Fibrosis contributes to ~45% of deaths in western countries. In chronic liver disease, fibrosis is a major factor determining outcomes, but efficient antifibrotic therapies are lacking. Although platelet-derived growth factor and transforming growth factor–β constitute key fibrogenic mediators, they do not account for the well-established link between cell death and fibrosis in the liver. Here, we hypothesized that damage-associated molecular patterns (DAMPs) may link epithelial cell death to fibrogenesis in the injured liver. DAMP receptor screening identified purinergic receptor P2Y14 among several candidates as highly enriched in hepatic stellate cells (HSCs), the main fibrogenic cell type of the liver. Conversely, P2Y14 ligands uridine 5′-diphosphate (UDP)–glucose and UDP-galactose were enriched in hepatocytes and were released upon different modes of cell death. Accordingly, ligand-receptor interaction analysis that combined proteomic and single-cell RNA sequencing data revealed P2Y14 ligands and P2Y14 receptor as a link between dying cells and HSCs, respectively. Treatment with P2Y14 ligands or coculture with dying hepatocytes promoted HSC activation in a P2Y14-dependent manner. P2Y14 ligands activated extracellular signal–regulated kinase (ERK) and Yes-associated protein (YAP) signaling in HSCs, resulting in ERK-dependent HSC activation. Global and HSC-selective P2Y14 deficiency attenuated liver fibrosis in multiple mouse models of liver injury. Functional expression of P2Y14 was confirmed in healthy and diseased human liver and human HSCs. In conclusion, P2Y14 ligands and their receptor constitute a profibrogenic DAMP pathway that directly links cell death to fibrogenesis.

Cholangiocarcinoma (CCA) comprises diverse tumors of the biliary tree and is characterized by late diagnosis, short-term survival, and chemoresistance. CCAs are mainly classified according to their anatomical location and include diverse molecular subclasses harboring inter-tumoral and intratumoral heterogeneity. Besides the tumor cell component, CCA is also characterized by a complex and dynamic tumor microenvironment where tumor cells and stromal cells crosstalk in an intricate network of interactions. Cancer-associated fibroblasts, one of the most abundant cell types in the tumor stroma of CCA, are actively involved in cholangiocarcinogenesis by participating in multiple aspects of the disease including extracellular matrix remodeling, immunomodulation, neo-angiogenesis, and metastasis. Despite their overall tumor-promoting role, recent evidence indicates the presence of transcriptional and functional heterogeneous CAF subtypes with tumor-promoting and tumor-restricting properties. To elucidate the complexity and potentials of cancer-associated fibroblasts as therapeutic targets in CCA, this review will discuss the origin of cancer-associated fibroblasts, their heterogeneity, crosstalk, and role during tumorigenesis, providing an overall picture of the present and future perspectives toward cancer-associated fibroblasts targeting CCA.

Abscisic acid (ABA) has shown anti-inflammatory and immunoregulatory properties in preclinical models of diabetes and inflammation. Herein, we studied the effects of ABA on angiogenesis, a strictly controlled process that, when dysregulated, leads to severe angiogenic disorders including vascular overgrowth, exudation, cellular inflammation and organ dysfunction. By using a 3D sprouting assay, we show that ABA effectively inhibits migration, growth and expansion of endothelial tubes without affecting cell viability. Analyses of the retinal vasculature in developing normoxic and hyperoxic mice challenged by oxygen toxicity reveal that exogenously administered ABA stunts the development and regeneration of blood vessels. In these models, ABA downregulates endothelial cell (EC)-specific growth and migratory genes, interferes with tip and stalk cell specification, and hinders the function of filopodial protrusions required for precise guidance of vascular sprouts. In addition, ABA skews macrophage polarization towards the M1 phenotype characterized by anti-angiogenic marker expression. In accordance with this, ABA treatment accelerates macrophage-induced programmed regression of fetal blood vessels. These findings reveal protective functions of ABA against neovascular growth through modulation of EC and macrophage plasticity, suggesting the potential utility of ABA as a treatment in vasoproliferative diseases.

Intrahepatic cholangiocarcinoma (iCCA) is an agressive tumour from the biliary tree that is characterized by a prominent desmoplastic stroma mainly composed of cancer-associated fibroblasts (CAF) and a poor prognosis due to its late clinical presentation and the lack of effective non-surgical treatments. Current therapies still include chemotherapeutic combinations of gemcitabine and cisplatin for the majority of the patients showing poor results due the apparition of resistance. This situation led us to interrogate the potential role in the development of chemoresistance of ZEB1, an EMT-inducing transcription factor (EMT-TF) that we previously identified as a pro tumorigenic factor in tumour cells and CAF of iCCA. By analysing human CCA samples and sc-RNAseq public databases, we show here that ZEB1 is present in the tumour microenvironment of all iCCA patients tested and is prominently expressed by CAF. Using cellular models of CAF, we show that cells depleted for ZEB1 are more sensitive to gemcitabine and cisplatin, via a mechanism involving the regulation of the anti-apoptotic gene BCL2. Moreover, ZEB1 expressing CAF protect iCCA tumour cells against the toxicity of the chemotherapeutic drugs, an event that could be reversed by a BCL2 inhibitor venetoclax. Therefore, our results point to the use of BCL2 inhibitors to improve the efficacy of current chemotherapeutic regimens of gemcitabine and cisplatin in iCCA patients.

Intrahepatic cholangiocarcinoma (iCCA) is an aggressive tumour from the biliary tree that is characterized by a prominent desmoplastic stroma, mainly composed of cancer-associated fibroblasts (CAF), and a poor prognosis due to its late clinical presentation and the lack of effective non-surgical treatments. Current therapies still include chemotherapeutic combinations of gemcitabine and cisplatin for the majority of the patients showing poor results due the apparition of resistance. This situation led us to interrogate the potential role in the development of chemoresistance of ZEB1, an EMT-inducing transcription factor (EMT-TF) that we previously identified as a pro-tumorigenic factor in tumour cells and CAF of iCCA. By analysing human CCA samples and sc-RNAseq public databases, we show here that ZEB1 is present in the tumour microenvironment of all iCCA patients tested and is prominently expressed by the myofibroblastic CAF subpopulation (myCAF). Using cellular models of CAF, we show that cells depleted for ZEB1 are more sensitive to gemcitabine and cisplatin, via a mechanism involving the direct regulation of the anti-apoptotic gene BCL2. Moreover, ZEB1 expressing CAF protect iCCA tumour cells against the toxicity of the chemotherapeutic drugs through the release of paracrine soluble factors, including CTGF, IL6 and IL8, an event that could be reversed by the BCL2 inhibitor venetoclax. Therefore, our results point to the use of BCL2 inhibitors as a way to improve the efficacy of current chemotherapeutic regimens in iCCA patients.