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Profibrotic priming of airway cell types in idiopathic pulmonary fibrosis and drug inhibition in single-cell resolution

The cause and etiology of idiopathic pulmonary fibrosis, a severe chronic lung disorder with limited treatment options, is still poorly understood. Early genetic studies hinted that airway epithelial cells play an important role in the development of IPF while more recent single-cell RNA sequencing atlases from explant IPF lungs have focused on macrophages. In this study, we used air-liquid interface cultures of primary cells taken from the subsegmental bronchi of IPF patients, reflecting early-stage fibrosis, to interrogate the single-cell transcriptional landscape of the airway mucosa. We identified IPF-enriched cell-cell interaction pathways. Moreover, we also observed that IPF cell types shared “core” signatures, where epithelial cells had a pro-inflammatory signature while fibroblasts had an early activation signature. Harnessing the in vitro culture system, we also treated the cells with nintedanib, pirfenidone, and saracatinib, an Src kinase inhibitor that could inhibit IPF progression, to investigate their effects on the previously described IPF signatures. Unfortunately, only certain signatures were positively affected by the three drugs. This study provides more insight into the disease mechanisms of IPF and is a key resource for the IPF community to further investigate the effects of pharmacological inhibition.