Hyaluronan Fragments Induce Lung Alveolar Edema by Activating Calcium-Sensing Receptor

Abstract

One of the hallmarks of lung injury is the breakdown of the cell matrix hygroscopic high molecular weight hyaluronan (HMW-HA >106 kD) into smaller fragments of low molecular weight (LMW-HA < 500 kD) which mediate the onset and progression of acute lung injury. We have found that instillation of very low dose (1μg) of LMW-HA to wt. C57/bl6 mice was suffcient to inhibit lung epithelial ions and water transport and cause lung edema assessed by measuring lungs wet/dry ratio. LMW-HA IC50 for the induction of lung edema, the inhibition of alveolar fluid clearance (AFC) and epithelial sodium channels (ENaC) in alveolar epithelial cells, AEC1 and AEC2, in-situ, in freshly cut lung slices, was 120 nM. We found the expression of calcium-sensing receptor (CaSR), a C class G-protein coupled receptor, was activated by LMW-HA. CD44 is known to be the main membrane receptor of hyaluronan expressed by most cells including lung alveolar epithelial cells, however, because it lacks the intrinsic kinase activity necessary for the transduction of extracellular signal carried by LMW-HA, we hypothesized that it cooperated with CaSR to transduce LMW-HA injurious signal and activated intracellular signaling cascades that induced lung edema by inhibiting ENaC and AFC at 24 h. These effects were prevented by NPS2143 (1 μM), a CaSR inhibitor or calcilytic, instilled 6 h post LMW-HA, and were absent in CD44 knockout mouse. The lack of an effect on W/D ratio, AFC, or ENaC in CD44−/− mouse is evidence that LMW-HA does not directly interact with CaSR, but rather activates CD44 which cooperate with CaSR to trigger intracellular signaling cascades that cause the observed effects. Four hours post mouse airway epithelial cells confluent monolayers were incubated with 1 μg LMW-HA, CaSR expression was increased 4-fold, while amiloride sensitive short-circuit current and αβγ-ENaC subunits expression, at the apical membranes, were significantly reduced. These effects were prevented when CaSR, PLC, or PKC were inhibited with 1 μM NPS2143, 10 μM U73122, or 100 μM Rottlerin, applied 4 h prior to cells incubation with 1 μg LMW-HA, respectively. Our data show that the deleterious effect of LMW-HA on ENaC are mediated by intricate interactions between CD44-LMW-HA complex with CaSR in lung alveolar epithelial cells. The use of calcilytics to decouple the molecular complex formed by CD44-LMW-HA and CaSR may prove to be effective in restoring alveolar sodium ion reabsorption required for lung edema clearance. Department of Anesthesiology and Perioperative Medicine. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.