Abstract
Background: End‐stage pulmonary arterial hypertension (PAH) is characterized by right ventricular (RV) dysfunction, failure and death. We have shown BMPR2 mutation is associated with impaired RV hypertrophy and cardiomyocyte lipid deposition in both heritable PAH patients and a murine model of mutant BMPR2 expression.Hypothesis: BMPR2 mutation alters hypertrophic response and fatty acid transport in RV cardiomyocytes.Methods: Stable mouse embryonic stem cell lines (ESC) were engineered to express BMPR2 mutation using pCI‐Neo‐BMPR2 plasmids with mutation in either cytoplasmic (CD) or kinase domain (KD) or a linearized pCI‐Neo vector (Control) and gene expression confirmed by RT‐PCR. Directed differentiation of the ESC to cardiac myocytes (ESC CM) performed using noggin. ESC CM treated with phenylephrine for 72 hours to induce hypertrophy. Western analysis performed for proteins: CD36 (a fatty acid transporter molecule), brain natriuretic peptide (BNP) and corin (a serine peptidase which cleaves pro‐BNP). Oil‐red‐O stain performed for intracellular lipid deposition in ESC‐CM.Results: All ESC‐CM expressed α‐SMA and demonstrated characteristic contraction in vitro. In response to hypertrophy, control ESC CM increased expression of BNP and corin, which remained unchanged in CD and KD BMPR2 mutant cells.At baseline expression of CD36 protein was higher in CD BMPR2 mutant containing ESC CM and Oil‐red‐O staining suggested increased intracellular lipid accumulation in mutant ESC CM relative to control cells. Hypertrophic stimulus reduced the expression of CD36 in CD and KD BMPR2 ESC CM compared to control cells.Conclusions: Altered BMPR2 signaling due to CD or KD mutations in ESC CM were associated with an impaired hypertrophic response. This impaired response was associated with decreased expression of BNP, corin and CD36. This may explain reduced ability of RV to adapt to increased RV afterload in PAH. Further characterization of the mechanism of impaired hypertrophy is planned.Grant Funding Source: P01HL108800
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