# Oxidized Phospholipids Derived from Apoptotic Pneumocytes Drives Macrophage Activation and Initiates Lung Fibrosis

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 · $617,007

## Abstract

Project Summary
 Progressive lung fibrosis is a feature of systemic diseases and chronic injury but can also occur in the
absence of any known etiology as with Idiopathic Pulmonary Fibrosis (IPF). IPF is a devastating disorder with a
median survival of ~4 years from time of diagnosis and current medical therapy only modestly slows disease
progression. Even fibrosis from known causes can lead to a difficult progressive course, thsu it is vital that the
pathogenesis of fibrosis is more precisely elucidated in order to identify novel therapeutic targets.
 Recent studies from both human fibrotic diseases and animal models have identified a critical role for type II
alveolar epithelial cell (AEC2) injury and apoptosis in the initiation of interstitial scarring. However, the
downstream pathways that translate AEC2 injury/death into fibrosis remain undefined. Our preliminary data
demonstrate that an array of AEC2 insults drives their expression of CCL2/CCL12, chemokines involved in
pro-fibrotic monocyte/macrophage recruitment. The importance of this response was confirmed by
demonstrating that mice deficient in AEC2-derived CCL12 developed attenuated fibrosis in a murine model.
 AEC2 injury can also progress to apoptosis with an accompanying oxidation of their abundant phospholipid
stores, and we discovered that uptake and accumulation of oxidized phospholipid (oxPL) derived from
apoptotic AEC2s (either released or retained within apoptotic bodies) induces a pro-fibrotic phenotypic switch
in the ingesting lung macrophage. Administration of apoptotic AEC2s or oxPL into the lungs of uninjured mice
is sufficient to drive lung fibrosis and this uptake is mediated by CD36. The accumulation of oxPL within
macrophages is also determined by its catabolism which we have shown is regulated primarily by lysosomal
phospholipase A2 (LPLA2). Our preliminary results indicate that the rapid intracellular degradation of oxPL by
LPLA2 in alveolar macrophages can minimize macrophage activation. Compared to resident macrophages,
monocyte-derived macrophages that are recruited to the injured lung exhibit a greater pro-fibrotic response to
oxPL accumulation due to their decreases expression of LPLA2.
 These preliminary data motivate our central hypothesis that AEC2 injury/apoptosis results in a coordinated
response in which the elaboration of CCL12 from injured AECs attracts monocyte-derived macrophages to the
alveolar space where they engulf and accumulate oxPL resulting in robust pro-fibrotic activation. We will
pursue a multifaceted approach using in vitro studies of primary murine and human macrophages with in vivo
mouse experiments using novel transgenic mice, bone marrow transplant chimeras, and complementary
models of lung fibrosis. We have formed a synergistic team with expertise in lipids, monocyte/macrophages,
and AEC2s. Our research project specifically addresses a recognized knowledge gap in fibrosis pathogenesis.
Importantly, the results of these studies will de...

## Key facts

- **NIH application ID:** 10470837
- **Project number:** 5R01HL153056-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** KEVIN KEEWOUN KIM
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $617,007
- **Award type:** 5
- **Project period:** 2021-09-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10470837

## Citation

> US National Institutes of Health, RePORTER application 10470837, Oxidized Phospholipids Derived from Apoptotic Pneumocytes Drives Macrophage Activation and Initiates Lung Fibrosis (5R01HL153056-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10470837. Licensed CC0.

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