Journal of Respiratory Biology and Translational Medicine Open Access

Epithelial-Mesenchymal Niche Dysfunction in COPD: Emerging Opportunities for Targeting Cellular Plasticity and Crosstalk

Chronic obstructive pulmonary disease (COPD) is a leading cause of global morbidity and mortality, characterized by progressive airway and alveolar remodeling. The disease pathogenesis is commonly driven by chronic environmental insults, leading to airway obstruction, emphysema, and chronic bronchitis. This review synthesizes emerging evidence that altered epithelial cell behavior and dysfunctional epithelial-mesenchymal interactions serve as pivotal drivers of COPD pathogenesis, orchestrating failed repair and structural degeneration. We detail how altered responses of airway (ciliated, club, basal, goblet) and alveolar (AT1 and AT2) epithelial cells lead to cellular senescence, metaplasia, defective regeneration, and barrier disruption, acting as primary instigators of pathogenesis. We also summarize current knowledge on the mechanisms of activation and pathogenic role of mesenchymal cells, which drive peribronchiolar fibrosis, alveolar destruction, and metabolic reprogramming, alongside the compromised reparative function of mesenchymal stem cells (MSCs). We emphasize how distinct mesenchymal niches (e.g., PDGFRα^Pos MANCs, FGF10^Pos lipofibroblasts, SFRP1^Pos fibroblasts) and distinct epithelial stem/progenitor subpopulations critically contribute to pathogenesis. Key signaling pathways—including FGF10/FGFR2b, WNT, Hippo, NOTCH, and TGF-β—mediate epithelial-mesenchymal transition (EMT), stem cell niche function, and structural remodeling. By dissecting how epithelial injury responses and mesenchymal niche failure collaboratively drive COPD progression, we identify actionable targets to disrupt pathogenesis and restore endogenous repair. We propose targeting EMT, including inhibiting EMT/fibrosis, promoting alveolar regeneration, MSC-based therapies, exosome-delivered biomolecules, and precision cell transplantation strategies, as promising future therapeutic strategies.

Mitochondrial Lon Peptidase 1 Controls Diaphragm and Lung Development in a Context-Dependent Manner

Congenital Diaphragmatic Hernia (CDH) is a rare neonatal disorder causing diaphragmatic defects and cardiopulmonary hypoplasia, traditionally attributed to mechanical compression from organ herniation. However, emerging evidence suggests genetic mutations may independently impair lung development, prompting debate over CDH etiology. Here, we investigated the requirement of mitochondrial function guarded by LON peptidase 1 (Lonp1), a CDH risk gene, in either diaphragm or lung development. Lonp1 loss in skeletal muscles of the diaphragm led to its thinning and membranization, recapitulating the pathology of sac-type CDH. On the other hand, lung-specific inactivation caused severe hypoplasia with defective branching morphogenesis, independent of diaphragm anomalies. Molecularly, Lonp1 disruption dysregulated key transcription factors and signaling pathways known to be critical for early lung development. Our findings here revealed that mitochondrial defects contribute to the pathogenesis of CDH in an organ and cell type specific manner, opening new avenues for drug and therapeutic development.

Commentary on “Nephrectomy and High-Salt Diet Inducing Pulmonary Hypertension and Kidney Damage by Increasing Ang II Concentration in Rats”

Spermidine Dampens Inflammation by Directly Inhibiting Th17 Cytokine Production through a PRDX1 Associated Antioxidant Pathway

The activation of IL-17 signaling has been linked to the pathogenesis of many chronic, inflammatory lung diseases including cystic fibrosis. Through unbiased single-cell RNAseq screening, we found that IL-17+ T cells highly express Srm and Smox, which encode two key enzymes involved in spermidine synthesis, spermidine synthase and spermine oxidase respectively. Spermidine has been shown to reduce inflammation by regulating macrophage activation and balancing Th17/Treg differentiation; however its direct effects on Th17 cytokine production have not been carefully investigated. Here, using already differentiated Th17 cells from cultured mouse splenocytes, we found that exogenous spermidine directly inhibits IL-1β/IL-23-induced IL-17 production. Blockade of endogenous spermidine synthesis enhanced IL-17 production above native levels, further supporting the notion that spermidine is a direct regulator of cytokine secretion independent of differentiation. In vivo, spermidine alleviates lung inflammation in both Pseudomonas aeruginosa (PA) and LPS induced acute lung injury models. Further RNA-seq analysis suggests that spermidine suppression of Th17 cytokine production is mediated through its PRDX1-dependent antioxidant activity. Our data suggests that spermidine is a direct regulator of Type-17 T cell cytokine production and has potent anti-inflammatory effects against lung inflammation.

Bone Marrow Transplantation as a Future Therapeutic Strategy for Idiopathic Pulmonary Fibrosis: Lessons from Hematopoietic Aging

Idiopathic pulmonary fibrosis (IPF) is a fatal disease with limited therapeutic options. Lung transplantation is the only curative treatment, but it is rarely available due to a lack of suitable donors. In a recent publication in Science Immunology, Farhat et al. demonstrated that bone marrow transplantation from young donors alleviates fibrosis by restoring immune resolution in aged hosts in animal models. Aged hematopoietic cells exacerbate fibrosis through the persistence of inflammatory macrophages and impaired Treg-derived IL-10, highlighting bone marrow rejuvenation as a potential treatment strategy for IPF.

Enhanced Spatial Transcriptomics Analysis of Mouse Lung Tissues Reveals Cell-Specific Gene Expression Changes Associated with Pulmonary Hypertension

Spatial transcriptomics technologies have emerged as powerful tools for understanding cellular identity and function within the natural spatial context of tissues. Traditional transcriptomics techniques, such as bulk and single-cell RNA sequencing, lose this spatial information, which is critical for addressing many biological questions. Here, we present a protocol for high-resolution spatial transcriptomics using fixed frozen mouse lung sections mounted on 10X Genomics Xenium slides. This method integrates multiplexed fluorescent in situ hybridization (FISH) with high-throughput imaging to reveal the spatial distribution of mRNA molecules in lung tissue sections, allowing detailed analysis of gene expression changes in a mouse model of pulmonary hypertension (PH). We compared two tissue preparation methods, fixed frozen and fresh frozen, for compatibility with the Xenium platform. Our fixed frozen approach, utilizing a free-floating technique to mount thin lung sections onto Xenium slides at room temperature, preserved tissue integrity and maximized the imaging area, resulting in high-fidelity spatial transcriptomics data. Using a predesigned 379-gene mouse panel, we identified 40 major lung cell types. We detected key cellular changes in PH, including an increase in arterial endothelial cells (AECs) and fibroblasts, alongside a reduction in capillary endothelial cells (CAP1 and CAP2). Through differential gene expression analysis, we observed markers of endothelial-to-mesenchymal transition and fibroblast activation in PH lungs. High-resolution spatial mapping further confirmed increased arterialization in the distal microvasculature. These findings underscore the utility of spatial transcriptomics in preserving the native tissue architecture and enhancing our understanding of cellular heterogeneity in disease. Our protocol provides a reliable method for integrating spatial and transcriptomic data using fixed frozen lung tissues, offering significant potential for future studies in complex diseases such as PH.

Commentary on “Ineffectiveness of Sotatercept Therapy in a Patient with Heritable Pulmonary Arterial Hypertension Associated with a Previously Unreported Missense Variant in GDF2, the Gene for Bone Morphogenic Protein-9”

USP11 Promotes Endothelial Apoptosis-Resistance in Pulmonary Arterial Hypertension by Deubiquitinating HINT3

Pulmonary arterial hypertension (PAH) is a progressive, lethal, and incurable disease of the pulmonary vasculature. A previous genome-wide association study (GWAS) with Affymetrix microarray analysis data exhibited elevated histidine triad nucleotide-binding protein 3 (HINT3) in the lung samples of PAH compared to control subjects (failed donors, FD) and the positive correlations of HINT3 with deubiquitinase USP11 and B-cell lymphoma 2 (BCL2). In this study, we aim to investigate the roles and interplay of USP11 and HINT3 in the apoptosis resistance of PAH. The levels of USP11 and HINT3 were increased in the lungs of idiopathic PAH (IPAH) patients and Hypoxia/Sugen-treated mice. USP11 and HINT3 interacted physically, as shown by co-immunoprecipitation (co-IP) assay in human pulmonary arterial endothelial cells (HPAECs). HINT3 was degraded by polyubiquitination, which was reversed by USP11. Furthermore, HINT3 interacted with the anti-apoptotic mediator, BCL2. Overexpression of USP11 increased BCL2 content, congruent to elevated lung tissue levels seen in IPAH patients and Hypoxia/Sugen-treated mice. Conversely, the knockdown of HINT3 function led to a depletion of BCL2. Thus, we conclude that USP11 stabilizes HINT3 activation, which contributes to endothelial apoptosis-resistance of pulmonary arterial endothelial cells in PAH. This can potentially be a novel therapeutic target for ubiquitination modulators for PAH.

Mechanisms and Therapeutic Potential of Myofibroblast Transformation in Pulmonary Fibrosis

Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible, and fatal disease with an increasing incidence and limited therapeutic options. It is characterized by the formation and deposition of excess extracellular matrix proteins resulting in the gradual replacement of normal lung architecture by fibrous tissue. The cellular and molecular mechanism of IPF has not been fully understood. A hallmark in IPF is pulmonary fibroblast to myofibroblast transformation (FMT). During excessive lung repair upon exposure to harmful stimuli, lung fibroblasts transform into myofibroblasts under stimulation of cytokines, chemokines, and vesicles from various cells. These mediators interact with lung fibroblasts, initiating multiple signaling cascades, such as TGFβ1, MAPK, Wnt/β-catenin, NF-κB, AMPK, endoplasmic reticulum stress, and autophagy, contributing to lung FMT. Furthermore, single-cell transcriptomic analysis has revealed significant heterogeneity among lung myofibroblasts, which arise from various cell types and are adapted to the altered microenvironment during pathological lung repair. This review provides an overview of recent research on the origins of lung myofibroblasts and the molecular pathways driving their formation, with a focus on the interactions between lung fibroblasts and epithelial cells, endothelial cells, and macrophages in the context of lung fibrosis. Based on these molecular insights, targeting the lung FMT could offer promising avenues for the treatment of IPF.

State of the ART: Drug Screening Reveals Artesunate as a Promising Anti-Fibrosis Therapy

Fibrosis is a progressive pathological process that severely impairs normal organ function. Current treatments for fibrosis are extremely limited, with no curative approaches available. In a recent article published in Cell, Zhang and colleagues employed drug screening using ACTA2 reporter iPSC-derived cardiac fibroblasts and identified artesunate as a potent antifibrotic drug by targeting MD2/TLR4 signaling. This study provides new insights into strategies for exploiting existing drugs to treat fibrosis.