Small-molecule Wnt inhibitors are a potential novel therapy for intestinal fibrosis in Crohns disease

Clin Sci (Lond). 2022 Oct 14;136(19):1405-1423. doi: 10.1042/CS20210889.

Abstract

Intestinal fibrosis and stricture formation is an aggressive complication of Crohns disease (CD), linked to increased morbidity and costs. The present study investigates the contribution of Wingless-Int-1 (Wnt) signalling to intestinal fibrogenesis, considers potential cross-talk between Wnt and transforming growth factor β1 (TGFβ) signalling pathways, and assesses the therapeutic potential of small-molecule Wnt inhibitors. β-catenin expression was explored by immunohistochemistry (IHC) in formalin-fixed paraffin embedded (FFPE) tissue from patient-matched nonstrictured (NSCD) and strictured (SCD) intestine (n=6 pairs). Functional interactions between Wnt activation, TGFβ signalling, and type I collagen (Collagen-I) expression were explored in CCD-18Co cells and primary CD myofibroblast cultures established from surgical resection specimens (n=16) using small-molecule Wnt inhibitors and molecular techniques, including siRNA-mediated gene knockdown, immunofluorescence (IF), Wnt gene expression arrays, and western blotting. Fibrotic SCD tissue was marked by an increase in β-catenin-positive cells. In vitro, activation of Wnt-β-catenin signalling increased Collagen-I expression in CCD-18Co cells. Conversely, ICG-001, an inhibitor of β-catenin signalling, reduced Collagen-I expression in cell lines and primary CD myofibroblasts. TGFβ increased β-catenin protein levels but did not activate canonical Wnt signalling. Rather, TGFβ up-regulated WNT5B, a noncanonical Wnt ligand, and the Wnt receptor FZD8, which contributed directly to the up-regulation of Collagen-I through a β-catenin-independent mechanism. Treatment of CCD-18Co fibroblasts and patient-derived myofibroblasts with the FZD8 inhibitor 3235-0367 reduced extracellular matrix (ECM) expression. Our data highlight small-molecule Wnt inhibitors of both canonical and noncanonical Wnt signalling, as potential antifibrotic drugs to treat SCD intestinal fibrosis. They also highlight the importance of the cross-talk between Wnt and TGFβ signalling pathways in CD intestinal fibrosis.

Keywords: Crohns disease; Wnt proteins; fibrosis; inhibitors; intestine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Collagen Type I / metabolism
  • Crohn Disease* / drug therapy
  • Crohn Disease* / metabolism
  • Crohn Disease* / pathology
  • Fibrosis
  • Formaldehyde / metabolism
  • Humans
  • Intestines
  • Ligands
  • Myofibroblasts / metabolism
  • RNA, Small Interfering / metabolism
  • Transforming Growth Factor beta1 / metabolism
  • Wnt Signaling Pathway
  • beta Catenin* / metabolism

Substances

  • Collagen Type I
  • Ligands
  • RNA, Small Interfering
  • Transforming Growth Factor beta1
  • beta Catenin
  • Formaldehyde