Metformin induces lipogenic differentiation in myofibroblasts to reverse lung fibrosis

Nat Commun. 2019 Jul 5;10(1):2987. doi: 10.1038/s41467-019-10839-0.

Abstract

Idiopathic pulmonary fibrosis (IPF) is a fatal disease in which the intricate alveolar network of the lung is progressively replaced by fibrotic scars. Myofibroblasts are the effector cells that excessively deposit extracellular matrix proteins thus compromising lung structure and function. Emerging literature suggests a correlation between fibrosis and metabolic alterations in IPF. In this study, we show that the first-line antidiabetic drug metformin exerts potent antifibrotic effects in the lung by modulating metabolic pathways, inhibiting TGFβ1 action, suppressing collagen formation, activating PPARγ signaling and inducing lipogenic differentiation in lung fibroblasts derived from IPF patients. Using genetic lineage tracing in a murine model of lung fibrosis, we show that metformin alters the fate of myofibroblasts and accelerates fibrosis resolution by inducing myofibroblast-to-lipofibroblast transdifferentiation. Detailed pathway analysis revealed a two-arm mechanism by which metformin accelerates fibrosis resolution. Our data report an antifibrotic role for metformin in the lung, thus warranting further therapeutic evaluation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Video-Audio Media

MeSH terms

  • AMP-Activated Protein Kinases / metabolism
  • Animals
  • Bone Morphogenetic Protein 2 / genetics
  • Bone Morphogenetic Protein 2 / metabolism
  • Cell Differentiation / drug effects
  • Cells, Cultured
  • Collagen / biosynthesis
  • Disease Models, Animal
  • Humans
  • Idiopathic Pulmonary Fibrosis / drug therapy*
  • Idiopathic Pulmonary Fibrosis / etiology
  • Idiopathic Pulmonary Fibrosis / pathology
  • Lipogenesis / drug effects*
  • Lung / cytology
  • Lung / drug effects*
  • Lung / pathology
  • Male
  • Metformin / pharmacology*
  • Metformin / therapeutic use
  • Mice
  • Myofibroblasts / drug effects*
  • Myofibroblasts / metabolism
  • PPAR gamma / genetics
  • PPAR gamma / metabolism
  • Primary Cell Culture
  • RNA, Small Interfering / metabolism
  • Signal Transduction / drug effects
  • Transforming Growth Factor beta1 / genetics
  • Transforming Growth Factor beta1 / metabolism
  • Treatment Outcome
  • Up-Regulation / drug effects

Substances

  • Bone Morphogenetic Protein 2
  • PPAR gamma
  • RNA, Small Interfering
  • Transforming Growth Factor beta1
  • Collagen
  • Metformin
  • AMP-Activated Protein Kinases