Targeting of dermal myofibroblasts through death receptor 5 arrests fibrosis in mouse models of scleroderma

Scleroderma is an autoimmune rheumatic disorder accompanied by severe fibrosis in skin and other internal organs. During scleroderma progression, resident fibroblasts undergo activation and convert to α-smooth muscle actin (α-SMA) expressing myofibroblasts (MFBs) with increased capacity to synthesize collagens and fibrogenic components. Accordingly, MFBs are a major therapeutic target for fibrosis in scleroderma and treatment with blocking MFBs could produce anti-fibrotic effects. TLY012 is an engineered human TNF-related apoptosis-inducing ligand (TRAIL) which induces selective apoptosis in transformed cells expressing its cognate death receptors (DRs). Here we report that TLY012 selectively blocks activation of dermal fibroblasts and induces DR-mediated apoptosis in α-SMA+ MFBs through upregulated DR5 during its activation. In vivo, TLY012 reverses established skin fibrosis to near-normal skin architecture in mouse models of scleroderma. Thus, the TRAIL pathway plays a critical role in tissue remodeling and targeting upregulated DR5 in α-SMA+ MFBs is a viable therapy for fibrosis in scleroderma.


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Policy information about studies involving animals; ARRIVE guidelines recommended for reporting animal research Laboratory animals (1) bleomycin-induced skin fibrosis. 6-weeks-old female DBA2/J mice were obtained from the Jackson Laboratories (ME, USA). Mice received subcutaneous injections of 100ul bleomycin (0.5 mg/ml) dissolved in 0.9% NaCl in a single location of the upper back every other day for 3 or 6 weeks. TLY012 (1 or 5 mg/kg) or MD5-1 (100ug/mouse) were intraperitoneally administered after 3 weeks bleomycin injection for weeks.
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