Division of Pulmonary-Critical Care, Department of Medicine, Duke University Durham, North Carolina.
Department of Pathology, Duke University Durham, North Carolina.
Am J Pathol. 2019 May;189(5):1029-1040. doi: 10.1016/j.ajpath.2019.01.017. Epub 2019 Mar 18.
Radiation-induced pulmonary fibrosis (RTPF) is a progressive, serious condition in many subjects treated for thoracic malignancies or after accidental nuclear exposure. No biomarker exists for identifying the irradiated subjects most susceptible to pulmonary fibrosis (PF). Previously, we determined that gastrin-releasing peptide (GRP) was elevated within days after birth in newborns exposed to hyperoxia who later developed chronic lung disease. The goal of the current study was to test whether radiation (RT) exposure triggers GRP release in mice and whether this contributes to RTPF in vivo. We determined urine GRP levels and lung GRP immunostaining in mice 0 to 24 after post-thoracic RT (15 Gy). Urine GRP levels were significantly elevated between 24 hours post-RT; GRP-blocking monoclonal antibody 2A11, given minutes post-RT, abrogated urine GRP levels by 6 to 12 hours and also altered phosphoprotein signaling pathways at 24 hours post-RT. Strong extracellular GRP immunostaining was observed in lung at 6 hours post-RT. Mice given one dose of GRP monoclonal antibody 2A11 24 hours post-RT had significantly reduced myofibroblast accumulation and collagen deposition 15 weeks later, indicating protection against lung fibrosis. Therefore, elevation of urine GRP could be predictive of RTPF development. In addition, transient GRP blockade could mitigate PF in normal lung after therapeutic or accidental RT exposure.
放射性肺纤维化(RTPF)是许多接受胸部恶性肿瘤治疗或意外核暴露后的患者中一种进行性的严重疾病。目前还没有生物标志物可用于识别最易发生肺纤维化(PF)的放射性照射患者。此前,我们发现,在暴露于高氧环境后发生慢性肺部疾病的新生儿中,胃泌素释放肽(GRP)在出生后几天内就会升高。本研究的目的是检测放射(RT)暴露是否会引发小鼠 GRP 释放,以及这是否会导致体内 RTPF。我们检测了胸部 RT(15 Gy)后 0 至 24 小时的小鼠尿液 GRP 水平和肺部 GRP 免疫染色。RT 后 24 小时内尿液 GRP 水平显著升高;GRP 阻断单克隆抗体 2A11 在 RT 后几分钟内给药,可使尿液 GRP 水平降低 6 至 12 小时,并在 RT 后 24 小时改变磷酸化蛋白信号通路。在 RT 后 6 小时观察到肺部强烈的细胞外 GRP 免疫染色。在 RT 后 24 小时给予单剂量 GRP 单克隆抗体 2A11 的小鼠在 15 周后肌成纤维细胞积累和胶原沉积明显减少,表明对肺纤维化有保护作用。因此,尿液 GRP 的升高可能是 RTPF 发展的预测指标。此外,在治疗性或意外 RT 暴露后的正常肺部中,短暂的 GRP 阻断可减轻 PF。