Smoothened Regulates Migration of Fibroblast-Like Synoviocytes in Rheumatoid Arthritis via Activation of Rho GTPase Signaling.

Fibroblast-like synoviocytes (FLSs) acquire aggressive phenotypes characterized with enhanced migration abilities and inherent invasive qualities in rheumatoid arthritis (RA). Smoothened (Smo) is a key component of sonic hedgehog (Shh) signaling and contributes to tumor cell invasion and metastasis. The objective of this study is to investigate the role of Smo in the modulation of cell migration and explore the underlying molecular mechanism(s). FLSs were isolated from RA synovium. Shh levels were regulated by a Smo agonist (purmorphamine), Smo antagonist (KAAD-cyclopamine), or small interfering RNA targeting the Smo gene (Smo-siRNA) in RA-FLSs. Expression of Smo was detected by real-time PCR and western blot analysis. Cell migration was examined by Transwell assay and activation of Rho GTPases was measured by pull-down assays. Incubation with purmorphamine resulted in a significant increase of cell migration and activation of Rho GTPase signaling compared to controls (P < 0.05). However, treatment with KAAD-cyclopamine or transfection with Smo-siRNA suppressed migration of RA-FLSs and showed an inhibitory effect of Rho GTPase signaling. Together, these results suggest that Smo plays an important role in RA-FLSs migration through activation of Rho GTPase signaling and may contribute to progression of RA, thus, targeting Shh signal may have a therapeutic potential in patients with RA.

Introduction

Activated fibroblast-like synoviocytes (FLSs) comprising the major cell population of the hyperplastic synovial linings have a central role in the pathogenesis of rheumatoid arthritis (RA). The FLSs of RA (RA-FLSs) display pathologic features including excessive proliferation, resistance to apoptosis, enhanced migration, and invasive properties (1). The aggressive phenotype of RA-FLSs was confirmed in a cartilage-severe combined immune deficient (SCID) mouse implantation model, showing that RA-FLSs spontaneously adhere to and invade into the articular cartilage (2). The tumor-like behavior of RA synoviocytes contributes to synovial hypertrophy and formation of invasive pannus tissue and ultimately leading to joint destruction (3). Therefore, therapies suppressing the tumor-like behavior of RA-FLSs could be one of the potential approaches for the treatment of RA, which could be a complement for the current immune-directed therapies.

Sonic hedgehog (Shh) signaling pathway is active in embryonic development; however, this morphogenetic signaling pathway is quiescent in healthy adult tissues. Recent studies reported that Shh signaling could function through “canonical signaling” or “non-canonical signaling.” In the canonical pathway, Shh signaling is launched by binding of Shh ligand to the transmembrane receptor, patched, and then the suppression of Smoothened (Smo) is reversed, resulting in the activation of Gli family of zinc-finger transcription factors and expression of downstream target genes (4). In the non-canonical Shh signaling pathway, Smo signals through heterotrimeric G proteins and stimulates the activation of Rho GTPases, and the signaling is independent of Gli activation (5). Smo is a key component in both the canonical and non-canonical Shh signaling pathway.

Accumulated evidence has suggested that aberrant activation and dysregulation of Shh signaling was also involved in adult tissues of various cancers, including basal cell carcinoma (BCC), medulloblastoma, lung, pancreatic, gastric, and renal cancers (6, 7). It has been demonstrated that Shh either directly regulates cellular growth and survival or indirectly influences the tumor stroma (8). Furthermore, overexpression of Shh signaling contributes to the invasiveness of cancer and the progression of non-invasive cancer to invasive cancer (9, 10). The non-canonical Shh signaling also promotes cell migration including FLSs migration and endothelial cell tubulogenesis (5, 11).

Recently, we have identified the overexpression of Shh signaling in RA synovium and selective inhibition of Shh by blocking Smo suppressed the proliferation of RA-FLSs, accompanying with the decreased expression of Gli1 in FLSs isolated from RA synovium (RA-FLSs) (12, 13). Others recently also demonstrated that Shh/Gli signaling contributes to proliferation of RA-FLSs (14). These observations suggest that Shh signaling may involve in the cell survival in a canonical manner. Additionally, previous studies also revealed that Rho GTPases including RhoA, Rac1, and Cdc42 contributed to abnormal migration and invasion of RA-FLSs (15–17). However, it is unclear whether Shh signaling has any effects on migration of RA-FLSs. In the current study, we made a new observation that stimulating and inhibiting Smo markedly modulates RA-FLSs migration. Moreover, we also demonstrated that the effect of Shh signal on RA-FLSs is mostly mediated by activating Rho GTPases.

Materials and Methods

Ethics and Samples

Han Chinese patients, including six patients with active RA (n = 6, 3 males, 3 females, mean age 54.16 ± 10.60 years), eight control patients with OA (n = 4, 2 males, 2 females, mean age 61.5 ± 4.6 years) and four patients with knee traumatic injury (n = 4, 2 males, 2 females, mean age 33.50 ± 6.60), were recruited from the third Affiliated Hospital at Sun Yat-sen University in Guangzhou, China, from January to August 2013. All the subjects collected were taking DMARDs, including methotrexate (10–15 mg/week) in combination with leflunomide (20 mg/day) or sulfasalazine (1.5–2 g/day). Some patients were treated with biologics (infliximab or adalimumab or tocilizumab) for at least 6 months. For patients suffering from joint pain or dysfunction, NSAIDs or low dose of steroid was used. Despite receiving intensive therapies, the patients were still with high disease activity and rapid radiographic progression. Synovial tissues were obtained during knee arthroscopy. The arthroscopy was applied in RA patients with severe cartilage or bone destruction by synovial hyperplasia that results in joint dysfunction or disabilities. One of the two surgical approaches, total joint replacement, or synovectomy was applied with the patients’ consents (18). RA patients were classified according to the 1987 American College of Rheumatology (ACR) revised classification criteria (19) and exhibited moderate to severe disease activity (disease activity score of 28 joint counts >3.2). This study was approved by the Medical Ethics Committee of the third Affiliated Hospital of Sun Yat-sen University. Written informed consent was obtained from all patients.

Cell Culture and Stimulation

Fibroblast-like synoviocytes were isolated and cultured from synovium of patients with RA, OA, and knee traumatic injury. The mass of tissue specimens obtained from each patient for cell culture were almost 30–50 g. Briefly, the collected synovial tissues were finely minced into pieces and transferred to a tissue culture flask in Dulbecco’s modified Eagle’s medium (DMEM) (Hyclone Laboratories, Losan, UT, USA) supplemented with 10% fetal bovine serum (FBS) (Hyclone Laboratories). Within 14 days, FLSs migrated out from the tissue explant and formed confluent monolayers. At approximately 80% confluency, FLSs were subsequently trypsinized, collected, re-suspended, and planted for expansion. FLSs of the three to five generation showed typical morphological characters under phase contrast microscope and the expression level of CD55 was over 95% using flow cytometry method. To examine the effect of Smo on cell migration and activation of RhoA and Rac1 of RA-FLSs, cells were incubated with Smo agonist (purmorphamine, 5 μmol/l) or Smo antagonist (KAAD-cyclopamine, 1 μmol/l) for 24 h. The control group was treated with vehicle (dimethyl sulfoxide in DMEM supplemented with 10% FBS).

RNA Isolation and Real-time PCR Analysis

Total RNA was extracted using Trizol reagent (Invitrogen Life Technologies, Santa Clara, CA, USA). cDNAs were synthesized from the isolated total RNA using the Prime Script®RT Reagent Kit (Takara Biotechnology, Dalian, China) according to the manufacturer’s protocols. Quantification of the expression of human Smo and GAPDH mRNAs was determined using SYBR® Premix Ex TaqTM Kit (Takara Biotechnology) on an ABI-7500 Thermal Cycler (Applied Biosystems Inc., Foster City, CA, USA) according to the manufacturer’s instructions. All experiments were examined in triplicate and positive (sample from liver cancer cells containing Smo nucleotide sequence) and negative (sterile deionized water containing no template) controls were included. Relative levels were quantified using the comparative ΔCt method. The expression of mRNA in FLSs of RA and OA patients was given as fold change of mRNA abundance relative to that in FLSs of patients with knee trauma. Primers for amplification were as follows (forward, reverse): Smo: forward: 5′-CCT GCT CAC CTG GTC ACT C-3′, reverse: 5′-CAC GGT ATC GGT AGT TCT TGT AG-3′, GAPDH: (5′-GGA TAT TGT TGC CAT CAT TdT dT-3′, 5′-AAT GAT GGC AAC AAT ATC CdT dT-3’).

Western Blot Analysis

Total protein was extracted using a cell lysis buffer containing protease and phosphatase inhibitors (Cell Signaling Technology, Beverly, MA, USA). Protein lysates (30 μg protein) were loaded and separated by 12% sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and then transferred to a polyvinylidene fluoride (PVDF) membrane. The membranes were blocked at room temperature for 2 h and probed overnight at 4°C with primary antibodies. Primary antibodies included rabbit anti-Smo (1:2,000, Santa Cruz Biotechnology, Dallas, TX, USA), and the phosphorylation of myosin phosphatase targeting subunit 1 (MYPT1, 1:500, Cell Signaling Technology, Beverly, MA, USA). Membranes were subsequently incubated with secondary antibodies conjugated with horseradish peroxidase at room temperature for 1 h and the immobilized proteins were measured by the enhanced chemiluminescent (ECL) detection system. The band density was quantified by AlphaView software (San Jose, CA, USA).

Cell Migration

Migration ability of FLSs was measured in a Transwell cell culture chamber apparatus with 8 μm pore membrane (Costar, New York, NY, USA). Briefly, FLSs were seed at a density of 5 × 104 cells/ml in six-well plates. Twelve hours later, FLSs were trypsinized, collected, and re-suspended with serum-free medium. The cell suspension (5 × 103 cells/ml) was loaded into the upper chamber of the Transwell insert. Medium containing 10% FBS (600 μl) was added to the lower compartment as a chemoattractant. After 8 h of incubation, the filters were removed and cells remaining on the upper surface of the membrane were removed with a cotton swab. The cells adhering beneath the membrane were fixed in 4% paraformaldehyde and stained with crystal violet for 30 min. Migration ability of FLSs was quantified by cell counts of five random fields at 100 magnifications in each membrane.

Pull-Down Assay

To determine the activation of RhoA and Rac1 in FLSs of RA, OA, and patients of knee trauma, and the effect of Smo on RhoA and Rac1 activation in RA-FLSs, pull-down assays were performed according to the manufacturer’s protocol (RhoA activation assay kit and Rac1 activation assay kit, Millipore, MA, USA). Briefly, at 80% confluency, FLSs were lysed and the lysates were collected and stored at −80°C for the pull-down assay. Thirty microliters of the Rho or Rac1 Assay Reagent were added to 500 μl cell extract and the reaction mixtures were incubated for 45 min at 4°C with gentle agitation. After brief centrifugation (10 s, 14,000 × g, 4°C), the agarose beads were washed three times with 1× MLB, the supernatant was removed, and the agarose beads were re-suspended in 2× Laemmili-reducing sample buffer. Bound proteins were collected and examined by Western Blot analysis as previously described. GTP-RhoA or GTP-Rac1 was detected using anti-RhoA (3 μg/ml, Millipore, MA, USA) or anti-Rac1 antibodies (1 μg/ml, Millipore, MA, USA), respectively.

RNA Interfering

Three sequences of siRNA targeting human Smo (Smo-homo-1542, Smo-homo-1292, Smo-homo-1732, Gene Pharma Co., Shanghai, China) were designed and synthesized. Smo-homo-1542: 5′-GGA GUC AUG ACU CUG UUC UTT-3′; 5′-AGA ACA GAG UCA UGA CUC CTT-3′; Smo-homo-1292: 5′-CUG GCA CAC UUC CUU CAA ATT-3′; 5′-UUU GAA GGA AGU GUG CCA GTT-3′; Smo-homo-1732: 5′-GGG ACU AUG UGC UAU GUC ATT-3′; 5′-UGA CAU AGC ACA UAG UCC CTT-3′; GAPDH: 5′-GGA TAT TGT TGC CAT CAT TdT dT-3′; 5″-AAT GAT GGC AAC AAT ATC CdT dT-3′; negative control: 5′-UUC UCC GAA CGU GUC ACG UTT-3′; 5′-ACG UGA CAC GUC GGA GAA TT-3′. At 40% confluency, RA-FLSs were transfected with siRNAs against Smo using the X-treme GENE siRNA transfection reagent (Roche, Mannheim, Germany) according to the manufacturer’s protocol. A glyceraldehyde-3-phosphate dehydrogenase (GAPDH-siRNA) positive control, a negative control siRNA (NC-siRNA group), and mock transfection (control group) were used for the studies. Cell viability after transfection was declined in some degree, but there is no statistical difference between experiment groups and control groups. The transfection efficiency was assessed by fluorescence microscopy 6 h after transfection with FITC-conjugated control siRNA. Transfection efficiency was over 90%. Gene silencing efficiency was determined 48 h posttransfection by Western Blot analysis.

Statistical Analysis

SPSS statistical software, version 17.0 (Chicago, IL, USA), was used for all statistical analyses. Values are presented as means ± SD. Statistical differences among groups were tested by one-way analysis of variance (ANOVA) or the Kruskal–Wallis test. Statistical significance was set at P < 0.05.

Results

SMO Was Highly Expressed in Cultured FLSs from RA Patients

Expression of Smo mRNA was detected in FLSs from RA, OA, and patients of knee trauma utilizing real-time PCR. Although Smo mRNA was expressed in FLSs isolated from RA, OA patients, and patient with traumatic injury, its levels were significantly greater in RA-FLSs than on FLSs from patients with knee trauma (Figure 1A). Western Blot analysis demonstrated that the expression of Smo protein in FLSs from RA patients was also higher compared to FLSs from patients with traumatic injury (Figure 1B). Interestingly, both Smo mRNA and protein were expressed in FLSs of OA (OA-FLSs), but the expression was significantly lower compared to that of RA-FLSs.

Figure 1

Smo was highly expressed in cultured fibroblast-like synoviocytes (FLSs) from rheumatoid arthritis (RA) patients. RA-FLSs, OA-FLSs, and FLSs from patients with knee traumatic injury were isolated and cultured. The expression of Smo mRNA was detected by real-time PCR. Relative quantification of gene expression was performed by the 2−ΔΔCt method (A). The expression of Smo protein was examined by Western Blot analysis (B). The results represent the mean ± SD of three independent experiments. *P < 0.05 versus control group.

FLSs from RA Patients Showed Property of Migration and Activation of Rho GTPase Signaling

In order to examine the property of migration of FLSs from patients of RA, OA, and knee trauma, we conducted Transwell assay and observed that the numbers of migrated cells were significantly higher in RA-FLSs (133.00 × 104 ± 4.73 × 104) than that in OA-FLSs (81.33 × 104 ± 1.45 × 104) and FLSs from patients with traumatic injury (45.67 × 104 ± 4.48 × 104) (P < 0.05) (Figure 2C). To further investigate whether the higher levels of migration rates of RA-FLSs were associated with activation of Rho GTPases, we determined the activation of RhoA and Rac1 using pull-down assays. The results revealed that the activities of RhoA and Rac1 were significantly increased in RA-FLSs, compared to that in OA-FLSs and FLSs from patients of trauma (Figures 2A,B).

Figure 2

Fibroblast-like synoviocytes (FLSs) from rheumatoid arthritis (RA) patients showed property of migration and activation of Rho GTPase signaling. RA-FLSs, OA-FLSs, and FLSs from patients with knee traumatic injury were isolated and cultured. The activation of RhoA and Rac1 was detected by pull-down assays (A,B). Cell migration was evaluated using Transwell assays and the numbers of migrated cells were calculated (×104 cells/ml) [(C), d] and representative images of migrated cells in RA-FLSs [(C), a], OA-FLSs [(C), b], and FLSs from patients of traumatic injury [(C), c] were displayed (100 magnifications). The results represent the Mean ± SD of three independent experiments. *P < 0.05 versus control group.

Smo Agonist and Antagonist Regulates RA-FLSs Migration and Rho GTPase Signaling

To investigate the effect of Smo on RA-FLSs migration, FLSs cells were treated in the presence of Smo agonist (purmorphamine, 5 μmol/l) or Smo antagonist (KAAD-cyclopamine, 1 μmol/l). As shown in Figure 3A, expression of Smo protein was significantly decreased after incubation with KAAD-cyclopamine and increased after treatment with purmorphamine. Furthermore, we found that purmorphamine effectively increased the numbers of migrated cells (155.70 × 104 ± 3.84 × 104), compared to controls (122.70 × 104 ± 2.73 × 104) (P < 0.05). We also observed that the migration of RA-FLSs significantly decreased by KAAD-cyclopamine, with decreased numbers of migrated cells 75.33 × 104 ± 1.45 × 104 (P < 0.05) compared to control incubation (Figure 3B).

Figure 3

Smo agonist and antagonist regulated rheumatoid arthritis (RA)-fibroblast-like synoviocytes (FLSs) migration and RhoGTPase signaling. RA-FLSs were cultured for 24 h before incubation with Smo agonist (purmorphamine, 5 μmol/l) or Smo antagonist (KAAD-cyclopamine, 1 μmol/l) for 24 h. The effects of purmorphamine and KAAD-cyclopamine on the expression of Smo were measured by Western Blot analysis, and Smo expression was evaluated and normalized to GAPDH (A). Cell migration was evaluated using Transwell assays and the numbers of migrated cells were calculated (×104 cells/ml) [(B), d]. Representative images of RA-FLSs migration after treatments with purmorphamine [(B), a], KAAD-cyclopamine [(B), b], or vehicle [(B), c] were displayed (100 magnifications). The activation of RhoA and Rac1 was detected by pull-down assays (C,D). Expression of MYPT1 was detected by Western Blot analysis and the levels of phospho-MYPT1 were normalized to expression of total MYPT1 (E). The results are the mean ± SD of three independent experiments. *P < 0.05 versus control group. pur, purmorphamine; K-cyc, KAAD-cyclopamine; MYPT1, myosin phosphatase targeting subunit 1.

To elucidate the effects of purmorphamine and KAAD-cyclopamine on Rho GTPase signaling, the activities of RhoA and Rac1 were examined in the current study. The results revealed that incubation of purmorphamine significantly increased the activities of RhoA and Rac1 in RA-FLSs, compared to the controls (Figures 3C,D). Accordingly, the activities of RhoA and Rac1 were significantly inhibited in the presence of Smo antagonist (Figures 3C,D). To further investigate the activation of RhoA/Rho-associated kinase (ROCK) signaling by Smo modulation, the effector of RhoA/ROCK, the levels of phosphorylation of MYPT1 were determined by Western Blot analysis in this study. Quantification demonstrated that phospho-MYPT1 was largely induced by purmorphamine in RA-FLSs. By contrast, inhibition of Smo significantly decreased the phosphorylation of MYPT1 (Figure 3E).

Knockdown of SMO Mediated by siRNA Decreased RA-FLSs Migration and GTPase Signaling

Based on the above findings, we used RNA interference as an alternative approach to further determine the role of Smo in migration of RA-FLSs and to explore the underlying molecular mechanisms. RA-FLSs were transfected with a NC-siRNA and siRNAs directed against Smo (Smo-siRNA). The efficiency of the transfection was monitored by Western Blot analysis after 48 h of incubation with siRNAs. The results revealed that the expression of Smo is predominantly inhibited in Smo-targeted siRNA-transfected cells versus NC-siRNA-transfected cells (Figure 4A). Cell migration was measured using Transwell assay and activation of Rho GTPase signaling was assessed using pull-down assay. The results of migration assay showed that suppression of Smo decreased the migration of RA-FLSs, with the numbers of migrated cells 40.33 × 104 ± 3.28 × 104, compared to that of the NC-siRNA group (99.00 × 104 ± 6.81 × 104, Figure 4E, P < 0.05). Thus, suppression of Smo significantly inhibited the activation of RhoA and Rac1 in RA-FLSs, compared to that of NC-siRNA group (Figures 4B,C, P < 0.05). The Western Blot analysis showed that the levels of MYPT1 phosphorylation were also significantly inhibited after Smo-siRNA transfection (Figure 4D).

Figure 4

Knockdown of Smo mediated by siRNA decreased rheumatoid arthritis (RA)-fibroblast-like synoviocytes (FLSs) migration and RhoGTPase signaling. RA-FLSs were cultured and transfected with small interfering RNAs directed against Smo (Smo-siRNA) or with a negative control siRNA (NC-siRNA) for 48 h. Silencing efficiency was measured by Western Blot analysis (A). The activation of RhoA and Rac1 was detected by pull-down assays (B,C). Expression of MYPT1 was detected by Western Blot analysis and the levels of phospho-MYPT1 were normalized to expression of total MYPT1 (D). Cell migration was evaluated using Transwell assays and the numbers of migrated cells were calculated (×104 cells/ml) (E). Representative images of RA-FLSs migration after being transfected small interfering RNAs directed against Smo (Smo-siRNA) [(E), a], a NC-siRNA [(E), b], or vehicle [(E), c] were displayed (100 magnifications). The results are the mean ± SD of three independent experiments. *P < 0.05 versus control group. MYPT1, myosin phosphatase targeting subunit 1.

Discussion

FLSs in the synovial intimal lining not only act as passive responders in the progression of RA, but also acquire an aggressive phenotype and increase invasiveness into the extracellular matrix, contributing to pannus formation and cartilage destruction. In the current study, we observed the excessive migration in RA-FLSs compared to OA-FLSs and FLSs from patients with knee traumatic injury. Combining with our recent report that Shh signaling is aberrantly activated in RA patients and inhibition of the key component of Shh signaling, Smo, decreases proliferation of RA-FLSs, we propose that Smo could be a potential target for the FLSs-directed therapies for RA.

Small-molecule inhibitors targeting Smo have been synthesized for the treatment of cancers. Vismodegib, one of the small-molecular inhibitors, has been approved for patients with advanced BCC. It is reported that the small-molecule inhibitors against Smo exert its antitumor activities by inhibiting cell growth and invasion and inducing apoptosis in cancer cells (20, 21). Previous in vitro study showed that vismodegib slows down migration by downregulating E-Cadherin expression in lung squamous cell carcinomas (22). In the current study, we showed that blockage of Smo with antagonist KAAD-cyclopamine or small interfering RNA suppressed migration of RA-FLSs, whereas upregulation of Smo promotes migration of RA-FLSs, suggesting that Smo may play a critical role in the regulation of RA-FLSs migration. However, it remains unclear how Smo promotes RA-FLSs migration and its role in the pathogenesis of RA.

Classically, activated Smo functions through activation of transcription factors belonging to the Gli family and expression of downstream target genes, involving proliferation (cyclin D and cyclin E), survival (BCL-2), metastasis (Snail), and stem cell activation (NANOG and SOX2) (23). However, as a canonical G protein-coupled receptor, Smo is reported to signal through a G protein (24) and involves in a non-canonical signaling of Shh. The studies performed by Polizio et al. revealed that Shh-induced fibroblast migration depends on the coupling of Smo to Gi proteins and is mediated by the stimulation of GTPases RhoA and Rac1 (5, 25). The results reported previously also showed that Shh stimulates tubulogenesis of endothelial cells in a non-canonical fashion, which is mediated by Smo, Gi proteins and Rho GTPases (11). In the present study, enhanced migration and Rho GTPase signaling activation in RA-FLSs are observed. Therefore, it is likely that Smo functions to induce RA-FLSs migration via activation of Rho GTPase signaling.

The Rho GTPases are known to serve as molecular switches and play central roles in directional migration by regulating organization of actin cytoskeleton and controlling cellular motility and polarity (26). Four members, including Rac1, Rac2, RhoA, and Cdc42 are best characterized in the Rho GTPases family and RhoA and Rac1 are identified to play major roles in the regulation of RA-FLSs migration. Using pull-down assays, we further validated the effect of Smo modulation on Rho GTPases activation in RA-FLSs and demonstrated that RA-FLSs are directly responsive to Smo regulation. The activities of RhoA and Rac1 are increased by Smo agonist, while inhibition of Smo with siRNA or specific inhibitor strongly prevents the activation of RhoA and Rac1. In addition, by coupling of G protein-coupled receptors, Smo modulates the activation of RhoA/ROCK (MYPT1) signaling through increasing/decreasing MLCP level to enhance/weaken traction force, which resulting in promoting/reducing RA-FLSs migration. On the other side, Rac1 induces actin polymerization to promoting RA-FLSs migration through its downstream protein such as WAVE/ARP2/3 complex (Figure 5).

Figure 5

Non-canonical signaling pathway of Shh. By coupling of G protein-coupled receptors, Smo modulates the activation of RhoA/ROCK (MYPT1) signaling through increasing/decreasing MLCP level to enhance/weaken traction force, which results in promoting/reducing rheumatoid arthritis (RA)-fibroblast-like synoviocytes (FLSs) migration. On the other side, Rac1 induces actin polymerization to promote RA-FLSs migration through its downstream protein such as WAVE/ARP2/3 complex. It is likely that Smo serves as a principal mediator of cytoskeletal tension in the process of cell migration.

Therefore, Smo seems to be a principal mediator of cytoskeletal tension in the process of cell migration. The results indicate that Smo is not only involved in RA-FLSs proliferation but also plays an important role in the progression of RA-FLSs migration through the activation of Rho GTPase signaling. However, the changes of actin cytoskeleton of RA-FLSs responding to Smo remain to be further investigated.

Conclusion

In the current study, we have identified a new effect of Smo on RA-FLSs migration and elucidated underlying molecular mechanisms by which the Shh pathway is linked to cell migration. These findings may provide a potential therapeutic target to suppress the aggressive phenotype of RA-FLSs and control pathological synovial invasion in RA.

Author Contributions

Designed the experiments: J-lH and SZ. Performed the experiments: W-xP, S-lZ, B-yZ, Y-mS, X-xF, and FL. Analyzed these data: W-xP, S-lZ, B-yZ, Y-mS, and X-xF. Wrote the manuscript: J-lH, SZ, W-xP, S-lZ, and B-yZ.

Conflict of Interest Statement

The authors declare that there is no conflict of interest regarding the publication of this paper.