Resetting proteostasis with ISRIB promotes epithelial differentiation to attenuate pulmonary fibrosis

S Watanabe, NS Markov, Z Lu… - Proceedings of the …, 2021 - National Acad Sciences
S Watanabe, NS Markov, Z Lu, R Piseaux Aillon, S Soberanes, CE Runyan, Z Ren, RA Grant
Proceedings of the National Academy of Sciences, 2021National Acad Sciences
Pulmonary fibrosis is a relentlessly progressive and often fatal disease with a paucity of
available therapies. Genetic evidence implicates disordered epithelial repair, which is
normally achieved by the differentiation of small cuboidal alveolar type 2 (AT2) cells into
large, flattened alveolar type 1 (AT1) cells as an initiating event in pulmonary fibrosis
pathogenesis. Using models of pulmonary fibrosis in young adult and old mice and a model
of adult alveologenesis after pneumonectomy, we show that administration of ISRIB, a small …
Pulmonary fibrosis is a relentlessly progressive and often fatal disease with a paucity of available therapies. Genetic evidence implicates disordered epithelial repair, which is normally achieved by the differentiation of small cuboidal alveolar type 2 (AT2) cells into large, flattened alveolar type 1 (AT1) cells as an initiating event in pulmonary fibrosis pathogenesis. Using models of pulmonary fibrosis in young adult and old mice and a model of adult alveologenesis after pneumonectomy, we show that administration of ISRIB, a small molecule that restores protein translation by EIF2B during activation of the integrated stress response (ISR), accelerated the differentiation of AT2 into AT1 cells. Accelerated epithelial repair reduced the recruitment of profibrotic monocyte-derived alveolar macrophages and ameliorated lung fibrosis. These findings suggest a dysfunctional role for the ISR in regeneration of the alveolar epithelium after injury with implications for therapy.
National Acad Sciences