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Mota PC, Soares ML, Vasconcelos CD, Ferreira AC, Lima BA, Manduchi E, Moore JH, Melo N, Novais-Bastos H, Pereira JM, Guimarães S, Moura CS, Marques JA, Morais A. Predictive value of common genetic variants in idiopathic pulmonary fibrosis survival. J Mol Med (Berl) 2022; 100:1341-1353. [DOI: 10.1007/s00109-022-02242-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/13/2022] [Accepted: 08/02/2022] [Indexed: 11/25/2022]
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2
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Menachery VD, Gralinski LE. Coagulation and wound repair during COVID-19. J Heart Lung Transplant 2021; 40:1076-1081. [PMID: 34334300 PMCID: PMC8195688 DOI: 10.1016/j.healun.2021.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/21/2021] [Accepted: 06/08/2021] [Indexed: 02/06/2023] Open
Abstract
While COVID-19 is best known as a respiratory infection, SARS-CoV-2 causes systemic disease manifestations including coagulopathies. Both dysregulated extracellular matrix remodeling pathways and circulating coagulation proteins are hallmarks of severe COVID-19 and often continue after the resolution of acute infection. Coagulation proteins have proven effective as biomarkers for severe disease and anticoagulants are a mainstay of COVID-19 therapeutics in hospitalized patients. While much knowledge has been gained about the role of clotting pathway activation in COVID-19, much remains to be elucidated in this complex network of signaling pathways.
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Affiliation(s)
- Vineet D Menachery
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas; World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston Texas; Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas.
| | - Lisa E Gralinski
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
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Jaffar J, Glaspole I, Symons K, Westall G. Inhibition of NF-κB by ACT001 reduces fibroblast activity in idiopathic pulmonary fibrosis. Biomed Pharmacother 2021; 138:111471. [PMID: 33730605 DOI: 10.1016/j.biopha.2021.111471] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/18/2021] [Accepted: 03/04/2021] [Indexed: 02/06/2023] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease of unknown etiology and poor prognosis. In IPF, aberrant extracellular matrix production by activated, hyperproliferative fibroblasts drives disease progression but the exact mechanisms by which this occurs remains undefined. The transcription factor nuclear factor kappa-B (NF-ĸB) has been suggested as a potential therapeutic target in IPF and therefore the aim of this study was to investigate the efficacy of ACT001, an NF-ĸB inhibitor, on primary fibroblasts derived from patients with and without IPF. Primary lung fibroblasts derived from eight patients with IPF and eight age-matched non-diseased controls (NDC) were treated with 0-10 µM ACT001 and the effects on fibroblast activity (viability and proliferation, fibroblast-to-myofibroblast transition, fibronectin expression), interleukin (IL)-6 and IL-8 cytokine release were quantified. ACT001 inhibited fibroblast activity in a concentration-dependent manner in both groups of fibroblasts. ACT001 inhibited IL-6 but not IL-8 production in unstimulated fibroblasts. ACT001 is a water-soluble compound with a stable half-life in plasma, thus making it an attractive candidate for further investigation as a therapeutic in IPF. This study adds to the growing body of literature that demonstrates anti-fibrotic activity of NF-ĸB inhibition in the context of IPF.
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Affiliation(s)
- Jade Jaffar
- Department of Respiratory Medicine, The Alfred Hospital, 99 Commercial Rd, Melbourne, VIC 3000, Australia; Department of Immunology and Pathology, Monash University, 89 Commercial Rd, Melbourne, VIC 3004, Australia; N.M.H.R.C. Centre of Research Excellence in Pulmonary Fibrosis, Australia.
| | - Ian Glaspole
- Department of Respiratory Medicine, The Alfred Hospital, 99 Commercial Rd, Melbourne, VIC 3000, Australia; Department of Immunology and Pathology, Monash University, 89 Commercial Rd, Melbourne, VIC 3004, Australia; N.M.H.R.C. Centre of Research Excellence in Pulmonary Fibrosis, Australia
| | - Karen Symons
- Department of Respiratory Medicine, The Alfred Hospital, 99 Commercial Rd, Melbourne, VIC 3000, Australia
| | - Glen Westall
- Department of Respiratory Medicine, The Alfred Hospital, 99 Commercial Rd, Melbourne, VIC 3000, Australia; Department of Immunology and Pathology, Monash University, 89 Commercial Rd, Melbourne, VIC 3004, Australia; N.M.H.R.C. Centre of Research Excellence in Pulmonary Fibrosis, Australia
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4
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The Fibrinolytic System in the Interstitial Space. Protein Sci 2016. [DOI: 10.1201/9781315374307-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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5
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Marudamuthu AS, Shetty SK, Bhandary YP, Karandashova S, Thompson M, Sathish V, Florova G, Hogan TB, Pabelick CM, Prakash YS, Tsukasaki Y, Fu J, Ikebe M, Idell S, Shetty S. Plasminogen activator inhibitor-1 suppresses profibrotic responses in fibroblasts from fibrotic lungs. J Biol Chem 2015; 290:9428-41. [PMID: 25648892 DOI: 10.1074/jbc.m114.601815] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Indexed: 02/04/2023] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease characterized by progressive interstitial scarification. A hallmark morphological lesion is the accumulation of myofibroblasts or fibrotic lung fibroblasts (FL-fibroblasts) in areas called fibroblastic foci. We previously demonstrated that the expression of both urokinase-type plasminogen activator (uPA) and the uPA receptor are elevated in FL-fibroblasts from the lungs of patients with IPF. FL-fibroblasts isolated from human IPF lungs and from mice with bleomycin-induced pulmonary fibrosis showed an increased rate of proliferation compared with normal lung fibroblasts (NL-fibroblasts) derived from histologically "normal" lung. Basal expression of plasminogen activator inhibitor-1 (PAI-1) in human and murine FL-fibroblasts was reduced, whereas collagen-I and α-smooth muscle actin were markedly elevated. Conversely, alveolar type II epithelial cells surrounding the fibrotic foci in situ, as well as those isolated from IPF lungs, showed increased activation of caspase-3 and PAI-1 with a parallel reduction in uPA expression. Transduction of an adenovirus PAI-1 cDNA construct (Ad-PAI-1) suppressed expression of uPA and collagen-I and attenuated proliferation in FL-fibroblasts. On the contrary, inhibition of basal PAI-1 in NL-fibroblasts increased collagen-I and α-smooth muscle actin. Fibroblasts isolated from PAI-1-deficient mice without lung injury also showed increased collagen-I and uPA. These changes were associated with increased Akt/phosphatase and tensin homolog proliferation/survival signals in FL-fibroblasts, which were reversed by transduction with Ad-PAI-1. This study defines a new role of PAI-1 in the control of fibroblast activation and expansion and its role in the pathogenesis of fibrosing lung disease and, in particular, IPF.
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Affiliation(s)
- Amarnath S Marudamuthu
- From the Texas Lung Injury Institute, University of Texas Health Science Center at Tyler, Tyler, Texas 75708
| | - Shwetha K Shetty
- From the Texas Lung Injury Institute, University of Texas Health Science Center at Tyler, Tyler, Texas 75708
| | - Yashodhar P Bhandary
- From the Texas Lung Injury Institute, University of Texas Health Science Center at Tyler, Tyler, Texas 75708
| | - Sophia Karandashova
- From the Texas Lung Injury Institute, University of Texas Health Science Center at Tyler, Tyler, Texas 75708
| | - Michael Thompson
- the Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905, and
| | | | - Galina Florova
- From the Texas Lung Injury Institute, University of Texas Health Science Center at Tyler, Tyler, Texas 75708
| | - Taryn B Hogan
- From the Texas Lung Injury Institute, University of Texas Health Science Center at Tyler, Tyler, Texas 75708
| | | | - Y S Prakash
- the Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905, and
| | - Yoshikazu Tsukasaki
- From the Texas Lung Injury Institute, University of Texas Health Science Center at Tyler, Tyler, Texas 75708
| | - Jian Fu
- the Center for Research on Environmental Disease and Toxicology, College of Medicine, University of Kentucky, Lexington, Kentucky 40536
| | - Mitsuo Ikebe
- From the Texas Lung Injury Institute, University of Texas Health Science Center at Tyler, Tyler, Texas 75708
| | - Steven Idell
- From the Texas Lung Injury Institute, University of Texas Health Science Center at Tyler, Tyler, Texas 75708
| | - Sreerama Shetty
- From the Texas Lung Injury Institute, University of Texas Health Science Center at Tyler, Tyler, Texas 75708,
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6
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MiR-10a and miR-181c regulate collagen type I generation in hypertrophic scars by targeting PAI-1 and uPA. FEBS Lett 2014; 589:380-9. [DOI: 10.1016/j.febslet.2014.12.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 12/17/2014] [Accepted: 12/17/2014] [Indexed: 11/19/2022]
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Role of the urokinase-fibrinolytic system in epithelial-mesenchymal transition during lung injury. THE AMERICAN JOURNAL OF PATHOLOGY 2014; 185:55-68. [PMID: 25447049 DOI: 10.1016/j.ajpath.2014.08.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 08/04/2014] [Accepted: 08/28/2014] [Indexed: 01/10/2023]
Abstract
Alveolar type II epithelial (ATII) cell injury precedes development of pulmonary fibrosis. Mice lacking urokinase-type plasminogen activator (uPA) are highly susceptible, whereas those deficient in plasminogen activator inhibitor (PAI-1) are resistant to lung injury and pulmonary fibrosis. Epithelial-mesenchymal transition (EMT) has been considered, at least in part, as a source of myofibroblast formation during fibrogenesis. However, the contribution of altered expression of major components of the uPA system on ATII cell EMT during lung injury is not well understood. To investigate whether changes in uPA and PAI-1 by ATII cells contribute to EMT, ATII cells from patients with idiopathic pulmonary fibrosis and chronic obstructive pulmonary disease, and mice with bleomycin-, transforming growth factor β-, or passive cigarette smoke-induced lung injury were analyzed for uPA, PAI-1, and EMT markers. We found reduced expression of E-cadherin and zona occludens-1, whereas collagen-I and α-smooth muscle actin were increased in ATII cells isolated from injured lungs. These changes were associated with a parallel increase in PAI-1 and reduced uPA expression. Further, inhibition of Src kinase activity using caveolin-1 scaffolding domain peptide suppressed bleomycin-, transforming growth factor β-, or passive cigarette smoke-induced EMT and restored uPA expression while suppressing PAI-1. These studies show that induction of PAI-1 and inhibition of uPA during fibrosing lung injury lead to EMT in ATII cells.
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Gharaee-Kermani M, Macoska JA. Promising molecular targets and biomarkers for male BPH and LUTS. Curr Urol Rep 2014; 14:628-37. [PMID: 23913202 DOI: 10.1007/s11934-013-0368-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Benign prostatic hyperplasia (BPH) is a major health concern for aging men. BPH is associated with urinary voiding dysfunction and lower urinary tract symptoms (LUTS), which negatively affects quality of life. Surgical resection and medical approaches have proven effective for improving urinary flow and relieving LUTS but are not effective for all men and can produce adverse effects that require termination of the therapeutic regimen. Thus, there is a need to explore other therapeutic targets to treat BPH/LUTS. Complicating the treatment of BPH/LUTS is the lack of biomarkers to effectively identify pathobiologies contributing to BPH/LUTS or to gauge successful response to therapy. This review will briefly discuss current knowledge and will highlight new studies that illuminate the pathobiologies contributing to BPH/LUTS, potential new therapeutic strategies for successfully treating BPH/LUTS, and new approaches for better defining these pathobiologies and response to therapeutics through the development of biomarkers and phenotyping strategies.
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Affiliation(s)
- Mehrnaz Gharaee-Kermani
- Center for Personalized Cancer Therapy and the Department of Biology, The University of Massachusetts, Boston, Boston, MA, 02125, USA
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9
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Vitronectin-binding PAI-1 protects against the development of cardiac fibrosis through interaction with fibroblasts. J Transl Med 2014; 94:633-44. [PMID: 24687120 PMCID: PMC4361016 DOI: 10.1038/labinvest.2014.51] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 02/27/2013] [Accepted: 03/06/2014] [Indexed: 01/18/2023] Open
Abstract
Plasminogen activator inhibitor-1 (PAI-1) promotes or abates fibrotic processes occurring in different organs. Binding of PAI-1 to vitronectin, an extracellular matrix component, may inhibit vitronectin-integrin complex-mediated cellular responses in pathophysiological conditions. To investigate the importance of plasmin suppression vs vitronectin-binding pathways of PAI-1 in cardiac fibrosis, we studied uninephrectomized mice fed a high salt diet and infused with angiotensin II (Ang II) together with different PAI-1 variants, including PAI-1AK (AK) that inhibits plasminogen activators but does not bind vitronectin, PAI-1RR (RR) that binds vitronectin but does not have protease inhibitory effects or control PAI-1 (CPAI), the control mutant that has similar molecular backbone and half-life as AK and RR while retaining all functions of native PAI-1. Compared with RR and CPAI, non-vitronectin-binding AK significantly increased expression of cardiac fibroblast marker, periostin (Ang+AK 8.40±3.55 vs Ang+RR 2.23±0.44 and Ang+CPAI 2.33±0.12% positive area, both P<0.05) and cardiac fibrosis (Ang+AK 1.79±0.26% vs Ang+RR 0.91±0.18% and Ang+CPAI 0.81±0.12% fibrotic area, both P<0.05), as well as Col1 mRNA (Ang+AK 12.81±1.84 vs Ang+RR 4.04±1.06 and Ang+CPAI 5.23±1.21 fold increase, both P<0.05). To elucidate mechanisms underlying the protective effects of vitronectin-binding PAI-1 against fibrosis, fibroblasts from normal adult human ventricles were stimulated with Ang and different PAI-1 variants. Protease inhibitory AK and CPAI increased supernatant fibronectin, while decreasing plasminogen activator/plasmin activities and matrix metalloproteinase. RR and CPAI variants significantly reduced fibroblast expression of integrin β3, vitronectin level in the supernatant and fibroblast adhesion to vitronectin compared with the non-vitronectin-binding AK. Further, RR and CPAI preserved apoptotic, decreased anti-apoptotic and proliferative activities in fibroblasts. Thus, PAI-1 promotes or protects against development of cardiac fibrosis differentially through the protease inhibitory pathway or through its binding to vitronectin.
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Glas GJ, Muller J, Binnekade JM, Cleffken B, Colpaert K, Dixon B, Juffermans NP, Knape P, Levi MM, Loef BG, Mackie DP, Malbrain M, Schultz MJ, van der Sluijs KF. HEPBURN - investigating the efficacy and safety of nebulized heparin versus placebo in burn patients with inhalation trauma: study protocol for a multi-center randomized controlled trial. Trials 2014; 15:91. [PMID: 24661817 PMCID: PMC3987885 DOI: 10.1186/1745-6215-15-91] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 03/07/2014] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Pulmonary coagulopathy is a hallmark of lung injury following inhalation trauma. Locally applied heparin attenuates lung injury in animal models of smoke inhalation. Whether local treatment with heparin benefits patients with inhalation trauma is uncertain. The present trial aims at comparing a strategy using frequent nebulizations of heparin with standard care in intubated and ventilated burn patients with bronchoscopically confirmed inhalation trauma. METHODS The Randomized Controlled Trial Investigating the Efficacy and Safety of Nebulized HEParin versus Placebo in BURN Patients with Inhalation Trauma (HEPBURN) is an international multi-center, double-blind, placebo-controlled, two-arm study. One hundred and sixteen intubated and ventilated burn patients with confirmed inhalation trauma are randomized to nebulizations of heparin (the nebulized heparin strategy) or nebulizations of normal saline (the control strategy) every four hours for 14 days or until extubation, whichever comes first. The primary endpoint is the number of ventilator-free days, defined as days alive and breathing without assistance during the first 28 days, if the period of unassisted breathing lasts for at least 24 consecutive hours. DISCUSSION As far as the authors know, HEPBURN is the first randomized, placebo-controlled trial, powered to investigate whether local treatment with heparin shortens duration of ventilation of intubated and ventilated burn patients with inhalation trauma. TRIAL REGISTRATION NCT01773083 (http://www.clinicaltrials.gov), registered on 16 January 2013.Recruiting. Randomisation commenced on 1 January 2014.
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Affiliation(s)
- Gerie J Glas
- Laboratory of Experimental Intensive Care and Anesthesiology (L · E · I C · A), Department of Intensive Care Medicine, Academic Medical Center, M0-210, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
- Department of Intensive Care Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Johannes Muller
- Department of Intensive Care, University Hospital Gasthuisberg, Leuven, Belgium
| | - Jan M Binnekade
- Department of Intensive Care Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Berry Cleffken
- Department of Intensive Care, Maasstad Hospital, Rotterdam, the Netherlands
| | - Kirsten Colpaert
- Department of Intensive Care, Ghent University Hospital, Ghent, Belgium
| | - Barry Dixon
- Department of Intensive Care, St Vincent’s Hospital, Melbourne, Australia
| | - Nicole P Juffermans
- Laboratory of Experimental Intensive Care and Anesthesiology (L · E · I C · A), Department of Intensive Care Medicine, Academic Medical Center, M0-210, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
- Department of Intensive Care Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Paul Knape
- Department of Intensive Care, Red Cross Hospital, Beverwijk, the Netherlands
| | - Marcel M Levi
- Department of Internal Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Bert G Loef
- Department of Intensive Care, Martini Hospital, Groningen, the Netherlands
| | - David P Mackie
- Department of Intensive Care, Red Cross Hospital, Beverwijk, the Netherlands
| | - Manu Malbrain
- Department of Intensive Care, Ziekenhuis Netwerk Antwerpen - Stuivenberg, Antwerp, Belgium
| | - Marcus J Schultz
- Laboratory of Experimental Intensive Care and Anesthesiology (L · E · I C · A), Department of Intensive Care Medicine, Academic Medical Center, M0-210, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
- Department of Intensive Care Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Koenraad F van der Sluijs
- Laboratory of Experimental Intensive Care and Anesthesiology (L · E · I C · A), Department of Intensive Care Medicine, Academic Medical Center, M0-210, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
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11
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Park HJ, Yang MJ, Oh JH, Yang YS, Kwon MS, Song CW, Yoon S. Genome-wide transcriptional response during the development of bleomycin-induced pulmonary fibrosis in sprague-dawley rats. Toxicol Res 2013; 26:137-47. [PMID: 24278517 PMCID: PMC3834473 DOI: 10.5487/tr.2010.26.2.137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 04/02/2010] [Accepted: 04/06/2010] [Indexed: 01/28/2023] Open
Abstract
Pulmonary fibrosis is a common consequence of many lung diseases and a leading cause of morbidity and mortality. The molecular mechanisms underlying the development of pulmonary fibrosis remain poorly understood. One model used successfully to study pulmonary fibrosis over the past few decades is the bleomycin-induced pulmonary fibrosis model. We aimed to identify the genes associated with fibrogenesis using an Affymetrix GeneChip system in a bleomycin-induced rat model for pulmonary fibrosis. To confirm fibrosis development, several analyses were performed, including cellular evaluations using bronchoalveolar lavage fluid, measurement of lactate dehydrogenase activity, and histopathological examinations. Common aspects of pulmonary fibrosis such as prolonged inflammation, immune cell infiltration, emergence of fibroblasts, and deposition of extracellular matrix and connective tissue elements were observed. Global gene expression analysis revealed significantly altered expression of genes (≥ 1.5-fold, p < 0.05.) in a time-dependent manner during the development of pulmonary fibrosis. Our results are consistent with previous results of well-documented gene expression. Interestingly, the expression of triggering receptor expressed on myeloid cells 2 (Trem2) , secreted phosphoprotein 1 (Spp1) , and several proteases such as Tpsab1, Mcpt1, and Cma1 was considerably induced in the lung after bleomycin treatment, despite little evidence that they are involved in pulmonary fibrogenesis. These data will aid in our understanding of fibrogenic mechanisms and contribute to the identification of candidate biomarkers of fibrotic disease development.
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Affiliation(s)
- Han-Jin Park
- Division of Research and Development, Korea Institute of Toxicology, Daejeon 305-343
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12
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Hart DA. Treatments for fibrosis development and progression: Lessons learned from preclinical models and potential impact on human conditions such as scleroderma, pulmonary fibrosis, hypertrophic scarring and tendinopathies. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/jbise.2013.68a2001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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13
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Gogali A, Wells AU. New pharmacological strategies for the treatment of pulmonary fibrosis. Ther Adv Respir Dis 2010; 4:353-66. [DOI: 10.1177/1753465810379454] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The treatment of pulmonary fibrosis continues to pose major difficulties. Idiopathic pulmonary fibrosis (IPF), the most prevalent chronic fibrosing lung disease, is a devastating condition that carries a prognosis worse than that of many cancers. Abnormalities in multiple pathways involved in wound healing and inflammation lead to the development of this condition. High doses of corticosteroids are now contraindicated in IPF, although they have a role in other fibrosing lung diseases. More effective treatments are urgently required and a number of novel candidate therapies have been put forward, based on animal and in vitro work. As in other complex disorders, it is likely that combinations of agents, rather than single treatments, will be needed. The principle of combination therapy was recently endorsed by the guidelines of the British Thoracic Society, which make a weak recommendation for a combination of prednisolone, azathioprine and N-acetylcysteine. However, enrolment of patients into trials of new therapies is considered to be ‘best current practice’ as this offers sufferers with IPF the chance to receive new agents that may be more effective than current treatments. In pulmonary fibrotic disorders other than IPF, anti-inflammatory therapy is broadly appropriate and benefits most patients, but a clear treatment strategy is essential. The art of management is to distinguish accurately between inherently stable fibrotic disease (with treatment not required), progressive predominantly fibrotic disease (with low-dose long-term treatment warranted to retard progression) and the presence of major associated inflammation (justifying initial high-dose treatment).
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Affiliation(s)
- Athena Gogali
- Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK
| | - Athol U. Wells
- Interstitial Lung Disease Unit, Royal Brompton Hospital, c/o Emmanuel Kaye Building, Manresa Road, Chelsea, London SW3 6LR, UK
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14
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Gramling MW, Church FC. Plasminogen activator inhibitor-1 is an aggregate response factor with pleiotropic effects on cell signaling in vascular disease and the tumor microenvironment. Thromb Res 2010; 125:377-81. [PMID: 20079523 DOI: 10.1016/j.thromres.2009.11.034] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 10/30/2009] [Accepted: 11/02/2009] [Indexed: 01/26/2023]
Abstract
In hemostasis, the serine protease inhibitor (serpin) plasminogen activator inhibitor-1 (PAI-1) functions to stabilize clots via inhibition of tissue plasminogen activator (tPA) with subsequent inhibition of fibrinolysis. In tissues, PAI-1 functions to inhibit extracellular matrix degradation via inhibition of urokinase plasminogen activator (uPA). Elevated levels of PAI-1 in the vasculature and in tissues have long been known to be associated with thrombosis and fibrosis, respectively. However, there is emerging evidence that PAI-1 may participate in the pathophysiology of a number of diseases such as atherosclerosis, restenosis, and cancer. In many of these disease states, the canonical view of PAI-1 as an inhibitor of tPA and uPA cannot fully account for a mechanism whereby PAI-1 contributes to the disease. In these cases, one must consider recent data, which indicates PAI-1 can directly promote pro-proliferative and anti-apoptotic signaling in a variety of cell types. Given the wide variety of inflammatory, hormonal, and metabolic signals that increase PAI-1 expression, it is important to consider mechanisms by which PAI-1 can directly participate in disease etiology.
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Affiliation(s)
- Mark W Gramling
- Department of Pathology and Laboratory Medicine, The University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC 27599-7035, USA
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15
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Pedroja BS, Kang LE, Imas AO, Carmeliet P, Bernstein AM. Plasminogen activator inhibitor-1 regulates integrin alphavbeta3 expression and autocrine transforming growth factor beta signaling. J Biol Chem 2009; 284:20708-17. [PMID: 19487690 PMCID: PMC2742836 DOI: 10.1074/jbc.m109.018804] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2009] [Indexed: 11/06/2022] Open
Abstract
Fibrosis is characterized by elevated transforming growth factor beta (TGFbeta) signaling, resulting in extracellular matrix accumulation and increased PAI-1 (plasminogen activator inhibitor) expression. PAI-1 induces the internalization of urokinase plasminogen activator/receptor and integrin alphavbeta3 from the cell surface. Since increased alphavbeta3 expression correlates with increased TGFbeta signaling, we hypothesized that aberrant PAI-1-mediated alphavbeta3 endocytosis could initiate an autocrine loop of TGFbeta activity. We found that in PAI-1 knock-out (KO) mouse embryonic fibroblasts), alphavbeta3 endocytosis was reduced by approximately 75%, leaving alphavbeta3 in enlarged focal adhesions, similar to wild type cells transfected with PAI-1 small interfering RNA. TGFbeta signaling was significantly enhanced in PAI-1 KO cells, as demonstrated by a 3-fold increase in SMAD2/3-containing nuclei and a 2.9-fold increase in TGFbeta activity that correlated with an increase in alphavbeta3 and TGFbeta receptor II expression. As expected, PAI-1 KO cells had unregulated plasmin activity, which was only partially responsible for TGFbeta activation, as evidenced by a mere 25% reduction in TGFbeta activity when plasmin was inhibited. Treatment of cells with an alphavbeta3-specific cyclic RGD peptide (GpenGRGD) led to a more profound (59%) TGFbeta inhibition; a nonspecific RGD peptide (GRGDNP) inhibited TGFbeta by only 23%. Human primary fibroblasts were used to confirm that PAI-1 inhibition and beta3 overexpression led to an increase in TGFbeta activity. Consistent with a fibrotic phenotype, PAI-1 KO cells were constitutively myofibroblasts that had a 1.6-fold increase in collagen deposition over wild type cells. These data suggest that PAI-1-mediated regulation of alphavbeta3 integrin is critical for the control of TGFbeta signaling and the prevention of fibrotic disease.
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Affiliation(s)
- Benjamin S. Pedroja
- From the Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York 10029 and
| | - Leah E. Kang
- From the Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York 10029 and
| | - Alex O. Imas
- From the Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York 10029 and
| | - Peter Carmeliet
- the Vesalius Research Center, Vlaams Instituut voor Biotechnologie and Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Audrey M. Bernstein
- From the Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York 10029 and
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Scriabine A, Rabin DU. New Developments in the Therapy of Pulmonary Fibrosis. ADVANCES IN PHARMACOLOGY 2009; 57:419-64. [DOI: 10.1016/s1054-3589(08)57011-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Yang MJ, Yang YS, Kim YB, Cho KH, Heo JD, Lee K, Song CW. Noninvasive Monitoring of Bleomycin-induced Lung Injury in Rats Using Pulmonary Function Test. Toxicol Res 2008; 24:273-280. [PMID: 32038805 PMCID: PMC7006277 DOI: 10.5487/tr.2008.24.4.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2008] [Accepted: 11/12/2008] [Indexed: 11/20/2022] Open
Abstract
The single intratracheal instillation (ITI) of bleomycin (BLM) is a widely used method for inducing experimental pulmonary fibrosis in rat model. In the present study, pulmonary function tests (PFTs) of tidal volume (VT), minute volume (VM), and respiratory frequency (FR) have been applied to study their possibility as a tool to monitor the progress of BLM-induced lung injury in rat model. Rats were treated with a single ITI of BLM (2.5 mg/kg) or saline (control). Animals were euthanized at 3, 7, 14, 21, and 28 days post-ITI. Lung toxicity effects were evaluated by inflammatory cell count, lactate dehydrogenase (LDH) activity in the bronchoalveolar lavage fluid (BALF), and light microscopic examination of lung injury. The PFT parameters were measured immediately before the animals were sacrificed. BLM treatment induced significant cellular changes in BALF-increase in number of total cells, neutrophils, and lymphocytes along with sustained increase in number of macrophages compared to the controls at days 3, 7, and 14. BALF LDH level was significantly increased compared to that in the controls up to day 14. On day 3, infiltration of neutrophils was observed in the alveolar spaces. These changes developed into marked peribronchiolar and interstitial infiltration by inflammatory cells, and extensive thickening of the interalveolar septa on day 7. At 14, 21, and 28 days, mild peribronchiolar fibrosis was observed along with inflammatory cell infiltration. The results of PFT show significant consistencies compared to the results of other toxicity tests. These data demonstrate that the most suitable time point for assessing lung fibrosis in this model is 14 days post-ITI of BLM based on the observation of fibrosis at 14, 21, and 28 days. Further, the progress of lung injury can be traced by monitoring the PFT parameters of FR, VT, and VM.
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Affiliation(s)
- Mi-Jin Yang
- Division of Inhalation Toxicology, KIT Jeongeup Campus, Jeongeup, Jeollabuk-do, 580-185 Korea
| | - Young-Su Yang
- Division of Inhalation Toxicology, KIT Jeongeup Campus, Jeongeup, Jeollabuk-do, 580-185 Korea
| | - Yong-Bum Kim
- Division of Inhalation Toxicology, KIT Jeongeup Campus, Jeongeup, Jeollabuk-do, 580-185 Korea
| | - Kyu-Hyuk Cho
- Division of Inhalation Toxicology, KIT Jeongeup Campus, Jeongeup, Jeollabuk-do, 580-185 Korea
| | - Jeong-Doo Heo
- Division of Inhalation Toxicology, KIT Jeongeup Campus, Jeongeup, Jeollabuk-do, 580-185 Korea
| | - Kyuhong Lee
- Division of Inhalation Toxicology, KIT Jeongeup Campus, Jeongeup, Jeollabuk-do, 580-185 Korea
| | - Chang-Woo Song
- Division of Inhalation Toxicology, KIT Jeongeup Campus, Jeongeup, Jeollabuk-do, 580-185 Korea
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