Abstract Rationale The emphysema phenotype represents a major subtype of COPD, characterized by destruction to the interlobular septa, progressive loss of lung function, and markedly reduced exercise tolerance. Despite advances in pharmacologic therapy for airway inflammation, no effective treatment currently exists to prevent or reverse alveolar destruction. Identifying molecular targets that promote alveolar repair and halt disease progression is therefore of critical importance. Previous work from our group demonstrated that excessive apoptosis of type II alveolar epithelial cells (ACEII) is a key mechanism underlying emphysematous change. PHLDA1, an anti-apoptotic protein predominantly expressed in type II alveolar epithelial cells, was markedly decreased in lung tissue from patients with emphysematous phenotype compared to those without emphysema. Methods This study investigates the mechanisms in cells and human specimens via nucleic acid detection, protein detection, transfection, CO-IP, immunohistochemistry, immunofluorescence, and flow cytometry; Results The present study explored the mechanism responsible for PHLDA1 expression and potential strategies for its restoration. We found that cigarette smoke exposure induced misfolding of PHLDA1, leading to its degradation via the ubiquitin-proteasome pathway. STUB1 was identified as the E3 ligase mediating this degradation and regulating PHLDA1 protein stability. Activation of the antioxidant transcription factor Nrf2 using its agonist tBHQ mitigated PHLDA1 misfolding and reduced AEC II apoptosis. Conclusion Type II alveolar epithelial cells are markedly reduced in emphysema-associated COPD. PHLDA1, predominantly expressed in these cells, is degraded via the ubiquitin-proteasome pathway, with STUB1 acts as the E3 ligase. Under CSE stimulation, PHLDA1 misfolds and undergoes accelerated degradation; activation of Nrf2 restores its structural integrity and diminishes apoptosis. Thus, STUB1 and Nrf2 represent potential therapeutic targets for modulating PHLDA1 stability and mitigating alveolar damage in emphysematous COPD. This abstract is funded by: Natural Science Foundation of China
Yu et al. (Fri,) studied this question.