Normal skin wound and hypertrophic scar myofibroblasts have differential responses to apoptotic inductors

Abstract

During wound healing, myofibroblasts play a central role in matrix formation and wound contraction. At the end of healing, there is evidence that myofibroblasts disappear via apoptotic pathways. Hypertrophic scars are a fibroproliferative disorder that leads to considerable morbidity. It has been postulated that a defect in myofibroblast apoptosis could be responsible for the pathological scar formation, but no evidence exists. We have isolated and cultured human normal wound (Wmyo) and hypertrophic scar (Hmyo) myofibroblasts and compared their basal apoptotic rates and their sensitivity to serum starvation and Fas antibody-induced apoptosis to that obtained for dermal fibroblasts (Fb). A higher rate of apoptosis as evidenced by morphological criteria and a propidium iodide assay was observed for Wmyo in comparison to Fb and Hmyo. These results came along with a low level of the anti-apoptotic proteins Bcl-2 and Bclx(L) in Wmyo, whereas there was an increase in the level of the pro-apoptotic molecule Bax when compared to the results obtained for Fb and Hmyo. Hmyo showed a higher level of Bcl-2 compared to Fb but no difference in the Bax or Bclx(L) level. After serum starvation, Wmyo revealed an increased apoptotic rate, whereas Hmyo and Fb did not show any difference. Anti-Fas treatment did not modify the levels of apoptosis but strongly increased the cell growth of Hmyo as compared to Wmyo. This is the first study presenting a broad vision of the apoptotic sensitivity of normal and pathological myofibroblasts. These results confirmed the hypothesis of defects in apoptosis and growth during pathological scar formation impeding myofibroblast disappearance at the end of healing.

Constitutive activation of prosurvival signaling in alveolar mesenchymal cells isolated from patients with nonresolving acute respiratory distress syndrome

“…However, we believe that the emergence of an apoptosis-resistant phenotype of AMCs may represent one plausible mechanism for "nonresolution" of the repair phase of ARDS. Apoptosis is a well-defined physiological process for normal tissue remodeling events in embryonic development and in the decreased cellularity that accompanies resolution of cutaneous wound healing (19,44). Furthermore, a previous study by our group demonstrated enhanced activation of Akt and focal adhesion kinase in fibrotic regions of the lung in a murine model of bleomycin-induced injury and fibrosis; systemic administration of a protein kinase inhibitor that targets these prosurvival protein kinases diminished the accumulation of myofibroblasts and attenuated fibrotic tissue responses (54).…”

The wound healing, chronic fibrosis, and cancer progression triad

“…1). In hypertrophic scars, the presence of apoptosis-resistant myofibroblasts high in antiapoptotic protein Bcl-2 has been reported (256). Although the mechanisms remain unclear, TGF-␤ may induce myofibroblast resistance to apoptosis (138).…”

Dynamic role of myofibroblasts in oral lesions

“…MFs also cause wound contraction and undergo apoptosis. However, in the last stage of wound healing, a defect in the apoptosis of MF and the persistence of MF results in an hypertrophic scar tissue [42] . A tumorigenic process involves acquiring multiple genetic mutations.…”