Targeted apoptosis of myofibroblasts with the BH3 mimetic ABT-263 reverses established fibrosis
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with ABT-263 (navitoclax) effectively treats established fibrosis in a mouse model of scleroderma dermal fibrosis by inducing myofibroblast apoptosis. Using a BH3 profiling assay to assess mitochondrial priming in dermal fibroblasts derived from patients with scleroderma, we demonstrate that the extent of apoptosis induced by BH3 mimetic drugs correlates with the extent of their mitochondrial priming, indicating that BH3 profiling could predict apoptotic responses of fibroblasts to BH3 mimetic drugs in patients with scleroderma. Together, our findings elucidate the potential efficacy of targeting myofibroblast antiapoptotic proteins with BH3 mimetic drugs in scleroderma and other fibrotic diseases.
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Increased extracellular matrix stiffness is an important survival signal for myofibroblasts; via mechanosensing it activates Rho and ROCK, increasing BCL2-XL expression.
“This increased stiffness is an important survival signal for myofibroblasts; via mechanosensing such stiffness results in intracellular activation of Rho and Rho-associated kinase (ROCK) whose activity increases BCL2-XL expression (36).”
From Unraveling SSc Pathophysiology; The Myofibroblast (2018) · cites this paper as [36]
Pharmacological inhibition of BCL2-XL can induce targeted BIM-mediated apoptosis in myofibroblasts and revert established murine fibrosis.
“Recently, it has been shown that pharmacological inhibition of BCL2-XL can mimic this process and induce targeted BIM-mediated apoptosis in myofibroblasts and even revert established (murine) fibrosis (36).”
From Unraveling SSc Pathophysiology; The Myofibroblast (2018) · cites this paper as [36]
Stiffness-induced BCL2-XL expression is needed to counteract pro-apoptotic BIM, which accumulates in myofibroblasts exposed to a stiff matrix and primes them for apoptosis.
“Importantly, this increased, stiffness-induced, BCL2-XL expression is needed to counteract the function of the pro-apoptotic protein BIM (36). BIM is an activator of BAX and accumulates in myofibroblasts exposed to a stiff matrix. This accumulation primes the cells to undergo apoptosis (36), and only the continued presence of BCL2-XL prevents this.”
From Unraveling SSc Pathophysiology; The Myofibroblast (2018) · cites this paper as [36]
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- Authors
- Lagares, D., Santos, A., Grasberger, P. E., Liu, F., Probst, C. K., Rahimi, R. A., Sakai, N., Kuehl, T., Ryan, J., Bhola, P., Montero, J., Kapoor, M., Baron, M., Varelas, X., Tschumperlin, D. J., Letai, A., & Tager, A. M.
- Affiliations
- Harvard University (US)
- Fibrosis Research Center and Center for Immunology and Inflammatory Diseases, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
- University Health Network (CA)
- Jewish General Hospital (CA)
- Boston University (US)
- Mayo Clinic (US)
- Corresponding author
- Lagares, David
- Santos, Alba
- Grasberger, Paula E.
- Tager, Andrew M.
- ORCID
- Venue
- Science Translational Medicine
- Published
- 2017-12-13
- Volume
- 9
- Issue
- 420
- ISSN
- 1946-6234 (ISSN-L)
- 1946-6242
- PMC
- PMC8520471
- OpenAlex
- W2774171294
- Cited by
- 246
- References
- 63
- Citations by year
- 2026: 31 · 2025: 25 · 2024: 30 · 2023: 36 · 2022: 21 · 2021: 34 · 2020: 28 · 2019: 23 · 2018: 17 · 2017: 1
- FWCI
- 14.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Science Translational Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (2r01hl092961-13)
- National Heart, Lung, and Blood Institute (R01-HL-092961, R01HL108975, K08HL140173)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cell death mechanisms and regulation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Mitochondrial Function and Pathology
- Keywords
- navitoclax, BH3 mimetics, myofibroblast apoptosis, systemic sclerosis, skin fibrosis, fibrosis reversal, mitochondrial priming, BH3 profiling, anti-apoptotic proteins, drug response prediction
- MeSH terms
- Aniline Compounds, Animals, Biomechanical Phenomena, Cell Survival, Disease Models, Animal, Extracellular Matrix, Fibrosis, Humans, Male, Mice, Inbred C57BL, Mitochondria, Scleroderma, Systemic, Sulfonamides, Signal Transduction, Apoptosis, Dermis, Mechanotransduction, Cellular, bcl-X Protein, Mitochondrial Membranes, Myofibroblasts
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