Abstract
Human immunodeficiency virus (HIV) infection is an established risk factor for pulmonary arterial hypertension (PAH); however, the pathogenesis of HIV-related PAH remains unclear. Since K+ channel dysfunction is a common marker in most forms of PAH, our aim was to analyze whether the expression of HIV proteins is associated with impairment of K+ channel function in the pulmonary vascular bed. HIV transgenic mice (Tg26) expressing seven of the nine HIV viral proteins and wild-type (WT) mice were used. Hemodynamic assessment was performed by echocardiography and catheterization. Vascular reactivity was studied in endothelium-intact pulmonary arteries. K+ currents were recorded in freshly isolated pulmonary artery smooth muscle cells (PASMC) using the patch-clamp technique. Gene expression was assessed using quantitative RT-PCR. PASMC from Tg26 mice had reduced K+ currents and were more depolarized than those from WT. Whereas voltage-gated K+ channel 1.5 (Kv1.5) currents were preserved, pH-sensitive noninactivating background currents ( IKN) were nearly abolished in PASMC from Tg26 mice. Tg26 mice had reduced lung expression of Kv7.1 and Kv7.4 channels and decreased responses to the Kv7.1 channel activator L-364,373 assessed by vascular reactivity and patch-clamp experimental approaches. Although we found pulmonary vascular remodeling and endothelial dysfunction in Tg26 mice, this was not accompanied by changes in hemodynamic parameters. In conclusion, the expression of HIV proteins in vivo impairs pH-sensitive IKN and Kv7 currents. This negative impact of HIV proteins in K+ channels was not sufficient to induce PAH, at least in mice, but may play a permissive or accessory role in the pathophysiology of HIV-associated PAH.
Highlights
Human immunodeficiency virus (HIV) infection and its associated pathologies constitute a global health concern
We report that HIV transgene expression leads to attenuation of endothelial-dependent relaxation and impairment of Kϩ channel activity in the pulmonary vasculature
A marked reduction of pH-sensitive IKN and Kv7 currents was found in PA smooth muscle cells (PASMC) from mice expressing HIV proteins
Summary
Human immunodeficiency virus (HIV) infection and its associated pathologies constitute a global health concern. It is estimated that ~37 million people are living with HIV globally [45]. Despite the success of highly active antiretroviral therapy, chronic inflammation persists and is independently associated with cardiovascular complications [44]. HIV-associated pulmonary arterial hypertension (PAH) is especially severe and is associated with significant morbidity and mortality [4]. HIV patients have a 2,500-fold increased risk of developing PAH and have a poorer prognosis than PAH in the general population [9]. Only a small proportion (0.46%) of patients with HIV will develop HIV-related PAH [42], there may be as many as 200,000 HIV-infected patients affected by PAH worldwide
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