Mechanostimulatory cues determine intestinal fibroblast fate and profibrotic remodeling in a physiodynamic human gut-on-a-chip

Biomechanical cues, including shear stress and mechanical strain, are key regulators of intestinal cellular behavior, yet their mechanostimulatory impact on fibroblasts responses during early fibrotic remodeling remains poorly understood. Using a bioengineered gut-on-a-chip model, we independently modulated flow and mechanical strain to assess fibroblast dynamics under intact or impaired epithelial barriers. Inflammation-associated fibroblasts resisted biomechanical stress, exhibiting myofibroblast-like phenotypes with hypertrophy and elevated -smooth muscle actin aligned with stress fibers. In contrast, normal fibroblasts were highly susceptible to shear stress, undergoing matrix metalloproteinase-dependent apoptotic injury, while mechanical strain alone had minimal effect. Notably, an intact epithelial barrier was both necessary and sufficient to protect fibroblasts from shear-induced damage, suggesting that "good fences make good neighbors". Under barrier dysfunction, prolonged exposure to shear stress induced the formation of stiff fibroblast aggregates composed of mechanoadaptive myofibroblast-like cells. These findings identify mechanostimulatory cues, particularly shear stress, as critical drivers of early fibrotic remodeling in inflammatory bowel disease and underscore epithelial barrier integrity as an essential biomechanical safeguard against pathological fibroblast dysregulation.