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J Am Soc Nephrol 14:601-610, 2003
© 2003 American Society of Nephrology

CTGF Mediates TGF-{beta}–Induced Fibronectin Matrix Deposition by Upregulating Active {alpha}5{beta}1 Integrin in Human Mesangial Cells

Benjamin S. Weston, Nadia Abdel Wahab and Roger M. Mason

Cell and Molecular Biology Section, Division of Biomedical Sciences, Imperial College School of Medicine, London, United Kingdom.

Correspondence to Dr. Roger M. Mason, Cell and Molecular Biology Section, Division of Biomedical Sciences, Imperial College School of Medicine, Sir Alexander Fleming Building, South Kensington, London SW7 2AZ, UK. Phone: +44-20-7594-43019; Fax: 44-20-7594-3015;


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
ABSTRACT. Excessive deposition of fibronectin in the glomerular mesangium in diabetic nephropathy (DN) is partly due to the induction of transforming growth factor-{beta} (TGF-{beta}) by high glucose. TGF-{beta} induces its downstream mediator connective tissue growth factor (CTGF), which stimulates fibronectin matrix synthesis, a process that requires the presence of {alpha}5{beta}1 integrin. Although TGF-{beta} has been shown to upregulate {alpha}5{beta}1 integrin expression in human mesangial cells (HMC), little is known about the effect of CTGF on levels of this receptor. This study tested whether CTGF modulates {alpha}5{beta}1 expression by HMC in culture and whether changes induced by TGF-{beta} are mediated through the induction of CTGF. FACS analysis showed that both TGF-{beta} and CTGF significantly increased cell-surface {alpha}5{beta}1 levels compared with basal conditions. RT-PCR indicated that the changes were at the level of transcription. Treatment of cells with TGF-{beta} and antisense CTGF oligonucleotides significantly reduced the TGF-{beta}–induced increases in {alpha}5{beta}1 levels. CTGF and TGF-{beta} also significantly increased levels of ligand-occupied cell-surface {beta}1 integrins and cell adhesion to fibronectin, the main {alpha}5{beta}1 substrate. Antisense CTGF significantly reduced the number of adherent cells from TGF-{beta}–stimulated cultures. Finally, {alpha}5{beta}1 blocking antibodies inhibited HMC fibronectin matrix deposition, confirming the importance of this receptor for this process. Taken together, these data provide evidence that CTGF controls {alpha}5{beta}1 expression by HMC in vitro. Alterations in {alpha}5{beta}1 levels induced by TGF-{beta} are mediated at least in part through the induction of CTGF, and specific targeting of either {alpha}5{beta}1 or CTGF could be useful in controlling excessive fibronectin matrix production in DN. E-mail roger.mason@ic.ac.uk


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Diabetic nephropathy (DN) is characterized by excessive deposition of extracellular matrix in the glomerular mesangium (1). Although hyperglycemia in diabetes is directly related to the severity of the disease (2), it is not entirely clear how high glucose concentration exerts its effects on mesangial cells. However many of the effects of high glucose are thought to be mediated through its induction of the growth factors, transforming growth factor-{beta} (TGF-{beta}) (3) and connective tissue growth factor (CTGF) (46). The level of both factors increase in the glomerulus in DN (3,6).

Connective tissue growth factor (CTGF) is a 36- to 38-kD cysteine-rich secreted protein (7). CTGF is encoded by an inducible immediate early gene and is one of six distinct members of the CCN family (8). The CTGF gene contains a novel TGF-{beta} response element in its promoter region (9) and is thought to be a downstream mediator of the some of the effects of TGF-{beta} (10). Several studies support this view (1114), but CTGF is also induced by a variety of other factors such as thrombin and VEGF (15,16).

CTGF is thought to drive glomerulosclerosis and tubulointerstitial fibrosis in renal diseases (4). CTGF levels are elevated in different renal fibrotic disorders where excessive extracellular matrix formation is observed (11,1719) and the growth factor induces matrix protein synthesis in mesangial cells in vitro (5,6,11,19).

One of the key extracellular matrix proteins secreted by human mesangial cells (HMC) is fibronectin. Levels of fibronectin are elevated in DN (20), and fibronectin secretion by HMC is increased when cultured under high glucose conditions (2123). Fibronectin is assembled into an insoluble matrix outside the cell, and distinct regions of the molecule are required for matrix assembly (24). One of the most important regions in the fibronectin monomer for this is the cell-binding domain that incorporates the ninth and tenth type III repeats, which contain the synergy sites and RGD integrin-binding consensus respectively (24). The predominant integrin receptor that binds fibronectin and is intimately involved in matrix assembly is the {alpha}5{beta}1 heterodimer. The importance of this receptor for fibronectin matrix assembly has been shown previously using monoclonal antibodies to block its function (25,26).

Levels of the {alpha}5{beta}1 fibronectin receptor correlate directly with the degree of fibronectin matrix accumulation in renal disease (27,28), and it is known that the profibrotic factor TGF-{beta} upregulates receptor expression in different cell types (29,30), including rat mesangial cells and glomeruli (27,31). Little is known about the effect of CTGF on {alpha}5{beta}1 levels, but it has been shown to upregulate {alpha}5 integrin transcripts in NRK fibroblasts (14). However, in view of the increased levels of CTGF in the diabetic glomerulus and its stimulatory effect on fibronectin synthesis by mesangial cells (6), we hypothesized that the factor may play a key role in promoting excessive deposition of fibronectin around mesangial cells by upregulating the expression of their fibronectin receptors. We report experiments below showing that this is the case and that similar effects induced by TGF-{beta}1 are in fact mediated by CTGF.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Materials
HMC were obtained from Biowhittaker UK Ltd, Wokingham, UK. Antibodies to total fibronectin and {beta}-actin were from Sigma (Poole, UK). The antibody to cellular (EDA+) fibronectin (MAS 521) was from Harlan Sera-Lab, Loughborough, UK. The BIIG2 hybridoma developed by Dr. Caroline H. Damsky was obtained from the Developmental Studies Hybridoma Bank developed under the auspices of the NICHD and maintained by the University of Iowa, Department of Biological Sciences, Iowa City, IA. The 12G10 {beta}1 antibody was a kind gift from Professor Martin Humphries, of the Wellcome Trust Center for Cell-Matrix Research, University of Manchester, UK. Recombinant CTGF, TGF-{beta}, and phosphothioate antisense CTGF and control oligonucleotides were obtained as described previously (6). Phosphothioate antisense (TGG GCA GAC GAA CG) and control oligonucleotides (ACC GAC CGA CGT GT) directed to CTGF were designed and manufactured by Biognostik GmbH (Göttingen, Germany), who own the intellectual property rights to the sequences (6). Monoclonal antibodies MAB1969 and MAB 1999 were from Chemicon International, Ltd, Harrow, UK. All other reagents were purchased from Sigma except where stated otherwise.

Cell Culture Conditions
HMC were routinely cultured and maintained as described previously (32). Cells between passage 6 to 10 were used for experiments.

Measurement of Fibronectin Deposited as Insoluble Matrix by HMC in Culture
HMC were maintained in RPMI 1640 medium containing 4 mM D-glucose and 10% fetal bovine serum (FBS), previously depleted of fibronectin by passing FBS over gelatin-Sepharose (Amersham Pharmacia Biotech, Amersham, UK) (32). After serum deprivation for 24 h post log-phase cultures were treated with serum-free medium containing 4 mM D-glucose, L-[4,5-3H]Leucine (8.3 µCi · ml-1; Amersham Pharmacia Biotech), and supplemented with either rCTGF (80 ng/ml) or TGF-{beta}1 (5 ng/ml) (2 ml/well). The cultures were incubated at 37°C for 48 h, after which the media were aspirated and stored at -20°C. The cell layers were extracted sequentially with detergent solutions to obtain a deoxycholate-insoluble matrix, as described in detail previously (32). 3H-Fibronectin was immunoprecipitated from all fractions before scintillation counting in a Beckman LS6000SC counter. Protein concentration in the cell-associated fraction was determined using the BCA-200 Protein Assay Kit (Pierce, Rockford, IL).

Western Blotting
Cell layers were washed three times with PBS and then solubilized in RIPA buffer (1% vol/vol NP-40; 0.5% wt/vol sodium deoxycholate; 0.1% wt/vol SDS). Protein samples were separated by reducing SDS-PAGE on 7.5% gels and then transferred to Immobilon-P PVDF membranes (Millipore, Bedford, UK). Nonspecific sites were blocked before incubation of the membrane with primary antibody (anti-fibronectin [1/2000]; anti-EDA+ fibronectin [1/400]; anti-{beta}-actin [1/3000]) overnight at 4°C. Incubation with an appropriate secondary antibody for 1 h at room temperature was followed by band visualization with enhanced chemiluminescence (ECL, Amersham Pharmacia Biotech). SDS-PAGE molecular weight markers (Rainbow colored protein molecular weight markers, Amersham Pharmacia Biotech) were run to calibrate the gel.

Use of CTGF Antisense Oligonucleotides
CTGF phosphothioate antisense oligonucleotide or a CG matched control was added directly to cultures at a final concentration of 2 µM (according to manufacturer’s recommendation). Previous experiments have shown that this concentration leads to an appreciable decline in CTGF mRNA levels from HMC in culture (6).

FACS Analysis of Cell Surface Levels of {alpha}5{beta}1 Integrin Receptor
HMC were seeded onto cell culture dishes (Corning Ltd, Corning, NY) in media containing 10% FBS previously depleted of fibronectin. Post log-phase cultures were serum-starved for 24 h before treatment with medium containing 4 mM D-glucose alone or media supplemented with either rCTGF (80 ng/ml), TGF-{beta} (5 ng/ml), or rCTGF and TGF-{beta} for different times (30 min to 72 h). Cells were then transferred to the wells of a 96-well conical-bottomed microtiter plate (Nunc International, Roskilde, Denmark). Cells were pelleted, resuspended in 100 µl of FACS buffer (HBSS containing 50 U · ml-1 penicillin, 50 µg · ml-1 streptomycin, 300 µg · ml-1 glutamine, and 2.5% FBS) containing a saturating concentration of mouse anti-human VLA-5 ({alpha}5{beta}1) integrin monoclonal antibody (10 µg/ml; MAB1999 Chemicon International, Inc, Temecula, CA), and incubated on ice for 30 min. After washing, the cells were incubated with goat anti-mouse IgG FITC conjugate (1/50; Dako, Glostrup, Denmark) for 30 min on ice in the dark. Washed cells were then resuspended in a total volume of 500 µl of PBS containing 1% paraformaldehyde (PFA) before analysis on a FACScan machine (Becton Dickinson, Franklin Lakes, NJ). Cells were also incubated with an isotype-matched control antibody, mouse IgG2b,{kappa}, (Sigma), or with secondary antibody alone. Data were analyzed using the CellQuest program. Relative fluorescence intensities were calculated by dividing the mean fluorescence intensity of test antibody by the mean fluorescence intensity of the appropriate isotype-matched control antibody or secondary antibody alone.

Additional experiments were undertaken, as above, for cells stimulated with either rCTGF or TGF-{beta}1 for 48 h and probed with the {beta}1 integrin antibody 12G10 (33), using a saturating concentration of 10 µg/ml.

RT-PCR Analyses
Total RNA was isolated using RNAzol B (AMS Biotechnology, Abingdon, UK) (34). Two micrograms of each RNA sample was converted into cDNA with Superscript II RNase H- reverse transcriptase and random hexamer primers (Life Technologies BRL, Paisley, Scotland, UK). Equal amounts of cDNA were subsequently amplified by PCR. Control amplifications were performed with GAPDH to confirm the use of equal amounts of RNA. The amount of reverse transcription reaction used for the amplification (0.5 µl) was selected as being nonsaturating for the PCR product of the genes under investigation after 27 cycles of amplification. The sequences of the primers used for the amplification of integrin alpha5 mRNA were: (sense) 5'-TGCATCAACCTTAGCTTCTGCCT -3' and (antisense) 5'-ACCAGCAGGCGGCTCTGGTTCAC -3' (35). The sequences of the primers used for the amplification of integrin beta1 mRNA were: (sense) 5'-GGAAAACGGCAAATTGTCAGAAGG-3' and (antisense) 5'-TGGACCAGTGGGACACTCTGGATT-3' (35). The sequences of the primers used for the amplification of GAPDH mRNA were: (sense) 5'-ACCACAGTCCATGCCATCAC-3' and (antisense) 5'-TCCACCACCCTGTTGCTGTA-3' (32). Amplification products were electrophoresed through 1.5% (wt/vol) agarose gels and visualized by ethidium bromide staining. Bands were scanned and quantitated by densitometry using NIH Image software.

Cell Adhesion Assays
Twenty-four–well flat-bottom plates (Corning Ltd) were coated overnight at 4°C with 200 µl of a 10 µg/ml solution of fibronectin (Sigma, Poole, UK). Wells were washed with PBS and blocked with 500 µl of 10 mg/ml denatured bovine serum albumin (BSA) for 1 h at 37°C. Cell adhesion assays were performed essentially as described by Kagami et al. (31). Briefly, growth-arrested HMC were treated with media containing 4 mM D-glucose and either CTGF (80 ng/ml), TGF-{beta} (5 ng/ml), or CTGF and TGF-{beta} for 48 h. Control cultures that were maintained in serum-free media containing 4 mM D-glucose were also included. Cells were detached with trypsin, washed, and pelleted. Cells were resuspended in RPMI containing 1 mM MnCl2 and 1 mM CaCl2 at a concentration 1 x 105 cells/ml. Cells were plated onto fibronectin-coated wells (300 µl of cell suspension/well) and placed at 37°C for 50 min. Adherent cells were fixed and stained with 0.1% crystal violet. Finally, extensively washed cells were solubilized with 1% Triton X-100, and the absorbance of the solubilized cell extracts was measured at 595 nm.

For antibody blocking experiments the {alpha}5 integrin antibody BIIG2 (36) was purified from BIIG2 hybridoma cultures to ensure that a sufficient amount of antibody was available for the adhesion experiments. Cell adhesion assays were carried out as described above, the only difference being that cell suspensions were incubated with 20 µg/ml purified BIIG2 antibody (30 min, room temperature) before seeding onto fibronectin-coated tissue-culture plastic. Control suspensions, where the cells were incubated under the same conditions in the absence of BIIG2 antibody were carried out.

Immunofluorescence
HMC (passage 6 to 10) were seeded onto coverslips in medium containing 4 mM D-glucose and FBS depleted of fibronectin. Once the monolayer had reached approximately 50 to 60% confluence, the cells were serum-starved overnight and were subsequently treated with serum-free media supplemented with 4 mM D-glucose and 5 ng/ml TGF-{beta}1 or 80 ng/ml rCTGF. After 48 h, the cells were fixed and permeabilized. Nonspecific sites were then blocked. The primary antibodies (anti-human {alpha}5{beta}1 [1/50] MAB1969, Chemicon; anti-human paxillin [1/100], Sigma) were incubated with the cells overnight at 4°C in a humidified chamber. Washed cells were incubated with the appropriate secondary antibody-conjugate (1/200) for 1 h at room temperature. In certain cases, incubation with the secondary antibody was followed by incubation with phalloidin-TRITC (50 µg · ml-1) for 1 h at room temperature. The coverslips were washed and mounted with Vectashield mounting medium (Vector Laboratories Inc, Burlingame, VT). The cells were inspected in a fluorescence microscope (Olympus Provis), and photographs were taken using 1600ASA Kodak color film. Control experiments, in which the primary antiserum was omitted, were also carried out.

For {alpha}5{beta}1 integrin-blocking experiments, adherent cells were treated with either 10 µg/ml or 20 µg/ml {alpha}5{beta}1 blocking antibody (MAB1969, Chemicon) in media containing 10% FBS depleted of fibronectin. After 48 h, the cells were processed for immunofluorescence as above, although they were not permeablized and were probed with an antibody to human fibronectin (1/500, Sigma).


    Results
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 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
The Deposition of Deoxycholate-Insoluble Fibronectin Matrix by HMC in Culture Is Stimulated by TGF-{beta} and CTGF
Post log-phase human mesangial cell cultures were treated with either 80 ng/ml CTGF or 5 ng/ml TGF-{beta} for 48 h to examine their effects on fibronectin synthesis. 3H-Leucine was included in the culture media to label all newly synthesized protein. After treatment, the deoxycholate-insoluble extracellular matrix fraction, which was solubilized with 1% SDS and 5 mM DTT at 37°C for 30 min, was isolated from the cell layer. Immunoprecipitation of 3H-FN from the medium and all fractions of the cell layer was followed by scintillation counting to determine the effect of the two growth factors on fibronectin synthesis and insoluble fibronectin-matrix deposition. The results from two separate experiments are shown in Table 1. The addition of CTGF or TGF-{beta} to HMC cultures appreciably increased total fibronectin synthesis over basal values, during the 48-h labeling period. There was no difference between the total amount of fibronectin synthesis in cultures treated with CTGF or TGF-{beta}. Measurement of 3H-FN in the deoxycholate-insoluble fraction indicated that treatment with CTGF or TGF-{beta} led to a greater proportion of total counts being deposited in this fraction than in control cultures. The counts in both the CTGF- and TGF-{beta}-treated cultures were >=60% higher than those observed in control cultures.


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Table 1. The effect of connective tissue growth factor (CTGF) and transforming growth factor-{beta} (TGF-{beta}) on fibronectin synthesis and deoxycholate-insoluble fibronectin matrix deposition by human mesangial cellsa
 
Western blot analyses confirmed that fibronectin levels were increased in cell layer extracts of cultures treated with either CTGF or TGF-{beta} for 48 h compared with control cultures (Figure 1, A and B). The EDA+ splice variant of the molecule was also increased (Figure 1, A and B). Taken together, these data indicate that, in addition to upregulating total fibronectin synthesis by mesangial cells in culture, both CTGF and TGF-{beta} specifically promote fibronectin matrix deposition by these cells.



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Figure 1. Effect of connective tissue growth factor (CTGF) and transforming growth factor-{beta} (TGF-{beta}) on fibronectin present in mesangial cell layer extracts. (A) Treated cells (48 h) were harvested in RIPA buffer and protein samples were subjected to SDS-PAGE (7.5% acrylamide) and Western blotting with antibodies to (i) total fibronectin, (ii) EDA+ splice variant fibronectin, and (iii) beta-actin. Lane 1, 4 mM glucose control cultures; lane 2, 4 mM glucose + CTGF (80 ng/ml); lane 3, 4 mM glucose + TGF-{beta} (5 ng/ml). Representative blots are shown. (B) The protein bands were quantified with a scanning densitometer. The results shown are the ratio of the integrated absorbance of the fibronectin or EDA+ fibronectin bands and the corresponding {beta}-actin band and are the means ± SEM for three separate experiments, each with duplicate cultures (total n = 6).

 
TGF-{beta} and CTGF Increase the Cell-Surface Expression of the Fibronectin Receptor, {alpha}5{beta}1 Integrin, by HMC in Culture
The {alpha}5{beta}1 integrin receptor is essential for fibronectin matrix assembly (24) and is expressed by many cell types, including mesangial cells (37). TGF-{beta} and CTGF were both shown to increase fibronectin matrix deposition by mesangial cells; we therefore examined whether this was related to differences in the level of cell-surface {alpha}5{beta}1 integrin receptor. Examination of the distribution of the {alpha}5{beta}1 integrin receptor in HMC by immunofluorescence revealed that the receptor was widely distributed on the cell in a characteristic fibrillar adhesion pattern, which appeared to be concentrated toward the center of the cell (Figure 2A). No differences in the amount or intensity of staining were detected using this technique between control cells and cells treated with either CTGF or TGF-{beta} for up to 48 h (data not shown). The distribution of the {alpha}5{beta}1 integrin receptor was compared with that observed of paxillin, a component of focal adhesions (Figure 2B). As expected, paxillin staining was observed at the ends of the actin filaments, unlike {alpha}5{beta}1 integrin, the distribution of which would be expected to be closely associated with fibronectin matrix assembly sites in cells actively depositing an insoluble fibronectin matrix (38).



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Figure 2. The distribution of the {alpha}5{beta}1 integrin receptor in human mesangial cells (HMC). (A) The distribution of the {alpha}5{beta}1 integrin receptor in HMC was analyzed by immunofluorescence as described in the Materials and Methods. It was compared to the distribution of (B) paxillin in the same cell-type, which is localized at the end of the phalloidin stained actin filaments at the sites of focal adhesions. A representative result is shown. Two further experiments gave similar results. Magnification x100.

 
FACS analysis was used to quantify cell-surface {alpha}5{beta}1 integrin levels. These were high on HMC maintained in 4 mM glucose medium. Moreover, exposure to either TGF-{beta} or CTGF for periods of up to 8 h had no effect on the level of {alpha}5{beta}1 expressed at the cell surface (Figure 3A). However, longer treatments with TGF-{beta} or CTGF led to an increase in cell-surface {alpha}5{beta}1, with TGF-{beta} having the greatest effect (Figure 3A). Levels of {alpha}5{beta}1 plateaued after 48 h treatment with either growth factor, with TGF-{beta} inducing approximately a 65% increase and CTGF approximately a 25% increase over basal levels. These levels were maintained after treatment for 72 h. A typical FACS profile for cells stimulated for 48 h is shown in Figure 3B. Control experiments showed that neither an isotype-matched control antibody, mouse IgG2b,{kappa}, nor the FITC-labeled secondary antibody bound HMC to any significant degree (Figure 3B). To determine whether changes in cell-surface levels of {alpha}5{beta}1 were associated with changes in the subunit mRNA levels, total RNA was extracted from cells treated with either TGF-{beta} or CTGF for 48 h. Semiquantitative RT-PCR indicated that CTGF and TGF-{beta} treatment brought about significant increases in the level of mRNA for each subunit, when compared with control cultures (Figure 3, C and D). The extent of the increases was similar for both growth factors.



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Figure 3. Effect of CTGF and TGF-{beta} on {alpha}5{beta}1 integrin expression by HMC. (A) Cell cultures were treated with either CTGF (80 ng/ml; filled triangles) or TGF-{beta} (5 ng/ml; filled boxes). At the time points indicated, cells were labeled with an antibody to the {alpha}5{beta}1 integrin receptor, followed by a FITC-labeled secondary antibody, prior to analysis by FACS, as described in the Materials and Methods. Triplicate cultures were treated in all experiments, which were repeated three times. The results shown are the mean ± SD for all experiments (total n = 9). (B) Representative FACS profile of cells treated with either CTGF (dashed line) or TGF-{beta} (dotted line) for 48 h, as compared with the profile for control cultures (thick black line). The thin black line shows the profile observed for an isotype-matched control. (C) Effect of CTGF and TGF-{beta} on the level of {alpha}5 and {beta}1 mRNA levels in HMC. Cells were treated either with control medium (lane 1), CTGF (lane 2), or TGF-{beta} (lane 3) for 48 h, after which total RNA was extracted and 2 µg reverse-transcribed. The product was amplified by PCR using primers for human (a) {alpha}5, (b) {beta}1, and (c) GAPDH as a control. The cDNA products were analyzed on a 1.5% agarose gel and visualized with ethidium bromide. Two other experiments gave the same result. (D) The cDNA bands were quantified with a scanning densitometer. The results shown are the ratio of the integrated absorbance of the {alpha}5 or {beta}1 bands and the corresponding GAPDH band and are the means ± SEM for three separate RT-PCR analyses. The Mann-Whitney U test was used to assess statistical significance. * P <= 0.05 (total n = 9).

 
The TGF-{beta}-Stimulated Increase in Mesangial Cell-Surface {alpha}5{beta}1 Integrin Levels Is Partially Mediated by CTGF
We have previously shown that in HMC in culture TGF-{beta} upregulates CTGF, and that the increase in fibronectin synthesis brought about by the addition of TGF-{beta} is mediated through the induction of CTGF (6). To determine whether the ability of TGF-{beta} to stimulate an increase in cell-surface {alpha}5{beta}1 integrin in HMC was dependent on CTGF activity, cells were stimulated with TGF-{beta} (5 ng/ml) for 48 h in the presence of 2 µM phosphothioate antisense CTGF oligonucleotide. This oligonucleotide has been used previously and has been shown to downregulate CTGF mRNA levels in HMC in culture (6). Cell-surface {alpha}5{beta}1 integrin levels were then determined by FACS. Figure 4 shows that the CTGF antisense significantly reduced TGF-{beta}–stimulated cell-surface {alpha}5{beta}1 integrin levels. However, levels of {alpha}5{beta}1 remained approximately 25% higher in the presence of antisense CTGF than in the control cultures. The control antisense oligonucleotide did not have any significant effect on TGF-{beta}-stimulated {alpha}5{beta}1 integrin levels. Interestingly, despite the marked inhibitory effect of antisense CTGF on TGF-{beta}-stimulated {alpha}5{beta}1 levels, exogenous rCTGF did not mimic exactly the effect of exogenous TGF-{beta}. It is possible that the exogenous rCTGF is not as active as CTGF produced by the cultures, and it may be more restricted in access to receptors than the latter through binding to matrix heparan sulfate proteoglycans. The apparent increase in {alpha}5{beta}1 levels in cultures treated with TGF-{beta} and CTGF together over those treated with TGF-{beta} alone was not statistically significant.



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Figure 4. The effect of CTGF antisense oligonucleotide on the TGF-{beta}–induced stimulation of cell surface {alpha}5{beta}1 expression by HMC. Cells were exposed to different treatments for 48 h, after which cell-surface {alpha}5{beta}1 integrin receptor levels were analyzed by FACS. The results are compared with the relative fluorescent intensity in untreated control cultures and represent the means ± SD for three separate experiments with quadruplicate cultures in each experiment for each condition. The Mann-Whitney U test was used to assess statistical significance. * P <= 0.05 (total n = 12).

 
CTGF and TGF-{beta} Stimulate Mesangial Cell Adhesion to Fibronectin
To assess whether the growth-factor–stimulated increase in cell-surface {alpha}5{beta}1 integrin levels affected HMC adhesion to the major {alpha}5{beta}1 substrate, cells were seeded onto fibronectin-coated plates after stimulation with either CTGF or TGF-{beta} for 48 h. After 50 min, adherent cells were stained with crystal violet. The results are shown in Figure 5. Pretreatment with either CTGF or TGF-{beta} significantly increased the number of cells that adhered to the fibronectin-coated wells over this time, with there being no significant difference between the effect of either factor. Antisense CTGF had the effect of significantly reducing cell adhesion to fibronectin in TGF-{beta} stimulated cells, although once more levels were not reduced to those in control cultures.



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Figure 5. Effect of CTGF and TGF-{beta} on mesangial cell adhesion to fibronectin. HMC were treated with either CTGF (80 ng/ml), TGF-{beta} (5 ng/ml), both CTGF and TGF-{beta}, or TGF-{beta} and antisense CTGF for 48 h before seeding (3 x 104 cells) onto fibronectin-coated wells (10 µg/ml) for 50 min. Adherent cells were stained with crystal violet, and the level of staining (Abs 595 nm) was compared with untreated cells. Results represent the mean ± SD for a representative experiment, with four cell-cultures for each condition (n = 4). Each culture was seeded onto eight wells for the adhesion assay. A value of 1 was assigned to untreated cells. The level of staining in BSA-coated control wells was subtracted from all results before analysis. The Mann-Whitney U test was used to assess statistical significance. * P <= 0.05. The experiment was repeated three times.

 
Mesangial cells express an array of integrin receptors that are able to bind fibronectin (37). Thus, to assess the importance of {alpha}5{beta}1 integrin in mediating mesangial cell adhesion to fibronectin, we treated cells with BIIG2 (20 µg/ml), an antibody to the {alpha}5 integrin receptor that blocks cell attachment to fibronectin (36), before seeding onto fibronectin. Table 2 shows that incubation with BIIG2 significantly reduced the number of adherent cells in all cell cultures to about 30% of that seen in control cultures. Control cultures were defined as those that had been previously subjected to the same treatments, but not exposed to BIIG2. The level of inhibition did not depend on the treatment to which the cells had been previously exposed. Taken together, these data indicate that both TGF-{beta} and CTGF increase the adhesive properties of mesangial cells to fibronectin, through a mechanism partly dependent on the {alpha}5{beta}1 integrin receptor. The TGF-{beta}-induced effect is mediated, at least in part, via CTGF.


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Table 2. The effect of the {alpha}5 integrin-blocking antibody BIIG2 on mesangial cell adhesion to fibronectina
 
TGF-{beta} and CTGF Increase the Number of {beta}1 Integrin Receptors in the Ligand-Occupied State
The 12G10 monoclonal antibody is a {beta}1 integrin monoclonal antibody that reacts preferentially with the ligand-occupied form of {beta}1-integrin containing heterodimers (33). FACS experiments were undertaken to determine whether the level of 12G10 binding to HMC treated with CTGF or TGF-{beta} was altered when compared with untreated control cultures. The results are shown in Figure 6. Treatment of HMC with CTGF (80 ng/ml) or TGF-{beta} (5 ng/ml) for 48 h led to a shift in the FACS profile for both growth factors when compared with the profile for untreated cells (Figure 6A). The effects of TGF-{beta} and CTGF on 12G10 binding were similar. CTGF and TGF-{beta} increased binding of 12G10 to HMC by 19% and 26%, respectively (Figure 6B). These changes were statistically significant and indicated that both CTGF and TGF-{beta} increased the level of ligand-occupied {beta}1 integrin on the mesangial cell surface. Control experiments, where 12G10 was omitted, showed that the secondary antibody did not bind mesangial cells.



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Figure 6. The effect of CTGF and TGF-{beta} on the level of ligand-occupied {beta}1 integrin. (A) FACS profile of cells treated with either CTGF (80 ng/ml; dashed line) or TGF-{beta} (5 ng/ml; dotted line) for 48 h compared with the profile for control cultures (thick black line). The thin black line shows the profile observed for a secondary-antibody only control. FACS analysis was performed following detection of cell-surface ligand-occupied {beta}1 integrin with the 12G10 monoclonal antibody, as described in the Materials and Methods. (B) The results are compared with the relative fluorescent intensity observed in untreated controls and represent the average value obtained for four separate cultures ± SD. The Mann-Whitney U test was used to assess statistical significance. * P <= 0.05 (n = 4). A representative result is shown. Two further experiments each with quadruplicate cultures for each condition gave similar results.

 
Blocking Antibodies to the {alpha}5{beta}1 Integrin Inhibit Fibronectin Matrix Deposition by HMC In Vitro
A further set of experiments sought to confirm the importance of the {alpha}5{beta}1 integrin receptor in fibronectin matrix deposition by mesangial cells in vitro. Newly adherent cells were fed with media supplemented with FBS previously depleted of fibronectin and containing antibody blocking {alpha}5{beta}1 integrin (Chemicon, MAB 1969). After 48 h, the fibronectin matrix was visualized by immunofluorescence. This showed that addition of the blocking antibody to adherent cells had no effect on the number of cells that remained attached to the coverslip (data not shown). The fibronectin matrix deposited around the cells (which were non-permeablized for analysis) was visible in the form of characteristic fibrils (Figure 7A). However, the addition of the blocking antibody led to appreciably lower amounts of fibronectin matrix, which also appeared more randomly organized and less fibrillar in structure (Figure 7, B and C). Similar observations were also made with cells that were stimulated with CTGF, in that the presence of {alpha}5{beta}1 integrin blocking antibody also brought about a decrease in the amount of fibronectin matrix deposited by the cells (data not shown).



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Figure 7. The effect of {alpha}5{beta}1 integrin-blocking antibodies on the fibronectin matrix deposited around human mesangial cells in culture. Fibronectin matrix was visualized by immunofluorescence around (A) untreated cells and cells exposed to blocking antibodies (MAB 1969) at concentrations of 10 µg/ml (B) and (C) 20 µg/ml. A representative experiment is shown. Two other experiments gave similar results (n = 3). Magnification x 50.

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Levels of the pro-fibrotic growth factor TGF-{beta} and its downstream mediator CTGF are increased in the kidney in diabetic nephropathy (3,6,17). Accumulation of extracellular matrix in the glomerular mesangium is one of the most prominent features of the disorder (1). One of the main matrix proteins deposited is fibronectin, which associates to form an insoluble matrix in a well-defined manner (24). The {alpha}5{beta}1 integrin receptor is key to fibronectin-matrix formation, providing an important point of contact between the cell and extracellular fibronectin fibrils.

Previous studies have shown that expression of {alpha}5{beta}1 integrin parallels mesangial content of both fibronectin and TGF-{beta} protein in renal disease (27,28,39). TGF-{beta} has also been shown to directly upregulate {alpha}5{beta}1 expression by cultured rat mesangial cells (31). However, very little is known about the relationship between the levels of CTGF and {alpha}5{beta}1 expression. One study showed upregulation of {alpha}5 transcripts in NRK fibroblasts (14), and CTGF levels have been shown to correlate very well with {alpha}5 levels in the ileum from patients with inflammatory bowel disease, Crohn disease, and ulcerative colitis (40). Using an HMC culture system, we sought to establish whether the ability of TGF-{beta} to stimulate {alpha}5{beta}1 expression in these cells is mediated through CTGF.

In addition to upregulating total fibronectin synthesis, our results showed that TGF-{beta} and CTGF preferentially stimulate the deposition of insoluble fibronectin matrix by HMC. Western blot analyses also revealed that synthesis of the EDA+ splice variant of fibronectin is upregulated by these factors. The inclusion of the EDA segment is thought to enhance the cell-adhesive activity of fibronectin by potentiating the interaction of fibronectin with the fibronectin receptor, the {alpha}5{beta}1 integrin (41). These observations led us to investigate whether the level of {alpha}5{beta}1 integrin is also altered, as this is an important factor for fibronectin matrix synthesis (2426).

Both CTGF and TGF-{beta} significantly upregulated {alpha}5 and {beta}1 at the message level, as determined by RT-PCR. TGF-{beta} stimulated cell-surface expression of the {alpha}5{beta}1 integrin in a manner very similar to that previously observed in other cell types (29,30), including rat mesangial cells (31). Treatment of the cells with CTGF also induced an increase in cell-surface {alpha}5{beta}1 integrin levels, although the stimulation was less pronounced than with TGF-{beta}. However, treatment of cells with TGF-{beta} and a phosphothioate antisense oligonucleotide to CTGF specifically abrogated much of the effect of TGF-{beta}, suggesting that the effect of TGF-{beta} is mediated at least in part through the induction of CTGF. The fact that antisense CTGF does not completely abolish TGF-{beta}-induced cell-surface {alpha}5{beta}1 expression suggests that TGF-{beta} can act on this through more than one mechanism.

Treatment of HMC with TGF-{beta} increased their ability to adhere to fibronectin, in a manner very similar to that observed with rat mesangial cells (31). Treatment with CTGF brought about similar effects, despite the fact that cell-surface levels of {alpha}5{beta}1 were much lower in these cultures. This presumably relates to CTGF treatment inducing a similar increase in ligand-occupied integrin receptor on the cell-surface as treatment with TGF-{beta}, as observed in experiments using the 12G10 antibody for detection. However, the use of blocking antibodies to the {alpha}5 integrin subunit suggested that, although {alpha}5{beta}1 is the predominant receptor expressed by HMC that mediates adhesion to fibronectin, it is unlikely to be the only receptor for this.

The direct importance of the {alpha}5{beta}1 integrin in fibronectin matrix assembly by HMC in culture was demonstrated by the fact that blocking antibodies to the receptor appreciably reduced matrix deposition by these cells. Soluble integrin receptors have been generated that have been shown to be functional (42,43). Specific targeting of the {alpha}5{beta}1 integrin receptor could prove successful in the control of excessive fibronectin matrix production in DN, although targets further upstream in the disease cascade may prove to be better points of intervention. One such attractive target would be CTGF. The data presented in this study provide further evidence that this growth factor is a downstream mediator of many of the profibrotic actions of TGF-{beta}.


    Acknowledgments
 
We are grateful for support from Diabetes UK (BSW) and the Medical Research Council, and we would like to thank Dr. Helen Yarwood for her assistance with the FACS analysis and Professor Martin Humphries for helpful discussions.


    References
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 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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Received for publication August 9, 2002. Accepted for publication November 13, 2002.




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