Use of a pulmosphere model to evaluate drug antifibrotic responses in interstitial lung diseases

Kevin G Dsouza; Ranu Surolia; Tejaswini Kulkarni; Fu Jun Li; Pooja Singh; Huaxiu Zeng; Crystal Stephens; Abhishek Kumar; Zheng Wang; Veena B Antony

doi:10.1186/s12931-023-02404-7

Use of a pulmosphere model to evaluate drug antifibrotic responses in interstitial lung diseases

Respir Res. 2023 Mar 28;24(1):96. doi: 10.1186/s12931-023-02404-7.

Authors

Kevin G Dsouza^#^{1

2}, Ranu Surolia^#^{1

2}, Tejaswini Kulkarni^{1

2}, Fu Jun Li^{1

2}, Pooja Singh^{1

2}, Huaxiu Zeng^{1

2}, Crystal Stephens^{1

2}, Abhishek Kumar³, Zheng Wang¹, Veena B Antony^{4

5}

Affiliations

¹ Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
² Superfund Research Center at The University of Alabama at Birmingham, 901 19Th St S, BMR2, Rm 404, Birmingham, AL, 35294, USA.
³ , Gainesville, Fl, USA.
⁴ Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. vantony@uabmc.edu.
⁵ Superfund Research Center at The University of Alabama at Birmingham, 901 19Th St S, BMR2, Rm 404, Birmingham, AL, 35294, USA. vantony@uabmc.edu.

^# Contributed equally.

Abstract

Background: Interstitial lung diseases (ILD) encompass a heterogenous group of diffuse parenchymal lung disorders characterized by variable degrees of inflammation and fibrosis. Pretherapeutic clinical testing models for such diseases can serve as a platform to test and develop effective therapeutic strategies. In this study, we developed patient derived 3D organoid model to recapitulate the disease process of ILDs. We characterized the inherent property of invasiveness in this model and tested for antifibrotic responses with an aim to develop a potential platform for personalized medicine in ILDs.

Methods: In this prospective study, 23 patients with ILD were recruited and underwent lung biopsy. 3D organoid-based models (pulmospheres) were developed from the lung biopsy tissues. Pulmonary functioning testing and other relevant clinical parameters were collected at the time of enrollment and follow up visits. The patient derived pulmospheres were compared to normal control pulmospheres obtained from 9 explant lung donor samples. These pulmospheres were characterized by their invasive capabilities and responsiveness to the antifibrotic drugs, pirfenidone and nintedanib.

Results: Invasiveness of the pulmospheres was measured by the zone of invasiveness percentage (ZOI%). The ILD pulmospheres (n = 23) had a higher ZOI% as compared to control pulmospheres (n = 9) (516.2 ± 115.6 versus 54.63 ± 19.6 respectively. ILD pulmospheres were responsive to pirfenidone in 12 of the 23 patients (52%) and responsive to nintedanib in all 23 patients (100%). Pirfenidone was noted to be selectively responsive in patients with connective tissue disease related ILD (CTD-ILD) at low doses. There was no correlation between the basal pulmosphere invasiveness, response to antifibrotics, and FVC change (Δ FVC).

Conclusions: The 3D pulmosphere model demonstrates invasiveness which is unique to each individual subject and is greater in ILD pulmospheres as compared to controls. This property can be utilized to test responses to drugs such as antifibrotics. The 3D pulmosphere model could serve as a platform for the development of personalized approaches to therapeutics and drug development in ILDs and potentially other chronic lung diseases.

MeSH terms

Connective Tissue Diseases*
Humans
Lung
Lung Diseases, Interstitial* / diagnosis
Lung Diseases, Interstitial* / drug therapy
Prospective Studies

Grants and funding

P42 ES027723/ES/NIEHS NIH HHS/United States