A PDGFRα-Mediated Switch toward CD9^high Adipocyte Progenitors Controls Obesity-Induced Adipose Tissue Fibrosis

Obesity-induced white adipose tissue (WAT) fibrosis is believed to accelerate WAT dysfunction. However, the cellular origin of WAT fibrosis remains unclear. Here, we show that adipocyte platelet-derived growth factor receptor-α-positive (PDGFRα⁺) progenitors adopt a fibrogenic phenotype in obese mice prone to visceral WAT fibrosis. More specifically, a subset of PDGFRα⁺ cells with high CD9 expression (CD9^high) originates pro-fibrotic cells whereas their CD9^low counterparts, committed to adipogenesis, are almost completely lost in the fibrotic WAT. PDGFRα pathway activation promotes a phenotypic shift toward PDGFRα⁺CD9^high fibrogenic cells, driving pathological remodeling and altering WAT function in obesity. These findings translated to human obesity as the frequency of CD9^high progenitors in omental WAT (oWAT) correlates with oWAT fibrosis level, insulin-resistance severity, and type 2 diabetes. Collectively, our data demonstrate that in addition to representing a WAT adipogenic niche, different PDGFRα⁺ cell subsets modulate obesity-induced WAT fibrogenesis and are associated with loss of metabolic fitness.