Extracellular matrix metalloproteinase inducer (EMMPRIN), a glycosylated transmembrane protein that induces matrix metalloproteinases (MMPs), is minimally expressed in the normal adult lung. We previously reported that it is upregulated in murine bleomycin-induced lung injury. In this study, we determined the expression of EMMPRIN and its association with MMPs-2, -7, and -9 in interstitial pneumonias (IPs). We performed immunohistochemistry for EMMPRIN and MMPs on lung tissue from 22 subjects with various IPs. We did bronchoalveolar lavage (BAL) on 9 of these subjects and 13 others with Thank you for the review of our manuscript, "Extracellular Matrix Metalloproteinase Inducer in Interstitial Pneumonias". We appreciate the constructive comments from you and the reviewers. We are pleased to enclose a revised manuscript, marked version of the manuscript and point-by-point responses to the comments of the reviewers.In the revised manuscript, we added a new table (labeled Table 2) according to the suggestion of reviewer 2. That table demonstrates that we have analyzed the three histological patterns of IPs, UIP, NSIP, and OP, separately. While the present findings do not point to mechanisms for EMMPRIN induction in IPs or a role of EMMPRIN in the development of IPs, we speculate that EMMPRIN affects reepithelialization in IPs via its capacity to induce the expression of MMPs, particularly in hyperplastic type II cells. We feel that the manuscript has been improved as a result of the review process and look forward to a favorable response to this revision.Thank you for your attention.
Response to ReviewersThe problem with this study is that the authors lump usual interstitia l pneumonia, nonspecific interstitia l pneumonia, and organizing pneumonia together as IPs. Although it is true that each of the three histological patterns can be classified as an IP, they are a very diverse group and their pathogeneses are most likely different. Therefore, for scientific purposes they should be analyzed separately. The data presented in the manuscript do not suggest a functional role of EMMPRIN in IPs. It merely indicates that reactive epithelial cells of all kinds may overexpress EMMPRIN.Otherwise, the scientific methods appear to be valid, the manuscript is well written, and the figures are of acceptable quality.We appreciate the reviewer's comments. According to the reviewer's suggestions, we have added new data demonstrating the individual scores for each type of abnormal epithelial cells and analyzed them in UIP, NSIP and OP, separately (new Table 2 in the revised manuscript). To reflect this change we have revised the manuscript as follows:"Neither squamous metaplasia nor bronchiolization was observed in OP. Only hyperplastic type II cells were present, and these cells expressed EMMPRIN to various degrees. Accordingly, we evaluated EMMPRIN only in UIP and NSIP. There were no statistical differences in the score of EMMPRIN in each type of epithelial cells between UIP and NSIP. Therefore, we compared the immunore...