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1 Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, 45229, Ohio, United States
2 Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
3 Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
4 Pulmonary Biology, Children's Hospital Medical Center, Cincinnati, Ohio, United States
5 Pulmonary Medicine, Feinberg School of Medicine, Chicago, Illinois, United States
* To whom correspondence should be addressed. E-mail: william.hardie{at}cchmc.org.
Transforming growth factor-alpha (TGF
) is a ligand for the epidermal growth factor receptor (EGFR). EGFR activation is associated with fibroproliferative processes in human lung disease and animal models of pulmonary fibrosis. We determined the effects of EGFR tyrosine kinase inhibitors gefitinib (Iressa®) and erlotinib (Tarceva®) on the development and progression of TGF-induced pulmonary fibrosis. Using a doxycycline regulatable transgenic mouse model of lung-specific TGF expression, we determined effects of treatment with gefitinib and erlotinib on changes in lung histology, total lung collagen, pulmonary mechanics, pulmonary hypertension and expression of genes associated with synthesis of extracellular matrix and vascular remodeling. Induction in the lung of TGF caused progressive pulmonary fibrosis over an 8 week period. Daily administration of gefitinib or erlotinib prevented development of fibrosis, reduced accumulation of total lung collagen, prevented weight loss, and prevented changes in pulmonary mechanics. Treatment of mice with gefitinib 4 weeks after the induction of TGF prevented further increases in and partially reversed total collagen levels and changes in pulmonary mechanics and pulmonary hypertension. Increases in expression of genes associated with synthesis of extracellular matrix as well as decreases of genes associated with vascular remodeling were also prevented or partially reversed. Administration of gefitinib or erlotinib did not cause interstitial fibrosis or increases in lavage cell counts. Administration of small molecule EGFR tyrosine kinase inhibitors prevented further increases in and partially reversed pulmonary fibrosis induced directly by EGFR activation without inducing inflammatory cell influx or additional lung injury.
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