Molecular Characterization of Hypoxic Alveolar Epithelial Cells After Lung Contusion Indicates an Important Role for HIF-1α

Ann Surg. 2018 Feb;267(2):382-391. doi: 10.1097/SLA.0000000000002070.

Abstract

Objective: To understand the fate and regulation of hypoxic type II alveolar epithelial cells (AECs) after lung contusion (LC).

Background: LC due to thoracic trauma is a major risk factor for the development of acute respiratory distress syndrome. AECs have recently been implicated as a primary driver of inflammation in LC. The main pathological consequence of LC is hypoxia, and a key mediator of adaptation to hypoxia is hypoxia-inducible factor (HIF)-1. We have recently published that HIF-1α is a major driver of acute inflammation after LC through type II AEC.

Methods: LC was induced in wild-type mice (C57BL/6), luciferase-based hypoxia reporter mice (ODD-Luc), and HIF-1α conditional knockout mice. The degree of hypoxia was assessed using hypoxyprobe and in vivo imaging system. The fate of hypoxic AEC was evaluated by luciferase dual staining with caspases-3 and Ki-67, terminal deoxynucleotidyl transferase dUTP nick end labeling, and flow cytometry with ApoStat. NLRP-3 expression was determined by western blot. Laser capture microdissection was used to isolate AECs in vivo, and collected RNA was analyzed by Q-PCR for HIF-related pathways.

Results: Global hypoxia was present after LC, but hypoxic foci were not uniform. Hypoxic AECs preferentially undergo apoptosis. There were significant reductions in NLRP-3 in HIF-1α conditional knockout mice. The expression of proteins involved in HIF-related pathways and inflammasome activation were significantly increased in hypoxic AECs.

Conclusions: These are the first in vivo data to identify, isolate, and characterize hypoxic AECs. HIF-1α regulation through hypoxic AECs is critical to the initiation of acute inflammation after LC.

MeSH terms

  • Alveolar Epithelial Cells / metabolism*
  • Animals
  • Biomarkers / metabolism
  • Blotting, Western
  • Contusions / metabolism*
  • Contusions / physiopathology
  • Flow Cytometry
  • Hypoxia / etiology*
  • Hypoxia / metabolism
  • Hypoxia-Inducible Factor 1, alpha Subunit / metabolism*
  • Inflammation / etiology
  • Inflammation / metabolism
  • Lung Injury / metabolism*
  • Lung Injury / physiopathology
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout

Substances

  • Biomarkers
  • Hif1a protein, mouse
  • Hypoxia-Inducible Factor 1, alpha Subunit