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Publication : A murine model of hereditary pulmonary alveolar proteinosis caused by homozygous <i>Csf2ra</i> gene disruption.

First Author  Shima K Year  2022
Journal  Am J Physiol Lung Cell Mol Physiol Volume  322
Issue  3 Pages  L438-L448
PubMed ID  35043685 Mgi Jnum  J:322934
Mgi Id  MGI:7257021 Doi  10.1152/ajplung.00175.2021
Citation  Shima K, et al. (2022) A murine model of hereditary pulmonary alveolar proteinosis caused by homozygous Csf2ra gene disruption. Am J Physiol Lung Cell Mol Physiol 322(3):L438-L448
abstractText  Hereditary pulmonary alveolar proteinosis (hPAP) is a rare disorder caused by recessive mutations in GM-CSF receptor subunit alpha/beta genes (CSF2RA/CSF2RB, respectively) characterized by impaired GM-CSF-dependent surfactant clearance by alveolar macrophages (AMs) resulting in alveolar surfactant accumulation and hypoxemic respiratory failure. Because hPAP is caused by CSF2RA mutations in most patients, we created an animal model of hPAP caused by Csf2ra gene disruption (Csf2ra(-/-) mice) and evaluated the effects on AMs and lungs. Macrophages from Csf2ra(-/-) mice were unable to bind and clear GM-CSF, did not exhibit GM-CSF signaling, and had functional defects in phagocytosis, cholesterol clearance, and surfactant clearance. Csf2ra(-/-) mice developed a time-dependent, progressive lung disease similar to hPAP in children caused by CSF2RA mutations with respect to the clinical, physiological, histopathological, biochemical abnormalities, biomarkers of PAP lung disease, and clinical course. In contrast, Csf2ra(+/-) mice had functionally normal AMs and no lung disease. Pulmonary macrophage transplantation (PMT) without myeloablation resulted in long-term engraftment, restoration of GM-CSF responsiveness to AMs, and a safe and durable treatment effect that lasted for the duration of the experiment (6 mo). Results demonstrate that homozygous (but not heterozygous) Csf2ra gene ablation caused hPAP identical to hPAP in children with CSF2RA mutations, identified AMs as the cellular site of hPAP pathogenesis in Csf2ra(-/-) mice, and have implications for preclinical studies supporting the translation of PMT as therapy of hPAP in humans.
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