Biochemical detection of type I cell damage after nitrogen dioxide-induced lung injury in rats

Hypoxia-Inducible Factor 1α Signaling Promotes Repair of the Alveolar Epithelium after Acute Lung Injury

During the acute respiratory distress syndrome, epithelial cells, primarily alveolar type (AT) I cells, die and slough off, resulting in enhanced permeability. ATII cells proliferate and spread onto the denuded basement membrane to reseal the barrier. Repair of the alveolar epithelium is critical for clinical recovery; however, mechanisms underlying ATII cell proliferation and spreading are not well understood. We hypothesized that hypoxia-inducible factor (HIF)1α promotes proliferation and spreading of ATII cells during repair after lung injury. Mice were treated with lipopolysaccharide or hydrochloric acid. HIF activation in ATII cells after injury was demonstrated by increased luciferase activity in oxygen degradation domain-Luc (HIF reporter) mice and expression of the HIF1α target gene GLUT1. ATII cell proliferation during repair was attenuated in ATII cell-specific HIF1α knockout (SftpcCreERT2+/-;HIF1αf/f) mice. The HIF target vascular endothelial growth factor promoted ATII cell proliferation in vitro and after lung injury in vivo. In the scratch wound assay of cell spreading, HIF stabilization accelerated, whereas HIF1α shRNA delayed wound closure. SDF1 and its receptor, CXCR4, were found to be HIF1α-regulated genes in ATII cells and were up-regulated during lung injury. Stromal cell-derived factor 1/CXCR4 inhibition impaired cell spreading and delayed the resolution of permeability after lung injury. We conclude that HIF1α is activated in ATII cells after lung injury and promotes proliferation and spreading during repair.

Alveolar type I cells protect rat lung epithelium from oxidative injury

The lung alveolar surface is covered by two morphologically and functionally distinct cells: alveolar epithelial cell types I and II (AEC I and II). The functions of AEC II, including surfactant release, cell differentiation and ion transport, have been extensively studied. However, relatively little is known regarding the physiological functions of AEC I. Global gene expression profiling of freshly isolated AEC I and II revealed that many genes were differentially expressed in AEC I. These genes have a diversity of functions, including cell defence. Nine out of 10 selected genes were verified by quantitative real-time PCR. Two genes, apolipoprotein E (Apo E) and transferrin, were further characterized and functionally studied. Immunohistochemistry indicated that both proteins were specifically localized in AEC I. Up-regulation of Apo E and transferrin was observed in hyperoxic lungs. Functionally, Apo E and transferrin play a protective role against oxidative stress in an animal model. Our studies suggest that AEC I is not just a simple barrier for gas exchange, but a functional cell that protects alveolar epithelium from injury.

Receptor for advanced glycation end-products is a marker of type I cell injury in acute lung injury

RATIONALE

Receptor for advanced glycation end-products (RAGE) is one of the alveolar type I cell-associated proteins in the lung.

OBJECTIVES

To test the hypothesis that RAGE is a marker of alveolar epithelial type I cell injury.

METHODS

Rats were instilled intratracheally with 10 mg/kg lipopolysaccharide or hydrochloric acid. RAGE levels were measured in the bronchoalveolar lavage (BAL) and serum in the rats and in the pulmonary edema fluid and plasma from patients with acute lung injury (ALI; n = 22) and hydrostatic pulmonary edema (n = 11).

MAIN RESULTS

In the rat lung injury studies, RAGE was released into the BAL and serum as a single soluble isoform sized approximately 48 kD. The elevated levels of RAGE in the BAL correlated well with the severity of experimentally induced lung injury. In the human studies, the RAGE level in the pulmonary edema fluid was significantly higher than the plasma level (p < 0.0001). The median edema fluid/plasma ratio of RAGE levels was 105 (interquartile range, 55-243). The RAGE levels in the pulmonary edema fluid from patients with ALI were higher than the levels from patients with hydrostatic pulmonary edema (p < 0.05), and the plasma RAGE level in patients with ALI were significantly higher than the healthy volunteers (p < 0.001) or patients with hydrostatic pulmonary edema (p < 0.05).

CONCLUSION

RAGE is a marker of type I alveolar epithelial cell injury based on experimental studies in rats and in patients with ALI.

Coexpression of RTI40 with alveolar epithelial type II cell proteins in lungs following injury: identification of alveolar intermediate cell types

Injured alveolar epithelial type (AT) I cells are replaced following the proliferation and transformation of ATII cells to new ATI cells. RTI(40) is an ATI cell-specific protein required for normal lung development. We hypothesized that intermediate cell types in the ATII-to-ATI cell transformation would coexpress RTI(40) and ATII cell-selective proteins. To test this hypothesis, we used a rat model of Staphylococcus aureus-induced acute lung injury and a panel of ATI and ATII cell-specific and -selective antibodies. S. aureus induced an acute inflammatory reaction that was resolving by day 3 postinoculation. At day 3 postinoculation, the alveolar wall was thickened secondary to ATII cell hyperplasia. With the use of confocal microscopy, there was a fivefold increase in the fractional surface area of alveolar walls stained with ATII cell membrane proteins (RTII(70) and MMC4) and a decrease in the fractional surface area associated with RTI(40)-expressing cells. S. aureus-treated lungs also contained unique cell types that coexpressed the RTI(40) and ATII markers RTI(40)/MMC4/RTII(70)- and RTI(40)/MMC4-positive cells. These cells were not observed in control lungs. RTI(40)/MMC4-positive cells were also found in cultured ATII cells before they transformed to an ATI-like phenotype. Our data suggest that RTI(40)/MMC4/RTII(70)- and RTI(40)/MMC4-positive cells are intermediates in the ATII-to-ATI cell transformation. These data also suggest that the coexpression of RTI(40) with ATII cell proteins may be used to identify and investigate ATII cell transdifferentiation to ATI cells following injury.

Alveolar type I cells: molecular phenotype and development

Understanding of the functions and regulation of the phenotype of the alveolar type I epithelial cell has lagged behind studies of its neighbor the type II cell because of lack of cell-specific molecular markers. The recent identification of several proteins expressed by type I cells indicates that these cells may play important roles in regulation of cell proliferation, ion transport and water flow, metabolism of peptides, modulation of macrophage functions, and signaling events in the peripheral lung. Cell systems and reagents are available to characterize type I cell biology in detail, an important goal given that the cells provide the extensive surface that facilitates gas exchange in the intact animal.

Monitoring alveolar epithelial function in acute lung injury

OBJECTIVE

Identification of humoral markers of acute lung injury may lead to insights into pathologic mechanisms. In addition, specific markers may be useful for predicting development of acute respiratory distress syndrome (ARDS) or for assessing prognosis. Ultimately, studies of lung injury markers may help define interventions that prevent or moderate ARDS. The alveolar epithelium is important both for the integrity of the blood-gas barrier and for repair of the barrier after lung injury. This article reviews markers that derive from or relate to the alveolar epithelium and that might be used for monitoring alveolar epithelial function in acute lung injury. Surfactant apoproteins may be important markers of injury or for prognosis. Levels of surfactant apoprotein A (SP-A) fall 50-75% in patients with severe lung injury compared to normal patients. Serum levels of SP-A in patients dying of acute respiratory distress syndrome are double serum levels of survivors.

Increased virulence of a fibronectin-binding protein mutant of Staphylococcus aureus in a rat model of pneumonia

Fibronectin-binding proteins mediate Staphylococcus aureus internalization into nonphagocytic cells in vitro. We have investigated whether fibronectin-binding proteins are virulence factors in the pathogenesis of pneumonia by using S. aureus strain 8325-4 and isogenic mutants in which fibronectin-binding proteins were either deleted (DU5883) or overexpressed [DU5883(pFnBPA4)]. We first demonstrated that fibronectin-binding proteins mediate S. aureus internalization into alveolar epithelial cells in vitro and that S. aureus internalization into alveolar epithelial cells requires actin rearrangement and protein kinase activity. Second, we established a rat model of S. aureus-induced pneumonia and measured lung injury and bacterial survival at 24 and 96 h postinoculation. S. aureus growth and the extent of lung injury were both increased in rats inoculated with the deletion mutant (DU5883) in comparison with rats inoculated with the wild-type (8325-4) and the fibronectin-binding protein-overexpressing strain DU5883(pFnBPA4) at 24 h postinfection. Morphological evaluation of infected lungs at the light and electron microscopic levels demonstrated that S. aureus was present within neutrophils from both 8325-4- and DU5883-inoculated lungs. Our data suggest that fibronectin-binding protein-mediated internalization into alveolar epithelial cells is not a virulence mechanism in a rat model of pneumonia. Instead, our data suggest that fibronectin-binding proteins decrease the virulence of S. aureus in pneumonia.

Parathyroid hormone-related protein-(38-64) regulates lung cell proliferation after silica injury

Inhalation of silica leads to acute lung injury and alveolar type II cell proliferation. Type II cell proliferation after hyperoxic lung injury is regulated, in part, by parathyroid hormone-related protein (PTHrP). In this study, we investigated lung PTHrP and its effects on epithelial proliferation after injury induced by silica. Lung PTHrP decreased modestly 4 days after we instilled 10 mg of silica into rat lungs and then recovered from 4 to 28 days. The number of proliferating cell nuclear antigen (PCNA)-positive type II cells was increased threefold in silica-injured lungs compared with controls. Subsequently, rats were treated with four exogenous PTHrP peptides in the silica instillate, which were administered subcutaneously daily. One peptide, PTHrP-(38-64), had consistent and significant effects on cell proliferation. PTHrP-(38-64) increased the median number of PCNA-positive cells/field nearly fourfold above controls, 380 vs. 109 (P < 0.05). Thymidine incorporation was 2.5 times higher in type II cells isolated from rats treated with PTHrP-(38-64) compared with PBS. PTHrP-(38-64) significantly increased the number of cells expressing alkaline phosphatase, a type II cell marker. This study indicates that PTHrP-(38-64) stimulates type II cell growth and may have a role in lung repair in silica-injured rats.

Can toxicogenomics provide information on the bioreactivity of diesel exhaust particles?

Epidemiologists have linked increased cardio-respiratory hospital admissions, morbidity and mortality rates and increases in particulate matter with an aerodynamic diameter less than 10 microns (PM10) concentrations (Anderson et al., 1991). PM10 consist of a heterogeneous mixture of particles that include minerals, metal oxides, sea salt, biological components and soot. In urban locations, soot, especially ultrafine diesel exhaust particles (DEP), accounts for 20-80% by mass of the airborne PM10 arising from vehicular activities. In the experiment described here, control [NaCl] and 1.25 mg of DEP were instilled into rat lung and the responses assessed using changes in lung permeability, inflammation and epithelial cell markers in lavage fluid, with the addition of a new technique of gene expression profiling using macroarrays. The aim of the study was to use these macroarrays as a sensitive measurement of acute up- or down-regulation of genes that were taking place in the rat lung in response to the small instilled mass of DEP. DEP instillation caused a slight oedematous lung with no overt inflammation and ten out of a possible 207 (5%) rat stress genes were repeatedly changed in response to DEP instillation. Therefore, the conclusion from the macroarray analysis is in agreement with the conventional toxicology and suggest that DEP elicits a low bioreactive response in a healthy rat lung.

Identification of a novel antigen on the apical surface of rat alveolar epithelial type II and Clara cells

Here we describe a monoclonal antibody (MMC4) that recognizes a novel antigen on the apical surface of rat alveolar epithelial type II and Clara cells in the lung, proximal tubule epithelial cells in the kidney, and villus epithelial cells in the small intestine. Biochemical analysis showed that the MMC4 antigen was sensitive to heating and proteinase K digestion and that it is distributed in the detergent-rich phase after Triton X-114 phase separation. These data suggest that the MMC4 antigen is an integral membrane protein. Glycerol gradient sedimentation identified two forms of the MMC4 antigen: one with a sedimentation coefficient of 10.1 and one with a sedimentation coefficient of 1.66, suggesting that the antigen may be part of a multiprotein complex. During rat development (fetal day 16 to adult), the MMC4 antigen increased 12-fold in the lung and 200-fold in the kidney. In the intestine, the MMC4 antigen increased 150-fold by neonatal day 1 and then decreased to adult values. Our data demonstrate that the MMC4 antigen is unlike known type II cell- and Clara cell-associated proteins. The MMC4 monoclonal antibody will be useful as a marker of epithelial cell phenotype in development and injury studies.

Alpha-toxin damages the air-blood barrier of the lung in a rat model of Staphylococcus aureus-induced pneumonia

We have shown that injury to alveolar epithelial type I cells may account, in part, for damage to the air-blood barrier of the lung in a rat model of Staphylococcus aureus pneumonia. We have also shown that alpha-toxin is an important cause of damage to the air-blood barrier; however, our data suggest that the toxin is not acting directly on alveolar type I cells.