Abstract

Right heart failure is the major cause of death among patients with pulmonary arterial hypertension (PAH). Understanding the biology of the right ventricle (RV) should help developing new therapeutic strategies. Rats subjected to the injection of Sugen5416 (an inhibitors of vascular endothelial growth factor receptor) plus the ovalbumin immunization had increased pulmonary arterial pressure and severe vascular remodeling. RVs of these rats were hypertrophied and had severe cardiac fibrosis. No apoptosis was, however, detected. Metabolomics analysis revealed that oxidized glutathione, xanthine and uric acid had increased in PAH RVs, suggesting the production of reactive oxygen species by xanthine oxidase. PAH RVs were also found to have a 30-fold lower level of α-tocopherol nicotinate, consistent with oxidative stress decreasing antioxidants and also demonstrating for the first time that the nicotinate ester of vitamin E is endogenously expressed. Oxidative/nitrosative protein modifications including S-glutathionylation, S-nitrosylation and nitrotyrosine formation, but not protein carbonylation, were found to be increased in RVs of rats with PAH. Mass spectrometry identified that S-nitrosylated proteins include heat shock protein 90 and sarcoplasmic reticulum Ca2+-ATPase. These results demonstrate that RV failure is associated with the promotion of specific oxidative and nitrosative stress.

Highlights

  • Pulmonary arterial hypertension (PAH) affects both men and women of any age, including children

  • This treatment produced pulmonary hypertension, with systolic right ventricle (RV) pressure elevated to ~60 mmHg (Fig 1C)

  • Histological evaluations of hematoxylin and eosin (H&E)-stained lung sections revealed that, compared to control rats (Fig 2A), rats subjected to OVA/Sugen5416 exhibited severe pulmonary vascular remodeling (Fig 2B & 2C)

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Summary

Introduction

Pulmonary arterial hypertension (PAH) affects both men and women of any age, including children. PAH is characterized by increased blood pressure in the pulmonary circulation with abnormal pathologies in the pulmonary vessels. Despite the availability of approved drugs for treatment, PAH remains a fatal disease [1,2,3,4]. Increased pulmonary artery (PA) resistance results in right-sided heart failure and death [5,6,7,8]. The median reported survival for PAH patients is 2.8 years from the time of diagnosis (3-yr survival of 48%) if left untreated [3,9]. New and improved therapeutic strategies are needed to satisfactorily treat PAH patients

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