[HTML][HTML] CD4+ CD25hiFoxp3+ cells exacerbate bleomycin-induced pulmonary fibrosis

SZ Birjandi, V Palchevskiy, YY Xue, S Nunez… - The American journal of …, 2016 - Elsevier
SZ Birjandi, V Palchevskiy, YY Xue, S Nunez, R Kern, SS Weigt, JP Lynch III, TA Chatila
The American journal of pathology, 2016Elsevier
Idiopathic pulmonary fibrosis is a fatal lung disease with a median survival of 2 to 5 years. A
decade of studies has downplayed inflammation contributing to its pathogenesis. However,
these studies preceded the discovery of regulatory T cells (Tregs) and all of their functions.
On the basis of human studies demonstrating Tregs can decrease graft-versus-host disease
and vasculitides, there is consideration of their use to treat idiopathic pulmonary fibrosis. We
hypothesized that Treg therapy would attenuate the fibroplasia involved in a preclinical …
Idiopathic pulmonary fibrosis is a fatal lung disease with a median survival of 2 to 5 years. A decade of studies has downplayed inflammation contributing to its pathogenesis. However, these studies preceded the discovery of regulatory T cells (Tregs) and all of their functions. On the basis of human studies demonstrating Tregs can decrease graft-versus-host disease and vasculitides, there is consideration of their use to treat idiopathic pulmonary fibrosis. We hypothesized that Treg therapy would attenuate the fibroplasia involved in a preclinical murine model of pulmonary fibrosis. IL-2 complex was used in vivo to expand CD4+CD25hiFoxp3+ cells in the lung during intratracheal bleomycin challenge; however, this unexpectedly led to an increase in lung fibrosis. More important, this increase in fibrosis was a lymphocyte-dependent process. We corroborated these results using a CD4+CD25hiFoxp3+ cellular-based therapy. Mechanistically, we demonstrated that CD4+CD25hiFoxp3+ cells undergo alterations during bleomycin challenge and the IL-2 complex had no effect on profibrotic (eg, transforming growth factor-β) or type 17 immune response cytokines; however, there was a marked down-regulation of the type 1 and augmentation of the type 2 immune response cytokines from the lungs. Collectively, our animal studies show that a specific lung injury can induce Treg alterations, which can augment pulmonary fibrosis.
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