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The pro-inflammatory niche: how the drives ?

Cellular & Molecular Mechanisms M Ruhmann, KS Midwood*

Abstract Introduction body of evidence supporting a major Introduction The extracellular matrix (ECM) is a role for these proteins in driving the The extracellular matrix is a complex organization of ­secreted mol- ­response to tissue ­injury1,2. The aim of ­complex, three-dimensional ­network ecules. The major constitutive compo- this ­review is to discuss how the ECM of ­secreted molecules that ­provides nents of the ECM ­include collagens, drives persistent upon structural support to tissues and elastin, fibronectin, ­hyaluronic acid tissue damage to the joint in rheuma- ­environmental cues to the cells and proteoglycans. Together these toid arthritis (RA). within. One particular subset of molecules form a network that pro- matrix molecules is specifically ex- vides structural support for tissues Discussion pressed upon tissue damage. These and delivers environmental signals The authors have referenced some molecules contribute to effective that regulate cell behaviour. However, of their own studies in this re- tissue repair by orchestrating the there exists a unique subset of ECM view. These referenced studies have behaviour of cells that mediate this molecules that are not constitutively been conducted in accordance with process, and once the repair is com- expressed. Found at high levels dur- the Declaration of Helsinki (1964), plete, the expression of this matrix is ing development, but absent from and the protocols of these studies down-regulated. Here, we focus on most healthy adult tissues, these pro- have been approved by the relevant the recent data that highlights a direct teins are specifically induced at sites ethics committees related to the role for injury-induced matrix mol- of tissue injury. These molecules have institution in which they were per- ecules in driving inflammation upon been termed ‘matricellular proteins’ formed. All human subjects, in these tissue damage and propose that and include the CCN family (CCN1-6), referenced studies, gave informed this matrix creates a specific micro­ galectins (Gal), fibulins, osteopontin consent to participate in these environment or ‘pro-inflammatory (OPN), periostin, secreted protein ­studies. niche’ that is permissive for local- acidic and rich in cysteine (SPARC), ized inflammation during repair. We small leucine rich proteoglycans Control of tissue repair by the ECM also examine the evidence indicating ­(SLPRs), tenascin-C (TNC) and throm- Tissue repair is a dynamic and that this niche exists, and persists, bospondins-1 and -2 (TSP-1/2). De- highly organized process that can be in the damaged joint of ­rheumatoid spite their structural diversity, these ­divided into three distinct but over- ­arthritis patients. Finally, we as- molecules possess a number of defin- lapping phases: inflammation, new sess the data which demonstrate ing common features in addition to tissue formation and tissue remodel- that these matrix molecules ac- their distinct pattern of expression. ling. During wound healing, a tempo- tively contribute to maintaining They are key orchestrators of cell rary matrix is deposited that acts as chronic inflammation during disease behaviour; this is mediated by their a template for repair and is eventu- ­progression. multimodular structure, which con- ally replaced by new structural ECM Conclusion fers the ability to interact with a large components, including collagen and Together these findings imply that number of diverse binding partners fibronectin, to restore the physical in- targeting the pro-inflammatory niche such as cell surface receptors, other tegrity of the tissue and re-establish in the joint may provide a novel ECM molecules, hormones, growth cellular ­homeostasis. Matricellular treatment strategy for ­rheumatoid factors and cytokines. Moreover, they proteins are specifically up-regulated­ arthritis. ­exert control over a wide range of cell at distinct points ­during wound heal- functions in a highly context- and cell ing. Their expression­ is transient; type-specific manner. Finally, although mRNA synthesis is down-regulated highly expressed during develop- and protein cleared from the site be- * Corresponding author ment, mice with targeted disruptions fore the end of tissue repair. Their Email: [email protected] in these genes exhibit grossly normal contribution to effective tissue repair Kennedy Institute of Rheumatology, Nuffield phenotypes until subjected to tissue has been reviewed in an issue dedi- Department of Orthopaedic Rheumatology and 3 Musculoskeletal Sciences, Oxford University, injury, whereupon they exhibit ab- cated to matricellular proteins , and Aspenlea Road, No. 65, London, W6 8LH, UK. normal tissue repair. There is a large Figure 1 summarizes the expression­

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Figure 1: The role of the ECM in tissue repair. The first response to injury includes the formation of a blood clot ­consisting of platelets and a fibrin/fibronectin-rich provisional matrix to prevent blood loss. Soluble cytokine and growth factors released by aggregated platelets promote the infiltration of a range of cell types into the provisional matrix. Neutrophils and macrophages cleanse the wound by removing debris, and re-epithelialization is promoted through the migration and proliferation of keratinocytes. The provisional matrix is replaced by granulation tissue which comprises new blood vessels, macrophages and activated that secrete type III collagen and fibronectin. Some fibroblasts differenti- ate into that contract and bring the edges of the wound together. The final phase of wound healing starts about two weeks after tissue injury and lasts for at least one year. Most macrophages, fibroblasts and endothelial cells undergo apoptosis. Type III collagen is replaced by type I collagen that is reorganized and cross-linked to produce scar tissue with a higher tensile strength. Matricellular proteins are induced at distinct points after tissue injury and mediate effective tissue deposition and remodelling during repair283. Red arrows represent inhibition, and green arrows indicate stimulation, of the delineated event. References are shown in brackets. and function of some of the key also play a role in the ­initial inflam- ­injury. The expression of cytokines, matricelluar proteins during tissue matory response to tissue ­injury4–42. chemokines, proteases and growth injury. Whilst their importance in factors by these cells orchestrates driving adhesion, migration, matrix The ECM supports immune cells subsequent phases of tissue repair deposition, angiogenesis, prolifera- and drives inflammation during including tissue debris clearance and tion and survival in stromal cells such tissue repair pathogen resorption, ­recruitment as fibroblasts, endothelial cells and The inflammatory response ­following and activation of further cells and keratinocytes during tissue forma- tissue damage is ­characterized by in- cell types, and new tissue ­formation tion and remodelling has long been filtration of a range of ­immune cells, and remodelling. It is becoming established, in the last decade it has including neutrophils, ­macrophages ­increasingly apparent that matricel- emerged that matricellular proteins and lymphocytes, to the site of lular proteins have a direct impact

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on inflammation in the early stages induce cytokine, chemokine and half-life, these molecules are large of tissue repair. This is discussed protease expression using distinct ­proteins that accumulate as part of a ­below and summarized in Table 1. mechanisms: activation of toll-like dense matrix specifically assembled A number of matricellular mol- receptor 4 (TLR4) in primary human at the site of injury. This physical ecules have been shown to support macrophages and synovial fibro- presence enables them to provide the adhesion of different types of blasts, and murine ­neutrophils47,48 a scaffold for immune cell adhesion immune cells, others to promote im- and activation of α9 integrins in and migration as well as forming a mune cell migration, whilst some primary murine arthritic synovial reservoir for soluble mediators of enhance immune cell survival and fibroblasts, macrophages and den- inflammation, but these molecules proliferation. Together, these data dritic cells43,44. It achieves this via also directly interact with cells to suggest that matricellular proteins ligation of integrins using its third stimulate inflammatory behaviour. provide an environment that allows fibronectin type III like domain This creation of a ‘pro-inflammatory immune cells to infiltrate and thrive (FNIII)43,44 and activation of TLR4 niche’ by matrix molecules induced at the site of tissue injury. These data via its ­fibrinogen-like globe (FBG)47. upon injury may shed new light on also reveal that matricellular mole- In addition to driving de novo syn- how we perceive the role of the ECM cules have both distinct and overlap- thesis of pro-inflammatory media- during tissue repair. ping functions during inflammation. tors, matricellular proteins can also For example, mice deficient in TNC bind directly to these mediators and A pro-inflammatory niche in the or TSP-1 both exhibit lower numbers modulate their activity. For ­example, RA joint of macrophages in corneal or dermal TNC interacts with a range of growth In addition to their transient expres- wounds, respectively, indicating that factors including FGF, PDGF and sion at sites of tissue repair, matricel- these proteins promote macrophage TGFβ via its FNIII 4–5 repeats49 and lular proteins are expressed at high infiltration or survival during wound TSP-1 activates latent TGFβ50,51. As levels in diseases characterized by healing32,38. In contrast, macrophage such, these proteins may further chronic inflammation and extensive infiltration into skin incisions is not potentiate inflammation by acting tissue destruction. This includes au- impaired in OPN-deficient mice com- as a reservoir for soluble mediators toimmune diseases such as RA. The pared to wild-type mice; however, the ­enabling their presentation in an hallmark of RA is prolonged immune level of tissue debridement is signifi- active form at high local concentra- cell migration into the joint and syno- cantly reduced, indicating that OPN tions to immune cells. vial hyperplasia. Persistent synthesis plays a role in macrophage ­activation The pro-inflammatory activity of pro-inflammatory mediators by during cutaneous wound ­healing25. of matricellular proteins is in part these infiltrating immune cells and Indeed, many matricellular pro- regulated by their tightly controlled resident fibroblasts causes chronic teins have also been shown to di- expression during tissue repair, but synovial inflammation and the pro- rectly interact with immune cells to can also be controlled by fellow duction of an invasive pannus medi- drive a pro-inflammatory phenotype. members of the family. For exam- ates destruction of healthy articular The mechanisms by which these ple, whilst a pro-inflammatory role cartilage and bone. Matricellular pro- functions are mediated are proving has been reported for the majority teins are predominantly absent from complex. For example, both OPN and of these molecules, TSP-2 appears normal joints, however, SPARC was TNC induce the expression of pro- more prone to inhibiting inflamma- reported at high levels in RA synovial inflammatory mediators in immune tory processes; it prevents T-cell mi- tissue and fluid as early as 1996134, cells. OPN has been shown to me- gration and leukocyte rolling as well and TNC expression has long been diate these effects via activation of as suppressing pro-inflammatory cy- observed in the RA synovium, lo- a number of cell surface receptors; tokine synthesis and promoting the calized to areas of ­inflammation it induces the synthesis of specific activation of regulatory T cells52–54. and fibrosis, ­specifically below the cytokines, chemokines and prote- Thus, the complex interplay between ­synovial lining, in the invading pan- ases in primary murine arthritic these molecules during tissue repair nus, in fibrin-rich deposits and synovial fibroblasts, macrophages appears to control both the induction­ around blood vessels135–138. More and dendritic cells via ­activation of and ­resolution of inflammation. recently, an up-regulation in the α9integrins43,44, it ­induces cytokine Together, these data reveal ma- ­expression of other matricellular synthesis in murine macrophage cell tricellular proteins as rather unique proteins has been reported in the RA lines via activation of β3 ­integrins45 pro-inflammatory stimuli. Un- joint ­(Table 2). For example, OPN is and it stimulates CD4 T-cell mi- like most inflammatory mediators, found in the synovium and the invad- gration and cytokine synthesis via such as cytokines, which comprise ing pannus139, demonstrating a simi- ­activation of CD4445,46. TNC can also small, soluble molecules of a limited lar pattern of expression to ­Gal-3140.

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Table 1. Pro-inflammatory functions of matricellular proteins. Protein Function References

CCN1 Promotes macrophage and adhesion 55, 56

Promotes adhesion and migration of circulating CD34+ progenitor cells 57

Promotes migration of , macrophages, T cells, B cells, natural killer (NK) cells 58–60

Promotes (DC) growth 61

Activates pro-inflammatory genes in macrophages and CD34+ progenitor cells 55, 57

Promotes CCL2 expression in osteoblastic cells 62

CCN2 Promotes monocyte adhesion 56

Promotes immune cell migration including monocytes, macrophages and T-cells 63, 64

Promotes expression of pro-inflammatory cytokines and chemokines in tubulo-epithelial cells, 64–68 ­mesangial cells, rat pancreatic stellate cells and cardiomyocytes

Gal-1 Inhibits rolling and adhesion of neutrophils 69

Inhibits T-cell adhesion and pro-inflammatory cytokine production in T-cells 70

Promotes DC activation and migration 71, 72

Induces T-cell apoptosis 73, 74

Promotes differentiation of tolerogenic DCs 75

Promotes Th2 polarization 76–78

Promotes immunoglobulin production during plasma cell differentiation 79

Promotes respiratory burst in neutrophils 80

Promotes Treg activity 81, 82

Inhibits phagocytosis and antigen presentation in monocytes and macrophages 83

Gal-3 Chemoattractant for monocytes and macrophages 84

Promotes DC migration 85

Induces T-cell apoptosis 86, 87

Promotes release of inflammatory mediators in mast cells 88

Promotes IL-2 production and Ca2+ uptake in Jurkat T-cells 89, 90

Inhibits production of pro-inflammatory cytokines in macrophages 91

Promotes respiratory burst in neutrophils 92, 93

Promotes macrophage phagocytosis 94, 95

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Table 1. Continued. Protein Function References

Promotes alternative macrophage activation 96

Promotes DC-mediated T-cell priming 97

OPN Promotes DC migration, activation, IL-12 and TNFα production and Th1 polarization 98

Promotes Langerhans cell and DC migration through CD44 and αvb3 integrins 99

Promotes macrophage migration, survival and differentiation 100–103

45, 104, Promotes IL-12 and TNFα production in macrophages via activation of α β integrin v 3 103

Inhibits IL-10 production in macrophages via activation of CD44 104

Promotes TLR9-dependent IFNα production in pDCs 105

Promotes IL-17,IFNγ(via β3 integrins) and IL-10 (via CD44) in CD4 T-cells 46

Promotes cytokine production in macrophages and synovial fibroblasts via α9 integrins 43

SPARC Inhibits DC migration and T-cell priming 106

Promotes follicular DC networking towards Th17 responses 107

TNC Promotes monocyte adhesion 108

Promotes macrophage migration 32, 35

Inhibits monocyte/macrophage migration 109

Inhibits of monocytes and polymorphonuclear leukocytes 110

Inhibits proliferation of activated peripheral blood T lymphocytes 111–113

Promotes pro-inflammatory cytokine production in macrophages and synovial fibroblasts via 47 ­activation of TLR4 Promotes pro-inflammatory cytokine production in DCs and IL-17 production in DC-CD4 T-cell ­ 114 co-cultures Promotes pro-inflammatory cytokine production in macrophages via regulation of microRNA-155 115 expression Promotes pro-inflammatory mediator production in human and bovine chondrocytes via activation 116 of TLR4

Promotes TLR4-dependent differentiation of macrophages into foam cells 117

Promotes MMP9 expression in neutrophils via activation of TLR4 48

Promotes pro-inflammatory cytokine production in macrophages and synovial fibroblasts via 43 activation of α9 integrins

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Table 1. Continued. Protein Function References

TSP-1 Promotes activated CD4 T-cell adhesion via α4 β1 and α5β1 integrins 118

Promotes neutrophil and monocyte chemotaxis 119, 120

Promotes activation and expansion of CD4 T-cells via CD36/CD47 121

Promotes apoptosis in T-cells, monocytes and DCs 122

Promotes Treg cell differentiation via CD47 123

Regulates cytokine production in monocytes via CD36 124

Inhibits cytokine production in monocytes and DCs via CD47 125–127

Activates latent TGFβ1 50, 51

Drives Th17 responses 51

Promotes macrophage phagocytosis of apoptotic cells via CD36 128, 129

Promotes allosensitization capacity of antigen-presenting cells 130

Promotes DC phagocytic and tolerizing states 131

Inhibits TCR-mediated T-cell activation 132

TSP-2 Inhibits leukocyte rolling during wound healing 133

Inhibits TGFβ activation and T-cell and antigen-presenting cell migration during experimental 52 glomerulonephritis

Inhibits production of pro-inflammatory cytokines and T-cell infiltration during RA 53

Promotes the activation of Tregs 54

However, both exhibit a distinct be interesting to examine if other implying that they possess a role in ­pattern to Gal-1, which is detected in matricellular proteins are formed innate immune responses in RA. Fur- the RA synovium but excluded from by immune cells and to compare the thermore, these three molecules may the invading pannus140. In consider- form and function of these molecules also impact adaptive immune events ing the source of these matrix mol- from different sources. in the joint; each can drive T-cell po- ecules during RA pathogenesis, the Evidence that matricellular pro- larization down the Th17 lineage in majority of studies examined their teins affect disease progression is vitro44,114,145,147. These are key patho- expression in synovial fibroblasts also emerging (Table 2). For ex- logical cell types that promote ­tissue and found out that these cells synthe- ample, CCN1 enhances RA synovial erosion in RA and in vivo studies size large amounts of such matrix. In ­ proliferation143 suggesting confirm the contribution of CCN-1, addition, however, immune cells can that it may contribute to synovial TNC and OPN in promoting Th17 cell also supply matricellular molecules hyperplasia. CCN1 and other mol- generation in murine models of ar- to the RA joint; myeloid cells of the ecules, such as TNC and OPN, drive thritic disease­ 44,114,145. In vivo models RA synovium significantly contrib- the synthesis of pro-inflammatory also reveal further information about ute to TNC synthesis141 and TSP-1 is mediators in isolated synovial fibro- the role of matricellular proteins ­expressed in RA monocytes142. It will blasts and immune cells43,44,47,114,144–146 in disease pathogenesis. OPN null

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Table 2. Matricellular proteins in the RA joint. Protein Expression/Function in RA References

CCN1 Expressed by RA synovial fibroblasts 144

Expressed in RA synovial tissue 160

Treatment with simvastatin attenuates CIA severity through reduction of CCN1 expression 144

Treatment with epigallocatechin-3-gallate attenuates CIA severity through reduction 161 of CCN1 expression

Promotes IL-17-mediated proliferation of RA fibroblast-like synoviocytes 143

(In synergy with TNFα) Promotes CCL20 production in RA synovial fibroblasts 144

Promotes IL-6 production and Th17 polarization by RA fibroblast-like synoviocytes 145

Treatment with anti-CCN1 mAb attenuates CIA severity (reduced Th17 response) 145

CCN2 Expression is elevated in RA synovial tissue 156

Enhances M-CSF/RANKL-mediated osteoclast activation in RA 156

Treatment with anti-CCN2 mAb attenuates CIA severity (reduced Th17 response, 155 osteoclastogenesis)

CCN4, 5, 6 WISP2 expression is upregulated in RA synoviocytes 162 (WISP1, 2, 3)

CCN5 Expression is upregulated in RA synovial fibroblasts 162 (WISP2)

CCN6 Expression is upregulated in RA synovial fibroblasts 163

Gal-1 Detected in RA joint (not at sites of synovial invasion) 140

Treatment with Gal-1 attenuates CIA severity through promotion of CD4 T-cell apoptosis 149

Treatment with Gal-1-nanogold complex attenuates CIA severity through promotion of 164 CD4 T-cell apoptosis

Overexpression attenuates CIA severity through promotion of CD4 T-cell death 149, 150

Gal-1 chimeric molecule promotes apoptosis in granulocytes from RA synovial fluid 165

Gal-3 Expression is elevated in RA joint (synovial membrane, synovial fluid, sites of joint destruction) 140

Expression is induced in RA synovial fibroblasts after adhesion to cartilage oligomeric matrix 166 protein

Promotes cytokine and chemokine production in RA synovial fibroblasts 151

Null mice exhibit attenuated AIA (reduced Th17 response) 152

Knockdown (lentiviral vector) decreases CIA severity 150

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Table 2. Continued. Protein Expression/Function in RA References

Gal-9 Expression is elevated in RA synovial tissue and fluid 167

Treatment with stable Gal-9 attenuates CIA severity by induction of apoptosis of synovial 167 ­fibroblasts

OPN Expressed in the RA synovial membrane and invading synovium 139

Promotes pro-inflammatory cytokine production in synovial fibroblasts and macrophages via 43 activation of α9 integrins Levels correlate with synovial levels of IL-17 and Th17 cells; OPN promotes CD44/29-mediated 147 Th17 cell differentiation in RA synovium Specifically modified OPN expressed by RA fibroblast-like synoviocytes promotes B cell adhesion 146 and IL-6 production Promotes matrix degradation in RA by stimulating the secretion of collagenase 1 in articular 139 chondrocytes

Treatment with anti-OPN mAb attenuates CIA disease severity 153

Null mice exhibit attenuated mAbs/LPS-mediated arthritis 148

Treatment with mAb against a cryptic site of OPN attenuates severity of CIA 154

A cryptic site of OPN promotes migration of monocytes from arthritic mice 154

SPARC Expression is elevated in RA synovial tissue and fluid 134

137, 138, Expression is elevated in RA synovial tissue, synovial fluid and cartilage and serum from RA TNC 141, 168, patients 169

Intraarticular injection of induces TLR4-dependent joint inflammation, bone and cartilage 47 ­destruction

Null mice are protected from joint inflammation and bone and cartilage destruction during AIA 47

Null mice exhibit reduced zymosan-induced joint inflammation 47

Expression correlates with pro-inflammatory cytokine expression in RA joint 141

Promotes expression of pro-inflammatory cytokines (including IL-17) in arthritic joints 114 ­during AIA Promotes pro-inflammatory cytokine production in synovial fibroblasts and macrophages via 43 activation of α9 integrins Induces α9-dependent IL-6 production in DCs and macrophages from mice with CIA and Th17 44 polarization

TSP-1 Expression is elevated in RA monocytes 142

Expressed in in RA synovial tissue 53

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Table 2. Continued. Protein Expression/Function in RA References Treatment with TSP1-derived peptide decreases severity of peptidoglycan-polysaccharide -induced 157, 158 erosive arthritis in rats

Implant increases joint inflammation in adjuvant-induced arthritis 170

Intraarticular expression reduces CIA severity 159

Promotes activation and clonal expansion of autoreactive synovial T cells 121

TSP-2 Expressed in RA synovial tissue 53

Overexpression in RA synovial fibroblasts decreases angiogenesis and inflammation in a human 53 RA ­synovium-SCID mouse chimera mice exhibit attenuated antibody- of studies show that treatment with ment in the RA joint, first ­proposed mediated arthritis148, supporting in anti-OPN antibodies attenuates CIA by Kanayama et al. in 200943, sug- vitro data that establish this protein disease severity153,154. Anti-CCN1 an- gests that the ­pro-inflammatory niche as a pro-inflammatory molecule. tibodies attenuate disease progres- that is designed to help tissue repair, ­Intraarticular injection of TNC drives sion in CIA by reducing Th17 cell if not properly regulated, can cause a ­synovial inflammation and joint frequencies145. Anti-CCN2 monoclo- perpetual cycle of inflammation and erosion in a TLR4 dependent man- nal antibodies reduce CIA disease se- tissue damage. This drives an increas- ner. Moreover, whilst joint inflam- verity by reducing ­osteoclastogeneis ing accumulation of matricellular mation can be initiated in TNC null in inflamed joints155, consistent with molecules in the joint as disease pro- mice, these mice are protected from in vitro data showing that CCN2 gresses causing further, non-resolving prolonged erosive joint destruction, ­enhances osteoclast activation156. Ex- inflammation. These data also raise implying that TNC is required for dis- ogenous administration of members the interesting possibility that block- ease chronicity47. The different dis- of the thrombospondin family dur- ade of matricellular protein function tribution of galectin family members ing murine models of joint disease or expression may provide a novel in the joints of RA patients implies also affects distinct processes dur- means to reduce ­inflammation in RA. that they may play distinct roles in ing joint inflammation. Intraperito- the RA synovium. Indeed, Gal-1 has neally administered TSP-1 peptides The ECM derived niche: lessons from been shown to promote the apoptisis decreased the severity of peptidogly- the bone marrow and cancer of T-cells in vitro and intraperitoneal can-polysaccharide-induced erosive This idea that the ECM creates spe- administration of exogenous Gal-1 arthritis in rats157,158 and intraarticu- cialized areas to support specific or intraarticular overexpression me- lar adenovirus-­mediated expression cell types and locally modulate cell diated by lentiviral gene transfer of TSP-1 ­reduced CIA ­severity159. ­behaviour is not at all new. Stem ­during collagen induced arthritis Intraperitoneal injection of TSP- cells, characterized by their capacity (CIA) in mice attenuates disease se- 2-expressing fibroblasts reduced for self-renewal and their ability to verity by enhancing T-cell death149,150. inflammation in vivo as well as ame- differentiate into different cell types, In contrast, Gal-3 promotes cytokine liorating angiogenesis in ­human RA are found in specific microenviron- production in RA synovial fibro- synovium-severe combined immuno- ments termed ‘niches’. This concept blasts151. Genetic deletion of Gal-3 deficiency (SCID) mouse ­chimeras53. was first proposed by Schofield in or lentiviral-mediated knockdown of Together, these data indicate that a 1978 to describe the compartment its expression in the joint attenuates complex mixture of matrix molecules of the bone marrow where haema- CIA severity150,152. Finally, adminis- is deposited upon injury to the RA topoietic stem cells (HSCs) reside171. tration of neutralizing monoclonal joint, which creates a niche that sup- The haematopoietic niche contains antibodies that recognize individual ports immune cells and synovial fi- a range of cell types of different matricellular proteins has demon- broblasts, and which is permissive for lineages, as well as specific ECM strated positive therapeutic effects pro-inflammatory processes to occur. molecules and soluble­ factors that in murine models of RA. A number This idea of a specific microenviron- together modulate HSC behaviour172.

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Niches have also been proposed to is a multistep process, in- of a metastatic niche promotes the play an important role in cancer devel- volving the dissemination of cancer growth of metastases176. Both the CSC opment, both in the primary tumour, as cells from the primary tumour site and the metastatic niches contain a well as at metastatic sites. Some stud- to distant tissues. The ‘seed and soil’ range of stromal as well as immune ies indicate that tumours contain low hypothesis by Paget175 proposes that cells, ECM components, cytokines and numbers of ­cancer stem cells (CSCs), metastatic cells (‘seeds’) require a per- growth factors177. characterized by their capacity to self- missive microenvironment (‘soil’) for Increasing evidence indicates that renew and initiate new tumours173. the generation of metastases at second- matricellular proteins are crucial­ com- Similar to HSCs, these cells inhabit a ary sites. In the metastatic niche model, ponents of haematopoietic niches, specialized microenvironment, the the formation of a pre-­metastatic niche where they regulate key aspects of CSC niche, which controls their main- is required for tumour cell engraft- stem cell behaviour (Table­ 3). For ex- tenance and differentiation174. Tumour ment, and the subsequent formation ample, OPN-deficient mice exhibit

Table 3. Matricellular proteins in the haematopoietic and metastatic niches. Protein Expression/Function References

CCN1

Haematopoietic Expressed by MSCs 189 niche

Promotes osteoblast differentiation of MSCs 190

Is a chemo attractant for multipotent MSCs 191

Promotes MSC proliferation 192

Metastatic niche Expressed in a range of tumours 193

Promotes breast cancer cell migrationin vitro 194

Overexpression promotes tumour growth and vascularization in vivo 195

Overexpression promotes glioma cell growth in vitro and in vivo 196

Overexpression inhibits melanoma tumour growth and metastasis 197

Inhibits hepatocellular carcinoma cell proliferation and invasion 198

CCN2

Haematopoietic Expressed in the bone marrow 199 niche

Expressed by MSCs 189

Promotes MSC differentiation into fibroblasts 200, 201

Promotes osteogenic differentiation of MSCs 202

Promotes bone marrow stromal cell attachment 203

Promotes osteogenesis in vivo 204

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Table 3. Continued. Protein Expression/Function References

Metastatic niche Expressed in a range of tumours 193

Inhibits lung cancer metastasis via promotion of cell death 205

Knockdown inhibits pancreatic tumour growth in vitro and in vivo 206

Inhibition reduces pancreatic cancer tumour growth and metastasis in vivo 207 Gal-1

Haematopoietic Expressed by stromal and haematopoietic cells in the bone marrow 183 niche

Expressed by MSCs 208

Gal-1+ stromal cells in the bone marrow constitute a niche for pre-BII cells 183, 209

Promotes pre-BII cell proliferation and differentiation 209

Regulates growth and death of premature haematopoietic cells 210

Regulates proliferation and differentiation of bone marrow stromal cells 211

Metastatic niche Expressed in a range of tumours 212

Knockdown inhibits glioma cell growth 213

Promotes tumour growth and metastasis in vivo via increasing apoptosis 214

Knockdown inhibits tumour growth and metastasis in vivo 215

Promotes lung cancer cell invasion in vitro and metastasis in vivo 216

Gal-3

Haematopoietic Expressed in myeloid cells, stromal cells and B cells in the bone marrow 217, 218 niche

Suppresses GM-CSF-induced proliferation and gene transcription in bone marrow cells 217

Knockout mice exhibit modified bone marrow histology 219

Promotes differentiation of myeloid progenitor cells 219

Inhibits B cell differentiation into plasma cells in the bone marrow 218

Metastatic niche Expressed in a range of tumours 220

Inhibition inhibits breast cancer cell growth in vitro and in vivo 221

Inhibits B cell lymphoma cell apoptosis 222

Overexpression promotes malignant transformation of thyroid follicular cells 223

Promotes breast carcinoma cell invasion in vitro 224

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Table 3. Continued. Protein Expression/Function References

OPN

Haematopoietic Expressed in the endosteal region of the bone marrow by osteoblasts 178 niche

Negatively regulates stem cell numbers in the bone marrow 178

Fragments promote stem and progenitor cell migration, retention and release from the 225 bone marrow

Inhibits HSC proliferation in vitro and in vivo 179

Metastatic niche Expressed in a range of tumours 226

Promotes ovarian cancer cell proliferation, migration, invasion and tumour 186 formation Promotes tumour growth and prostate cancer cell proliferation, migration and 187 invasion

Fragment promotes hepatocellular carcinoma cell invasion via CD44 227

Knockdown in renal carcinoma cells increases apoptosis and decreases 228 invasiveness Overexpression promotes fibrosarcoma or pancreatic tumour growth and lung 229 metastasis through inhibition of apoptosis

SPARC

Haematopoietic Knockout mice have no defects in steady state haematopoiesis or haematopoieitic 230 niche ­recovery after myeloablation

Promotes osteoblast formation, maturation and survival 231

Promotes erythroid colony forming capacity 230, 232

Promotes erythroid cell progenitor differentiation in zebrafish 233

Metastatic niche Expressed in a range of tumours 234

Overexpression reduces breast cancer cell invasion and colony formation in vitro and 235 bone metastasis in vivo

Overexpression promotes glioblastoma invasion in vitro 236

Knockdown abrogates human melanoma cell tumourigenicity in vitro and in vivo 237

Inhibits tumour cell growth in vitro and in vivo 238

Overexpression inhibits tumour growth in vivo 239

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Table 3. Continued. Protein Expression/Function References

TNC

Haematopoietic 180, 181, Expressed by stromal and endothelial cells in the bone marrow niche 240, 241

Promotes adhesion of haematopoietic cells to stromal cells 181, 182

Promotes the generation of haematopoietic progenitor cells in long term bonemarrow ­ 242 cultures

Promotes the proliferation of haematopoietic stem and progenitor cells in vitro and in vivo 180

Knockout mice exhibit impaired haematopoietic recovery after bone marrow ablation 180

Metastatic niche Expressed in a range of tumours 243

Knockdown reduces breast cancer cell migration, proliferation, tumour growth and lung 244 metastasis

Knockdown reduces survival and outgrowth of lung metastases 188

Promotes the survival of Metastasis-initiating breast cancer cells by EnhancingWnt and 188 Notch signalling

Promotes metastatic colonization 245

Inhibits IFNγ production by tumour-infiltrating lymphocytes 111

Overexpression promotes breast cancer cell invasion and proliferation through up-­ 246 regulation of MMP expression

Inhibits transmigration of T-lymphocytes in glioblastoma 247

TSP-1

Haematopoietic Expressed by haematopoietic and stromal cells in the bone marrow 248 niche

Inhibits osteogenic differentiation of MSCs through activation of TGFβ 249

Promotes adhesion of haematopoietic progenitor cells 248, 250

Inhibits megakaryocytopoiesis 251

Metastatic niche Expressed in a range of tumours 252

Overexpression inhibits melanoma angiogenesis and lung metastasis in vivo 253

Promotes breast cancer cell migration in vitro and metastasis in vivo 254

Knockdown inhibits prostate tumour growth in vivo 255

Promotes the recruitment of M1 tumour-associated macrophages (TAMs) 256

Inhibits mammary tumour angiogenesis and growth in vivo 257

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Table 3. Continued. Protein Expression/Function References

TSP-2

Haematopoietic Expressed by MSCs in the bone marrow 208, 258 niche

Expressed by haematopoietic stem and progenitor cells 259

TSP-2 deficiency increases osteoprogenitor cell numbers and proliferation 260, 261

Inhibits MSC proliferation 258

Promotes platelet release from megakaryocytes 262

Promotes adhesion of haematopoietic stem and progenitor cells 259

Metastatic niche Expressed in a range of tumours 263

Overexpression inhibits melanoma invasiveness in vitro and liver metastasis in vivo 264

Deficiency promotes skin carcinoma tumour angiogenesis and decreases tumour cell 265 apoptosis Overexpression inhibits squamous cell carcinoma tumour growth and angiogenesis in 266 vivo

Overexpression inhibits pancreatic cancer cell invasion in vitro 267

Knockdown inhibits invasion of tumour-derived pancreatic stellate cells 268

increased frequencies of stem cells types in vitro186,187 and TNC expression can exert on different cells within in the bone marrow,­ and OPN was by breast cancer cells promotes their different niches. The answer most shown to inhibit HSC proliferation ability to ­metastasise into the lungs by likely lies in the precise combination in vitro and in vivo178,179. In contrast, enhancing cancer stem cell fitness188. of proteins that make up the niche TNC-deficient mice have no defects in Throughout this literature, there is together with the cell surface recep- steady state ­haematopoiesis; ­however, a strong emphasis on matricellular tor repertoire of the interacting cells haematopoietic ­recovery after bone proteins promoting stem and can- to enable a context-specific response. marrow ablation is impaired in these cer cell survival, differentiation and A number of studies have gone mice180. TNC was shown to promote proliferation. It will be interesting to into addressing these issues. Pri- the adhesion of HSCs to stromal cells see whether these molecules, which mary tumours do not metastasize to and to promote the proliferation of from their matrix in the RA joint all ­tissues, and indeed tumours of hematopoietic stem and progenitor can promote inflammation, also af- ­distinct types often migrate to dif- cells181,182. Gal-1-expressing stromal fect inflammation within the tumour ferent secondary sites. This suggests cells were identified as a component stroma. Whilst inflammation is now that a specific type of soil is required for a pre-BII cell-specific niche in the widely recognized as a key feature by specific tumours seeds176. More- bone marrow183. Matricellular ­protein of cancer disease progression, in- over, metastasis of the same tumour expression in metastatic niches has flammation within the homeostatic type to different secondary sites is also been shown to regulate different environment of the bone marrow, driven by very different ­molecular aspects of tumour progression and however, would be extremely detri- mechanisms. Genes that are spe- metastasis184,185 (Table 3). For example, mental. Thus, the question arises as cifically associated with breast can- OPN promotes the proliferation, migra- to what dictates the particular effects cer cells that metastasize to the tion and invasion of various­ cancer cell that the same matricellular protein lungs are largely distinct from the

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­gene-­expression signature of breast osteal bone surfaces and proposed cells and resident fibroblasts cancer cells that exhibit high poten- to promote HSC quiescence, and the ­(Figure 2). Analogous to the metastatic tial to metastasize to the brain or to vascular niche, ­localized at the sur- niche ‘seed and soil’ paradigm, where bone269–271. Amongst these gene sets, faces of sinusoidal blood vessels and the extracellular environment is es- for example TNC was enriched in proposed to promote HSC prolifera- sential for supporting tumour cell sur- those breast cancer cells that spread tion and ­differentiation272. It will be vival176, we propose that the creation to the lungs, but not to other sites. of great interest to examine the com- of an extracellular niche within the This implies that there is not one position of the ECM in each of these synovium helps to sustain chronic in- type of unifying ECM environment locations. flammation. Synovial fibroblasts from that comprises a metastatic niche RA joints autonomously induce joint but there exists specific ECM signa- Conclusion disease upon systemic injection into tures for specific cancers. Recently, Here we describe a model for RA dis- mice, but do not cause inflammation two distinct types of ­haematopoietic ease pathogenesis in which the syno- in any other tissue273, indicating that niche have also been defined: the vial environment is key to ­determining factors endogenous to the synovium osteoblastic niche, localized at end- the behaviour of ­infiltrating ­immune ­support site-specific disease ­induction.

Figure 2: Model of how the pro-inflammatory niche drives sustained inflammation in RA. Many ECM ­molecules that are induced in response to tissue damage are found at high levels in the RA joint. Here we propose that they form a pro-­inflammatory niche which supports immune cell infiltration, and is permissive for both infiltrating ­immune cells and tissue resident cells to proliferate and thrive. By virtue of their multimodular domain structures, ECM molecules also interact with a variety of cell surface receptors in a number of types to actively regulate many ­different aspects of inflammatory cell behaviour. Finally, this ECM also integrates signals from soluble mediators by acting as a reservoir for cytokines, chemokines and growth factors. Lack of effective control of the expression of these matrix molecules, coupled with or caused by, progressive tissue damage serves to create an environment that contributes to a prolonged immune response in the RA joint. Development of agents that block the pro-inflammatory action of this niche, either alone or coupled to established anti-inflammatory agents, may reveal new strategies to locally dampen chronic inflammation in the RA joint without globally ablating the immune response.

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Targeting the metastatic niche, as well we target one or all matricellular mol- 2. Roberts DD. Emerging functions of as the metastasizing cell, is proving ecules, aim to block single or common matricellular proteins. Cell Mol Life Sci. essential for effective prevention of pro-inflammatory pathways, must be 2011 Oct;68(19):3133–6. tumor progression184,188,274,275. Identifi- addressed to fully understand how this 3. Bornstein P. Matricellular proteins: an overview. J Cell Commun Signal. 2009 cation of a pro-inflammatory niche in complex matrix functions in RA and if Dec;3(3–4):163–5. the joint could also provide an entirely we wish to use matricellular protein 4. Jun JI, Lau LF. Taking aim at the novel means of treating RA. The ex- ­expression in the joint for ­anything other ­extracellular matrix: CCN proteins as pression of injury specific ECM mole- than a sophisticated delivery system. emerging therapeutic targets. Nat Rev cules not found in healthy tissues may Drug Discov. 2011 Dec;10(12):945–63. serve as a postcode to direct delivery Competing interests 5. Kim KH, Chen CC, Monzon RI, Lau of anti-inflammatory agents to the in- KM and MR have filed patents LF. The Matricellular Protein CCN1 flamed synovium. Combination of this around targeting the pro-inflamma- Promotes Regression of Liver Fibrosis approach with agents that prevent tory function of tenascin-C. KM is a through Induction of Cellular Senescence in Hepatic Myofibroblasts. Mol Cell Biol. ECM-mediated inflammation may pro- founder and director of Nascient­ Ltd. 2013 May;33(10):2078–90. vide a powerful, tissue-specific strat- 6. Chen CC, Mo FE, Lau LF. The egy for RA treatment. Acknowledgement ­angiogenic factor Cyr61 activates a Indeed, in the cancer field ­using TNC KM is supported by a Senior ­genetic program for wound healing in as a means to deliver cytotoxic agents ­Research Fellowship from Arthritis human skin fibroblasts. J Biol Chem. to glioma sites has proved an effective Research, UK and MR by a Ph.D. stu- 2001 Dec;276(50):47329–37. means of reducing ­tumour burden276–81. dentship from The Kennedy Trust. 7. Latinkic BV, Mo FE, Greenspan JA, Expanding on this theme, ­Schwager ­Copeland NG, Gilbert DJ, Jenkins NA, et al, in a recent and very elegant study, et al. Promoter function of the angio- Abbreviations genic inducer Cyr61gene in transgenic conjugated monoclonal antibodies AIA, Antigen-induced ­arthritis; CIA, mice: tissue specificity, inducibility dur- raised against fibronectin EDA, a splice Collagen-induced ­arthritis; CSC, ing wound healing, and role of the serum variant of this matrix glycoprotein that is ­Cancer stem cell; DC, ­Dendritic response element. Endocrinology. 2001 specifically induced during tissue injury cell; ECM, Extracellular ­matrix; Jun;142(6):2549–57. and found at high levels in RA synovia, FBG, ­Fibrinogen globe; FGF, 8. Mori T, Kawara S, Shinozaki M, to the anti-inflammatory­ cytokine IL- ­Fibroblast growth factor; FNIII, Fi- Hayashi N, Kakinuma T, Igarashi A, et al. Role and interaction of connective tis- 10. These conjugates were ­systemically bronectin type III domain; Gal, sue growth factor with transforming administered during murine CIA and Galectin; GM-CSF, Granulocyte demonstrated significant inhibition of growth factor-beta in persistent fibrosis: ­macrophage-­colony-stimulating fac- A mouse fibrosis model. J Cell Physiol. the progression of established arthri- tor; HSC, Haematopoietic­ stem cell; 282 1999 Oct;181(1):153–9. tis . This approach shows that using IFN, Interferon; mAb, Monoclonal 9. Wang JF, Olson ME, Ma L, Brigstock injury-specific ECM to deliver anti-in- antibody; M-CSF, Macrophage-­colony DR, Hart DA. Connective tissue growth flammatory agents to the RA joint may stimulating factor; MMP, Matrix factor siRNA modulates mRNA levels be therapeutically useful in treating RA; ­metalloproteinase; OPN, Osteopontin; for a subset of molecules in normal and fibronectin-EDA-­ antibody-IL10­ conju- PDGF, Platelet-derived growth factor; TGF-beta 1-stimulated porcine skin fi- broblasts. Wound Repair Regen. 2004 gates are now being­ tested in the clinic. RA, Rheumatoid arthritis; RANKL, Mar–Apr;12(2):205–16. However, the data indicating that these Receptor activator of nuclear factor matrix molecules also actively contribute 10. Garrett Q, Khaw PT, Blalock TD, kappa-B ligand; SCID, Severe com- Schultz GS, Grotendorst GR, Daniels to driving inflammation in RA may offer bined immunodeficiency; SLPR, Small JT. Involvement of CTGF in TGF-beta1- additional therapeutic benefit. However, leucine rich proteoglycan; SPARC, stimulation of differen- before this can be achieved there remain Secreted protein­ acidic and rich in tiation and collagen matrix contraction many intriguing questions to answer. cysteine; TGF, Transforming growth in the presence of mechanical stress. Why do many matricellular molecules factor; Th, T helper; TLR, ­Toll-like Invest Ophthalmol Vis Sci. 2004 exert the same pro-inflammatory ef- receptor; TNC, Tenascin-c; TNF, Tu- Apr;45(4):1109–16. 11. Frazier K, Williams S, Kothapalli D, fects? Why does a single matricellular mour necrosis factor; Treg, Regula- Klapper H, Grotendorst GR. Stimulation molecule exhibit two or more mecha- tory T cell; TSP, ­Thrombospondin. nisms for inducing inflammatory cyto- of fibroblast cell growth, matrix pro- duction, and granulation tissue forma- kine synthesis? Which molecules (and References tion by connective tissue growth ­factor. which mechanisms) are key players in 1. Bornstein P, Sage EH. Matricellular J Invest Dermatol. 1996 Sep;107(3): driving inflammation in RA and which proteins: extracellular modulators of 404–11. merely constitute collateral ­damage? cell function. Curr Opin Cell Biol. 2002 12. Sisco M, Kryger ZB, O’Shaughnessy This question of redundancy, i.e. should Oct;14(5):608–16. KD, Kim PS, Schultz GS, Ding XZ, et al.

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­rheumatoid arthritis? OA Arthritis 2013 Mar 02;1(1):6. none declared. declared in the article . Conflict of interests: interests: Competing the final manuscript. as well read and approved design, and preparation of the manuscript, the conception, to All authors contributed rules of disclosure. ethical Ethics (AME) for Medical the Association All authors abide by Page 21 of 25

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­rheumatoid arthritis? OA Arthritis 2013 Mar 02;1(1):6. none declared. declared in the article . Conflict of interests: interests: Competing the final manuscript. as well read and approved design, and preparation of the manuscript, the conception, to All authors contributed rules of disclosure. ethical Ethics (AME) for Medical the Association All authors abide by Page 22 of 25

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­rheumatoid arthritis? OA Arthritis 2013 Mar 02;1(1):6. none declared. declared in the article . Conflict of interests: interests: Competing the final manuscript. as well read and approved design, and preparation of the manuscript, the conception, to All authors contributed rules of disclosure. ethical Ethics (AME) for Medical the Association All authors abide by Page 23 of 25

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­rheumatoid arthritis? OA Arthritis 2013 Mar 02;1(1):6. none declared. declared in the article . Conflict of interests: interests: Competing the final manuscript. as well read and approved design, and preparation of the manuscript, the conception, to All authors contributed rules of disclosure. ethical Ethics (AME) for Medical the Association All authors abide by Page 24 of 25

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For citation purposes: Ruhmann M, Midwood KS. The pro-inflammatory niche: how the extracellular matrix drives

­rheumatoid arthritis? OA Arthritis 2013 Mar 02;1(1):6. none declared. declared in the article . Conflict of interests: interests: Competing the final manuscript. as well read and approved design, and preparation of the manuscript, the conception, to All authors contributed rules of disclosure. ethical Ethics (AME) for Medical the Association All authors abide by Page 25 of 25

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­rheumatoid arthritis? OA Arthritis 2013 Mar 02;1(1):6. none declared. declared in the article . Conflict of interests: interests: Competing the final manuscript. as well read and approved design, and preparation of the manuscript, the conception, to All authors contributed rules of disclosure. ethical Ethics (AME) for Medical the Association All authors abide by