Short telomeres are a risk factor for idiopathic pulmonary fibrosis

Jonathan K. Alder, Julian Chen, Lisa Lancaster, Sonye Danoff, Shu Chih Su, Joy D. Cogan, Irma Vulto, Mingyi Xie, Xiaodong Qi, Rubin M. Tuder, John A. Phillips, Peter M. Lansdorp, James E. Loyd, Mary Y. Armanios

Research output: Contribution to journalArticle

423 Citations (Scopus)

Abstract

Idiopathic interstitial pneumonias (IIPs) have a progressive and often fatal course, and their enigmatic etiology has complicated approaches to effective therapies. Idiopathic pulmonary fibrosis (IPF) is the most common of IIPs and shares with IIPs an increased incidence with age and unexplained scarring in the lung. Short telomeres limit tissue renewal capacity in the lung and germ-line mutations in telomerase components, hTERT and hTR, underlie inheritance in a subset of families with IPF. To examine the hypothesis that short telomeres contribute to disease risk in sporadic IIPs, we recruited patients who have no family history and examined telomere length in leukocytes and in alveolar cells. To screen for mutations, we sequenced hTERT and hTR. We also reviewed the cases for features of a telomere syndrome. IIP patients had shorter leukocyte telomeres than age-matched controls (P < 0.0001). In a subset (10%), IIP patients had telomere lengths below the first percentile for their age. Similar to familial cases with mutations, IPF patients had short telomeres in alveolar epithelial cells (P < 0.0001). Although telomerase mutations were rare, detected in 1 of 100 patients, we identified a cluster of individuals (3%) with IPF and cryptogenic liver cirrhosis, another feature of a telomere syndrome. Short telomeres are thus a signature in IIPs and likely play a role in their age-related onset. The clustering of cryptogenic liver cirrhosis with IPF suggests that the telomere shortening we identify has consequences and can contribute to what appears clinically as idiopathic progressive organ failure in the lung and the liver.

Original languageEnglish (US)
Pages (from-to)13051-13056
Number of pages6
JournalProceedings of the National Academy of Sciences of the United States of America
Volume105
Issue number35
DOIs
StatePublished - Sep 2 2008

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Idiopathic Pulmonary Fibrosis
Idiopathic Interstitial Pneumonias
Telomere
Alveolar Epithelial Cells
Telomerase
Liver Cirrhosis
Mutation
Leukocytes
Telomere Shortening
Lung Volume Measurements
Lung
Germ-Line Mutation
Age of Onset
Cicatrix
Cluster Analysis
Liver

Keywords

  • Aplastic anemia
  • Dyskeratosis congenita
  • Interstitial lung disease
  • Liver fibrosis
  • Telomerase

ASJC Scopus subject areas

  • Genetics
  • General

Cite this

Short telomeres are a risk factor for idiopathic pulmonary fibrosis. / Alder, Jonathan K.; Chen, Julian; Lancaster, Lisa; Danoff, Sonye; Su, Shu Chih; Cogan, Joy D.; Vulto, Irma; Xie, Mingyi; Qi, Xiaodong; Tuder, Rubin M.; Phillips, John A.; Lansdorp, Peter M.; Loyd, James E.; Armanios, Mary Y.

In: Proceedings of the National Academy of Sciences of the United States of America, Vol. 105, No. 35, 02.09.2008, p. 13051-13056.

Research output: Contribution to journalArticle

Alder, JK, Chen, J, Lancaster, L, Danoff, S, Su, SC, Cogan, JD, Vulto, I, Xie, M, Qi, X, Tuder, RM, Phillips, JA, Lansdorp, PM, Loyd, JE & Armanios, MY 2008, 'Short telomeres are a risk factor for idiopathic pulmonary fibrosis', Proceedings of the National Academy of Sciences of the United States of America, vol. 105, no. 35, pp. 13051-13056. https://doi.org/10.1073/pnas.0804280105
Alder, Jonathan K. ; Chen, Julian ; Lancaster, Lisa ; Danoff, Sonye ; Su, Shu Chih ; Cogan, Joy D. ; Vulto, Irma ; Xie, Mingyi ; Qi, Xiaodong ; Tuder, Rubin M. ; Phillips, John A. ; Lansdorp, Peter M. ; Loyd, James E. ; Armanios, Mary Y. / Short telomeres are a risk factor for idiopathic pulmonary fibrosis. In: Proceedings of the National Academy of Sciences of the United States of America. 2008 ; Vol. 105, No. 35. pp. 13051-13056.
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AU - Alder, Jonathan K.

AU - Chen, Julian

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AU - Danoff, Sonye

AU - Su, Shu Chih

AU - Cogan, Joy D.

AU - Vulto, Irma

AU - Xie, Mingyi

AU - Qi, Xiaodong

AU - Tuder, Rubin M.

AU - Phillips, John A.

AU - Lansdorp, Peter M.

AU - Loyd, James E.

AU - Armanios, Mary Y.

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AB - Idiopathic interstitial pneumonias (IIPs) have a progressive and often fatal course, and their enigmatic etiology has complicated approaches to effective therapies. Idiopathic pulmonary fibrosis (IPF) is the most common of IIPs and shares with IIPs an increased incidence with age and unexplained scarring in the lung. Short telomeres limit tissue renewal capacity in the lung and germ-line mutations in telomerase components, hTERT and hTR, underlie inheritance in a subset of families with IPF. To examine the hypothesis that short telomeres contribute to disease risk in sporadic IIPs, we recruited patients who have no family history and examined telomere length in leukocytes and in alveolar cells. To screen for mutations, we sequenced hTERT and hTR. We also reviewed the cases for features of a telomere syndrome. IIP patients had shorter leukocyte telomeres than age-matched controls (P < 0.0001). In a subset (10%), IIP patients had telomere lengths below the first percentile for their age. Similar to familial cases with mutations, IPF patients had short telomeres in alveolar epithelial cells (P < 0.0001). Although telomerase mutations were rare, detected in 1 of 100 patients, we identified a cluster of individuals (3%) with IPF and cryptogenic liver cirrhosis, another feature of a telomere syndrome. Short telomeres are thus a signature in IIPs and likely play a role in their age-related onset. The clustering of cryptogenic liver cirrhosis with IPF suggests that the telomere shortening we identify has consequences and can contribute to what appears clinically as idiopathic progressive organ failure in the lung and the liver.

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KW - Liver fibrosis

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