Reversion of in vivo fibrogenesis by novel chromone scaffolds

Abstract

Background: Myofibroblasts are known to play a key role in the development of idiopathic pulmonary fibrosis (IPF). Two drugs, pirfenidone and nintedanib, are the only approved therapeutic options for IPF, but their applications are limited due to their side effects. Thus, curative IPF drugs represent a huge unmet medical need. Methods: A mouse hepatic stellate cell (HSC) line was established that could robustly differentiate into myofibroblasts upon treatment with TGF-beta. Eupatilin was assessed in diseased human lung fibroblasts from IPF patients (DHLFs) as well as in human lung epithelial cells (HLECs). The drug's performance was extensively tested in a bleomycin-induced lung fibrosis model (BLM). Global gene expression studies and proteome analysis were performed. Findings: Eupatilin attenuated disease severity of BLM in both preventative and therapeutic studies. The drug inhibited the in vitro transdifferantiation of DHLFs to myofibroblasts upon stimulation with TGF-beta. No such induction of the in vitro transdifferantiation was observed in TGF-beta treated HLECs. Specific carbons of eupatilin were essential for its anti-fibrotic activity. Eupatilinwas capable of dismantling latent TGF-beta complex, specifically by eliminating expression of the latent TGF-beta binding protein 1 (LTBP1), in ECM upon actin depolymerization. Unlike eupatilin, pirfenidone was unable to block fibrosis of DHLFs or HSCs stimulated with TGF-beta. Eupatilin attenuated phosphorylation of Smad3 by TGF-beta. Eupatilin induced myofibroblasts to dedifferentiate into intermediate HCS-like cells. Interpretation: Eupatilin may act directly on pathogenic myofibroblasts, disarming them, whereas the antifibrotic effect of pirfenidone may be indirect. Eupatilin could increase the efficacy of IPF treatment to curative levels. (c) 2018 The Authors. Published by Elsevier B.V.