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TWIST1+FAP+ fibroblasts in the pathogenesis of intestinal fibrosis in Crohn’s disease
Yao Zhang, … , Duowu Zou, Bing Su
Yao Zhang, … , Duowu Zou, Bing Su
Published July 18, 2024
Citation Information: J Clin Invest. 2024;134(18):e179472. https://doi.org/10.1172/JCI179472.
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Research Article Gastroenterology

TWIST1+FAP+ fibroblasts in the pathogenesis of intestinal fibrosis in Crohn’s disease

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Abstract

Intestinal fibrosis, a severe complication of Crohn’s disease (CD), is characterized by excessive extracellular matrix (ECM) deposition and induces intestinal strictures, but there are no effective antifibrosis drugs available for clinical application. We performed single-cell RNA sequencing (scRNA-Seq) of fibrotic and nonfibrotic ileal tissues from patients with CD with intestinal obstruction. Analysis revealed mesenchymal stromal cells (MSCs) as the major producers of ECM and the increased infiltration of its subset FAP+ fibroblasts in fibrotic sites, which was confirmed by immunofluorescence and flow cytometry. Single-cell transcriptomic profiling of chronic dextran sulfate sodium salt murine colitis model revealed that CD81+Pi16– fibroblasts exhibited transcriptomic and functional similarities to human FAP+ fibroblasts. Consistently, FAP+ fibroblasts were identified as the key subtype with the highest level of ECM production in fibrotic intestines. Furthermore, specific knockout or pharmacological inhibition of TWIST1, which was highly expressed by FAP+ fibroblasts, could significantly ameliorate fibrosis in mice. In addition, TWIST1 expression was induced by CXCL9+ macrophages enriched in fibrotic tissues via IL-1β and TGF-β signal. These findings suggest the inhibition of TWIST1 as a promising strategy for CD fibrosis treatment.

Authors

Yao Zhang, Jiaxin Wang, Hongxiang Sun, Zhenzhen Xun, Zirui He, Yizhou Zhao, Jingjing Qi, Sishen Sun, Qidi Yang, Yubei Gu, Ling Zhang, Chunhua Zhou, Youqiong Ye, Ningbo Wu, Duowu Zou, Bing Su

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Figure 3

TWIST1 is a critical transcription factor in the differentiation of FAP+ fibroblasts.

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TWIST1 is a critical transcription factor in the differentiation of FAP+...
(A) Representative IF staining of human fibrotic and nonfibrotic intestinal tissue (original magnification, ×20). DAPI (blue), FAP (red), and COL1A1 (green) in individual and merged channels are shown. Scale bar: 100 μm. (B) Quantitative analysis (integrated fluorescence intensity) of FAP and COL1A1 in IF staining. The points corresponding to the paired samples (n = 5) in the graph are connected. Statistical differences were determined by paired t tests. (C) The mRNA levels of COL1A1, ACAT2, and POSTN in FAP+ fibroblasts, FGFR2+ fibroblasts, and pericytes sorted from fibrotic and nonfibrotic sites were analyzed by qPCR. The points corresponding to the paired samples (n = 5) in the graph are connected. Statistical differences were determined by paired t tests. (D) RNA velocity of 4 fibroblast subclusters. Color is as in Figure 2A. The inferred developmental trajectory of FAP+ fibroblasts enlarged. (E) Heatmap showing the relative expression (Z score) of the top 5 transcription factor (TF) genes in each MSC subtype. Color is as in Figure 2A. (F) Heatmap showing the normalized activity of the top 5 TF regulons in MSC subtypes predicted by SCENIC. Color is as in Figure 2A. (G) Feature plots showing the expression of TWIST1 (top) and the activity of TWIST1 regulon (bottom). The position of FAP+ fibroblasts is red circled. (H) The mRNA levels of TWIST1 in FAP+ fibroblasts sorted from fibrotic and nonfibrotic sites were analyzed by qPCR. The points corresponding to the paired samples (n = 5) in the graph are connected. Statistical differences were determined by paired t tests.

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