Macrophage migration inhibitory factor mediates joint capsule fibrosis via facilitating phospholipid metabolite PGE2 production in fibroblasts.

Background: Joint capsule persistent inflammation and subsequent fibrosis lead to post-traumatic joint contracture (PTJC). Fibroblasts, as a bridge between inflammation and fibrosis, participate in regulating the pathological microenvironment after injury. Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine that can be inducibly expressed in lesioned joint capsule, yet its role in regulating fibroblast function to tune milieu following PTJC remains elusive.

Methods: The influence of MIF on the expression of phospholipid metabolite prostaglandin E2 (PGE2) and relevant pathways were investigated using qRT-PCR, Western blot, ELISA, EdU, Transwell, siRNA, and immunofluorescence following establishment of rat PTJC model, fibroblast model, and macrophage model.

Results: MIF/COX2/PGE2 synchronously increased in injured joint capsules following PTJC. Treatment the lesion sites with MIF inhibitor 4-IPP significantly reduced the expression of COX2 and PGE2. In vitro, MIF activated COX2/PGE2 pathway in joint capsule fibroblasts through interaction with membrane receptor CD74 and subsequent regulation of ERK/CREB signaling. Joint capsule fibroblast-derived PGE2 in turn selectively modulated fibroblast and macrophage functions to synergistically promote the inflammation and fibrosis process.

Conclusions: Our results reveal a novel function of MIF-mediated fibroblast, which tunes pathological microenvironment by activating phospholipid metabolism to accelerate and exacerbate joint capsule inflammation and fibrosis. These suggest a new insights and potential therapeutic strategy for inflammation- and fibrosis-associated diseases.