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Publication : An aberrant immune-epithelial progenitor niche drives viral lung sequelae.

First Author  Narasimhan H Year  2024
Journal  Nature PubMed ID  39232171
Mgi Jnum  J:354757 Mgi Id  MGI:7736445
Doi  10.1038/s41586-024-07926-8 Citation  Narasimhan H, et al. (2024) An aberrant immune-epithelial progenitor niche drives viral lung sequelae. Nature
abstractText  The long-term physiological consequences of respiratory viral infections, particularly in the aftermath of the COVID-19 pandemic-termed post-acute sequelae of SARS-CoV-2 (PASC)-are rapidly evolving into a major public health concern(1-3). While the cellular and molecular aetiologies of these sequelae are poorly defined, increasing evidence implicates abnormal immune responses(3-6) and/or impaired organ recovery(7-9) after infection. However, the precise mechanisms that link these processes in the context of PASC remain unclear. Here, with insights from three cohorts of patients with respiratory PASC, we established a mouse model of post-viral lung disease and identified an aberrant immune-epithelial progenitor niche unique to fibroproliferation in respiratory PASC. Using spatial transcriptomics and imaging, we found a central role for lung-resident CD8(+) T cell-macrophage interactions in impairing alveolar regeneration and driving fibrotic sequelae after acute viral pneumonia. Specifically, IFNgamma and TNF derived from CD8(+) T cells stimulated local macrophages to chronically release IL-1beta, resulting in the long-term maintenance of dysplastic epithelial progenitors and lung fibrosis. Notably, therapeutic neutralization of IFNgamma + TNF or IL-1beta markedly improved alveolar regeneration and pulmonary function. In contrast to other approaches, which require early intervention(10), we highlight therapeutic strategies to rescue fibrotic disease after the resolution of acute disease, addressing a current unmet need in the clinical management of PASC and post-viral disease.
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