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mTOR inhibition and BMP signaling act synergistically to reduce muscle fibrosis and improve myofiber regeneration
Shailesh Agarwal, David Cholok, Shawn Loder, John Li, Christopher Breuler, Michael T. Chung, Hsiao Hsin Sung, Kavitha Ranganathan, Joe Habbouche, James Drake, Joshua Peterson, Caitlin Priest, Shuli Li, Yuji Mishina, Benjamin Levi
Shailesh Agarwal, David Cholok, Shawn Loder, John Li, Christopher Breuler, Michael T. Chung, Hsiao Hsin Sung, Kavitha Ranganathan, Joe Habbouche, James Drake, Joshua Peterson, Caitlin Priest, Shuli Li, Yuji Mishina, Benjamin Levi
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Research Article Inflammation Therapeutics

mTOR inhibition and BMP signaling act synergistically to reduce muscle fibrosis and improve myofiber regeneration

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Abstract

Muscle trauma is highly morbid due to intramuscular scarring, or fibrosis, and muscle atrophy. Studies have shown that bone morphogenetic proteins (BMPs) reduce muscle atrophy. However, increased BMP signaling at muscle injury sites causes heterotopic ossification, as seen in patients with fibrodysplasia ossificans progressiva (FOP), or patients with surgically placed BMP implants for bone healing. We use a genetic mouse model of hyperactive BMP signaling to show the development of intramuscular fibrosis surrounding areas of ectopic bone following muscle injury. Rapamycin, which we have previously shown to eliminate ectopic ossification in this model, also eliminates fibrosis without reducing osteogenic differentiation, suggesting clinical value for patients with FOP and with BMP implants. Finally, we use reporter mice to show that BMP signaling is positively associated with myofiber cross-sectional area. These findings underscore an approach in which 2 therapeutics (rapamycin and BMP ligand) can offset each other, leading to an improved outcome.

Authors

Shailesh Agarwal, David Cholok, Shawn Loder, John Li, Christopher Breuler, Michael T. Chung, Hsiao Hsin Sung, Kavitha Ranganathan, Joe Habbouche, James Drake, Joshua Peterson, Caitlin Priest, Shuli Li, Yuji Mishina, Benjamin Levi

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Figure 2

Rapamycin eliminates fibrosis associated with hyperactive BMP signaling.

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Rapamycin eliminates fibrosis associated with hyperactive BMP signaling....
(A) Area of myofiber injury with centralized nuclei in untreated or rapamycin-treated caAcvr1fl/fl mice 20 days after adenoviral Cre and cardiotoxin (Ad.cre/CTX) injury (black arrowheads indicate myofibers with centralized nuclei). (B) Fibrosis corresponding with regions of myofiber injury in untreated or rapamycin-treated caAcvr1fl/fl mice 20 days after Ad.cre/CTX injury (blue arrowheads indicate fibrosis). (C) Increased fibrosis based on picrosirius red staining in untreated caAcvr1fl/fl mice when compared with rapamycin-treated mice 20 days after Ad.cre/CTX injury (normalized ratio: 0.22 vs. 1.0, P < 0.05, Student’s 2-tailed t test, n = 3). (D) Increased ratio of collagen I (Col1a1) mRNA expression in injured muscle harvested from untreated caAcvr1fl/fl mice when compared with rapamycin-treated mice (2.73 vs. 1.27, Student’s 2-tailed t test, n = 6). (E) Representative immunostaining for platelet-derived growth factor receptor α (PDGFRA) in untreated and rapamycin-treated caAcvr1fl/fl mice 20 days after Ad.cre/CTX injury (white arrowheads indicate PDGFRA+ cells, white dashed line demarcates area of muscle injury). (F) Gating strategy for FACS analysis to quantify PDGFRA+CD45– (nonhematopoietic) and PDGFRA+CD45+ (hematopoietic origin) mesenchymal cells in untreated and rapamycin-treated Ad.cre/CTX-injured caAcvr1fl/fl mice. (G) Increased PDGFRA+CD45– (normalized ratio: 0.42 vs. 1.0, P < 0.05, n = 6 untreated, 4 rapamycin treated) and PDGFRA+CD45+ (normalized ratio: 0.12 vs. 1.0, P < 0.05, n = 6 untreated, 4 rapamycin treated) mesenchymal cells in hindlimbs from untreated caAcvr1fl/fl mice relative to rapamycin-treated mice 20 days after Ad.cre/CTX injury. SSC, side scatter. All scale bars: 200 μm. *P < 0.05.

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