# Chronic IL-21 exposure reshapes pulmonary environment, elevating risk of respiratory diseases

**Authors:** Sudhanshu Agrawal, Hugo Oyamada, Nicholas Steven Korvink, Siyi Zhou, Cleonice Alves de Melo Bento, Farah Rahmatpanah, Veedamali S Subramanian, Anshu Agrawal

PMC · DOI: 10.1007/s00018-026-06106-3 · Cellular and Molecular Life Sciences: CMLS · 2026-02-14

## TL;DR

Chronic exposure to IL-21 in the lungs increases inflammation and cellular aging, contributing to respiratory diseases like pulmonary fibrosis.

## Contribution

This study reveals that IL-21 drives age-related lung dysfunction by promoting inflammation, senescence, and macrophage lipid changes.

## Key findings

- IL-21 exposure increases inflammatory cytokines like TNF-α, IL-6, and IL-18 in the lungs.
- Chronic IL-21 leads to macrophage lipid accumulation and upregulation of TREM-2 and CD36.
- Elevated IL-21 levels in aged mice and IPF patients suggest a link to pulmonary fibrosis.

## Abstract

Age-related pulmonary diseases pose a significant health burden, yet the underlying mechanisms remain poorly understood. This study investigates the role of interleukin-21 (IL-21) in driving age-associated changes in lung function and immune responses. Using both murine models and human samples, we demonstrate that IL-21 induces a pro-inflammatory state in the lungs, characterized by increased levels of key inflammatory cytokines including TNF-α, IL-6, IL-33, CXCL-10, and IL-18. IL-21 exposure also promoted cellular senescence, evidenced by upregulation of senescence-associated genes and increased frequencies of KLRG1-positive T cells. Notably, IL-21 treatment led to significant alterations in lung macrophage phenotype and function. We observed increased lipid accumulation in macrophages, accompanied by upregulation of lipid uptake receptors TREM-2 and CD36. These changes were associated with elevated TGF-β secretion, suggesting a potential mechanism for IL-21-induced pulmonary fibrosis. Furthermore, IL-21 exposure resulted in impaired antiviral responses, characterized by reduced MHC-II expression on macrophages and diminished IFN-α production in response to viral challenges. Importantly, aged mice exhibited a lung phenotype strikingly similar to that induced by IL-21 treatment in young mice, including increased inflammation, cellular senescence, and altered macrophage lipid metabolism. Furthermore IL-21 expression was found to be elevated in the lungs of Idiopathic pulmonary fibrosis (IPF) patients compared to controls. These findings suggest that age-related elevation of IL-21 levels may be a key driver of pulmonary dysfunction in the elderly.

## Linked entities

- **Genes:** TREM2 (triggering receptor expressed on myeloid cells 2) [NCBI Gene 54209], CD36 (CD36 molecule (CD36 blood group)) [NCBI Gene 948]
- **Proteins:** IL21 (interleukin 21), TNF (tumor necrosis factor), IL6 (interleukin 6), IL33 (interleukin 33), CXCL10 (C-X-C motif chemokine ligand 10), IL18 (interleukin 18), TGFB1 (transforming growth factor beta 1), H2 (histocompatibility-2, MHC), IFN1@ (interferon, type 1, cluster)
- **Diseases:** Idiopathic pulmonary fibrosis (MONDO:0800029), pulmonary fibrosis (MONDO:0002771)
- **Species:** Mus musculus (taxon 10090)

## Full-text entities

- **Genes:** Il33 (interleukin 33) [NCBI Gene 77125] {aka 9230117N10Rik, Il-33, Il1f11, NF-HEV}, Gzmb (granzyme B) [NCBI Gene 14939] {aka CCP-1/C11, CCP1, Ctla-1, Ctla1, GZB}, Csf2 (colony stimulating factor 2 (granulocyte-macrophage)) [NCBI Gene 12981] {aka CSF, Csfgm, GMCSF, Gm-CSf, MGI-IGM}, CD8A (CD8 subunit alpha) [NCBI Gene 925] {aka CD8, CD8alpha, IMD116, Leu2, p32}, Apc (APC, WNT signaling pathway regulator) [NCBI Gene 11789] {aka CC1, Min, mAPC}, Cd68 (CD68 antigen) [NCBI Gene 12514] {aka Lamp4, Scard1, gp110}, Gal (galanin and GMAP prepropeptide) [NCBI Gene 14419] {aka Galn}, Acta2 (actin alpha 2, smooth muscle, aorta) [NCBI Gene 11475] {aka 0610041G09Rik, Actvs, SMAalpha, SMalphaA, a-SMA, alphaSMA}, H2 (histocompatibility-2, MHC) [NCBI Gene 111364] {aka H-2, MHC-II}, Cxcr3 (C-X-C motif chemokine receptor 3) [NCBI Gene 12766] {aka Cd183, Cmkar3}, Tnf (tumor necrosis factor) [NCBI Gene 21926] {aka DIF, TNF-a, TNF-alpha, TNFSF2, TNFalpha, Tnfa}, Cxcl10 (C-X-C motif chemokine ligand 10) [NCBI Gene 15945] {aka C7, CRG-2, INP10, IP-10, IP10, Ifi10}, CXCL10 (C-X-C motif chemokine ligand 10) [NCBI Gene 3627] {aka C7, IFI10, INP10, IP-10, SCYB10, crg-2}, Abca1 (ATP-binding cassette, sub-family A member 1) [NCBI Gene 11303] {aka ABC-1, Abc1}, Tgfb1 (transforming growth factor, beta 1) [NCBI Gene 21803] {aka TGF-beta1, TGFbeta1, Tgfb, Tgfb-1}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, Cd38 (CD38 antigen) [NCBI Gene 12494] {aka ADPRC 1, Cd38-rs1, I-19}, Ly6g (lymphocyte antigen 6 family member G) [NCBI Gene 546644] {aka Gr-1, Gr1, Ly-6G}, Trem2 (triggering receptor expressed on myeloid cells 2) [NCBI Gene 83433] {aka TREM-2, Trem2a, Trem2b, Trem2c}, Ccl2 (C-C motif chemokine ligand 2) [NCBI Gene 20296] {aka HC11, JE, MCAF, MCP-1, MCP1, SMC-CF}, Il2rg (interleukin 2 receptor, gamma chain) [NCBI Gene 16186] {aka CD132, [g]c, gamma(c), gc, p64}, Il1b (interleukin 1 beta) [NCBI Gene 16176] {aka IL-1beta, Il-1b}, Pnpla2 (patatin-like phospholipase domain containing 2) [NCBI Gene 66853] {aka 0610039C21Rik, 1110001C14Rik, Atgl, TTS-2.2}, Gm12551 (perilipin 2 pseudogene) [NCBI Gene 101055843], Il18 (interleukin 18) [NCBI Gene 16173] {aka Igif, Il-18}, IL21 (interleukin 21) [NCBI Gene 59067] {aka CVID11, IL-21, Za11}, Il6 (interleukin 6) [NCBI Gene 16193] {aka Il-6}, IFNA1 (interferon alpha 1) [NCBI Gene 3439] {aka IFL, IFN, IFN-ALPHA, IFN-alphaD, IFNA13, IFNA@}, Cdkn1a (cyclin dependent kinase inhibitor 1A) [NCBI Gene 12575] {aka CAP20, CDKI, CIP1, Cdkn1, P21, SDI1}, Cd4 (CD4 antigen) [NCBI Gene 12504] {aka L3T4, Ly-4}, Itgam (integrin alpha M) [NCBI Gene 16409] {aka CD11b/CD18, CR3, CR3A, Cd11b, F730045J24Rik, Ly-40}, CD4 (CD4 molecule) [NCBI Gene 920] {aka CD4mut, IMD79, Leu-3, OKT4D, T4}, Actb (actin, beta) [NCBI Gene 11461] {aka Actx, E430023M04Rik, beta-actin}, Irf4 (interferon regulatory factor 4) [NCBI Gene 16364] {aka IRF-4, LSIRF, NF-EM5, Spip}, KLRG1 (killer cell lectin like receptor G1) [NCBI Gene 10219] {aka 2F1, CLEC15A, MAFA, MAFA-2F1, MAFA-L, MAFA-LIKE}, Il21 (interleukin 21) [NCBI Gene 60505] {aka IL-21}, Klrg1 (killer cell lectin-like receptor subfamily G, member 1) [NCBI Gene 50928] {aka 2F1-Ag, MAFA, MAFA-L}, Ptprc (protein tyrosine phosphatase receptor type C) [NCBI Gene 19264] {aka B220, CD45R, Cd45, L-CA, Ly-5, Lyt-4}, Ifna (interferon alpha complex region) [NCBI Gene 111654] {aka Ifa, Ifa8}, Cdkn2a (cyclin dependent kinase inhibitor 2A) [NCBI Gene 12578] {aka ARF-INK4a, Arf, INK4a-ARF, Ink4a/Arf, MTS1, Pctr1}, Ifng (interferon gamma) [NCBI Gene 15978] {aka IFN-g, If2f, Ifg}, Il21r (interleukin 21 receptor) [NCBI Gene 60504] {aka NILR}, Tlr3 (toll-like receptor 3) [NCBI Gene 142980], Cd14 (CD14 antigen) [NCBI Gene 12475]
- **Diseases:** pulmonary decline (MESH:D060825), infection (MESH:D007239), IPF (MESH:D054990), immune dysfunction (MESH:D007154), COVID-19 (MESH:D000086382), lung (MESH:D008171), cancer (MESH:D009369), asthma (MESH:D001249), lung injury (MESH:D055370), lung infections (MESH:D012141), disease (MESH:D004194), Inflammatory (MESH:D007249), fibrosis (MESH:D005355), acute injury (MESH:D001930), influenza (MESH:D007251), respiratory diseases (MESH:D012140), pulmonary emphysema (MESH:D011656), chlamydial lung infection (MESH:D061387), viral (MESH:D014777), pulmonary arterial hypertension (MESH:D000081029), immune dysregulation (OMIM:614878), pulmonary dysfunction (MESH:D011660), acute infections (MESH:D000208), ARDS (MESH:D012128), tissue (MESH:D017695), NSCLC (MESH:D002289), pulmonary hypertension (MESH:D006976), sepsis (MESH:D018805), chronic (MESH:D002908), Age-related pulmonary diseases (MESH:D008569), diminished pulmonary function (OMIM:608852), CMV (MESH:D003586), COPD (MESH:D029424), pulmonary fibrosis (MESH:D011658), lung inflammation (MESH:D011014)
- **Chemicals:** Polyinosinic: polycytidylic acid (MESH:D011070), fatty acid (MESH:D005227), BODIPY (-), Poly I:C (MESH:D011066), sphingolipid (MESH:D013107), cholesterol (MESH:D002784), phospholipids (MESH:D010743), Lipid (MESH:D008055)
- **Species:** Mus musculus (house mouse, species) [taxon 10090], Homo sapiens (human, species) [taxon 9606]
- **Cell lines:** C57BL/6 — Mus musculus (Mouse), Transformed cell line (CVCL_C0MU)

## Full text

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## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12913840/full.md

## References

15 references — full list in the complete paper: https://tomesphere.com/paper/PMC12913840/full.md

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Source: https://tomesphere.com/paper/PMC12913840