Collagen VI (COL6) is known for its role in a spectrum of congenital muscular dystrophies, which are often accompanied by respiratory dysfunction. However, little is known regarding the function of COL6 in the lung. We confirmed the presence of COL6 throughout the basement membrane region of mouse lung tissue. Lung structure and organization were studied in a previously described Col6a1 À/À mouse, which does not produce detectable COL6 in the lung. The Col6a1 À/À mouse displayed histopathologic alveolar and airway abnormalities. The airspaces of Col6a1 À/À lungs appeared simplified, with larger (29%; P < 0.01) and fewer (31%; P < 0.001) alveoli. These airspace abnormalities included reduced isolectin B4 þ alveolar capillaries and surfactant protein Cepositive alveolar epithelial type-II cells. Alterations in lung function consistent with these histopathologic changes were evident. Col6a1 À/À mice also displayed multiple airway changes, including increased branching (59%; P < 0.001), increased mucosal thickness (34%; P < 0.001), and increased epithelial cell density (13%; P < 0.001). Comprehensive transcriptome analysis revealed that the loss of COL6 is associated with reductions in integrin-paxillinephosphatidylinositol 3-kinase signaling in vivo. In vitro, COL6 promoted steady-state phosphorylated paxillin levels and reduced cell density (16% to 28%; P < 0.05) at confluence. Inhibition of phosphatidylinositol 3-kinase, or its downstream effectors, resulted in increased cell density to a level similar to that seen on matrices lacking COL6. (Am J Pathol 2020, 190: 426e441; https:// The extracellular matrix (ECM) is composed of the noncellular components of a tissue and provides multiple critical structural and signaling properties. Major components of the ECM include collagens, proteoglycans, glycoproteins, elastin, and fibronectin. Highly diverse organization of the ECM contributes a broad range of properties, including tissue stiffness and elasticity, to facilitate proper tissue and organ function. 1e3 In addition to structural properties, ECM can provide numerous signaling cues for events, including migration, proliferation, and differentiation, to direct development, healing, and homeostatic conditions. 4,5 This can be accomplished via direct interaction of cells with the matrix or by sequestration and release or presentation of growth factors by the matrix. Disruption of any of the functions of the ECM can be devastating to the tissue and is known to be involved in a multitude of diseases. 6The ECM is known to be critical in the development, organization, and maintenance of lung structure. During development and homeostasis, organization and presence of particular ECM components direct both cellular function and further remodeling and maturation of the matrix by the surrounding cells. This can be due to cell signaling initiated by interaction with matrix components or mechanotransduction, a process by which cells respond to the mechanical forces