Anti-fibrotic effect of a selective estrogen receptor modulator in systemic sclerosis

Stem Cell Res Ther. 2022 Jul 15;13(1):303. doi: 10.1186/s13287-022-02987-w.

Abstract

Background: The rarity of systemic sclerosis (SSc) has hampered the development of therapies for this intractable autoimmune disease. Induced pluripotent stem cell (iPSC) can be differentiated into the key disease-affected cells in vitro. The generation of patient-derived iPSCs has opened up possibilities for rare disease modeling. Since these cells can recapitulate the disease phenotypes of the cell in question, they are useful high-throughput platforms for screening for drugs that can reverse these abnormal phenotypes.

Methods: SSc iPSC was generated from PBMC by Sendai virus. Human iPSC lines from SSc patients were differentiated into dermal fibroblasts and keratinocytes. The iPSC-derived differentiated cells from the SSc patients were used on high-throughput platforms to screen for FDA-approved drugs that could be effective treatments for SSc.

Results: Skin organoids were generated from these cells exhibited fibrosis that resembled SSc skin. Screening of the 770-FDA-approved drug library showed that the anti-osteoporotic drug raloxifene reduced SSc iPSC-derived fibroblast proliferation and extracellular matrix production and skin fibrosis in organoids and bleomycin-induced SSc-model mice.

Conclusions: This study reveals that a disease model of systemic sclerosis generated using iPSCs-derived skin organoid is a novel tool for in vitro and in vivo dermatologic research. Since raloxifene and bazedoxifene are well-tolerated anti-osteoporotic drugs, our findings suggest that selective estrogen receptor modulator (SERM)-class drugs could treat SSc fibrosis.

Keywords: 3D skin organoid; Disease modeling; Drug repositioning; High-throughput screening; Induced pluripotent stem cells; Raloxifene; Systemic sclerosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cells, Cultured
  • Fibroblasts / metabolism
  • Fibrosis
  • Humans
  • Leukocytes, Mononuclear / metabolism
  • Mice
  • Raloxifene Hydrochloride / adverse effects
  • Scleroderma, Systemic* / genetics
  • Selective Estrogen Receptor Modulators / adverse effects
  • Skin / pathology
  • Skin Diseases* / pathology

Substances

  • Selective Estrogen Receptor Modulators
  • Raloxifene Hydrochloride