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      Single-cell RNA-seq reveals ectopic and aberrant lung-resident cell populations in idiopathic pulmonary fibrosis

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          Abstract

          Human lung single-cell atlas reveals the complexity and diversity of aberrant cellular populations in pulmonary fibrosis.

          Abstract

          We provide a single-cell atlas of idiopathic pulmonary fibrosis (IPF), a fatal interstitial lung disease, by profiling 312,928 cells from 32 IPF, 28 smoker and nonsmoker controls, and 18 chronic obstructive pulmonary disease (COPD) lungs. Among epithelial cells enriched in IPF, we identify a previously unidentified population of aberrant basaloid cells that coexpress basal epithelial, mesenchymal, senescence, and developmental markers and are located at the edge of myofibroblast foci in the IPF lung. Among vascular endothelial cells, we identify an ectopically expanded cell population transcriptomically identical to bronchial restricted vascular endothelial cells in IPF. We confirm the presence of both populations by immunohistochemistry and independent datasets. Among stromal cells, we identify IPF myofibroblasts and invasive fibroblasts with partially overlapping cells in control and COPD lungs. Last, we confirm previous findings of profibrotic macrophage populations in the IPF lung. Our comprehensive catalog reveals the complexity and diversity of aberrant cellular populations in IPF.

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          Single-Cell Transcriptomic Analysis of Human Lung Provides Insights into the Pathobiology of Pulmonary Fibrosis

          Rationale: 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. Objectives: 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. Methods: 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 in situ RNA hybridization, immunohistochemistry, and bulk RNA-sequencing on flow-sorted cells from 22 additional subjects. Measurements and Main Results: 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. Conclusions: 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.
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            Idiopathic pulmonary fibrosis: prevailing and evolving hypotheses about its pathogenesis and implications for therapy.

            Idiopathic pulmonary fibrosis is a progressive and usually fatal lung disease characterized by fibroblast proliferation and extracellular matrix remodeling, which result in irreversible distortion of the lung's architecture. Although the pathogenetic mechanisms remain to be determined, the prevailing hypothesis holds that fibrosis is preceded and provoked by a chronic inflammatory process that injures the lung and modulates lung fibrogenesis, leading to the end-stage fibrotic scar. However, there is little evidence that inflammation is prominent in early disease, and it is unclear whether inflammation is relevant to the development of the fibrotic process. Evidence suggests that inflammation does not play a pivotal role. Inflammation is not a prominent histopathologic finding, and epithelial injury in the absence of ongoing inflammation is sufficient to stimulate the development of fibrosis. In addition, the inflammatory response to a lung fibrogenic insult is not necessarily related to the fibrotic response. Clinical measurements of inflammation fail to correlate with stage or outcome, and potent anti-inflammatory therapy does not improve outcome. This review presents a growing body of evidence suggesting that idiopathic pulmonary fibrosis involves abnormal wound healing in response to multiple, microscopic sites of ongoing alveolar epithelial injury and activation associated with the formation of patchy fibroblast-myofibroblast foci, which evolve to fibrosis. Progress in understanding the fibrogenic mechanisms in the lung is likely to yield more effective therapies.
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              A cellular census of human lungs identifies novel cell states in health and in asthma

              Human lungs enable efficient gas exchange and form an interface with the environment, which depends on mucosal immunity for protection against infectious agents. Tightly controlled interactions between structural and immune cells are required to maintain lung homeostasis. Here, we use single-cell transcriptomics to chart the cellular landscape of upper and lower airways and lung parenchyma in healthy lungs, and lower airways in asthmatic lungs. We report location-dependent airway epithelial cell states and a novel subset of tissue-resident memory T cells. In the lower airways of patients with asthma, mucous cell hyperplasia is shown to stem from a novel mucous ciliated cell state, as well as goblet cell hyperplasia. We report the presence of pathogenic effector type 2 helper T cells (TH2) in asthmatic lungs and find evidence for type 2 cytokines in maintaining the altered epithelial cell states. Unbiased analysis of cell-cell interactions identifies a shift from airway structural cell communication in healthy lungs to a TH2-dominated interactome in asthmatic lungs.
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                Author and article information

                Journal
                Sci Adv
                Sci Adv
                SciAdv
                advances
                Science Advances
                American Association for the Advancement of Science
                2375-2548
                July 2020
                08 July 2020
                : 6
                : 28
                : eaba1983
                Affiliations
                [1 ]Section of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, CT, USA.
                [2 ]Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.
                [3 ]Interdepartmental Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA.
                [4 ]Division of Pulmonary Medicine, Boston’s Children Hospital, Harvard Medical School, Boston, MA, USA.
                [5 ]Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.
                [6 ]NuMedii, Inc., San Mateo, CA, USA.
                [7 ]Department of Pathology, Yale School of Medicine, New Haven, CT, USA.
                [8 ]Pathology and Laboratory Medicine Service and VA CT HealthCare System, West Haven, CT, USA.
                Author notes
                [*]

                These authors contributed equally to this work.

                []Corresponding author. Email: irosas@ 123456rics.bwh.harvard.edu (I.O.R.); naftali.kaminski@ 123456yale.edu (N.K.)
                Author information
                http://orcid.org/0000-0003-4280-9070
                http://orcid.org/0000-0002-7714-8076
                http://orcid.org/0000-0001-5442-3189
                http://orcid.org/0000-0002-5560-6136
                http://orcid.org/0000-0002-4144-9395
                http://orcid.org/0000-0003-2206-5748
                http://orcid.org/0000-0003-0841-8156
                http://orcid.org/0000-0002-8442-3312
                http://orcid.org/0000-0002-2055-5885
                http://orcid.org/0000-0001-8688-9004
                http://orcid.org/0000-0003-4622-618X
                http://orcid.org/0000-0001-5917-4601
                Article
                aba1983
                10.1126/sciadv.aba1983
                7439502
                32832599
                db1b9afc-1d05-4755-bfea-7dc97f9ba5d6
                Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution NonCommercial License 4.0 (CC BY-NC).

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial license, which permits use, distribution, and reproduction in any medium, so long as the resultant use is not for commercial advantage and provided the original work is properly cited.

                History
                : 13 November 2019
                : 01 June 2020
                Funding
                Funded by: doi http://dx.doi.org/10.13039/100000002, National Institutes of Health;
                Award ID: R01HL127349
                Funded by: doi http://dx.doi.org/10.13039/100000002, National Institutes of Health;
                Award ID: U01HL145567
                Funded by: doi http://dx.doi.org/10.13039/100000002, National Institutes of Health;
                Award ID: U01HL122626
                Funded by: doi http://dx.doi.org/10.13039/100000002, National Institutes of Health;
                Award ID: U54HG008540
                Funded by: doi http://dx.doi.org/10.13039/100000050, National Heart, Lung, and Blood Institute;
                Award ID: P01 HL114501
                Funded by: doi http://dx.doi.org/10.13039/501100001659, Deutsche Forschungsgemeinschaft;
                Award ID: SCHU 3147/1
                Funded by: Pulmonary Fibrosis Fund;
                Funded by: Three Lake Partners;
                Award ID: Unrestricted Gift
                Funded by: Three Lake Partners;
                Award ID: Unrestricted Gift
                Categories
                Research Article
                Research Articles
                SciAdv r-articles
                Developmental Biology
                Diseases and Disorders
                Diseases and Disorders
                Custom metadata
                Mariane Belen

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