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Macrophage-derived netrin-1 drives adrenergic nerve–associated lung fibrosis
Ruijuan Gao, Xueyan Peng, Carrighan Perry, Huanxing Sun, Aglaia Ntokou, Changwan Ryu, Jose L. Gomez, Benjamin C. Reeves, Anjali Walia, Naftali Kaminski, Nir Neumark, Genta Ishikawa, Katharine E. Black, Lida P. Hariri, Meagan W. Moore, Mridu Gulati, Robert J. Homer, Daniel M. Greif, Holger K. Eltzschig, Erica L. Herzog
Ruijuan Gao, Xueyan Peng, Carrighan Perry, Huanxing Sun, Aglaia Ntokou, Changwan Ryu, Jose L. Gomez, Benjamin C. Reeves, Anjali Walia, Naftali Kaminski, Nir Neumark, Genta Ishikawa, Katharine E. Black, Lida P. Hariri, Meagan W. Moore, Mridu Gulati, Robert J. Homer, Daniel M. Greif, Holger K. Eltzschig, Erica L. Herzog
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Research Article Pulmonology

Macrophage-derived netrin-1 drives adrenergic nerve–associated lung fibrosis

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Abstract

Fibrosis is a macrophage-driven process of uncontrolled extracellular matrix accumulation. Neuronal guidance proteins such as netrin-1 promote inflammatory scarring. We found that macrophage-derived netrin-1 stimulates fibrosis through its neuronal guidance functions. In mice, fibrosis due to inhaled bleomycin engendered netrin-1–expressing macrophages and fibroblasts, remodeled adrenergic nerves, and augmented noradrenaline. Cell-specific knockout mice showed that collagen accumulation, fibrotic histology, and nerve-associated endpoints required netrin-1 of macrophage but not fibroblast origin. Adrenergic denervation; haploinsufficiency of netrin-1’s receptor, deleted in colorectal carcinoma; and therapeutic α1 adrenoreceptor antagonism improved collagen content and histology. An idiopathic pulmonary fibrosis (IPF) lung microarray data set showed increased netrin-1 expression. IPF lung tissues were enriched for netrin-1+ macrophages and noradrenaline. A longitudinal IPF cohort showed improved survival in patients prescribed α1 adrenoreceptor blockade. This work showed that macrophages stimulate lung fibrosis via netrin-1–driven adrenergic processes and introduced α1 blockers as a potentially new fibrotic therapy.

Authors

Ruijuan Gao, Xueyan Peng, Carrighan Perry, Huanxing Sun, Aglaia Ntokou, Changwan Ryu, Jose L. Gomez, Benjamin C. Reeves, Anjali Walia, Naftali Kaminski, Nir Neumark, Genta Ishikawa, Katharine E. Black, Lida P. Hariri, Meagan W. Moore, Mridu Gulati, Robert J. Homer, Daniel M. Greif, Holger K. Eltzschig, Erica L. Herzog

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Figure 1

Macrophage-derived NTN1 in experimentally induced lung fibrosis.

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Macrophage-derived NTN1 in experimentally induced lung fibrosis.
(A and ...
(A and B) WT mice received a single orotracheal dose of vehicle or 1.25 U/kg pharmacological grade bleomycin and were followed for 14 days. After the mice were euthanized, the lungs underwent immunohistochemical detection of NTN1 (brown stain). Vehicle- (A) and bleomycin-challenged lungs (B) contained multiple populations of NTN1+ cells that appeared more numerous in the bleomycin condition. Slides were counterstained with hematoxylin and are shown as ×10 original magnification. (C–F) Flow cytometric detection of NTN1+ macrophages (C, identified with the markers F4/80+CD11b+CD11c+), fibroblasts (D, identified with the markers CD45–ColIα1+), epithelial cells (E, identified with the markers CD45–CD31–EpCAM+) and endothelial cells (F, identified with the markers CD45–EpCAM–CD31+) in single-cell suspensions prepared from lungs of WT mice challenged with vehicle (round symbol) or bleomycin (triangle). Left axis shows percentages, and right axis shows quantities. (G–J) Relative to mice with “intact” expression of Ntn1 in macrophages (LysM-Cre, Ntn1+/+, round symbol), mice with macrophage Ntn1 “deleted” (LysM-Cre, Ntn1fl/fl, triangle) show reduced right lung collagen (G, P = 0.0056, 2-tailed Student’s t test) and, in a separate group of mice, both MAS (H, P = 0.0013 by 2-tailed Student’s t test) and trichrome staining (I, “intact” and J, “deleted”). (K–N) Relative to mice with “intact” expression of Ntn1 in fibroblasts (corn oil–treated ColIα2-CreER, Ntn1fl/fl animals, round symbol), mice with Ntn1 “deleted” in fibroblasts (tamoxifen-treated ColIα2-CreER, Ntn1fl/fl mice, triangle) show unchanged right lung collagen (K), and in a separate group of mice, both MAS (L) and trichrome staining (M, “intact” and N, “deleted”). *P < 0.05, **P < 0.01, ***P < 0.001, and ****P < 0.0001. Data are shown as mean ± SEM.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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