BackgroundConnective tissue growth factor (CTGF) is widely thought to promote the development of fibrosis in collaboration with transforming growth factor (TGF)-β; however, most of the evidence for its involvement comes from correlative and culture-based studies. In this study, the importance of CTGF in tissue fibrosis was directly examined in three murine models of fibrotic disease: a novel model of multiorgan fibrosis induced by repeated intraperitoneal injections of CTGF and TGF-β2; the unilateral ureteral obstruction (UUO) renal fibrosis model; and an intratracheal bleomycin instillation model of pulmonary fibrosis.ResultsIntraperitoneal coadministration of CTGF and TGF-β2 elicited a profound fibrotic response that was inhibited by the human anti-CTGF antibody FG-3019, as indicated by the ability of FG-3019 to ameliorate the histologic signs of fibrosis and reduce the otherwise increased hydroxyproline:proline (Hyp:Pro) ratios by 25% in kidney (P < 0.05), 30% in liver (P < 0.01) and 63% in lung (P < 0.05). Moreover, administration of either cytokine alone failed to elicit a fibrotic response, thus demonstrating that CTGF is both necessary and sufficient to initiate fibrosis in the presence of TGF-β and vice versa. In keeping with this requirement for CTGF function in fibrosis, FG-3019 also reduced the renal Hyp:Pro response up to 20% after UUO (P < 0.05). In bleomycin-injured animals, a similar trend towards a FG-3019 treatment effect was observed (38% reduction in total lung Hyp, P = 0.056). Thus, FG-3019 antibody treatment consistently reduced excessive collagen deposition and the pathologic severity of fibrosis in all models.ConclusionCooperative interactions between CTGF and TGF-β signaling are required to elicit overt tissue fibrosis. This interdependence and the observed anti-fibrotic effects of FG-3019 indicate that anti-CTGF therapy may provide therapeutic benefit in different forms of fibroproliferative disease.

The most frequently expressed drug resistance genes, MDR1 and MRP1, occur in human tumors with mutant p53. However, it was unknown if mutant p53 transcriptionally regulated both MDR1 and MRP1. We demonstrated that mutant p53 did not activate either the MRP1 promoter or the endogenous gene. In contrast, mutant p53 strongly up-regulated the MDR1 promoter and expression of the endogenous MDR1 gene. Notably, cells that expressed either a transcriptionally inactive mutant p53 or the empty vector showed no endogenous MDR1 up-regulation. Transcriptional activation of the MDR1 promoter by mutant p53 required an Ets binding site, and mutant p53 and Ets-1 synergistically activated MDR1 transcription. Biochemical analysis revealed that Ets-1 interacted exclusively with mutant p53s in vivo but not with wild-type p53. These findings are the first to demonstrate the induction of endogenous MDR1 by mutant p53 and provide insight into the mechanism.The emergence of drug resistance poses a major obstacle to the success of cancer chemotherapy. Tumor cells acquire drug resistance via many routes including alterations in transport, drug targets, metabolism, and/or genes regulating cell survival. The most common alterations in drug transport are increased expression of MDR1 1 (the gene product is P-glycoprotein (1, 2)) and the multidrug resistance-associated protein (MRP1) (3, 4). Both are energy-dependent anticancer drug efflux pumps and play critical roles in the response to chemotherapeutic drugs (e.g. vinca alkaloids, taxanes, and epipodophyllotoxins). Further, both MDR1 and MRP1 are expressed in colon tumors that frequently express mutant (MT) forms of p53 (5, 6) and are intractable to chemotherapy. Notably, we have shown directly that MDR1 in colon tumors is normally repressed by wild-type (wt) p53 (7). In an analogous fashion Wang and Beck (9) as well as Sullivan et al. (8) have shown that wt p53 represses MRP1. Many clinical studies show that MT p53 expression is associated with increased MDR1 and/or MRP1 expression (5, 10, 11). These findings are fully consistent with a loss of p53 repression leading to MDR1 or MRP1 up-regulation. However, it is just as likely that these genes could be up-regulated by the "gain-offunction" activity of MT p53s (12-14).p53 deletion or mutation is one of the most frequent alterations in human malignancy and is clearly a critical step in the progression of colorectal cancer (15). Close to 90% of the p53 mutations in human tumors results in a disruption of the DNA binding domain. This not only disrupts transrepression and sequence-specific transactivation but also confers a gain-offunction activity that was first demonstrated for many MT p53s as acquiring the ability to induce tumors (13). This property was associated with the capability of these MT p53s to stimulate the expression of an alternate set of endogenous genes (13, 14, 16) that could potentially promote tumor progression and impair therapeutic response. However, although c-myc has unequivocally been demonstrated to be an endogenous t...

Background-Transforming growth factor (TGF-) is a key mediator of collagen synthesis in the development of lung fibrosis. It has previously been shown that the administration of TGF-antibody and TGF-binding proteoglycan, decorin, reduced bleomycin (BL) induced lung fibrosis in animals. The present study was carried out to investigate whether intratracheal instillation of TGF-soluble receptor (TR) would minimise the BL induced lung fibrosis in hamsters. Methods-The eVect of a recombinant TR (TGF RII) on the lung collagen accumulation was evaluated in a BL hamster model of pulmonary fibrosis. Animals were divided into four groups and intratracheally injected with saline or BL at 6.5 U/4 ml/kg followed by intratracheal instillation of phosphate buVered saline (PBS) or 4 nmol TR in 0.3 ml twice a week. Twenty days after the first intratracheal instillation the hamsters were killed for bronchoalveolar lavage (BAL) fluid, biochemical, and histopathological analyses. Results-Treatment of hamsters with TR after intratracheal instillation of BL significantly reduced BL induced lung fibrosis as shown by decreases in the lung hydroxyproline level and prolyl hydroxylase activity, although they were still significantly higher than those of the saline control. Histopathological examination showed a considerable decrease in BL induced fibrotic lesions by TR treatment. However, TR did not prevent the BL induced increases in total cells and protein in the BAL fluid. Conclusions-These results suggest that TR has antifibrotic potential in vivo and may be useful in the treatment of fibrotic diseases where increased TGF-is associated with excess collagen accumulation. (Thorax 1999;54:805-812)

The present study describes the pharmacokinetics and metabolism of pirfenidone (PD), a compound which has been shown to have significant antifibrotic effects in rodent models of pulmonary and cardiac fibrosis. Despite the fact that this compound is currently in phase II clinical trials, little data are available on the metabolism and disposition of this agent in rodents or humans. Radioactive PD [benzene ring (14)C(U)] was administered i.v. to mice at 40 mg PD/kg body weight, and animals were killed at varying times for determination of parent compound and metabolites in various tissues. The disappearance of parent compound from the plasma followed apparent 2-compartment elimination kinetics with a terminal elimination half-life of 8.6 min. Cl (0.10 ml/min/g) and V(d(ss)) (0.67 ml/g) indicated that PD was rapidly distributed in body water. This is consistent with the finding that peak tissue radioactivity occurred within 5 min following the i.v. administration of [(14)C]-PD and that well-perfused tissues, kidney>liver>lung have much higher levels of parent compound and metabolites than did fat. Two peaks isolated from plasma samples by HPLC yielded mass spectra that were consistent with initial oxidation to the alcohol followed by further metabolism to the carboxylic acid. The radioactivity recovered in the 24 h urine samples averaged 97% of the administered dose and none of that was associated with the parent compound. The short plasma half-life of parent compound in mice supports the need for additional studies in humans where the compound has been shown to have clinical benefits.

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Bleomycin (BLM)-induced lung fibrosis has been shown to be accompanied by the activation of poly(ADP-ribose) polymerase and depletion of nicotinamide adenine dinucleotide (NAD) in the lung. Niacin, a precursor of NAD, was used in the present study to investigate its possible ameliorating effect on BLM-induced pulmonary fibrosis in hamsters. Niacin (500 mg/kg IP) or saline (IP) was injected daily for 16 or 23 days. On day 3, hamsters were treated with BLM (7.5 U/5 mL/kg) or an equivalent volume of saline intratracheally. BLM alone significantly increased lung hydroxyproline levels, bronchoalveolar lavage fluid protein concentration, and various inflammatory cell counts in the lavage in both experiments. In addition, BLM alone elevated prolyl hydroxylase and poly(adenosine-5'-diphosphate [ADP]-ribose) polymerase activities in the 3-week study. Niacin treatment significantly decreased BLM-elevated lung hydroxyproline, prolyl hydroxylase, and poly(ADP-ribose) polymerase activities. Histopathology revealed that niacin treatment attenuated BLM-induced thickened alveolar septa, foci of fibrotic consolidation, and accumulations of inflammatory cells in the parenchyma and air spaces. The ability of niacin to attenuate BLM-induced lung fibrosis in hamsters suggests that it may have potential as an antifibrotic agent in humans.

Four groups of hamsters were assigned as saline + saline, taurine + saline (TS), saline + bleomycin (SB), and taurine + bleomycin (TB). The animals were treated with either saline or taurine (500 mg/kg ip) for 1 week and just prior to intratracheal instillation of bleomycin (7.5 units/kg) or saline on the eighth day. Thereafter, taurine administration was continued ip (250 mg/kg) and in drinking water (1%) for another 14 days. Bleomycin-induced increases in lung collagen were significantly inhibited in TB hamsters. Plasma taurine concentration in the TS group was significantly higher than that of the other groups. Lung lavage (bronchoalveolar lavage fluid) taurine in the SB group was significantly higher than the saline + saline and TS groups. Bronchoalveolar lavage fluid supernatant protein and acid phosphatase levels in the SB and TB groups were significantly increased over the saline + saline and TS groups. Although the total numbers of cells recovered in bronchoalveolar lavage fluid was not different among the four groups, there were significantly fewer neutrophils in the TB as compared with SB hamsters. Morphometric analysis revealed less than half as much lesion (diffuse mononuclear alveolitis and multifocal fibroplasia) in TB as compared with SB hamsters. Also, consolidated foci were less frequent and smaller in TB as compared with SB hamsters. Taurine may attenuate bleomycin-induced inflammation and fibrosis by scavenging reactive oxygen metabolites.