CIBER de Enfermedades Respiratorias, Instituto de Investigación Carlos III, Madrid, Spain.
Department of Critical Care Medicine, Hospital Universitario de Getafe, Madrid, Spain.
Thorax. 2019 Jan;74(1):69-82. doi: 10.1136/thoraxjnl-2018-211535. Epub 2018 Nov 1.
The acute respiratory distress syndrome (ARDS) is characterized by protein-rich oedema in the alveolar spaces, a feature in which Fas-mediated apoptosis of the alveolar epithelium has been involved. To determine whether Fas activation increases protein permeability by mechanisms involving disruption of the paracellular tight junction (TJ) proteins in the pulmonary alveoli. Protein permeability and the expression of TJ proteins were assessed in vivo in wild-type and Fas-deficient lpr mice 16 hours after the intratracheal instillation of recombinant human soluble Fas ligand (rh-sFasL), and at different time points in vitro in human pulmonary alveolar epithelial cells (HPAEpiC) exposed to rh-sFasL Activation of the Fas pathway increased protein permeability in mouse lungs and altered the expression of the TJ proteins occludin and zonula occludens-1 in the alveolar-capillary membrane in vivo and in human alveolar epithelial cell monolayers in vitro. Blockade of caspase-3, but not inhibition of tyrosine kinase dependent pathways, prevented the alterations in TJ protein expression and permeability induced by the Fas/FasL system in human alveolar cell monolayers in vitro. We also observed that both the Fas-induced increase of protein permeability and disruption of TJ proteins occurred before cell death could be detected in the cell monolayers in vitro. Targeting caspase pathways could prevent the disruption of TJs and reduce the formation of lung oedema in the early stages of ARDS.
急性呼吸窘迫综合征(ARDS)的特征是肺泡空间富含蛋白质的水肿,其中 Fas 介导的肺泡上皮细胞凋亡已被涉及。为了确定 Fas 激活是否通过破坏肺肺泡中细胞旁紧密连接(TJ)蛋白的机制增加蛋白质通透性。 在重组人可溶性 Fas 配体(rh-sFasL)气管内滴注后 16 小时,在体内评估野生型和 Fas 缺陷 lpr 小鼠中的蛋白质通透性和 TJ 蛋白的表达,并在体外不同时间点在人肺泡上皮细胞(HPAEpiC)中暴露于 rh-sFasL, Fas 途径的激活增加了小鼠肺中的蛋白质通透性,并改变了 TJ 蛋白闭合蛋白和闭锁蛋白-1 在体内肺泡毛细血管膜和体外人肺泡上皮细胞单层中的表达。 体外 Fas/FasL 系统诱导的 TJ 蛋白表达和通透性改变可以被 caspase-3 阻断,但不能被抑制酪氨酸激酶依赖性途径阻断。 我们还观察到,在体外细胞单层中可以检测到细胞死亡之前,Fas 诱导的蛋白质通透性增加和 TJ 蛋白的破坏就已经发生了。 靶向半胱天冬酶途径可以防止 TJ 的破坏,并减少 ARDS 早期肺水肿的形成。