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[Preprint]. 2023 Aug 11:2023.08.04.551943. Originally published 2023 Aug 4. [Version 2] doi: 10.1101/2023.08.04.551943

Bronchoconstriction damages airway epithelia by excess crowding-induced extrusion

Dustin C Bagley, Tobias Russell, Elena Ortiz-Zapater, Kristina Fox, Paulina Frances Redd, Merry Joseph, Cassandra Deering Rice, Christopher A Reilly, Maddy Parsons, Jody Rosenblatt
PMCID: PMC10418241  PMID: 37577550

Abstract

Asthma is deemed an inflammatory disease, yet the defining diagnostic symptom is mechanical bronchoconstriction. We previously discovered a conserved process that drives homeostatic epithelial cell death in response to mechanical cell crowding called cell extrusion(1, 2). Here, we show that the pathological crowding of a bronchoconstrictive attack causes so much epithelial cell extrusion that it damages the airways, resulting in inflammation and mucus secretion. While relaxing airways with the rescue treatment albuterol did not impact these responses, inhibiting live cell extrusion signaling during bronchoconstriction prevented all these symptoms. Our findings propose a new etiology for asthma, dependent on the mechanical crowding of a bronchoconstrictive attack. Our studies suggest that blocking epithelial extrusion, instead of ensuing downstream inflammation, could prevent the feed-forward asthma inflammatory cycle.

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