在以往的研究中,我们已经证明,应激反应引起的高糖皮质激素水平可能是创伤性异位骨化(HO)的根本原因,我们已经建立了糖皮质激素诱导的异位矿化(EM)小鼠模型,通过向心肌毒素注射引起的肌肉损伤的动物全身给药高剂量的地塞米松(DEX)。在这个模型中,营养不良性钙化(DC)以细胞自主方式发展为HO。然而,目前尚不清楚DEX治疗后DC是如何形成的。因此,在这项研究中,我们旨在探讨糖皮质激素如何在细胞和分子水平引发肌肉EM.我们发现DEX治疗抑制炎症细胞浸润到受损肌肉,但肌肉中的炎症细胞因子产生显著增加,提示其他非炎性肌细胞类型可能调节炎症反应和肌肉修复过程。伴随着这种表型,转化生长因子β1(TGF-β1)在纤维脂肪祖细胞(FAP)中的表达大大下调。由于TGF-β1是一种强大的免疫抑制剂,FAP的调节作用对肌肉修复有很大的影响,我们假设DEX治疗后FAP中TGF-β1的下调导致了这种过度炎症状态,随后导致肌肉修复和EM形成失败.为了检验我们的假设,我们利用转基因小鼠模型特异性敲除PDGFRα阳性FAP中的Tgfb1基因,以研究转基因小鼠是否可以重现DEX治疗诱导的表型.我们的结果表明,转基因小鼠完全表现出这种高炎性状态,并在肌肉损伤后自发发展为EM。相反,增强FAP中TGF-β1信号传导的治疗剂抑制了炎症反应并减弱了肌肉EM。总之,这些结果表明,FAPs衍生的TGF-β1是调节肌肉炎症反应和随后的EM的关键分子,糖皮质激素通过下调FAP中的TGF-β1发挥其作用。
异位骨化(HO)是软组织中异常的骨形成。糖皮质激素,具有很强的抗炎特性,通常被用作HO疗法。然而,我们的发现提示糖皮质激素也能促进HO的形成.在这项研究中,我们试图解释这些看似矛盾的观察的根本原因。我们发现糖皮质激素,除了对炎症细胞发挥抗炎作用外,还可以靶向另一种类型的肌肉细胞以发挥促炎作用。这些细胞被称为纤维脂肪原祖细胞(FAP),我们证明FAP通过调节转化生长因子β1(TGF-β1)的表达在肌肉炎症反应中起主要调节作用,众所周知的免疫抑制剂.总之,我们的发现强调了FAPTGF-β1水平在影响肌肉HO进展和消退中的重要性,并根据其提高FAP中TGF-β1水平的能力为HO提供了新的治疗选择。
In previous studies, we have demonstrated that stress response-induced high glucocorticoid levels could be the underlying cause of traumatic heterotopic ossification (HO), and we have developed a glucocorticoid-induced ectopic mineralization (EM) mouse model by systemic administration of a high dose of dexamethasone (DEX) to animals with muscle injury induced by cardiotoxin injection. In this model, dystrophic calcification (DC) developed into HO in a cell autonomous manner. However, it is not clear how DC is formed after DEX treatment. Therefore, in this study, we aimed to explore how glucocorticoids initiate muscle EM at a cellular and molecular level. We showed that DEX treatment inhibited inflammatory cell infiltration into injured muscle but inflammatory cytokine production in the muscle was significantly increased, suggesting that other non-inflammatory muscle cell types may regulate the inflammatory response and the muscle repair process. Accompanying this phenotype, transforming growth factor β1 (TGF-β1) expression in fibro-adipogenic progenitors (FAPs) was greatly down-regulated. Since TGF-β1 is a strong immune suppressor and FAP\'s regulatory role has a large impact on muscle repair, we hypothesized that down-regulation of TGF-β1 in FAPs after DEX treatment resulted in this hyperinflammatory state and subsequent failed muscle repair and EM formation. To test our hypothesis, we utilized a transgenic mouse model to specifically knock out Tgfb1 gene in PDGFRα positive FAPs to investigate if the transgenic mice could recapitulate the phenotype that was induced by DEX treatment. Our results showed that the transgenic mice completely phenocopied this hyperinflammatory state and spontaneously developed EM following muscle injury. On the contrary, therapeutics that enhanced TGF-β1 signaling in FAPs inhibited the inflammatory response and attenuated muscle EM. In summary, these results indicate that FAPs-derived TGF-β1 is a key molecule in regulating muscle inflammatory response and subsequent EM, and that glucocorticoids exert their effect via down-regulating TGF-β1 in FAPs.
Heterotopic ossification (HO) is abnormal bone formation in soft tissue. Glucocorticoids, which have strong anti-inflammatory properties, have usually been used as HO therapeutics. However, our findings suggest that glucocorticoids can also promote HO formation. In this study, we tried to explain the underlying reason for these seemingly contradictory observations. We showed that glucocorticoids, in addition to exerting an anti-inflammatory effect on inflammatory cells, can also target another type of muscle cell to exert a pro-inflammatory effect. These cells are called fibro-adipogenic progenitors (FAPs), and we demonstrated that FAPs played a master regulatory role in the muscle inflammatory response by modulating the expression of transforming growth factor β1 (TGF-β1), a well-known immune suppressor. In summary, our findings highlighted the importance of FAP TGF-β1 levels in affecting the progression and regression of muscle HO, and provided new treatment options for HO based on their ability to elevate TGF-β1 levels in FAPs.