Looking across diseases for drugs that treat fibrosis

One disease hardens the skin; another progressively impairs lung function. These seemingly distant conditions share a process called fibrosis: the excessive accumulation of material that supports tissue.

The 3D-MOFIB research programme, introduced by the NIH's National Center for Advancing Translational Sciences, or NCATS, aims to use this common ground to find drugs. Its initial focus is scleroderma and pulmonary fibrosis associated with Hermansky–Pudlak syndrome. Researchers plan to build three-dimensional skin and lung models from patient-derived fibroblasts, test many compounds in them and examine changes associated with fibrosis.

The plan includes analysing proteins and metabolites as well as gene expression. Finding molecular processes shared across diseases could point towards treatments useful in more than one condition. NCATS description ↗

The question we want to consider is which disease a particular drug should be developed to treat.

If the same candidate works in both skin and lung models, researchers can investigate whether it acts on a shared disease process. If it works in only one, that could provide clues to differences in the local tissue environment or the pathways that lead to fibrosis. Either result could inform where to take the drug next.

Activity in a cultured model does not, of course, establish that a drug can treat several diseases. Even so, there is a reason to study different disease processes side by side from the discovery stage, rather than finding a candidate first and only then asking whether it could be used elsewhere.

What interests us about this programme is not just how sophisticated the engineered tissues become. It is whether comparing skin and lung models produces evidence that could support a drug's use in a broader range of diseases.