Usual interstitial pneumonia and smoking-related interstitial fibrosis display epithelial to mesenchymal transition in fibroblastic foci
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Data
2014-09-01
Autores
Fabro, Alexandre Todorovic [UNESP]
Minatel, Igor Otavio [UNESP]
Rangel, Maristela Peres
Halbwedl, Iris
Parra, Edwin Roger
Capelozzi, Vera Luiza
Popper, Helmut
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Editor
W B Saunders Co Ltd
Resumo
Background: Fibroblastic foci (FF) are a major histological feature of usual interstitial pneumonia (UIP) in idiopathic pulmonary fibrosis (IPF) and collagen vascular diseases (non-IPF). In addition, FF are occasionally associated with smoking-related interstitial fibrosis (SRIF). Recent studies have suggested a role for epithelial to mesenchymal transition (EMT) in pulmonary fibrogenesis.Methods: Here, we investigated whether EMT was present in patients with IPF (n = 19), non-IPF (n = 17), and SRIF (n = 16) using morphometric immunohistochemistry, electron microscopy, and confocal microscopy. All patients had received lung biopsies or lobectomies for lung cancer.Results: IPF and non-IPF patients displayed restrictive lung function patterns, whereas those with SRIF presented mixed patterns. Cells within FF presented high number of alpha-smooth muscle actin (alpha SMA)-staining cells; however, the foci of IPF patients showed comparatively lower number. Moreover, colocalization of thyroid transcription factor-1 (TTF1) and alpha SMA within FF showed low number of staining cells for IPF and SRIF in comparison to non-IPF (p < 0.01). Nevertheless, all groups displayed colocalization of high rate of TTF1(+)-cells and low rate of alpha SMA(+)-cells within hyperplastic epithelioid cells in FF. Also, we observed areas with low proportion of TTF1(+) cells and alpha SMA(+) cells, which were present in SRIF and non-IPF more often than IPF (p < 0.001). Electron microscopy revealed small breaks in the alveolar basal lamina, which allowed epithelioid cells to directly contact the collagenous matrix and fibroblasts. Three-dimensional reconstruction revealed intense alpha SMA staining within some epithelioid cells, suggesting that they had gained a mesenchymal phenotype.Conclusions: These findings constitute the first report of EMT in SRIF and suggest that EMT occurs more prominently in SRIF and non-IPF than IPF. (C) 2014 Elsevier Ltd. All rights reserved.
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Palavras-chave
Epithelial-mesenchymal transition, Usual interstitial pneumonia, Idiopathic pulmonary fibrosis, Smoking-related interstitial fibrosis, Double-staining immunohistochemistry
Como citar
Respiratory Medicine. London: W B Saunders Co Ltd, v. 108, n. 9, p. 1377-1386, 2014.