Autonomous MTOR activation in COPD airway epithelium impairs resolution through persistent mucus cell metaplasia and lysosome dysfunction

Background: COPD is associated with persistent airway epithelial mucous cell metaplasia (MCM), mucin hypersecretion, and airway obstruction. Cytokines, such as IL-13, are well-known inflammatory drivers of airway MCM development. However, less is known about the factors that contribute to the impaired resolution of MCM in COPD. We hypothesized that MTOR activation in COPD airway epithelial cells (AECs) impairs autophagy and contributes to the delayed resolution of MCM. Methods: AEC from COPD and non-diseased donors were grown under air-liquid interface (ALI) conditions and treated with IL-13 to promote MCM. Airway sections from COPD lung explants or non-diseased lung donors were utilized for immunohistochemical and immunostaining. Lysosomes were assessed using molecular probes and immunostaining. Results: There was persistent MTOR-dependent MUC5AC immunostaining and epithelial hypertrophy in COPD AEC, which did not resolve after IL-13 withdrawal. MTOR substrate phosphorylation of RBS6, S6K1, and ULK1 was significantly elevated under baseline conditions, and at multiple timepoints independent of IL-13. Pharmacologic activation of MTOR led to increased IL-13-mediated MUC5AC levels in normal AEC but less robustly in COPD derived AEC. We hypothesized that persistent MTOR activation would reduce lysosome function and abundance in disease. COPD airways had reduced lysosome markers, LAMP1 and LAMP2 and fewer functional lysosomes by live-cell reporter probes. This lysosome deficiency in COPD AEC was partially rescued with MTOR inhibition. Conclusions: We provide evidence to support an axis of autonomous MTOR activation and impaired lysosome function in the COPD airway epithelium. Persistent MTOR signaling is a molecular driver that contributes to persistent MCM.