The TGFβ/BMP pathway was significantly overrepresented in the vitreous-modulated genes. TGF-β and BMP belong to the TGFβ superfamily of growth factors, both have been implicated in EMT
46 47 and both can induce Slug.
29 TGF-β is known to play an important role in wound-healing and fibrosis and it has been postulated that it plays a role in PVR. In a mouse model of PVR, signaling via SMAD3 (a downstream target of TGFβ) is necessary for PVR, for transdifferentiation of RPE cells and for RPE cell expression of the myofibroblast marker, smooth muscle actin.
48 Normal vitreous contains TGFβ2, and levels of this cytokine have been reported to be elevated in PVR.
49 50 51 52 53 Hence, vitreous treatment may be expected to activate TGF-β signaling, and we have preliminary evidence that TGF-β signaling plays a role in vitreous-induced phenotypic changes in low-passage human RPE cells
35 (Parapuram S, Li L, Ganti R, Hunt RC, Hunt DM, unpublished data, 2004–2006). From the array data, it appeared that the TGFβ-dependent arm of the pathway might be downregulated at later times, since expression of mRNA for TGFβ2, the major form of TGFβ made by RPE cells,
54 and its receptor TGFβR1 was decreased at 12 to 48 and 24 to 48 hours, respectively. The decrease in thrombospondin-1 (THBS1) and increase in latent TGFβ-binding protein (LTBP1) expression could result in less activation and more sequestration of TGFβ.
55 CTGF has been reported to be induced by TGFβ, to prolong TGFβ signaling, and to be important in some of the profibrotic effects of TGFβ.
56 Thus, although downregulation of CTGF mRNA was unexpected in view of some of the models of the initial events in PVR,
31 this finding would fit with the concept of decreased TGFβ signaling at later times in vitreous-treated RPE cells. In PVR, RPE cells can acquire myofibroblast-like properties, and TGFβ and CTGF play important roles in myofibroblast differentiation,
56 which is associated with increased smooth muscle actin (ACTA2) expression.
ACTA2 mRNA expression was decreased at later times, which would also be consistent with a downregulation of the TGFβ/CTGF pathway. Thus, although the vitreous-treated RPE cells have some features of fibroblasts, they may not be differentiating into myofibroblasts in this system, at least at the times examined. NRK fibroblasts treated with TGFβ and CTGF do not differentiate into myofibroblasts if they are still proliferating
57 and our experiments were performed with subconfluent cells in the presence of serum. Thus, even if TGFβ and CTGF were present and functional at early times, they may not be able to induce full myofibroblast differentiation in the subconfluent system. The fact that genes upregulated by vitreous did not include genes associated with fibrotic extracellular matrix production such as fibronectin or collagen I would be consistent with this. Thus, cultured, vitreous-treated RPE cells may be able to control fibrotic and myofibroblast responses induced by TGFβ by downregulation of the TGFβ pathway at later times, at least in subconfluent conditions. In vivo, additional factors, including variation between individuals in patterns of gene expression,
39 may interfere with this protective mechanism and contribute to the disease progression and fibrosis.