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Fibroblast pathology in inflammatory diseases
Kevin Wei, … , Hung N. Nguyen, Michael B. Brenner
Kevin Wei, … , Hung N. Nguyen, Michael B. Brenner
Published October 15, 2021
Citation Information: J Clin Invest. 2021;131(20):e149538. https://doi.org/10.1172/JCI149538.
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Review

Fibroblast pathology in inflammatory diseases

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Abstract

Fibroblasts are important cells for the support of homeostatic tissue function. In inflammatory diseases such as rheumatoid arthritis and inflammatory bowel disease, fibroblasts take on different roles (a) as inflammatory cells themselves and (b) in recruiting leukocytes, driving angiogenesis, and enabling chronic inflammation in tissues. Recent advances in single-cell profiling techniques have transformed the ability to examine fibroblast states and populations in inflamed tissues, providing evidence of previously underappreciated heterogeneity and disease-associated fibroblast populations. These studies challenge the preconceived notion that fibroblasts are homogeneous and provide new insights into the role of fibroblasts in inflammatory pathology. In addition, new molecular insights into the mechanisms of fibroblast activation reveal powerful cell-intrinsic amplification loops that synergize with primary fibroblast stimuli to result in striking responses. In this Review, we focus on recent developments in our understanding of fibroblast heterogeneity and fibroblast pathology across tissues and diseases in rheumatoid arthritis and inflammatory bowel diseases. We highlight new approaches to, and applications of, single-cell profiling techniques and what they teach us about fibroblast biology. Finally, we address how these insights could lead to the development of novel therapeutic approaches to targeting fibroblasts in disease.

Authors

Kevin Wei, Hung N. Nguyen, Michael B. Brenner

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Figure 3

Approaches to targeting fibroblasts in inflammatory diseases.

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Approaches to targeting fibroblasts in inflammatory diseases.
(i) Strate...
(i) Strategies to target fibroblasts in inflammatory disease can be categorized into several broad categories. (ii) Preventing fibroblast activation by neutralizing key cytokines such as TNF, IL-1, IL-17, and IFNs that lead to fibroblast inflammatory activation. (iii) Primary activating factors. The full extent of fibroblast inflammatory activation requires secreted autocrine factors (LIF) and paracrine factors (OSM). Strategies to block fibroblast amplification factors could result in attenuating the fibroblast inflammatory response. (iv) Targeting key fibroblast-derived factors crucial for immune cell activation or recruitment. (v) Preventing pathogenic fibroblast differentiation by blocking morphogen signaling pathways. In RA, Notch-mediated vascular fibroblasts could be targeted by blockade of Notch3 receptor signaling. In fibrotic disease, myofibroblast differentiation driven by TGF-β could be targeted by blockade of TGF-β signaling. (vi) Depleting pathogenic fibroblast subsets. Conceptually, pathogenic fibroblasts in inflammatory disease expressing distinct surface markers, such as fibroblast activation protein (FAP), could be targeted therapeutically through an antibody-mediated depletion strategy. Markers specifically expressed in disease-associated fibroblasts would enable depletion of pathogenic subsets without disruption of normal fibroblast functions in noninvolved organ tissues. (vii) Disrupting pathological processes mediated by fibroblasts. In this example, an inhibitory antibody against cadherin-11 could potentially prevent fibroblast-mediated invasion and blunt cytokine-induced inflammation.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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