1
|
Kumar R, Kumar S, Mickael C, Fonseca Balladares D, Nolan K, Lee MH, Sanders L, Nilsson J, Molofsky AB, Tuder RM, Stenmark KR, Graham BB. Interstitial macrophage phenotypes in Schistosoma-induced pulmonary hypertension. Front Immunol 2024; 15:1372957. [PMID: 38779688 PMCID: PMC11109442 DOI: 10.3389/fimmu.2024.1372957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Background Schistosomiasis is a common cause of pulmonary hypertension (PH) worldwide. Type 2 inflammation contributes to the development of Schistosoma-induced PH. Specifically, interstitial macrophages (IMs) derived from monocytes play a pivotal role by producing thrombospondin-1 (TSP-1), which in turn activates TGF-β, thereby driving the pathology of PH. Resident and recruited IM subpopulations have recently been identified. We hypothesized that in Schistosoma-PH, one IM subpopulation expresses monocyte recruitment factors, whereas recruited monocytes become a separate IM subpopulation that expresses TSP-1. Methods Mice were intraperitoneally sensitized and then intravenously challenged with S. mansoni eggs. Flow cytometry on lungs and blood was performed on wildtype and reporter mice to identify IM subpopulations and protein expression. Single-cell RNA sequencing (scRNAseq) was performed on flow-sorted IMs from unexposed and at day 1, 3 and 7 following Schistosoma exposure to complement flow cytometry based IM characterization and identify gene expression. Results Flow cytometry and scRNAseq both identified 3 IM subpopulations, characterized by CCR2, MHCII, and FOLR2 expression. Following Schistosoma exposure, the CCR2+ IM subpopulation expanded, suggestive of circulating monocyte recruitment. Schistosoma exposure caused increased monocyte-recruitment ligand CCL2 expression in the resident FOLR2+ IM subpopulation. In contrast, the vascular pathology-driving protein TSP-1 was greatest in the CCR2+ IM subpopulation. Conclusion Schistosoma-induced PH involves crosstalk between IM subpopulations, with increased expression of monocyte recruitment ligands by resident FOLR2+ IMs, and the recruitment of CCR2+ IMs which express TSP-1 that activates TGF-β and causes PH.
Collapse
Affiliation(s)
- Rahul Kumar
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Sushil Kumar
- Department of Pediatrics and Cardiovascular Pulmonary Research Laboratory, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Claudia Mickael
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Dara Fonseca Balladares
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Kevin Nolan
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Michael H. Lee
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Linda Sanders
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Julia Nilsson
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Ari B. Molofsky
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Rubin M. Tuder
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Kurt R. Stenmark
- Department of Pediatrics and Cardiovascular Pulmonary Research Laboratory, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Brian B. Graham
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| |
Collapse
|
2
|
Bobrovski VG, Pinheiro AL, de-Castro JAL, Rech EB, Zacarkim EV, Dos-S-Reis ES, Eger I. Schistosomiasis: A neglected cause of pulmonary arterial hypertension in Brazil. Curr Probl Cardiol 2024; 49:102340. [PMID: 38103813 DOI: 10.1016/j.cpcardiol.2023.102340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Abstract
Schistosomiasis is a prevalent disease in Brazil whose etiological agent is Schistosoma mansoni, the main species associated with pulmonary arterial hypertension (PAH), a serious complication. It is estimated that this complication affects up to 15% of patients with the hepatosplenic form of the disease. Despite being an endemic country, Brazil does not have a screening scheme for cases of PAH associated with schistosomiasis (PAH-Sch), nor protocols for notification and treatment of this vascular complication. The objectives of this literature review are to gather knowledge about the pathophysiology, clinical manifestations, diagnosis and treatment of PAH-Sch and to highlight relevant aspects for the Brazilian reality. The pathophysiology, although lacking information, has proliferative vasculopathy as a central element. The clinical presentation of this disease can be asymptomatic or with nonspecific manifestations. Thus, complementary exams are essential for a confirmatory diagnosis, the gold standard being right heart catheterization, a scarce resource in endemic regions of the country. The treatment of PAH-Sch is similar to that performed for other causes of PAH, but the impact of anthelmintic therapy on the evolution of the vascular pathology is unknown. Therefore, Brazil needs to develop a screening plan for early diagnosis of PAH-Sch and new studies should be carried out to determine a more specific treatment.
Collapse
Affiliation(s)
- Vinícius G Bobrovski
- Department of Medicine, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Ponta Grossa, Paraná 84030-900, Brazil.
| | - Alisson L Pinheiro
- Department of Medicine, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Ponta Grossa, Paraná 84030-900, Brazil
| | - João A L de-Castro
- Department of Medicine, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Ponta Grossa, Paraná 84030-900, Brazil
| | - Eduardo B Rech
- Department of Medicine, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Ponta Grossa, Paraná 84030-900, Brazil
| | - Ezequiel V Zacarkim
- Department of General Biology, State University of Ponta Grossa, Paraná, Brazil
| | - Elise S Dos-S-Reis
- Department of Medicine, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Ponta Grossa, Paraná 84030-900, Brazil
| | - Iriane Eger
- Department of General Biology, State University of Ponta Grossa, Paraná, Brazil
| |
Collapse
|
3
|
Suswał K, Tomaszewski M, Romaniuk A, Świechowska-Starek P, Zygmunt W, Styczeń A, Romaniuk-Suswał M. Gut-Lung Axis in Focus: Deciphering the Impact of Gut Microbiota on Pulmonary Arterial Hypertension. J Pers Med 2023; 14:8. [PMID: 38276223 PMCID: PMC10817474 DOI: 10.3390/jpm14010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
Recent advancements in the understanding of pulmonary arterial hypertension (PAH) have highlighted the significant role of the gut microbiota (GM) in its pathogenesis. This comprehensive review delves into the intricate relationship between the GM and PAH, emphasizing the influence of gut microbial composition and the critical metabolites produced. We particularly focus on the dynamic interaction between the gut and lung, examining how microbial dysbiosis contributes to PAH development through inflammation, altered immune responses, and changes in the gut-lung axis. Noteworthy findings include variations in the ratios of key bacterial groups such as Firmicutes and Bacteroidetes in PAH and the pivotal roles of metabolites like trimethylamine N-oxide (TMAO), short-chain fatty acids (SCFAs), and serotonin in the disease's progression. Additionally, the review elucidates potential diagnostic biomarkers and novel therapeutic approaches, including the use of probiotics and fecal microbiota transplantation, which leverage the gut microbiota for managing PAH. This review encapsulates the current state of research in this field, offering insights into the potential of gut microbiota modulation as a promising strategy in PAH diagnosing and treatment.
Collapse
Affiliation(s)
- Konrad Suswał
- Department of Pulmonology, Alergollogy and Oncology, Medical University of Lublin, 20-954 Lublin, Poland;
| | - Michał Tomaszewski
- Department of Cardiology, Medical University of Lublin, 20-954 Lublin, Poland;
| | - Aleksandra Romaniuk
- Cardiology Student Scientific Circle, Academy of Silesia, 40-555 Katowice, Poland;
| | | | - Wojciech Zygmunt
- Department of Pulmonology, Alergollogy and Oncology, Medical University of Lublin, 20-954 Lublin, Poland;
| | - Agnieszka Styczeń
- Department of Cardiology, Medical University of Lublin, 20-954 Lublin, Poland;
| | - Małgorzata Romaniuk-Suswał
- Department of Psychiatry, Psychotheraphy and Early Intervention, Medical University of Lublin, 20-954 Lublin, Poland
| |
Collapse
|