Epithelial cell apoptosis causes acute lung injury masquerading as emphysema

Am J Respir Cell Mol Biol. 2009 Oct;41(4):407-14. doi: 10.1165/rcmb.2008-0137OC. Epub 2009 Feb 2.

Abstract

Theories of emphysema traditionally revolved around proteolytic destruction of extracellular matrix. Models have recently been developed that show airspace enlargement with the induction of pulmonary cell apoptosis. The purpose of this study was to determine the mechanism by which a model of epithelial cell apoptosis caused airspace enlargement. Mice were treated with either intratracheal microcystin (MC) to induce apoptosis, intratracheal porcine pancreatic elastase (PPE), or their respective vehicles. Mice from all groups were inflated and morphometry was measured at various time points. Physiology measurements were performed for airway resistance, tissue elastance, and lung volumes. The groups were further analyzed by air-saline quasistatic measurements, surfactant staining, and surfactant functional studies. Mice treated with MC showed evidence of reversible airspace enlargement. In contrast, PPE-treated mice showed irreversible airspace enlargement. The airspace enlargement in MC-treated mice was associated with an increase in elastic recoil due to an increase in alveolar surface tension. PPE-treated mice showed a loss of lung elastic recoil and normal alveolar surface tension, a pattern more consistent with human emphysema. Airspace enlargement that occurs with the MC model of pulmonary epithelial cell apoptosis displays physiology distinct from human emphysema. Reversibility, restrictive physiology due to changes in surface tension, and alveolar enlargement associated with heterogeneous alveolar collapse are most consistent with a mild acute lung injury. Inflation near total lung capacity gives the appearance of enlarged alveoli as neighboring collapsed alveoli exert tethering forces.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Lung Injury / chemically induced
  • Acute Lung Injury / diagnosis
  • Acute Lung Injury / etiology*
  • Acute Lung Injury / pathology
  • Acute Lung Injury / physiopathology
  • Airway Resistance
  • Animals
  • Apoptosis / drug effects
  • Apoptosis / physiology*
  • Diagnosis, Differential
  • Disease Models, Animal
  • Elasticity
  • Epithelial Cells / pathology*
  • Female
  • Inflammation / chemically induced
  • Inflammation / physiopathology
  • Lung Volume Measurements
  • Mice
  • Mice, Inbred C57BL
  • Microcystins / toxicity
  • Models, Biological
  • Pancreatic Elastase / toxicity
  • Pulmonary Alveoli / drug effects*
  • Pulmonary Alveoli / pathology
  • Pulmonary Emphysema / diagnosis
  • Pulmonary Emphysema / etiology*
  • Pulmonary Surfactants
  • Surface Tension
  • Total Lung Capacity

Substances

  • Microcystins
  • Pulmonary Surfactants
  • microcystin
  • Pancreatic Elastase