Metformin reverses established lung fibrosis in a bleomycin model

S Rangarajan, NB Bone, AA Zmijewska, S Jiang… - Nature medicine, 2018 - nature.com
S Rangarajan, NB Bone, AA Zmijewska, S Jiang, DW Park, K Bernard, ML Locy, S Ravi…
Nature medicine, 2018nature.com
Fibrosis is a pathological result of a dysfunctional repair response to tissue injury and occurs
in a number of organs, including the lungs. Cellular metabolism regulates tissue repair and
remodelling responses to injury,–. AMPK is a critical sensor of cellular bioenergetics and
controls the switch from anabolic to catabolic metabolism. However, the role of AMPK in
fibrosis is not well understood. Here, we demonstrate that in humans with idiopathic
pulmonary fibrosis (IPF) and in an experimental mouse model of lung fibrosis, AMPK activity …
Abstract
Fibrosis is a pathological result of a dysfunctional repair response to tissue injury and occurs in a number of organs, including the lungs. Cellular metabolism regulates tissue repair and remodelling responses to injury, –. AMPK is a critical sensor of cellular bioenergetics and controls the switch from anabolic to catabolic metabolism. However, the role of AMPK in fibrosis is not well understood. Here, we demonstrate that in humans with idiopathic pulmonary fibrosis (IPF) and in an experimental mouse model of lung fibrosis, AMPK activity is lower in fibrotic regions associated with metabolically active and apoptosis-resistant myofibroblasts. Pharmacological activation of AMPK in myofibroblasts from lungs of humans with IPF display lower fibrotic activity, along with enhanced mitochondrial biogenesis and normalization of sensitivity to apoptosis. In a bleomycin model of lung fibrosis in mice, metformin therapeutically accelerates the resolution of well-established fibrosis in an AMPK-dependent manner. These studies implicate deficient AMPK activation in non-resolving, pathologic fibrotic processes, and support a role for metformin (or other AMPK activators) to reverse established fibrosis by facilitating deactivation and apoptosis of myofibroblasts.
nature.com