1 Division of Pulmonary and Critical Care Medicine, Department of Medicine.
2 Division of Thoracic Surgery, Department of Surgery.
Am J Respir Crit Care Med. 2019 Jun 15;199(12):1517-1536. doi: 10.1164/rccm.201712-2410OC.
The contributions of diverse cell populations in the human lung to pulmonary fibrosis pathogenesis are poorly understood. Single-cell RNA sequencing can reveal changes within individual cell populations during pulmonary fibrosis that are important for disease pathogenesis. To determine whether single-cell RNA sequencing can reveal disease-related heterogeneity within alveolar macrophages, epithelial cells, or other cell types in lung tissue from subjects with pulmonary fibrosis compared with control subjects. We performed single-cell RNA sequencing on lung tissue obtained from eight transplant donors and eight recipients with pulmonary fibrosis and on one bronchoscopic cryobiospy sample from a patient with idiopathic pulmonary fibrosis. We validated these data using RNA hybridization, immunohistochemistry, and bulk RNA-sequencing on flow-sorted cells from 22 additional subjects. We identified a distinct, novel population of profibrotic alveolar macrophages exclusively in patients with fibrosis. Within epithelial cells, the expression of genes involved in Wnt secretion and response was restricted to nonoverlapping cells. We identified rare cell populations including airway stem cells and senescent cells emerging during pulmonary fibrosis. We developed a web-based tool to explore these data. We generated a single-cell atlas of pulmonary fibrosis. Using this atlas, we demonstrated heterogeneity within alveolar macrophages and epithelial cells from subjects with pulmonary fibrosis. These results support the feasibility of discovery-based approaches using next-generation sequencing technologies to identify signaling pathways for targeting in the development of personalized therapies for patients with pulmonary fibrosis.
多种细胞群体在人类肺部对肺纤维化发病机制的贡献尚不清楚。单细胞 RNA 测序可以揭示肺纤维化过程中单个细胞群体内的变化,这些变化对疾病发病机制很重要。为了确定单细胞 RNA 测序是否可以揭示肺纤维化患者与对照相比肺组织中肺泡巨噬细胞、上皮细胞或其他细胞类型的疾病相关异质性。我们对来自 8 名移植供体和 8 名肺纤维化受体的肺组织以及 1 名特发性肺纤维化患者的支气管镜冷冻活检样本进行了单细胞 RNA 测序。我们使用来自 22 名额外受试者的流式分选细胞的 RNA 杂交、免疫组织化学和批量 RNA 测序对这些数据进行了验证。我们鉴定了一种独特的、新型的致纤维化肺泡巨噬细胞群,仅存在于纤维化患者中。在上皮细胞中,参与 Wnt 分泌和反应的基因的表达仅限于不重叠的细胞。我们鉴定了一些稀有细胞群体,包括在肺纤维化过程中出现的气道干细胞和衰老细胞。我们开发了一个基于网络的工具来探索这些数据。我们生成了肺纤维化的单细胞图谱。使用这个图谱,我们证明了肺纤维化患者的肺泡巨噬细胞和上皮细胞内存在异质性。这些结果支持使用下一代测序技术进行基于发现的方法的可行性,以确定针对肺纤维化患者的个性化治疗开发的靶向信号通路。