1. Introduction
Our previous studies demonstrated that adipose-derived stem cells (ASCs) have diverse skin and hair regenerative potential [
1,
2]. Although the injection of ASCs and a conditioned medium of ASCs (ASC-CM) promoted the telogen-to-anagen transition in an animal model, their regenerative potential remains unsatisfactory [
3,
4]. For example, anagen induction by ASCs or ASC-CM is not as effective as induction by minoxidil. Consequently, several studies have been conducted to identify ASC stimulators. ASCs can be stimulated with LL-37 to improve their paracrine effects and hair regenerative potential [
5]. Additionally, hypoxia and low-dose reactive oxygen species (ROS) promote ASC proliferation and the secretion of growth factors by ASCs, and ASC-CM obtained under hypoxia was reported to enhance the telogen-to-anagen transition in vivo [
6,
7]. Platelet-derived growth factor-D (PDGF-D) generates mitochondrial ROS to increase mitochondrial fission and ASC proliferation [
8]. Though PDGF-D-preconditioned ASCs show enhanced hair regenerative potential in vivo, there remains a need to further improve the hair inductivity of ASCs.
Our previous study aimed to differentiate ASCs into dermal papilla cells (DPCs) via the transfection of three trichogenic genes, namely PDGF-A, Sox2, and β-catenin [
9]. mRNAseq was performed to compare the global gene expression profiles of the ASCs, three gene-transfected ASCs (tfASCs), and DPCs. Amphiregulin and epiregulin are expressed at high levels in tfASCs and DPCs [
9]. As these molecules are epidermal growth factor (EGF) mimetics, we hypothesized that recombinant proteins of amphiregulin, epiregulin, or other EGF mimetics, such as heparin binding-EGF-like growth factor (HB-EGF), could differentiate or stimulate ASCs to enhance hair inductivity. Among these EGF mimetics, HB-EGF had the best effect on ASC proliferation and migration. Therefore, the hair growth function of HB-EGF was focused on in this study. It was first checked whether HB-EGF treatment can differentiate ASCs into DPCs. When HB-EGFs are treated for long periods of time, ASCs change their motility, but do not differentiate into DPCs, by confirming cell morphology and the expression of DPC marker genes. HB-EGF treatment did not affect ASC morphology and the expression level of the DPC marker genes (data not shown). Therefore, we focused on whether HB-EGF can stimulate ASC motility and their hair growth effect.
EGF and receptor tyrosine kinases of the EGF family (ErbBs) are essential in regulating cell proliferation, survival, differentiation, and migration. EGF assists in epidermal layer regeneration and is commonly used as a raw material in cosmetics, as well as to treat diabetic foot ulcers [
10]. EGF is involved in cancer progression and both inhibitors and antibodies targeting ErbBs have been developed to treat various cancer types [
11]. It was reported that EGFR signaling is indispensable for the initiation of hair growth, and the continuous expression of EGF prevents entry into the catagen phase [
12]. In addition, EGF promotes the proliferation and migration of follicular outer root sheath cells via Wnt/β-catenin signaling [
13]. However, whether EGF mimetics, such as HB-EGF, exert effects on hair growth or hair cycling has not been investigated.
The ligand specificity, redundancy, processing, variable tissue expression patterns, and signaling diversity of the EGF pathway have been well-reported. The mitogen-activated protein kinase (MAPK), STAT, and PI3K/Akt pathways are activated following EGF receptor (EGFR) phosphorylation. Between the phosphorylation of ErbB and these signaling molecules, SRC families play key roles in mediating the signaling pathways. EGF binding to its receptor causes rapid phosphorylation of the clathrin heavy chain at tyrosine 1477, which lies in a domain controlling clathrin assembly [
14]. In cells lacking SRC kinase, or cells treated with a specific SRC family kinase inhibitor, EGF stimulation of clathrin phosphorylation and redistribution does not occur, and EGF endocytosis is delayed [
14]. These observations demonstrate a role for SRC kinase in the modification and recruitment of clathrin during ligand-induced EGFR endocytosis. In our study, to elucidate novel receptor tyrosine kinase (RTK) binding with HB-EGF, we carried out an RTK assay. We found that Hck, which is one of the SRC family kinases, was phosphorylated after HB-EGF treatment, in addition to EGFR1. However, there is little to no evidence that Hck is associated with the ErbB and mitogenic signal pathways.
Although the basic fibroblast growth factor (bFGF) and PDGF families play key roles in the self-renewal, proliferation, and paracrine effects of ASCs, there have been several reports on the effects of EGF families on the proliferation and differentiation of ASCs during culturing. For example, EGF treatment promoted the proliferation and maintained the multipotency of continuously cultured ASCs via activating the STAT-signaling pathway in vitro [
15]. EGF increased the secretion of vascular endothelial growth factor, hepatocyte growth factor, and stromal-derived factor-1 via the ERK and JNK pathways in ASCs [
16]. Epiregulin promotes the migration and chemotactic abilities of ASCs via the MAPK pathways [
17]. However, the preconditioning effect of EGF mimetics, such as HB-EGF, on the hair regenerative potential of ASCs, has not been well-reported. Therefore, the present study investigated whether HB-EGF could enhance the hair regenerative potential of ASCs. The underlying signaling pathways and molecular mechanisms of ASC stimulation by these growth factors were clarified.
3. Discussion
HB-EGF is a mitogenic and chemotactic molecule involved in tissue repair, tumor growth, and other tissue-modeling phenomena, including angiogenesis and fibrogenesis. Therefore, HB-EGF has been used to increase the proliferation and migration of mesenchymal stem cells (MSCs), which proliferate more rapidly and persistently in the presence of HB-EGF. This effect is dose-dependent and is inhibited by anti-HER-1 and anti-HB-EGF antibodies [
20]. Ozaki et al. compared the chemotactic effects of growth factors and reported that EGF and HB-EGF showed mild stimulatory effects on MSCs [
21]. HB-EGF has been shown to significantly increase the proliferation and migration of MSCs isolated from bone marrow and amniotic fluid [
22]. HB-EGF also augments the ability of MSCs isolated from bone marrow and amniotic fluid to attenuate intestinal injury [
23]. It is of importance that the present study is the first, to the best of our knowledge, to indicate that HB-EGF has mitogenic and preconditioning effects on ASCs.
The present study aimed to investigate the mechanism of action underlying the enhancing effects of HB-EGF on the hair growth-promoting effects of ASCs in vivo. Initially, PKH26-labeled hASCs were traced in vivo, and HB-EGF-preconditioned ASCs survived for longer periods of time than control ASCs after injection. In addition, HE-EGF increased hASCs growth by checking the PKH26+ cell area in vivo. These data were consistent with the increase in cell proliferation and population doubling in vitro. In addition, HB-EGF-CM exerted a superior hair growth-promoting effect on the ASC-CM. The present study analyzed the mRNA expression of growth factors and the results showed that diverse growth factors were upregulated following HB-EGF treatment. Therefore, it is reasonable to suggest that HB-EGF preconditioning enhanced the hair inductivity of ASCs via the migration to hair follicles following the secretion of some growth factors, specially THPO (thrombopoietin).
When we evaluated the hair growth effect of BMP5, FGF23, IL2, THPO, and CSF3, only THPO led to significant hair growth promotion in vivo and ex vivo. In addition, THPO stimulated DPCs that increase DPC growth and the upregulation of DPC marker genes. THPO is also known as a megakaryocyte growth and development factor, and regulates the differentiation of megakaryocytes and platelets. However, there is currently no study on THPO and hair growth. It was only reported that there could be an association between pulmonary hypertension and the THPO level [
24]. THPO may be an important place for megakaryocytopoiesis in blood vessels [
24]. Interestingly, vasodilators such as minoxidil and udenfil stimulated ASC motility, thereby inducing hair growth [
25,
26]. The relationship between the THPO level, vasodilation, and hair growth should be further studied. In addition, the mRNA expression of THPO was not upregulated by HB-EGF in the NOX4-knockout ASCs, whereas the expression of THPO was significantly upregulated by HB-EGF in the control ASCs (
Figure 5G). These results indicate that a hypoxic condition can regulate THPO expression via NOX4 activity in ASCs. It has been reported that growth factors, including VEGF, PDGF, and EGF, are activated or secreted in a hypoxic state [
27,
28]. Although we did not check that hypoxia can induce THPO expression, an increased ROS level, which is a mimic condition with hypoxia in ASC by HB-EGF treatment, may induce the expression and release of THPO.
It has been reported that growth factors mediate increased proliferation, migration, and paracrine effects on ASCs via ROS generation [
8]. For example, PDGF-B increased the proliferation and migration of ASCs via ROS generation. PDGF-D also induced the mitogenic effects of ASCs via ROS generation, and the preconditioning of ASCs with PDGF-D increased the paracrine effects of ASCs, enhancing the hair inductivity of ASCs [
8]. EGF and its mimetics reportedly affect the proliferation and differentiation of ASCs [
15] and EGFRs mediate these functions via ROS generation in other cell types [
29]. However, this is the first indication that HB-EGF increases the mitogenic and hair growth-promoting effects of ASCs via ROS generation. The ROS-generating system was further examined and the results showed that HB-EGF led to ROS generation in the mitochondrial region in ASCs. The expression of NOX4 is high in the mitochondria of ASCs, and NOX4 silencing attenuated the stimulation by HB-EGF, indicating that HB-EGF increases ROS generation through mitochondrial NOX4 in ASCs.
It has been well-established that EGF mimetics increase cell proliferation and migration through Src family activation. For example, the EGF-dependent activation of Src family tyrosine kinases has been observed in NIH3T3 and A431 cells [
30]. The inhibition of Src family kinases by PP1 inhibits the EGF-induced activation of Akt, phosphorylation of c-Cbl, and ubiquitination of EGFR [
31]. However, there is little to no direct evidence that HB-EGF mediates mitogenic signals through the phosphorylation of Hck in ASCs. In the present study, it was found that HB-EGF phosphorylates Hck, which subsequently phosphorylates Akt and Erk. The siRNA-mediated knockdown of Hck attenuated the HB-EGF-mediated proliferation and migration of ASCs.
In summary, HB-EGF increased the proliferation, migration, and growth factor secretion of ASCs via ROS generation and the phosphorylation of Hck (
Figure 7). The preconditioning of ASCs with HB-EGF improved the hair growth-promoting effects of ASCs via the secretion of growth factors such as THPO. Thus, released THPO from ASCs stimulated DPCs, thereby transducing signals for hair growth. Therefore, combination therapy consisting of HB-EGF and ASCs may offer a novel solution for hair-loss treatment.
4. Materials and Methods
4.1. Cell Culture
Human ASCs were isolated via the liposuction of subcutaneous fat, as reported previously [
32,
33], following informed consent (Yonsei University College of Medicine, 4-2018-0141). The ASCs were cultured in α-MEM (α-minimum essential medium, Hyclone, Logan, UT, USA) with 10% FBS (fetal bovine serum, Gibco, CA, USA) and 1% penicillin/streptomycin (Gibco). Human DPCs were purchased from PromoCell (#C-12071) and cultured in follicle DPC medium with supplement mix (PromoCell, Heidelberg, Germany) and 0.1% anti-antibiotics (Gibco). DPCs and ASCs were maintained at 37 °C in a humidified 5% CO
2 incubator. DPCs and ASCs for all experiments were used at passages 2–3 and approximately passages 4–6, respectively.
4.2. Cell Growth Assay
To measure cell growth, the cells were seeded in 12-well plates at 5 × 103 cells per well, treated with HB-EGF (ASCs, 5 or 20 ng) and THPO (DPC, 5 or 20 ng), and incubated for 10 and 4 days, respectively. To measure the cell number, cells were then trypsinized (Gibco, CA, USA), stained with trypan blue (Sigma-Aldrich, MO, USA), and counted each day using a hemocytometer under a Nikon ECLIPSE Ts2 microscope.
4.3. Scratch Migration Assay
To measure the migratory effect, the cells were seeded into 6-well plates, treated with HB-EGF (5 and 20 ng) after 24 h, and cultured to confluence. A sterile 1-mL pipette tip was used to scratch the cell monolayer. The cells were then washed with PBS, treated again with HB-EGF (5 and 20 ng) in serum-free medium, and incubated for 4 days. The migration of cells into the scratched area (wound closure) was visualized using a ZEISS Observer D1 microscope. Multiple images were captured per well and monitored over 4 days. The average cell number was counted using the Adobe photoshop CS6 extended program.
4.4. Cell Migration Measurement Using a Transwell Migration Assay
The ASCs were seeded into 60-mm plates (5 × 104 per well) and treated with HB-EGF (5 and 20 ng) for 3 days. The cells (1.5 × 104 per well) were then cultured in serum-free medium for 24 h and seeded on the upper side of transwell membrane plates (BD Falcon, CA, USA). Next, 700 μL medium containing serum was added to the lower chambers. The cultures were incubated for 24 h to allow transwell migration. To remove non-migrated cells, the upper surface of inserts was cleaned with cotton swabs and washed with PBS. The inserts were stained with 0.1% formalin/2% crystal-violet solution (Sigma-Aldrich) for 30 min and dried. Multiple random images (10) per insert were captured using a ZEISS Observer D1 microscope and the average number of cells was counted using the Adobe photoshop CS6 extended program.
4.5. Measurement of Colony-Forming Units (CFUs)
For the clonogenic assay, 1 × 103 ASCs were seeded in six-well plates, treated with HB-EGF (5 or 20 ng) after 24 h, and incubated for 14 days. The cells were stained with formalin/0.1% crystal violet solution and analyzed using a Nikon ECLIPSE Ts2 microscope.
4.6. Measuring Population Doublings
To measure the population doublings of the ASCs following HB-EGF treatment, cells at passage 4 were seeded in 6-well plates at 5 × 104 cells per well, followed by the addition of HB-EGF the next day and incubation for 5 days. The cells were trypsinized, stained with trypan blue, and counted using a hemocytometer. This step was repeated up to seven times (until passage 11). The numbers of cells seeded at the start of each passage and harvested at the end were used to calculate the number of population doublings. The formula for population doublings (PD) is as follows: PD = ln (harvested cells/seeded cells)/ln 2, where PD = population doublings and ln = natural log.
4.7. RNA Extraction, Quantitative RT-PCR, qPCR Array, and RT-PCR
Total RNA was extracted from the ASCs using TRIzol reagent (Invitrogen, NY, USA). cDNA was synthesized using extracted RNA, oligodT, and the HelixCript™ Thermo Reverse Transcription system (NANOHELIX, WI, USA), according to the manufacturer’s instructions. SYBRGreen qPCR master mix (Takara, Shiga, Japan) was used for qPCR reactions, according to the manufacturer’s instructions. For the qPCR reaction, total RNA was extracted from HB-EGF (5 ng)-treated ASCs, THPO (20 ng)-treated DPCs, and NOX4-KO ASCs, and subjected to cDNA synthesis in the manner described above. The qPCR array for growth factors was conducted using an RT² First Strand cDNA Synthesis Kit (Cat#: PAHS-041ZC, QUAZEN, Hilden, Germany). For identification of the human
ALU and mouse
c-MOS genes, genomic DNA was isolated from human ASCs and mouse back skin tissues using a genomic DNA isolation kit (Bioneer, Daejeon, Korea). The RT-PCR conditions were as follows: 95 °C for 5 min, followed by 40 cycles of 95 °C for 1 min, 55 °C for 1 min, 72 °C for 1 min, and 72 °C for 10 min. The primers of human
ALU and mouse
c-MOS are described in
Supplementary Table S1.
4.8. X-Gal Staining for Cellular Senescence and Sudan III Staining
A β-galactosidase assay was carried out using a β-galactosidase staining kit (Sigma-Aldrich) to assess cellular senescence, according to the manufacturer’s instructions. In summary, aged cells were fixed with fixation buffer (20% formaldehyde and 2% glutaraldehyde in PBS) for 10 min and washed with PBS. The fixed cells were incubated at 37 °C overnight, following the addition of cell-staining solution containing potassium ferricyanide, potassium ferrocyanide, and X-gal. The following day, the cell-staining solution was removed and the cells were washed twice with PBS. Green-colored cells were considered senescent. For staining, fat droplet, control, or HB-EGF-treated ASCs were stained with sudan III (Sigma-Aldrich, MO, USA).
4.9. Hematoxylin and Eosin Staining
For hematoxylin and eosin staining, paraffin sections were dewaxed using xylene for 15 min three times and hydrated in 100%, 90%, 80%, and 70% EtOH. Then, slides were dipped into Mayer’s hematoxylin (Sigma-Aldrich) for 10 min and rinsed in flowing water for 1 min. Slides was again dipped into eosin Y (Sigma-Aldrich) for 1 min 30 sec and rinsed in flowing water for 1 min. Slides were dehydrated with 70%, 80%, 90%, and 100% EtOH; washed with fresh xylene for 15 min two times; and then dried and mounted with mounting medium. Images were captured using a ZEISS Observer D1 microscope.
4.10. Immunofluorescence Staining
The paraffin sections were dewaxed using xylene for 15 min three times and hydrated in 100%, 90%, 80%, and 70% EtOH. Antigen retrieval was performed by a microwave in boiling antigen retrieval solution (pH 6.0, Dako, CA, USA) for 2 min 20 s. The sections were stained with the rabbit Ki67 antibody (Abcam, IA, USA, 1:300) overnight at 4 °C, and then incubated with secondary antibodies, such as Alexa Fluor 594 goat anti-rabbit IgG or Alexa Fluor 488 goat anti-rabbit IgG (Invitrogen, NY, USA, 1:1000), for 1 h at room temperature with 4,6-diamidino-2-phenylindole (DAPI; Sigma-Aldrich). For cell staining with phospho-EGFR1, phospho-ErBb4, or phospho-Hck antibodies, the cells were fixed with 4% paraformaldehyde for 30 min at room temperature; washed with PBS; and incubated with phospho-EGFR1 (Abcam, 1:300), phospho-ErBb4 (Abcam, 1:300), or phospho-Hck (Abcam, 1:300) antibodies overnight at 4 °C. The samples were then incubated with Alexa Fluor 594 goat anti-rabbit IgG or Alexa Fluor 488 goat anti-rabbit IgG (Invitrogen, NY, USA, 1:1000) secondary antibodies for 1 h at room temperature with DAPI. Images of immunofluorescence staining were captured using a ZEISS LSM700 confocal microscope.
4.11. Western Blot Analysis
The cells were lysed with protein extraction solution (PRO-PREP™; iNtRON, Seoul, Korea) containing protease inhibitors and western blot analysis was performed as follows. The protein extracts were loaded on an 8% acrylamide gel, blotted on a nitrocellulose membrane, and incubated with the phospho-Hck antibody (Abcam, IA, USA, 1:500) overnight at 4 °C. The membrane was then washed with TBST buffer and incubated with HRP-tagged secondary antibodies (Jackson ImmunoResearch, PA, USA) for 1 h. Blot images were obtained using ImageQuant LAS 4000 (GE Healthcare Life Sciences, PA, USA).
4.12. Mouse Anagen Induction
The mice were maintained and anesthetized according to a protocol approved by the U.S. Pharmacopoeia and the Institutional Animal Care and Use Committee of Yonsei University (IACUC-201712-681-03, 22 October 2018: IACUC-201902-866-01, 11 March 2019). The dorsal region of 6-week-old male C3H/HeN mice in the telogen stage of the hair cycle was shaved with a clipper and electric shaver, with special care taken to avoid damaging the bare skin. Subsequently, 5 × 104 of the control ASCs or ASCs treated with HB-EGF for 48 h were injected into the dorsal skin of the shaved mice, as indicated. Conditioned medium from the ASCs or HB-EGF-treated ASCs was injected into the dorsal skin of the shaved mice. Any darkening of the skin (indicative of hair cycle induction) was carefully monitored by image capture. After approximately 16–17 days, the dorsal hair was shaved and weighed to estimate the growth rate, and the dorsal skin was analyzed using HE staining and immunostaining. Human THPO peptide (100 ng/per day/1 male, PeproTech, CA, USA) was injected into the dorsal skin of the shaved mice and also analyzed with the same method above mentioned.
4.13. Purification of Conditioned Medium and Vibrissae Follicle Organ Culture
For purification of the conditioned medium of control and HB-EGF-treated ASCs, the ASCs were seeded in a 100-mm plate at a density of 1 × 106. After 24 h, HB-EGF (5 ng) was added and cultured with normal medium for 2 days, and then cultured with serum-free medium for 1 day. The medium was filtered with a 0.2-µm membrane and was centrifuged in a VIVASPIN at 4 °C. For anagen induction, 100 µL conditioned medium was injected into the dorsal skin of the shaved mice. For organ culture, vibrissae hair follicles were cut from the vibrissae hair of C57BL/6 mice and washed with PBS on ice. Then, vibrissae hair follicles were cultured in special medium (Williams E medium supplemented with 2 mM l-glutamine, 10 µg mL−1 insulin, 10 ng mL−1 hydrocortisone, 1% penicillin/streptomycin, without serum) with the conditioned medium, THPO peptide (5 or 20 ng), for 3 days.
4.14. Statistical Analysis
Three independent experiments were conducted for all data points. All data are presented as the mean ± standard error. The mean values were compared using the Student’s t-test. For all statistical tests, p < 0.05 was accepted as statistically significant.