Lin You-Min, Zhang Ke, Geesala Ramasatyaveni, Lipson Kenneth E, Qiu Suimin, Powell Don W, Cohn Steven, Shi Xuan-Zheng
Department of Internal Medicine, The University of Texas Medical Branch, John Sealy School of Medicine, Galveston, Texas, United States.
FibroGen, Inc., San Francisco, California, United States.
Am J Physiol Gastrointest Liver Physiol. 2024 Aug 1;327(2):G295-G305. doi: 10.1152/ajpgi.00123.2024. Epub 2024 Jul 2.
Crohn's disease (CD) is an inflammatory bowel disease characterized by transmural inflammation and intestinal fibrosis. Mechanisms of fibrosis in CD are not well understood. Transmural inflammation is associated with inflammatory cell infiltration, stenosis, and distention, which present mechanical stress (MS) to the bowel wall. We hypothesize that MS induces gene expression of profibrotic mediators such as connective tissue growth factor (CTGF), which may contribute to fibrosis in CD. A rodent model of CD was induced by intracolonic instillation of TNBS to the distal colon. TNBS instillation induced a localized transmural inflammation (), with a distended colon segment () proximal to . We detected significant fibrosis and collagen content not only in but also in in CD rats by . CTGF expression increased significantly in and , but not in the segment distal to the inflammation site. Increased CTGF expression was detected mainly in the smooth muscle cells (SMCs). When rats were fed exclusively with clear liquid diet to prevent mechanical distention in colitis, expression of CTGF in and was blocked. Direct stretch led to robust expression of CTGF in colonic SMC. Treatment of CD rats with anti-CTGF antibody FG-3149 reduced fibrosis and collagen content in both and and exhibited consistent trends toward normalizing expression of collagen mRNAs. In conclusion, our studies suggest that mechanical stress, by upregulating profibrotic mediators, i.e., CTGF, may play a critical role in fibrosis in CD. We found that CTGF expression increased significantly not only in the inflammation site but in the distended segment proximal to inflammation in a rodent model of CD-like colitis. Release of mechanical distention prevented CTGF expression in CD rats, whereas direct stretch induced CTGF expression. Treatment with anti-CTGF antibody reduced fibrosis and collagen contents in CD rats. Thus, mechanical stress, via upregulating profibrotic mediators, i.e., CTGF, may play a critical role in fibrosis in CD.
Am J Physiol Gastrointest Liver Physiol. 2024-8-1
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