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Molecular and Cellular Biology, July 2006, p. 5518-5527, Vol. 26, No. 14
0270-7306/06/$08.00+0 doi:10.1128/MCB.00625-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
Centre for Rheumatology, Department of Medicine, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, United Kingdom,1 Departamento de Estructura y Función de Proteínas, Centro de Investigaciones Biológicas, C.S.I.C., Ramiro de Maeztu 9, E-28040 Madrid, Spain,2 Centre for Cardiovascular Biology & Medicine, GKT School of Biomedical Sciences, King's College London, Guy's Campus, London SE1 1UL, United Kingdom,3 Department of Molecular Pathology, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, United Kingdom,4 Interstitial Lung Disease Unit, Royal Brompton Hospital, Imperial College of Science, Technology and Medicine, Emmanuel Kaye Building, 1B Manresa Road, London SW3 6LR, United Kingdom,5 CIHR Group in Skeletal Development and Remodeling, Division of Oral Biology, Schulich School of Medicine and Dentistry, Dental Sciences Bldg., University of Western Ontario, London, Ontario N6A 5C1, Canada6
Received 11 April 2006/ Returned for modification 27 April 2006/ Accepted 8 May 2006
| ABSTRACT |
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| INTRODUCTION |
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-smooth muscle actin (
-SMA), a protein which promotes ECM contraction and remodeling (6, 20, 55). In normal wound repair, myofibroblasts disappear and organ function is restored; however, should the tissue repair program not appropriately terminate, myofibroblasts persist in the lesion, resulting in the extensive, exaggerated amount of excessively contracted ECM characteristic of scar tissue (17). Indeed, a characteristic of scar tissue is the presence of
-SMA-enhanced contraction of the extracellular matrix by lesional fibroblasts (20, 55). In addition, in vitro and in vivo studies have consistently shown that fibroblasts isolated from patients with systemic sclerosis (SSc) directly contribute to the excessive scarring observed in fibrosis by enhancing production of ECM components (22, 27, 28, 49). Excessive scarring can result in organ failure and death (40).
A growing body of evidence implicates the vasoconstrictive peptide endothelin-1 (ET-1) as a mediator of organ-based fibrosis (1, 50-52, 54). There are three known endothelin isoforms (1, 2, and 3), which arise by proteolytic processing of large precursors (
200 amino acid residues). Intermediates, termed big endothelins, are excised from prepropeptides at sites containing paired basic amino acids and are subsequently cleaved at Trp-21-Val/Ile-22 to produce mature 21-residue, biologically active peptides (3, 44). The enzyme responsible for the specific cleavage at Trp-21 has been termed endothelin-converting enzyme (39, 56); its mRNA is stabilized in response to injury, resulting in the generation of bioactive endothelin (45).
Elevated levels of ET-1 are observed in patients with persistent, chronic fibrosis, suggesting that ET-1 may contribute not only to normal tissue repair but also to the pathogenesis of fibrosis (1, 29, 34). Elevated levels of circulating ET-1 in patients with skin and lung fibrosis correlate with the severity of the fibrotic phenotype (1, 29, 34). This increase in circulating ET-1 is paralleled by an increase in ET-1 synthesis in vivo (1, 29, 34). When added to fibroblasts, ET-1 promotes ECM production and contraction (50-52). ET-1 is overproduced by fibroblasts isolated from patients with fibrotic lung of scleroderma and contributes to the persistent myofibroblast phenotype of these cells (51). Lung fibroblasts from patients with pulmonary fibrosis associated with SSc (fibrosing alveolitis associated with systemic sclerosis [FASSc]) produce elevated levels of ET-1 (51). Endogenous ET-1 activity in lung FASSc fibroblasts directly contributed to the contractile phenotype of the FASSc fibroblasts, as blocking ET-1 signaling by the specific ET-1 dual receptor antagonist bosentan and the ETA antagonist PD156707 greatly reduced the ability of FASSc fibroblasts to contract a collagen gel matrix (51). In addition, FASSc fibroblasts produced elevated levels of
-SMA, ezrin, moesin, and paxillin, which depended on endogenous ET-1 signaling and phosphatidylinositol 3-kinase (51). Therefore, the enhanced contractile ability of the FASSc fibroblast depends on the elevated levels of endogenous ET-1 expression demonstrated by lung FASSc fibroblasts. Consequently, elucidating the molecular basis for the overproduction of ET-1 in fibroblasts isolated from patients with pulmonary fibrosis is necessary not only to understand the mechanism behind the persistence of the myofibroblast in this disorder but also to develop novel antifibrotic therapies.
In addition to ET-1, other secreted proteins have been demonstrated to play key roles in fibrogenesis. For example, the potent profibrotic transforming growth factor ß (TGF-ß) has long been known to induce fibroblasts to produce and contract ECM in vitro and in vivo, and anti-TGF-ß strategies are effective at alleviating fibrosis in animal models (31). Subcutaneous injection of TGF-ß alone results in transient fibrosis that depends on the continuous application of ligand, whereas sustained fibrotic response to TGF-ß requires an additional stimulus (35, 48). Consistent with this notion, it was recently demonstrated that TGF-ß and ET-1 cooperate to induce myofibroblast formation (46). Recently, it was shown that TGF-ß induces ET-1 production in vascular endothelial cells via Smads and Ap-1 (43). However, whether ET-1 is induced by TGF-ß in lung fibroblasts is unknown. Furthermore, to what extent TGF-ß contributes to the overexpression of ET-1 in pulmonary fibrosis is unclear. There is no therapy for fibrotic disease; consequently, an appreciation of the molecular basis of the origin and persistence of the myofibroblast phenotype will not only influence tissue engineering and regenerative medicine but also have a significant impact on the treatment of pathological fibrosis. Indeed, the signal transduction cascades involved with promoting the expression of profibrogenic proteins in fibrosis, including pulmonary fibrosis, is almost wholly unknown. Such knowledge is necessary for developing an understanding of the origin of fibrosis and in the design of antifibrotic therapies.
In this report we investigate the regulation of ET-1 expression, in the presence or absence of added TGF-ß, in normal and fibrotic pulmonary fibroblasts. Our studies provide new insights into the mechanism underlying ET-1 overproduction in pulmonary fibrosis and hence into the molecular basis for chronic fibrotic disease.
| MATERIALS AND METHODS |
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Smad knockout and wild-type fibroblasts (a generous gift from Anita B. Roberts, NIH, Bethesda, MD) were isolated from PCR-genotyped Smad3 wild-type and knockout newborn mice by standard methods and were cultured in Dulbecco's modified Eagle's medium (DMEM)-10% fetal bovine serum-1% Pen-Strep. TAK1 wild-type and knockout fibroblasts (a generous gift from Sankar Ghosh, Yale University) (47) were similarly cultured.
Measurement of ET-1 in control and SSc lung fibroblast culture supernatants. Endothelin-1 secretion was measured in supernatants collected from confluent monolayer cultures of normal and SSc lung fibroblasts in serum-free medium by using an enzyme-linked immunosorbent assay (ELISA) kit according to the manufacturer's (Biomedica, Vienna, Austria) instructions. This assay uses two antibodies directed against different epitopes of ET-1 and has a sensitivity of <1.0 pg/ml. These data were adjusted in accordance with cell counts at the time of sampling, and values are given as amounts of ET-1 per milliliter per 106 cells.
Western blot analysis.
Normal and SSc lung fibroblasts were grown to confluence in DMEM with 10% fetal calf serum and then serum starved in DMEM with 0.5% bovine serum albumin for 24 h. After serum starvation, cells were stimulated with 4 ng TGF-ß1 from 0 to 180 min with 0.5% bovine serum albumin. For blocking experiments, cells were incubated for 24 h in the presence or absence of the JNK inhibitor SP600125 (10 µM; Calbiochem), the ALK5 inhibitor SB 431542 (10 µM; Tocris), the JNK inhibitor SP600125 (10 µM; Calbiochem), the platelet-derived growth factor (PDGF) receptor inhibitor Gleevec (imatinib mesylate, 2 mM; Novartis, Basel, Switzerland), the angiotensin II inhibitor Losartan (100 nM; Merck, Whitehouse Station, NJ), or recombinant human interleukin 1 (IL-1) receptor antagonist (50 ng/ml; R&D Systems, Minneapolis, MN). In addition, the ETA receptor antagonist PD156707, sodium 2-benzo[1,3]dioxol-5-yl-4-(4-methoxy-phenyl)-4-oxo-3-(3,4,5-trimethoxy-benzyl)-but-2-enoate (10 µM); the ETB receptor antagonist BQ788, N-cis-2,6-dimethyl-piperidimocarbonyl-L-gMeLeuD-Nle-ONa (10 µM); and the mixed ETA/B receptor antagonist bosentan (10 µM) (all from M. Clozel, Actelion Pharmaceuticals, Allschwil, Switzerland) were used. TAK1 cells were similarly cultured and treated for 30 min with ET-1 (100 nM; R and D Systems) for phospho-JNK blots and for 24 h for
-SMA blots. For the experiment in which the ability of bosentan to reduce the TGF-ß induction of
-SMA was tested, cells isolated from three normal individuals were preincubated for 1 h prior to the incubation with TGF-ß1 for 24 h.
Cell layer lysates were examined. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis was performed on 12% polyacrylamide gels, and the separated proteins were transferred onto nitrocellulose membranes at 30 V for 90 min. Membranes were blocked by incubation for 1 h with 5% nonfat milk in phosphate-buffered saline containing 0.2% Tween 20, and antigens were detected using specific antibodies. Cell layer lysates (10 µg/sample) were probed using antibodies directed against JNK1, c-jun, and c-fos (all from Santa Cruz, CA) or antibody against
-SMA (Sigma, St Louis, MO) followed by incubation with appropriate horseradish peroxidase-conjugated bound secondary antibody (Jackson ImmunoResearch Laboratories, Hornby, Canada). Signal was detected using an enhanced chemiluminescence protocol (Amersham Biosciences, Piscataway, NJ) as described by the manufacturer.
Reverse transcription-PCR. Lung fibroblasts were serum starved for 18 h and treated with 4 ng TGF-ß for 4 h. Total RNA was isolated using Trizol (Invitrogen), and the integrity of the RNA was verified by gel electrophoresis. Total RNA (10 µg) was reverse transcribed in a 20-µl reaction volume containing an oligonucleotide (dT18) and random decamers (dN10) using Moloney murine leukemia virus reverse transcriptase (Promega) for 1 h at 37°C. The cDNA was diluted to 100 µl with diethylpyrocarbonate-treated water, and the target was measured by real-time PCR using FastStart DNA Master SYBR green (Roche Applied Science) according to the manufacturer's instructions. Triplicate samples were run, transcripts were measured in picograms, and expression values were standardized to values obtained with control 28S RNA primers. Primers (Sigma Genosys) used to amplify ET-1 were as follows: 5'-TTC TCT CTG CTG TTT GTG GC3-' (forward) and 5'-CCA AGT CCA TAC GGA ACA AC-3' (reverse).
Construction of reporter plasmids and cell transfection. Luciferase reporter constructs, a 650-bp fragment of the human ET-1 promoter (650-bp ppET-1-prom-luc), and constructs with specific mutations in the Smad or AP-1 binding sites were generated by PCR and cloned into pGL3-basic (43). A luciferase reporter gene driven by multiple copies of a Smad response element (courtesy of Peter ten Dijke) was also used. Transient transfection experiments were performed as described previously (43, 52). Promoter/reporter constructs were transfected into lung fibroblasts using FuGENE6 transfection reagent (Roche Applied Science) according to the manufacturer's instructions. Promoter/reporter plasmids were cotransfected with pCMV-ßGal (Clontech), which was used to adjust for differences in transfection efficiencies between samples. Following transfection, cells were incubated in DMEM with 0.5% fetal bovine serum for 18 h. Media were changed, and cells were incubated in the presence or absence of inhibitors for 45 min and cultured for an additional 24 h in the presence or absence of TGF-ß1 (4 ng). Fibroblasts were rinsed once with phosphate-buffered saline, and cellular protein was extracted using 200 µl of reporter lysis buffer (Promega Corp, Madison, WI). Reporter gene activity was measured by luminometry (Turner Designs, Sunnyvale, CA) using luciferase and ß-galactosidase assays (Tropix Inc. Bedford, MA) according to the manufacturers' instructions. Values given are means ± standard errors of triplicate assays from three individual experiments.
Fibroblasts were also cotransfected with empty expression vector; expression vectors encoding Smad 7 (P. ten Dijke, Ludwig Institute for Cancer Research, Biomedical Center, Uppsala, Sweden) (38); or TAM-67 (7) (M. J. Birrer, National Cancer Institute, Bethesda, Md.), a dominant negative c-jun expression vector which blocks the activity of all endogenous Jun and Fos proteins by forming nonfunctional heterodimers. Alternatively, reporter constructs were transfected with expression vector encoding JNK interacting protein 1 (jip-1), a protein inhibiting JNK/c-jun (A. J. Whitmarsh, University College, London, United Kingdom) (59). For blocking experiments, cells were treated overnight in the presence or absence of the ALK5 inhibitor SB 431542 (10 µM; Tocris).
Nuclear extract preparation and electrophoretic mobility shift assays. Electrophoretic mobility shift assays were performed with nuclear extracts or purified c-Jun and radiolabeled double-stranded oligonucleotides, and anti-c-jun or anti-HuR antibody (Santa Cruz), using standard procedures (43).
Statistical analysis. Data were analyzed by using the unpaired Student t test or nonparametric tests as appropriate. The probability values obtained are indicated in the text and/or in the figure legends when statistically significant.
| RESULTS |
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-SMA production is inhibited by antagonism of the endothelin A/B receptors.
To verify that the ability of TGF-ß to induce ET-1 was of functional relevance to fibroblasts, cells isolated from three normal individuals were pretreated with or without the ETA/ETB receptor antagonist bosentan prior to treatment with or without TGF-ß1 for 24 h. Cell extracts were then prepared and subjected to Western blot analysis with anti-
-SMA antibody. The ability of TGF-ß to induce
-SMA depended on ET-1 as bosentan blocked TGF-ß-induced
-SMA protein expression (Fig. 2D). Fibrotic lung fibroblasts display increased JNK/Ap-1 activation. ET-1 protein is overexpressed by fibrotic lung fibroblasts isolated from patients with scleroderma (FASSc) and is essential for the persistence of the myofibroblast phenotype in these cells (51). As we were interested in examining the mechanism underlying ET-1 overproduction in fibrotic lung fibroblasts, and since we had demonstrated the central contribution of Ap-1 to the induction of the ET-1 promoter in normal lung fibroblasts, we sought to ascertain whether the elevated expression of ET-1 in fibrotic lung fibroblasts could be due to an increased level of JNK activation in this cell type. To investigate this question, we cultured normal and FASSc fibroblasts to 80% confluence. We then cultured cells in the absence of serum for 18 h, prior to exposure of cells to TGF-ß1 (4 ng/ml) for various lengths of time. Cell layers were harvested and subjected to Western blot analysis with anti-JNK1 and anti-phospho-JNK1 antibodies. We found that, whereas TGF-ß was able of inducing JNK activation in normal and FASSc lung fibroblasts, fibrotic lung fibroblasts displayed constitutively elevated JNK activation as visualized by increased phosphorylation revealed by the anti-phospho-JNK1 antibody and an increase in c-jun phosphorylation revealed by an anti-phopsho-c-jun antibody (Fig. 3).
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-SMA protein expression in TAK1-deficient fibroblasts (Fig. 7).
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-SMA, a hallmark of the fibrotic phenotype, by fibrotic scleroderma lung fibroblasts at least partially depended on endogenous ET signaling through the ETA and ETB receptors (51). To extend these previous results and to confirm our hypothesis that JNK inhibition would reduce the overexpression of profibrotic markers in fibrotic lung fibroblasts, we investigated whether incubation of FASSc lung fibroblasts with the JNK inhibitor SP600125 would reduce the overexpression of
-SMA in this cell type. Fibroblasts isolated from three normal individuals and three individuals with FASSc were examined. In all cases examined, SP600125 did not affect
-SMA expression in normal fibroblasts but significantly reduced the elevated
-SMA production in the FASSc fibroblasts (Fig. 9). Similarly, SP600125 reduced ET-1 production by FASSc fibroblasts (Fig. 9). Collectively, our results suggest that a constitutively elevated JNK activation, mediated by an ET-1 autocrine loop, contributes to the activated fibrotic phenotype of fibroblasts isolated from patients with pulmonary fibrosis (Fig. 10).
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| DISCUSSION |
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-SMA expression through TAK1. Finally, we showed that activated JNK1 in fibrotic cells was dependent on an autocrine ET loop and that inhibition of JNK1 reduced the elevated production of type I collagen and
-smooth muscle actin in fibrotic lung fibroblasts. It is interesting to note that, in this context, we recently found that the overexpression of
-SMA in fibrotic fibroblasts was independent of signaling through the ALK5 receptor (11). In fibrotic disease, and consistent with the notions that ET-1 and TGF-ß cooperate to cause myofibroblast formation (46) and that factors working with TGF-ß are required to generate sustained fibrotic responses in vivo (35), the constitutive ALK5-independent JNK/Ap-1-dependent ET-1 expression observed in fibrotic pulmonary fibroblasts, caused by an autocrine ET loop, would be expected to cooperate with ALK5-dependent ET-1 produced in response to TGF-ß to generate the fibrotic phenotype. Thus, ALK5/TGF-ß-independent ET-1 production, which would not be expected to be under the controls normally regulating TGF-ß signaling in fibroblasts (31), is likely to be a key feature contributing to pathological fibrotic disease in lung (Fig. 10). Our results suggest that understanding the interactions among ET-1 and TGF-ß is likely to have a major impact in understanding wound healing and the progression to pathological fibrotic responses in vivo. Smads were not required for the TGF-ß induction of ET-1.
These results are consistent with observations that TGF-ß indirectly causes an increase in
-SMA mRNA and protein expression, which occurs in Smad3 knockout fibroblasts (30). In addition, Smad3 knockout mice are only partially resistant to the bleomycin model of fibrosis, indicating that there is a non-Smad component to the acquisition of the fibrotic phenotype (30). Our observation that TGF-ß-induced
-SMA requires ET-1 signaling through the ETA and ETB receptors is consistent with these observations.
Dysregulation of signal transduction in pulmonary fibrosis.
Collectively, our results are consistent with the notion that signaling pathways normally controlling gene expression of key profibrotic genes are dysregulated in fibrotic disease, resulting in the bypassing of controls that normally suppress profibrotic responses (31). In this regard, it is interesting to note that the JNK activation observed in fibrotic lung fibroblasts would be predicted to generally suppress Smad-dependent signaling as activation of JNK/c-jun represses non-Ap-1-dependent Smad-responsive promoters in favor of combined Smad/Ap-1-dependent transcriptional responses (32, 57, 58). For example, the net result of Smad/JNK activation would be to block matrix metalloproteinase 1 and enhance TIMP-1 expression (21, 33a)and hence indirectly affect matrix accumulationyet attenuate Smad-dependent activation of type I collagen and CCN2 (32, 57, 58). In this regard, although "leading edge" dermal scleroderma fibroblasts show increased Smad3 activity (36), dermal scleroderma fibroblasts are less responsive to exogenous TGF-ß, as visualized by the induction of the type I collagen promoter, than their normal counterparts (4). That ET-1 induces CCN2 and type I collagen may be especially important in the context of fibrosis (52). That such dysregulation of signaling exists might explain the divergent results that have been obtained when the effect of Smad signaling pathways have been examined in fibrotic cells (25, 36) and further emphasize the importance of a complex series of interactions involving MAP kinase cascades such as JNK (this report and reference 21) or ERK (8-10, 32, 52, 53) in regulating fibrogenic responses, either dependent or independent of TGF-ß. It is interesting to note, consistent with our observations that the ability of TGF-ß to induce
-SMA is ET-1 dependent and that ET-1 induced
-SMA production requires JNK1, that JNK inhibition blocks the ability of TGF-ß to induce
-SMA expression in lung fibroblasts (23). It is likely that fibrosis results from a dysregulation of signal transduction pathways that renders the fibrotic fibroblast incapable of responding to signals that normally downregulate the wound healing/fibrotic response (2).
In conclusion, we have provided evidence that both TGF-ß/ALK5-dependent and TGF-ß/ALK5-independent induction of ET-1 are likely to play key roles in the expression of ET-1 in pulmonary fibrosis and hence in fibrogenesis. Dysregulated constitutive activation of JNK, due to an autocrine ET loop, contributes to the enhanced basal production of ET-1 in fibrotic lung fibroblasts and hence to the constitutively activated persistent myofibroblast phenotype observed in pulmonary fibrosis.
| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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