Three-dimensional characterization of fibroblast foci in idiopathic pulmonary fibrosis

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Abstract

In idiopathic pulmonary fibrosis (IPF), the fibroblast focus is a key histological feature representing active fibroproliferation. On standard 2D pathologic examination, fibroblast foci are considered small, distinct lesions, although they have been proposed to form a highly interconnected reticulum as the leading edge of a “wave” of fibrosis. Here, we characterized fibroblast focus morphology and interrelationships in 3D using an integrated micro-CT and histological methodology. In 3D, fibroblast foci were morphologically complex structures, with large variations in shape and volume (range, 1.3 × 10⁴ to 9.9 × 10⁷ μm³). Within each tissue sample numerous multiform foci were present, ranging from a minimum of 0.9 per mm³ of lung tissue to a maximum of 11.1 per mm³ of lung tissue. Each focus was an independent structure, and no interconnections were observed. Together, our data indicate that in 3D fibroblast foci form a constellation of heterogeneous structures with large variations in shape and volume, suggesting previously unrecognized plasticity. No evidence of interconnectivity was identified, consistent with the concept that foci represent discrete sites of lung injury and repair.

Authors

Mark G. Jones, Aurélie Fabre, Philipp Schneider, Francesco Cinetto, Giacomo Sgalla, Mark Mavrogordato, Sanjay Jogai, Aiman Alzetani, Ben G. Marshall, Katherine M.A. O’Reilly, Jane A. Warner, Peter M. Lackie, Donna E. Davies, David M. Hansell, Andrew G. Nicholson, Ian Sinclair, Kevin K. Brown, Luca Richeldi