Connective Tissue Response in IBD Dr I C Lawrance MB BS, PhD FRACP School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital
Intestinal response to Chronic Inflammation Control UC CD Trichrome Staining of Collagen
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Deposition Degradation
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Deposition Degradation
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Deposition Degradation
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Deposition Degradation
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Degradation Deposition
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Degradation Deposition
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Degradation Deposition
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Deposition Degradation
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Deposition Degradation
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Deposition Degradation
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Deposition Degradation
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Deposition Degradation
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Deposition Degradation
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Deposition Degradation
Balancing ECM deposition and degradation Collagens Elastin Fibronectin Laminin TIMPs PAI Proteoglycans Plasmin/PA MMPs Collagenases Gelatinases Stromeolysins Deposition Degradation
Immunohistochemisrty Collagen III and I 1.50 1.25 LP Lamina Propria Control 1.00 0.75 0.50 0.25 SM Submucosa ME Muscularis Externa Inflamed UC Ratio Collagen type III:I 0.00 1.50 1.25 1.00 0.75 0.50 0.25 0.00 1.50 LP SM * SM ME A A Adverntia Fibrosed CD 1.25 1.00 0.75 ** 0.50 0.25 Collagen III Collagen I 0.00 LP SM ME A Lawrance et.al. IBD 2001
Isolated IBD Intestinal Fibroblasts-like like cells Phase contrast light microscopy Electron microscopy Rough endoplasmic reticulum (thick arrows) Collagen fibrils (thin arrows). Lawrance et.al. IBD 2001
Intestinal Fibroblasts 200 bfgf 10 ng/ml 150 Scintillation CPM x10 3 /μgdna 100 50 0 75 50 Doubling times in days 3.5 3.0 2.5 2.0 IGF-1 10 ng/ml 1.5 1.0 Control Bowel Fibrosed CD Inflamed CD Inflamed UC 25 0 Unstim Stim Unstim Stim Unstim Stim Control CD UC Lawrance et.al. IBD 2001
Fibroblast TGF-β1 IGF-1 bfgf Myofibroblast Smooth Muscle Cell
Regulators of ECM - TGF-β1 Plasmin - + PAI-1 PA + + + + TGF-β1 + + - + + COL I TIMP-1 - IGF-1 + - MMP-1 MMP-3 MMP-9 PDGF Recruitment Macrophages Leukocytes Recruitment Fibroblasts Myofibroblasts
150 TGF-β1 1 and IGF-1 1 expression in IBD TGF- β1 In situ hybridisation TGF- β1 Immunohistochemistry 125 100 No. Positive cells per HPF 75 50 25 0 150 125 100 75 50 LP SM ME A IGF-1 Insitu hybridisation LP SM ME A IGF-1 Immunohistochemistry Control Inflamed UC Fibrosed CD LP - Lamina Propria SM - Submucosa ME - Muscularis Externa A- Adverntia 25 0 LP SM ME A LP SM ME A Lawrance et.al. IBD 2001
Regulators of ECM - SPARC SPARC (Secreted Protein Acidic and Rich in Cysteine) Transiently secreted in actively inflamed tissue Plasmin - PAI-1 + + PDGF - + + Retinoic acid TGF-β1 SPARC + + + COX-2 - Indomethacin COX-2 2 inhibitors COL I TIMP-1 - PGE2? + Blocks TGF-β1 1 effects Fibroblast MMP-1 MMP-3 MMP-9 Macrophage MMP-1 MMP-3
Microarray analysis of ECM-related genes UC & CD compared to Control UC 24 genes 5 genes CD 15 genes 0 genes 7 genes in common Inflamed UC Fibrosed CD Mucin Trefoil factor 1 Mucin 4 MMP-12 MMP-9 MMP-1 MMP-3 Elafin Cystatin A Fibronectin 1 COL4A2 COL3A1 COL1A2 COL1A1 COL6A3 COL6A2 Proteoglycan 1 Epican Amelogenin Vimentin a2-sma g2-sma PMP22 vwf APM2 TGFbI OSF-2 SPARC Hevin Adducin 2 Zygin 2 Trichohyalin Actin-related Cytokeratin 20 Paralemmin Caldesmon 1 Tropomyosin 4 20 15 10 5 0 Lawrance et.al. Human Mol Genetics 2001 Fold Change c/w Control
SPARC Immunohistochemistry Control Intestine Neural bundles Fibroblast-like like cells Lawrance et.al. Gastro 126 (4): Suppl. 2 2004
SPARC Immunohistochemistry Inflamed UC Inflamed Ischaemic Colitis Neo-endothlial endothlial cells Inflammatory cells
SPARC Immunohistochemistry Fibrosed CD Fibrosed Diverticular Disease Neo-endothlial endothlial cells Fibroblasts-like like cells Inflammatory cells
Methods TNBS murine model of Chronic Inflammation-induced induced intestinal fibrosis 12 week old female CD-1 1 and BALB/c mice sensitised to TNBS. Weekly enemas for 6-88 weeks Colons removed cleaned & weighed Lawrance, Wu et.al. Gastroenterology 2003
Histology H & E Trichrome Water control TNBS & ETOH 2/52 TNBS & ETOH 8/52 Lawrance, Wu et.al. Gastroenterology 2003
Methods TNBS murine model ± Indomethacin or Retinoic Acid 12 week old female CD-1 mice sensitised to TNBS. Retinoic Acid 50ug/day or Indomethacin 0.2mg/kg/day Weekly enemas for 6 weeks Colons removed cleaned & weighed Lawrance et.al. Gastroenterology 126 (4): Suppl. 2 2004
Histology at 2 weeks TNBS alone or with 0.2mg/kg/day indomethacin or 50ug RA/day TNBS TNBS + Indo TNBS + RA Nil Mild Mod Severe Inflammation Nil Mild Mod/Severe Fibrosis
SPARC mrna at 2 weeks Ratio to control mice SPARC/ βactin 8 6 4 2 0 Control p=0.047 TNBS High Fibrosis p=0.0090 p=0.016 TNBS Low Fibrosis p=0.005 p=0.016 p=0.047 RA/TNBS Indo/TNBS
SPARC Immunohistochemistry Trichrome SPARC
SPARC +ve+ Cells per High Power Field 150 p=0.007 p=0.005 Cell count 100 50 p=0.01 0 Water Control n=10 RA Control n=5 Indo Control n=5 TNBS High n=6 TNBS Low n=6 RA n=6 Indo n=10
Regulators of ECM - SPARC Indomethacin SPARC - + + COX-2 - PGE2 PGE2? + Fibroblast MMP-1 MMP-3 MMP-9 Macrophage MMP-1 MMP-3
SPARC-null and WT mice TNBS murine model Weekly enemas for 2 weeks and 6 weeks Indomethacin 0.2mg/kg/day.. SPARC-null 11 week female C57bl6 x 129SV mice SPARC WT ± Indomethacin 11 week female C57bl6 x 129SV mice Lawrance et.al. Gastroenterology 128 (4): Suppl. 2 Apr 2005
SPARC-null and WT mice at 2 weeks SPARC +/+ mice TNBS ± with 0.2mg/kg/day indomethacin SPARC -/- mice TNBS alone Wild type TNBS alone Wild type TNBS + Indo SPARC -/- TNBS alone Nil Mild Mod Severe Inflammation Nil Mild Mod/Severe Fibrosis
IGF-1 SPARC TGF-β1 Myofibroblast Epithelial cells SPARC IGF-1 Fibroblast TGF-β1 SPARC Smooth Muscle Cells Macrophage Collagen III IGF-1 Collagen I TGF-β1 Extracellular Matrix (ECM)