Hua Feng, Sun Jinpeng, Shi Mohan, Mei Rui, Song Zeyuan, Liu Jun, Zhang Mingshun
Department of Orthopedics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
NHC Key Laboratory of Antibody Technique, Jiangsu Province Engineering Research Center of Antibody Drug, Department of Immunology, Nanjing Medical University, Nanjing, China.
NPJ Regen Med. 2024 Dec 30;9(1):43. doi: 10.1038/s41536-024-00388-6.
Epidural fibrosis post laminectomy is the leading cause of failed back surgery syndrome. Little is known about the role and mechanisms of adipose tissues in epidural fibrosis. Here, we found that obese patients were more likely to develop epidural fibrosis after spine surgery. Similarly, obesity led to more progressive epidural fibrosis in a mouse model of laminectomy. Adipocyte-myofibroblast transition (AMT) occurs in epidural scarring. Mechanistically, large extracellular vesicles (EVs) from M2-type macrophages transfer mitochondria into adipocytes and promote AMT by activating the TGF-β and PAI-1 pathways. Blocking the PAI-1 pathway significantly attenuated the transition of adipocytes into myofibroblasts. We conclude that large EVs from macrophages transfer mitochondria to promote AMT in epidural fibrosis.
椎板切除术后硬膜外纤维化是腰椎手术失败综合征的主要原因。目前对于脂肪组织在硬膜外纤维化中的作用和机制知之甚少。在此,我们发现肥胖患者在脊柱手术后更易发生硬膜外纤维化。同样,在椎板切除小鼠模型中,肥胖导致更严重的进行性硬膜外纤维化。脂肪细胞-肌成纤维细胞转分化(AMT)发生于硬膜外瘢痕形成过程中。机制上,M2型巨噬细胞来源的大型细胞外囊泡(EVs)将线粒体转移至脂肪细胞,并通过激活TGF-β和PAI-1信号通路促进AMT。阻断PAI-1信号通路可显著减弱脂肪细胞向肌成纤维细胞的转分化。我们得出结论,巨噬细胞来源的大型EVs通过转移线粒体促进硬膜外纤维化中的AMT。
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