Lyn A. Thet

Changes in ling morphology and cell number in radiation pneumonitis and fibrosis: A quantitative ultrastructural study

We used stereologic-morphometric techniques to obtain a detailed quantitative picture of the changes in lung ultrastructure of rats at 12 and 26 weeks after unilateral thoracic irradiation with 3000 cGy. At 12 weeks post-radiation, the total number type 1 epithelial cells, type 2 epithelial cells and capillary endothelial cells were decreased 50-70%, total type 1 epithelial and capillary surface areas were decreased 55-60%, and the total volume of intracapillary blood was decreased 75%. The interstitial cells and matrix together accounted for more than 9% of the peripheral lung tissue volume including air, compared to 3% in controls. The numerical density of interstitial cells was increased to 3-fold the control value. The numerical density of interstitial cells was increased to 3-fold the control value. Although fibroblasts still comprised the largest interstitial cell subgroup, the numerical density of mast cells was increased over 150-fold and other inflammatory and immune cells were increased to a lesser extent. At 26 weeks post-radiation, the number, volume, and surface area of the type 1 epithelium and capillary endothelium had further decreased to only 5-10% of control values. The total number of type 2 epithelial cells was reduced by 75% but the volume density was actually increased because of a 4-fold increase in the mean cell volume. The interstitial cells and matrix now comprised over 77% of total peripheral lung tissue volume including air as compared to 6% in controls. Mast cells and plasma cells comprised 11% and 19% of all interstitial cells respectively and the densities of these cells were 540 and 180-fold the control value respectively. The relation of these morphometric findings to the results of previous morphologic studies is discussed.

Sequential Changes in Lung Morphology during the Repair of Acute Oxygen-induced Lung Injury in Adult Rats

We studied changes in lung ultrastructure and collagen content during the repair of acute lung injury in adult rats exposed to 100% O2 for 60 h and recovering in ambient air. In the interstitium, during the first 3 days of repair, the number of neutrophils decreased 16-fold, and monocytes and lymphocytes increased to 7-fold and 4-fold the respective control values. Myofibroblasts increased about 5-fold and the volume of the interstitial matrix remained high. By 7 days, the differential count of inflammatory cells was normal although the number of total interstitial cells and myofibroblasts decreased more slowly. In the capillary endothelium, after 3 days of repair, the cells were hypertrophied and had organelle-rich cytoplasm, and total cell number had increased back to control values; endothelial cell number increased an additional 63% between 3 and 7 days of repair. In the epithelium, type 2 cells increased 150% during the first 3 days of repair before decreasing; type 1 cell number did not change. After 28 days of repair, the lungs appeared qualitatively almost normal; however, interstitial cell number and collagen content were still increased. We conclude that the repair of oxygen-induced lung injury involves a complex pattern of morphologic changes that has important similarities to those occurring during repair on other tissues such as the skin.

Repair of chronic hyperoxic lung injury: changes in lung ultrastructure and matrix

We studied changes in lung ultrastructure, fibronectin, and collagen during repair of chronic hyperoxic lung injury induced by exposure of rats to 85% oxygen for 14 days. Morphologically, the most persistent changes were in the alveolar interstitium. After 28 days of repair, the extracellular matrix volume was still twofold normal. Total interstitial cell numbers also remained high and interstitial myofibroblast number actually doubled between Days 7 and 14. These changes contrast markedly with repair of acute lung injury induced by 100% oxygen (Thet et al. (1986) Exp. Lung Res. 11, 209-228) in which matrix volume and interstitial myofibroblast number increased initially but then returned to normal. Biochemically, tissue-associated fibronectin was high initially and peaked at 3 days before slowly declining. Tissue collagen content began to increase after the peak in fibronectin content and was over 150% of controls at 28 days; this correlated with an increase in visible collagen fibers. We conclude that changes in lung morphology and matrix after chronic hyperoxic lung injury are more persistent than after acute hyperoxic lung injury and result in a greater degree of chronic interstitial fibrosis.

Effect of Transforming Growth Factor Beta on Synthesis of Glycosaminoglycans by Human Lung Fibroblasts

The processes of lung growth, injury, and repair are characterized by alterations in fibroblast synthesis and interstitial distribution of extracellular matrix components. Transforming growth factor beta (TGF-beta), which is postulated to play a role in modulating lung repair, alters the distribution of several matrix components such as collagen and fibronectin. We studied the effect of TGF-beta on the synthesis and distribution of the various glycosaminoglycans (GAGs) and whether these effects may explain its role in lung repair. Human diploid lung fibroblasts (IMR-90) were exposed to various concentrations of TGF-beta (0-5 nM) for variable periods of time (0-18 h). Newly synthesized GAGs were labeled with either [3H]glucosamine or [35S]sulfate. Individual GAGs were separated by size exclusion chromatography after serial enzymatic and chemical digestions and quantitated using scintillation counting. There was a dose-dependent increase in total GAG synthesis with maximal levels detected after 6 h of exposure. This increase was noted in all individual GAG types measured and was observed in both the cell associated GAGs (cell-matrix fraction) as well as the GAGs released into the medium (medium fraction). In the cell-matrix fraction, TGF-beta increased the proportion of heparan sulfate that was membrane bound as well as the proportion of dermatan sulfate in the intracellular compartment. In the medium fraction, TGF-beta increased the proportion of hyaluronic acid, chondroitin sulfate and dermatan sulfate released. We conclude that the role of TGF-beta in lung growth and repair may be related to increased synthesis of GAGs by human lung fibroblasts as well as alterations in the distribution of individual GAGs.

Changes in lung hyaluronidase activity associated with lung growth, injury and repair

We measured lung hyaluronidase activity in rats during postnatal life and during the repair of oxygen-induced lung injury. Hyaluronidase activity increased rapidly after birth and peaked at 16-fold the initial value at 8 days. The peak preceded decreased cell proliferation and the onset of differentiation; this is consistent with current concepts of the role of hyaluronidase. During the repair of lung injury, hyaluronidase activity increased to 2.5-fold the control value at 1 day post-injury, but had decreased by 3 days. This early peak is probably related to simultaneous cell proliferation and differentiation. We postulate that changes in hyaluronidase can influence lung growth and repair and that the system may be amenable to manipulation.

Unilateral paraquat‐induced lung fibrosis: Evolution of changes in lung fibronectin and collagen after graded degrees of lung injury

We describe a model of pulmonary fibrosis in which doses of paraquat ranging from 0.001 mg/kg to 1.0 mg/kg were instilled into the right lung of rats. Lung injury, as measured by right lung lavage albumin content and differential neutrophil count, ranged from undetectable to extremely severe, depending on the dose. Lung fibrosis, as assessed by collagen content and electron microscopy, showed similar dose-response effects. Mortality was minimal. Lavage fibronectin increased after high doses of paraquat, peaked at 2 d postinjury, decreased sharply after 3 d and was normal by 7 d. The temporal pattern was similar to that for albumin. Cultured alveolar macrophages obtained at 4 d postinjury did not have significant increases in fibronectin release. Tissue fibronectin content increased more slowly than lavage fibronectin, peaking at 4 d postinjury, and was still elevated at 7 and 14 d postinjury. Incorporation of [35S]methionine into tissue fibronectin by lung explants obtained at different times postinjury showed a similar time course. Lung collagen content increased steadily between 4 and 14 d postinjury. We conclude that, in our model, graded degrees of lung injury and fibrosis can be produced by varying the dose of unilaterally instilled paraquat and that the increases in lavage fibronectin were related mainly to capillary permeability whereas increases in tissue fibronectin represented parenchymal synthesis. The time course of changes in lung tissue fibronectin and collagen was consistent with the proposed roles of fibronectin in tissue repair and fibrosis. The ability of our model to produce graduated degrees of lung injury and fibrosis should be useful in further studies on the pathogenesis of postinjury lung fibrosis.

Changes in tissue fibronectin in elastase induced lung injury

We studied changes in rat lung fibronectin (FN) content and synthesis after endobronchial administration of elastase. A severe hemorrhagic neutrophilic alveolitis ensued with plasma protein leakage, initial rise in tissue FN content, and sustained rise in FN synthesis. Unlike fibrotic models where initial rises in tissue FN levels are sustained, levels in this model normalized promptly. This, in the setting of increased synthesis is consistent with increased degradation. This degradation of tissue FN may result in the disruption of the lung architecture, interfere with the deposition of newly synthesized matrix and could partly explain the development of emphysema in a model where excess fibronectin synthesis is observed.

Effect of 70% oxygen on postresectional lung growth in rats.

We tested the hypothesis that exposure to hyperoxia could inhibit postresectional compensatory lung growth to the same degree that it inhibits newborn lung growth. We removed the 3 upper lobes of the right lung of rats, allowed them to breathe either air or 70% oxygen after surgery, and performed electron microscopy and morphometry on the left lung at 14 d postresection. Rats that had a thoracotomy without removal of lung were used as controls. Resection of lung tissue resulted in increases of about 100-200% (relative to controls) in the total volume per left lung of alveolar type 1 and type 2 epithelial cells, capillary endothelial cells, interstitial cells, and interstitial matrix; the total capillary and type 1 epithelial surface areas each increased about 40%. Exposure to 70% oxygen did not significantly inhibit postresectional growth, although there was a trend toward a lesser increase in capillary surface area. However, 70% oxygen did result in a 78% greater (relative to the nonexposed resected group) alveolar type 2 cell volume density and a 54% greater interstitial cell volume density; this suggested that increased proliferation of type 2 cells and interstitial cells occurred. Qualitative ultrastructural assessment confirmed that the type 2 cells and fibroblasts appeared increased and that interstitial edema and neutrophil accumulation were also present. We conclude that although 70% oxygen exposure is not entirely innocuous, it does not inhibit postresectional lung growth.