Abstract

Pulmonary arterial hypertension (PAH) is a multi-factorial disease characterized by the hyperproliferation of pulmonary artery smooth muscle cells (PASMCs). Excessive reactive oxygen species (ROS) formation resulted in alterations of the structure and function of pulmonary arterial walls, leading to right ventricular failure and death. Diabetes mellitus has not yet been implicated in pulmonary hypertension. However, recently, variable studies have shown that diabetes is correlated with pulmonary hypertension pathobiology, which could participate in the modification of pulmonary artery muscles. The metabolomic changes in PASMCs were studied in response to 25 mM of D-glucose (high glucose, or HG) in order to establish a diabetic-like condition in an in vitro setting, and compared to five mM of D-glucose (normal glucose, or LG). The effect of co-culturing these cells with an ideal blood serum concentration of cholecalciferol-D3 and tocopherol was also examined. The current study aimed to examine the role of hyperglycemia in pulmonary arterial hypertension by the quantification and detection of the metabolomic alteration of smooth muscle cells in high-glucose conditions. Untargeted metabolomics was carried out using hydrophilic interaction liquid chromatography and high-resolution mass spectrometry. Cell proliferation was assessed by cell viability and the [3H] thymidine incorporation assay, and the redox state within the cells was examined by measuring reactive oxygen species (ROS) generation. The results demonstrated that PASMCs in high glucose (HG) grew, proliferated faster, and generated higher levels of superoxide anion (O2·−) and hydrogen peroxide (H2O2). The metabolomics of cells cultured in HG showed that the carbohydrate pathway, especially that of the upper glycolytic pathway metabolites, was influenced by the activation of the oxidation pathway: the pentose phosphate pathway (PPP). The amount of amino acids such as aspartate and glutathione reduced via HG, while glutathione disulfide, N6-Acetyl-L-lysine, glutamate, and 5-aminopentanoate increased. Lipids either as fatty acids or glycerophospholipids were downregulated in most of the metabolites, with the exception of docosatetraenoic acid and PG (16:0/16:1(9Z)). Purine and pyrimidine were influenced by hyperglycaemia following PPP oxidation. The results in addition showed that cells exposed to 25 mM of glucose were oxidatively stressed comparing to those cultured in five mM of glucose. Cholecalciferol (D3, or vitamin D) and tocopherol (vitamin E) were shown to restore the redox status of many metabolic pathways.

Highlights

  • Pulmonary artery hypertension (PAH) is a disease characterized by an increase in mean pulmonary arterial pressure by more than 25 mmHg, as well as vasoconstriction and vascular obstruction.This in turn increases pulmonary vascular resistance and right ventricular failure

  • It focused on the abnormal changes in the cellular metabolome in order to investigate the effect of adding the antioxidants vitamin D or E on the prevention of cell proliferation and the oxidative damage caused by reactive oxygen species (ROS) generation, which could be induced by stimulating the pulmonary artery smooth muscle cells (PASMCs) with HG medium

  • It can lead to cellular damage, and could contribute to pulmonary hypertension via enhancing the generation of free radicals and promoting the proliferation of PASMCs, which eventually resulted in the narrowing and remodeling of the pulmonary arteries and pulmonary hypertension

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Summary

Introduction

Pulmonary artery hypertension (PAH) is a disease characterized by an increase in mean pulmonary arterial pressure by more than 25 mmHg, as well as vasoconstriction and vascular obstruction. This in turn increases pulmonary vascular resistance and right ventricular failure. The United Kingdom (UK) and Ireland pulmonary hypertension registry data shows that more than 20% of pulmonary hypertension (PH) patients above 50 years old had diabetes [5]. Mortality was found to be higher among diabetic pulmonary hypertension patients compared to non-diabetic patients [6], indicating that hyperglycemia could adversely contribute to the PAH patients’ survival. Another study that investigated the survival of PAH patients with and without diabetes mellitus (DM) found that

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