Abstract

Pulmonary arterial hypertension (PAH) is a progressive disease with a very poor prognosis. Recent studies have demonstrated that PAH is associated with diminished nitric oxide bioavailability, increased levels of endogenous nitric oxide synthase (NOS) inhibitor ADMA, and decreased lung dimethylarginine dimethylaminohydrolase (DDAH) activity. We have demonstrated that DDAH1 is essential for degradation of endogenous NOS inhibitor ADMA, and is important for optimal vascular endothelial NO production. However, it is not clear whether decreased DDAH activity and ADMA accumulation exacerbates development or progression of PAH and right ventricular hypertrophy. In addition, the impact of cardiomyocyte specific DDAH1 dysfunction on right ventricular hypertrophy is unknown. Using global DDAH1 gene deficient mice, we demonstrate that chronic ADMA accumulation by global DDAH1 gene deletion did not cause spontaneous PAH under control conditions, but significantly exacerbated chronic hypoxia-induced PAH, as indicated by significantly increased right ventricular (RV) pressure, more RV hypertrophy, and enhanced pulmonary vascular remodeling in DDAH1 deficient mice as compared to wild type mice. Chronic hypoxia resulted in reduced lung DDAH activity and increased circulating ADMA content in wild type mice. Cardiomyocyte specific DDAH1 gene deletion did not exacerbate hypoxia-induced increases in RV pressure or lung vascular remodeling, but significantly exacerbated hypoxia-induced RV hypertrophy in comparison to wild type littermates, indicating DDAH1 distributed in cardiomyocytes protect the heart against RV hypertrophy independent to pressure overload. Collectively, our data indicate that lung DDAH1 plays a critical role in protection against hypoxia-induced PAH and right ventricular hypertrophy.

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