This program has arisen from our long-standing interest in familial lung diseases, including familial interstitial pneumonia (FIP). We intend to use this unique cohort of families with FIP to investigate the underlying mechanisms that lead to progressive lung fibrosis. This information will be highly relevant to individuals with sporadic idiopathic pulmonary fibrosis (IPF) and other forms of idiopathic interstitial pneumonia (IIP). There are important advantages to investigating lung fibrosis in families. First, it is possible to study genetic causes of disease in this group. Three genes linked to disease, surfactant protein C and components of the telomerase complex, have already been identified using these FIP families, and this identification has led to new insights into disease pathogenesis. Second, this population allows us the unprecedented opportunity to identify pre-symptomatic patients that can be studied at the earliest stages of disease. This gives us the ability to study the primary manifestations of disease as opposed to pathobiological changes that occur as a result of progressive lung remodeling. Project 1 will identify pre-symptomatic individuals at risk for FIP families by high resolution CT scanning that have radiographic abnormalities in the lungs. At risk individuals (with and without radiographic abnormalities) will undergo bronchoscopy to identify phenotypic characteristics of alveolar epithelial cells, such as ER stress, herpesvirus infection, or telomere shortening that contribute to disease progression in FIP. Project 2 will utilize a candidate gene approach to identify and characterize rare genetic vanants in the surfactant and telomerase pathways, as well as genes known to be associated with secondary forms of pulmonary fibrosis, that impact development of FIP. Project 3 will perform a linkage study to discover new genetic loci associated with disease in FIP and sporadic MP patients. Additional studies will identify viruses present in lung tissue of patients with IIP and investigate gene-gene and gene-environment interactions that influence disease manifestation. The integrated approach in this Program will lead to new concepts in pathogenesis of FIP and sporadic IPF (as well as other forms of IIP), and suggest opportunities for novel treatment or prevention strategies.

Public Health Relevance

Interstitial lung diseases, including the idiopathic interstitial pneumonias, are a substantial cause of morbidity and mortality for which there are no effective treatments. In this program, we will study the genetics and underlying biological mechanisms that lead to progressive fibrosis in the lungs, leading to new concepts in disease pathogenesis and identification of novel treatment strategies.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Program Projects (P01)
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Heart, Lung, and Blood Initial Review Group (HLBP)
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Eu, Jerry Pc
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Vanderbilt University Medical Center
Internal Medicine/Medicine
Schools of Medicine
United States
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Sivley, R Michael; Sheehan, Jonathan H; Kropski, Jonathan A et al. (2018) Three-dimensional spatial analysis of missense variants in RTEL1 identifies pathogenic variants in patients with Familial Interstitial Pneumonia. BMC Bioinformatics 19:18
Burman, Ankita; Kropski, Jonathan A; Calvi, Carla L et al. (2018) Localized hypoxia links ER stress to lung fibrosis through induction of C/EBP homologous protein. JCI Insight 3:
Wilfong, Erin M; Lentz, Robert J; Guttentag, Adam et al. (2018) Interstitial Pneumonia With Autoimmune Features: An Emerging Challenge at the Intersection of Rheumatology and Pulmonology. Arthritis Rheumatol 70:1901-1913
Celada, Lindsay J; Kropski, Jonathan A; Herazo-Maya, Jose D et al. (2018) PD-1 up-regulation on CD4+ T cells promotes pulmonary fibrosis through STAT3-mediated IL-17A and TGF-?1 production. Sci Transl Med 10:
Hewlett, Justin C; Kropski, Jonathan A; Blackwell, Timothy S (2018) Idiopathic pulmonary fibrosis: Epithelial-mesenchymal interactions and emerging therapeutic targets. Matrix Biol 71-72:112-127
Kropski, Jonathan A; Blackwell, Timothy S (2018) Endoplasmic reticulum stress in the pathogenesis of fibrotic disease. J Clin Invest 128:64-73
Evans, Christopher M; Dickey, Burton F; Schwartz, David A (2018) E-Cigarettes: Mucus Measurements Make Marks. Am J Respir Crit Care Med 197:420-422
Lentz, Robert J; Taylor, Trevor M; Kropski, Jonathan A et al. (2018) Utility of Flexible Bronchoscopic Cryobiopsy for Diagnosis of Diffuse Parenchymal Lung Diseases. J Bronchology Interv Pulmonol 25:88-96
Brittain, Evan L; Thennapan, Thennapan; Maron, Bradley A et al. (2018) Update in Pulmonary Vascular Disease 2016 and 2017. Am J Respir Crit Care Med 198:13-23
Kook, Seunghyi; Qi, Aidong; Wang, Ping et al. (2018) Gene-edited MLE-15 Cells as a Model for the Hermansky-Pudlak Syndromes. Am J Respir Cell Mol Biol 58:566-574

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