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2017 ; 7
(1
): 16192
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PDGFR Signaling Mediates Hyperproliferation and Fibrotic Responses of Subsynovial
Connective Tissue Cells in Idiopathic Carpal Tunnel Syndrome
#MMPMID29170419
Saito Y
; Chikenji T
; Ozasa Y
; Fujimiya M
; Yamashita T
; Gingery A
; Iba K
Sci Rep
2017[Nov]; 7
(1
): 16192
PMID29170419
show ga
Fibrosis of the subsynovial connective tissue (SSCT) is a pathognomonic change in
carpal tunnel syndrome (CTS). Identification of molecular targets and
anti-fibrotic therapies could provide new treatment strategies for CTS. The
contribution of SSCT cells to fibrosis and the signaling pathways that initiate
and aggravate fibrosis in CTS remain unknown. Here we report that
platelet-derived growth factor receptor alpha (PDGFR?) positive (?+?) cells
accumulate in CTS SSCT and that the presence of fibrotic growth factor, PDGF-AA,
results in increased proliferation of PDGFR?+ cells via PI3K/Akt signaling
pathway. Although PI3K inhibition decreased proliferation, there was no change in
fibrosis-related gene expression. Indeed, protein levels of fibrosis signaling
mediator TGF-? remained the same and the second messenger, Smad2/3, accumulated
in the nucleus. In contrast AMP-activated protein kinase (AMPK) activation, which
can be induced with metformin and AICAR inhibited proliferation, TGF-?
expression, and altered cell morphology in SSCT cells. Further we show that AMPK
activation by metformin reduced collagen III levels and the ratio of Collagen I
to Collagen III. Both AICAR and metformin reduced F-actin and significantly
reduced the fiber cross alignment. Our results suggest that PDGFRa signaling may
be an important fibrosis target and that activators of AMPK, may be an important
therapeutic approach for treating CTS.