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van der Have O, Mead TJ, Westöö C, Peruzzi N, Mutgan AC, Norvik C, Bech M, Struglics A, Hoetzenecker K, Brunnström H, Westergren‐Thorsson G, Kwapiszewska G, Apte SS, Tran‐Lundmark K. Aggrecan accumulates at sites of increased pulmonary arterial pressure in idiopathic pulmonary arterial hypertension. Pulm Circ 2023; 13:e12200. [PMID: 36824691 PMCID: PMC9941846 DOI: 10.1002/pul2.12200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Expansion of extracellular matrix occurs in all stages of pulmonary angiopathy associated with pulmonary arterial hypertension (PAH). In systemic arteries, dysregulation and accumulation of the large chondroitin-sulfate proteoglycan aggrecan is associated with swelling and disruption of vessel wall homeostasis. Whether aggrecan is present in pulmonary arteries, and its potential roles in PAH, has not been thoroughly investigated. Here, lung tissue from 11 patients with idiopathic PAH was imaged using synchrotron radiation phase-contrast microcomputed tomography (TOMCAT beamline, Swiss Light Source). Immunohistochemistry for aggrecan core protein in subsequently sectioned lung tissue demonstrated accumulation in PAH compared with failed donor lung controls. RNAscope in situ hybridization indicated ACAN expression in vascular endothelium and smooth muscle cells. Based on qualitative histological analysis, aggrecan localizes to cellular, rather than fibrotic or collagenous, lesions. Interestingly, ADAMTS15, a potential aggrecanase, was upregulated in pulmonary arteries in PAH. Aligning traditional histological analysis with three-dimensional renderings of pulmonary arteries from synchrotron imaging identified aggrecan in lumen-reducing lesions containing loose, cell-rich connective tissue, at sites of intrapulmonary bronchopulmonary shunting, and at sites of presumed elevated pulmonary blood pressure. Our findings suggest that ACAN expression may be an early response to injury in pulmonary angiopathy and supports recent work showing that dysregulation of aggrecan turnover is a hallmark of arterial adaptations to altered hemodynamics. Whether cause or effect, aggrecan and aggrecanase regulation in PAH are potential therapeutic targets.
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Affiliation(s)
- Oscar van der Have
- Department of Experimental Medical Science, Faculty of MedicineLund UniversityLundSweden
| | - Timothy J. Mead
- Department of Biomedical EngineeringCleveland Clinic Lerner Research InstituteClevelandOhioUSA
| | - Christian Westöö
- Department of Experimental Medical Science, Faculty of MedicineLund UniversityLundSweden
| | - Niccolò Peruzzi
- Department of Experimental Medical Science, Faculty of MedicineLund UniversityLundSweden,Department of Medical Radiation Physics, Clinical Sciences LundLund UniversityLundSweden
| | - Ayse C. Mutgan
- Ludwig Boltzmann Institute for Lung Vascular ResearchGrazAustria,Division of Physiology, Otto Loewi Research CenterMedical University GrazGrazAustria
| | - Christian Norvik
- Department of Experimental Medical Science, Faculty of MedicineLund UniversityLundSweden
| | - Martin Bech
- Department of Medical Radiation Physics, Clinical Sciences LundLund UniversityLundSweden
| | - André Struglics
- Department of Clinical Sciences Lund, Orthopaedics, Faculty of MedicineLund UniversityLundSweden
| | | | - Hans Brunnström
- Department of Clinical Sciences Lund, Division of Pathology, Faculty of MedicineLund UniversityLundSweden,Department of Genetics and PathologyDivision of Laboratory MedicineLundSweden
| | - Gunilla Westergren‐Thorsson
- Department of Experimental Medical Science, Faculty of MedicineLund UniversityLundSweden,Wallenberg Center for Molecular MedicineLund UniversityLundSweden
| | - Grazyna Kwapiszewska
- Ludwig Boltzmann Institute for Lung Vascular ResearchGrazAustria,Division of Physiology, Otto Loewi Research CenterMedical University GrazGrazAustria,Institute for Lung HealthJustus Liebig UniversityGiessenGermany
| | - Suneel S. Apte
- Department of Biomedical EngineeringCleveland Clinic Lerner Research InstituteClevelandOhioUSA
| | - Karin Tran‐Lundmark
- Department of Experimental Medical Science, Faculty of MedicineLund UniversityLundSweden,Wallenberg Center for Molecular MedicineLund UniversityLundSweden,The Pediatric Heart CenterSkåne University HospitalLundSweden
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Grignola JC, Trujillo P. Proximal pulmonary arterial remodeling impairs right ventricular-arterial coupling in postcapillary pulmonary hypertension patients. J Appl Physiol (1985) 2022; 132:217-218. [PMID: 35030043 PMCID: PMC8759953 DOI: 10.1152/japplphysiol.00798.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Juan C. Grignola
- 1Department of Pathophysiology, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, and Unidad de Hipertensión Pulmonar, Hospital Maciel, Ministerio de Salud Pública, Montevideo, Uruguay
| | - Pedro Trujillo
- 2Cardiology Department, Centro Cardiovascular Universitario, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, and Unidad de Hipertensión Pulmonar, Hospital Maciel, Ministerio de Salud Pública, Montevideo, Uruguay
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Westöö C, Norvik C, Peruzzi N, van der Have O, Lovric G, Jeremiasen I, Tran PK, Mokso R, de Jesus Perez V, Brunnström H, Bech M, Galambos C, Tran-Lundmark K. Distinct types of plexiform lesions identified by synchrotron-based phase-contrast micro-CT. Am J Physiol Lung Cell Mol Physiol 2021; 321:L17-L28. [PMID: 33881927 DOI: 10.1152/ajplung.00432.2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
In pulmonary arterial hypertension, plexiform lesions are associated with severe arterial obstruction and right ventricular failure. Exploring their structure and position is crucial for understanding the interplay between hemodynamics and vascular remodeling. The aim of this research was to use synchrotron-based phase-contrast micro-CT to study the three-dimensional structure of plexiform lesions. Archived paraffin-embedded tissue samples from 14 patients with pulmonary arterial hypertension (13 idiopathic, 1 with known BMPR2-mutation) were imaged. Clinical data showed high-median PVR (12.5 WU) and mPAP (68 mmHg). Vascular lesions with more than 1 lumen were defined as plexiform. Prior radiopaque dye injection in some samples facilitated 3-D rendering. Four distinct types of plexiform lesions were identified: 1) localized within or derived from monopodial branches (supernumerary arteries), often with a connection to the vasa vasorum; 2) localized between pulmonary arteries and larger airways as a tortuous transformation of intrapulmonary bronchopulmonary anastomoses; 3) as spherical structures at unexpected abrupt ends of distal pulmonary arteries; and 4) as occluded pulmonary arteries with recanalization. By appearance and localization, types 1-2 potentially relieve pressure via the bronchial circulation, as pulmonary arteries in these patients were almost invariably occluded distally. In addition, types 1-3 were often surrounded by dilated thin-walled vessels, often connected to pulmonary veins, peribronchial vessels, or the vasa vasorum. Collaterals, bypassing completely occluded pulmonary arteries, were also observed to originate within plexiform lesions. In conclusion, synchrotron-based imaging revealed significant plexiform lesion heterogeneity, resulting in a novel classification. The four types likely have different effects on hemodynamics and disease progression.
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Affiliation(s)
- Christian Westöö
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Christian Norvik
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Niccolò Peruzzi
- Department of Clinical Sciences, Division of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Oscar van der Have
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Goran Lovric
- Centre d'Imagerie BioMédicale, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Swiss Light Source, Paul Scherrer Institute, Villigen, Switzerland
| | - Ida Jeremiasen
- Department of Experimental Medical Science, Lund University, Lund, Sweden.,Children's Heart Center, Skåne University Hospital, Lund, Sweden
| | - Phan-Kiet Tran
- Children's Heart Center, Skåne University Hospital, Lund, Sweden
| | - Rajmund Mokso
- Max IV Laboratory, Lund University, Lund, Sweden.,Institute for Biomedical Engineering, University and ETH Zürich, Zurich, Switzerland
| | | | - Hans Brunnström
- Department of Clinical Sciences Lund, Division of Pathology, Lund University, Lund, Sweden.,Department of Genetics and Pathology, Division of Laboratory Medicine, Lund University, Lund, Sweden
| | - Martin Bech
- Department of Clinical Sciences, Division of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Csaba Galambos
- Department of Pathology and Laboratory Medicine, Children's Hospital Colorado, Aurora, Colorado
| | - Karin Tran-Lundmark
- Department of Experimental Medical Science, Lund University, Lund, Sweden.,Children's Heart Center, Skåne University Hospital, Lund, Sweden.,Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
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Wu Y, Cai C, Yang L, Xiang Y, Zhao H, Zeng C. Inhibitory effects of formononetin on the monocrotaline‑induced pulmonary arterial hypertension in rats. Mol Med Rep 2020; 21:1192-1200. [PMID: 31922224 PMCID: PMC7003019 DOI: 10.3892/mmr.2020.10911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/31/2019] [Indexed: 12/11/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is a fatal syndrome resulting from enhanced pulmonary arterial pressure and pulmonary vessel resistance. Perivascular inflammation and extracellular matrix deposition are considered to be the crucial pathophysiologic bases of PAH. Formononetin (FMN), a natural phytoestrogen isolated from red clover (Trifolium pratense), has a variety of proapoptotic, anti-inflammatory and anti-tumor activities. However, the therapeutic effectiveness of FMN for PAH remains unclear. In the present study, 60 mg/kg monocrotaline (MCT) was first used to induce PAH in rats, and then all rats were treated with different concentrations of FMN (10, 30 and 60 mg/kg/day). At the end of this study, the hemodynamics and pulmonary vascular morphology of rats were evaluated. Specifically, matrix metalloproteinase (MMP)2, transforming growth factor β1 (TGFβ1) and MMP9 were measured using western blot and immunohistochemical staining. Collagen type I, collagen type III, fibronectin, monocyte chemotactic protein-1, tumor necrosis factor-α, interleukin-1β, ERK and NF-κB were quantified using western blotting. The results demonstrated that FMN significantly alleviated the changes of hemodynamics and pulmonary vascular morphology, and decreased the MCT-induced upregulations of TGFβ1, MMP2 and MMP9 expression levels. Meanwhile, the expression levels of collagen type I, collagen type III and fibronectin in rat lungs decreased after FMN treatment. Furthermore, the phosphorylated ERK and NF-κB also decreased after FMN treatment. Taken together, the present study indicated that FMN serves a therapeutic role in the MCT-induced PAH in rats via suppressing pulmonary vascular remodeling, which may be partially related to ERK and NF-κB signals.
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Affiliation(s)
- Yonghui Wu
- Department of Cardiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Changhong Cai
- Department of Cardiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Lebing Yang
- Department of Cardiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Yijia Xiang
- Department of Cardiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Huan Zhao
- Department of Cardiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Chunlai Zeng
- Department of Cardiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
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