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Huang R, Lin B, Lei Z, Xu L, Zhang H, Wang W, Zhang Y, Xiao S, Long Y, Li J, Li X. On-Site Construction of a Full-Thickness Skin Equivalent with Endothelial Tube Networks via Multilayer Electrospinning for Wound Coverage. ACS Biomater Sci Eng 2023; 9:6241-6255. [PMID: 37823558 DOI: 10.1021/acsbiomaterials.3c00913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Novel full-thickness skin substitutes are of increasing interest due to the inherent limitations of current models lacking capillary networks. Herein, we developed a novel full-thickness skin tissue containing blood capillary networks through a layer-by-layer assembly approach using a handy electrospinning apparatus and evaluated its skin wound coverage potential in vivo. The average diameter and thickness of fabricated poly-ε-caprolactone-cellulose acetate scaffolds were easily tuned in the range of 474 ± 77-758 ± 113 nm and 9.43 ± 2.23-29.96 ± 5.78 μm by varying electrospinning distance and duration, as indicated by FE-SEM. Besides, keratinocytes exhibited homogeneous differentiation throughout the fibrous matrix prepared with electrospinning distance and duration of 9 cm and 1.5 min within five-layer (5L) epidermal tissues with thickness of 135-150 μm. Moreover, coculture of vascular endothelial cells, circulating fibrocytes, and fibroblasts within the 5L dermis displayed network formation in vitro, resulting in reduced inflammatory factor levels and enhanced integration with the host vasculature in vivo. Additionally, the skin equivalent grafts consisting of the epidermal layer, biomimetic basement membrane, and vascularized dermis layer with an elastic modulus of approximately 11.82 MPa exhibited accelerated wound closure effect indicative of re-epithelialization and neovascularization with long-term cell survival into the host, which was confirmed by wound-healing rate, bioluminescence imaging activity, and histological analysis. It is the first report of a full-thickness skin equivalent constructed using a battery-operated electrospinning apparatus, highlighting its tremendous potential in regenerative medicine.
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Affiliation(s)
- Rong Huang
- Department of Burn and Plastic Surgery, Second Affiliated Hospital, Air Force Medical University, Xi'an 710038, China
| | - Bin Lin
- Department of Burn and Plastic Surgery, Second Affiliated Hospital, Air Force Medical University, Xi'an 710038, China
| | - Zhanjun Lei
- Department of Burn and Plastic Surgery, Second Affiliated Hospital, Air Force Medical University, Xi'an 710038, China
| | - Lirong Xu
- Department of Burn and Plastic Surgery, Second Affiliated Hospital, Air Force Medical University, Xi'an 710038, China
| | - Hao Zhang
- Department of Burn and Plastic Surgery, Second Affiliated Hospital, Air Force Medical University, Xi'an 710038, China
| | - Wenxuan Wang
- Department of Burn and Plastic Surgery, Second Affiliated Hospital, Air Force Medical University, Xi'an 710038, China
| | - Yuheng Zhang
- Department of Burn and Plastic Surgery, Second Affiliated Hospital, Air Force Medical University, Xi'an 710038, China
| | - Shuao Xiao
- Department of Burn and Plastic Surgery, Second Affiliated Hospital, Air Force Medical University, Xi'an 710038, China
| | - Yunze Long
- College of Physics, Qingdao University, Qingdao 266071, China
| | - Jing Li
- Department of Burn and Plastic Surgery, Second Affiliated Hospital, Air Force Medical University, Xi'an 710038, China
| | - Xueyong Li
- Department of Burn and Plastic Surgery, Second Affiliated Hospital, Air Force Medical University, Xi'an 710038, China
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Miądlikowska E, Rzepka-Wrona P, Miłkowska-Dymanowska J, Białas AJ, Piotrowski WJ. Review: Serum Biomarkers of Lung Fibrosis in Interstitial Pneumonia with Autoimmune Features-What Do We Already Know? J Clin Med 2021; 11:79. [PMID: 35011819 DOI: 10.3390/jcm11010079] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/13/2021] [Accepted: 12/21/2021] [Indexed: 02/06/2023] Open
Abstract
Interstitial pneumonia with autoimmune features (IPAF) belongs to a group of diseases called interstitial lung diseases (ILDs), which are disorders of a varied prognosis and course. Finding sufficiently specific and sensitive biomarkers would enable the progression to be predicted, the natural history to be monitored and patients to be stratified according to their treatment. To assess the significance of pulmonary fibrosis biomarkers studied thus far, we searched the PubMed, Medline and Cochrane Library databases for papers published between January 2015 and June 2021. We focused on circulating biomarkers. A primary review of the databases identified 38 articles of potential interest. Overall, seven articles fulfilled the inclusion criteria. This review aims to assess the diagnostic and prognostic value of molecules such as KL-6, SP-A, SP-D, circulating fibrocytes, CCL2, CXCL13, CXCL9, CXCL10 and CXCL11. All of these biomarkers have previously been studied in idiopathic pulmonary fibrosis (IPF) and connective tissue disease-associated interstitial lung disease (CTD-ILD). IPAF is a disorder of a heterogeneous nature. It explains the lack of coherent observations in terms of correlations with functional parameters. There is still no meta-analysis of pulmonary fibrosis biomarkers in IPAF. This is mainly due to the heterogeneity of the methodology and groups analysed in the research. More research in this area is needed.
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Li X, Liu X, Zhang H, Zhang R, Li G. Elevated circulating fibrocyte levels in hemodialysis-dependent end-stage renal disease patients. Hemodial Int 2021; 25:489-497. [PMID: 34132025 DOI: 10.1111/hdi.12945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/17/2021] [Accepted: 05/23/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Numerous studies have demonstrated that end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) have high myocardial fibrosis (MF) levels. Circulating fibrocytes are bone marrow-derived circulating mesenchymal progenitors, and new evidence suggests a vital role for fibrocytes in the development of MF. This study aimed to investigate whether fibrocyte levels are elevated in patients undergoing HD and its influence factors. METHODS We carried out a flow cytometry analysis to measure the proportion of peripheral blood circulating fibrocytes in a cohort of 126 healthy control individuals and 161 subjects with HD. Cardiac function and morphology were assessed by electrocardiogram and transthoracic echocardiogram. FINDINGS Compared to healthy controls, individuals with ESRD had significantly higher levels of circulating fibrocytes. There was a strong correlation between the frequency of fragmented QRS (fQRS) and circulating fibrocytes in HD patients. Furthermore, higher fibrocytes correlated to increasing age, dialysis age, left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), and hypertension complication. On multivariate analysis, the dialysis age [odds ratio (OR) 1.011, 95% confidence interval (CI) 1.003-1.019, p = 0.006], LVMI (OR 1.012, 95% CI 1.002-1.022, p = 0.016), hypertension (OR 4.303, 95% CI 1.129-16.406, p = 0.033), and fQRS (OR 2.439, 95% CI 1.049-5.262, p = 0.038) were significant independent predictors of fibrocytes percentage. DISCUSSION We concluded that bone marrow-derived circulating fibrocytes were significantly increased in ESRD patients with HD compared with controls. Our data suggested that these cells might play essential roles during MF in HD patients.
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Affiliation(s)
- Xinjian Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xing Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Haipeng Zhang
- Department of Clinical Laboratory, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Ruining Zhang
- Department of Kidney Disease and Blood Purification, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Guangping Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China
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Kiernan MG, Coffey JC, Sahebally SM, Tibbitts P, Lyons EM, O’leary E, Owolabi F, Dunne CP. Systemic Molecular Mediators of Inflammation Differentiate Between Crohn's Disease and Ulcerative Colitis, Implicating Threshold Levels of IL-10 and Relative Ratios of Pro-inflammatory Cytokines in Therapy. J Crohns Colitis 2020; 14:118-129. [PMID: 31241755 PMCID: PMC6930002 DOI: 10.1093/ecco-jcc/jjz117] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Faecal diversion is associated with improvements in Crohn's disease but not ulcerative colitis, indicating that differing mechanisms mediate the diseases. This study aimed to investigate levels of systemic mediators of inflammation, including fibrocytes and cytokines, [1] in patients with Crohn's disease and ulcerative colitis preoperatively compared with healthy controls and [2] in patients with Crohn's disease and ulcerative colitis prior to and following faecal diversion. METHODS Blood samples were obtained from healthy individuals and patients with Crohn's disease or ulcerative colitis. Levels of circulating fibrocytes were quantified using flow cytometric analysis and their potential relationship to risk factors of inflammatory bowel disease were determined. Levels of circulating cytokines involved in inflammation and fibrocyte recruitment and differentiation were investigated. RESULTS Circulating fibrocytes were elevated in Crohn's disease and ulcerative colitis patients when compared with healthy controls. Smoking, or a history of smoking, was associated with increases in circulating fibrocytes in Crohn's disease, but not ulcerative colitis. Cytokines involved in fibrocyte recruitment were increased in Crohn's disease patients, whereas patients with ulcerative colitis displayed increased levels of pro-inflammatory cytokines. Faecal diversion in Crohn's disease patients resulted in decreased circulating fibrocytes, pro-inflammatory cytokines, and TGF-β1, and increased IL-10, whereas the inverse was observed in ulcerative colitis patients. CONCLUSIONS The clinical effect of faecal diversion in Crohn's disease and ulcerative colitis may be explained by differing circulating fibrocyte and cytokine responses. Such differences aid in understanding the disease mechanisms and suggest a new therapeutic strategy for inflammatory bowel disease.
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Affiliation(s)
- Miranda G Kiernan
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity [4i], University of Limerick, Limerick, Ireland
| | - J Calvin Coffey
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity [4i], University of Limerick, Limerick, Ireland,Department of Surgery, University Hospital Limerick, Limerick, Ireland
| | - Shaheel M Sahebally
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity [4i], University of Limerick, Limerick, Ireland,Department of Surgery, University Hospital Limerick, Limerick, Ireland
| | - Paul Tibbitts
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity [4i], University of Limerick, Limerick, Ireland,Department of Surgery, University Hospital Limerick, Limerick, Ireland
| | - Emma M Lyons
- Department of Surgery, University Hospital Limerick, Limerick, Ireland
| | - Eimear O’leary
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity [4i], University of Limerick, Limerick, Ireland
| | - Funke Owolabi
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity [4i], University of Limerick, Limerick, Ireland
| | - Colum P Dunne
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity [4i], University of Limerick, Limerick, Ireland,Corresponding author: Professor Colum Dunne, Graduate Entry Medical School, University of Limerick, Limerick, Ireland. Tel.: 353-[0]61-234703;
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Shields MC, Mehrad B, Keeley EC. Association between circulating fibrocytes and angiographic coronary collaterals in patients with obstructive coronary artery disease. Am J Transl Res 2018; 10:2722-2725. [PMID: 30210709 PMCID: PMC6129513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/06/2018] [Indexed: 06/08/2023]
Abstract
Circulating fibrocytes are a population of bone marrow-derived progenitor cells that have been implicated in neovascularization. The recruitment of coronary artery collaterals, a form of neovascularization, is associated with improved outcomes in coronary artery disease. In this study, we tested the hypothesis that, in subjects with stable chronic coronary artery disease, the blood concentration of fibrocytes is associated with the presence of angiographic coronary collaterals. A total of 58 subjects with at least one epicardial coronary artery with ≥ 90% luminal stenosis were enrolled, among whom 26 (45%) had angiographic evidence of coronary collaterals. Subjects with collaterals had significantly elevated circulating concentrations of all examined subsets of activated fibrocytes, suggesting that there is a relationship between fibrocytes and coronary collateral recruitment.
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Affiliation(s)
- Mary C Shields
- Department of Medicine, Division of Cardiology, University of VirginiaCharlottesville, Virginia
| | - Borna Mehrad
- The Department of Medicine, University of FloridaGainesville, Florida
- Division of Pulmonary, Critical Care, Sleep MedicineGainesville, Florida
| | - Ellen C Keeley
- The Department of Medicine, University of FloridaGainesville, Florida
- Division of Cardiovascular Medicine, University of FloridaGainesville, Florida
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Tai W, Zhou Z, Zheng B, Li J, Ding J, Wu H, Gao L, Dong Z. Inhibitory effect of circulating fibrocytes on injury repair in acute lung injury/acute respiratory distress syndrome mice model. J Cell Biochem 2018; 119:7982-7990. [PMID: 29323734 DOI: 10.1002/jcb.26664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 01/09/2018] [Indexed: 11/06/2022]
Abstract
The study was aimed to explore the functions of circulating fibrocytes (CFs) on injury repair in acute lung injury/acute respiratory distress syndrome (ALI/ARDS) mice model and its clinical value as a biomarker for ALI/ARDS. ALI/ARDS mice model was established by intratracheal instillation of lipopolysaccharide (LPS). Mononuclear cells were isolated from peripheral blood of ALI/ARDS model and flow cytometry was used to measure CFs defined as cells positive for CD45 and collagen-1. Histological changes of lung tissues were evaluated by H&E staining and Masson's trichrome staining. The correlations of CFs counts with damnification of lung tissue and the severity of pulmonary fibrosis were evaluated by Pearson correlation analyses. Western blot was used to detect the protein expression of collagen-1. ELISA was applied to determine cytokine CXCL12 concentration. Clinical relevance between CFs and ALI/ARDS was investigated. The greater number of CFs in the ALI/ARDS group implied higher degree of lung injury and more severe pulmonary fibrosis. The protein expression of collagen-1 and concentration of cytokine CXCL12 in ALI/ARDS group were higher than that in control group. Clinical and prognostic analysis revealed the higher injury degree and death rates in ALI/ARDS group than those in control group, and identified a greater severity and mortality for patients with ARDS than those with ALI. ROC curve analysis indicated the counts of CFs greater than 5.85% can predict death rates with AUC = 0.928. CFs had an inhibitory effect on injury repair in ALI/ARDS mice model. This might be unfavorable as a clinical marker for progression of ALI/ARDS.
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Affiliation(s)
- Wenlin Tai
- Department of Clinical Laboratory, Yunnan Molecular Diagnostic Center, The 2nd Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Zeping Zhou
- Department of Hematology, The 2nd Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Boyang Zheng
- Department of Clinical Laboratory, Yunnan Molecular Diagnostic Center, The 2nd Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Jinyu Li
- Department of Clinical Laboratory, Yunnan Molecular Diagnostic Center, The 2nd Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Jiawei Ding
- Department of Clinical Laboratory, Yunnan Molecular Diagnostic Center, The 2nd Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Hanxin Wu
- Department of Clinical Laboratory, Yunnan Molecular Diagnostic Center, The 2nd Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Ling Gao
- Department of Clinical Laboratory, Yunnan Molecular Diagnostic Center, The 2nd Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Zhaoxing Dong
- Department of Respiratory, The 2nd Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
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Abstract
Fibrocytes, ahematopoietic stem cell source of fibroblasts/myofibroblasts, were previously implicated to infiltrate into the intestinal and enhance inflammation.The aims of the present study were to elucidate the role of fibrocytes in necrotizing enterocolitis (NEC) pathogenesis and to explore the mechanisms by which fibrocytes contributed to the inflammatory responses.We investigated circulating and intestinal local fibrocytes from 32 patients with NEC, 8 patients with noninflammatory conditions of the gastrointestinal tract and 12 normal subjects.Significantly higher numbers of circulating fibrocytes were found in the peripheral blood from NEC patients than the controls (P < .01). Numerous fibrocytes were found infiltrating the NEC intestinal mucous membranes. The percentage of fibrocytes to total leukocytes in the NEC inflammatory lesions was significantly increased compared with the percentage in the noninflammatory gastrointestinal tract. The fibrocyte attractant chemokine C-X-C motif chemokine ligand 12 (CXCL12) was significantly increased in the plasma and was detectable in 80% of the peritoneal lavage fluid from NEC patients but not the controls. Furthermore, chemokine expression was increased in fibrocytes infiltrating and trafficking to leukocyte sites. In culture, lipopolysaccharide (LPS) induced a significant increase in the expression of the Toll-like receptor (TLR4) signal, with the upregulation of p38 in both the isolated fibrocytes and macrophages. Similarly, interleukin (IL)-1β induced increased the upregulation of the IL-6, tumor necrosis factor (TNF)-α, and intercellular cell adhesion molecule-1 mRNAs but downregulated ColI in fibrocytes isolated from NEC patients compared with the controls.These findings indicate that circulating fibrocytes are increased in NEC patients and may be recruited to the inflammatory intestinal track, most likely through the CXCR4/CXCL12 axis. These cells may contribute to intestinal inflammation through TLR4 signaling by producing the TNF-α and IL-6 cytokines.
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Affiliation(s)
- Ye Liu
- Department of Neonatal, Children's Hospital, Chongqing Medical University, Chongqing
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University
| | - Shang Qingjuan
- Department of Pathology, Linyi People's Hospital, Linyi, Shandong Province
| | - Zongwei Gao
- Department of Pathology, Linyi People's Hospital, Linyi, Shandong Province
| | - Chun Deng
- Department of Neonatal, Children's Hospital, Chongqing Medical University, Chongqing
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University
| | - Yan Wang
- Department of Neonatology, Yongchuan Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Chunbao Guo
- Department of Pediatric General Surgery
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University
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Alhamad EH, Shakoor Z, Al-Kassimi FA, Almogren A, Gad ElRab MO, Maharaj S, Kolb M. Rapid detection of circulating fibrocytes by flowcytometry in idiopathic pulmonary fibrosis. Ann Thorac Med 2015; 10:279-83. [PMID: 26664567 PMCID: PMC4652295 DOI: 10.4103/1817-1737.157294] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: Current protocols for detection of circulating fibrocytes (CFs) in peripheral blood described in various pulmonary and nonpulmonary disorders involve complex and time consuming, non standardized techniques. OBJECTIVE: Testing a method to rapidly detect and quantify CFs using whole blood lysis flow cytometry-based assay in patients with idiopathic pulmonary fibrosis (IPF) and healthy controls. METHODS: One milliliter of venous blood sample in ethylenediaminetetraacetic acid (EDTA) from 33 IPF patients and 35 healthy control subjects was collected. Using whole blood lysis method peripheral blood leukocytes were labeled with monoclonal antibodies for cell surface (CD34 and CD45) and intracellular markers (collagen-1) for flow cytometric analysis. CFs were defined as CD45+ cells coexpressing collagen-I and CD34 molecules. RESULTS: In 29 (87.8%) IPF patients and 10 (28.5%) control subjects, a well-defined highly granular CD45+ cell population was detected in dot plots generated by side scatter properties of CD45+ cells. These CD45+ cells were identified as CFs on the basis of coexpression of collagen-I and CD34; none of the other cell types in the peripheral blood were labeled with these monoclonal antibodies. In IPF patients the percentage of CFs was significantly higher compared to healthy controls (median (range): 1.37% (0.52-5.65) and 1.04% (0.1-1.84), respectively; P = 0.03). CONCLUSIONS: Whole blood lysis method combined with fluorescence-activated cell sorting (FACS) allows detecting a well-defined homogeneous population of CFs. This method is simple, reproducible, and provides an accurate and rapid estimation of CFs.
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Affiliation(s)
- Esam H Alhamad
- Department of Medicine, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Zahid Shakoor
- Department of Pathology, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Feisal A Al-Kassimi
- Department of Medicine, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Adel Almogren
- Department of Pathology, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed O Gad ElRab
- Department of Pathology, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Shyam Maharaj
- Firestone Institute for Respiratory Health, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Martin Kolb
- Firestone Institute for Respiratory Health, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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De Biasi S, Cerri S, Bianchini E, Gibellini L, Persiani E, Montanari G, Luppi F, Carbonelli CM, Zucchi L, Bocchino M, Zamparelli AS, Vancheri C, Sgalla G, Richeldi L, Cossarizza A. Levels of circulating endothelial cells are low in idiopathic pulmonary fibrosis and are further reduced by anti-fibrotic treatments. BMC Med 2015; 13:277. [PMID: 26552487 PMCID: PMC4640202 DOI: 10.1186/s12916-015-0515-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 10/16/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It has been suggested that circulating fibrocytes and endothelial cells actively participate in the intense remodelling of the pulmonary vasculature in patients with idiopathic pulmonary fibrosis (IPF). Indeed, fibrotic areas exist that have fewer blood vessels, whereas adjacent non-fibrotic tissue is highly vascularized. The number of circulating endothelial cells (CEC) and endothelial progenitor cells (EPC) might reflect the balance between vascular injury and repair. Thus, fibrocytes as well as endothelial cells could potentially be used as biomarkers of disease progression and treatment outcome. METHODS Peripheral blood samples were collected from 67 patients with a multidisciplinary diagnosis of IPF and from 45 age-matched and sex-matched healthy volunteers. Buffy coat was isolated according to standard procedures and at least 20 million cells were stained with different monoclonal antibodies for the detection of CEC, EPC and circulating fibrocytes. For the detection of CEC and EPC, cells were stained with anti-CD45, anti-CD34, anti-CD133, anti-CD14, anti-CD309 and with the viability probe Far-Red LIVE/DEAD. For the detection of circulating fibrocytes, cells were first stained with LIVE/DEAD and the following monoclonal antibodies: anti-CD3, anti-CD19, anti-CD45, anti-CD34 and anti-CD14, then cells were fixed, permeabilized and stained with fluorochrome-conjugated anti-collagen I monoclonal antibodies. RESULTS Patients with IPF displayed almost undetectable levels of circulating fibrocytes, low levels of CEC, and normal levels of EPC. Patients treated with nintedanib displayed higher levels of CEC, but lower levels of endothelial cells expressing CD309 (the type II receptor for vascular endothelial growth factor). Treatment with both nintedanib and pirfenidone reduced the percentage of CEC and circulating fibrocytes. CONCLUSIONS Levels of CEC were reduced in patients with IPF as compared to healthy individuals. The anti-fibrotic treatments nintedanib and pirfenidone further reduced CEC levels. These findings might help explain the mechanism of action of these drugs and should be explored as predictive biomarkers in IPF.
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Affiliation(s)
- Sara De Biasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia School of Medicine, via Campi, 287-41125, Modena, Italy.
| | - Stefania Cerri
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
| | - Elena Bianchini
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | - Lara Gibellini
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia School of Medicine, via Campi, 287-41125, Modena, Italy.
| | - Elisa Persiani
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
| | - Gloria Montanari
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
| | - Fabrizio Luppi
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
| | - Cristiano Matteo Carbonelli
- Pulmonology Unit, Department of Cardiology, Thoracic and Vascular Surgery and Critical Care Medicine, IRCCS - Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
| | - Luigi Zucchi
- Pulmonology Unit, Department of Cardiology, Thoracic and Vascular Surgery and Critical Care Medicine, IRCCS - Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
| | - Marialuisa Bocchino
- Respiratory Medicine Section, Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy.
| | - Alessandro Sanduzzi Zamparelli
- Respiratory Medicine Section, Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy.
| | - Carlo Vancheri
- Regional Centre for Rare Lung Diseases, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
| | - Giacomo Sgalla
- Department of Respiratory Medicine, University of Southampton, Southampton, UK.
| | - Luca Richeldi
- Department of Respiratory Medicine, University of Southampton, Southampton, UK.
| | - Andrea Cossarizza
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia School of Medicine, via Campi, 287-41125, Modena, Italy. .,Dipartimento Sperimentale Interaziendale, Campus San Lazzaro, University of Modena and Reggio Emilia, 42122, Reggio Emilia, Italy.
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