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Pulmonary inflammation and fibroblast immunoregulation: from bench to bedside
Mohamed A. Ghonim, … , Tim Flerlage, Paul G. Thomas
Mohamed A. Ghonim, … , Tim Flerlage, Paul G. Thomas
Published September 1, 2023
Citation Information: J Clin Invest. 2023;133(17):e170499. https://doi.org/10.1172/JCI170499.
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Review Series

Pulmonary inflammation and fibroblast immunoregulation: from bench to bedside

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Abstract

In recent years, there has been an explosion of interest in how fibroblasts initiate, sustain, and resolve inflammation across disease states. Fibroblasts contain heterogeneous subsets with diverse functionality. The phenotypes of these populations vary depending on their spatial distribution within the tissue and the immunopathologic cues contributing to disease progression. In addition to their roles in structurally supporting organs and remodeling tissue, fibroblasts mediate critical interactions with diverse immune cells. These interactions have important implications for defining mechanisms of disease and identifying potential therapeutic targets. Fibroblasts in the respiratory tract, in particular, determine the severity and outcome of numerous acute and chronic lung diseases, including asthma, chronic obstructive pulmonary disease, acute respiratory distress syndrome, and idiopathic pulmonary fibrosis. Here, we review recent studies defining the spatiotemporal identity of the lung-derived fibroblasts and the mechanisms by which these subsets regulate immune responses to insult exposures and highlight past, current, and future therapeutic targets with relevance to fibroblast biology in the context of acute and chronic human respiratory diseases. This perspective highlights the importance of tissue context in defining fibroblast-immune crosstalk and paves the way for identifying therapeutic approaches to benefit patients with acute and chronic pulmonary disorders.

Authors

Mohamed A. Ghonim, David F. Boyd, Tim Flerlage, Paul G. Thomas

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Figure 1

Lymphatic tissues in the lung regulate the differentiation and release of circulating leukocytes, while fibroblasts coordinate the convergence and communication between innate and adaptive immune cells.

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Lymphatic tissues in the lung regulate the differentiation and release o...
Lung insult caused by airway exposure to environmental triggers (e.g., aeroallergens, viral infection) induces a localized inflammatory response that drives the transformation of epithelial and endothelial cells to myofibroblasts through EMT and endothelial-mesenchymal transition (EndMT) processes. These processes also associate with the recruitment of circulating fibrocytes to lung ECM. Lung ECM-resident fibroblasts are simultaneously induced by a range of cytokines and growth factors, including IL-25, IL-33, TSLP, and TGF-β, and they transition from a resting state to an activated phenotype and finally to hypersecretory myofibroblasts. Myofibroblasts produce a range of cytokines and chemokines as well as soluble inflammatory factors, including IL-1, IL-6, IL-8, IL-13, M-CSF, CXCLs, CCLs, and TGF-β. These mediators regulate the infiltration, trafficking, and polarization of various adoptive and innate immune cells, including eosinophils, neutrophils, macrophages, and NK cells, as well as a variety of subsets of T lymphocytes, including Th1, Th2, and Th17 cells and Tregs. The subsequent blended matrix facilitates crosstalk and interaction between various immune subsets in the stromal tissue, further exacerbating the inflammatory cascade and promoting a tissue remodeling process.

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

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