OSMRβ is elevated in the endothelial cells and fibroblasts of limited and diffuse SSc skin biopsies
OSMRβ was recently identified as a prognostic biomarker that correlates with progression of the skin disease in patients with diffuse Systemic Sclerosis (dcSSc) [16]. To illustrate the distribution of OSMRβ and OSM in SSc skin, we performed immunohistochemical (IHC) staining on biopsies from diffuse and limited patients. As shown on Fig. 1A, we observed increased expression of OSMRβ in the skin vessels of SSc patients as compared to healthy control skin. Semiquantitative scoring of the staining intensity demonstrated increased OSMRβ levels mostly in endothelial/perivascular cells and fibroblasts of SSc patients (Fig. 1B). In contrast, OSM protein, which was also detected in endothelial cells and fibroblasts was comparable in SSc and HC skin biopsies (Supplemental Fig. 1). Double immunofluorescence of OSMRβ and CD31 confirmed the presence of OSMRβ on ECs (Fig. 1C). OSMRβ did not appear to co-localize with αSMA in the skin (Fig. 1D). These results suggest, that increased expression of OSMRβ on ECs could contribute to the process of vasculopathy in the skin of SSc patients.
OSM Regulates mRNA Levels Of Proinflammatory Genes In HDMECs
OSM was previously shown to regulate expression of proinflammatory cytokines and adhesion molecules in ECs [17, 18]. To assess the effect of OSM on the inflammatory phenotype of HDMECs we examined the gene expression of selected interleukin, chemokine, and adhesion molecule genes by real time PCR. Cells were treated with human recombinant OSM (10 ng/ml) for 3 and 24 h. Human recombinant IL-6 (100 ng/ml) was used for comparisons. Since HDMECs have very low expression of IL-6R, addition of soluble IL-6R (sIL-6R) was required to initiate IL-6 signaling. A rapid increase in IL-6 mRNA levels in cells treated with OSM and IL-6 + sIL-6R occurred at 3 h, and remained high at 24 h (Fig. 2A). Expression levels of other IL-6 family members, including LIF and OSM were unchanged (data not shown). We also observed increased mRNA levels of IL33 and its receptor IL1R1 in cells treated with OSM and IL-6 + sIL-6R for 3 h and 24 h (Fig. 2A). Among the chemokines, increased mRNA levels of CCL7 (also known as MCP3), CXCL12 and CXCL2 was observed in response to both treatments at 3 h and 24 h (Fig. 2B). The expression of adhesion molecule ICAM-1 was increased only at the 3 h timepoint in cells treated with OSM and IL-6 + sIL-6R (Fig. 2C). Expression of other adhesion molecules, including ICAM-2 and VCAM-1 were unchanged (data not shown). Interestingly JUP (also known as plakoglobin or gamma catenin) and CAV1 mRNA levels were gradually decreasing over time with both treatments (Fig. 2C). These data suggest that both OSM and IL-6 + IL-6R can induce a proinflammatory phenotype in HDMECs, however IL-6 required a 10x higher concentration and the addition of the sIL-6R to achieve comparable results.
OSM Stimulates Transition To A Mesenchymal Phenotype In HDMECs
Previous studies have shown that bovine aortic endothelial cells (BAEC) treated with OSM became spindle-shaped and exhibited increased proliferation and migration [19]. Likewise, we found that HDMECs treated with human recombinant OSM (10 ng/ml) showed a statistically significant increase in mRNA levels of selected EndMT genes, including SNAIL1, TGFβ3, ET-1 and TGFβ3R at 3 h and 24 h when compared to the controls (Fig. 3A). Treatment with human recombinant IL-6 + sIL-6R had similar effects on the mRNA levels of TGFβ3, ET-1 and TGFβ3R, however significant changes to mRNA levels of SNAIL1 were only observed at 24 h (Fig. 3A).
To determine the effect of OSM and IL-6 + sIL-6R on EC morphology, we performed double-fluorescence staining for VE-cadherin and phalloidin. HDMECs treated with OSM showed decreased VE-cadherin staining as well as elongated F-actin stress fibers at 48 h and 72 h (Fig. 3B). In contrast, treatment with IL-6 + sIL-6R showed similar changes only at 72 h (Fig. 3B). Western blot analysis confirmed decreased levels of endothelial markers such as VE-cadherin and CD31 and increased levels of αSMA and TGFβ1, -2, -3 at 24 h and 48 h timepoints in cells treated with OSM or IL-6 + sIL-6R (Fig. 3C). Together these data suggest that both OSM and IL-6 + sIL-6R can induce morphological EndMT-like changes in HDMECs with OSM acting more rapidly when compared to IL-6 + sIL6R.
Because cells undergoing EndMT could acquire a more migratory phenotype, we assessed the effect of OSM and IL-6 + sIL-6R on HDMEC migration using the scratch assay provided by the Essen BioScience IncuCyteTM Live-Cell Imaging system. HDMECs were treated with OSM and IL6 + sIL-6R at the concentrations of 10, 50 and 100 ng/ml for 50 h. Cells stimulated with OSM showed significantly increased migration at the lowest dose, while the higher doses had no additional effect. In contrast, in cells treated with IL-6 + sIL-6R we only observed a trend toward increased migration, which was not statistically significant (Supplementary Fig. 2A). It may be relevant to the pro-migratory effects of OSM that plasminogen activation system-related genes, urokinase plasminogen activator (PLAUR) and tissue plasminogen activator (PLAT), were induced by OSM only [20] (Fig. 4C).
We next evaluated the effect of OSM and IL-6 + sIL-6R on HDMECs proliferation. Cells were treated with OSM and IL-6 + sIL-6R at the concentrations of 10, 50 and 100 ng/ml for 50 h. Both OSM and IL-6 + sIL-6R significantly induced proliferation of HDMECs, however IL-6 + IL-6R increased cell proliferation at lower concentrations than OSM (Supplementary Fig. 2B). OSM and IL-6 + sIL-6R exhibited similar behavior in a capillary tube formation assay in the presence of 2.5% FCS, however neither cytokine was able to efficiently induce tube formation in 1% FCS (Supplementary Fig. 2C). These data suggest that OSM compared to IL-6 + sIL-6R is a more potent inducer of HDMECs migration. In contrast, IL-6 + sIL-6R, although a weak stimulator of cell migration, potently induced proliferation of HDMECs. Together these data demonstrated an important role of OSM in modulating the function of HDMECs.
OSM induces a profibrotic response in the human skin organoid cultures
To further investigate the effects of OSM and IL-6 + IL-6Ra on vascular injury we employed an ex vivo human skin culture system, which more closely mimics the in vivo environment. OSM or IL-6 + sIL-6R treated tissue explants showed increased collagen deposition as well as an increased number of PDGFRβ+ cells around the vessels (Fig. 4A). To characterize those vessels, we performed double immunostaining for PDGFRβ and CD31. As shown on Fig. 4B, in tissues treated with OSM or IL-6 + sIL-6R, vessels with increased number of PDGFRβ positive cells also showed decreased expression of CD31. Moreover, we observed increased expression of phosphorylated STAT3 in the vessels and in numerous stromal cells in OSM and IL-6 + sIL-6R treated skin as compared to controls (Supplementary Fig. 3A). Interestingly, activation of PDGFRβ was only observed around the blood vessels, but not lymphatic vessels as illustrated by the double staining for PDGFRβ/podoplanin (PDPN) (Supplemental Fig. 3B). These observations are consistent with the expansion of the perivascular mesenchymal stromal cells during fibrosis [21].
To gain additional insights into the profibrotic effects of OSM, we assessed the expression of additional profibrotic genes. Cells treated with OSM or IL-6 + sIL-6R, showed decreased expression of FGFR1 and increased expression of FAP, POSTN and TIMP1 (Fig. 4C). Also, CHI3L1 (YKL-40), a protein associated with fibrosis that has been implicated in SSc lung and skin fibrosis, was highly elevated by OSM, and to a lesser degree by IL-6 + sIL-6R [22–25] (Fig. 4C). Notably, increased expression of hyaluronan synthase (HAS2) and decreased expression of Wnt pathway inhibitor Dkk1, were only observed in cells stimulated with OSM (Fig. 4). HAS2 has been shown to regulate EndMT during cardiac valve formation [26]. Furthermore, elevated expression of HAS2 by lung fibroblasts promoted severe lung fibrosis [27]. Activation of the Wnt pathway has also been implicated in the process of EndMT [28], and downregulation of Dkk1 has been shown in SSc skin in vivo and in cultured SSc fibroblasts [29, 30].
OSM-induced EC activation is mediated primarily by OSMRβ and depends on STAT3 phosphorylation
In humans, OSM signaling is initiated by binding of OSM to its specific type I receptor complex (LIFRβ/gp130) or type II receptor complex (OSMRβ/gp130). To determine which receptor is responsible for the OSM-induced phenotype in HDMECs, cells were treated with SCR, OSMRβ siRNA, LIFR siRNA or both for 48 h and then stimulated with OSM for another 3 h. Cells treated with siOSMRβ, siLIFR and both showed around 80% efficiency in downregulating these genes (Fig. 5A). Treatment with OSMRβ siRNA significantly decreased expression of IL-6, SNAIL1 and TIMP1, but only partially blocked the expression of OSM-induced TGFβ3 (Fig. 5B). In contrast, treatment with LIFR siRNA had no significant effect on the OSM-induced mRNA levels of any of these genes (Fig. 5B). Treatment with both OSMRβ/LIFR siRNA completely blocked the OSM-induced mRNA levels of all tested genes (Fig. 5B). This data suggests that OSM induces activation of HDMECs primarily via OSMRβ.
STAT3 is a transcription factor that is activated by IL-6 family cytokines, including OSM. The levels of the activated (phosphorylated) form of STAT3 are elevated in the skin and lung of SSc patients, suggesting that it is involved in SSc pathogenesis [31, 32]. HDMECs treated with OSM or IL-6 + sIL-6R showed increased phosphorylation of STAT3 (Fig. 5C). A specific inhibitor of STAT3, BP-1-102 (10uM) completely blocked the STAT3 phosphorylation (Fig. 5D). To determine if OSM and IL-6 + sIL-6R-induced phenotype is STAT3 dependent, we pretreated HDMECs with BP-1-102 for 1 h, and then treated with OSM and IL-6 + sIL-6R for another 3 h and 24 h. BP-1-102 pretreatment reversed the OSM- and IL-6 + sIL-6R induced mRNA levels of IL-6 and TGFβ3 (Fig. 5E). In contrast, inhibitors of TGFβ (SB431542), ERK (SCH772984) and WNT (ICG-001) signaling pathways had no effect on the OSM- and IL-6 + sIL-6R-induced gene expression (data not shown). These results suggest that OSM and IL-6 + sIL-6R can activate ECs directly via STAT3 phosphorylation, independent of TGFβ, WNT and ERK signaling.
OSMRβ expression in HDMECs is regulated by FLI1 and ERG
In the course of this study, we noticed that many of the effects of OSM/IL-6 on HDMECs, including downregulation of VE-cadherin and CD31, and upregulation of the pro-fibrotic and pro-inflammatory genes were similar to those previously attributed to the deficiency of FLI1 [33–35], thus raising the possibility that FLI1 may mediate some of the functional effects of OSM/IL-6. However, OSM/IL-6 did not affect FLI1 protein levels, suggesting that those cytokines act independently of FLI1. Since FLI1 and its close homolog, ERG are known to suppress inflammatory responses in ECs and the expression of both factors have been shown to be reduced in SSc ECs [33, 34], we next asked whether FLI1 or ERG could be involved in regulating the expression of OSMRβ. Depletion of either FLI1 or ERG led to increased mRNA and protein levels of OSMRβ, suggesting that the lower protein levels of these transcription factors in SSc vasculature, may, at least in part, contribute to the increased expression of OSMRβ in SSc dermal ECs.