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Circadian regulation of lung repair and regeneration
Amruta Naik, Kaitlyn M. Forrest, Oindrila Paul, Yasmine Issah, Utham K. Valekunja, Soon Y. Tang, Akhilesh B. Reddy, Elizabeth J. Hennessy, Thomas G. Brooks, Fatima Chaudhry, Apoorva Babu, Michael Morley, Jarod A. Zepp, Gregory R. Grant, Garret A. FitzGerald, Amita Sehgal, G. Scott Worthen, David B. Frank, Edward E. Morrisey, Shaon Sengupta
Amruta Naik, Kaitlyn M. Forrest, Oindrila Paul, Yasmine Issah, Utham K. Valekunja, Soon Y. Tang, Akhilesh B. Reddy, Elizabeth J. Hennessy, Thomas G. Brooks, Fatima Chaudhry, Apoorva Babu, Michael Morley, Jarod A. Zepp, Gregory R. Grant, Garret A. FitzGerald, Amita Sehgal, G. Scott Worthen, David B. Frank, Edward E. Morrisey, Shaon Sengupta
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Research Article Pulmonology Virology

Circadian regulation of lung repair and regeneration

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Abstract

Optimal lung repair and regeneration are essential for recovery from viral infections, including influenza A virus (IAV). We have previously demonstrated that acute inflammation and mortality induced by IAV is under circadian control. However, it is not known whether the influence of the circadian clock persists beyond the acute outcomes. Here, we utilize the UK Biobank to demonstrate an association between poor circadian rhythms and morbidity from lower respiratory tract infections, including the need for hospitalization and mortality after discharge; this persists even after adjusting for common confounding factors. Furthermore, we use a combination of lung organoid assays, single-cell RNA sequencing, and IAV infection in different models of clock disruption to investigate the role of the circadian clock in lung repair and regeneration. We show that lung organoids have a functional circadian clock and the disruption of this clock impairs regenerative capacity. Finally, we find that the circadian clock acts through distinct pathways in mediating lung regeneration — in tracheal cells via the Wnt/β-catenin pathway and through IL-1β in alveolar epithelial cells. We speculate that adding a circadian dimension to the critical process of lung repair and regeneration will lead to novel therapies and improve outcomes.

Authors

Amruta Naik, Kaitlyn M. Forrest, Oindrila Paul, Yasmine Issah, Utham K. Valekunja, Soon Y. Tang, Akhilesh B. Reddy, Elizabeth J. Hennessy, Thomas G. Brooks, Fatima Chaudhry, Apoorva Babu, Michael Morley, Jarod A. Zepp, Gregory R. Grant, Garret A. FitzGerald, Amita Sehgal, G. Scott Worthen, David B. Frank, Edward E. Morrisey, Shaon Sengupta

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Figure 1

UK Biobank analyses.

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UK Biobank analyses.
(A) Description of study cohort from UK Biobank. (B...
(A) Description of study cohort from UK Biobank. (B) Hazard ratio for the risk of hospitalization for respiratory infections across the quintiles of relative amplitude (RA) of actigraphy as a measure of circadian rhythms. The lowest quintile represents individuals with the poorest circadian rhythms and serves as the comparison group. (C) Length of hospital stay defined across the quintiles of RA scores (median, IQR). (D) Hazard ratio of the risk of death within 30 days after discharge from above-defined hospitalization. All hazard ratios were adjusted for cofounding factors that included, age, sex, HbA1c, cancer diagnosis, FEV1, BMI, smoking status, history of previous respiratory illness requiring hospitalization, overall physical activity level, use of bronchodilators and inhaled corticosteroids, and self-rated overall health.

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