Abstract

Background: Vitamin D (vitD) deficiency is highly prevalent in patients with pulmonary arterial hypertension (PAH). Moreover, PAH-patients with lower levels of vitD have worse prognosis. We hypothesize that recovering optimal levels of vitD in an animal model of PAH previously depleted of vitD improves the hemodynamics, the endothelial dysfunction and the ionic remodeling. Methods: Male Wistar rats were fed a vitD-free diet for five weeks and then received a single dose of Su5416 (20 mg/Kg) and were exposed to vitD-free diet and chronic hypoxia (10% O2) for three weeks to induce PAH. Following this, vitD deficient rats with PAH were housed in room air and randomly divided into two groups: (a) continued on vitD-free diet or (b) received an oral dose of 100,000 IU/Kg of vitD plus standard diet for three weeks. Hemodynamics, pulmonary vascular remodeling, pulmonary arterial contractility, and K+ currents were analyzed. Results: Recovering optimal levels of vitD improved endothelial function, measured by an increase in the endothelium-dependent vasodilator response to acetylcholine. It also increased the activity of TASK-1 potassium channels. However, vitD supplementation did not reduce pulmonary pressure and did not ameliorate pulmonary vascular remodeling and right ventricle hypertrophy. Conclusions: Altogether, these data suggest that in animals with PAH and severe deficit of vitD, restoring vitD levels to an optimal range partially improves some pathophysiological features of PAH.

Highlights

  • Pulmonary arterial hypertension (PAH) is a progressive disease affecting the lung vasculature, characterized by sustained vasoconstriction and remodeling of distal pulmonary arteries (PA), resulting in abnormal elevated pulmonary vascular resistance, mean pulmonary arterial pressure and right ventricular failure [1]

  • Important nutritional deficiencies have been consistently described in pulmonary arterial hypertension (PAH) patients for iron and Vitamin D [9,10]

  • We have recently evaluated the impact of Vitamin D (vitD) deficiency on a rat model of PAH [24]

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Summary

Introduction

Pulmonary arterial hypertension (PAH) is a progressive disease affecting the lung vasculature, characterized by sustained vasoconstriction and remodeling of distal pulmonary arteries (PA), resulting in abnormal elevated pulmonary vascular resistance, mean pulmonary arterial pressure (mPAP) and right ventricular failure [1]. Altered pulmonary arterial tone due to endothelial dysfunction and ionic remodeling are key features in the pathogenesis of PAH both in patients as well as in experimental models [2]. Biomolecules 2021, 11, 795 cells (PASMC) results in a more depolarized membrane potential (Em), leading to PASMC vasoconstriction and proliferation [5,6,7]. Important nutritional deficiencies have been consistently described in PAH patients for iron and Vitamin D (vitD) [9,10]. Vitamin D (vitD) deficiency is highly prevalent in patients with pulmonary arterial hypertension (PAH). PAH-patients with lower levels of vitD have worse prognosis. We hypothesize that recovering optimal levels of vitD in an animal model of PAH previously depleted of vitD improves the hemodynamics, the endothelial dysfunction and the ionic remodeling

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