Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy.
Division of Dermatology, Department of Clinical and Experimental Sciences, Spedali Civili University Hospital Brescia, 25121 Brescia, Italy.
Cells. 2022 Dec 14;11(24):4040. doi: 10.3390/cells11244040.
Hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD) are clinically overlapping connective tissue disorders of unknown etiology and without any validated diagnostic biomarker and specific therapies. Herein, we in-depth characterized the cellular phenotype and gene expression profile of hEDS and HSD dermal fibroblasts by immunofluorescence, amplicon-based RNA-seq, and qPCR. We demonstrated that both cell types show a common cellular trait, i.e., generalized extracellular matrix (ECM) disarray, myofibroblast differentiation, and dysregulated gene expression. Functional enrichment and pathway analyses clustered gene expression changes in different biological networks that are likely relevant for the disease pathophysiology. Specifically, the complex gene expression dysregulation (mainly involving growth factors, structural ECM components, ECM-modifying enzymes, cytoskeletal proteins, and different signal transducers), is expected to perturb many ECM-related processes including cell adhesion, migration, proliferation, and differentiation. Based on these findings, we propose a disease model in which an unbalanced ECM remodeling triggers a vicious cycle with a synergistic contribution of ECM degradation products and proinflammatory mediators leading to a functional impairment of different connective tissues reflecting the multisystemic presentation of hEDS/HSD patients. Our results offer many promising clues for translational research aimed to define molecular bases, diagnostic biomarkers, and specific therapies for these challenging connective tissue disorders.
患有超机动性 Ehlers-Danlos 综合征 (hEDS) 和高机动性综合征 (HSD) 的患者,其结缔组织存在重叠的临床病症,这些病症病因不明,也没有任何经过验证的诊断生物标志物和特定疗法。在此,我们通过免疫荧光、基于扩增子的 RNA-seq 和 qPCR,深入研究了 hEDS 和 HSD 皮肤成纤维细胞的细胞表型和基因表达谱。我们证明,这两种细胞类型都表现出一种共同的细胞特征,即广泛的细胞外基质 (ECM) 紊乱、肌成纤维细胞分化和基因表达失调。功能富集和通路分析将基因表达变化聚类到不同的生物学网络中,这些网络可能与疾病的病理生理学相关。具体来说,复杂的基因表达失调(主要涉及生长因子、结构 ECM 成分、ECM 修饰酶、细胞骨架蛋白和不同的信号转导物),预计会扰乱许多与 ECM 相关的过程,包括细胞黏附、迁移、增殖和分化。基于这些发现,我们提出了一个疾病模型,即 ECM 重塑失衡引发了一个恶性循环,其中 ECM 降解产物和促炎介质的协同作用导致不同结缔组织的功能障碍,反映了 hEDS/HSD 患者的多系统表现。我们的研究结果为旨在确定这些具有挑战性的结缔组织疾病的分子基础、诊断生物标志物和特定疗法的转化研究提供了许多有希望的线索。
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