Granulocyte-macrophage colony stimulating factor targets lung stem cell niches to accelerate alveolar repair after virus-induced lung injury

Abstract

Influenza virus pneumonia causes severe damage of the lung parenchyma, resulting in respiratory failure. Timely and coordinated epithelial tissue repair is crucial for re-establishment of gas exchange. We identify granulocyte-macrophage colony-stimulating factor (GM-CSF) as a niche-derived growth factor produced in response to viral lung injury by distal epithelial progenitor cell populations, including alveolar epithelial type II cells (AECII) and bronchioalveolar stem cells (BASCs). Using complementary in vivo infection models, loss- and gain-of-function approaches, and lung organoid systems, we reveal that GM-CSF directly promotes distal epithelial progenitor cell expansion and alveolarization. Mechanistically, GM-CSF suppresses AMP-activated protein kinase activation and enables mechanistic target of rapamycin complex 1 (mTORC1) signaling, driving epithelial progenitor cell proliferation. Administration of recombinant GM-CSF during the initial days of infection enhances AECII proliferation and differentiation into AEC type I, accelerating lung barrier repair. Together, our findings establish GM-CSF as a key regulator of distal lung progenitor cell niches that couples cytokine signaling to metabolic control of tissue regeneration. These results uncover a previously unrecognized epithelial-intrinsic function of GM-CSF and highlight its therapeutic potential to promote lung repair in acute injury.