Epidermal Growth Factor receptor (EGFR) regulates mechanical ventilation–induced lung injury in mice

Mechanical ventilation (MV) is used as therapy to support critically ill patients; however, the mechanisms by which MV induces lung injury and inflammation remain unclear. Epidermal growth factor receptor (EGFR)-mediated signaling plays a key role in various physiologic and pathologic processes, which include those modulated by mechanical and shear forces, in various cell types. We hypothesized that EGFR-activated signaling plays a key role in ventilator-induced lung injury and inflammation (VILI). To test this hypothesis, we assessed lung vascular and alveolar permeability as well as inflammation, which are cardinal features of VILI, in mice treated with the EGFR inhibitor AG1478. Inhibition of EGFR activity greatly diminished MV-induced lung alveolar permeability and neutrophil accumulation in the bronchoalveolar lavage (BAL) fluid, as compared with vehicle-treated controls. Similarly, AG1478 inhibition diminished lung vascular leak (as assessed by Evans blue extravasation), but it did not affect interstitial neutrophil accumulation. Inhibition of the EGFR pathway also blocked expression of genes induced by MV. However, intratracheal instillation of EGF alone failed to induce lung injury. Collectively, our findings suggest that EGFR-activated signaling is necessary but not sufficient to produce acute lung injury in mice.

Abbreviations: ALI, acute lung injury, ARDS, adult respiratory distress syndrome, BAL, bronchoalveolar lavage, DMSO, dimethyl sulfoxide, EBD, Evans blue dye, EGFR, epidermal growth factor receptor, MAP, mitogen-activated protein, MV, mechanical ventilation, PBS, phosphate buffered saline, RT-PCR, reverse transcriptase polymerase chain reaction, SE, standard error, SpV, sham-operated, anesthetized mice breathing spontaneously, VILI, ventilator-induced lung injury and inflammation