Tendon injuries are common with poor healing potential. The paucity of therapies for tendon injuries is due to our limited understanding of the cells and molecular pathways that drive tendon regeneration. Using a mouse model of neonatal tendon regeneration, we identified TGFβ signaling as a major molecular pathway that drives neonatal tendon regeneration. Through targeted gene deletion, small molecule inhibition, and lineage tracing, we elucidated TGFβ-dependent and TGFβ-independent mechanisms underlying tendon regeneration. Importantly, functional recovery depended on canonical TGFβ signaling and loss of function is due to impaired tenogenic cell recruitment from both Scleraxis-lineage and non-Scleraxis-lineage sources. We show that TGFβ signaling is directly required in neonatal tenocytes for recruitment and that TGFβ ligand is positively regulated in tendons. Collectively, these results show a functional role for canonical TGFβ signaling in tendon regeneration and offer new insights toward the divergent cellular activities that distinguish regenerative vs fibrotic healing.
Acromelic dysplasias are a group of rare musculoskeletal disorders that collectively present with short stature, pseudomuscular build, stiff joints, and tight skin. Acromelic dysplasias are caused by mutations in genes (FBN1, ADAMTSL2, ADAMTS10, ADAMTS17, LTBP2, and LTBP3) that encode secreted extracellular matrix proteins, and in SMAD4, an intracellular coregulator of transforming growth factor-β (TGF-β) signaling. The shared musculoskeletal presentations in acromelic dysplasias suggest that these proteins cooperate in a biological pathway, but also fulfill distinct roles in specific tissues that are affected in individual disorders of the acromelic dysplasia group. In addition, most of the affected proteins directly interact with fibrillin microfibrils in the extracellular matrix and have been linked to the regulation of TGF-β signaling. Together with recently developed knockout mouse models targeting the affected genes, novel insights into molecular mechanisms of how these proteins regulate musculoskeletal development and homeostasis have emerged. Here, we summarize the current knowledge highlighting pathogenic mechanisms of the different disorders that compose acromelic dysplasias and provide an overview of the emerging biological roles of the individual proteins that are compromised. Finally, we develop a conceptual model of how these proteins may interact and form an "acromelic dysplasia complex" on fibrillin microfibrils in connective tissues of the musculoskeletal system.
The disintegrin-like and metalloprotease with thrombospondin type 1 motifs (ADAMTS) family comprises 19 proteases that are secreted into the extracellular matrix (ECM).ADAMTS proteases execute a plethora of functions in tissue development and homeostasis. 1,2 For example, ADAMTS2 and ADAMTS3 are procollagen propeptidases that are pivotal for collagen assembly and mediate vascular endothelial growth factor (VEGF)-C processing, respectively. [3][4][5]
Marfan syndrome (MFS) is a connective tissue disorder characterized by long bone overgrowth, enlargement of the aorta, ocular anomalies and other symptoms. Current treatment focuses on managing aortic aneurysms to avoid dissection or rupture. However, no cures are available. MFS is caused by one of >1,800 dominant pathogenic variants in FBN1, which encodes the extracellular matrix (ECM) protein fibrillin-1. A significant number of FBN1 variants result in premature termination codons (PTCs). Recently, small molecules were identified that can promote translational readthrough of PTCs and were evaluated in preclinical and clinical trials for several genetic disorders. Here, we show that the translational readthrough drugs ataluren and gentamicin ameliorated FBN1 deposition in some MFS patient-derived skin fibroblast lines harboring PTC variants in FBN1. In contrast, inhibitors of NMD were cytotoxic to the skin fibroblast lines that we analyzed. We conclude that promoting translational readthrough of PTC variants in FBN1 could result in a therapeutic benefit for MFS patients with specific PTCs in FBN1 and that its efficacy will likely depend on the PTC sequence context, the amino acids that are incorporated in FBN1 after PTC suppression and the overall increase of FBN1 deposition in the ECM.
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