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Title: Computational modeling predicts simultaneous targeting of fibroblasts and epithelial cells is necessary for treatment of pulmonary fibrosis

Journal Article · · Frontiers in Pharmacology
 [1];  [2];  [2];  [3];  [4];  [1]
  1. Univ. of Michigan Medical School, Ann Arbor, MI (United States). Dept. of Microbiology and Immunology
  2. Univ. of Michigan Medical School, Ann Arbor, MI (United States). Dept. of Internal Medicine
  3. Univ. of Michigan, Ann Arbor, MI (United States). Dept. of Chemical Engineering
  4. Univ. of Michigan Medical School, Ann Arbor, MI (United States). Dept. of Microbiology and Immunology, Dept. of Internal Medicine

Pulmonary fibrosis is pathologic remodeling of lung tissue that can result in difficulty breathing, reduced quality of life, and a poor prognosis for patients. Fibrosis occurs as a result of insult to lung tissue, though mechanisms of this response are not well-characterized. The disease is driven in part by dysregulation of fibroblast proliferation and differentiation into myofibroblast cells, as well as pro-fibrotic mediator-driven epithelial cell apoptosis. The most well-characterized pro-fibrotic mediator associated with pulmonary fibrosis is TGF-β1. Excessive synthesis of, and sensitivity to, pro-fibrotic mediators as well as insufficient production of and sensitivity to anti-fibrotic mediators has been credited with enabling fibroblast accumulation. Available treatments neither halt nor reverse lung damage. In this study we have two aims: to identify molecular and cellular scale mechanisms driving fibroblast proliferation and differentiation as well as epithelial cell survival in the context of fibrosis, and to predict therapeutic targets and strategies. We combine in vitro studies with a multi-scale hybrid agent-based computational model that describes fibroblasts and epithelial cells in co-culture. Within this model TGF-β1 represents a pro-fibrotic mediator and we include detailed dynamics of TGFβ1 receptor ligand signaling in fibroblasts. PGE2 represents an anti-fibrotic mediator. Using uncertainty and sensitivity analysis we identify TGF-β1 synthesis, TGF-β1 activation, and PGE2 synthesis among the key mechanisms contributing to fibrotic outcomes. We further demonstrate that intervention strategies combining potential therapeutics targeting both fibroblast regulation and epithelial cell survival can promote healthy tissue repair better than individual strategies. Combinations of existing drugs and compounds may provide significant improvements to the current standard of care for pulmonary fibrosis. In conclusion, a two-hit therapeutic intervention strategy may prove necessary to halt and reverse disease dynamics.

Research Organization:
Univ. of Michigan Medical School, Ann Arbor, MI (United States)
Sponsoring Organization:
USDOE Office of Science (SC), National Energy Research Scientific Computing Center
Grant/Contract Number:
AC02-05CH11231
OSTI ID:
1285867
Journal Information:
Frontiers in Pharmacology, Vol. 7; ISSN 1663-9812
Publisher:
Frontiers Research FoundationCopyright Statement
Country of Publication:
United States
Language:
English
Citation Metrics:
Cited by: 23 works
Citation information provided by
Web of Science

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Ginsenoside Rg1 Ameliorates Cigarette Smoke-Induced Airway Fibrosis by Suppressing the TGF-β1/Smad Pathway In Vivo and In Vitro journal January 2017
In Vitro Granuloma Models of Tuberculosis: Potential and Challenges journal March 2019
Differential effects of Nintedanib and Pirfenidone on lung alveolar epithelial cell function in ex vivo murine and human lung tissue cultures of pulmonary fibrosis journal September 2018
Agent‐based models of inflammation in translational systems biology: A decade later journal June 2019
Multiscale Coupling of an Agent-Based Model of Tissue Fibrosis and a Logic-Based Model of Intracellular Signaling journal December 2019
Dynamic balance of pro- and anti-inflammatory signals controls disease and limits pathology journal August 2018
A review of inflammatory mechanism in airway diseases journal October 2018