Patients with COPD and mechanically ventilated patients with """"""""permissive hypercapnia"""""""" can have significant elevation of pCO2. We hypothesize that hypercapnia causes dysfunction of the alveolar epithelium by specifically downregulating the alveolar epithelial Na,K-ATPase and decreasing alveolar fluid clearance. The focus of this application is to determine whether short term (30-60 min) hypercapnia impairs reversibly alveolar fluid reabsorption by inhibiting the Na,K-ATPase and promoting its endocytosis from the plasma membrane into intracellular compartments via specific pathways involving JNK and ERK kinases and protein kinase C (PKC) signaling molecules. We also propose to determine whether long term (5 and 7 days) hypercapnia sensitizes the alveolar epithelium to ventilation induced lung injury and causes not only endocytosis but degradation of the Na,K-ATPase via the ubiquitin/proteosome pathway. The cellular signals that sense hypercapnia are largely unknown, therefore we will take advantage that the genome of C. Elegans has been completely mapped and conduct experiments in C. elegans to study potential genes that may participate in the sensing and response to high pCO2. As such, we will study the effects of hypercapnia on the alveolar epithelium and C. elegans via four interrelated aims:
in Specific Aim 1 we propose to determine whether hypercapnia decreases alveolar fluid reabsorption in normal and injured lungs and whether these effects are due to high pCO2 or the associated acidosis, in Specific Aim 2 we will determine the signaling pathways by which hypercapnia promotes alveolar epithelial Na,K-ATPase endocytosis in alveolar epithelial cells , in Specific Aim 3 we will determine whether hypercapnia inhibits Na,K-ATPase activity via phosphorylation and ubiquitination leading to the endocytosis and degradation of Na,K-ATPase proteins and in Specific Aim 4 we will determine the effect of elevated levels of CO2 on C. elegans development, motility and fertility and establish a collection of lines mutated in genes that regulate the sensing and cellular response to elevated levels of CO2. Experiments have been conducted for each of the specific aims and the preliminary results support the feasibility of this proposal. Completion of the proposed studies will provide novel information on the effects of hypercapnia on the alveolar epithelium, specifically as it pertains to mechanisms of alveolar epithelial barrier dysfunction which may be of importance for the treatment of hypercapnic patients.
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