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Zhang H, Liu Y, Yan L, Du W, Zhang X, Zhang M, Chen H, Zhang Y, Zhou J, Sun H, Zhu D. Bone morphogenetic protein-7 inhibits endothelial-mesenchymal transition in pulmonary artery endothelial cell under hypoxia. J Cell Physiol 2017; 233:4077-4090. [PMID: 28926108 DOI: 10.1002/jcp.26195] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/14/2017] [Indexed: 12/11/2022]
Abstract
Pulmonary artery hypertension (PAH) is characterized by structural changes in pulmonary arteries. Increased numbers of cells expressing α-smooth muscle actin (α-SMA) is a nearly universal finding in the remodeled artery. It has been confirmed endothelial-to-mesenchymal transition (EndoMT) may be a source of those α-SMA-expressing cells. In addition, the EndoMT is reversible. Here, we show that under hypoxia, the expression of bone morphogenetic protein 7 (BMP-7) was decreased both in vivo and in vitro. We also found that under normoxia, BMP-7 deficiency induced spontaneous EndoMT and cell migration. The hypoxia-induced EndoMT and cell migration were markedly attenuated after pretreatment with rh-BMP-7. Moreover, m-TOR phosphorylation was involved in EndoMT and BMP-7 suppressed hypoxia-induced m-TORC1 phosphorylation in pulmonary artery endothelial cells. Our results demonstrate that BMP-7 attenuates the hypoxia-induced EndoMT and cell migration by suppressing the m-TORC1 signaling pathway. Our study revealed a novel mechanism underlying the hypoxia-induced EndoMT in pulmonary artery endothelial cells and suggested a new therapeutic strategy targeting EndoMT for the treatment of pulmonary arterial hypertension.
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Affiliation(s)
- Hongyue Zhang
- Department of Biopharmaceutical Sciences, Harbin Medical University-Daqing, Daqing, Heilongjiang, China.,Biopharmaceutical Key Laboratory of Heilongjiang Province, Harbin Medical University, China
| | - Ying Liu
- Department of Biopharmaceutical Sciences, Harbin Medical University-Daqing, Daqing, Heilongjiang, China.,Biopharmaceutical Key Laboratory of Heilongjiang Province, Harbin Medical University, China
| | - Lixin Yan
- Department of Biopharmaceutical Sciences, Harbin Medical University-Daqing, Daqing, Heilongjiang, China.,Biopharmaceutical Key Laboratory of Heilongjiang Province, Harbin Medical University, China
| | - Wei Du
- School of Pharmacy, Harbin University of Commerce, Harbin, Heilongjiang Province, China
| | - Xiaodan Zhang
- School of Pharmacy, Harbin University of Commerce, Harbin, Heilongjiang Province, China
| | - Min Zhang
- Department of Biopharmaceutical Sciences, Harbin Medical University-Daqing, Daqing, Heilongjiang, China.,Biopharmaceutical Key Laboratory of Heilongjiang Province, Harbin Medical University, China
| | - He Chen
- Department of Obstetrics and gynecology, The Second affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yafeng Zhang
- School of Basic Medical Sciences, Harbin Medical University-Daqing, Daqing, Heilongjiang Province, China
| | - Jianqiu Zhou
- School of Basic Medical Sciences, Harbin Medical University-Daqing, Daqing, Heilongjiang Province, China
| | - Hanliang Sun
- Medical Laboratory Technology, Harbin Medical University-Daqing, Daqing, Heilongjiang Province, China
| | - Daling Zhu
- Department of Biopharmaceutical Sciences, Harbin Medical University-Daqing, Daqing, Heilongjiang, China.,Biopharmaceutical Key Laboratory of Heilongjiang Province, Harbin Medical University, China
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(1)H NMR-Based Analysis of Serum Metabolites in Monocrotaline-Induced Pulmonary Arterial Hypertensive Rats. DISEASE MARKERS 2016; 2016:5803031. [PMID: 27057080 PMCID: PMC4745193 DOI: 10.1155/2016/5803031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 12/07/2015] [Indexed: 01/18/2023]
Abstract
AIMS To study the changes of the metabolic profile during the pathogenesis in monocrotaline (MCT) induced pulmonary arterial hypertension (PAH). METHODS Forty male Sprague-Dawley (SD) rats were randomly divided into 5 groups (n = 8, each). PAH rats were induced by a single dose intraperitoneal injection of 60 mg/kg MCT, while 8 rats given intraperitoneal injection of 1 ml normal saline and scarified in the same day (W0) served as control. Mean pulmonary arterial pressure (mPAP) was measured through catherization. The degree of right ventricular hypertrophy and pulmonary hyperplasia were determined at the end of first to fourth weeks; nuclear magnetic resonance (NMR) spectra of sera were then acquired for the analysis of metabolites. Principal component analysis (PCA) and orthogonal partial least-squares discriminant analysis (OPLS-DA) were used to discriminate different metabolic profiles. RESULTS The prominent changes of metabolic profiles were seen during these four weeks. Twenty specific metabolites were identified, which were mainly involved in lipid metabolism, glycolysis, energy metabolism, ketogenesis, and methionine metabolism. Profiles of correlation between these metabolites in each stage changed markedly, especially in the fourth week. Highly activated methionine and betaine metabolism pathways were selected by the pathway enrichment analysis. CONCLUSIONS Metabolic dysfunction is involved in the development and progression of PAH.
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Bruce E, Shenoy V, Rathinasabapathy A, Espejo A, Horowitz A, Oswalt A, Francis J, Nair A, Unger T, Raizada MK, Steckelings UM, Sumners C, Katovich MJ. Selective activation of angiotensin AT2 receptors attenuates progression of pulmonary hypertension and inhibits cardiopulmonary fibrosis. Br J Pharmacol 2015; 172:2219-31. [PMID: 25522140 DOI: 10.1111/bph.13044] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/28/2014] [Accepted: 12/03/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND PURPOSE Pulmonary hypertension (PH) is a devastating disease characterized by increased pulmonary arterial pressure, which progressively leads to right-heart failure and death. A dys-regulated renin angiotensin system (RAS) has been implicated in the development and progression of PH. However, the role of the angiotensin AT2 receptor in PH has not been fully elucidated. We have taken advantage of a recently identified non-peptide AT2 receptor agonist, Compound 21 (C21), to investigate its effects on the well-established monocrotaline (MCT) rat model of PH. EXPERIMENTAL APPROACH A single s.c. injection of MCT (50 mg·kg(-1) ) was used to induce PH in 8-week-old male Sprague Dawley rats. After 2 weeks of MCT administration, a subset of animals began receiving either 0.03 mg·kg(-1) C21, 3 mg·kg(-1) PD-123319 or 0.5 mg·kg(-1) A779 for an additional 2 weeks, after which right ventricular haemodynamic parameters were measured and tissues were collected for gene expression and histological analyses. KEY RESULTS Initiation of C21 treatment significantly attenuated much of the pathophysiology associated with MCT-induced PH. Most notably, C21 reversed pulmonary fibrosis and prevented right ventricular fibrosis. These beneficial effects were associated with improvement in right heart function, decreased pulmonary vessel wall thickness, reduced pro-inflammatory cytokines and favourable modulation of the lung RAS. Conversely, co-administration of the AT2 receptor antagonist, PD-123319, or the Mas antagonist, A779, abolished the protective actions of C21. CONCLUSIONS AND IMPLICATIONS Taken together, our results suggest that the AT2 receptor agonist, C21, may hold promise for patients with PH.
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Affiliation(s)
- E Bruce
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA
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4
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Ivarsson B, Ekmehag B, Hesselstrand R, Rådegran G, Sjöberg T. Perceptions of received information, social support, and coping in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. CLINICAL MEDICINE INSIGHTS-CIRCULATORY RESPIRATORY AND PULMONARY MEDICINE 2014; 8:21-8. [PMID: 25374462 PMCID: PMC4213136 DOI: 10.4137/ccrpm.s18586] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 08/17/2014] [Accepted: 08/25/2014] [Indexed: 01/25/2023]
Abstract
Patients with a life-limiting diagnosis of pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) need disease-specific information, ability to cope, and functioning social networks. This cohort study investigated the experiences of PAH and CTEPH patients who received information about their diagnosis, treatment, and management, in addition to coping and social support. Sixty-eight adult patients (mean ± SD, age 67 ± 14; 66% women) were included. A total of 54% of the patients wanted more information. Patients received information mostly in areas concerning medical test procedures, the diagnosis, disease severity, possible disease causes, and how to manage their disease. Coping ability was significantly better in patients who were satisfied with the received information (P = 0.0045). The information given to PAH or CTEPH patients and their communication with healthcare professionals can be greatly improved. Gaps in information and misunderstandings can be avoided by working in cooperation with the patients, their relatives, and within the PAH team.
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Affiliation(s)
- Bodil Ivarsson
- Department of Cardiothoracic Surgery, Clinical Sciences, Lund University, Lund, Sweden. ; The clinic for Cardiothoracic Surgery, Skåne University Hospital, Lund, Sweden. ; Medical Services, University Healthcare, Skåne, Sweden
| | - Björn Ekmehag
- Department of Public Health and Caring Science, Uppsala University, and Uppsala University Hospital, Uppsala, Sweden
| | - Roger Hesselstrand
- Department of Rheumatology, Clinical Sciences, Lund University, Lund, Sweden. ; The clinic for Rheumatology, Skåne University Hospital, Lund, Sweden
| | - Göran Rådegran
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden. ; The Section for Heart Failure and Valvular Disease, Skåne University Hospital, Lund, Sweden
| | - Trygve Sjöberg
- Department of Cardiothoracic Surgery, Clinical Sciences, Lund University, Lund, Sweden. ; The clinic for Cardiothoracic Surgery, Skåne University Hospital, Lund, Sweden
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5
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Ramiro-Diaz JM, Nitta CH, Maston LD, Codianni S, Giermakowska W, Resta TC, Gonzalez Bosc LV. NFAT is required for spontaneous pulmonary hypertension in superoxide dismutase 1 knockout mice. Am J Physiol Lung Cell Mol Physiol 2013; 304:L613-25. [PMID: 23475768 PMCID: PMC3652021 DOI: 10.1152/ajplung.00408.2012] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 03/04/2013] [Indexed: 01/29/2023] Open
Abstract
Elevated reactive oxygen species are implicated in pulmonary hypertension (PH). Superoxide dismutase (SOD) limits superoxide bioavailability, and decreased SOD activity is associated with PH. A decrease in SOD activity is expected to increase superoxide and reduce hydrogen peroxide levels. Such an imbalance of superoxide/hydrogen peroxide has been implicated as a mediator of nuclear factor of activated T cells (NFAT) activation in epidermal cells. We have shown that NFATc3 is required for chronic hypoxia-induced PH. However, it is unknown whether NFATc3 is activated in the pulmonary circulation in a mouse model of decreased SOD1 activity and whether this leads to PH. Therefore, we hypothesized that an elevated pulmonary arterial superoxide/hydrogen peroxide ratio activates NFATc3, leading to PH. We found that SOD1 knockout (KO) mice have elevated pulmonary arterial wall superoxide and decreased hydrogen peroxide levels compared with wild-type (WT) littermates. Right ventricular systolic pressure (RVSP) was elevated in SOD1 KO and was associated with pulmonary arterial remodeling. Vasoreactivity to endothelin-1 was also greater in SOD1 KO vs. WT mice. NFAT activity and NFATc3 nuclear localization were increased in pulmonary arteries from SOD1 KO vs. WT mice. Administration of A-285222 (selective NFAT inhibitor) decreased RVSP, arterial wall thickness, vasoreactivity, and NFAT activity in SOD1 KO mice to WT levels. The SOD mimetic, tempol, also reduced NFAT activity, NFATc3 nuclear localization, and RVSP to WT levels. These findings suggest that an elevated superoxide/hydrogen peroxide ratio activates NFAT in pulmonary arteries, which induces vascular remodeling and increases vascular reactivity leading to PH.
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Affiliation(s)
- Juan Manuel Ramiro-Diaz
- Vascular Physiology Group, Department of Cell Biology and Physiology, School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA
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6
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Abstract
Cell therapy is based on the replacement of damaged cells in order to restore injured tissues. The first consideration is that an abundant source of cells is needed; second, these cells should be immunologically compatible with the guest and third, there should be no real threat of these cells undergoing malignant transformation in the future. Given these requirements, already differentiated adult cells or adult stem cells obtained from the body of the patient appear to be the ideal candidates to meet all of these demands. The utilization of somatic cells also avoids numerous ethical and political drawbacks and concerns. Transdifferentiation is the phenomenon by which an adult differentiated cell switches to another differentiated cell. This paper reviews the importance of transdifferentiation, discussing the cells that are suitable for this process and the methods currently employed to induce the change in cell type.
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Jie W, Wang X, Huang L, Guo J, Kuang D, Zhu P, Li M, Zhao X, Duan Y, Wang G, Ao Q. Contribution of CXCR4(+)/PDGFRbeta(+) progenitor cells in hypoxic alveolar arterioles muscularization: role of myocardin. Cardiovasc Res 2010; 87:740-50. [PMID: 20484220 DOI: 10.1093/cvr/cvq147] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
AIMS Bone marrow (BM) progenitor cells may contribute to vascular remodelling. The present study aimed to investigate the contribution of BM-derived CXCR4(+) (a CXC chemokine receptor) and PDGFRbeta(+) (platelet-derived growth factor receptor beta) progenitor cells in hypoxia-induced muscularization of alveolar arterioles. METHODS AND RESULTS Accumulation of GFP(+) (green fluorescent protein) cells was markedly increased in the pulmonary vasculature by the hypoxic (10% O(2,) 4 weeks) chimeric mice with transgenic GFP-tagged BM. After injection of BM-derived CXCR4(+)/PDGFRbeta(+) progenitor cells into C57BL/6J mice, followed by 6-week hypoxia, the cells were found to home to the alveolar arterioles and readily differentiated into smooth muscle cells (SMCs). Under the same hypoxic conditions, mice infused with myocardin lentiviral RNAi vector-transduced progenitor cells displayed lower myocardin expression in the muscularized alveolar arterioles, correlating with decreased pulmonary artery pressure and arteriole muscularization. In vitro experiments further confirmed that the differentiation of the progenitor cells into SMCs occurred under hypoxia (1% O(2)), and SMC differentiation could be suppressed when myocardin RNAi was administered. CONCLUSION Theses results suggest that myocardin may contribute to the differentiation of CXCR4(+)/PDGFRbeta(+) progenitor cells into SMCs induced by hypoxia, which leads to the muscularization of alveolar arterioles.
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Affiliation(s)
- Wei Jie
- Institute of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Da Dao, Wuhan 430030, PR China
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Abstract
Major advances have been made in the understanding and treatment of pulmonary hypertension in the last few years. Without treatment (medication) for idiopathic pulmonary arterial hypertension, which is a rare and potentially fatal condition, the survival time is only about 3 years after diagnosis. However, if pulmonary hypertension is secondary to other causes such as congenital heart disease, it is possible to survive for 30 years or more without treatment. The condition can affect children at any age, from fetal life to adulthood. Patients with pulmonary hypertension can present to the respiratory pediatrician with unresponsive asthma, to the neurologist with faints, or to the general pediatrician with failure to thrive. Over the last few years there have been significant developments in the available therapy for managing this complicated disease. There is now a generally recognized ladder of long-term therapy for chronic pulmonary hypertension. Treatment can start with oxygen at home at night or even during the day. Next is the use of oral phosphodiesterase inhibitors, mostly type V, such as sildenafil, which enhance endogenous nitric oxide. More potent are the endothelin receptor antagonists and the most potent are the prostanoids, especially epoprostenol, which is given by constant intravenous infusion. In addition to interventional catheterization with atrial septostomy, these agents have improved the prognostic outlook. This article reviews the current knowledge about the etiology, investigation, and treatment of children with pulmonary hypertension in the clinical setting.
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Affiliation(s)
- Robert Tulloh
- Department of Congenital Heart Disease, Bristol Royal Hospital for Children and Bristol Royal Infirmary, Bristol, England.
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Hawkins A, Tulloh R. Treatment of pediatric pulmonary hypertension. Vasc Health Risk Manag 2009; 5:509-24. [PMID: 19554091 PMCID: PMC2697585 DOI: 10.2147/vhrm.s4171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Indexed: 12/04/2022] Open
Abstract
Pulmonary hypertension was once thought to be a rare condition and only managed in specialized centers. Now however, with the advent of echocardiography, it is found in many clinical scenarios, in the neonate with chronic lung disease, in the acute setting in the intensive care unit, in connective tissue disease and in cardiology pre- and postoperatively. We have a better understanding of the pathological process and have a range of medication which is starting to be able to palliate this previously fatal condition. This review describes the areas that are known in this condition and those that are less familiar. The basic physiology behind pulmonary hypertension and pulmonary vascular disease is explained. The histopathologic process and the various diagnostic tools are described and are followed by the current and future therapy at our disposal.
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Affiliation(s)
- Amy Hawkins
- Department of Congenital Heart Disease, Bristol Royal Hospital for Children, Bristol BS2 8BJ, UK
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10
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Dickinson MG, Schölvinck EH, Boonstra A, Vonk-Noordegraaf A, Snijder RJ, Berger RM. Low Complication Rates With Totally Implantable Access Port Use in Epoprostenol Treatment of Pulmonary Hypertension. J Heart Lung Transplant 2009; 28:273-9. [DOI: 10.1016/j.healun.2008.11.913] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Revised: 09/19/2008] [Accepted: 11/19/2008] [Indexed: 11/15/2022] Open
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Olson TP, Frantz RP, Turner ST, Bailey KR, Wood CM, Johnson BD. Gene Variant of the Bradykinin B2 Receptor Influences Pulmonary Arterial Pressures in Heart Failure Patients. CLINICAL MEDICINE. CIRCULATORY, RESPIRATORY AND PULMONARY MEDICINE 2009. [DOI: 10.4137/ccrpm.s2147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background Pulmonary arterial pressure (PAP) varies considerably in heart failure (HF) despite similar degrees of left ventricular (LV) dysfunction. Bradykinin alters vascular tone and common variations in the kinin B2 receptor (BDKRB2) gene exists. We hypothesized that genetic variation in this receptor would influence PAP in HF. Methods 131 HF patients (>1yr history systolic HF), without COPD, not currently smoking, BMI < 40, without atrial fibrillation completed the study which included a blood draw for genotyping and neurohormones (ACE, A-II, Bradykinin, ANP, BNP, and catecholamines), an echocardiogram for cardiac function and systolic PAP (PAPsys). Results Mean LVEF was 29% ∓ 12%, NYHA class 2 ∓ 1, age 56 ∓ 12 yr, BMI 28 ∓ 5 kg/m2. Forty-six patients (35%) were homozygous for the +9 allele, 58 (44%) were heterozygous (+9/-9) and 27 (21%) were homozygous for the -9 allele of the BDKRB2. PAPsys averaged 42 ∓ 13, 38 ∓ 12, and 35 ∓ 11 mmHg for +9/+9, +9/-9 and -9/-9, respectively (p = 0.03). There was a trend towards gene effect for plasma ACE with the highest values in +9/+9 and lowest in -9/-9 patients (9.5 ∓ 10.7, 7.1 ∓ 8.7, and 5.4 ∓ 6.4 U/L, respectively, p = 0.06). There were no differences in plasma bradykinin or A-II, LVEF, or NYHA across genotypes. Conclusion These data suggest the +9/+9 polymorphism of the BDKRB2 receptor influences pulmonary vascular tone in stable HF.
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13
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de Frutos S, Spangler R, Alò D, Bosc LVG. NFATc3 mediates chronic hypoxia-induced pulmonary arterial remodeling with alpha-actin up-regulation. J Biol Chem 2007; 282:15081-9. [PMID: 17403661 PMCID: PMC2754407 DOI: 10.1074/jbc.m702679200] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Physiological responses to chronic hypoxia include polycythemia, pulmonary arterial remodeling, and vasoconstriction. Chronic hypoxia causes pulmonary arterial hypertension leading to right ventricular hypertrophy and heart failure. During pulmonary hypertension, pulmonary arteries exhibit increased expression of smooth muscle-alpha-actin and -myosin heavy chain. NFATc3 (nuclear factor of activated T cells isoform c3), which is aCa(2+)-dependent transcription factor, has been recently linked to smooth muscle phenotypic maintenance through the regulation of the expression of alpha-actin. The aim of this study was to determine if: (a) NFATc3 is expressed in murine pulmonary arteries, (b) hypoxia induces NFAT activation, (c) NFATc3 mediates the up-regulation of alpha-actin during chronic hypoxia, and (d) NFATc3 is involved in chronic hypoxia-induced pulmonary vascular remodeling. NFATc3 transcript and protein were found in pulmonary arteries. NFAT-luciferase reporter mice were exposed to normoxia (630 torr) or hypoxia (380 torr) for 2, 7, or 21 days. Exposure to hypoxia elicited a significant increase in luciferase activity and pulmonary arterial smooth muscle nuclear NFATc3 localization, demonstrating NFAT activation. Hypoxia induced up-regulation of alpha-actin and was prevented by the calcineurin/NFAT inhibitor, cyclosporin A (25 mg/kg/day s.c.). In addition, NFATc3 knock-out mice did not showed increased alpha-actin levels and arterial wall thickness after hypoxia. These results strongly suggest that NFATc3 plays a role in the chronic hypoxia-induced vascular changes that underlie pulmonary hypertension.
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MESH Headings
- Actins/biosynthesis
- Actins/genetics
- Active Transport, Cell Nucleus/drug effects
- Active Transport, Cell Nucleus/genetics
- Animals
- Calcineurin/metabolism
- Calcineurin Inhibitors
- Cardiomyopathy, Hypertrophic/genetics
- Cardiomyopathy, Hypertrophic/metabolism
- Cardiomyopathy, Hypertrophic/pathology
- Cardiomyopathy, Hypertrophic/physiopathology
- Cell Nucleus/metabolism
- Chronic Disease
- Cyclosporine/pharmacology
- Enzyme Inhibitors/pharmacology
- Hypertension, Pulmonary/genetics
- Hypertension, Pulmonary/metabolism
- Hypertension, Pulmonary/pathology
- Hypertension, Pulmonary/physiopathology
- Hypoxia/genetics
- Hypoxia/metabolism
- Hypoxia/pathology
- Hypoxia/physiopathology
- Male
- Mice
- Mice, Inbred BALB C
- Mice, Knockout
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- NFATC Transcription Factors/antagonists & inhibitors
- NFATC Transcription Factors/deficiency
- NFATC Transcription Factors/metabolism
- Polycythemia/genetics
- Polycythemia/metabolism
- Polycythemia/pathology
- Polycythemia/physiopathology
- Pulmonary Artery/metabolism
- Pulmonary Artery/pathology
- Pulmonary Artery/physiopathology
- Up-Regulation/drug effects
- Up-Regulation/genetics
- Vasoconstriction/drug effects
- Vasoconstriction/genetics
- Ventricular Remodeling/drug effects
- Ventricular Remodeling/genetics
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Affiliation(s)
- Sergio de Frutos
- Department of Cell Biology and Physiology, School of Medicine, University of New Mexico, Albuquerque, New Mexico 87131, USA
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14
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Olson TP, Snyder EM, Frantz RP, Turner ST, Johnson BD. Repeat length polymorphism of the serotonin transporter gene influences pulmonary artery pressure in heart failure. Am Heart J 2007; 153:426-32. [PMID: 17307423 DOI: 10.1016/j.ahj.2006.12.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2006] [Accepted: 12/17/2006] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pulmonary hypertension is common in patients with heart failure (HF); however, for a given degree of left ventricular dysfunction, the range in pulmonary artery pressures (PAPs) is large. Polymorphisms of the serotonin transporter (5-HTT) gene have been implicated in contributing to smooth muscle dysfunction and remodeling of the pulmonary vasculature. This study examined the influence of a repeat length polymorphism in the promoter region of the 5-HTT gene on PAP between patients with HF and healthy control participants. METHODS A total of 90 patients with HF (age, 55 +/- 14 years; left ventricular ejection fraction, 28% +/- 10%; New York Heart Association, 2.0 +/- 0.9) and 90 age- and sex-matched controls (CTL) (age, 51 +/- 15 years; left ventricular ejection fraction, 63% +/- 7%) were recruited. Patients with HF and CTL participants were divided into 3 genotype groups: homozygotes for the short variant (SS), homozygotes for the long variant (LL), and heterozygotes (LS). For both HF and CTL, there are 20 patients in the SS group, 41 in the LS, and 29 in the LL. Pulmonary artery pressure was calculated from the tricuspid regurgitant velocity. RESULTS Age and sex did not differ between the HF and CTL groups. Pulmonary artery pressure was higher in HF patients compared with CTL (38.9 +/- 12.5 vs 27.7 +/- 8.2 mm Hg, respectively; P < .01). There was a significant interaction between the HF and CTL groups for PAP by genotype (P < .03), with a significant genotype effect in HF (SS = 34.2 +/- 8.6 vs LL = 43.2 +/- 15.2 mm Hg; P < .05) but not in CTL. The HF group also demonstrated elevated left atrial diameter compared with CTL (48.0 +/- 8.7 vs 32.8 +/- 4.8 mm, respectively; P < .01), although no significant genotype difference was seen within either group. CONCLUSION These results suggest that the LL variant of the 5-HTT is associated with elevated PAP in patients with HF.
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Affiliation(s)
- Thomas P Olson
- Mayo Clinic, College of Medicine, Rochester, MN 55905, USA
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15
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Zhu P, Huang L, Ge X, Yan F, Wu R, Ao Q. Transdifferentiation of pulmonary arteriolar endothelial cells into smooth muscle-like cells regulated by myocardin involved in hypoxia-induced pulmonary vascular remodelling. Int J Exp Pathol 2007; 87:463-74. [PMID: 17222214 PMCID: PMC2517388 DOI: 10.1111/j.1365-2613.2006.00503.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Myocardin gene has been identified as a master regulator of smooth muscle cell differentiation. Smooth muscle cells play a critical role in the pathogenesis of hypoxia-induced pulmonary hypertension (PH) and pulmonary vascular remodelling (PVR). The purpose of this study was to investigate the change of myocardin gene expression in the pulmonary vessels of hypoxia-induced PH affected by Sildenafil treatment and the involvement of endothelial cells transdifferentiation into smooth muscle cells in the process of hypoxia-induced PH and PVR. Myocardin and relative markers were investigated in animal models and cultured endothelial cells. Mean pulmonary artery pressure (mPAP) was measured. Immunohistochemistry and immunofluorescence were used to show the expression of smooth muscle alpha-actin (SMA), in situ hybridization (ISH) and reverse transcription polymerase chain reaction (RT-PCR) were performed respectively to detect the myocardin and SMA expression at mRNA levels. Small interfering RNA (siRNA) induced suppression of myocardin in cultured cells. We confirmed that hypoxia induced the PH and PVR in rats. Sildenafil could attenuate the hypoxia-induced PH. We found that myocardin mRNA expression is upregulated significantly in the hypoxic pulmonary vessels and cultured cells but downregulated in PH with Sildenafil treatment. The porcine pulmonary artery endothelial cells (PAECs) transdifferentiate into smooth muscle-like cells in hypoxic culture while the transdifferentiation did not occur when SiRNA of myocardin was applied. Our results suggest that myocardin gene, as a marker of smooth muscle cell differentiation, was expressed in the pulmonary vessels in hypoxia-induced PH rats, which could be downregulated by Sildenafil treatment, as well as in hypoxic cultured endothelial cells. Hypoxia induced the transdifferentiation of endothelial cells of vessels into smooth muscle-like cells which was regulated by myocardin.
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MESH Headings
- Actins/analysis
- Actins/genetics
- Animals
- Arterioles
- Biomarkers/analysis
- Cell Differentiation
- Cells, Cultured
- Endothelial Cells/metabolism
- Endothelial Cells/pathology
- Gene Expression Regulation
- Hypertension, Pulmonary/drug therapy
- Hypertension, Pulmonary/metabolism
- Hypertension, Pulmonary/pathology
- Hypoxia/genetics
- Hypoxia/metabolism
- Immunohistochemistry/methods
- Male
- Models, Animal
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- Nuclear Proteins/genetics
- Nuclear Proteins/metabolism
- Piperazines/therapeutic use
- Pulmonary Artery/metabolism
- Pulmonary Artery/pathology
- Purines
- RNA Interference
- Rats
- Rats, Sprague-Dawley
- Reverse Transcriptase Polymerase Chain Reaction
- Sildenafil Citrate
- Sulfones
- Trans-Activators/genetics
- Trans-Activators/metabolism
- Vasodilator Agents/therapeutic use
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Affiliation(s)
- Pengcheng Zhu
- Department of Pathology, Tongji Medical College, Huazhong University of Science and TechnologyWuhan City, China
- Key Laboratory of Pulmonary Diseases, Ministry of Health of ChinaWuhan City, China
| | - Lei Huang
- Department of Gynaecology and Obstetrics, The Central Hospital of WuhanWuhan City, China
| | - Xiaona Ge
- Department of Pathology, Tongji Medical College, Huazhong University of Science and TechnologyWuhan City, China
- Key Laboratory of Pulmonary Diseases, Ministry of Health of ChinaWuhan City, China
| | - Fei Yan
- Department of Internal Medicine, Zhongshan Hospital of Hubei ProvinceWuhan City, China
| | - Renliang Wu
- Department of Pathology, Tongji Medical College, Huazhong University of Science and TechnologyWuhan City, China
- Key Laboratory of Pulmonary Diseases, Ministry of Health of ChinaWuhan City, China
| | - Qilin Ao
- Department of Pathology, Tongji Medical College, Huazhong University of Science and TechnologyWuhan City, China
- Key Laboratory of Pulmonary Diseases, Ministry of Health of ChinaWuhan City, China
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Abstract
Idiopathic pulmonary arterial hypertension is a rare and potentially fatal condition. Without treatment, survival is only approximately 2.8 years from diagnosis. However, if the pulmonary hypertension is secondary to other causes, especially to congenital heart disease, it is possible to survive for 30 years or more without treatment. In recent years, remarkable progress has been made, risk factors have been identified and improved imaging techniques, including echocardiography, computer tomography and magnetic resonance imaging, are available. The condition can affect children at any age from fetal life through to adulthood. Patients can present to the respiratory pediatrician with unresponsive asthma, to the neurologist with faints or to the general pediatrician with failure to thrive. Over the last few years there have been significant developments in the available therapy for managing this complicated disease, which have improved the prognostic outlook, such as oral bosentan and sildenafil, intravenous epoprostenol and interventional catheterization with atrial septostomy. This article reviews the current knowledge about causation, investigation and treatment of children with pulmonary hypertension in the clinical setting.
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Affiliation(s)
- Robert Tulloh
- Department of Congenital Heart Disease, Bristol Royal Hospital for Children and Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8BJ, UK.
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