Flow Cytometry Analysis of Lung Tissue Immune Cells

To validate results from the GSVA immune enrichment in the LTRC, we used flow cytometry, a non-mRNA related method. Fresh lung tissue samples of IPF patients undergoing bilateral lung transplant at the University of Pittsburgh (USA) were washed with PBS and enzymatically digested as previously described [34 (link)]. Lung homogenates included multiple areas of the same lung lobe, ensuring the representability of the sample to address patient’s heterogeneity. Lung tissue homogenates (10⁶ cells) were then stained 5 min with the viability staining (Fixable viability-Alexa600, BD, USA) and 30 min at 4ºC in the dark with the following conjugated monoclonal antibodies CD3-PECy5.5, CD45-Alexa700, CD16-BV412, CD56-FITC, CD8-V500, CD4-APC-Cy7, CD19-BV650 (BD, USA) and CD14-PE (BioLegend, USA). A minimum of 5 × 10⁵ cells per sample were acquired in a FACS LSRII (BD Biosciences, USA), and data was analyzed using FlowJo v10 (FlowJo LLC, USA). Immune cell populations were determined using the gating strategy depicted in Additional file 1: Fig. S1.