD248 as a potential severity marker in idiopathic pulmonary fibrosis. BMC Pulm Med 2016; 16:51. [PMID: 27080864 PMCID: PMC4832513 DOI: 10.1186/s12890-016-0211-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 03/23/2016] [Indexed: 01/07/2023] Open
Abstract
Background CD248 or Endosialin is a transmembrane molecule expressed in stromal cells binding to extracellular matrix (ECM) components. It has been previously implicated in kidney fibrosis, rheumatoid arthritis as well as in tumour-stromal interactions. This study investigates the role of CD248 in the pathogenesis of fibrotic diseases in Idiopathic Pulmonary Fibrosis (IPF). Methods CD248 quantitative immunohistochemistry (IHC) was performed on lung samples from 22 IPF patients and its expression was assayed in cultured pulmonary fibroblasts and epithelial cells. Effects of CD248 silencing was evaluated on fibroblast proliferation and myofibroblast differentiation. Results IHC revealed strong CD248 expression in mesenchymal cells of normal lung structures such as pleura and adventitia but not in epithelium. Fibrotic areas showed markedly stronger staining than unaffected lung tissue. The extent of CD248 staining showed a significant negative correlation to lung function parameters FEV1, FVC, TLC, and TLCO (r2 > 0 · 35, p < 0 · 01). CD248 protein levels were significantly greater in IPF-derived lung fibroblasts vs normal lung fibroblasts (p < 0 · 01) and CD248 silencing significantly reduced the proliferation of lung fibroblasts, but did not affected myofibroblast differentiation. Conclusion We conclude that CD248 overexpression is possibly involved in the pathogenesis of IPF and it has potential as a disease severity marker. Given that CD248 ligands are collagen type I, IV and fibronectin, we hypothesise that CD248 signalling represents a novel matrix-fibroblast interaction that may be a potential therapeutic target in IPF. Electronic supplementary material The online version of this article (doi:10.1186/s12890-016-0211-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Domokos Bartis
- Respiratory Research Group, Centre for Translational Inflammation and Fibrosis Research, University of Birmingham, Birmingham, United Kingdom. .,Department of Pharmacological Biotechnology, Szentágothai Research Centre, University of Pécs, 20 Ifjusag Utja, H-7624, Pécs, Hungary.
| | - Louise E Crowley
- Respiratory Research Group, Centre for Translational Inflammation and Fibrosis Research, University of Birmingham, Birmingham, United Kingdom
| | - Vijay K D'Souza
- Respiratory Research Group, Centre for Translational Inflammation and Fibrosis Research, University of Birmingham, Birmingham, United Kingdom
| | - Lee Borthwick
- Fibrosis research group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Andrew J Fisher
- Fibrosis research group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.,Institute of Transplantation, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Adam P Croft
- Rheumatology Research Group, Centre for Translational Inflammation and Fibrosis Research, University of Birmingham, Birmingham, United Kingdom
| | - Judit E Pongrácz
- Department of Pharmacological Biotechnology, Szentágothai Research Centre, University of Pécs, 20 Ifjusag Utja, H-7624, Pécs, Hungary
| | - Richard Thompson
- Department of Heart & Lung Transplantation, University Hospital Foundation NHS trust Birmingham, Birmingham, United Kingdom
| | - Gerald Langman
- Department of Pathology, Heart of England foundation NHS trust, Birmingham, United Kingdom
| | - Christopher D Buckley
- Rheumatology Research Group, Centre for Translational Inflammation and Fibrosis Research, University of Birmingham, Birmingham, United Kingdom
| | - David R Thickett
- Respiratory Research Group, Centre for Translational Inflammation and Fibrosis Research, University of Birmingham, Birmingham, United Kingdom
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Poletti V, Ravaglia C, Tomassetti S. Pirfenidone for the treatment of idiopathic pulmonary fibrosis. Expert Rev Respir Med 2014; 8:539-45. [DOI: 10.1586/17476348.2014.915750] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Oltmanns U, Kahn N, Palmowski K, Träger A, Wenz H, Heussel CP, Schnabel PA, Puderbach M, Wiebel M, Ehlers-Tenenbaum S, Warth A, Herth FJ, Kreuter M. Pirfenidone in Idiopathic Pulmonary Fibrosis: Real-Life Experience from a German Tertiary Referral Center for Interstitial Lung Diseases. Respiration 2014; 88:199-207. [DOI: 10.1159/000363064] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 04/16/2014] [Indexed: 11/19/2022] Open
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Gomer RH. New approaches to modulating idiopathic pulmonary fibrosis. Curr Allergy Asthma Rep 2014; 13:607-12. [PMID: 23959780 DOI: 10.1007/s11882-013-0377-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Until recently, idiopathic pulmonary fibrosis (IPF) has been a devastating and generally fatal disease with no effective therapeutic. New developments in understanding the biology of the disease include a growing consensus that the lesions are mainly composed of cells that originated from resident fibroblasts. New developments in therapeutics include recommendations against several treatment regimes that have been previously used. On a positive note, the orally available drug pirfenidone has been approved for use in IPF in China, Japan, India, and the European Union, but not yet in the United States. Other possibilities for managing IPF include managing gastrointestinal reflux, and limiting excessive salt intake. A variety of potential therapeutics for IPF are in clinical trials; for instance, in a Phase 1b trial, intravenous injections of a recombinant version of the normal human serum protein Serum Amyloid P (SAP, also known as PTX2) improved lung function in IPF patients.
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Bartis D, Mise N, Mahida RY, Eickelberg O, Thickett DR. Epithelial-mesenchymal transition in lung development and disease: does it exist and is it important? Thorax 2013; 69:760-5. [PMID: 24334519 DOI: 10.1136/thoraxjnl-2013-204608] [Citation(s) in RCA: 225] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Epithelial-mesenchymal transition (EMT) is a process when epithelial cells gradually transform into mesenchymal-like cells losing their epithelial functionality and characteristics. EMT is thought to be involved in the pathogenesis of numerous lung diseases ranging from developmental disorders, fibrotic tissue remodelling to lung cancer. The most important question--namely what is the importance and contribution of EMT in the pathogenesis of several chronic lung conditions (asthma, COPD, bronchiolitis obliterans syndrome and lung fibrosis)--is currently intensely debated. This review gives a brief insight into the mechanism and assessment methods of EMT in various pulmonary diseases and summarises the recent literature highlighting the controversial experimental data and conclusions.
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Affiliation(s)
- Domokos Bartis
- Department of Clinical Respiratory Sciences, Centre for Translational Inflammation and Fibrosis Research, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
| | - Nikica Mise
- Comprehensive Pneumology Center, University Hospital, Ludwig-Maximilians University and Helmholtz Zentrum, München, Germany
| | - Rahul Y Mahida
- Department of Clinical Respiratory Sciences, Centre for Translational Inflammation and Fibrosis Research, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
| | - Oliver Eickelberg
- Comprehensive Pneumology Center, University Hospital, Ludwig-Maximilians University and Helmholtz Zentrum, München, Germany
| | - David R Thickett
- Department of Clinical Respiratory Sciences, Centre for Translational Inflammation and Fibrosis Research, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
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McMahan ZH, Wigley FM. Novel investigational agents for the treatment of scleroderma. Expert Opin Investig Drugs 2013; 23:183-98. [PMID: 24261610 DOI: 10.1517/13543784.2014.848852] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The purpose of this article is to highlight novel therapies that are being used in scleroderma (SSc). Therapeutic interventions in SSc generally target at least one of three ongoing biological processes characteristic of the disease: vasculopathy, autoimmunity and tissue fibrosis. Treatment decisions in SSc are determined by the level of disease activity and the degree of specific organ involvement. Traditional therapy has primarily focused on organ-specific management without clear evidence of overall disease modification. AREAS COVERED The authors provide a review of a variety of agents, which are already used for other autoimmune diseases, that are now being used to treat active SSc skin or lung disease, including rituximab, tocilizumab and IVIG. Several agents studied in vitro and in animal models of fibrosis have shown promise, including bortezomib, LPA-1 antagonists, anti-CCN2 therapy, anti-IL-13 and thrombin antagonists. The authors also provide details on targeting intracellular molecular pathways and matricellular proteins, which is another novel area of investigation. EXPERT OPINION Combination therapy may be necessary to control the complex biological network active in SSc. Most of the current evidence that suggest benefit of these agents is based on small population studies. Ultimately well-designed clinical trials are required to define the role of these agents in treating SSc.
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Affiliation(s)
- Zsuzsanna Hortobagyi McMahan
- Johns Hopkins University, Medicine/Rheumatology , 55200 Eastern Avenue, MFL Center Tower, Suite 5300, Baltimore, MD 21224 , USA
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