Cancer In normal cells, TGF-β, acting through its signaling pathway, stops the cell cycle at the G1 stage to stop proliferation, induce differentiation, or promote apoptosis. In many cancer cells, parts of the TGF-β signaling pathway are mutated, and TGF-β no longer controls the cell. These cancer cells proliferate. The surrounding stromal cells (fibroblasts) also proliferate. Both cells increase their production of TGF-β. This TGF-β acts on the surrounding stromal cells, immune cells, endothelial and smooth-muscle cells. It causes
immunosuppression and
angiogenesis, which makes the cancer more invasive. TGF-β also converts effector T-cells, which normally attack cancer with an inflammatory (immune) reaction, into regulatory (suppressor) T-cells, which turn off the inflammatory reaction. Normal tissue integrity is preserved by feedback interactions between different cell types that express adhesion molecules and secrete cytokines. Disruption of these feedback mechanisms in cancer damages a tissue. When TGF-β signaling fails to control NF-κB activity in cancer cells, this has at least two potential effects: first, it enables the malignant tumor to persist in the presence of activated immune cells, and second, the cancer cell outlasts immune cells because it survives in the presence of apoptotic, and anti-inflammatory mediators. Furthermore,
forkhead box protein 3 (FOXP3) as a transcription factor is an essential molecular marker of regulatory T (
Treg) cells.
FOXP3 polymorphism (rs3761548) might be involved in cancer progression like
gastric cancer through influencing Tregs function and the secretion of immunomodulatory cytokines such as
IL-10,
IL-35, and
TGF-β.
Liver fibrosis TGF-β1 has been implicated in the process of activating
hepatic stellate cells (HSCs) with the magnitude of
hepatic fibrosis being in proportion to increase in TGF-β levels. Studies have shown that ACTA2 is associated with TGF-β pathway that enhances contractile properties of HSCs leading to liver fibrosis.
Tuberculosis Mycobacterium tuberculosis infection, or tuberculosis, has been shown to result in increased levels of active TGF-β within the lung. Due to the broad range of suppressive effects of TGF-β on immune cells, computer modeling has predicted that TGF-β blockade may improve immune responses and infection outcome. Research in animal models has further shown that TGF-β impairs immune responses and elimination of TGF-β signaling results in an enhanced T cell response and lower bacterial burdens. Thus, therapies which block TGF-β may have the potential to improve therapy for tuberculosis.
Heart disease One animal study suggests that
cholesterol suppresses the responsiveness of cardiovascular cells to TGF-β and its protective qualities, thus allowing
atherosclerosis and
heart disease to develop, while
statins, drugs that lower cholesterol levels, may enhance the responsiveness of cardiovascular cells to the protective actions of TGF-β. TGF-β is involved in regeneration of zebrafish heart.
Marfan syndrome TGF-β signaling also likely plays a major role in the pathogenesis of
Marfan syndrome, a disease characterized by disproportionate height,
arachnodactyly,
ectopia lentis and heart complications such as
mitral valve prolapse and aortic enlargement increasing the likelihood of
aortic dissection. While the underlying defect in Marfan syndrome is faulty synthesis of the
glycoprotein fibrillin I, normally an important component of
elastic fibers, it has been shown that the Marfan syndrome phenotype can be relieved by addition of a TGF-β antagonist in affected mice. This suggests that while the symptoms of Marfan syndrome may seem consistent with a connective tissue disorder, the mechanism is more likely related to reduced sequestration of TGF-β by fibrillin.
Loeys–Dietz syndrome TGF-β signaling is also disturbed in
Loeys–Dietz syndrome which is caused by mutations in the TGF-β receptor.
Obesity and diabetes TGF-β/SMAD3 signaling pathway is important in regulating glucose and energy homeostasis and might play a role in
diabetic nephropathy. As noted above in the section about macrophages, loss of TGF-β signaling in obesity is one contributor to the inflammatory milieu generated in the case of obesity. Decreased levels of TGF-β have been observed in patients diagnosed with multiple sclerosis. Its role in multiple sclerosis can be explained due to TGF-β role in regulating apoptosis of
Th17 cells. The decreased TGF-β levels lead to increased Th17 cells and subsequently increased TNFα levels. suggesting a possible role in the neurodegenerative cascade leading to Alzheimer's disease symptoms and pathology. The role of TGF-β in neuronal dysfunction remains an active area of research.
Other Overactive TGF-β pathway, with an increase of TGF-β2, was reported in the studies of patients with
keratoconus. There is substantial evidence in animal and some human studies that TGF-β in breast milk may be a key immunoregulatory factor in the development of infant immune response, moderating the risk of atopic disease or autoimmunity. Skin aging is caused in part by
TGF-β, which reduces the subcutaneous fat that gives skin a pleasant appearance and texture.
TGF-β does this by blocking the conversion of
dermal fibroblasts into
fat cells; with fewer fat cells underneath to provide support, the skin becomes saggy and wrinkled. Subcutaneous fat also produces
cathelicidin, which is a
peptide that fights bacterial infections. == See also ==