Abstract

BackgroundInflammation may contribute to the pathogenesis of various forms of pulmonary hypertension (PH). Recent studies in patients with idiopathic PH or PH associated with underlying diseases suggest a role for interleukin-6 (IL-6).MethodsTo determine whether endogenous IL-6 contributes to mediate hypoxic PH and lung inflammation, we studied IL-6-deficient (IL-6-/-) and wild-type (IL-6+/+) mice exposed to hypoxia for 2 weeks.ResultsRight ventricular systolic pressure, right ventricle hypertrophy, and the number and media thickness of muscular pulmonary vessels were decreased in IL-6-/- mice compared to wild-type controls after 2 weeks' hypoxia, although the pressure response to acute hypoxia was similar in IL-6+/+ and IL-6-/- mice. Hypoxia exposure of IL-6+/+ mice led to marked increases in IL-6 mRNA and protein levels within the first week, with positive IL-6 immunostaining in the pulmonary vessel walls. Lung IL-6 receptor and gp 130 (the IL-6 signal transducer) mRNA levels increased after 1 and 2 weeks' hypoxia. In vitro studies of cultured human pulmonary-artery smooth-muscle-cells (PA-SMCs) and microvascular endothelial cells revealed prominent synthesis of IL-6 by PA-SMCs, with further stimulation by hypoxia. IL-6 also markedly stimulated PA-SMC migration without affecting proliferation. Hypoxic IL-6-/- mice showed less inflammatory cell recruitment in the lungs, compared to hypoxic wild-type mice, as assessed by lung protein levels and immunostaining for the specific macrophage marker F4/80, with no difference in lung expression of adhesion molecules or cytokines.ConclusionThese data suggest that IL-6 may be actively involved in hypoxia-induced lung inflammation and pulmonary vascular remodeling in mice.

Highlights

  • Inflammation may contribute to the pathogenesis of various forms of pulmonary hypertension (PH)

  • Hemodynamic response to acute hypoxia The effect of an acute hypoxic challenge on Right ventricular systolic pressure (RVSP) was examined in normoxic mice

  • Under ventilation with room air, RVSP and heart rate did not differ between IL-6+/+ and IL-6-/- mice

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Summary

Introduction

Inflammation may contribute to the pathogenesis of various forms of pulmonary hypertension (PH). Recent studies in patients with idiopathic PH or PH associated with underlying diseases suggest a role for interleukin-6 (IL-6). Inflammation is recognized as a potential contributor to the pathogenesis of both idiopathic pulmonary hypertension (PH) and PH associated with underlying diseases [1,2]. Patients with idiopathic or associated PH exhibit higher circulating levels and pulmonary expression of various inflammatory cytokines and chemokines including interleukin-1beta (IL-1β), IL-6, monocyte chemoattractant protein (MCP-1), RANTES, and fractalkine [4,5,6,7,8,9,10]. In recent studies of patients with COPD, we found that pulmonary artery pressure correlated positively with the circulating levels of two cytokines, namely, IL-6 and MCP-1 [11]. This polymorphism influences the levels of circulating IL-6, suggesting a causal role for high circulating IL-6 levels in the pathogenesis of PH in patients with COPD

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