Human subjects: Upon informed consent and in compliance with the Institutional Review Board (IRB) for Human Studies, skin biopsy from the affected areas were obtained from nine patients with diffuse SSc, eight patients with limited SSc and seven healthy donors. Patient characteristics are included in Table 1.
Table 1. Healthy controls and Scleroderma patient’s data
Name
|
Sex
|
Age
|
Disease duration
|
Skin score
|
Endothelial cells / perivascular cells
|
Fibroblasts
|
HC1
|
F
|
42
|
-
|
|
+
|
-
|
HC2
|
F
|
28
|
-
|
|
++
|
+
|
HC3
|
F
|
52
|
-
|
|
+
|
-
|
HC4
|
M
|
28
|
-
|
|
+
|
-
|
Diffuse SSc 1
|
F
|
62
|
2 years
|
24
|
++
|
+
|
Diffuse SSc 2
|
F
|
47
|
1 year
|
15
|
+++
|
++
|
Diffuse SSc 3
|
F
|
47
|
8 years
|
15
|
+++
|
++
|
Diffuse SSc 4
|
F
|
72
|
1 year
|
34
|
++
|
++
|
Diffuse SSc 5
|
M
|
33
|
3 years
|
18
|
++
|
++
|
Diffuse SSc 6
|
M
|
36
|
7 years
|
35
|
+++
|
++
|
Diffuse SSc 7
|
M
|
61
|
5 years
|
54
|
+++
|
++
|
Limited SSc 1
|
F
|
42
|
2 years
|
3
|
+++
|
++
|
Limited SSc 2
|
F
|
52
|
2 years
|
3
|
++
|
+
|
Limited SSc 3
|
F
|
42
|
2 years
|
4
|
++
|
++
|
Limited SSc 4
|
F
|
68
|
1 year
|
0
|
+
|
+
|
Limited SSc 5
|
F
|
37
|
1 year
|
2
|
++
|
+
|
Limited SSc 6
|
F
|
52
|
5 years
|
16
|
++
|
++
|
Limited SSc 7
|
F
|
44
|
2 years
|
3
|
+++
|
+
|
Biopsies used in IF
|
|
|
|
|
|
|
HC 4
|
F
|
63
|
|
|
|
|
HC 5
|
M
|
44
|
|
|
|
|
HC 6
|
F
|
50
|
|
|
|
|
Diffuse SSc 8
|
F
|
60
|
5 years
|
12
|
|
|
Diffuse SSc 9
|
M
|
62
|
2 months
|
23
|
|
|
Limited SSc 10
|
F
|
74
|
4 years
|
0
|
|
|
F,female; M, male
Cells: Human dermal microvascular endothelial cells (HDMECs) were isolated from human foreskin as previously described [13, 14]. The human biological samples were sourced ethically, and their research use was in accord with the terms of the informed consents under an IRB/EC approved protocol. Cells were cultured on bovine collagen-coated 6-well plates in EBM medium supplemented with 10% FBS, and EC growth supplement mix at 37°C with 5% CO2 in air. All the experiments were performed on cells from early passages.
siRNA Transient Transfections
HDMECs were transfected with siRNA specific to human OSMRβ, LIFR, ERG and FLI1 (ON-TARGETplus SMART pool; GE Dharmacon, Lafayette, CO) or negative control siRNA at the concentration of 10 nM using Lipofectamine RNAiMAX Transfection Reagent (Thermo Fisher Scientific, Waltham, MA) according to the manufacturer's protocol.
Western Blot
For Western blot, whole-cell extracts were prepared from HDMECs using lysis buffer with the following composition: 1% Triton X-100, 50 mmol/L Tris-HCl (pH 7.4), 150 mmol/L NaCl, 3 mmol/L MgCl2, 1 mmol/L CaCl2, proteinase inhibitor mixture (Roche), and 1 mmol/L phenylmethyl sulfonyl fluoride. Protein extracts were subjected to SDS-PAGE and transferred to nitrocellulose membranes. Membranes were incubated overnight with primary antibodies, washed, and incubated for 1 hour with appropriate horseradish peroxidase-conjugated secondary antibody. After washing, visualization was performed by enhanced chemiluminescence (Pierce, Rockford, IL). Primary antibodies and concentrations are listed in Supplemental Table II.
Quantitative RT-PCR analysis
Total RNA was isolated using TRIzol reagent (MRC, Inc., Cincinnati, OH). Real-time PCR assays were performed using the StepOnePlus Real-Time PCR system (Applied Biosystems, Foster City, CA). Briefly, 1 μg of total RNA was reverse transcribed with random hexamers using the Transcriptor First Strand complementary DNA Synthesis kit (Roche Applied Science, Indianapolis, IN) according to the manufacturer's protocol. The amplification mixture (10 μl) contained 1 μl of complementary DNA, 0.5 μM of each primer, and 5 μl of SYBR Green PCR Master Mix. The primers are listed in Supplementary Table I. Relative changes in the levels of genes of interest were determined by the 2−ΔΔCT method.
Immunofluorescence staining on adherent cell cultures
For immunofluorescence, cultured HDMECs grown on collagen-coated cover slips. Cells were treated with OSM and IL-6+sIL6R for 48h and 72h, or siRNA for ERG and FLI1. Cells were fixed with 4% paraformaldehyde for 15 minutes. Non-specific protein binding was blocked with 3% BSA for 1 h. Next, cells were incubated at 4°C overnight with primary antibody. After washing, cell cultures were incubated with appropriate fluorophore-conjugated secondary antibody (Invitrogen, Carlsbad, CA) for 1.5 h. Skin biopsies were embedded in OCT and fixed in acetone:methanol (1:1). Sections were blocked in 3% BSA for 1h, before the addition of primary antibodies diluted in 1% BSA. After washing, sections were incubated in appropriate fluorophore-conjugated secondary antibodies for 45 minutes. Cells and biopsy sections were mounted on slides using Vectashield with DAPI (Vector Laboratories, Burlingame, CA) and examined using a FluoView FV10i confocal microscope system (Olympus, Center Valley, PA) at 488 nm (green), 594 nm (red) and 405 nm (blue). Secondary Alexafluor antibodies (Invitrogen, Carlsbad, CA) were used for each stain. Primary antibodies and concentrations are listed in Supplemental Table II
Migration and Proliferation assay
Migration and Proliferation were examined using the Essen BioScience IncuCyteTM Live-Cell Imaging system. Briefly, HDMECs were plated on an ImageLock 96-well plate and grown to 100% confluence (for the migration) or 5-10% confluence (for the proliferation) cells were treated additionally with 10, 50 and 100 ng/ml of OSM or IL-6 and sIL-6R Images were captured every 3h for a total of 50h. Area under curves was measured using the GraphPad Prism software.
Immunohistochemistry
Immunohistochemistry was performed on formalin-fixed, paraffin-embedded skin tissue sections. Briefly, sections (5-μm thick) were deparaffinized with Histo-Clear (National Diagnostics, Atlanta, GA), and rehydrated through a graded series of ethanol. For OSMRβ, endogenous peroxidase was blocked by incubation in 3% hydrogen peroxide for 30 minutes, followed by normal blocking serum for 1 hour. The sections were then incubated overnight at 4 °C primary antibody diluted in blocking buffer, followed by incubation for 30 minutes with appropriate polymer detection kit. Immunoreactivity was visualized with NovaRED (Vector Laboratories, Burlingame, CA). For OSM, antigen retrieval was performed using 1mM Tris-EDTA pH 9.0. Sections were blocked with TBS containing 5% normal horse serum, and then incubated overnight at 4 °C with primary antibody. Appropriate polymer detection kit was used for a subsequent 30 min incubation. Immunoreactivity was visualized with diaminobenzidine (Vector Laboratories, Burlingame, CA), and sections were counterstained with hematoxylin. For double staining, slides were prepared as described and incubated with primary antibody overnight. Subsequent appropriate polymer detection kit was used, and immunoreactivity was visualized with NovaRED (Vector Laboratories, Burlingame, CA). Quenching was achieved with 3% hydrogen peroxide. Sections were incubated in a primary antibody Appropriate polymer detection kit was used, and immunoreactivity was visualized with high depth blue (Enzo Life Sciences, Farmingdale, NY). Images were collected using a microscope (BH-2; Olympus, Center Valley, PA). ImmPRESS HRP Polymer Detection Kits (Vector Laboratories, Burlingame, CA) were used for each stain. Primary antibodies and concentrations are listed in Supplemental Table II.
Histologic assessment
The OSMRβ staining intensity for immunohistochemistry was scored semi-quantitatively. The staining intensity (1: negative or weak staining, 2: moderate staining, and 3: strong staining) were evaluated in six randomly selected fields in subcutaneous area. Then a semiquantitative score per sample was generated by calculating the average of the six intensity scores per sample. Semi-quantitative analysis was performed by two independent blinded researchers.
Gomori's Trichrome staining
Gomori's Trichrome staining was used to detect collagen deposition. The skin samples were fixed in 4% paraformaldehyde for 24h and then processed for paraffin embedding. Staining was performed on 5 µm thick paraffin sections following the manufacturer's instructions (Chromaview, Dublin, OH, Gomori's Trichrome Blue Collagen Kit cat#: S7440-19). Collagen fibers were stained blue, nuclei were stained black, and the background was stained red.
Human skin organoid culture ex vivo.
We utilized the previously described dermal ex vivo organoid culture technique [15]. The human biological samples were sourced ethically, and their research use was in accord with the terms of the informed consents under an IRB/EC approved protocol. Briefly, dermal biopsy punches (6mm) obtained from foreskins were placed onto nitrocellulose membranes, to avoid contact with plastic or matrigel, and treated with human recombinant OSM (obtained from GlaxoSmithKline, Stevenage, UK) and IL-6+sIL-6R for 14 days. The medium was changed, and the OSM and IL-6+sIL-6R treatments were repeated every 48h. At Day14, tissue biopsies were collected for IHC analysis.
Statistical analyses
Data were analyzed by Student’s t-Test or Mann-Whitney U-test where appropriate. The level for statistical significance was set at p≤0.05.