Research: Fetal hypoplastic lungs have multilineage inflammation that is reversed by amniotic fluid stem cell extracellular vesicle treatment

Sci Adv

. 2024 Jul 26;10(30):eadn5405.

 doi: 10.1126/sciadv.adn5405. Epub 2024 Jul 26. https://pubmed.ncbi.nlm.nih.gov/39058789/

Fetal hypoplastic lungs have multilineage inflammation that is reversed by amniotic fluid stem cell extracellular vesicle treatment

Lina Antounians 1 2Rebeca Lopes Figueira 1 2Bharti Kukreja 3Michael L Litvack 4Elke Zani-Ruttenstock 1 2Kasra Khalaj 1 2Louise Montalva 1 2Fabian Doktor 1 2Mikal Obed 1 2Matisse Blundell 1 2Taiyi Wu 3Cadia Chan 5 6Richard Wagner 7Martin Lacher 7Michael D Wilson 5 6Martin Post 4 8Brian T Kalish 3 6 9Augusto Zani 1 2 10

Affiliations Expand

Abstract

Antenatal administration of extracellular vesicles from amniotic fluid stem cells (AFSC-EVs) reverses features of pulmonary hypoplasia in models of congenital diaphragmatic hernia (CDH). However, it remains unknown which lung cellular compartments and biological pathways are affected by AFSC-EV therapy. Herein, we conducted single-nucleus RNA sequencing (snRNA-seq) on rat fetal CDH lungs treated with vehicle or AFSC-EVs. We identified that intra-amniotically injected AFSC-EVs reach the fetal lung in rats with CDH, where they promote lung branching morphogenesis and epithelial cell differentiation. Moreover, snRNA-seq revealed that rat fetal CDH lungs have a multilineage inflammatory signature with macrophage enrichment, which is reversed by AFSC-EV treatment. Macrophage enrichment in CDH fetal rat lungs was confirmed by immunofluorescence, flow cytometry, and inhibition studies with GW2580. Moreover, we validated macrophage enrichment in human fetal CDH lung autopsy samples. Together, this study advances knowledge on the pathogenesis of pulmonary hypoplasia and further evidence on the value of an EV-based therapy for CDH fetuses.

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