Published ahead of print on August 10, 2006, doi:10.1165/rcmb.2005-0343RC
© 2006 American Thoracic Society DOI: 10.1165/rcmb.2005-0343RC
Muscarinic Receptors Mediate Stimulation of Human Lung Fibroblast ProliferationInstitute of Pharmacology and Toxicology; and Department of Pulmonary Diseases, Medical Polyclinic, University of Bonn, Bonn, Germany Correspondence and request for reprints should be addressed to Kurt Racké, MD, Institute of Pharmacology and Toxicology, University of Bonn, Reuterstraße 2b, D-53113 Bonn, Germany. E-mail: racke.kurt{at}uni-bonn.de
Airway remodeling is a structural alteration associated with chronic inflammatory and obstructive airway diseases, wherein fibroblasts are crucially involved. The present study investigates whether lung fibroblast proliferation is influenced by muscarinic mechanisms. For this purpose, expression of muscarinic receptors in MRC-5 human lung fibroblasts was characterized by semiquantitative RT-PCR, and the effects of muscarinic agonists and antagonists on (3H)-thymidine incorporation as a measure of proliferative activity were studied under different culture conditions. MRC-5 fibroblasts express mRNA encoding different subtypes of muscarinic receptors (M2 > M3 > M4, traces for M5 and no M1). Expression of M2 and M3 receptors was confirmed at the protein level by immunoblot analysis. Under different culture conditions, carbachol (up to 10 µM) or oxotremorine (10 µM) stimulated (3H)-thymidine incorporation, with maximum increases between about 40 and 100%. The stimulatory effect of 10 µM carbachol was prevented by pretreatment with pertussis toxin and antagonized in a concentration-dependent manner by the muscarinic receptor antagonists tiotropium, AQ-RA 741, AF-DX 384, 4-diphenylacetoxy-N-methylpiperidine methoiodide, himbacine, p-fluorohexahydrosiladifenidol, and pirenzepine, with concentrations producing 50% inhibition of 14 pM, 24, 64, 127, 187, 452 nM, and 1.5 µM, respectively. Primary human lung fibroblasts were also found to express mRNA for muscarinic receptors (M2 > M1 > M3, traces for M4 and no M5), and showed a pertussis toxinsensitive proliferative response to muscarinic receptor stimulation. In conclusion, proliferation of human lung fibroblasts can be stimulated by activation of muscarinic receptors with a pharmacologic profile correlating best to M2 receptors.
Key Words: airway remodeling lung fibroblast proliferation muscarinic receptors tiotropium
Airway remodeling is a pathologic feature observed both in asthma and chronic obstructive pulmonary disease (COPD). Although the nature of the airway remodeling process is somewhat different in asthma and COPD, fibrotic alterations are observed in both diseases (1). Based on their bronchodilatatory effects, anticholinergic drugs constitute an essential element in the therapy of obstructive airway diseasesin particular, COPD (2). Moreover, preliminary clinical data indicate that treatment with the long-acting muscarinic antagonist tiotropium may delay the decline in airway function in COPD (3, 4), suggesting that cholinergic mechanisms contribute to structural changes. Indeed, muscarinic agonists enhanced the proliferative response of human and bovine airway smooth muscle to epidermal growth factor and platelet-derived growth factor (PDGF), respectively (5, 6). Moreover, tiotropium was found to attenuate the increase in airway smooth muscle mass and myosin expression induced by repeated allergen challenges (7). Apart from airway smooth muscle, almost every cell type in the airways expresses cholinoceptors (for review, see Refs. 8 and 9) and may, therefore, be a target for acetylcholine released from neuronal or nonneuronal sources (for review, see Refs. 810). In airway fibroblasts, expression of mRNA encoding different nicotinic receptor subunits (11) and M2 receptors (12) has been described, but a detailed study on expression of muscarinic receptor subtypes in lung and airway fibroblasts is still lacking. Activation of nicotinic receptors has been shown to stimulate collagen gene expression and fibronectin synthesis (13, 14), whereas the functional role of muscarinic receptors in airway fibroblasts remains to be determined. The aims of this study were to characterize the expression pattern of muscarinic receptors in human lung fibroblasts and to investigate whether muscarinic receptors mediate effects on cell proliferation.
Culture of Lung Fibroblasts MCR-5 human lung fibroblasts (CCL-171; American Type Culture Collection, Manassas, VA) were grown in Eagle's minimum essential medium (MEM) with Earle's salts supplemented with 10% FCS, 2 mM L-glutamine, 0.1 mM nonessential amino acids, 1.0 mM sodium pyruvate, 100 U/ml penicillin, and 100 µg/ml streptomycin. Cells were grown in a humidified incubator at 37°C and 5% CO2 and passaged by trypsinization at near confluence. Early-passage cells were used in experiments. Primary human lung fibroblasts were established from histologically normal areas of surgically resected lung tissue, which was obtained from lung cancer patients after thoracotomy. The protocol for obtaining human tissue was approved by the local ethics review board for human studies (Ethics Committee, Medical Faculty, University of Bonn, Bonn, Germany), and informed consent was obtained from the patient. Tissue was cut into small pieces, treated with pronase (1 mg/ml; Calbiochem Novabiochem, San Diego, CA) at 37°C for 30 min, placed in cell culture plates, and incubated in Eagle's MEM, supplemented as described previously here, with FCS increased to 15%. After 2 wk, fibroblasts had grown out from the tissue and were passaged by standard trypsinization. For experiments described here, cells of passages 110 were used.
Extraction of RNA and RT-PCR Muscarinic receptor genes are intronless, and contamination of the RNA preparation by genomic DNA would cause false-positive PCR results; hence, the RNA preparation was treated with DNase before the RT reaction in order to remove traces of genomic DNA. In control experiments with cells not expressing muscarinic receptors, it was confirmed that false-positive results could be prevented by this pretreatment.
Western Blot Analysis
(3H)-Thymidine Incorporation
Statistical Analysis
Drugs and Materials
Muscarinic Receptor Expression in MRC-5 Human Lung Fibroblasts As shown in Figure 1, MRC-5 fibroblasts express mRNA encoding different muscarinic receptor subtypes. The highest expression was found for mRNA encoding M2 receptor, followed by M3 receptor transcripts. Lower but still detectable expression was observed for M4 receptor, whereas only traces of mRNA encoding M5 receptor were detected, and no transcript for M1 receptor was detected. The described pattern of muscarinic receptor mRNA expression appears to be stable under the culture conditions, as a similar pattern was found in different passages (passages 113).
The expression of M2 and M3 receptors could also be confirmed at the protein level by Western blot analysis using specific, commercially available polyclonal antibodies (Figure 2). The immunoblot for M2 receptor showed a single band, somewhat larger than 80 kDa. A band of similar size was also observed for the M3 receptor, but here two additional products, with a lower molecular weight, were also detected. Most likely, they reflect cellular degradation products, which are still recognized by the antibody. For comparison, Figure 2 also shows immunoblots performed with proteins extracted from rat lung tissue.
Muscarinic Stimulation of Proliferation of MRC-5 Human Lung Fibroblasts In order to test whether putative muscarinic effects on fibroblast proliferation depend on culture conditions and exposure time, various experimental conditions were explored. In a first set of experiments, cells were first cultured for 24 h in the presence of 10% FCS, followed by 24-h culture in FCS-free medium. Thereafter, cells were cultured for a further 24 h under FCS-free conditions in the presence of (3H)-thymidine and in the absence or presence of increasing concentrations of carbachol. Under control conditions (i.e., absence of drugs), (3H)-thymidine incorporation amounted to 7,281 ± 548 d.p.m. (disintegration per minute) (n = 52). As shown in Figure 3A, carbachol caused an increase in (3H)-thymidine incorporation (by 38 ± 18% at 10 µM) in a concentration-dependent manner. This effect was abolished in the presence of 1 µM atropine (Figure 3), which alone had no effect on (3H)-thymidine incorporation. Although the stimulatory effect of carbachol was clearly significant, the magnitude of the effect showed considerable variation.
In a second protocol, cells were again cultured for 24 h in the presence of 10% FCS, followed by 48 h FCS-free conditions in the absence or presence of carbachol (10 µM). Under these conditions, carbachol enhanced (3H)-thymidine incorporation by 52 ± 10% (Figure 3B). Again the effect of carbachol was prevented by atropine and also by the long-acting muscarinic antagonist, tiotropium (Figure 3B). Furthermore, oxotremorine caused a similar increase (by 61%), an effect also inhibited by atropine (Figure 3B). For comparison, when FCS (1 or 10%) was present instead of a muscarinic agonist during the last 48 h, (3H)-thymidine incorporation was enhanced by 69 ± 17% (n = 6) and 216 ± 30% (n = 9), respectively, compared to FCS-free conditions. In a further set of experiments, cells were FCS-deprived and drugs were applied from the onset of the test culture period. Under these conditions, 10 µM carbachol or oxotremorine increased (3H)-thymidine incorporation by 64 ± 8% and 100 ± 26%, respectively, when present 24 h before (3H)-thymidine, for a total of 48 h. These effects were again shown to be atropine-sensitive (Figure 3C). When carbachol was applied 6 h before (3H)-thymidine, for a total of 30 h, (3H)-thymidine incorporation was increased by 76 ± 4% (n = 80). These conditions were held for the subsequent interaction experiments with subtype-preferring muscarinic receptor antagonists. As summarized in Figure 4, all muscarinic receptor antagonists tested here inhibited the stimulatory effect of carbachol on (3H)-thymidine incorporation in a concentration-dependent manner. Tiotropium was by far the most potent drug, with an IC50 value of 14 pM. The M2/M4 receptorpreferring antagonists, AQ-RA 741, AF-DX 384, and himbacine, showed IC50 values of 24, 64, and 187 nM, respectively, whereas, for the M3/M1 receptorpreferring antagonists, 4-DAMP and p-FHHSiD, IC50 values of 127 and 452 nM were determined. The IC50 values for the M1/M4 receptorpreferring antagonist pirenzepine was 1.5 µM. None of the antagonists at any of the concentrations studied significantly affected (3H)-thymidine incorporation on its own (data not shown, each n = 612). When the potencies of these antagonists as determined here were correlated to their reported affinity constants to cloned human muscarinic receptors, the best and highly significant correlation was obtained for the M2 receptor. Figures 4B4D present only the correlations for M1, M2, and M3 receptors, as affinity data of tiotropium for cloned M4 and M5 receptors have not yet been published. For these two receptors, the respective correlations calculated on the basis of the remaining six antagonists failed to be statistically significant, with r = 0.60 and 0.27 for M4 and M5 receptors, respectively.
Pretreatment of the fibroblasts with PTX resulted in a slight reduction in (3H)-thymidine incorporation, and abolished the stimulatory effect of carbachol (Figure 5). In order to test the specificity of PTX, the effects of this toxin were also studied on the proliferative action of PDGF, which is known to act via a different class of receptors. Pretreatment of the cells with PTX, as described in Figure 5, did not inhibit the PDGF-induced stimulation of (3H)-thymidine incorporation (increase by 219 ± 40% [n = 6] and 283 ± 40% [n = 3] in the absence and presence of PTX, respectively).
When 1% FCS was present from the onset of the test culture period (6 h before (3H)-thymidine, for a total of 30 h), (3H)-thymidine incorporation was increased by 450% (Figure 6). Additional presence of 10 µM carbachol or oxotremorine induced a further significant increase in (3H)-thymidine incorporation, by about 300 and 240%, respectively, relative to the FCS-free controls (Figure 6). This corresponds to an increase of 54 and 43%, respectively, when expressed in relation to FCS-containing control experiments.
Muscarinic Receptor Expression and Function in Primary Human Lung Fibroblasts As Figure 7 shows, mRNA encoding muscarinic receptors was also detected in primary human lung fibroblasts obtained from patients with lung cancer. At different passages, it was observed that expression of M2 receptor transcripts was most prominent, followed by mRNA encoding M1 and M3 receptors, whereas only traces of mRNA for M4, and none for M5, were found.
In coherence to MRC-5 cells also in these primary lung fibroblasts, 10 µM carbachol or oxotremorine stimulated the incorporation of (3H)-thymidine, and the presence of tiotropium or atropine, as well as pretreatment with PTX, abolished the stimulatory effect of carbachol (Figure 8). Also, in primary human lung fibroblasts, PTX pretreatment failed to inhibit the proliferative effect of 100 ng/ml PDGF (increase by 403 ± 49% [n = 12] and 487 ± 80% [n = 3] in the absence and presence of PTX, respectively).
Almost every cell type in the lung and airways expresses cholinoceptors, but expression of muscarinic receptors in lung fibroblasts and their functional role have not yet been characterized. The present experiments demonstrate that human lung fibroblasts express muscarinic receptors, which mediate a stimulatory effect on cell proliferation. Using semiquantitative RT-PCR, several muscarinic receptors were found to be expressed in MRC-5, as well as in primary lung fibroblasts. In both, the cell line and primary cells, the strongest mRNA expression was observed for M2 receptor, whereas some gradual differences were found with regard to the other muscarinic receptors. In MRC-5 cells, the levels of mRNA encoding M3 receptor appeared to be higher than in primary cells, which, to the contrary, seemed to express a clear message for M1 receptor. As mentioned previously here, the genes of muscarinic receptors are intronless. Therefore, the RNA preparations were treated with DNase before the RT reaction to prevent contamination by genomic DNA. The differential expression pattern observed in the present studyin particular, the lack of PCR products accounting for M1 and M5 receptors in MRC-5 and primary lung fibroblasts, respectivelyargues against an artifact. Moreover, in MRC-5 cells, expression of M2 and M3 receptors could be confirmed at the protein level by Western blot analysis. Proliferation of lung fibroblasts in vitro largely depends on the presence of FCS, which obviously contains a cocktail of diverse factors promoting fibroblast growth. Therefore, the effects of muscarinic agonists were first tested in FCS-deprived conditions (i.e., in absence of other mitogenic stimuli). Under these conditions, carbachol and oxotremorine caused an increase in (3H)-thymidine incorporation in both MRC-5 and primary human lung fibroblasts. In both cell types, the proliferative effects of carbachol or oxotremorine were blocked by the muscarinic antagonist, atropine, and the long-acting muscarinic antagonist, tiotropium, at concentrations at least 10- and 100-fold lower, respectively, than those of the agonists, proving the involvement of specific muscarinic receptors. The antagonists had no effect on their own, which excludes significant effects of nonneuronal acetylcholine on fibroblast proliferation under the present culture conditions. In MRC-5 cells, muscarinic stimulation of proliferation was studied in more detail. The stimulatory effect of carbachol appeared to be somewhat more pronounced when the drug was added after dissemination isochronal to FCS-deprivation and when it was already present before the (3H)-thymidine exposure compared with conditions in which the agonist was applied simultaneously with (3H)-thymidine for the last phase of the incubation period. This may suggest that the muscarinic mitogenic stimulus is slow in developing, but is long lasting. A mitogenic effect of muscarinic agonists has also been demonstrated on airway smooth muscle (5, 6); however, in contrast to the present observations on fibroblasts, muscarinic agonists alone showed no proliferative effect in airway smooth muscle, but augmented the effect of other mitogenic stimuli, such as PDGF or epidermal growth factor. The present experiments, showing that the proliferative effects of carbachol and oxotremorine were basically the same in the absence or the presence of 1% FCS (Figure 6), indicate that, in human lung fibroblasts, the proliferative response induced by muscarinic receptor activation may be additive to proliferative effects caused by other mitogenic stimuli. Both M2 and/or M3 receptors have been shown to mediate activation of the mitogen-activated protein kinase/extracellular signalregulated kinase 1/2 pathway (1719), which is known to mediate proliferative responses in various cell types (2022). In order to characterize the muscarinic receptor subtype mediating the proliferative effect in MRC-5 fibroblasts, the M2/M4 receptorpreferring antagonists, AF-DX384, AQ-RA741, and himbacine, the M3/M1 receptorpreferring antagonists, 4-DAMP and p-FHHSiD, and the M1/M4 receptorpreferring antagonist, pirenzepine, were tested in addition to tiotropium. It should be emphasized that the subtype selectivity of the currently available "selective" muscarinic receptor antagonists is rather limited. Usually, they reveal a relatively high potency at least for two of the five muscarinic receptors, and the potency difference from the other muscarinic receptors is only about one order of magnitude. Nonetheless, comparing the potency of a series of subtype-preferring antagonists is an approach to deal with this problem (e.g., Ref. 23). When the antagonist potencies, as observed in the present experiments, were correlated to their reported potencies on cloned human muscarinic receptors (24, 25), the best correlation was obtained for the M2 receptor, supporting the assumption that this muscarinic receptor subtype may be essential in mediating the proliferative effects. This correlates well with the observation that, at the mRNA level, M2 receptors represented the major muscarinic receptor subtype in these cells. In line with this conclusion also lies the observation that PTX abolished the effect of carbachol, as PTX is known to inhibit Gi/o G proteins, to which only M2 and M4 receptors couple (26). An unspecific antiproliferative action of PTX may be excluded, as PTX did not inhibit the proliferative effect of PDGF, which is known to exert its effects via activation of a tyrosine kinase receptor, a class of receptors different from G proteincoupled receptors. Therefore, the PTX-induced reduction of baseline proliferation may reflect a background activation of Gi-mediated effects, possibly caused by paracrine mediators (as, for example, chemokines) released by the fibroblasts themselves. The long-acting muscarinic antagonist, tiotropium, was by far the most potent antagonist. The affinity constants of tiotropium are similar for M1, M2, and M3 receptors, but the dissociation of the respective receptor complexes shows different kinetics, with the longest half-life for the M3 receptor (25). This kinetic subtype selectivity of tiotropium may not be of significance in the present experiments, because they were performed under equilibrium conditions. Whether the kinetical subtype selectivity of tiotropium is of clinical importance is still debatable (27). Because the half-life of the tiotropiumM2 receptor complex, although shorter than that of the M3 receptor complex, is still 3.6 h (25), it may be expected that tiotropium causes a significant blockade of M2 receptors in the lung under clinical conditions. Although detailed pharmacologic experiments have only been performed on MRC-5 cells, the observations that PTX also abolished the proliferative effect of carbachol in primary human lung fibroblasts, and that M2 receptor mRNA represented the predominant muscarinic receptor transcript in these cells as well, suggest that M2 receptors might also mediate the proliferative stimulus in primary human lung fibroblasts. In conclusion, human lung fibroblasts express muscarinic receptors, which obviously mediate a proliferative stimulus, an effect which might contribute to structural changes known to occur in chronic obstructive airway diseases. Prolonged blockade of these receptors may contribute to the long-term beneficial effects of anticholinergics, as observed, for example, for the long-acting muscarinic antagonist, tiotropium, in COPD (3, 4).
This work was supported by a research grant from Boehringer Ingelheim. Originally Published in Press as DOI: 10.1165/rcmb.2005-0343RC on August 10, 2006
Conflict of Interest Statement: S.M. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript; A.B. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript; S.K. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript; S.H. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript; M.F. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript; C.S. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript; U.R.J. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript; K.R. has received Received in original form September 7, 2005 Accepted in final form August 9, 2006
This article has been cited by other articles:
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||