Targeting TAZ and YAP as a New Therapeutic Approach to Diabetic Nephropathy
Introduction Fibrosis is a major contributor to chronic kidney disease (CKD), for which no effective clinical treatment exists. The primary source of fibrosis is the activation of fibroblasts to the myofibroblast state. Fibroblast-myofibroblast transition requires transforming growth factor-β (TGF-β) and its canonical Smad signaling pathway. Purpose Recent findings suggest that mechanical stimuli affect fibroblast behavior. Nuclear localization of YAP/TAZ, closely associated mechanosensitive transcriptional co-factors, are regulated by substrate stiffness. As YAP/TAZ are Smad nuclear retention factors promoting TGF- β signaling, we hypothesized that YAP/TAZ inhibition could attenuate stiffness-mediated, TGF- β induced pro-fibrotic responses. Methods Immunostaining and immunoblotting were used to analyze localization and activity of YAP/TAZ and Smad levels, respectively. Results YAP/TAZ are in an active nuclear location in fibroblasts grown on stiff, fibrotic-like substrates (100kPa). In fibroblasts grown on soft substrates (2kPa), YAP/TAZ are primarily in an inactive cytosolic position. Cells grown on soft surfaces demonstrated strongly attenuated nuclear Smad 2/3 translocation and Smad-3 dependent transcription upon TGF-β stimulation, indicating impaired pro-fibrotic signaling. Verteporfin, a clinically approved drug with YAP inhibitory properties, was used to test the role of YAP/TAZ in reduced TGF-β signaling. Verteporfin reduced TGF-β-induced nuclear Smad2/3 accumulation and Smad3-mediated transcription in fibroblasts grown on stiff surfaces. In vivo, Verteporfin significantly reduces markers of renal fibrosis. Conclusions Soft, healthy kidney-like substrates inhibit, while stiff fibrotic-like substrates promote, pro-fibrotic TGF-β Smad signalling. Verteporfin inactivates the YAP/TAZ fibroblast mechanosensor, reduces stiffness-augmented fibroblast responses to TGF-β through blockade of Smad signalling, and may be a novel anti-fibrotic agent for CKD.