121 Dysregulated cross talk between alveolar epithelial cells and stromal cells in IPF reduces epithelial regenerative capacity Conclusions Overall, our observations indicate that aberrant crosstalk between (alveolar) epithelial cells and stromal cells changes the regenerative capacity of alveolar progenitors in IPF. This dysregulation may contribute to the abnormal alveolar repair in IPF, partly leading to bronchial and squamous metaplasia. In addition, this disturbance might also contribute to an abnormal alveolar micro-environment and ECM interactions in the lung in IPF. Further investigations regarding the contribution of specific stromal cells in epithelial regeneration will be necessary to understand the influence of aberrant alveolar repair in IPF pathophysiology. It will be of interest to investigate the behaviour of metaplastic bronchial epithelial cells in culture systems like organoids to provide further insight into abnormal alveolar repair in IPF. Future research using the combination of different epithelial cell types, as well their interaction with specific stromal cells, will deepen our understanding of IPF pathophysiology. 5
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