Bronchopulmonary dysplasia (BPD) is a chronic lung disease that occurs in preterm infants following mechanical ventilation and high levels of supplemental oxygen. While survival of premature newborns has increased due to recent improvements in perinatal care, BPD remains a serious and common complication of prematurity, affecting approximately 15,000 infants annually in USA. Infants with BPD are at higher risk of respiratory morbidity and mortality in early childhood. BPD has long-term respiratory and neurodevelopmental complications that reach beyond childhood and increase health care costs. Given the lack of major improvements in prevention and treatment of BPD, there is a major need for innovative molecular approaches to complement existing BPD therapies. Promising therapeutic approaches for BPD treatment include increasing postnatal angiogenesis and protection of alveolar endothelial cells from apoptosis after the injury caused by mechanical ventilation and high levels of oxygen. Based on our preliminary results, we believe that Forkhead Box F1 (Foxf1) transcription factor (also known as HFH-8 and Freac-1) plays a key role in both these processes and therefore, targeting the Foxf1 can be beneficial for both chemoprevention and treatment of children with BPD. Published studies from my laboratory have demonstrated that Foxf1 is expressed in pulmonary endothelial cells (EC) of embryonic and neonatal lungs. Mice heterozygous for the Foxf1 null allele exhibited lung hypoplasia, decreased number of alveolar capillaries, increased apoptosis of EC, and increased mortality in the early neonatal period. Genomic mutations in FoxF1 gene locus were recently found in 30% of human patients with Alveolar Capillary Dysplasia (ACD), a congenital lethal lung disease. Pulmonary Foxf1 mRNA and protein levels are reduced in newborn mice exposed to hyperoxia, a mouse model of BPD. Diminished Foxf1 levels are associated with loss of pulmonary vasculature in hyperoxia-treated newborn mice and human patients with BPD. Given the critical role of Foxf1 for pulmonary vascular development in mice and humans, it is important to determine the role of Foxf1 in the pathogenesis of BPD. We will use hyperoxia- mediated lung injury in newborn mice as a model of BPD to test the hypothesis that Foxf1 is required to maintain normal lung morphogenesis after hyperoxia injury by stimulating angiogenesis and increasing survival of endothelial cells.
In Aim I, we will determine whether Foxf1 is required for formation of new pulmonary capillaries in a BPD model using two transgenic mouse lines with Foxf1 deficiency: Foxf1 mice and Tie2-Cre- fl/fl ER Foxf1 mice.
In Aim II, we will determine whether Foxf1 directly regulates expression of anti-apoptotic genes and is required for survival of endothelial cells in a BPD model. Since the long-term goal of our studies is to find novel therapeutic agents preventing BPD in human patients, in Aim III we will determine whether increasing Foxf1 levels in neonatal lungs will accelerate vessel formation, increase EC survival and prevent BPD. Foxf1 levels in hyperoxia-treated newborn mice will be increased by either pharmacological approach (TAT-Foxf1 fusion protein) or genetic approach (Doxycycline-inducible over-expression of Foxf1 in endothelial cells). Completion of these studies will determine whether increasing Foxf1 levels is a promising therapeutic approach to prevent endothelial apoptosis and induce angiogenesis in BPD patients.

Public Health Relevance

Foxf1 transcription factor is an important and clinically-relevant transcriptional regulator of pulmonary vascular development in mice and humans, but its role in Bronchopulmonary dysplasia (BPD) remains unknown. Using two novel mouse models with Foxf1 deficiency, we propose to determine whether Foxf1 is required to maintain postnatal lung morphogenesis by stimulating angiogenesis and increasing survival of endothelial cells (EC) after hyperoxia-mediated injury, a mouse model of BPD. We also propose to use cell-penetrating TAT-Foxf1 fusion protein, a novel therapeutic agent, to determine whether increasing Foxf1 in newborn mice will promote vascular repair after hyperoxia lung injury, decrease EC apoptosis and prevent BPD.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL084151-09
Application #
8656384
Study Section
Respiratory Integrative Biology and Translational Research Study Section (RIBT)
Program Officer
Lin, Sara
Project Start
2006-07-01
Project End
2015-04-30
Budget Start
2014-05-01
Budget End
2015-04-30
Support Year
9
Fiscal Year
2014
Total Cost
Indirect Cost
City
Cincinnati
State
OH
Country
United States
Zip Code
45229
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Ustiyan, Vladimir; Bolte, Craig; Zhang, Yufang et al. (2018) FOXF1 transcription factor promotes lung morphogenesis by inducing cellular proliferation in fetal lung mesenchyme. Dev Biol 443:50-63
Milewski, David; Pradhan, Arun; Wang, Xinjian et al. (2017) FoxF1 and FoxF2 transcription factors synergistically promote rhabdomyosarcoma carcinogenesis by repressing transcription of p21(Cip1) CDK inhibitor. Oncogene 36:850-862
Milewski, David; Balli, David; Ustiyan, Vladimir et al. (2017) FOXM1 activates AGR2 and causes progression of lung adenomas into invasive mucinous adenocarcinomas. PLoS Genet 13:e1007097
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Yamamoto, Junpei; Imai, Junta; Izumi, Tomohito et al. (2017) Neuronal signals regulate obesity induced ?-cell proliferation by FoxM1 dependent mechanism. Nat Commun 8:1930
Cai, Yuqi; Bolte, Craig; Le, Tien et al. (2016) FOXF1 maintains endothelial barrier function and prevents edema after lung injury. Sci Signal 9:ra40
Fulford, Logan; Milewski, David; Ustiyan, Vladimir et al. (2016) The transcription factor FOXF1 promotes prostate cancer by stimulating the mitogen-activated protein kinase ERK5. Sci Signal 9:ra48
Xu, Jingyue; Liu, Han; Lan, Yu et al. (2016) A Shh-Foxf-Fgf18-Shh Molecular Circuit Regulating Palate Development. PLoS Genet 12:e1005769
Pradhan, Arun; Ustiyan, Vladimir; Zhang, Yufang et al. (2016) Forkhead transcription factor FoxF1 interacts with Fanconi anemia protein complexes to promote DNA damage response. Oncotarget 7:1912-26

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