1. Academic Validation
  2. Fidaxomicin Reduces Collagen Expression in Intestinal Fibroblasts Via Platelet-Derived Growth Factor Receptor Beta and Glycogen Synthase Kinase-3 Beta Inhibition

Fidaxomicin Reduces Collagen Expression in Intestinal Fibroblasts Via Platelet-Derived Growth Factor Receptor Beta and Glycogen Synthase Kinase-3 Beta Inhibition

  • Gastroenterology. 2025 May 19:S0016-5085(25)00765-6. doi: 10.1053/j.gastro.2025.04.028.
Sophie Irwin 1 Mieke van Daelen 1 Isabella Almaraz 1 Rebecca Park 1 Becca Nelson 1 Swapna Mahurkar-Joshi 2 Florian Rieder 3 David Q Shih 4 Wendy Ho 1 Berkeley Limketkai 1 Hon Wai Koon 5
Affiliations

Affiliations

  • 1 Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California.
  • 2 Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California; Goodman-Luskin Microbiome Center, David Geffen School of Medicine at UCLA, Los Angeles, California.
  • 3 Department of Gastroenterology, Hepatology, and Nutrition, Digestive Diseases Institute, Department of Inflammation and Immunity, Lerner Research Institute Program for Global Translational Inflammatory Bowel Diseases, Cleveland Clinic Foundation, Cleveland, Ohio.
  • 4 F. Widjaja Foundation, Inflammatory Bowel & Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California.
  • 5 Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California. Electronic address: hkoon@mednet.ucla.edu.
Abstract

Introduction: About 30%-50% of patients with Crohn's disease (CD) eventually develop intestinal strictures, with intestinal fibrosis being a major component of them. There is currently no approved medication to treat fibrotic strictures.

Methods: 10X Genomics Visium spatial RNA Sequencing and high-throughput screening were used to discover the molecular targets of intestinal fibrosis. Stricturing Crohn's disease (CDS) patient-derived primary human intestinal fibroblasts (CD-HIFs), stricturing Crohn's disease patient-derived serum exosomes (CDSE), fresh surgically resected whole-thickness ileal tissues, and mouse models of intestinal fibrosis were used.

Results: Spatial RNA Sequencing found overexpression of platelet-derived growth factor receptor beta (PDGFRB) in the fibrotic ileal tissues of CDS patients. PDGFRB siRNA inhibited Collagen expression in the CDSE-treated CD-HIFs. High-throughput screening identified PDGFRB inhibitors that suppressed Collagen promoter activity in CDSE-treated CD-HIFs. A machine learning algorithm and molecular docking predicted PDGFR as a target for fidaxomicin. Fidaxomicin, a Food and Drug Administration-approved drug for Cdifficile Infection, inhibited Collagen and PDGFRB messenger RNA (mRNA) expression in CDSE-treated CD-HIFs and CDS patient-derived ileal tissues. CDSE-treated CD-HIFs had increased PDGFRb and glycogen synthase kinase-3 alpha/beta (GSK3a/b) phosphorylation. Fidaxomicin inhibited PDGFRb phosphorylation, PDGFRB mRNA expression, and GSK3b phosphorylation in CDSE-treated CD-HIFs. The antifibrogenic effect of fidaxomicin was attenuated by platelet-derived growth factor-BB (PDGF-BB) and insulin-like growth factor 1, which are a PDGFRb ligand and a GSK3a/b phosphorylation activator, respectively. In the SAMP1/YitFc mice, oral fidaxomicin treatment inhibited ileal fibrosis and ileal PDGFRB mRNA expression and PDGFRb and GSK3b phosphorylation, which were abolished by Pdgfrb and Gsk3b overexpression.

Conclusions: Fidaxomicin inhibits intestinal fibrosis by reducing PDGFRb phosphorylation and expression, GSK3b phosphorylation, and Collagen expression in intestinal fibroblasts.

Keywords

Fibrosis; High-Throughput Screening; Protein Array; Receptor; Spatial RNA Sequencing.

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