Abstract

Fibrosis represents a major global disease burden, yet a potent antifibrotic compound is still not in sight. Part of the explanation for this situation is the difficulties that both academic laboratories and research and development departments in the pharmaceutical industry have been facing in re-enacting the fibrotic process in vitro for screening procedures prior to animal testing. Effective in vitro characterization of antifibrotic compounds has been hampered by cell culture settings that are lacking crucial cofactors or are not holistic representations of the biosynthetic and depositional pathway leading to the formation of an insoluble pericellular collagen matrix. In order to appreciate the task which in vitro screening of antifibrotics is up against, we will first review the fibrotic process by categorizing it into events that are upstream of collagen biosynthesis and the actual biosynthetic and depositional cascade of collagen I. We point out oversights such as the omission of vitamin C, a vital cofactor for the production of stable procollagen molecules, as well as the little known in vitro tardy procollagen processing by collagen C-proteinase/BMP-1, another reason for minimal collagen deposition in cell culture. We review current methods of cell culture and collagen quantitation vis-à-vis the high content options and requirements for normalization against cell number for meaningful data retrieval. Only when collagen has formed a fibrillar matrix that becomes cross-linked, invested with ligands, and can be remodelled and resorbed, the complete picture of fibrogenesis can be reflected in vitro. We show here how this can be achieved. A well thought-out in vitro fibrogenesis system represents the missing link between brute force chemical library screens and rational animal experimentation, thus providing both cost-effectiveness and streamlined procedures towards the development of better antifibrotic drugs.

Highlights

  • Repair of damaged tissues is an essential biological process which allows directed replacement of dead or damaged cells with connective tissue after injury

  • Besides local scarring at sites of acute trauma, a variety of other causes, such as chronic infections, chronic exposure to alcohol and other toxins, autoimmune and allergic reactions, radio- and chemotherapy, can all lead to fibrosis

  • Every implant is surrounded by a fibrotic tissue reaction that depends on the material, its surface and its degradation profile [5,6,7]

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Summary

Conclusions

With the current burden of fibrosis worldwide and acquired connective tissue disorders as seen in diabetes, the development of in vitro test systems that mimic fibrosis and connective tissue formation is more needed than ever. The lack of adequate systems to study fibrogenesis in vitro has either impeded the development of antifibrotics or has forced research and development to move too early into animal models. As there are several key points along the collagen biosynthesis pathway that can be interfered with, it is necessary to emulate all of these steps in vitro and, ideally, to get high content information out of a single well. This problem has been solved with the Scar-in-a-Jar. we look forward with great interest to seeing refinements and further developments of antifibrotics screening in the quest for the most potent and versatile antifibrotic compound. DAPI: 4',6-diamidino-2-phenylindole; DxS: dextran sulphate; ECM: extracellular matrix; EMT: epithelial-mesenchymal transition; Fc: Ficoll cocktail; HPLC: highperformance liquid chromatography; PAGE: polyacrylamide gel electrophoresis; SDS: sodium dodecyl sulphate; SMA: smooth muscle actin; TGF: transforming growth factor

21. Gristina AG
30. Wynn TA
40. Wynn T
42. Wynn TA
71. Barbul A
75. Woessner JF Jr
Findings
82. Stimler NP
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