thromboplastin and Idiopathic-Pulmonary-Fibrosis

Idiopathic pulmonary fibrosis (IPF) is characterized by infiltration of inflammatory cells, excessive collagen production and accumulation of myofibroblasts. We explored the possible role of subepithelial lung myofibroblasts (SELMs) in the development of fibrosis in IPF. SELMs, isolated from surgical specimens of healthy lung tissue, were cultured with pro-inflammatory factors or bronchoalveolar lavage fluid (BALF) from patients with IPF or idiopathic non-specific interstitial pneumonia (iNSIP) and their fibrotic activity was assessed. Stimulation of SELMs with pro-inflammatory factors induced a significant increase of Tissue Factor (TF) and Tumor necrosis factor-Like cytokine 1 A (TL1A) expression and collagen production in culture supernatants. Stimulation with BALF from IPF patients with mild to moderate, but not severe disease, and from iNSIP patients induced a significant increase of TF expression. BALF from all IPF patients induced a significant increase of TL1A expression and collagen production, while BALF from iNSIP patients induced a significant increase of TL1A, but not of collagen production. Interestingly, TGF-β1 and BALF from all IPF, but not iNSIP patients, induced a significant increase in SELMs migration. In conclusion, BALF from IPF patients induces fibrotic activity in lung myofibroblasts, similar to mediators associated with lung fibrosis, indicating a key role of SELMs in IPF.

Topics: Bronchoalveolar Lavage Fluid; Collagen; Humans; Idiopathic Interstitial Pneumonias; Idiopathic Pulmonary Fibrosis; Myofibroblasts; Severity of Illness Index; Thromboplastin; Transforming Growth Factor beta1; Tumor Necrosis Factor Ligand Superfamily Member 15

The disturbance of hemostatic balance, associated with increased tissue factor (TF) expression and activity, occurs in the lungs of patients with idiopathic pulmonary fibrosis (IPF). However, the molecular mechanisms responsible for the regulation of TF expression under profibrotic conditions have not been assessed. We found that transforming growth factor-β1 (TGF-β1) markedly enhanced TF expression in primary human lung fibroblasts (HLFs), whereas platelet-derived growth factor (PDGF)-BB and IGF (insulin-like growth factor)-1 showed only a moderate effect, and PDGB-CC exerted no effect. TGF-β1-induced TF expression correlated with its elevated cell-surface activity, it required de novo gene transcription and protein synthesis, and it was dependent on JNK and Akt activity, because pharmacological inhibition or the knockdown of the previously mentioned kinases prevented TF synthesis. Exposure of HLFs to TGF-β1 activated JNK in a PI3K-dependent manner and induced Akt phosphorylation at threonine 308 and serine 473, but did not change the phosphorylation status of threonine 450. Akt phosphorylation at serine 473 correlated with JNK activity, and co-immunoprecipitation studies revealed a direct interaction between JNK and Akt. Furthermore, TGF-β1-induced TF expression required the recruitment of c-Fos and JunD into a heterodimeric activator protein (AP)-1 complex. Moreover, strong immunoreactivity for phosphorylated Akt and JNK as well as c-Fos and JunD was observed in fibroblasts and myofibroblasts in IPF lungs. In conclusion, PI3K/JNK/Akt and AP-1 synergize to induce TF expression in HLFs after TGF-β1 challenge. Our findings provide new insights into the molecular mechanisms responsible for the regulation of TF expression, and open new perspectives on the treatment of pulmonary fibrosis and other diseases characterized by the inappropriate expression of this cell-surface receptor.

Topics: Cells, Cultured; Fibroblasts; Gene Expression Regulation; Half-Life; Idiopathic Pulmonary Fibrosis; JNK Mitogen-Activated Protein Kinases; Lung; Phosphatidylinositol 3-Kinases; Phosphorylation; Primary Cell Culture; Protein Processing, Post-Translational; Protein Serine-Threonine Kinases; Proto-Oncogene Proteins c-akt; Proto-Oncogene Proteins c-fos; Proto-Oncogene Proteins c-jun; Receptor, Transforming Growth Factor-beta Type I; Receptors, Transforming Growth Factor beta; RNA Stability; Signal Transduction; Thromboplastin; Transcription Factor AP-1; Transcription, Genetic; Transforming Growth Factor beta1

Activation of the coagulation cascade has been demonstrated in pulmonary fibrosis. In addition to its procoagulant function, various coagulation proteases exhibit cellular effects that may also contribute to fibrotic processes in the lung.. To investigate the importance of protease-activated receptor (PAR)-2 and its activators, coagulation factor VIIa (FVIIa)/tissue factor (TF), in the development of idiopathic pulmonary fibrosis (IPF).. Expression and localization of PAR-2 and its activators were examined in IPF lung tissue. The ability of PAR-2 to mediate various cellular processes was studied in vitro.. Expression of PAR-2 was strongly elevated in IPF lungs and was attributable to alveolar type II cells and fibroblasts/myofibroblasts. Transforming growth factor-β(1), a key profibrotic cytokine, considerably enhanced PAR-2 expression in human lung fibroblasts. FVIIa stimulated proliferation of human lung fibroblasts and extracellular matrix production in a PAR-2-dependent manner, but did not initiate differentiation of fibroblasts into myofibroblasts. PAR-2/FVIIa-driven mitogenic activities were mediated via the p44/42 mitogen-activated protein kinase pathway and were independent of factor Xa and thrombin production. Proproliferative properties of FVIIa were markedly potentiated in the presence of TF and abrogated by TF antisense oligonucleotides. Hyperplastic alveolar type II cells overlying fibroblastic foci were found to be the source of FVII in IPF lungs. Moreover, TF colocalized with PAR-2 on fibroblasts/myofibroblasts in IPF lungs.. The PAR-2/TF/FVIIa axis may contribute to the development of pulmonary fibrosis; thus, interference with this pathway confers novel therapeutic potential for the treatment of IPF.

Topics: Cell Differentiation; Factor VIIa; Factor Xa; Female; Fibroblasts; Fibronectins; Humans; Idiopathic Pulmonary Fibrosis; In Vitro Techniques; Lung; Male; Middle Aged; Mitosis; Myofibroblasts; Osteopontin; Pulmonary Alveoli; Receptor, PAR-2; Thrombin; Thromboplastin; Transforming Growth Factor beta