Mesenchymal stromal cells attenuate pulmonary fibrosis via macrophage

Abstract Background：Pulmonary fibrosis (PF) is a growing clinical problem with limited therapeutic options. Human umbilical cord mesenchymal stromal cell (hucMSC) therapy is being investigated in clinical trials for the treatment of PF patients. However, little is known about the underlying molecular and cellular mechanisms of hucMSC therapy on PF. In this study, the molecular and cellular behavior of hucMSC was investigated in a bleomycin induced mouse PF model. Methods: The effect of hucMSC on mouse lung regeneration was determined by detecting Ki67 expression and Edu incorporation in alveolar type 2 (AT2) and lung fibroblast cells. The hucMSC was transfected to express the membrane localized GFP before transplant into the mouse lung. The cellular behavior of hucMSC in mouse lung was tracked by GFP staining. Single cell RNA sequencing was performed to investigate the molecular mechanism of hucMSC on PF. Results: hucMSCs could alleviate collagen accumulation in lung and decrease the mortality of mouse induced by bleomycin. hucMSCs transplantation promoted AT2 cell proliferation and inhibited lung fibroblast cell proliferation. Mouse lung macrophage phenotype was changed after interacting with hucMSCs. By using single-cell RNA sequencing, a subcluster of interferon-sensitive macrophages were identified after hucMSC infusion. These macrophages elevate the secretion of CXCL9 and CXCL10 following hucMSC infusion and recruit more Treg cells to the injured lung. Conclusions: Our study establishes a link between hucMSCs, macrophage proliferation, and PF with potential applications in PF therapeutics. It provides new insights into how hucMSCs interact with macrophage during the repair process of bleomycin-induced PF and play its immunoregulation function.