Dysplastic Epithelial Repair Propagates Chronic Pathology Through the Paracrine Transformation of Pulmonary Fibroblasts

Severe lung injury promotes the ectopic accumulation of basal cells in the alveoli and the presence of these dysplastic epithelial cells are strongly associated with regions of pulmonary fibrosis (PF) in diseased lungs. Recent studies have identified a unique subset of "inflammatory" fibroblasts expressing pro-inflammatory genes, especially cytokines involved in monocyte recruitment, that are also enriched in disease and thought to contribute to the onset and progression of PF. Here we show that these two injury-induced cell types are intricately connected, in that dysplastic basal cells generate diffusible signals to robustly induce the inflammatory phenotype in pulmonary fibroblasts. Capitalizing on transcriptomic analysis, we identify the enriched inflammatory signaling pathways in treated fibroblasts and specifically demonstrate that IL-1 secreted by dysplastic basal cells is responsible for this fibroblastic transformation. IL-1 neutralization in vivo is sufficient to significantly reduce the inflammatory fibroblast burden in regions of alveolar bronchiolization, and the resolution of inflammatory fibroblasts in turn reduces CCR2+ immune cell recruitment to these areas. These results suggest dysplastic basal cells play an indirect role in chronic inflammation and fibrotic remodeling through the induction of a proinflammatory fibroblast phenotype and subsequent recruitment of immune cells, establishing a chronic wound healing microenvironment that prolongs localized pathologic remodeling.