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The PERK/ATF4 pathway is required for metabolic reprogramming and progressive lung fibrosis
Jyotsana Pandey, Jennifer L. Larson-Casey, Mallikarjun H. Patil, Chao He, Nisarat Pinthong, A. Brent Carter
Jyotsana Pandey, Jennifer L. Larson-Casey, Mallikarjun H. Patil, Chao He, Nisarat Pinthong, A. Brent Carter
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Research Article Immunology Pulmonology

The PERK/ATF4 pathway is required for metabolic reprogramming and progressive lung fibrosis

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Abstract

Asbestosis is a prototypical type of fibrosis that is progressive and does not resolve. ER stress is increased in multiple cell types that contribute to fibrosis; however, the mechanism(s) by which ER stress in lung macrophages contributes to fibrosis is poorly understood. Here, we show that ER stress resulted in protein kinase RNA-like ER kinase (PERK; Eif2ak3) activation in humans with asbestosis. Similar results were seen in asbestos-injured mice. Mice harboring a conditional deletion of Eif2ak3 were protected from fibrosis. Lung macrophages from asbestosis individuals had evidence of metabolic reprogramming to fatty acid oxidation (FAO). Eif2ak3fl/fl mice had increased oxygen consumption rate (OCR), whereas OCR in Eif2ak3–/– Lyz2-cre mice was reduced to control levels. PERK increased activating transcription factor 4 (Atf4) expression, and ATF4 bound to the Ppargc1a promoter to increase its expression. GSK2656157, a PERK-specific inhibitor, reduced FAO, Ppargc1a, and Aft4 in lung macrophages and reversed established fibrosis in mice. These observations suggest that PERK is a therapeutic target to reverse established fibrosis.

Authors

Jyotsana Pandey, Jennifer L. Larson-Casey, Mallikarjun H. Patil, Chao He, Nisarat Pinthong, A. Brent Carter

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Figure 8

PERK regulates macrophage pro-fibrotic gene expression.

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PERK regulates macrophage pro-fibrotic gene expression.
Lung macrophages...
Lung macrophages from normal and asbestosis humans were obtained by BAL. mRNA expression of (A) TGFB1 (n = 5), (B) IL10 (n = 5–7), (C) ARG1 (n = 6), and (D) MRC1 (n = 6) in humans. (E) Tgfb1 (n = 4), (F) Il10 (n = 4), and (G) Pdgfb (n = 4) mRNA expression in BAL isolated at day 21 from exposed Eif2ak3fl/fl and Eif2ak3–/– Lyz2-cre mice. (H) Tgfb1 (n = 3) and (I) Pdgfb (n = 3) mRNA expression in FACS-sorted BAL cells isolated at day 21 from exposed Eif2ak3fl/fl and Eif2ak3–/– Cx3cr1creER mice. (J) Active TGF-β1 (n = 4–5) and (K) PDGF-BB (n = 4–5) in BAL fluid harvested at day 21 from WT mice administered GSK 13 days after exposure to MMVF or asbestos. Data shown as mean ± SEM. Two-tailed Student’s t test in A–D. One-way ANOVA with Tukey’s post hoc comparison in E–K. *P ≤ 0.05, ***P ≤ 0.001, and ****P ≤ 0.0001. (See also Supplemental Figure 7.)

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