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Contributions of alveolar epithelial cell quality control to pulmonary fibrosis
Jeremy Katzen, Michael F. Beers
Jeremy Katzen, Michael F. Beers
Published September 1, 2020
Citation Information: J Clin Invest. 2020;130(10):5088-5099. https://doi.org/10.1172/JCI139519.
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Review

Contributions of alveolar epithelial cell quality control to pulmonary fibrosis

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Abstract

Epithelial cell dysfunction has emerged as a central component of the pathophysiology of diffuse parenchymal diseases including idiopathic pulmonary fibrosis (IPF). Alveolar type 2 (AT2) cells represent a metabolically active lung cell population important for surfactant biosynthesis and alveolar homeostasis. AT2 cells and other distal lung epithelia, like all eukaryotic cells, contain an elegant quality control network to respond to intrinsic metabolic and biosynthetic challenges imparted by mutant protein conformers, dysfunctional subcellular organelles, and dysregulated telomeres. Failed AT2 quality control components (the ubiquitin-proteasome system, unfolded protein response, macroautophagy, mitophagy, and telomere maintenance) result in diverse cellular endophenotypes and molecular signatures including ER stress, defective autophagy, mitochondrial dysfunction, apoptosis, inflammatory cell recruitment, profibrotic signaling, and altered progenitor function that ultimately converge to drive downstream fibrotic remodeling in the IPF lung. As this complex network becomes increasingly better understood, opportunities will emerge to identify targets and therapeutic strategies for IPF.

Authors

Jeremy Katzen, Michael F. Beers

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Figure 2

AT2 cell quality control pathways: homeostasis for proteins, organelles, and DNA.

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AT2 cell quality control pathways: homeostasis for proteins, organelles,...
Proteostasis (blue): Competitive binding of misfolded conformers to the molecular chaperone BiP activates one or more ER UPR sensors (ATF6, IRE1, PERK), initiating signaling to upregulate chaperones via three pathways: (i) ATF6p90 cleavage to ATF6p50 in the Golgi; (ii) IRE1 endoribonuclease activity for splicing XBP1; and (iii) PERK phosphorylation of eIF2α, repressing translation and upregulating ATF4. Proteins refractory to refolding are retrotranslocated from the ER and targeted to the 26S proteasome for degradation by the UPS, via the ERAD process. UPS inhibition can promote the accumulation of cytosolic protein macroaggregates in the aggresome via a microtubule-dependent manner. Autophagy and mitophagy (purple): The autophagosome-lysosome system targets cytosolic protein aggregates (macroautophagy) and dysfunctional organelles, such as mitochondria (mitophagy), for degradation. Ubiquitin-binding receptors, such as p62/SQSTM1, recognize K-48–linked polyubiquitinated protein aggregates or K-63–linked polyubiquitin-tagged mitochondrial outer membrane proteins (initiated by PINK1 recruitment of the E3 ligase parkin). LC3 binding envelopes ubiquitinated cargo and leads to elongation of isolation membranes (phagophores) and maturation into autophagosomes. Fusion with LAMP1+ lysosomes results in an acidified and functional autophagolysosome (autolysosome) that degrades the internalized content. Telomere maintenance (orange): Telomere length relies on the interaction between the multiprotein shelterin complex (end protection), the telomerase holoenzyme (elongation), and the DNA helicase RTEL1. Shelterin is composed of telomeric repeat binding factors 1 and 2 (TRF1 and -2), Tin2, TPP1, Rap1, and POT1. Key telomerase components include a reverse transcriptase subunit (TERT), an RNA template (TERC), and dyskerin. PARN promotes TERC RNA maturation. Not depicted is the CST complex. This figure was adapted with permission from Mulugeta et al. (46).

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

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