Adipocyte dysfunction promotes lung inflammation and aberrant repair: a potential target of COPD

Abstract

BackgroundObesity and chronic obstructive pulmonary disease (COPD) are prevailing worldwide, bringing a heavy medical burden. Clinical and pathophysiological relationship between obesity and COPD is paradoxical and elusive. We aim to explore their inherent associations from clinical, genetic, and animal levels.MethodsWe performed literature review and cohort analysis of patients with COPD to compare lung function, symptom, and prognosis among different weight groups. After retrieving datasets of obesity and COPD in Gene Expression Omnibus (GEO) database, we carried out differentially expressed gene analysis, functional enrichment, protein–protein interactions network, and weighted gene co-expression network analysis. Then, we acquired paraffin-embedded lung tissues of fatty acid–binding protein 4–Cre-BMPR2fl/fl conditional knockout (CKO) mice that were characterized by adipocyte-specific knockout of bone morphogenetic protein receptor 2 (BMPR2) for staining and analysis.ResultsOur cohort study reports the effect of obesity on COPD is inconsistent with previous clinical studies. Lung function of overweight group was statistically superior to that of other groups. We also found that the inflammatory factors were significantly increased hub genes, and cytokine-associated pathways were enriched in white adipose tissue of patients with obesity. Similarly, injury repair–associated genes and pathways were further enhanced in the small airways of patients with COPD. CKO mice spontaneously developed lung injury, emphysema, and pulmonary vascular remodeling, along with increased infiltration of macrophages. BMPR2-defiecient adipocytes had dysregulated expression of adipocytokines.ConclusionInflammation and abnormal repair might be potential mechanisms of the pathological association between obesity and COPD. BMPR2-associated adipocyte dysfunction promoted lung inflammation and aberrant repair, in which adipocytokines might play a role and thus could be a promising therapeutic target.

The association between adipokines and pulmonary diseases: a mendelian randomization study

“…Collectively, adipokines may play a crucial role in pulmonary diseases, particularly in the context of inflammatory disorders, malignancies, and interstitial lung diseases. However, the associations between adipokines and interstitial lung disease (ILD) [ 4 ], asthma [ 5 ], chronic obstructive pulmonary disease (COPD) [ 6 ], lung cancer [ 7 ], tuberculosis [ 8 ], sleep apnea syndrome (SAS) [ 9 ], and pneumonia [ 10 ] remain unclear. Causality cannot be deduced from the existing evidence.…”