Acute lung injury (ALI) and the Adult Respiratory Distress Syndrome (ARDS) claim approximately 75,000 lives in North America each year. While mechanical ventilation is a life saving treatment, it may nevertheless cause harm by straining lungs at a time they are particularly prone to injury from deforming stress. Unlike a broken bone which can be casted, one cannot immobilize injured lungs. Therefore, even so-called lung protective ventilator settings may not spare them from further damage. For the past three years we have studied the determinants of cellular stress failure as a central driver of the lungs' innate immune response to deforming stress. We have shown that cells of lungs, which are exposed to mechanical ventilation with high volumes and trans-pulmonary pressure, experience reversible plasma membrane wounds and that such wounds can trigger proinflammatory signaling cascades. In this competing renewal application we will identify and test therapies designed to protect alveolar epithelial cells from deformation injury or to promote wound repair and we will define their mechanisms of action. Guided by compelling preliminary data we will focus our efforts on osmotic stress as lung-protective intervention and test the efficacy of concentrated salt and sugar solutions in experimental models of ventilator induced lung injury. The proposed experiments will serve three specific aims: 1) To test the effect of osmotic stress on the susceptibility of lung cells to deformation injury and on the probability of cell repair; 2) To examine the effect of osmotic stress on the regulation of volume, surface area and plasma membrane tension in type I and type II alveolar epithelial cells (AEC); 3) To examine the importance of purinergic signaling on osmotic stress mediated alveolar epithelial repair. Experiments will be carried out on anesthetized mechanically ventilated rodents, in isolated perfuse lungs and on cells that will be injured and/or deformed in tissue culture. Study endpoints include the number of wounded and/or repaired cells as assessed by live specimen microscopy, measures of lung inflammation, as well as measures of lung and cell structure and function. We will use optical traps to characterize the length tension relationships of plasma membrane tethers in AEC's and interpret the data as a biophysical readout of membrane area and tension regulation and the effects of osmotic stress on them. The knowledge we will gain, will inform about disease mechanisms and the risks and benefits of conducting a clinical trial.

Public Health Relevance

. Our group investigates the determinants of cellular stress failure as a central driver of the lungs' innate immune response to deforming stress. In preliminary experiments we have identified osmotic stress as potential cytoprotective adjunct to mechanical ventilation. The proposal seeks to establish the efficacy of this intervention in preclinical models of ventilator induced lung injury and to dissect its mechanisms of action. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
2R01HL063178-09A1
Application #
7473067
Study Section
Special Emphasis Panel (ZRG1-RES-B (04))
Program Officer
Harabin, Andrea L
Project Start
2000-04-01
Project End
2012-05-31
Budget Start
2008-06-01
Budget End
2009-05-31
Support Year
9
Fiscal Year
2008
Total Cost
$377,750
Indirect Cost
Name
Mayo Clinic, Rochester
Department
Type
DUNS #
006471700
City
Rochester
State
MN
Country
United States
Zip Code
55905
Hubmayr, Rolf D; Oeckler, Richard A (2014) The hidden consequences of ventilator management decisions. Respir Care 59:1302-5
Hubmayr, Rolf D; Malhotra, Atul (2014) Still looking for best PEEP. Anesthesiology 121:445-6
Suki, Béla; Hubmayr, Rolf (2014) Epithelial and endothelial damage induced by mechanical ventilation modes. Curr Opin Crit Care 20:17-24
Hubmayr, Rolf D (2014) Regional lung strain and the metabolic signature of injury*. Crit Care Med 42:1745-6
Hussein, Omar; Walters, Bruce; Stroetz, Randolph et al. (2013) Biophysical determinants of alveolar epithelial plasma membrane wounding associated with mechanical ventilation. Am J Physiol Lung Cell Mol Physiol 305:L478-84
Hubmayr, Rolf D (2013) Volutrauma and regional ventilation revisited. Am J Respir Crit Care Med 188:1388-9
Hubmayr, Rolf D (2012) Does oxygen tune cellular mechanotransduction? Am J Physiol Lung Cell Mol Physiol 302:L1233-4
Plataki, Maria; Hubmayr, Rolf D (2011) Should mechanical ventilation be guided by esophageal pressure measurements? Curr Opin Crit Care 17:275-80
Godin, Lindsay M; Vergen, Jorge; Prakash, Y S et al. (2011) Spatiotemporal dynamics of actin remodeling and endomembrane trafficking in alveolar epithelial type I cell wound healing. Am J Physiol Lung Cell Mol Physiol 300:L615-23
Belete, Hewan A; Hubmayr, Rolf D; Wang, Shaohua et al. (2011) The role of purinergic signaling on deformation induced injury and repair responses of alveolar epithelial cells. PLoS One 6:e27469

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