Alveolar epithelial cell differentiation during lung repair requires cell-extracellular matrix interactions

During alveolar repair, alveolar type 2 (AT2) epithelial cell progenitors rapidly proliferate and differentiate into flat type 1 alveolar epithelial cells. Failure of normal alveolar repair mechanisms can lead to loss of alveolar structure (emphysema) or development of fibrosis, depending on the type and severity of injury. To test if {beta}1-containing integrins are required during repair following acute injury, we administered E. coli lipopolysaccharide (LPS) by intratracheal injection to mice with a post-developmental deletion of {beta}1 integrin in AT2 cells. While control mice recovered from LPS injury without structural abnormalities, {beta}1-deficient mice had more severe inflammation and developed emphysema. In addition, recovering alveoli were repopulated with an abundance of rounded epithelial cells co-expressing type 2, type 1, and mixed intermediate cell state markers, with few mature type 1 cells. {beta}1-deficient AT2 cells showed persistently increased proliferation after injury, which was blocked by inhibiting NF-{kappa}B activation in these cells. Lineage tracing experiments revealed that {beta}1-deficient AT2 cells failed to differentiate into mature type 1 alveolar epithelial cells. Together, these findings demonstrate that functional alveolar repair after injury with terminal alveolar epithelial differentiation requires {beta}1-containing integrins.