Novel Molecular and Phenotypic Insights into Congenital Lung Malformations
Overview
Authors
Affiliations
Rationale: Disruption of normal pulmonary development is a leading cause of morbidity and mortality in infants. Congenital lung malformations are a unique model to study the molecular pathogenesis of isolated structural birth defects, as they are often surgically resected.
Objectives: To provide insight into the molecular pathogenesis of congenital lung malformations through analysis of cell-type and gene expression changes in these lesions.
Methods: Clinical data, and lung tissue for DNA, RNA, and histology, were obtained from 58 infants undergoing surgical resection of a congenital lung lesion. Transcriptome-wide gene expression analysis was performed on paired affected and unaffected samples from a subset of infants (n = 14). A three-dimensional organoid culture model was used to assess isolated congenital lung malformation epithelium (n = 3).
Measurements And Main Results: Congenital lung lesions express higher levels of airway epithelial related genes, and dysregulated expression of genes related to the Ras and PI3K-AKT-mTOR (phosphatidylinositol 3-kinase-AKT-mammalian target of rapamycin) signaling pathways. Immunofluorescence confirmed differentiated airway epithelial cell types throughout all major subtypes of congenital lung lesions, and three-dimensional cell culture demonstrated a cell-autonomous defect in the epithelium of these lesions.
Conclusions: This study provides the first comprehensive analysis of the congenital lung malformation transcriptome and suggests that disruptions in Ras or PI3K-AKT-mTOR signaling may contribute to the pathology through an epithelial cell-autonomous defect.
The dynamics of tubulogenesis in development and disease.
Romero A, Walker B, Krneta-Stankic V, Gerner-Mauro K, Youmans L, Miller R Development. 2025; 152(3).
PMID: 39959988 PMC: 11883272. DOI: 10.1242/dev.202820.
Congenital Pulmonary Hybrid Lesions: Clinical Presentation, Surgical Management, and Outcomes.
Gatt D, Lapidus-Krol E, Chiu P Indian J Pediatr. 2025; .
PMID: 39833625 DOI: 10.1007/s12098-024-05393-7.
Li F, Tan Z, Chen H, Gao Y, Xia J, Huang T Cell Biosci. 2024; 14(1):94.
PMID: 39026356 PMC: 11264590. DOI: 10.1186/s13578-024-01276-8.
Cancemi G, Distefano G, Vitaliti G, Milazzo D, Terzo G, Belfiore G Children (Basel). 2024; 11(6).
PMID: 38929218 PMC: 11201397. DOI: 10.3390/children11060638.
Congenital lung malformations.
Pederiva F, Rothenberg S, Hall N, IJsselstijn H, Wong K, Von Der Thusen J Nat Rev Dis Primers. 2023; 9(1):60.
PMID: 37919294 DOI: 10.1038/s41572-023-00470-1.