Abstract
BackgroundPulmonary fibrosis is a late manifestation of acute respiratory distress syndrome (ARDS). Sepsis is a major cause of ARDS, and its pathogenesis includes endotoxin-induced vascular injury. Recently, endothelial-to-mesenchymal transition (EndMT) was shown to play an important role in pulmonary fibrosis. On the other hand, dipeptidyl peptidase (DPP)-4 was reported to improve vascular dysfunction in an experimental sepsis model, although whether DPP-4 affects EndMT and fibrosis initiation during lipopolysaccharide (LPS)-induced lung injury is unclear. The aim of this study was to investigate the anti-EndMT effects of the DPP-4 inhibitor vildagliptin in pulmonary fibrosis after systemic endotoxemic injury.MethodsA septic lung injury model was established by intraperitoneal injection of lipopolysaccharide (LPS) in eight-week-old male mice (5 mg/kg for five consecutive days). The mice were then treated with vehicle or vildagliptin (intraperitoneally, 10 mg/kg, once daily for 14 consecutive days from 1 day before the first administration of LPS.). Flow cytometry, immunohistochemical staining, and quantitative polymerase chain reaction (qPCR) analysis was used to assess cell dynamics and EndMT function in lung samples from the mice.ResultsLung tissue samples from treated mice revealed obvious inflammatory reactions and typical interstitial fibrosis 2 days and 28 days after LPS challenge. Quantitative flow cytometric analysis showed that the number of pulmonary vascular endothelial cells (PVECs) expressing alpha-smooth muscle actin (α-SMA) or S100 calcium-binding protein A4 (S100A4) increased 28 days after LPS challenge. Similar increases in expression were also confirmed by qPCR of mRNA from isolated PVECs. EndMT cells had higher proliferative activity and migration activity than mesenchymal cells. All of these changes were alleviated by intraperitoneal injection of vildagliptin. Interestingly, vildagliptin and linagliptin significantly attenuated EndMT in the absence of immune cells or GLP-1.ConclusionsInhibiting DPP-4 signaling by vildagliptin could ameliorate pulmonary fibrosis by downregulating EndMT in systemic LPS-induced lung injury.
Highlights
Pulmonary fibrosis is a late manifestation of acute respiratory distress syndrome (ARDS)
Masson’s trichrome staining of lung sections to evaluate fibrotic lesions showed that recurrent LPS exposure led to prominent pulmonary fibrosis, and this fibrosis was attenuated in the presence of the Dipeptidyl peptidase-4 (DPP-4) inhibitor vildagliptin. (Fig. 1d, e)
Vildagliptin attenuated endothelial-to-mesenchymal transition (EndMT) in pulmonary vascular endothelial cells (PVECs) Hashimoto et al reported that EndMT is involved in bleomycin-induced pulmonary fibrosis [7]
Summary
Pulmonary fibrosis is a late manifestation of acute respiratory distress syndrome (ARDS). Sepsis is a major cause of ARDS, and its pathogenesis includes endotoxin-induced vascular injury. Dipeptidyl peptidase (DPP)-4 was reported to improve vascular dysfunction in an experimental sepsis model, whether DPP-4 affects EndMT and fibrosis initiation during lipopolysaccharide (LPS)-induced lung injury is unclear. The most common cause of ARDS is sepsis that involves direct or indirect interactions between endotoxins and pulmonary vascular endothelial cells (PVECs). Some of pulmonary microvascular endothelial cells transform into mesenchymal phenotype with retaining reversibility to their original phenotype when endotoxin stimulation is transient. It is unclear whether continuous or intermittent endotoxin exposure promotes complete EndMT and pulmonary fibrosis
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