Hyperoxic
acute lung injury (HALI) is characterized by a cell death response with features of apoptosis and
necrosis that is inhibited by
IL-11 and other interventions. We hypothesized that
Bfl-1/A1, an antiapoptotic Bcl-2
protein, is a critical regulator of HALI and a mediator of IL-11-induced cytoprotection. To test this, we characterized the expression of A1 and the
oxygen susceptibility of WT and
IL-11 Tg(+) mice with normal and null A1 loci. In WT mice, 100% O(2) caused TUNEL(+) cell death, induction and activation of intrinsic and mitochondrial-death pathways, and alveolar
protein leak. Bcl-2 and Bcl-xl were also induced as an apparent protective response. A1 was induced in
hyperoxia, and in A1-null mice, the toxic effects of
hyperoxia were exaggerated, Bcl-2 and Bcl-xl were not induced, and premature death was seen. In contrast,
IL-11 stimulated A1, diminished the toxic effects of
hyperoxia, stimulated Bcl-2 and Bcl-xl, and enhanced murine survival in 100% O(2). In A1-null mice, IL-11-induced protection, survival advantage, and Bcl-2 and Bcl-xl induction were significantly decreased.
VEGF also conferred protection via an A1-dependent mechanism. In vitro
hyperoxia also stimulated A1, and A1 overexpression inhibited
oxidant-induced epithelial cell apoptosis and
necrosis. A1 is an important regulator of
oxidant-induced
lung injury, apoptosis,
necrosis, and Bcl-2 and Bcl-xl gene expression and a critical mediator of IL-11- and
VEGF-induced cytoprotection.