Hepatocyte growth factor attenuates collagen accumulation in a murine model of pulmonary fibrosis

We investigated the in vivo effects of recombinant human hepatocyte growth factor (HGF) on epithelial cell proliferation in normal mouse lung and on the repair process that follows bleomycin-induced lung injury. Intratracheal administration of 100 micrograms of rhHGF to C57BL/6 mice led to proliferation of bronchial and alveolar epithelial cells as indicated by an increased number of cells staining for proliferating cell nuclear antigen (PCNA). The effect of HGF on the lung repair process was examined by administration of 100 micrograms of rhHGF on Day 3 and Day 6 after intratracheal injection of bleomycin to mice. We found that HGF significantly attenuated collagen accumulation induced by bleomycin as determined by quantitation of hydroxyproline content and by scoring of the extent of fibrosis. To explore the potential mechanisms involved in the beneficial effects of HGF, we performed in vitro studies with A549 pulmonary epithelial cells and found that HGF enhanced cell surface plasmin generation, expression of u-PA activity, and cell migration. In summary, HGF has potent in vivo and in vitro effects on epithelial cells, which suggests it may have a role in the therapy of pulmonary fibrosis.     

Mechanisms of alveolar epithelial repair in acute lung injury--a translational approach

In patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS), extensive damage to the alveolar epithelial and endothelial barrier is observed, resulting in the influx of protein-rich oedema fluid into the air spaces. Efficient alveolar epithelial repair is crucial to ALI/ARDS patients' recovery. Future therapeutic strategies may therefore include acceleration of the epithelial repair process in the injured lung. However, a better understanding of the cellular and molecular mechanisms that promote alveolar epithelial repair is needed if novel therapeutic strategies are to be developed. Pulmonary oedema fluid from patients with ALI/ARDS and from patients with hydrostatic oedema as control was obtained, and the effect on alveolar epithelial repair in vitro using our alveolar epithelial wound repair bioassay was studied. In contrast to the initial hypothesis, pulmonary oedema fluid from ALI/ARDS patients increased alveolar epithelial repair in vitro by an interleukin-1beta (IL-1beta)-dependent mechanism, demonstrating a novel, possibly beneficial role for IL-1beta in patients with ALI/ARDS. Further studies using primary alveolar epithelial cells from rats revealed that IL-1beta induced alveolar epithelial repair by an epidermal growth factor (EGF)/transforming growth factor-alpha (TGF-alpha)-dependent pathway. Besides EGF and TGF-alpha, keratinocyte growth factor (KGF) and hepatocyte growth factor (HGF)--both present in pulmonary oedema fluid obtained from patients with ALI/ARDS--stimulate alveolar epithelial repair in vitro. Further experimental and clinical studies will show whether acceleration of alveolar epithelial repair by modulating cytokines and growth factors in the injured lung represents a promising new therapeutic strategy in patients with ALI/ARDS.     

Increase in the beta chain of hepatocyte growth factor (HGF beta) precedes c-met expression after bleomycin-induced lung injury in the rat

After lung injury the regeneration of the alveolar epithelium is highly dependent on the proliferation of type II alveolar epithelial cells (AECs). Hepatocyte growth factor (HGF), a potent epithelial cell mitogen, is present as a single chain in normal tissue, but after injury HGF is converted to an active form composed of an alpha and a beta chain. In this study it was demonstrated that there was an increase in the beta chain of HGF 4 days after bleomycin administration, coinciding with the time of maximal type II AEC proliferation. Bronchoalveolar lavage fluid (BALF) obtained 4 days after bleomycin administration was maximally mitogenic to L2 cells, a nontransformed rat alveolar epithelial cell line. Type II cells isolated from normal rats do not express the HGF receptor, c-met. However, 4 days after bleomycin injury, using Western blot analysis, an increase in c-met was detected in AEC protein extracts. HGF induced c-met expression by L2 cells and neutralizing antibodies to HGF inhibited the mitogenic activity in the BALF. These findings suggest that HGF may regulate its own receptor on AECs and is an important mitogen for AECs 4 days after bleomycin administration.     

Stretch induces a growth factor in alveolar cells via protein kinase

Positive-pressure mechanical ventilation can injure the lung, causing edema and alveolar inflammation in a complication termed ventilator-induced lung injury (VILI). Cytokines such as interleukin-8 (IL-8) reportedly are important in this inflammatory response. On the other hand, hepatocyte growth factor (HGF) promotes regeneration of the lung, and delays pulmonary fibrosis. We postulated that cyclic stretch upregulates production and release of both of mediators. Human alveolar epithelial cells (A549) cultured on a silicoelastic membrane were tested for mRNA expression and release of IL-8 and HGF after cyclic stretch in vitro. Stretch induced mRNA expression and release of these mediators. The signaling pathway from cyclic stretch to release of IL-8 and HGF appeared to involve protein kinase C in the signal transduction pathway.     

Stem cells and pulmonary fibrosis: cause or cure?

Pulmonary fibrosis is a feature of a number of important lung diseases, and alveolar epithelial injury plays a key role in their pathogenesis. Traditionally, type II alveolar epithelial cells have been viewed as the progenitor cells of the alveolar epithelium; however, recent studies have identified a number of other progenitor and stem cell populations that may participate in alveolar epithelial repair. These studies suggest that the injury microenvironment plays a role in regulation of progenitor cell populations. In human idiopathic pulmonary fibrosis, epithelial abnormalities including altered cell cycling characteristics, hyperplasia, and metaplasia are observed, suggesting that dysregulation of epithelial progenitor cells contributes to the characteristic aberrant repair process. Reactivation of developmental signaling pathways such as the Wnt-β-catenin pathway is implicated in the dysregulation of these cells, and targeting these pathways may provide opportunities for therapeutic intervention. There has been a great deal of interest in the delivery of exogenous stem cells as a therapeutic strategy, and various stem and progenitor cell populations have improved outcomes in animal lung fibrosis models. The contributions of these cells to alveolar epithelial regeneration have been variable, and secretion of soluble mediators has been implicated in the beneficial effects. It remains to be seen whether the promising results seen in the preclinical studies will translate to human disease, and the first studies using mesenchymal stem cells in clinical trials for fibrotic lung disease are underway. Strategies using other stem cell populations hold promise, but currently these are a lot further from the bedside.     

Role of epithelial cells in idiopathic pulmonary fibrosis: from innocent targets to serial killers

Idiopathic pulmonary fibrosis (IPF), a progressive and relentless lung scarring of unknown etiology, has been recognized as the most lethal interstitial lung disease. Despite the growing interest in IPF, the precise molecular mechanisms underlying the development of fibrosis and leading to the irreversible destruction of the lung are still unknown. Recently, it has been proposed that IPF, instead of being a chronic inflammatory disorder, results from multiple cycles of epithelial cell injury and activation. In turn, active alveolar epithelial cells provoke the migration, proliferation, and activation of mesenchymal cells with the formation of fibroblastic/myofibroblastic foci and the exaggerated accumulation of extracellular matrix, mirroring abnormal wound repair. In this article, some characteristics of the alveolar epithelium are briefly outlined, and the fibrogenic mechanisms specifically operated by active abnormal epithelial cells are examined.     

Defect of hepatocyte growth factor secretion by fibroblasts in idiopathic pulmonary fibrosis

Hepatocyte growth factor (HGF) is a growth factor that protects alveolar epithelial cells from pulmonary fibrosis in various animal models. We compared in vitro HGF production by human lung fibroblasts from patients with idiopathic pulmonary fibrosis (IPF, n = 8) and from control subjects (n = 6). Basal HGF secretion by IPF fibroblasts was decreased by 50% when compared with control fibroblasts (p < 0.05). HGF was secreted mainly in the cleaved mature form, both in IPF and control fibroblasts. HGF messenger RNA levels were reduced in IPF fibroblasts. Prostaglandin (PG) E2 secretion by IPF fibroblasts was low when compared with control subjects (p < 0.05). After the addition of PGE2 (10-6 M) or dibutyryl cyclic AMP (10-3 M), HGF secretion by IPF fibroblasts reached the level of control subjects. Inhibition of PGE2 synthesis with indomethacin reduced HGF secretion by control fibroblasts but had no effect on IPF fibroblasts. HGF secretion by control fibroblasts was also slightly inhibited by transforming growth factor (TGF)-beta1 and stimulated by anti-TGF-beta antibody, whereas both agents had no effect on IPF fibroblasts. Our results demonstrate a defect in HGF production by IPF fibroblasts that seems secondary to a defect in PGE2 secretion.     

Hepatocyte growth factor: Molecular structure and implications for a central role in liver regeneration

Hepatocyte growth factor (HGF) is a most potent factor for mature parenchymal hepatocytes in primary culture and may act as a trigger for liver regeneration. We purified HGF from rat platelets to homogeneity and cloned both human and rat HGF cDNA. HGF is a heterodimer molecule composed of the 69 kDa alpha-subunit and the 34 kDa beta-subunit. HGF has no amino acid sequence homology with other known peptide growth factors and possesses the highest potential among known growth factors to stimulate proliferation of hepatocytes in primary culture. HGF is derived from a single chain precursor of 728 amino acid residues and the precursor is proteolytically processed to form a two-chain mature HGF. The alpha-subunit of HGF contains 4 kringle structures and HGF has a homology (38%) with plasmin. Biologically active recombinant human HGF could be expressed from COS-1 cells and CHO cells transfected with cloned cDNA. HGF activity and the HGF mRNA level are markedly increased in the liver following insult such as hepatitis, by the administration of hepatotoxins, ischaemia, physical damage and partial hepatectomy. Moreover, HGF mRNA is induced in the lung and kidney, in the presence of liver injury. In situ hybridization revealed that HGF-producing cells in liver are non-parenchymal liver cells, presumably Kupffer and sinusoidal endothelial cells. Therefore, HGF from neighbouring cells (Kupffer and sinsuoidal endothelial cells) and distal organs (lung and kidney) may function as a trigger for liver regeneration by both a paracrine mechanism and an endocrine mechanism. HGF has mitogenic activity for renal tubular epithelial cells, epidermal melanocytes and keratinocytes as well as mature hepatocytes, and has the potential to promote cell migration for some epithelial cells, including normal human keratinocytes. Since cell growth and cell motility are relevant to tissue repair and embryogenesis, HGF may well have important roles in tissue repair and embryogenesis as well as in liver regeneration.     

Inducible expression of keratinocyte growth factor (KGF) in mice inhibits lung epithelial cell death induced by hyperoxia

Oxidant-induced injury to the lung is associated with extensive damage to the lung epithelium. Instillation of keratinocyte growth factor (KGF) in the lungs of animals protects animals from oxidant-induced injury but the mechanism of protection is not well understood. An inherent problem in studying KGF function in vivo has been that constitutive overexpression of KGF in the lung causes embryonic lethality with extensive pulmonary malformation. Here we report the development of a stringently regulated, tetracycline-inducible, lung-specific transgenic system that allows regulated expression of KGF in the lung without causing developmental abnormalities from leaky KGF expression. By using this system, we show that exposure of KGF-expressing mice to hyperoxia protects the lung epithelium but not the endothelium from cell death in accordance with the selective expression of KGF receptor on epithelial and not on endothelial cells. Investigations of KGF-induced cell survival pathways revealed KGF-induced activation of the multifunctional pro-survival Akt signaling axis both in vitro and in vivo. Inhibition of KGF-induced Akt activation by a dominant-negative mutant of Akt blocked the KGF-mediated protection of epithelial cells exposed to hyperoxia. KGF-induced Akt activation may play an important role in inhibiting lung alveolar cell death thereby preserving the lung architecture and function during oxidative stress.     

Hepatocyte growth factor promotes growth and lumen formation of fetal lung epithelial cells in primary culture

Abstract Mesenchyme-epithelium interactions are generally considered critical for fetal lung development. Hepatocyte growth factor (HGF), a mesenchyme-derived mitogen active on a variety of epithelial cells, appears to be involved in the morphogenesis of fetal liver and kidney. During lung development, HGF and its receptor, c-Met, are expressed in close proximity in mesenchymal cells and epithelial cells, respectively. To examine the role of HGF in fetal lung development, we investigated the effects of HGF on lung epithelial cells derived from a 15-day-old mouse fetus. First, HGF induces a 45% increase in [³H]thymidine incorporation and a 65% increase in cell number by crystal violet analysis at 10 ng/mL concentration, and the increase is dose dependent. Second, HGF facilitates the formation of an organotypic arrangement of the fetal epithelial cells on a basement membrane extract (Matrigel) that resembles alveolar structures in vivo , and the maximum increase is about twice the control level at 10 ng/mL. These results suggest that HGF may be implicated in fetal lung development through the regulation of mesenchyme-epithelium interactions.     

Von Hippel-Lindau protein and respiratory diseases

Von Hippel-Lindau protein (pVHL) was first identified as a tumor suppressor gene as mutations in the VHL gene predispose individuals to systemic benign or malignant tumors and cysts in many organs, including renal cell carcinoma of the clear-cell type and hemangioblastoma. Although pVHL is best known to act as a component of ubiquitin protein ligase for the proteasomal degradation of hypoxia inducible factor (HIF)-α, pVHL also interacts with extracellular matrix proteins and cytoskeleton, regulating extracellular matrix assembly, cell signaling, and many other cellular functions. Recent studies suggest that pVHL contributes to many lung diseases, including pulmonary arterial hypertension, lung cancer, pulmonary fibrosis, and acute respiratory distress syndrome. Mutation or loss of function of pVHL activates HIF and induced expression of vascular endothelial growth factor, endothelin-1, and FoxM1, leading to pulmonary arterial hypertension. Loss of pVHL in lung cancer cells promotes epithelial-mesenchymal transition and cancer migration and invasion while decreasing lung cancer cell proliferation and colonization. In patients of idiopathic pulmonary fibrosis, elevated expression of pVHL induces expression of fibronectin/integrin α5β1/focal adhesion kinase signaling, resulting in fibroproliferation and fibrosis. In alveolar epithelial cells, pVHL mediates Na-K-ATPase degradation in an HIF independent pathway, causing decreased edema clearance during hypoxia. These studies suggest that pVHL plays key roles in the pathogenesis of many lung diseases, and further investigations are warranted to elucidate the underlying molecular mechanisms.     

Differential expression of transforming growth factor-beta type I and II receptors by pulmonary cells in bleomycin-induced lung injury: correlation with repair and fibrosis

In a rat model of lung injury induced by the antineoplastic antibiotic, bleomycin, there is loss of type I alveolar epithelial cells (AECs) followed by infiltration of activated inflammatory cells, type II AEC proliferation, and fibrosis. At 4 and 7 days after bleomycin administration alveolar macrophages have increased production and release of active transforming growth factor (TGF)-beta1, an inhibitor of epithelial cell proliferation. Paradoxically at these same time intervals there is a concomitant induction of type II AEC proliferation. For TGF-beta-mediated signal transduction to occur, the expression of both TCF-beta receptor types I (TbetaR-I) and II (TbetaR-II) must be present. Using immunohistochemistry and in situ hybridization, 4 and 7 days after bleomycin administration the expression of TbetaR-I on AECs was reduced whereas that of TbetaR-II was unaltered. However, 14 and 28 days after bleomycin injury, when there is decreased proliferation and induction of differentiation of type II AECs, there was a return of TbetaR-I expression on AECs. In contrast, TbetaR-I and TbetaR-II were observed on interstitial fibroblasts at all time intervals after bleomycin administration. Because both TbetaR-I and TbetaR-II are required for signal transduction, the reduction of TbetaR-I levels on the alveolar epithelium may alter the sensitivity of AECs to the antiproliferative effects of TGF-beta1 present in increased quantities following bleomycin injury. The loss of an antiproliferative response to TGF-beta1 may be important for the regeneration of the alveolar epithelium by proliferation while the expression of both receptors onfibroblasts would result in TGF-1 signaling for the synthesis of connective tissue proteins. Ourfindings suggest that during bleomycin-induced pulmonary fibrosis, the effects of TGF-beta1 on cells may be regulated by the expression of TbetaRs.     

细胞因子在特发性肺间质纤维化血管生成中的作用

目的 通过研究特发性肺间质纤维化（ＩＰＦ）患者开胸肺活检标本中胰岛素样生长因子（ＩＧＦ）－Ⅰ和血小板衍生长因子（ＰＤＧＦ）的表达,进一步阐明它们在ＩＰＦ过程中的作用。方法 采用免疫组化和原位杂交方法,分别利用ＩＧＦ－Ⅰ和ＰＤＧＦ的特异抗体和特异引物,检测其在ＩＰＦ患者开胸肺活检标本中的要布和表达。结果 在ＩＰＦ患者中,ＩＧＦ－Ⅰ主要分布在肺动脉血管、新生血管的平涌肌细胞和内皮细胞。肺泡巨噬细胞、Ⅱ     

Development of connective tissue and surfactant production in fetal lung

The important processes in fetal pulmonary development are devoted to gain large surfaces for gas exchange and surfactant production. Basement membrane components, collagen fibers and elastic fibers are formed immediately around the epithelium in the early stage of lung development. Primordia of alveolar septa composed of elastic fibers and smooth muscle cells, develop in the glandular stage and form alveolar septa by protruding into the glandular lumina in later stages. The differentiation of alveolar walls, including the appearance of surfactant-producing cells, begins earlier in the proximal portion than in the distal portion of primitive alveoli. The process of fibrosis and regeneration in lung fibrosis defectively mimics the embryogenesis of the lung. Pulmonary structural remodeling occurs when the epithelial basement membrane, a scaffold for regenerating epithelial cells, is lost because of intra-alveolar fibrosis. In panacinar emphysema, simple and dilated air spaces are formed by the degradation of elastic fibers in alveolar septa, and this process may be reverse to the formation of alveolar septa in developing lung.     

肺纤维化大鼠肺泡Ⅱ型细胞中细胞因子的表达

目的观察博莱霉素致肺纤维化大鼠肺泡Ｉ型上皮细胞肿瘤坏死因子（ＴＮＦα）和血小板衍化生长因子（ＰＤＧＦ）表达的变化。方法大鼠气管内灌注博莱霉素Ａ５复制肺纤维化模型，分别于注药后第３、７、１４和２８天处死动物，进行免疫组织化学染色；同时提取肺泡Ⅱ型上皮细胞总ＲＮＡ进行Ｎｏｒｔｈｅｒｎ杂交。结果正常大鼠肺泡Ⅱ型上皮细胞不表达ＴＮＦα和ＰＤＧＦ；而肺纤维化大鼠肺泡Ⅱ型上皮细胞则表达ＴＮＦα和ＰＤＧＦ。其中ＴＮＦα表达高峰在注药后第２８天；ＰＤＧＦ的表达高峰在注药后第７天。结论肺纤维化大鼠肺泡Ⅱ型细胞过度表达ＴＮＦα和ＰＤＧＦ，参与了肺纤维的发病过程。     

Lung cancer in pulmonary fibrosis: tales of epithelial cell plasticity

Lung epithelial cells exhibit a high degree of plasticity. Alterations to lung epithelial cell function are critically involved in several chronic lung diseases such as pulmonary fibrosis. Pulmonary fibrosis is characterized by repetitive injury and subsequent impaired repair of epithelial cells, which leads to aberrant growth factor activation and fibroblast accumulation. Increased proliferation and hyper- and metaplasia of epithelial cells upon injury have also been observed in pulmonary fibrosis; this epithelial cell activation might represent the basis for lung cancer development. Indeed, several studies have provided histopathological evidence of an increased incidence of lung cancer in pulmonary fibrosis. The mechanisms involved in the development of cancer in pulmonary fibrosis, however, remain poorly understood. This review highlights recently uncovered molecular mechanisms shared between lung cancer and fibrosis, which extend the current evidence of a common trait of cancer and fibrosis, as provided by histopathological observations.     

Expression of hepatocyte growth factor by activated eosinophiles in inflammatory lung tissue]

Hepatocyte growth factor (HGF) plays a multifunctional role in the regeneration of alveolar type-II and other epithelial cells. HGF is produced by various kinds of mesenchymal cells, including polymorphonuclear granulocytes. However, it was not evident that eosinophiles produce HGF. In this investigation, we utilized immunohistochemical techniques to show that Eol-1 cells, an eosinophilic leukemia cell line, as well as activated eosinophiles in inflammatory lung tissue, produce HGF. It was also shown that IL-5 induced the production of HGF by peripheral eosinophiles in vitro. These findings suggest that, in inflammatory lung diseases, eosinophiles activated in the presence of IL-5 produce not only tissue-injurious substances (e.g., eosinophilic cationic protein, major basic protein, and peroxidase) but also HGF; and that eosinophiles may play a role in the regeneration of injured lung tissue through the production of HGF.     

Inflammation and angiogenesis in fibrotic lung disease

The pathogenesis of pulmonary fibrosis is poorly understood. Although inflammation has been presumed to have an important role in the development of fibrosis this has been questioned recently, particularly with regard to idiopathic pulmonary fibrosis (IPF). It is, however, increasingly recognized that the polarization of the inflammatory response toward a type 2 phenotype supports fibroproliferation. Increased attention has been on the role of noninflammatory structural cells such as the fibroblast, myofibroblast, epithelial cell, and endothelial cells. Furthermore, the origin of these cells appears to be multifactorial and includes resident cells, bone marrow-derived cells, and epithelial to mesenchymal transition. Increasing evidence supports the presence of vascular remodeling in fibrotic lung disease, although the precise role in the pathogenesis of fibrosis remains to be determined. Therefore, the pathogenesis of pulmonary fibrosis is complex and involves the interaction of multiple cell types and compartments within the lung.