1
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Torbic H, Chen A, Lumpkin M, Yerke J, Mehkri O, Abraham S, Wang X, Duggal A, Scheraga RG. Antipsychotic Use for ICU Delirium and Associated Inflammatory Markers. J Intensive Care Med 2024; 39:313-319. [PMID: 37724016 PMCID: PMC10922065 DOI: 10.1177/08850666231201567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Purpose: We sought to evaluate critically ill patients with delirium to evaluate inflammatory cytokine production and delirium progression and the role of antipsychotics. Materials and Methods: Adult critically ill patients with confirmed delirium according to a positive CAM-ICU score were included and IL-6 and IL-8 levels were trended for 24 h in this single-center, prospective, observational cohort study. Results: A total of 23 patients were consented and had blood samples drawn for inclusion. There was no difference in IL-6 and IL-8 levels at baseline, 4 to 8 h, and 22 to 28 h after enrollment when comparing patients based on antipsychotic exposure. We identified 2 patient clusters based on age, APACHE III, need for mechanical ventilation, and concomitant infection. In cluster 1, 5 (33.3%) patients received antipsychotics versus 5 (62.5%) patients in cluster 2 (P = .18). Patients in cluster 1 had more co-inflammatory conditions (P < .0001), yet numerically lower baseline IL-6 (P = .18) and IL-8 levels (P = .80) compared to cluster 2. Patients in cluster 1 had a greater median number of delirium-free days compared to cluster 2 (17.0 vs 6.0 days; P = .05). Conclusions: In critically ill patients with delirium, IL-6 and IL-8 levels were variable and antipsychotics were not associated with improvements in delirium or inflammatory markers.
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Affiliation(s)
- Heather Torbic
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA
| | - Alyssa Chen
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA
| | - Mollie Lumpkin
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA
| | - Jason Yerke
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA
| | - Omar Mehkri
- Department of Critical Care Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Susamma Abraham
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, USA
| | - Xiaofeng Wang
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Abhijit Duggal
- Department of Critical Care Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Rachel G. Scheraga
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, USA
- Department of Critical Care and Pulmonary Medicine, Cleveland Clinic, Cleveland, OH, USA
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2
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Orsini EM, Roychowdhury S, Gangadhariah M, Cross E, Abraham S, Reinhardt A, Grund ME, Zhou JY, Stuehr O, Pant B, Olman MA, Vachharajani V, Scheraga RG. TRPV4 Regulates the Macrophage Metabolic Response to Limit Sepsis-induced Lung Injury. Am J Respir Cell Mol Biol 2024. [PMID: 38346220 DOI: 10.1165/rcmb.2023-0456oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/12/2024] [Indexed: 02/21/2024] Open
Abstract
Sepsis is a systemic inflammatory response that requires effective macrophage metabolic functions to resolve ongoing inflammation. Previous work showed that the mechanosensitive cation channel, transient receptor potential vanilloid 4 (TRPV4), mediates macrophage phagocytosis and cytokine production in response to lung infection. Here, we show that TRPV4 regulates glycolysis in a stiffness dependent manner by augmenting macrophage glucose uptake by GLUT1. In addition, TRPV4 is required for lipopolysaccharide (LPS)-induced phagolysosome maturation in a GLUT1-dependent manner. In a cecal slurry mouse model of sepsis, TRPV4 regulates sepsis-induced glycolysis as measured by bronchoalveolar lavage fluid (BALF) lactate and sepsis-induced lung injury as measured by BALF total protein and lung compliance. TRPV4 is necessary for bacterial clearance in the peritoneum to limit sepsis-induced lung injury. Interestingly, BALF lactate is increased in septic patients compared with healthy controls, supporting the relevance of lung cell glycolysis to human sepsis. These data show that macrophage TRPV4 is required for glucose uptake through GLUT1 for effective phagolysosome maturation to limit sepsis-induced lung injury. Our work presents TRPV4 as a potential target to protect the lung from injury in sepsis.
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Affiliation(s)
- Erica M Orsini
- Cleveland Clinic Foundation, 2569, Respiratory Institute, Department of Critical Care, Cleveland, Ohio, United States
| | - Sanjoy Roychowdhury
- Cleveland Clinic, 2569, Lerner Research Institute, Department of Inflammation and Immunity, Cleveland, Ohio, United States
| | - Mahesha Gangadhariah
- Cleveland Clinic, 2569, Lerner Research Institute, Department of Inflammation and Immunity, Cleveland, Ohio, United States
| | - Emily Cross
- Cleveland Clinic, 2569, Lerner Research Institute, Department of Inflammation and Immunity, Cleveland, Ohio, United States
| | - Susamma Abraham
- Cleveland Clinic, 2569, Lerner Research Institute, Department of Inflammation and Immunity, Cleveland, Ohio, United States
| | - Amanda Reinhardt
- Cleveland Clinic, 2569, Lerner Research Institute, Department of Inflammation and Immunity, Cleveland, Ohio, United States
| | - Megan E Grund
- Cleveland Clinic, 2569, Lerner Research Institute, Department of Inflammation and Immunity, Cleveland, Ohio, United States
| | - Julie Y Zhou
- Cleveland Clinic, 2569, Lerner Research Institute, Department of Inflammation and Immunity, Cleveland, Ohio, United States
| | - Olivia Stuehr
- Cleveland Clinic, 2569, Lerner Research Institute, Department of Inflammation and Immunity, Cleveland, Ohio, United States
| | - Bishnu Pant
- Cleveland Clinic, 2569, Lerner Research Institute, Department of Inflammation and Immunity, Cleveland, Ohio, United States
| | - Mitchell A Olman
- Cleveland Clinic, 2569, Respiratory Institute, Department of Pulmonary and Critical Care and Lerner Research Institute, Department of Inflammation and Immunity, Cleveland, Ohio, United States
| | - Vidula Vachharajani
- Cleveland Clinic, 2569, Respiratory Institute, Department of Critical Care and Lerner Research Institute, Department of Inflammation and Immunity, Cleveland, Ohio, United States
| | - Rachel G Scheraga
- Cleveland Clinic, 2569, Respiratory Institute, Department of Pulmonary and Critical Care and Lerner Research Institute, Department of Inflammation and Immunity, Cleveland, Ohio, United States;
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3
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Southern BD, Li H, Mao H, Crish JF, Grove LM, Scheraga RG, Mansoor S, Reinhardt A, Abraham S, Deshpande G, Loui A, Ivanov AI, Rosenfeld SS, Bresnick AR, Olman MA. A novel mechanoeffector role of fibroblast S100A4 in myofibroblast transdifferentiation and fibrosis. J Biol Chem 2024; 300:105530. [PMID: 38072048 PMCID: PMC10789633 DOI: 10.1016/j.jbc.2023.105530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/25/2023] [Accepted: 10/28/2023] [Indexed: 12/23/2023] Open
Abstract
Fibroblast to myofibroblast transdifferentiation mediates numerous fibrotic disorders, such as idiopathic pulmonary fibrosis (IPF). We have previously demonstrated that non-muscle myosin II (NMII) is activated in response to fibrotic lung extracellular matrix, thereby mediating myofibroblast transdifferentiation. NMII-A is known to interact with the calcium-binding protein S100A4, but the mechanism by which S100A4 regulates fibrotic disorders is unclear. In this study, we show that fibroblast S100A4 is a calcium-dependent, mechanoeffector protein that is uniquely sensitive to pathophysiologic-range lung stiffness (8-25 kPa) and thereby mediates myofibroblast transdifferentiation. Re-expression of endogenous fibroblast S100A4 rescues the myofibroblastic phenotype in S100A4 KO fibroblasts. Analysis of NMII-A/actin dynamics reveals that S100A4 mediates the unraveling and redistribution of peripheral actomyosin to a central location, resulting in a contractile myofibroblast. Furthermore, S100A4 loss protects against murine in vivo pulmonary fibrosis, and S100A4 expression is dysregulated in IPF. Our data reveal a novel mechanosensor/effector role for endogenous fibroblast S100A4 in inducing cytoskeletal redistribution in fibrotic disorders such as IPF.
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Affiliation(s)
- Brian D Southern
- Lerner Research Institute Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA; Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Haiyan Li
- Lerner Research Institute Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
| | - Hongxia Mao
- Lerner Research Institute Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
| | - James F Crish
- Lerner Research Institute Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
| | - Lisa M Grove
- Lerner Research Institute Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
| | - Rachel G Scheraga
- Lerner Research Institute Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA; Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sanaa Mansoor
- Lerner Research Institute Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
| | - Amanda Reinhardt
- Lerner Research Institute Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
| | - Susamma Abraham
- Lerner Research Institute Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gauravi Deshpande
- Lerner Research Institute Imaging Core, Cleveland Clinic, Cleveland, Ohio, USA
| | - Alicia Loui
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrei I Ivanov
- Lerner Research Institute Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
| | - Steven S Rosenfeld
- Division of Hematology/Oncology, Mayo Clinic Jacksonville, Jacksonville, Florida, USA
| | - Anne R Bresnick
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Mitchell A Olman
- Lerner Research Institute Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA; Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA.
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4
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Jeng M, Orsini EM, Yerke J, Mehkri O, Mireles-Cabodevila E, Khouli H, Mujanovic S, Wang X, Duggal A, Vachharajani V, Scheraga RG. Nonbronchoscopic Bronchoalveolar Lavage Improves Respiratory Culture Accuracy in Critically Ill Patients. Crit Care Explor 2023; 5:e1008. [PMID: 38020848 PMCID: PMC10656098 DOI: 10.1097/cce.0000000000001008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVES Diagnosis of pneumonia is challenging in critically ill, intubated patients due to limited diagnostic modalities. Endotracheal aspirate (EA) cultures are standard of care in many ICUs; however, frequent EA contamination leads to unnecessary antibiotic use. Nonbronchoscopic bronchoalveolar lavage (NBBL) obtains sterile, alveolar cultures, avoiding contamination. However, paired NBBL and EA sampling in the setting of a lack of gold standard for airway culture is a novel approach to improve culture accuracy and limit antibiotic use in the critically ill patients. DESIGN We designed a pilot study to test respiratory culture accuracy between EA and NBBL. Adult, intubated patients with suspected pneumonia received concurrent EA and NBBL cultures by registered respiratory therapists. Respiratory culture microbiology, cell counts, and antibiotic prescribing practices were examined. SETTING We performed a prospective pilot study at the Cleveland Clinic Main Campus Medical ICU in Cleveland, Ohio for 22 months from May 2021 through March 2023. PATIENTS OR SUBJECTS Three hundred forty mechanically ventilated patients with suspected pneumonia were screened. Two hundred fifty-seven patients were excluded for severe hypoxia (Fio2 ≥ 80% or positive end-expiratory pressure ≥ 12 cm H2O), coagulopathy, platelets less than 50,000, hemodynamic instability as determined by the treating team, and COVID-19 infection to prevent aerosolization of the virus. INTERVENTIONS All 83 eligible patients were enrolled and underwent concurrent EA and NBBL. MEASUREMENTS AND MAIN RESULTS More EA cultures (42.17%) were positive than concurrent NBBL cultures (26.51%, p = 0.049), indicating EA contamination. The odds of EA contamination increased by eight-fold 24 hours after intubation. EA was also more likely to be contaminated with oral flora when compared with NBBL cultures. There was a trend toward decreased antibiotic use in patients with positive EA cultures if paired with a negative NBBL culture. Alveolar immune cell populations were recovered from NBBL samples, indicating successful alveolar sampling. There were no major complications from NBBL. CONCLUSIONS NBBL is more accurate than EA for respiratory cultures in critically ill, intubated patients. NBBL provides a safe and effective technique to sample the alveolar space for both clinical and research purposes.
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Affiliation(s)
- Margaret Jeng
- Department of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Erica M Orsini
- Department of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Jason Yerke
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH
| | - Omar Mehkri
- Department of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | | | - Hassan Khouli
- Department of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Samin Mujanovic
- Department of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Xiaofeng Wang
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Abhijit Duggal
- Department of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Vidula Vachharajani
- Department of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Rachel G Scheraga
- Department of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
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5
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Scheraga RG, Olman MA. TRP Channels in Pulmonary Fibrosis: Variety Is a Spice of Life. Am J Respir Cell Mol Biol 2023; 68:241-242. [PMID: 36413749 PMCID: PMC9989481 DOI: 10.1165/rcmb.2022-0446ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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6
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Abstract
BACKGROUND In septic shock, vasopressors aim to improve tissue perfusion and prevent persistent organ dysfunction, a characteristic of chronic critical illness (CCI). Adjunctive vasopressin is often used to decrease catecholamine dosage, but the association of vasopressin response with subsequent patient outcomes is unclear. We hypothesized vasopressin response is associated with favorable clinical trajectory. METHODS We included patients with septic shock receiving vasopressin as a catecholamine adjunct in this retrospective cohort study. We defined vasopressin response as a lowering of the catecholamine dose required to maintain mean arterial pressure ≥65 mm Hg, 6 h after vasopressin initiation. Clinical trajectories were adjudicated as early death (ED; death before day 14), CCI (ICU stay ≥14 days with persistent organ dysfunction), or rapid recovery (RR; not meeting ED or CCI criteria). Trajectories were placed on an ordinal scale with ED the worst outcome, CCI next, and RR the best outcome. The association of vasopressin response with clinical trajectory was assessed with multivariable ordinal logistic regression. RESULTS In total 938 patients were included; 426 (45.4%) were vasopressin responders. The most frequent trajectory was ED (49.8%), 29.7% developed CCI, and 20.5% had rapid recovery. In survivors to ICU day 14 (those without ED), 59.2% had CCI and 40.8% experienced RR. Compared with vasopressin non-responders, vasopressin responders less frequently experienced ED (42.5% vs. 55.9%) and more frequently experienced RR (24.6% vs. 17.0%; P < 0.01). After controlling for confounders, vasopressin response was independently associated with higher odds of developing a better clinical trajectory (OR 1.63; 95% CI 1.26-2.10). Medical patients most frequently developed ED and survivors more commonly developed CCI than RR; surgical patients developed the three trajectories with similar frequency (P < 0.01). CONCLUSIONS Vasopressin responsive status was associated with improved clinical trajectory in septic shock patients. Early vasopressin response is a potential novel prognostic marker for short-term clinical trajectory.
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Affiliation(s)
- Seth R. Bauer
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH,
USA
- Cleveland Clinic Lerner College of Medicine, Case Western
Reserve University, Cleveland, OH, USA
| | | | - Matthew T. Siuba
- Cleveland Clinic Lerner College of Medicine, Case Western
Reserve University, Cleveland, OH, USA
- Department of Critical Care Medicine, Respiratory
Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Lu Wang
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH,
USA
- Department of Quantitative Health Sciences, Lerner Research
Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Xiaofeng Wang
- Cleveland Clinic Lerner College of Medicine, Case Western
Reserve University, Cleveland, OH, USA
- Department of Quantitative Health Sciences, Lerner Research
Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Rachel G. Scheraga
- Cleveland Clinic Lerner College of Medicine, Case Western
Reserve University, Cleveland, OH, USA
- Department of Critical Care Medicine, Respiratory
Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Inflammation and Immunity, Lerner Research
Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Vidula Vachharajani
- Cleveland Clinic Lerner College of Medicine, Case Western
Reserve University, Cleveland, OH, USA
- Department of Critical Care Medicine, Respiratory
Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Inflammation and Immunity, Lerner Research
Institute, Cleveland Clinic, Cleveland, OH, USA
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7
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Orsini EM, Perelas A, Southern BD, Grove LM, Olman MA, Scheraga RG. Stretching the Function of Innate Immune Cells. Front Immunol 2021; 12:767319. [PMID: 34795674 PMCID: PMC8593101 DOI: 10.3389/fimmu.2021.767319] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
The importance of innate immune cells to sense and respond to their physical environment is becoming increasingly recognized. Innate immune cells (e.g. macrophages and neutrophils) are able to receive mechanical signals through several mechanisms. In this review, we discuss the role of mechanosensitive ion channels, such as Piezo1 and transient receptor potential vanilloid 4 (TRPV4), and cell adhesion molecules, such as integrins, selectins, and cadherins in biology and human disease. Furthermore, we explain that these mechanical stimuli activate intracellular signaling pathways, such as MAPK (p38, JNK), YAP/TAZ, EDN1, NF-kB, and HIF-1α, to induce protein conformation changes and modulate gene expression to drive cellular function. Understanding the mechanisms by which immune cells interpret mechanosensitive information presents potential targets to treat human disease. Important areas of future study in this area include autoimmune, allergic, infectious, and malignant conditions.
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Affiliation(s)
- Erica M Orsini
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Apostolos Perelas
- Department of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, VA, United States
| | - Brian D Southern
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States.,Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Lisa M Grove
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Mitchell A Olman
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States.,Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Rachel G Scheraga
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States.,Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
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8
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Abstract
Severe covid-19 pneumonia has posed critical challenges for the research and medical communities. Older age, male sex, and comorbidities increase the risk for severe disease. For people hospitalized with covid-19, 15-30% will go on to develop covid-19 associated acute respiratory distress syndrome (CARDS). Autopsy studies of patients who died of severe SARS CoV-2 infection reveal presence of diffuse alveolar damage consistent with ARDS but with a higher thrombus burden in pulmonary capillaries. When used appropriately, high flow nasal cannula (HFNC) may allow CARDS patients to avoid intubation, and does not increase risk for disease transmission. During invasive mechanical ventilation, low tidal volume ventilation and positive end expiratory pressure (PEEP) titration to optimize oxygenation are recommended. Dexamethasone treatment improves mortality for the treatment of severe and critical covid-19, while remdesivir may have modest benefit in time to recovery in patients with severe disease but shows no statistically significant benefit in mortality or other clinical outcomes. Covid-19 survivors, especially patients with ARDS, are at high risk for long term physical and mental impairments, and an interdisciplinary approach is essential for critical illness recovery.
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Affiliation(s)
- Amy H Attaway
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Rachel G Scheraga
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
| | - Adarsh Bhimraj
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Michelle Biehl
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Umur Hatipoğlu
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA
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9
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Scheraga RG, Southern BD, Grove LM, Olman MA. The Role of TRPV4 in Regulating Innate Immune Cell Function in Lung Inflammation. Front Immunol 2020; 11:1211. [PMID: 32676078 PMCID: PMC7333351 DOI: 10.3389/fimmu.2020.01211] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/15/2020] [Indexed: 12/22/2022] Open
Abstract
Ion channels/pumps are essential regulators of innate immune cell function. Macrophages have been increasingly recognized to have phenotypic plasticity and location-specific functions in the lung. Transient receptor potential vanilloid 4 (TRPV4) function in lung injury has been shown to be stimulus- and cell-type specific. In the current review, we discuss the importance of TRPV4 in macrophages and its role in phagocytosis and cytokine secretion in acute lung injury/acute respiratory distress syndrome (ARDS). Furthermore, TRPV4 controls a MAPK molecular switch from predominately c-Jun N-terminal kinase, JNK activation, to that of p38 activation, that mediates phagocytosis and cytokine secretion in a matrix stiffness-dependent manner. Expanding knowledge regarding the downstream mechanisms by which TRPV4 acts to tailor macrophage function in pulmonary inflammatory diseases will allow for formulation of novel therapeutics.
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Affiliation(s)
- Rachel G. Scheraga
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Brian D. Southern
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Lisa M. Grove
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Mitchell A. Olman
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
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10
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Affiliation(s)
- Rachel G Scheraga
- Respiratory Instituteand.,Lerner Research InstituteCleveland Clinic FoundationCleveland, Ohio
| | - Mitchell A Olman
- Respiratory Instituteand.,Lerner Research InstituteCleveland Clinic FoundationCleveland, Ohio
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11
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Scheraga RG, Abraham S, Grove LM, Southern BD, Crish JF, Perelas A, McDonald C, Asosingh K, Hasday JD, Olman MA. TRPV4 Protects the Lung from Bacterial Pneumonia via MAPK Molecular Pathway Switching. J Immunol 2020; 204:1310-1321. [PMID: 31969384 DOI: 10.4049/jimmunol.1901033] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 12/22/2019] [Indexed: 12/11/2022]
Abstract
Mechanical cell-matrix interactions can drive the innate immune responses to infection; however, the molecular underpinnings of these responses remain elusive. This study was undertaken to understand the molecular mechanism by which the mechanosensitive cation channel, transient receptor potential vanilloid 4 (TRPV4), alters the in vivo response to lung infection. For the first time, to our knowledge, we show that TRPV4 protects the lung from injury upon intratracheal Pseudomonas aeruginosa in mice. TRPV4 functions to enhance macrophage bacterial clearance and downregulate proinflammatory cytokine secretion. TRPV4 mediates these effects through a novel mechanism of molecular switching of LPS signaling from predominant activation of the MAPK, JNK, to that of p38. This is accomplished through the activation of the master regulator of inflammation, dual-specificity phosphatase 1. Further, TRPV4's modulation of the LPS signal is mechanosensitive in that both upstream activation of p38 and its downstream biological consequences depend on pathophysiological range extracellular matrix stiffness. We further show the importance of TRPV4 on LPS-induced activation of macrophages from healthy human controls. These data are the first, to our knowledge, to demonstrate new roles for macrophage TRPV4 in regulating innate immunity in a mechanosensitive manner through the modulation of dual-specificity phosphatase 1 expression to mediate MAPK activation switching.
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Affiliation(s)
- Rachel G Scheraga
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195; .,Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195; and
| | - Susamma Abraham
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195; and
| | - Lisa M Grove
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195; and
| | - Brian D Southern
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195.,Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195; and
| | - James F Crish
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195; and
| | | | - Christine McDonald
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195; and
| | - Kewal Asosingh
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195; and
| | - Jeffrey D Hasday
- Department of Pulmonary and Critical Care, University of Maryland, Baltimore, MD 21201
| | - Mitchell A Olman
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195; .,Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195; and
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12
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Yerke JR, Sacha GL, Scheraga RG, Culver DA, Abraham S, Torbic H, Lam SW, Ammar MA, Olman MA, Bauer SR. Vasopressin Plasma Concentrations Are Not Associated with Hemodynamic Response to Exogenous Vasopressin for Septic Shock. Pharmacotherapy 2019; 40:33-39. [PMID: 31705703 DOI: 10.1002/phar.2346] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Positive hemodynamic response to vasopressin after 6 hours of infusion was independently associated with lower mortality in a previous retrospective study of patients with septic shock. However, factors previously associated with higher plasma vasopressin concentration were not associated with response, and the relationship between plasma vasopressin concentration and hemodynamic response has not been evaluated. OBJECTIVES This cross-sectional study compared plasma vasopressin concentrations in hemodynamic responders and nonresponders to vasopressin in patients with septic shock to evaluate plasma vasopressin concentration as a therapeutic target for hemodynamic response to vasopressin. METHODS Adult patients with septic shock were included if they were treated with fixed-dose vasopressin as an adjunct to catecholamines for at least 3 hours. Patients were assigned to groups based on vasopressin response. RESULTS Ten hemodynamic responders to vasopressin and eight nonresponders were included. Blood samples for plasma vasopressin concentration were collected 3-6 hours after vasopressin initiation. Baseline characteristics were similar between groups. No difference was detected in plasma vasopressin concentrations between hemodynamic responders and nonresponders (median 88.6 pg/ml [interquartile range (IQR) 84.4-107.5 pg/ml] vs 89.9 pg/ml [IQR 67.5-157.4 pg/ml], p=0.79, respectively). We also did not detect a difference between groups after correcting for vasopressin dose; median vasopressin plasma concentration per 0.01 units/minute of vasopressin infusion for responders was 25.9 pg/ml (IQR 21.8-31.8 pg/ml) versus 29.5 pg/ml (IQR 23.0-57.5 pg/ml, p=0.48) for nonresponders. No difference in clinical outcomes was detected between groups. The findings were robust to multiple sensitivity analyses. CONCLUSIONS This study does not support the use of plasma vasopressin concentrations as a therapeutic target to predict hemodynamic response to exogenous vasopressin in septic shock.
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Affiliation(s)
- Jason R Yerke
- Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio
| | | | - Rachel G Scheraga
- Department of Pulmonary and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Daniel A Culver
- Department of Pulmonary and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Susamma Abraham
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Heather Torbic
- Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio
| | - Simon W Lam
- Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio
| | - Mahmoud A Ammar
- Department of Pharmacy, Yale New Haven Health System, New Haven, Connecticut
| | - Mitchell A Olman
- Department of Pulmonary and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Seth R Bauer
- Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio
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13
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Grove LM, Mohan ML, Abraham S, Scheraga RG, Southern BD, Crish JF, Naga Prasad SV, Olman MA. Translocation of TRPV4-PI3Kγ complexes to the plasma membrane drives myofibroblast transdifferentiation. Sci Signal 2019; 12:12/607/eaau1533. [PMID: 31719171 DOI: 10.1126/scisignal.aau1533] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Myofibroblasts are key contributors to pathological fibrotic conditions of several major organs. The transdifferentiation of fibroblasts into myofibroblasts requires both a mechanical signal and transforming growth factor-β (TGF-β) signaling. The cation channel transient receptor potential vanilloid 4 (TRPV4) is a critical mediator of myofibroblast transdifferentiation and in vivo fibrosis through its mechanosensitivity to extracellular matrix stiffness. Here, we showed that TRPV4 promoted the transdifferentiation of human and mouse lung fibroblasts through its interaction with phosphoinositide 3-kinase γ (PI3Kγ), forming nanomolar-affinity, intracellular TRPV4-PI3Kγ complexes. TGF-β induced the recruitment of TRPV4-PI3Kγ complexes to the plasma membrane and increased the activities of both TRPV4 and PI3Kγ. Using gain- and loss-of-function approaches, we showed that both TRPV4 and PI3Kγ were required for myofibroblast transdifferentiation as assessed by the increased production of α-smooth muscle actin and its incorporation into stress fibers, cytoskeletal changes, collagen-1 production, and contractile force. Expression of various mutant forms of the PI3Kγ catalytic subunit (p110γ) in cells lacking PI3Kγ revealed that only the noncatalytic, amino-terminal domain of p110γ was necessary and sufficient for TGF-β-induced TRPV4 plasma membrane recruitment and myofibroblast transdifferentiation. These data suggest that TGF-β stimulates a noncanonical scaffolding action of PI3Kγ, which recruits TRPV4-PI3Kγ complexes to the plasma membrane, thereby increasing myofibroblast transdifferentiation. Given that both TRPV4 and PI3Kγ have pleiotropic actions, targeting the interaction between them could provide a specific therapeutic approach for inhibiting myofibroblast transdifferentiation.
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Affiliation(s)
- Lisa M Grove
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Maradumane L Mohan
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Susamma Abraham
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Rachel G Scheraga
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Brian D Southern
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - James F Crish
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Sathyamangla V Naga Prasad
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Mitchell A Olman
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA. .,Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA
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14
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Perelas A, Glennie J, van Kerkhove K, Li M, Scheraga RG, Olman MA, Culver DA. Choice of antifibrotic medication and disease severity predict weight loss in idiopathic pulmonary fibrosis. Pulm Pharmacol Ther 2019; 59:101839. [PMID: 31518649 DOI: 10.1016/j.pupt.2019.101839] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/31/2019] [Accepted: 09/09/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Although safety and tolerability of approved antifibrotics has been reported extensively, little is known about their effects on weight. We analyzed predictors of weight change after one year of uninterrupted antifibrotic therapy in patients followed at our institution's interstitial lung disease clinic. METHODS/RESULTS We identified 80 patients on antifibrotic therapy (44 pirfenidone/36 nintedanib) with at least one year of follow-up and no therapy interruptions. Thirty-five patients (44%) lost more than 5% of their baseline body weight, and 11 (19%) lost more than 10%. A higher proportion of patients on nintedanib experienced a clinically significant weight loss (>5%) versus pirfenidone (61% vs 30%, p = 0.005). Univariate and multivariate analyses identified nintedanib therapy and a higher composite physiologic index (CPI) as predictors of weight loss. CONCLUSIONS Weight loss is common among IPF patients on antifibrotic therapy. Nintedanib therapy and more advanced disease were identified as predictors of weight loss in this population.
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Affiliation(s)
- Apostolos Perelas
- Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
| | - Jessica Glennie
- Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Manshi Li
- Quantitative Health Sciences Department, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Rachel G Scheraga
- Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH, USA; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland, OH, USA
| | - Mitchell A Olman
- Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH, USA; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland, OH, USA
| | - Daniel A Culver
- Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
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15
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Southern BD, Scheraga RG, Olman MA. Impaired AMPK Activity Drives Age-Associated Acute Lung Injury after Hemorrhage. Am J Respir Cell Mol Biol 2018; 56:553-555. [PMID: 28459384 DOI: 10.1165/rcmb.2017-0023ed] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Brian D Southern
- 1 Cleveland Clinic Respiratory Institute Lerner Research Institute Department of Pathobiology Cleveland, Ohio
| | - Rachel G Scheraga
- 1 Cleveland Clinic Respiratory Institute Lerner Research Institute Department of Pathobiology Cleveland, Ohio
| | - Mitchell A Olman
- 1 Cleveland Clinic Respiratory Institute Lerner Research Institute Department of Pathobiology Cleveland, Ohio
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16
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Harford TJ, Rezaee F, Scheraga RG, Olman MA, Piedimonte G. Asthma predisposition and respiratory syncytial virus infection modulate transient receptor potential vanilloid 1 function in children's airways. J Allergy Clin Immunol 2017; 141:414-416.e4. [PMID: 28982576 DOI: 10.1016/j.jaci.2017.07.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/19/2017] [Accepted: 07/26/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Terri J Harford
- Center for Pediatric Research, Pediatric Institute and Children's Hospital, The Cleveland Clinic, Cleveland, Ohio
| | - Fariba Rezaee
- Center for Pediatric Research, Pediatric Institute and Children's Hospital, The Cleveland Clinic, Cleveland, Ohio
| | - Rachel G Scheraga
- Department of Pathobiology, Lerner Research Institute, The Cleveland Clinic, Cleveland, Ohio
| | - Mitchell A Olman
- Department of Pathobiology, Lerner Research Institute, The Cleveland Clinic, Cleveland, Ohio
| | - Giovanni Piedimonte
- Center for Pediatric Research, Pediatric Institute and Children's Hospital, The Cleveland Clinic, Cleveland, Ohio.
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17
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Scheraga RG, Southern BD, Grove LM, Olman MA. The Role of Transient Receptor Potential Vanilloid 4 in Pulmonary Inflammatory Diseases. Front Immunol 2017; 8:503. [PMID: 28523001 PMCID: PMC5415870 DOI: 10.3389/fimmu.2017.00503] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/12/2017] [Indexed: 01/01/2023] Open
Abstract
Ion channels/pumps are essential regulators of organ homeostasis and disease. In the present review, we discuss the role of the mechanosensitive cation channel, transient receptor potential vanilloid 4 (TRPV4), in cytokine secretion and pulmonary inflammatory diseases such as asthma, cystic fibrosis (CF), and acute lung injury/acute respiratory distress syndrome (ARDS). TRPV4 has been shown to play a role in lung diseases associated with lung parenchymal stretch or stiffness. TRPV4 indirectly mediates hypotonicity-induced smooth muscle contraction and airway remodeling in asthma. Further, the literature suggests that in CF TRPV4 may improve ciliary beat frequency enhancing mucociliary clearance, while at the same time increasing pro-inflammatory cytokine secretion/lung tissue injury. Currently it is understood that the role of TRPV4 in immune cell function and associated lung tissue injury/ARDS may depend on the injury stimulus. Uncovering the downstream mechanisms of TRPV4 action in pulmonary inflammatory diseases is likely important to understanding disease pathogenesis and may lead to novel therapeutics.
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Affiliation(s)
- Rachel G Scheraga
- Cleveland Clinic, Department of Pathobiology, Lerner Research Institute, Cleveland, OH, USA
| | - Brian D Southern
- Cleveland Clinic, Department of Pathobiology, Lerner Research Institute, Cleveland, OH, USA
| | - Lisa M Grove
- Cleveland Clinic, Department of Pathobiology, Lerner Research Institute, Cleveland, OH, USA
| | - Mitchell A Olman
- Cleveland Clinic, Department of Pathobiology, Lerner Research Institute, Cleveland, OH, USA
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18
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Abstract
As long-term smokers undergo computed tomography (CT) to screen for lung cancer, cases of interstitial lung disease are being discovered incidentally. This article explains how to distinguish among the most common forms of interstitial lung disease in this situation and the role of primary care physicians in managing them.
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Affiliation(s)
- Brian D Southern
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA. E-mail: .,Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Rachel G Scheraga
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.,Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Ruchi Yadav
- Associate Staff, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
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19
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Scheraga RG, Thompson C, Tulapurkar ME, Nagarsekar AC, Cowan M, Potla R, Sun J, Cai R, Logun C, Shelhamer J, Todd NW, Singh IS, Luzina IG, Atamas SP, Hasday JD. Activation of heat shock response augments fibroblast growth factor-1 expression in wounded lung epithelium. Am J Physiol Lung Cell Mol Physiol 2016; 311:L941-L955. [PMID: 27638903 DOI: 10.1152/ajplung.00262.2016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 09/08/2016] [Indexed: 12/29/2022] Open
Abstract
We previously showed that coincident exposure to heat shock (HS; 42°C for 2 h) and TNF-α synergistically induces apoptosis in mouse lung epithelium. We extended this work by analyzing HS effects on human lung epithelial responses to clinically relevant injury. Cotreatment with TNF-α and HS induced little caspase-3 and poly(ADP-ribose) polymerase cleavage in human small airway epithelial cells, A549 cells, and BEAS2B cells. Scratch wound closure rates almost doubled when A549 and BEAS2B cells and air-liquid interface cultures of human bronchial epithelial cells were heat shocked immediately after wounding. Microarray, qRT-PCR, and immunoblotting showed fibroblast growth factor 1 (FGF1) to be synergistically induced by HS and wounding. Enhanced FGF1 expression in HS/wounded A549 was blocked by inhibitors of p38 MAPK (SB203580) or HS factor (HSF)-1 (KNK-437) and in HSF1 knockout BEAS2B cells. PCR demonstrated FGF1 to be expressed from the two most distal promoters in wounded/HS cells. Wound closure in HS A549 and BEAS2B cells was reduced by FGF receptor-1/3 inhibition (SU-5402) or FGF1 depletion. Exogenous FGF1 accelerated A549 wound closure in the absence but not presence of HS. In the presence of exogenous FGF1, HS slowed wound closure, suggesting that it increases FGF1 expression but impairs FGF1-stimulated wound closure. Frozen sections from normal and idiopathic pulmonary fibrosis (IPF) lung were analyzed for FGF1 and HSP70 by immunofluorescence confocal microscopy and qRT-PCR. FGF1 and HSP70 mRNA levels were 7.5- and 5.9-fold higher in IPF than normal lung, and the proteins colocalized to fibroblastic foci in IPF lung. We conclude that HS signaling may have an important impact on gene expression contributing to lung injury, healing, and fibrosis.
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Affiliation(s)
- Rachel G Scheraga
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.,Critical Care Section, National Heart, Lung, Blood Institute, Bethesda, Maryland
| | | | - Mohan E Tulapurkar
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Ashish C Nagarsekar
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Mark Cowan
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.,Medicine and Research Services, Baltimore Veterans Affairs Medical Care System, Baltimore, Maryland
| | - Ratnakar Potla
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Junfeng Sun
- Critical Care Section, National Heart, Lung, Blood Institute, Bethesda, Maryland
| | - Rongman Cai
- Critical Care Section, National Heart, Lung, Blood Institute, Bethesda, Maryland
| | - Carolea Logun
- Critical Care Section, National Heart, Lung, Blood Institute, Bethesda, Maryland
| | - James Shelhamer
- Critical Care Section, National Heart, Lung, Blood Institute, Bethesda, Maryland
| | - Nevins W Todd
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.,Medicine and Research Services, Baltimore Veterans Affairs Medical Care System, Baltimore, Maryland
| | - Ishwar S Singh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.,Medicine and Research Services, Baltimore Veterans Affairs Medical Care System, Baltimore, Maryland
| | - Irina G Luzina
- Division of Rheumatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.,Medicine and Research Services, Baltimore Veterans Affairs Medical Care System, Baltimore, Maryland
| | - Sergei P Atamas
- Division of Rheumatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.,Medicine and Research Services, Baltimore Veterans Affairs Medical Care System, Baltimore, Maryland
| | - Jeffrey D Hasday
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland; .,Medicine and Research Services, Baltimore Veterans Affairs Medical Care System, Baltimore, Maryland
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20
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Southern BD, Grove LM, Rahaman SO, Abraham S, Scheraga RG, Niese KA, Sun H, Herzog EL, Liu F, Tschumperlin DJ, Egelhoff TT, Rosenfeld SS, Olman MA. Matrix-driven Myosin II Mediates the Pro-fibrotic Fibroblast Phenotype. J Biol Chem 2016; 291:6083-95. [PMID: 26763235 DOI: 10.1074/jbc.m115.712380] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Indexed: 01/06/2023] Open
Abstract
Pro-fibrotic mesenchymal cells are known to be the key effector cells of fibroproliferative disease, but the specific matrix signals and the induced cellular responses that drive the fibrogenic phenotype remain to be elucidated. The key mediators of the fibroblast fibrogenic phenotype were characterized using a novel assay system that measures fibroblast behavior in response to actual normal and fibrotic lung tissue. Using this system, we demonstrate that normal lung promotes fibroblast motility and polarization, while fibrotic lung immobilizes the fibroblast and promotes myofibroblast differentiation. These context-specific phenotypes are surprisingly both mediated by myosin II. The role of myosin II is supported by the observation of an increase in myosin phosphorylation and a change in intracellular distribution in fibroblasts on fibrotic lung, as compared with normal lung. Moreover, loss of myosin II activity has opposing effects on protrusive activity in fibroblasts on normal and fibrotic lung. Loss of myosin II also selectively inhibits myofibroblast differentiation in fibroblasts on fibrotic lung. Importantly, these findings are recapitulated by varying the matrix stiffness of polyacrylamide gels in the range of normal and fibrotic lung tissue. Comparison of the effects of myosin inhibition on lung tissue with that of polyacrylamide gels suggests that matrix fiber organization drives the fibroblast phenotype under conditions of normal/soft lung, while matrix stiffness drives the phenotype under conditions of fibrotic/stiff lung. This work defines novel roles for myosin II as a key regulatory effector molecule of the pro-fibrotic phenotype, in response to biophysical properties of the matrix.
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Affiliation(s)
| | | | | | | | | | | | - Huanxing Sun
- Yale ILD Center of Excellence, Yale School of Medicine, New Haven, Connecticut 06520
| | - Erica L Herzog
- Yale ILD Center of Excellence, Yale School of Medicine, New Haven, Connecticut 06520
| | - Fei Liu
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02115, and
| | - Daniel J Tschumperlin
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota 55905
| | | | - Steven S Rosenfeld
- Department of Cancer Biology, Cleveland Clinic, Lerner Research Institute, Cleveland, Ohio 44195
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21
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Scheraga RG, Abraham S, Niese KA, Southern BD, Grove LM, Hite RD, McDonald C, Hamilton TA, Olman MA. TRPV4 Mechanosensitive Ion Channel Regulates Lipopolysaccharide-Stimulated Macrophage Phagocytosis. J Immunol 2015; 196:428-36. [PMID: 26597012 DOI: 10.4049/jimmunol.1501688] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 11/01/2015] [Indexed: 12/31/2022]
Abstract
Macrophage phagocytosis of particles and pathogens is an essential aspect of innate host defense. Phagocytic function requires cytoskeletal rearrangements that depend on the interaction between macrophage surface receptors, particulates/pathogens, and the extracellular matrix. In the present study we determine the role of a mechanosensitive ion channel, transient receptor potential vanilloid 4 (TRPV4), in integrating the LPS and matrix stiffness signals to control macrophage phenotypic change for host defense and resolution from lung injury. We demonstrate that active TRPV4 mediates LPS-stimulated murine macrophage phagocytosis of nonopsonized particles (Escherichia coli) in vitro and opsonized particles (IgG-coated latex beads) in vitro and in vivo in intact mice. Intriguingly, matrix stiffness in the range seen in inflamed or fibrotic lung is required to sensitize the TRPV4 channel to mediate the LPS-induced increment in macrophage phagocytosis. Furthermore, TRPV4 is required for the LPS induction of anti-inflammatory/proresolution cytokines. These findings suggest that signaling through TRPV4, triggered by changes in extracellular matrix stiffness, cooperates with LPS-induced signals to mediate macrophage phagocytic function and lung injury resolution. These mechanisms are likely to be important in regulating macrophage function in the context of pulmonary infection and fibrosis.
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Affiliation(s)
- Rachel G Scheraga
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195; Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195; and
| | - Susamma Abraham
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195; and
| | - Kathryn A Niese
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195
| | - Brian D Southern
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195; Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195; and
| | - Lisa M Grove
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195
| | - R Duncan Hite
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195; Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195; and
| | - Christine McDonald
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195
| | | | - Mitchell A Olman
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195; Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195; and
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22
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Bridges TM, Scheraga RG, Tulapurkar ME, Suffredini D, Liggett SB, Ramarathnam A, Potla R, Singh IS, Hasday JD. Polymorphisms in human heat shock factor-1 and analysis of potential biological consequences. Cell Stress Chaperones 2015; 20:47-59. [PMID: 25023647 PMCID: PMC4255257 DOI: 10.1007/s12192-014-0524-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 06/24/2014] [Accepted: 06/30/2014] [Indexed: 11/30/2022] Open
Abstract
The stress-activated transcription factor, heat shock factor-1 (HSF1), regulates many genes including cytoprotective heat shock proteins (HSPs). We hypothesized that polymorphisms in HSF1 may alter the level or function of HSF1 protein accounting for interindividual viability in disease susceptibility or prognosis. We searched for exomic variants in HSF1 by querying human genome databases and directly sequencing DNA from 80 anonymous genomic DNA samples. Overall, HSF1 sequence was highly conserved, with no common variations. We found 31 validated deviations from a reference sequence in the dbSNP database and an additional 5 novel variants by sequencing, with allele frequencies that were 0.06 or less. Of these 36, 2 were in 5'-untranslated region (5'UTR), 10 in 3'UTR, and 24 in the coding region. The potential effects of 5'UTR on secondary structure, protein structure/function, and 3'UTR targets of microRNAs were analyzed using RNAFold, PolyPhen-2, SIFT, and MicroSNiper. One of the 5'UTR variants was predicted to strengthen secondary structure. Eight of 3'UTR variants were predicted to modify microRNA target sequences. Eight of the coding region variants were predicted to modify HSF1 structure/function. Reducing HSF1 levels in A549 cells using short hairpin RNA (shRNA) increased sensitivity to heat-induced killing demonstrating the impact that genetic variants that reduce HSF1 levels might have. Using the pmirGLO expression system, we found that the wild-type HSF1 3'UTR suppressed translation of a firefly luciferase reporter plasmid by 65 %. Introducing two of four 3'UTR single nucleotide polymorphisms (SNPs) increased HSF1 3'UTR translational suppression by 27-44 % compared with the wild-type HSF1 3'UTR sequence while a third SNP reduced suppression by 25 %. HSF1 variants may alter HSF1 protein levels or function with potential effects on cell functions, including sensitivity to stress.
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Affiliation(s)
- Tiffany M. Bridges
- />Pulmonary and Critical Care Medicine Division, Department of Medicine, University of Maryland School of Medicine, 110 S. Paca St. 2nd floor, Baltimore, Maryland USA
| | - Rachel G. Scheraga
- />Pulmonary and Critical Care Medicine Division, Department of Medicine, University of Maryland School of Medicine, 110 S. Paca St. 2nd floor, Baltimore, Maryland USA
| | - Mohan E. Tulapurkar
- />Pulmonary and Critical Care Medicine Division, Department of Medicine, University of Maryland School of Medicine, 110 S. Paca St. 2nd floor, Baltimore, Maryland USA
| | - Dante Suffredini
- />Pulmonary and Critical Care Medicine Division, Department of Medicine, University of Maryland School of Medicine, 110 S. Paca St. 2nd floor, Baltimore, Maryland USA
| | - Stephen B. Liggett
- />Departments of Medicine and Molecular Physiology and Pharmacology, University of South Florida, Tampa, FL 22612 USA
| | - Aparna Ramarathnam
- />Pulmonary and Critical Care Medicine Division, Department of Medicine, University of Maryland School of Medicine, 110 S. Paca St. 2nd floor, Baltimore, Maryland USA
| | - Ratnakar Potla
- />Pulmonary and Critical Care Medicine Division, Department of Medicine, University of Maryland School of Medicine, 110 S. Paca St. 2nd floor, Baltimore, Maryland USA
| | - Ishwar S. Singh
- />Pulmonary and Critical Care Medicine Division, Department of Medicine, University of Maryland School of Medicine, 110 S. Paca St. 2nd floor, Baltimore, Maryland USA
- />Medicine and Research services of the Baltimore VA Medical Center, Baltimore, MD 21201 USA
| | - Jeffrey D. Hasday
- />Pulmonary and Critical Care Medicine Division, Department of Medicine, University of Maryland School of Medicine, 110 S. Paca St. 2nd floor, Baltimore, Maryland USA
- />Medicine and Research services of the Baltimore VA Medical Center, Baltimore, MD 21201 USA
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23
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Rahaman SO, Grove LM, Paruchuri S, Southern BD, Abraham S, Niese KA, Scheraga RG, Ghosh S, Thodeti CK, Zhang DX, Moran MM, Schilling WP, Tschumperlin DJ, Olman MA. TRPV4 mediates myofibroblast differentiation and pulmonary fibrosis in mice. J Clin Invest 2014; 124:5225-38. [PMID: 25365224 DOI: 10.1172/jci75331] [Citation(s) in RCA: 200] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 09/18/2014] [Indexed: 12/31/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a fatal fibrotic lung disorder with no effective medical treatments available. The generation of myofibroblasts, which are critical for fibrogenesis, requires both a mechanical signal and activated TGF-β; however, it is not clear how fibroblasts sense and transmit the mechanical signal(s) that promote differentiation into myofibroblasts. As transient receptor potential vanilloid 4 (TRPV4) channels are activated in response to changes in plasma membrane stretch/matrix stiffness, we investigated whether TRPV4 contributes to generation of myofibroblasts and/or experimental lung fibrosis. We determined that TRPV4 activity is upregulated in lung fibroblasts derived from patients with IPF. Moreover, TRPV4-deficient mice were protected from fibrosis. Furthermore, genetic ablation or pharmacological inhibition of TRPV4 function abrogated myofibroblast differentiation, which was restored by TRPV4 reintroduction. TRPV4 channel activity was elevated when cells were plated on matrices of increasing stiffness or on fibrotic lung tissue, and matrix stiffness-dependent myofibroblast differentiation was reduced in response to TRVP4 inhibition. TRPV4 activity modulated TGF-β1-dependent actions in a SMAD-independent manner, enhanced actomyosin remodeling, and increased nuclear translocation of the α-SMA transcription coactivator (MRTF-A). Together, these data indicate that TRPV4 activity mediates pulmonary fibrogenesis and suggest that manipulation of TRPV4 channel activity has potential as a therapeutic approach for fibrotic diseases.
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Scheraga RG, Thannickal VJ. Wnt/β-catenin and transforming growth factor-β signaling in pulmonary fibrosis. A case for antagonistic pleiotropy? Am J Respir Crit Care Med 2014; 190:129-31. [PMID: 25025351 DOI: 10.1164/rccm.201406-1037ed] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Rachel G Scheraga
- 1 Department of Pulmonary, Allergy and Critical Care Medicine Cleveland Clinic Respiratory Institute Cleveland, Ohio and
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Todd NW, Scheraga RG, Galvin JR, Iacono AT, Britt EJ, Luzina IG, Burke AP, Atamas SP. Lymphocyte aggregates persist and accumulate in the lungs of patients with idiopathic pulmonary fibrosis. J Inflamm Res 2013; 6:63-70. [PMID: 23576879 PMCID: PMC3617818 DOI: 10.2147/jir.s40673] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease with no known effective therapy. It is often assumed, but has not been objectively evaluated, that pulmonary inflammation subsides as IPF progresses. The goal of this work was to assess changes in the degree of inflammatory cell infiltration, particularly lymphocytic infiltration, over the duration of illness in IPF. Methods Sixteen patients with confirmed IPF were identified in patients whom surgical lung biopsy (SLB) was performed in early disease, and in patients whom lung transplantation was subsequently performed in end stage disease. A numerical scoring system was used to histologically quantify the amount of fibrosis, honeycomb change, fibroblastic foci, and lymphocyte aggregates in each SLB and lung explant tissue sample. Analyses of quantitative scores were performed by comparing paired, matched samples of SLB to lung explant tissue. Results Median time [1st, 3rd quartiles] from SLB to lung transplantation was 24 [15, 29] months. Histologic fibrosis and honeycomb change were more pronounced in the explant samples compared with SLB (P < 0.001 and P < 0.01, respectively), and most notably, higher numbers of lymphocyte aggregates were observed in the explant samples compared to SLB (P = 0.013). Immunohistochemical analyses revealed abundant CD3+ (T lymphocyte) and CD20+ (B lymphocyte) cells, but not CD68+ (macrophage) cells, within the aggregates. Conclusion Contrary to the frequent assumption, lymphocyte aggregates were present in greater numbers in advanced disease (explant tissue) compared to early disease (surgical lung biopsy). This finding suggests that active cellular inflammation continues in IPF even in severe end stage disease.
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Affiliation(s)
- Nevins W Todd
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA ; Baltimore VA Medical Center, Baltimore, MD, USA
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