Objective-We have investigated expression and function of the P2X 7 receptor in fibroblasts from healthy subjects and patients with type 2 diabetes. Methods and Results-Fibroblasts were isolated from skin biopsies. P2X 7 receptor expression in both cell populations was measured by functional assays, RT-PCR, fluorescence-activated cell sorter, and immunoblotting. We found that fibroblasts from diabetic subjects are characterized by enhanced P2X 7 -mediated responses as indicated by increased shape changes, microvesiculation, enhanced fibronectin and interleukin 6 secretion, and accelerated apoptosis. These responses were blocked by preincubation with the P2X blockers KN-62, oxidized ATP, or pyridoxal phosphate-6-azo(benzene-2,4-disulfonic acid). Furthermore, we also found a higher level of spontaneous fibronectin secretion and of apoptosis in fibroblasts from diabetic compared with healthy subjects. Both higher basal level of fibronectin secretion and spontaneous rate of apoptosis were likely attributable to the increased pericellular concentration of ATP because fibroblasts from diabetic subjects released 3ϫ as much ATP into the supernatants compared with fibroblasts from healthy subjects. Conclusions-We conclude that fibroblasts from type 2 diabetes patients are characterized by a hyperactive purinergic loop based either on a higher level of ATP release or on increased P2X 7 reactivity. (Arterioscler Thromb Vasc Biol.
2004;24:1240-1245.)Key Words: P2 receptors Ⅲ fibroblasts Ⅲ atherosclerosis Ⅲ cytokines Ⅲ diabetes Ⅲ apoptosis F ibroblasts are a key structural element of the arterial wall and a target and source of several diffusible factors that regulate the homeostasis of circulating and vessel wall cells. 1,2 They are well known for being the major producers of extracellular matrix, an active source of inflammatory mediators, as well as key players in wound repair and tissue remodeling. 3,4 In human pathology, fibroblast dysfunction is implicated in diseases of unknown etiology, such as scleroderma, but also in chronic degenerative diseases, such as atherosclerosis or diabetic angiopathy. 5,6 In the vessel wall, fibroblasts and smooth muscle cells share several features, and it is well established that within the atherosclerotic plaque, smooth muscle cells may acquire a dedifferentiated phenotype that resembles that of fibroblasts. 7 In turn, activated fibroblasts proliferate and migrate into the plaque, contributing to plaque thickening and fibrous cap formation. 8 In the atheromatous lesion, fibroblasts are the main source of extracellular matrix and the main causative agent of the progressive fibrosis, as well as an active source of mediators that stimulate endothelial cells and promote recruitment of leukocytes, thus accelerating damage of the arterial intima and media. 8 Under certain poorly known conditions, the fibrous cap can undergo thinning and set the conditions for life-threatening plaque rupture. Molecular mechanisms underlying this dramatic outcome are basically unknown, but sudden apoptosis of ...