Connective Tissue Growth Factor Production by Activated Pancreatic

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Connective Tissue Growth Factor Production by Activated Pancreatic Laboratory Investigation (2010) 90, 1179–1188 & 2010 USCAP, Inc All rights reserved 0023-6837/10 $32.00 Connective tissue growth factor production by activated pancreatic stellate cells in mouse alcoholic chronic pancreatitis Alyssa L Charrier1,2 and David R Brigstock1,2,3 Alcoholic chronic pancreatitis (ACP) is characterized by pancreatic necrosis, inflammation, and scarring, the latter of which is due to excessive collagen deposition by activated pancreatic stellate cells (PSC). The aim of this study was to establish a model of ACP in mice, a species that is usually resistant to the toxic effects of alcohol, and to identify the cell type(s) responsible for production of connective tissue growth factor (CTGF), a pro-fibrotic molecule. C57Bl/6 male mice received intraperitoneal ethanol injections for 3 weeks against a background of cerulein-induced acute pancreatitis. Peak blood alcohol levels remained consistently high in ethanol-treated mice as compared with control mice. In mice receiving ethanol plus cerulein, there was increased collagen deposition as compared with other treatment groups as well as increased frequency of a-smooth muscle actin and desmin-positive PSC, which also showed significantly enhanced CTGF protein production. Expression of mRNA for collagen a1(I), a-smooth muscle actin or CTGF were all increased and co- localized exclusively to activated PSC in ACP. Pancreatic expression of mRNA for key profibrotic markers were all increased in ACP. In conclusion, a mouse model of ACP has been developed that mimics key pathophysiological features of the disease in humans and which shows that activated PSC are the principal producers of collagen and CTGF. PSC-derived CTGF is thus a candidate therapeutic target in anti-fibrotic strategies for ACP. Laboratory Investigation (2010) 90, 1179–1188; doi:10.1038/labinvest.2010.82; published online 5 April 2010 KEYWORDS: connective tissue growth factor; fibrosis; pancreas Chronic pancreatitis stems from relapsing episodes of acute come activated and transition to a myofibroblast-like, alpha- pancreatitis,1 and is characterized by destruction of acinar smooth muscle actin (a-SMA)-positive cell type that is cap- tissue, a sustained pancreatic inflammatory response, and able of depositing large quantities of fibrillar collagen in the fibrosis.2,3 Although development of chronic pancreatitis is interstitial spaces.11,12 The effects of alcohol exposure on PSC strongly associated with heavy alcohol consumption, only a function have been largely deduced from in vitro studies and small percentage of heavy drinkers actually develop the dis- from analysis of human pathological specimens. Studies of ease4–7 suggesting that other predisposing factors (for ex- the mechanisms of alcohol on PSC function in vivo remain ample, genetics, environment, injury) must also be present ambiguous and are confounded by the fact that a good an- for disease progression. Pancreatitis is responsible for ap- imal model of alcoholic chronic pancreatitis (ACP) does not proximately 3500 deaths each year in the USA, 16% of which yet exist.9,13 are due to chronic disease with about half of those deaths due Connective tissue growth factor (CTGF; also known as to alcohol.8 CCN2) is a member of the CCN family of proteins14,15 which Although the pathophysiology of chronic pancreatitis re- associates with components of the extracellular matrix or cell mains poorly understood,9 pancreatic stellate cells (PSC) are surface integrins16 and regulates cellular processes such believed to have a central role in the initiation and progres- as, adhesion, migration, mitogenesis and differentiation.15 sion of the fibrotic response.10 Under normal circumstances Although CTGF has an important role in vertebrate devel- PSC remain quiescent but after pancreatic injury they be- opment17–19 it is weakly expressed in adult connective tissues 1Center for Clinical and Translational Research, The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA; 2Molecular, Cellular and Developmental Biology Program, The Ohio State University, Columbus, OH, USA and 3Department of Surgery, The Ohio State University, Columbus, OH, USA Correspondence: Dr DR Brigstock, PhD, Room WA2022, Center for Clinical and Translational Research, The Research Institute at Nationwide Children’s Hospital, 700 Children’s Drive, Columbus OH 43205, USA. E-mail: [email protected] Received 23 October 2009; revised 18 December 2009; accepted 25 January 2010 www.laboratoryinvestigation.org | Laboratory Investigation | Volume 90 August 2010 1179 CTGF in alcoholic chronic pancreatitis in mice AL Charrier and DR Brigstock except during wound healing, tissue regeneration, cancer or and AEC chromogenic substrate (all from ScyTek Labora- fibrosis.16 A role for CTGF in pancreatic fibrosis was first tories, Logan, UT, USA). Double immunofluorescent detec- proposed from studies that showed CTGF overexpression in tion of a-SMA and CTGF or a-SMA and desmin acute necrotizing pancreatitis20,21 and in desmoplastic re- was achieved by incubation of sections with anti-a-SMA gions of pancreatic cancer.22 In in vitro studies, activated PSC and NH1 anti-CTGF IgY (5 mg/ml; an in-house antibody have been shown to co-express CTGF, transforming growth raised in chickens against recombinant human CTGF) or factor b-1 (TGF-b1), collagen 1 and other extracellular ma- a-SMA and desmin (H:76) (1:50, Santa Cruz Laboratories, trix proteins23,24 and to synthesize CTGF after exposure to Santa Cruz, CA, USA) followed by incubation with ethanol or acetaldehyde.25 However, data showing that CTGF Alexa Fluors 647 goat-anti mouse IgG (1:1000, is expressed by activated PSC in ACP in vivo are lacking. Invitrogen, Carlsbad, CA, USA) and goat-anti chicken Ig- We have produced a rapid and efficient model of ACP in Biotin (1:400, Santa Cruz Laboratories) or Alexa Flour 647 mice that mimics key pathophysiological features of the goat-anti mouse IgG and Alexa Fluor 488 goat-anti rabbit human form of the disease and which shows that activated IgG (1:1000, Invitrogen) for 1 h at room temperature. Slides PSC are a principal source of CTGF in ethanol-induced were incubated with Fluorescent NeutrAvidin (1:200, pancreatic fibrosis. Invitrogen), mounted with Vectashield Mounting Medium with DAPI (Vector Laboratories, Burlingame, CA, USA), and examined by confocal laser microscopy (LSM510, Carl Zeiss MATERIALS AND METHODS Co. Ltd, Jena, Germany) using an oil-immersion objective Animal Model lens (Plan-Apochromat  63/NA ¼ 1.4). All animal procedures were approved by the Institutional Animal Care and Use Committee of The Research Institute at Nationwide Children’s Hospital (Columbus, OH). Male In Situ Hybridization C57Bl/6 mice 6–8 weeks old were injected with ethanol Total RNA was extracted from cultured murine PSC with (3.2 g/kg; administered in a 33.3% ethanol: 67.7% water so- RNA STAT-60 (Tel-Test Inc., Friendswood, TX, USA) fol- lution) i.p. one time per day, six times per week, for 3 weeks. lowing the manufacturer’s instructions as previously de- On one day each week, some mice also received an i.p. in- scribed.25 Aliquots of 4 mg of total RNA were reverse jection of cerulein every hour for 6 hours. (50 mg/kg; Sigma transcribed using a SuperScript II Reverse Transcriptase kit Chemical Co., St Louis, MI, USA). Control mice received (Invitrogen). The cDNA was then amplified by polymerase either ethanol alone, cerulein alone, or water alone (n ¼ 6 per chain reaction using primers specific for a-SMA: 50- group). Mice were housed three to a cage and fed a low-fat CTACTGCCGAGCGTGAGATTGTCC-30 (sense) and 50-AGG diet ad libitum. Twice weekly, serum samples were collected GCCCAGCTTCGTCGTATTC-30 (antisense) (497 bp); col- 1 hour after ethanol administration for assessment of peak lagen a(I): 50-GACGTCCCTGGTGAAGTTGGT-30 (sense) blood alcohol levels (BAL). Mice were killed 2 days after the and 50-AGCCACGATGACCCTTTATG-30 (antisense) last ethanol treatment and pancreata were removed before (587 bp); or CTGF: 50-AGTGGAGATGCCAGGAGAAA-30 fixation in 4% paraformaldehyde (pH 7.2–7.4) or for RNA (sense) and 50-ACCTGCACAGCATTTGTTTG-30 (antisense) extraction, as described below. (540 bp). Following initial denaturation at 941C for 2 min, the samples were amplified by 35 cycles of denaturation at Blood Alcohol Levels (BAL) 941C for 30 s, annealing at 601C (621C for CTGF or 651C for Peak BAL were measured using an Ethanol-L3K assay (Di- a-SMA) for 40 s, extension at 721C for 90 s, and ended by agnostic Chemicals Limited, Oxford, CT, USA). NADH extension at 721C for 10 min. The PCR products were se- produced in the assay reaction was quantified by measuring parated on 1.5% agarose gels and then gel extraction was absorption at 340 nm with a SpectraMax M2 Microplate performed using QIAquick Gel Extraction (Qiagen, Valencia, Reader (Molecular Devices, Sunnyvale, CA, USA). CA, USA). Gel extraction products were subcloned into the pCRII-TOPO transcription vector (Invitrogen) according to Histology the manufacturer’s protocol and sequenced using the M13R Fixed pancreatic tissues were embedded in paraffin, cut into sequencing primer. 4 mm sections and stained with haemotoxylin-eosin for Antisense and sense RNA probes labeled with digoxignein- standard histological examination. Collagen staining was UTP or Biotin-UTP were generated by in vitro transcription performed using acidified 0.1% Sirius red F3B (Pfalz & of linearized plasmids with SP6 and T7 RNA polymerases Bauer, Waterbury, CT) as described.26,27 Immunohisto- (Roche Molecular Biochemicals, Mannheim, Germany) chemical staining for a-SMA or F4/80 was performed using according to the manufacturer’s protocol. The digoxigenin- monoclonal mouse-anti human a-SMA (1:100, Dako Cyto- labeled RNA was localized using Anti-digoxignenin-fluor- mation, Denmark) or anti-mouse F4/80 antigen respectively escein, Fab fragments (Roche Molecular Biochemicals). (1:100, eBioscience, San Diego, CA, USA), followed by Biotin-labeled RNA was localized using NeutrAvidin or development with UltraTek Anti-Polyvalent, UltraTek HRP Texas Red (Invitrogen).
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