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Am J Physiol Lung Cell Mol Physiol (October 7, 2005). doi:10.1152/ajplung.00276.2005
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00276.2005v1
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Submitted on June 27, 2005
Accepted on October 5, 2005

Constitutive Activation of Pro-Survival Signaling in Alveolar Mesenchymal Cells Isolated from Patients with Nonresolving Acute Respiratory Distress Syndrome

Jeffrey C Horowitz1, Zongbin Cui1, Thomas A Moore1, Tamara R Meier1, Raju C Reddy1, Galen B Toews1, Theodore J Standiford1, and Victor J Thannickal1*

1 Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

* To whom correspondence should be addressed. E-mail: vjt{at}umich.edu.

Acute Respiratory Distress Syndrome (ARDS) is a clinical syndrome characterized by stereotypic host inflammatory and repair cellular responses; however, mechanisms regulating the resolution of ARDS are poorly understood. Here, we report the isolation and characterization of a novel population of mesenchymal cells isolated from the alveolar space of ARDS patients via fiberoptic bronchoscopy with bronchoalveolar lavage (BAL). BAL was performed on 17 patients during the course of ARDS. Immunofluorescence staining and multiparameter flow cytometric analysis defined a population of alveolar mesenchymal cells (AMCs) that are CD45-/prolyl-4-hydroxylase+/alpha-smooth muscle actin+/-. AMCs proliferated in ex-vivo cell culture for multiple passages; early passage (3-5) cells were subsequently analyzed in 13 patients. AMCs isolated from patients with persistent or nonresolving ARDS (ARDS-NR; n = 4) demonstrate enhanced constitutive activation of pro-survival signaling pathways involving PKB/Akt, FKHR, and BCL-2 family proteins compared to AMCs from patients with resolving ARDS (ARDS-R; n = 9). Exogenous transforming growth factor-{beta}1 markedly induces PKB/Akt activation in AMCs from ARDS-R. ARDS-NR cells are more resistant to serum deprivation-induced apoptosis compared with ARDS-R. This study identifies a novel population of mesenchymal cells that can be isolated from the alveolar spaces of ARDS patients. Alveolar mesenchymal cells isolated from patients with nonresolving ARDS acquire an activational profile characterized by enhanced pro-survival signaling and an anti-apoptotic phenotype. These findings support the concept that apoptosis of mesenchymal cells may be an essential component of normal repair and resolution of ARDS and suggest that dysregulation of this process may contribute to persistent, nonresolving ARDS.




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