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表皮生长因子受体酪氨酸激酶抑制剂可减轻转化生长因子-α诱导的肺纤维化。

EGF receptor tyrosine kinase inhibitors diminish transforming growth factor-alpha-induced pulmonary fibrosis.

作者信息

Hardie William D, Davidson Cynthia, Ikegami Machiko, Leikauf George D, Le Cras Timothy D, Prestridge Adrienne, Whitsett Jeffrey A, Korfhagen Thomas R

机构信息

Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229, USA.

出版信息

Am J Physiol Lung Cell Mol Physiol. 2008 Jun;294(6):L1217-25. doi: 10.1152/ajplung.00020.2008. Epub 2008 Apr 18.

Abstract

Transforming growth factor-alpha (TGF-alpha) is a ligand for the EGF receptor (EGFR). EGFR activation is associated with fibroproliferative processes in human lung disease and animal models of pulmonary fibrosis. We determined the effects of EGFR tyrosine kinase inhibitors gefitinib (Iressa) and erlotinib (Tarceva) on the development and progression of TGF-alpha-induced pulmonary fibrosis. Using a doxycycline-regulatable transgenic mouse model of lung-specific TGF-alpha expression, we determined effects of treatment with gefitinib and erlotinib on changes in lung histology, total lung collagen, pulmonary mechanics, pulmonary hypertension, and expression of genes associated with synthesis of ECM and vascular remodeling. Induction in the lung of TGF-alpha caused progressive pulmonary fibrosis over an 8-wk period. Daily administration of gefitinib or erlotinib prevented development of fibrosis, reduced accumulation of total lung collagen, prevented weight loss, and prevented changes in pulmonary mechanics. Treatment of mice with gefitinib 4 wk after the induction of TGF-alpha prevented further increases in and partially reversed total collagen levels and changes in pulmonary mechanics and pulmonary hypertension. Increases in expression of genes associated with synthesis of ECM as well as decreases of genes associated with vascular remodeling were also prevented or partially reversed. Administration of gefitinib or erlotinib did not cause interstitial fibrosis or increases in lavage cell counts. Administration of small molecule EGFR tyrosine kinase inhibitors prevented further increases in and partially reversed pulmonary fibrosis induced directly by EGFR activation without inducing inflammatory cell influx or additional lung injury.

摘要

转化生长因子-α(TGF-α)是表皮生长因子受体(EGFR)的配体。EGFR激活与人类肺部疾病和肺纤维化动物模型中的纤维增生过程相关。我们确定了EGFR酪氨酸激酶抑制剂吉非替尼(易瑞沙)和厄洛替尼(特罗凯)对TGF-α诱导的肺纤维化的发生和进展的影响。使用一种强力霉素可调节的肺特异性TGF-α表达转基因小鼠模型,我们确定了吉非替尼和厄洛替尼治疗对肺组织学变化、肺总胶原含量、肺力学、肺动脉高压以及与细胞外基质合成和血管重塑相关基因表达的影响。肺中TGF-α的诱导在8周内导致进行性肺纤维化。每天给予吉非替尼或厄洛替尼可预防纤维化的发生,减少肺总胶原的积累,防止体重减轻,并防止肺力学改变。在TGF-α诱导4周后用吉非替尼治疗小鼠可防止总胶原水平进一步升高,并部分逆转肺力学和肺动脉高压的变化。与细胞外基质合成相关基因的表达增加以及与血管重塑相关基因的表达降低也得到了预防或部分逆转。给予吉非替尼或厄洛替尼不会引起间质性纤维化或灌洗细胞计数增加。给予小分子EGFR酪氨酸激酶抑制剂可防止由EGFR激活直接诱导的肺纤维化进一步加重,并部分逆转肺纤维化,且不会引起炎症细胞流入或额外的肺损伤。

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