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1 Lung Biology Laboratory, Department of Medicine and Pediatrics, Georgetown University School of Medicine, Washington, DC, USA
* To whom correspondence should be addressed. E-mail: massarod{at}georgetown.edu.
Lung tissue elastic recoil and the dimension and number of pulmonary gasexchange units (alveoli) are major determinants of gas exchange function. Loss of gas exchange function accelerates after menopause in the healthy aged, and is progressively lost in individuals with chronic obstructive pulmonary disease (COPD). The latter, a disease of midlife and later, though more common in men than in women, is a disease to which women smokers and never smokers may be more susceptible than men; it is characterized by diminished lung tissue elastic recoil and presently irremediable alveolar loss. Ovariectomy in sexually immature rats diminishes the formation of alveoli, estrogen prevents the diminution. In the present work, we found estrogen receptor alpha and estrogen receptor beta, the only recognized mammalian estrogen receptors, are required for the formation of a full complement of alveoli in female mice. However, only the absence of estrogen receptor beta diminishes lung elastic tissue recoil. Further, ovariectomy in adult mice results, within three weeks, in loss of alveoli and of alveolar surface area without a change of lung volume. Estrogen replacement, after alveolar loss, induces alveolar regeneration, reversing the architectural effects of ovariectomy. These studies 1) reveal estrogen receptors regulate alveolar size and number in a nonredundant manner, 2) show estrogen is required for maintenance of already formed alveoli and induces alveolar regeneration following their loss in adult ovariectomized mice, and 3) offer the possibility estrogen can slow alveolar loss and induce alveolar regeneration in women with COPD.
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