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      Progressive Renal Disease: Fibroblasts, Extracellular Matrix, and Integrins


      Cardiorenal Medicine

      S. Karger AG

      Fibrosis, Interstitital fibroblasts, Extracellular matrix, Integrins

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          Progressive renal disease is characterized by expansion of the tubulo-interstitium and accumulation of extracellular matrix within this tissue compartment. Interstitial fibroblasts are the primary producers of the interstitial matrix, and in the evolution of tubulo-interstitial fibrosis these cells undergo changes, namely increased proliferation, differentiation to myofibroblasts, and altered extracellular matrix metabolism, all of which, in other cell types, have been shown to be regulated by the major family of extracellular matrix receptors, the integrins. In the normal kidney, interstitial fibroblasts express α<sub>1</sub>, α<sub>4</sub>, α<sub>5</sub>, and β<sub>1</sub> integrins, and fibrosis is associated with increased expression of α<sub>1</sub>, α<sub>2</sub>, α<sub>5</sub>, α<sub>v</sub>, and β<sub>1</sub> integrins. In particular, α<sub>5</sub>, β<sub>1</sub>, and α<sub>v</sub> are suggested to be linked with the fibrotic process. In vitro, renal fibroblasts express a similar range of integrins, and ligation of selected receptors is associated with specific functions. Ligation of α<sub>6</sub> stimulates proliferation, while α<sub>5</sub> promotes expression of myofibroblastic phenotype, and β<sub>1</sub> integrin has been implicated in cell contraction. Recent studies suggest that renal fibroblasts also express the non-integrin matrix receptors, discoidin domain receptors, and that changes in activation of these receptors may be associated with fibrogenic events. Thus the current, albeit limited, data suggest an important role for receptors for extracellular matrix molecules in the pathogenesis of progressive renal fibrosis.

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          Most cited references 19

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          Integrins: Versatility, modulation, and signaling in cell adhesion

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            Integrin αvβ3 antagonists promote tumor regression by inducing apoptosis of angiogenic blood vessels

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              The Fibronectin Domain ED-A Is Crucial for Myofibroblastic Phenotype Induction by Transforming Growth Factor-β1

              Transforming growth factor-β1 (TGFβ1), a major promoter of myofibroblast differentiation, induces α-smooth muscle (sn) actin, modulates the expression of adhesive receptors, and enhances the synthesis of extracellular matrix (ECM) molecules including ED-A fibronectin (FN), an isoform de novo expressed during wound healing and fibrotic changes. We report here that ED-A FN deposition precedes α-SM actin expression by fibroblasts during granulation tissue evolution in vivo and after TGFβ1 stimulation in vitro. Moreover, there is a correlation between in vitro expression of α-SM actin and ED-A FN in different fibroblastic populations. Seeding fibroblasts on ED-A FN does not elicit per se α-SM actin expression; however, incubation of fibroblasts with the anti-ED-A monoclonal antibody IST-9 specifically blocks the TGFβ1-triggered enhancement of α-SM actin and collagen type I, but not that of plasminogen activator inhibitor-1 mRNA. Interestingly, the same inhibiting action is exerted by the soluble recombinant domain ED-A, but neither of these inhibitory agents alter FN matrix assembly. Our findings indicate that ED-A–containing polymerized FN is necessary for the induction of the myofibroblastic phenotype by TGFβ1 and identify a hitherto unknown mechanism of cytokine-determined gene stimulation based on the generation of an ECM-derived permissive outside in signaling, under the control of the cytokine itself.

                Author and article information

                Nephron Exp Nephrol
                Cardiorenal Medicine
                S. Karger AG
                April 1999
                23 April 1999
                : 7
                : 2
                : 167-177
                Department of Medicine, Royal Free and University College Medical School, London, UK
                20597 Exp Nephrol 1999;7:167–177
                © 1999 S. Karger AG, Basel

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                Page count
                Figures: 1, Tables: 1, References: 94, Pages: 11
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