Abstract

Acute Lung Injury/Acute Respiratory Distress Syndrome (ALI/ARDS) is characterized by alveolar edema accumulation with reduced alveolar fluid clearance (AFC), alveolar-capillary barrier disruption, and substantial inflammation, all leading to acute respiratory failure. Enhancing AFC has long been considered one of the primary therapeutic goals in gene therapy treatments for ARDS. We previously showed that electroporation-mediated gene delivery of the Na+, K+-ATPase β1 subunit not only increased AFC, but also restored alveolar barrier function through upregulation of tight junction proteins, leading to treatment of LPS-induced ALI in mice. We identified MRCKα as an interaction partner of β1 which mediates this upregulation in cultured alveolar epithelial cells. In this study, we investigate whether electroporation-mediated gene transfer of MRCKα to the lungs can attenuate LPS-induced acute lung injury in vivo. Compared to mice that received a non-expressing plasmid, those receiving the MRCKα plasmid showed attenuated LPS-increased pulmonary edema and lung leakage, restored tight junction protein expression, and improved overall outcomes. Interestingly, gene transfer of MRCKα did not alter AFC rates. Studies using both cultured microvascular endothelial cells and mice suggest that β1 and MRCKα upregulate junctional complexes in both alveolar epithelial and capillary endothelial cells, and that one or both barriers may be positively affected by our approach. Our data support a model of treatment for ALI/ARDS in which improvement of alveolar-capillary barrier function alone may be of more benefit than improvement of alveolar fluid clearance.

Highlights

  • Acute Lung Injury/Acute Respiratory Distress Syndrome (ALI/ARDS) is characterized by alveolar edema accumulation with reduced alveolar fluid clearance (AFC), alveolar-capillary barrier disruption, and substantial inflammation, all leading to acute respiratory failure

  • We previously have reported that the induction of tight junction proteins and their membrane localization by the ­Na+, ­K+-ATPase β1 subunit in cultured alveolar epithelial cells is mediated through the kinase MRCKα and further that forced expression of MRCKα in these cells was sufficient to increase tight junction protein ­levels[23]

  • These results show that increased level of ZO-1 and occludin following overexpression of MRCKα alone was comparable to that caused by overexpression of β1-Na+, ­K+-ATPase alone or in combination with MRCKα, and are consistent with the engagement of β1-Na+, ­K+-ATPase/MRCKα axis observed in cultured alveolar epithelial cells to enhance tight j­unctions[23]

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Summary

Introduction

Acute Lung Injury/Acute Respiratory Distress Syndrome (ALI/ARDS) is characterized by alveolar edema accumulation with reduced alveolar fluid clearance (AFC), alveolar-capillary barrier disruption, and substantial inflammation, all leading to acute respiratory failure. We previously showed that electroporation-mediated gene delivery of the ­Na+, ­K+-ATPase β1 subunit increased AFC, and restored alveolar barrier function through upregulation of tight junction proteins, leading to treatment of LPS-induced ALI in mice. Acute Respiratory Distress Syndrome (ARDS) is a devastating clinical condition of acute respiratory ­failure[1,2] It is characterized by pulmonary edema of noncardiogenic origin and a pathologic diffuse alveolar damage phenotype, primarily caused by alveolar capillary barrier dysfunction and protein rich fluid flooding into alveoli and lung interstitial ­space[1,2]. Gene transfer of the β1 subunit of the ­Na+, ­K+-ATPase (β1-Na+, ­K+-ATPase) increases fluid clearance in healthy rat ­lungs[16], and protected mice from subsequent lipopolysaccharide (LPS) induced injury and even treated previously existing LPS-induced lung injury in mice by enhancing A­ FC17–19 This approach was able to treat pigs with sepsis-ischemia/reperfusion injury-induced ­ARDS19

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