Fibroblast stimulation in schistosomiasis. II. Functional and biochemical characteristics of egg granuloma-derived fibroblast-stimulating factor

The pathogenetic mechanisms that underlie hepatic fibrosis in schistosomiasis are unknown, but may be under the regulation of molecules secreted by the hepatic granulomas that encase the helminth eggs. Previous studies in mice demonstrated that isolated Schistosoma mansoni egg granulomas can elaborate in vitro substances that stimulate fibroblast proliferation and collagen synthesis. The present study provides the initial characterization of the granuloma-derived factor(s). Serum-free cell culture supernatants from isolated granulomas contained activity that stimulated the uptake of (3H)-thymidine by quiescent human dermal fibroblasts. This activity was present in fractions (Sephadex G-200 chromatography) with estimated m.w. of 30,000 to 40,000. Activity eluted with linear salt gradients from ion exchange columns (DEAE Sephadex) with 0.4 to 0.7 and 1.5 to 1.8 M NaCl (pH 8.4). Activity was present in fractions with approximate pI of 6 to 6.5 and 4, prepared by flat-bed isoelectrofocusing of crude supernatant in granular gel. Activity that stimulated thymocyte proliferation in an interleukin 1 (IL 1) assay was present in crude granuloma supernatants as well as in the partially purified fractions that contained fibroblast-stimulating activity. We conclude that the granuloma-derived fibroblast-stimulating factor has biologic activity similar to IL 1 but on the basis of m.w. and pI determination is distinct from IL 1.     

Fibroblast stimulation in schistosomiasis. IV. Isolated egg granulomas elaborate a fibroblast chemoattractant in vitro

Hepatic fibrosis complicates the chronic granulomatous inflammatory reaction to Schistosoma mansoni eggs, and is the major cause of morbidity and mortality in human schistosomiasis. We previously presented evidence that schistosomal egg granulomas secreted factors that can stimulate fibroblast proliferation and collagen synthesis in vitro. We now report that serum-free supernatants from cultures of hepatic egg granulomas isolated from S. mansoni-infected mice contained activity that stimulated the directional migration of human and guinea pig dermal fibroblasts in modified Boyden chambers. This fibroblast chemotactic activity was also detected in culture supernatants of granuloma adherent cells highly enriched for macrophages (95% latex-ingesting) but not in culture supernatants from resident peritoneal macrophages of uninfected or infected mice. This suggests that granuloma macrophages are a source of the chemotactic activity. The chemoattractant had the properties of large molecular weight (greater than 200,000 daltons; Sephadex G-200 gel filtration), pl approximately 4.5 (preparative flatbed isoelectrofocusing in granular matrix), heat stability (56 degrees C; 45 min), and trypsin sensitivity. Since preincubation of the partially purified granuloma and adherent-cell derived chemoattractants with rabbit anti-human fibronectin antibody abolished their chemotactic activity, it appears that the factor is antigenically similar to fibronectin. We propose that egg granuloma macrophages are activated in vivo to secrete a fibronectin-like molecule with activity that stimulates the directional migration of fibroblasts. This factor may therefore play a role in the local recruitment of fibroblasts and, in concert with other granuloma-derived factors, may play an important role in the pathogenesis of hepatic fibrosis in schistosomiasis.     

Fibroblast stimulation in schistosomiasis. V. Egg granuloma macrophages spontaneously secrete a fibroblast-stimulating factor

Isolated intact egg granulomas from the liver of Schistosoma mansoni-infected mice have been previously shown to elaborate factors in vitro that can stimulate fibroblasts for biological functions that are of potential importance in the pathogenesis of hepatic fibrosis in schistosomiasis. We report here that cell cultures obtained from monodispersed granuloma cell suspensions, and specifically enriched for macrophages (95% to 100%) spontaneously elaborated fibroblast proliferation-stimulating activity in vitro. These cells possessed functional and phenotyptic characteristics of activated macrophages. In contrast, control peritoneal macrophages from uninfected mice lacked such phenotypic characteristics, and did not spontaneously elaborate fibrogenic activity in vitro. The granuloma macrophage activity was present, pre-formed within the isolated cells, and was continuously elaborated during 72 hr of incubation. By gel infiltration chromatography (Sephacryl S-200 sf), fibroblast-stimulating activity was identified in two pooled fractions, one with estimated molecular radius (Mr) of 46 kd to 57 kd and the other with Mr of 10 kd to 16 kd. Preparative isoelectric focusing in granular gel of crude macrophage culture supernatants identified peak activity in fractions with pI approximately 5. Two different serine esterase inhibitors had no effect on the ability of crude granuloma macrophage supernatants to stimulate fibroblast proliferation. Whereas crude and chromatographed fractions of granuloma macrophage supernatant were active for fibroblasts, they had minimal or no interleukin 1 (IL 1) activity when tested in a thymocyte proliferation assay. In contrast, resident peritoneal macrophages from the same infected mice spontaneously secreted substantial IL 1 and fibroblast-stimulating activity in vitro. We conclude that egg granuloma macrophages are activated in vivo to secrete fibrogenic molecules functionally distinct from IL 1, which might contribute to the pathogenesis of hepatic fibrosis in schistosomiasis.     

Fibroblast stimulation in schistosomiasis. IX. Schistosomal egg granulomas from congenitally athymic mice are deficient in production of fibrogenic factors

Schistosomal egg granulomas spontaneously secrete fibrogenic factors, suggesting that there exists a molecular link between granulomatous inflammation and hepatic fibrosis in schistosomiasis. To further assess this possibility, we compared elaboration of fibrogenic factors by egg granulomas isolated from Schistosoma mansoni-infected euthymic mice that develop substantial liver fibrosis, with those elaborated by similarly infected congenitally athymic mice that develop minimal fibrosis. Conditioned medium from cultures of granulomas from euthymic mice stimulated fibroblast proliferation, chemotaxis, and synthesis of collagen, collagenase, tissue inhibitor of metalloproteinases, and hyaluronate, whereas those prepared from cultures of granulomas isolated from athymic mice were relatively or absolutely deficient in such activities. These observations provide a correlation between the presence of fibrosis in vivo and the production of fibrogenic factors and reinforce our hypothesis that granuloma-derived fibrogenic factors play a role in the pathogenesis of liver fibrosis in schistosomiasis. Furthermore, the results of this study suggest a central role of T lymphocytes in the fibrogenic process.     

Dynamics of fibrosis production and resorption in intestinal schistosomiasis of mice.

A histological, morphometric and immunocytochemical study of schistosomal periovular granulomas in the liver and intestines of mice revealed that intestinal granulomas are smaller and contain less collagen than those in the liver. After curative treatment intestinal granulomas undergo a relatively more rapid resorption, although the general pattern of collagen degradation apparently does not differ from that observed in the liver. Tendency to form scattered, usually isolated granulomas that are only mildly fibrogenic, coupled with a well-balanced process of resorption appear as the explanation why intestinal fibrosis is not an outstanding feature of schistosomiasis as it is in the liver.     

Changes in collagen and albumin mRNA in liver tissue of mice infected with Schistosoma mansoni as determined by in situ hybridization

We have employed in situ hybridization to evaluate the molecular mechanisms responsible for hypoalbuminemia and increased liver collagen content in murine schistosomiasis. Results were compared using a simplified method of hybridizing isolated hepatocytes from Schistosoma mansoni-infected and normal mouse liver with mouse albumin (pmalb-2) and chick pro-alpha 2(l) collagen (pCg45) probes. Whereas hepatocytes from infected mice showed significantly less albumin mRNA than hepatocytes from control, there were more grains of procollagen mRNA in hepatocytes from infected as compared with control liver. Hybridization of infected liver tissue sections with the collagen probe showed more grains per field in granulomas than in liver regions, whereas with the albumin probe there was more hybridization in liver tissue than in granulomas. These results suggest that in murine schistosomiasis a reduction in albumin mRNA sequence content may be associated with decreased albumin synthesis and ultimately leads to hypoalbuminemia. In addition, although the granuloma seems to be the primary source of type I collagen synthesis, hepatocytes are also capable of synthesizing collagen, especially under fibrogenic stimulation.     

The four biochemically distinct species of human interleukin 1 all exhibit similar biologic activities

The supernatants of human monocytes incubated with endotoxin are able to stimulate the proliferation of murine thymocytes in the presence of PHA. This is known as LAF (lymphocyte activating factor) activity and is a characteristic activity of interleukin 1 (IL 1). The LAF activity can be resolved into four major fractions: a 15,000 dalton (pI 7), a 15,000 (pI 5.5), a 35,000 (pI 7), and a 35,000 (pI 5.5) fraction. To determine whether these four fractions shared the other biologic activities ascribed to IL 1, they were compared in a series of bioassays. When standardized with respect to their LAF activities, the four fractions did not differ significantly as mitogens for murine thymocytes, inducers of IL 2, murine or human B cell activators, human chondrocyte or synoviocyte stimulants, or inducers of acute phase proteins in vivo. On the other hand, the samples differed markedly as stimulators of porcine synoviocytes, with the 15,000 dalton (pI 5.5) fraction being the only strongly active fraction. These results are consistent with the hypothesis that all four LAF could be products of a single gene, although the porcine receptor may be able to distinguish between them. If this is the case, all four fractions can properly be termed IL 1.     

Radioimmunoassay of soluble and insoluble collagenases in fibrotic liver.

We have postulated that an insufficient active of collagenase relative to increased collagen synthesis may be the cause of the increased collagen accumulation in fibrotic tissues. In the present study, 125I-collagenase and rabbit anti-collagenase immunoglobulin G were used to develop a sensitive radioimmunoassay that detects 0.1 nM (3 ng) of collagenase protein in tissue samples. The assay also can detect collagenase protein that is associated with extracellular-matrix collagen fibrils. Good correlation with an assay of enzyme activity validates the radioimmunoassay for quantification of collagenase. The assay was used to measure amounts of collagenase in relation to fibrotic processes in livers of mice with schistosomiasis. Results indicate that the amounts of collagenase relative to synthesized collagens were significantly lower, and this may contribute to the progressive fibrosis. The occurrence of a maximum amount of collagenase at 7 weeks after infection with Schistosoma mansoni cercariae in concanavalin A-treated animals, as compared with 8 weeks in controls, could account for the large remission of fibrosis in mice so treated. The results emphasize the possible importance of collagenase in controlling or limiting fibrosis.     

Liver collagen glucosyltransferase in experimental primary liver carcinoma.

Collagen glucosyltransferase activity (EC 2.4.1.66) was quantified in experimentally-induced liver carcinoma, murine schistosomiasis mansoni-induced liver fibrosis and compared to the level of enzyme activity in control liver samples. Enzyme activity in hepatoma and fibrotic tissues were 12 and 5 times the mean level of enzyme activity in the control liver tissue respectively. The level of enzyme activity in the hepatoma tissue was two times the level of enzyme activity found in the fibrotic tissue. The findings in this study provide the basis for the highly elevated serum values of this intracellular enzyme in experimentally-induced primary hepatocellular carcinoma or in human primary hepatoma. The enzyme activity may be increased in primary liver carcinoma to compensate for an increased rate of collagen synthesis.     

Why does liver fibrosis occur in schistosomiasis?

Schistosomiasis is one of the most prevalent of several chronic inflammatory diseases in which morbidity results primarily from tissue scarring. New concepts regarding the molecular pathogenesis of scar formation are being applied in research efforts to define the basis of liver fibrosis in schistosomiasis. Such investigations have led to the identification of an apparently novel lymphokine, fibroblast stimulating factor-I (FsF-I), produced in the egg granulomas. FsF-1 and other granulomo-derived fibrogenic cytokines may represent the molecular links between periovular granulomotous inflammation and hepatic fibrosis. Here, David Wyler postulates that the unmodified production of these f brogenic signals may be responsible for the development of severe hepatic fibrosis in the subpopulotion of infected individuals who develop this complication.     

Inhibitory effects of glucocorticoids on collagen synthesis by mouse sponge granulomas and granuloma fibroblasts in culture.

The basis for the glucocorticoid-mediated decrease in tissue collagen was studied in mouse granulomas and in primary granuloma fibroblast cultures. Injection of mice for 12 days with dexamethasone (0.35 mg/kg body weight) resulted in a 50--70% inhibition of collagen synthesis and accumulation in polyvinyl sponge-induced granulomas whereas total protein synthesis was inhibited by only about 25%. The decreased collagen content of the granuloma was accounted for by both a reduced fibroblast number and diminished synthesis per cell. Growth rates, total protein synthesis and collagen synthesis were the same in granuloma fibroblast cultures derived from control or steroid-treated mice. However, addition of 3.10(-7) M hydrocortisone to the culture medium caused a 30--50% inhibition of both collagen and non-collagen protein synthesis in firbroblasts from either source. These inhibitory effects were dose- and time-dependent with a lag time of 12--24 h. Prolyl hydroxylase activity was reduced both in sponge granulomas from glucocorticoid-treated mice and in hydrocortisone-treated fibroblast cultures. However, protein synthesis was inhibited to the same extent as the inhibition of prolyl hydroxylase activity and there was no effect on peptidyl prolyl hydroxylation. These results indicate that the glucocorticoid-induced reduction of collagen synthesis and accumulation observed in mouse granulomas and primary granuloma fibroblast cultures is not specific for this protein. Furthermore, glucocorticoid-induced inhibition of collagen synthesis cannot be attributed to underhydroxylation of collagen prolyl residues.     

Host nutritional status as a contributory factor to the remodeling of schistosomal hepatic fibrosis

Weaning Swiss mice were percutaneously infected with 30 cercariae of Schistosoma mansoni and submitted to a shifting either from a deficient to a balanced diet or vice-versa, for 24 weeks. The nutritional status was weekly evaluated by measurements of growth curves and food intake. Hepatic fibrosis and periovular granulomas were studied by histological, morphometric and biochemical methods. All mice fed on a deficient diet failed to develop periportal "pipestem" fibrosis after chronic infection. An unexpected finding was the absence of pipestem fibrosis in mice on normal diet, probably related to the sample size. The lower values for nutritional parameters were mainly due to the deficient diet, rather than to infection. Liver/body weight ratio was higher in "early undernutrition" group, after shifting to the balanced diet. Volume density and numerical density of egg granulomas reached lowest values in undernourished animals. The amount of collagen was reduced in undernourished mice, attaining higher concentrations in well-fed controls and in "late undernutrition" (balanced diet shifted to a deficient one), where collagen deposition appeared increased in granulomas. That finding suggested interference with collagen degradation and resorption in "late" undernourished animals. Thus, host nutritional status plays a role in connective tissue changes of hepatic schistosomiasis in mice.     

Hyperplasia of elastic tissue in hepatic schistosomal fibrosis.

Elastic tissue hyperplasia, revealed by means of histological, immunocytochemical and ultra-structural methods, appeared as a prominent change in surgical liver biopsies taken from 61 patients with schistosomal periportal and septal fibrosis. Such hyperplasia was absent in experimental murine schistosomiasis, including mice with "pipe-stem" fibrosis. Displaced connective tissue cells in periportal areas, such as smooth muscle cells, more frequently observed in human material, could be the site of excessive elastin synthesis, and could explain the differences observed in human and experimental materials. Elastic tissue, sometimes represented by its microfibrillar components, also appeared to be more condensed in areas of matrix (collagen) degradation, suggesting a participation of this tissue in the remodelling of the extracellular matrix. By its rectratile properties elastic tissue hyperplasia in hepatic schistosomiasis can cause vascular narrowing and thus play a role in the pathogenesis of portal hypertension.     

Liver connective tissue cells isolated from human schistosomal fibrosis or alcoholic cirrhosis represent a modified phenotype of smooth muscle cells

Hepatic connective tissue cells associated with schistosomal fibrosis and alcoholic cirrhosis were studied in vitro. Primary cell lines were isolated from all biopsies: they were identified as specific homogeneous cell populations, named liver connective tissue cells (LCTC). They were recognized as analogous to smooth muscle cells, different from true fibroblasts by morphological and physiological criteria. The proliferative capacity of LCTC is directly proportional to the degree of fibrosis in hepatic tissues. LCTC are able to secrete type I, III and IV collagen, fibronectin, laminin and amyloid P component. Their relationship with specific pathology of intrahepatic vascular tree in schistosomiasis is hypothesized.     

矽肺成纤维细胞增生因子的纯化及分析

过去的研究资料充分证明,巨噬细胞和由巨噬细胞释放的可溶性因子在矽肺纤维化过程中起着重要的调节作用。然而,对这种调节矽肺纤维化过程的蛋白因子的理化特性迄今还知道得很少。本研究采用矽肺大鼠肺泡巨噬细胞体外培养的方法获得其培养上清液,实验证明,该上清液可以促进体外培养的成纤维细胞对~3H-TdR和~3H-脯氨酸的摄取。我们从巨噬细胞上清液中分离纯化出一种具有促进成纤维细胞增殖能力的蛋白质因子。该因子在聚丙烯酰胺凝胶电泳上显示单个带谱,在SDS-聚丙烯酰胺凝胶电泳上测得分子量为66kD,在pH3-11的等电聚焦电泳上测得该因子的等电点为4.72。我们认为这种具有成纤维细胞增生因子活性的蛋白质可能就是在矽肺纤维化过程中刺激成纤维细胞增殖和胶原合成的调节因子。     

Production of a fibroblast-stimulating factor by Schistosoma mansoni antigen-reactive T cell clones

Fibrosis in schistosomiasis is the terminal event of a complex pathophysiologic cascade involving interactions between fibroblasts and both host and parasite products. In the present study, the effect of lymphokines produced by cloned Schistosoma mansoni antigen-reactive T cells on the proliferation of murine fibroblasts was investigated. These T cells previously have been shown to proliferate, produce lymphokines, mediate delayed-type hypersensitivity responses, and generate in vitro granulomas in response to soluble egg antigen (SEA). T cells, co-cultured with irradiated antigen-presenting cells and pulsed with SEA, produced levels of fibroblast-stimulating factor (FSF) comparable to equivalent numbers of dispersed hepatic granuloma cells isolated from infected mice. Supernatants of cloned T cells pulsed with Con A (in the absence of macrophages) contained no detectable interleukin 1 activity, but did stimulate fibroblast activation and growth. T cell FSF activity was trypsin-sensitive, was stable at 56 degrees C but not to boiling, and was retained by Con A Sepharose. Activity was associated with HPLC fractions corresponding to an m.w. of 10,000 to 40,000. Neither recombinant interferon-gamma nor affinity-purified interleukin 2 was capable of stimulating fibroblast proliferation. In functional studies, the degree of fibroblast proliferation was related to the length of exposure to the factor. In addition, quiescent fibroblasts were maximally stimulated by T cell FSF only if a second co-factor such as insulin or epidermal growth factor was present. The synergism between T cell FSF and known progression factors suggests that FSF-T may provide a competence signal to fibroblasts. The present results suggest that a direct molecular link may exist between T cells and fibroblasts in schistosomiasis.     

Global gene expression profiles during acute pathogen-induced pulmonary inflammation reveal divergent roles for Th1 and Th2 responses in tissue repair

T helper 1 responses are typically proinflammatory, while Th2 responses have been considered regulatory. Interestingly, Th2 responses characterize a number of pulmonary diseases, many of which terminate in tissue remodeling and fibrosis. We developed a mouse model using Schistosoma mansoni eggs and cytokine-deficient mice to induce highly polarized Th1- or Th2-type inflammation in the lung. In this study, we examined the pathology and cytokine profiles in Th1- and Th2-polarized environments and used oligonucleotide microarray analysis to decipher the genes responsible for these effects. We further elaborated on the results using IL-10- and IL-13-deficient mice because these cytokines are believed to be the central regulators of Th2-associated pathology. We found that the Th1-polarized mice developed small granulomas with less fibrosis while expressing genes characteristic of tissue damage. Th2-polarized mice, in contrast, formed large granulomas with massive collagen deposition and up-regulated genes associated with wound healing, specifically, arginase, collagens, matrix metalloproteinases (MMPs), and tissue inhibitors of MMP. In addition, several members of the chitinase-like family were up-regulated in the lung following egg challenge. We also developed a method of defining the net collagen deposition using the expression profiles of several collagen, MMP, and tissue inhibitors of MMP genes. We found that Th1-polarized mice did not elaborate collagens or MMPs and therefore did not have a significant capacity for repair in this model. Thus, Th1-mediated inflammation is characterized by tissue damage, while Th2 directs wound healing and fibrosis.