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探讨血小板及血小板衍生转化生长因子-β在特发性肺纤维化中的作用。

Investigating the role of platelets and platelet-derived transforming growth factor-β in idiopathic pulmonary fibrosis.

机构信息

UCL Respiratory, Division of Medicine, University College London, London, United Kingdom.

Institute for Infection and Immunity, St George's University of London, London, United Kingdom.

出版信息

Am J Physiol Lung Cell Mol Physiol. 2023 Oct 1;325(4):L487-L499. doi: 10.1152/ajplung.00227.2022. Epub 2023 Aug 29.

Abstract

Transforming growth factor-β1 (TGFβ1) is the key profibrotic cytokine in idiopathic pulmonary fibrosis (IPF), but the primary source of this cytokine in this disease is unknown. Platelets have abundant stores of TGFβ1, although the role of these cells in IPF is ill-defined. In this study, we investigated whether platelets, and specifically platelet-derived TGFβ1, mediate IPF disease progression. Patients with IPF and non-IPF patients were recruited to determine platelet reactivity, and separate cohorts of patients with IPF were followed for mortality. To study whether platelet-derived TGFβ1 modulates pulmonary fibrosis (PF), mice with a targeted deletion of TGFβ1 in megakaryocytes and platelets (TGFβ1.PF4-Cre) were used in the well-characterized bleomycin-induced pulmonary fibrosis (PF) animal model. In a discovery cohort, we found significantly higher mortality in patients with IPF who had elevated platelet counts within the normal range. However, our validation cohort did not confirm this observation, despite significantly increased platelets, neutrophils, active TGFβ1, and CCL5, a chemokine produced by inflammatory cells, in the blood, lung, and bronchoalveolar lavage (BAL) of patients with IPF. In vivo, we showed that despite platelets being readily detected within the lungs of bleomycin-treated mice, neither the degree of pulmonary inflammation nor fibrosis was significantly different between TGFβ1.PF4-Cre and control mice. Our results demonstrate for the first time that platelet-derived TGFβ1 does not significantly mediate inflammation or fibrosis in a PF animal model. Furthermore, our human studies revealed blood platelet counts do not consistently predict mortality in IPF but other platelet-derived mediators, such as C-C chemokine ligand 5 (CCL5), may promote neutrophil recruitment and human IPF. Platelets are a rich source of profibrotic TGFβ; however, the role of platelets in idiopathic pulmonary fibrosis (IPF) is unclear. We identified that patients with IPF have significantly more platelets, neutrophils, and active TGFβ in their airways than control patients. Using an animal model of IPF, we demonstrated that platelet-derived TGFβ does not significantly drive lung fibrosis or inflammation. Our findings offer a better understanding of platelets in both human and animal studies of IPF.

摘要

转化生长因子-β1(TGFβ1)是特发性肺纤维化(IPF)中的关键致纤维化细胞因子,但这种细胞因子在这种疾病中的主要来源尚不清楚。血小板含有丰富的 TGFβ1,但这些细胞在 IPF 中的作用尚不清楚。在这项研究中,我们研究了血小板,特别是血小板衍生的 TGFβ1 是否介导 IPF 疾病进展。招募了 IPF 患者和非 IPF 患者以确定血小板反应性,并对单独的 IPF 患者队列进行了随访以确定死亡率。为了研究血小板衍生的 TGFβ1 是否调节肺纤维化(PF),我们在已建立的博来霉素诱导的 PF 动物模型中使用了巨核细胞和血小板中 TGFβ1 缺失的基因敲除小鼠(TGFβ1.PF4-Cre)。在一个发现队列中,我们发现血小板计数在正常范围内升高的 IPF 患者死亡率显著更高。然而,我们的验证队列并没有证实这一观察结果,尽管在 IPF 患者的血液、肺和支气管肺泡灌洗液(BAL)中,血小板、中性粒细胞、活性 TGFβ1 和趋化因子 CCL5 的水平显著升高,趋化因子 CCL5 是由炎症细胞产生的。在体内,我们表明尽管在博来霉素处理的小鼠肺部中很容易检测到血小板,但 TGFβ1.PF4-Cre 小鼠和对照小鼠之间的肺部炎症和纤维化程度没有显著差异。我们的结果首次表明,血小板衍生的 TGFβ1 在 PF 动物模型中并没有显著介导炎症或纤维化。此外,我们的人类研究表明,血小板计数不能始终预测 IPF 患者的死亡率,但其他血小板衍生的介质,如 C-C 趋化因子配体 5(CCL5),可能促进中性粒细胞募集和人类 IPF。血小板是丰富的致纤维化 TGFβ 的来源;然而,血小板在特发性肺纤维化(IPF)中的作用尚不清楚。我们发现,与对照患者相比,IPF 患者的气道中血小板、中性粒细胞和活性 TGFβ1 的含量明显更多。使用 IPF 的动物模型,我们证明血小板衍生的 TGFβ1 并没有显著驱动肺纤维化或炎症。我们的发现为在人类和动物研究中更好地理解血小板提供了依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3263/10639018/84e8a1bea450/l-00227-2022r01.jpg

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