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Benjamin JT, Plosa EJ, Sucre JM, van der Meer R, Dave S, Gutor S, Nichols DS, Gulleman PM, Jetter CS, Han W, Xin M, Dinella PC, Catanzarite A, Kook S, Dolma K, Lal CV, Gaggar A, Blalock JE, Newcomb DC, Richmond BW, Kropski JA, Young LR, Guttentag SH, Blackwell TS. Neutrophilic inflammation during lung development disrupts elastin assembly and predisposes adult mice to COPD. J Clin Invest 2021; 131:139481. [PMID: 33108351 PMCID: PMC7773387 DOI: 10.1172/jci139481] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [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: 04/23/2020] [Accepted: 10/21/2020] [Indexed: 12/31/2022] Open
Abstract
Emerging evidence indicates that early life events can increase the risk for developing chronic obstructive pulmonary disease (COPD). Using an inducible transgenic mouse model for NF-κB activation in the airway epithelium, we found that a brief period of inflammation during the saccular stage (P3-P5) but not alveolar stage (P10-P12) of lung development disrupted elastic fiber assembly, resulting in permanent reduction in lung function and development of a COPD-like lung phenotype that progressed through 24 months of age. Neutrophil depletion prevented disruption of elastic fiber assembly and restored normal lung development. Mechanistic studies uncovered a role for neutrophil elastase (NE) in downregulating expression of critical elastic fiber assembly components, particularly fibulin-5 and elastin. Further, purified human NE and NE-containing exosomes from tracheal aspirates of premature infants with lung inflammation downregulated elastin and fibulin-5 expression by saccular-stage mouse lung fibroblasts. Together, our studies define a critical developmental window for assembling the elastin scaffold in the distal lung, which is required to support lung structure and function throughout the lifespan. Although neutrophils play a well-recognized role in COPD development in adults, neutrophilic inflammation may also contribute to early-life predisposition to COPD.
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Affiliation(s)
- John T Benjamin
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Erin J Plosa
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jennifer Ms Sucre
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Riet van der Meer
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Shivangi Dave
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sergey Gutor
- Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David S Nichols
- Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Peter M Gulleman
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christopher S Jetter
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Wei Han
- Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Matthew Xin
- Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Peter C Dinella
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ashley Catanzarite
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Seunghyi Kook
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kalsang Dolma
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Charitharth V Lal
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Amit Gaggar
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA
| | - J Edwin Blalock
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA
| | - Dawn C Newcomb
- Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Bradley W Richmond
- Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Nashville Veterans Affairs Medical Center, Nashville, Tennessee, USA
| | - Jonathan A Kropski
- Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Nashville Veterans Affairs Medical Center, Nashville, Tennessee, USA
| | - Lisa R Young
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Pediatrics, Division of Pulmonary Medicine, Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Susan H Guttentag
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Timothy S Blackwell
- Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Nashville Veterans Affairs Medical Center, Nashville, Tennessee, USA
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Schuler BA, Habermann AC, Plosa EJ, Taylor CJ, Jetter C, Negretti NM, Kapp ME, Benjamin JT, Gulleman P, Nichols DS, Braunstein LZ, Hackett A, Koval M, Guttentag SH, Blackwell TS, Webber SA, Banovich NE, Kropski JA, Sucre JM. Age-determined expression of priming protease TMPRSS2 and localization of SARS-CoV-2 in lung epithelium. J Clin Invest 2021; 131:140766. [PMID: 33180746 DOI: 10.1172/jci140766] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [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: 06/01/2020] [Accepted: 11/05/2020] [Indexed: 01/08/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) novel coronavirus 2019 (COVID-19) global pandemic has led to millions of cases and hundreds of thousands of deaths. While older adults appear at high risk for severe disease, hospitalizations and deaths due to SARS-CoV-2 among children have been relatively rare. Integrating single-cell RNA sequencing (scRNA-seq) of developing mouse lung with temporally resolved immunofluorescence in mouse and human lung tissue, we found that expression of SARS-CoV-2 Spike protein primer TMPRSS2 was highest in ciliated cells and type I alveolar epithelial cells (AT1), and TMPRSS2 expression increased with aging in mice and humans. Analysis of autopsy tissue from fatal COVID-19 cases detected SARS-CoV-2 RNA most frequently in ciliated and secretory cells in airway epithelium and AT1 cells in peripheral lung. SARS-CoV-2 RNA was highly colocalized in cells expressing TMPRSS2. Together, these data demonstrate the cellular spectrum infected by SARS-CoV-2 in lung epithelium and suggest that developmental regulation of TMPRSS2 may underlie the relative protection of infants and children from severe respiratory illness.
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Affiliation(s)
| | - A Christian Habermann
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | | | - Chase J Taylor
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | | | | | - Meghan E Kapp
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | | | - David S Nichols
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Lior Z Braunstein
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Michael Koval
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Emory University, Atlanta, Georgia, USA
| | | | - Timothy S Blackwell
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and.,Department of Cell and Developmental Biology, Vanderbilt University, Nashville, Tennessee, USA.,Department of Veterans Affairs Medical Center, Nashville, Tennessee, USA
| | | | | | | | | | - Jonathan A Kropski
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and.,Department of Cell and Developmental Biology, Vanderbilt University, Nashville, Tennessee, USA.,Department of Veterans Affairs Medical Center, Nashville, Tennessee, USA
| | - Jennifer Ms Sucre
- Department of Pediatrics.,Department of Cell and Developmental Biology, Vanderbilt University, Nashville, Tennessee, USA
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