The anti‐malaria drug artesunate and other chemical analogs of artemisinin have demonstrated cytostatic and cytotoxic effects in bacterial and cancer cells. Artemisinin‐derived compounds have also been demonstrated to attenuate fibrosis in preclinical animal models, but the mechanisms by which this inhibition occurs are not well‐understood. We investigated the effects of artesunate on the emergence of the myofibroblast, which is causally implicated in pro‐fibrotic pathologies. CRL‐2097 human dermal fibroblasts were analyzed for protein and transcript expression after treatment with artesunate to analyze fibroblast activation. Proliferation and apoptosis were also evaluated following treatment with artesunate in this cell line. Treatment of human dermal fibroblasts with artesunate antagonized fibroblast activation and pro‐fibrotic extracellular matrix (ECM) deposition, both at basal culture conditions and when cultured in the presence of exogenous transforming growth factor‐β1 (TGF‐β1), a major pro‐fibrotic cytokine. Artesunate‐treated fibroblasts also demonstrated decreased proliferation and increased apoptosis. Transcript analysis by quantitative real‐time polymerase chain reaction demonstrated that artesunate downregulated expression of pro‐fibrotic genes including canonical myofibroblast markers, ECM genes, and several TGF‐β receptors and ligands, and upregulated expression of cell cycle inhibitors and matrix‐metalloproteinases. Together, these data demonstrate that artesunate antagonizes fibroblast activation and decreases expression of pro‐fibrotic genes, while also promoting myofibroblast apoptosis, suggesting that these mechanisms may be responsible in part for the anti‐fibrotic effects of artesunate described previously.
- Award ID(s):
- 1436173
- NSF-PAR ID:
- 10081325
- Date Published:
- Journal Name:
- RSC Advances
- Volume:
- 6
- Issue:
- 88
- ISSN:
- 2046-2069
- Page Range / eLocation ID:
- 85457 to 85467
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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Objective Subglottic stenosis (SGS) may result from prolonged intubation where fibrotic scar tissue narrows the airway. The scar forms by differentiated myofibroblasts secreting excessive extracellular matrix (ECM). TGF‐β1 is widely accepted as a regulator of fibrosis; however, it is unclear how biomechanical pathways co‐regulate fibrosis. Therefore, we phenotyped fibroblasts from pediatric patients with SGS to explore how key signaling pathways, TGF‐β and Hippo, impact scarring and assess the impact of inhibiting these pathways with potential therapeutic small molecules SB525334 and DRD1 agonist dihydrexidine hydrochloride (DHX).
Methods Laryngeal fibroblasts isolated from subglottic as well as distal control biopsies of patients with evolving and maturing subglottic stenosis were assessed by α‐smooth muscle actin immunostaining and gene expression for α‐SMA, FN, HGF, and CTGF markers. TGF‐β and Hippo signaling pathways were modulated during TGF‐β1‐induced fibrosis using the inhibitor SB525334 or DHX and analyzed by RT‐qPCR for differential gene expression and atomic force microscopy for ECM stiffness.
Results SGS fibroblasts exhibited higher α‐SMA staining and greater inflammatory cytokine and fibrotic marker expression upon TGF‐β1 stimulation (
p < 0.05). SB525334 restored levels to baseline by reducing SMAD2/3 nuclear translocation (p < 0.0001) and pro‐fibrotic gene expression (p < 0.05). ECM stiffness of stenotic fibroblasts was greater than healthy fibroblasts and was restored to baseline by Hippo pathway modulation using SB525334 and DHX (p < 0.01).Conclusion We demonstrate that distinct fibroblast phenotypes from diseased and healthy regions of pediatric SGS patients respond differently to TGF‐β1 stimulation, and SB525334 has the superior potential for subglottic stenosis treatment by simultaneously modulating TGF‐β and Hippo signaling pathways.
Level of Evidence NA
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.1039/C6RA16607E
