Landscape of transcription and long non-coding RNAs reveals new insights into the inflammatory and fibrotic response following ventilator-induced lung injury

Lu Wang,Jingen Xia,Yi Zhang,Chen Wang,Nannan Zhang,Qingyuan Zhan

doi:10.1186/s12931-018-0822-z

Abstract

BackgroundMechanical ventilation can cause ventilator-induced lung injury (VILI) and lung fibrosis; however, the underlying mechanisms are still not fully understood. RNA sequencing is a powerful means for detecting vitally important protein-coding transcripts and long non-coding RNAs (lncRNAs) on a genome-wide scale, which may be helpful for reducing this knowledge gap.MethodsNinety C57BL/6 mice were subjected to either high tidal volume ventilation or sham operation, and then mice with ventilation were randomly allocated to periods of recovery for 0, 1, 3, 5, 7, 14, 21, or 28 days. Lung histopathology, wet-to-dry weight ratio, hydroxyproline concentration, and transforming growth factor beta 1 (TGF-β1) levels were determined to evaluate the progression of inflammation and fibrosis. To compare sham-operated lungs, and 0- and 7-day post-ventilated lungs, RNA sequencing was used to elucidate the expression patterns, biological processes, and functional pathways involved in inflammation and fibrosis.ResultsA well-defined fibrotic response was most pronounced on day 7 post-ventilation. Pairwise comparisons among the sham and VILI groups showed a total of 1297 differentially expressed transcripts (DETs). Gene Ontology analysis determined that the stimulus response and immune response were the most important factors involved in inflammation and fibrosis, respectively. Kyoto Encyclopedia of Genes and Genomes analysis revealed that mechanistic target of rapamycin (mTOR), Janus kinase-signal transducer and activator of transcription (JAK/STAT), and cyclic adenosine monophosphate (cAMP) signaling were implicated in early inflammation; whereas TGF-β, hypoxia inducible factor-1 (HIF-1), Toll-like receptor (TLR), and kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathways were significantly involved in subsequent fibrosis. Additionally, 332 DE lncRNAs were identified and enriched in the processes of cellular and biological regulation. These lncRNAs may potentially regulate fibrosis through signaling pathways such as wingless/integrase-1 (Wnt), HIF-1, and TLR.ConclusionsThis is the first transcriptome study to reveal all of the transcript expression patterns and critical pathways involved in the VILI fibrotic process based on the early inflammatory state, and to show the important DE lncRNAs regulated in inflammation and fibrosis. Together, the results of this study provide novel perspectives into the potential molecular mechanisms underlying VILI and subsequent fibrosis.

Highlights

Mechanical ventilation can cause ventilator-induced lung injury (VILI) and lung fibrosis; the underlying mechanisms are still not fully understood
Numerous studies have demonstrated that mechanical ventilation (MV) is imperfect and can cause ventilator-induced lung injury (VILI) [1, 2], a common condition that pathologically manifests as an influx of neutrophils, release of inflammatory cytokines, increased alveolar exudation, and non-cardiogenic pulmonary edema [3]
Through target prediction and enrichment analysis, we found that the identified differentially expressed (DE) long non-coding RNAs (lncRNAs) likely participate in the processes of cellular and biological regulation through the mechanistic target of rapamycin (mTOR), forkhead box protein O (FOXO), mitogen-activated protein kinase (MAPK), and cyclic adenosine monophosphate (cAMP) signaling pathways

Summary

Introduction

Mechanical ventilation can cause ventilator-induced lung injury (VILI) and lung fibrosis; the underlying mechanisms are still not fully understood. Numerous studies have demonstrated that MV is imperfect and can cause ventilator-induced lung injury (VILI) [1, 2], a common condition that pathologically manifests as an influx of neutrophils, release of inflammatory cytokines, increased alveolar exudation, and non-cardiogenic pulmonary edema [3]. Several major mechanisms of VILI have been described including barotrauma, volutrauma, atelectrauma, and biotrauma. Barotrauna and volutrauma are caused by alveolar overdistension, and atelectrauma is due to the cyclic collapse/reopening of lung units. Biotrauma is considered to be amplification of the pro-inflammatory cascade based on a pre-existing lung injury [3, 4]. The translocation of mediators and pathogens from the alveolar spaces into systemic circulation may result in increased alveolar–capillary permeability, pulmonary edema, or even fatal multiple organ dysfunction and death [4]

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