PROJECT SUMMARY/ABSTRACT
Acute respiratory distress syndrome (ARDS) and its less severe form, acute lung injury (ALI), are devastating,
life-threatening respiratory illnesses that can result from pneumonia. Injury to the alveolar epithelial-endothelial
barrier in ARDS results in alveolar edema that mechanically impairs alveolar distensibility, hinders gas
exchange, and promotes inflammation. Disruption of normal lung mechanics and biology demonstrate the need
to study ARDS at the intersection of lung immunobiology and physical sciences. The importance of lung
mechanobiology is reflected by current effective therapeutic interventions that target lung mechanics, such as
protective mechanical ventilation and prone positioning. While ARDS edema is known to compromise alveolar
mechanics, the downstream consequences on capillary mechanics, hemodynamics, and oxygen transport are
not well known. As a result, it remains unknown how altered capillary function in ARDS affects the trafficking,
sequestration, migration, and phagocytosis of key immune cell types, such as resident and recruited
macrophages. Our understanding of ARDS microphysiology is limited by a technological gap to study lung
respiratory-circulatory function at the cellular scale in real-time. Current imaging modalities such as MRI/CT
and histological analyses lack the necessary spatial and temporal resolution to probe dynamic events such as
vascular flow, cellular trafficking and migration, and gas exchange. To address these needs, we have
developed a novel “LungEx” system that allows mechanistic probing of lung respiratory-circulatory function in
real-time at the single capillary scale. LungEx is an ex vivo ventilated and perfused murine lung with preserved
physics and biology near that of in vivo lungs, combined with a transparent “crystal” ribcage to allow high-
resolution optical microscopy of capillary function in real-time. Combining LungEx with experimental murine
models of ALI caused by pneumonia (PNA-ALI), we have preliminarily observed altered capillary function in
edematous PNA-ALI regions. Here, utilizing LungEx, we will test the hypotheses that: altered alveolar
mechanics in PNA-ALI impairs capillary mechanics, restricts RBC flow trafficking, and hence reduces oxygen
transport on the capillary scale (Aim 1); and altered mechanics in PNA-ALI differentially impedes resident vs
recruited macrophage function, promoting a mechanosensitive inflammatory profile (Aim 2). These studies will
improve our understanding of the mechanobiology and mechanoimmunity underlying pneumonia-associated
ARDS pathogenesis that begins on the single capillary level and how it affects key immunovascular
components of the lung. As part of the pre-doctoral fellowship training towards a physician-scientist career, the
proposed work will emphasize hypothesis-based experimental design, scientific communication and
mentorship, integration of research with clinical practice, and will be carried out at Boston University.