Abstract

Pulmonary vascular remodeling, including proliferation and migration of pulmonary artery endothelial cells (PAEC), is a pathologic hallmark of pulmonary arterial hypertension (PAH). Multiple studies have shown evidence of increased levels of DNA damage and lineage-specific genetic changes in PAH lung vascular cells, suggesting increased genomic instability. Highly proliferative endothelial colony-forming cell (ECFC) clones can be isolated from PAEC. Here we utilized ECFC to track chromosomal copy number of 20 PAH and eight control clones across serial passages using genome-wide microarrays. All PAH clones were genomically stable for at least 20–22 population doublings. At very late passages, ECFC developed a highly aneuploid karyotype, but this was generally associated with senescence and was common to both PAH and controls. We also utilized ECFC to isolate the chromosomally abnormal cells from a mixed population of PAH PAEC. Analysis of PAEC harboring two different changes affecting chromosomes 1 and X demonstrated that both abnormalities were present in the same clone, indicating they originated in a common ancestral cell. In a second case, with a partial duplication of chromosome 17, clones carrying the duplication were more frequent at later passages than chromosomally normal clones from the same PAEC culture, suggesting the rearrangement may confer a proliferative advantage. Overall, this small study suggests that endothelial cells from PAH lungs are stable in culture, but that when chromosome abnormalities do occur, they may confer a selective advantage that allows expansion of the abnormal cell population and could contribute to lung vascular remodeling in vivo.

Highlights

  • There is growing evidence that Pulmonary arterial hypertension (PAH) lung vascular cells show higher levels of DNA damage than controls,[7,8,9,10] and chromosomal abnormalities are detectable in pulmonary artery endothelial cells (PAEC) from explant lung tissue in about one-third

  • PAECs were obtained from the explant lungs of PAH patients and controls, as previously described[19] and maintained in complete endothelial growth media-2 (EGM-2; Lonza, Walkersville, MD, USA)

  • Cellular heterogeneity within the systemic circulation is well established and segmental variation in nitric oxide production, surface antigen expression, and proliferative potential have been observed in pulmonary endothelial cells.[16,22]

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Summary

Introduction

Pulmonary arterial hypertension (PAH) is characterized by a progressive increase in pulmonary vascular resistance, which may eventually lead to right ventricular failure.[1,2] an imbalance between pulmonary artery vasoconstriction and vasodilation contributes to the pathophysiology of the disease, it is widely recognized that remodeling of small pulmonary arteries represents the main pathologic finding related to PAH, with marked proliferation of pulmonary smooth muscle and the formation of plexiform and concentric lesions comprising proliferative endothelial cells and myofibroblasts.[1,3]. Endothelial cells within the plexiform lesions of idiopathic (IPAH) and associated PAH (APAH) cases were previously found to be monoclonal[4,5] and some lesions showed microsatellite instability.[6] There is growing evidence that PAH lung vascular cells show higher levels of DNA damage than controls,[7,8,9,10] and chromosomal abnormalities are detectable in pulmonary artery endothelial cells (PAEC) from explant lung tissue in about one-third. It has been difficult to study these abnormalities and their functional effects in detail, as they are often present as a minor clone comprising less than 50% of the overall cell population

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