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Gu S, Goel K, Forbes LM, Kheyfets VO, Yu YRA, Tuder RM, Stenmark KR. Tensions in Taxonomies: Current Understanding and Future Directions in the Pathobiologic Basis and Treatment of Group 1 and Group 3 Pulmonary Hypertension. Compr Physiol 2023; 13:4295-4319. [PMID: 36715285 PMCID: PMC10392122 DOI: 10.1002/cphy.c220010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In the over 100 years since the recognition of pulmonary hypertension (PH), immense progress and significant achievements have been made with regard to understanding the pathophysiology of the disease and its treatment. These advances have been mostly in idiopathic pulmonary arterial hypertension (IPAH), which was classified as Group 1 Pulmonary Hypertension (PH) at the Second World Symposia on PH in 1998. However, the pathobiology of PH due to chronic lung disease, classified as Group 3 PH, remains poorly understood and its treatments thus remain limited. We review the history of the classification of the five groups of PH and aim to provide a state-of-the-art review of the understanding of the pathogenesis of Group 1 PH and Group 3 PH including insights gained from novel high-throughput omics technologies that have revealed heterogeneities within these categories as well as similarities between them. Leveraging the substantial gains made in understanding the genomics, epigenomics, proteomics, and metabolomics of PAH to understand the full spectrum of the complex, heterogeneous disease of PH is needed. Multimodal omics data as well as supervised and unbiased machine learning approaches after careful consideration of the powerful advantages as well as of the limitations and pitfalls of these technologies could lead to earlier diagnosis, more precise risk stratification, better predictions of disease response, new sub-phenotype groupings within types of PH, and identification of shared pathways between PAH and other types of PH that could lead to new treatment targets. © 2023 American Physiological Society. Compr Physiol 13:4295-4319, 2023.
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Affiliation(s)
- Sue Gu
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Colorado, USA
- Cardiovascular Pulmonary Research Lab, University of Colorado School of Medicine, Colorado, USA
- National Jewish Health, Denver, Colorodo, USA
| | - Khushboo Goel
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Colorado, USA
- National Jewish Health, Denver, Colorodo, USA
| | - Lindsay M. Forbes
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Colorado, USA
| | - Vitaly O. Kheyfets
- Cardiovascular Pulmonary Research Lab, University of Colorado School of Medicine, Colorado, USA
| | - Yen-rei A. Yu
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Colorado, USA
- Cardiovascular Pulmonary Research Lab, University of Colorado School of Medicine, Colorado, USA
| | - Rubin M. Tuder
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Colorado, USA
- Program in Translational Lung Research, Department of Medicine, University of Colorado Anschutz Medical Campus, Colorado, USA
| | - Kurt R. Stenmark
- Cardiovascular Pulmonary Research Lab, University of Colorado School of Medicine, Colorado, USA
- Department of Pediatrics Section of Critical Care Medicine, University of Colorado Anschutz Medical Campus, Colorado, USA
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Zheng X, Qu N, Wang L, Wang G, Jiao R, Deng H, Li S, Qin Y. Effect of Vitamin D 3 on Lung Damage Induced by Cigarette Smoke in Mice. Open Med (Wars) 2019; 14:827-832. [PMID: 31737787 PMCID: PMC6843493 DOI: 10.1515/med-2019-0096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 07/18/2019] [Indexed: 11/22/2022] Open
Abstract
Cigarette smoking is known to induce serious lung diseases, but there is not an effective method to solve this problem. The present study investigated vitamin D3 on over-expression of CXCR3 and CXCL10 in mice induced by cigarette smoking. A pulmonary airway model was designed, and morphological assessment of emphysema, IL-4, IFN-γ and CXCL10 concentration in bronchoalveolar lavage fluids, expression of CXCR3 and CXCL10 were detected. Emphysema of the mice only exposed to cigarette smoke was significant, and concentration of IL-4, IFN-γ and CXCL10 was also increased. In addition, CXCR3 and CXCL10 were over-expressed. The degree of emphysema, concentration of IL-4, IFN-γ and CXCL10, and expression of CXCR3 and CXCL10 in mice administrated with low dose vitamin D3 were similar to the normally treated mice. Low dose of vitamin D3 can effectively protect the lung from the damage induced by cigarette smoke.
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Affiliation(s)
- Xin Zheng
- Respiratory Department, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, NO.33 Beiling Street, Huanggu District, Shenyang, 110032, Liaoning, P.R.China
| | - Nini Qu
- Respiratory Department, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, NO.33 Beiling Street, Huanggu District, Shenyang, 110032, Liaoning, P.R.China
| | - Lina Wang
- Respiratory Department, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, NO.33 Beiling Street, Huanggu District, Shenyang, 110032, Liaoning, P.R.China
| | - Guoli Wang
- Respiratory Department, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, NO.33 Beiling Street, Huanggu District, Shenyang, 110032, Liaoning, P.R.China
| | - Rui Jiao
- Respiratory Department, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, NO.33 Beiling Street, Huanggu District, Shenyang, 110032, Liaoning, P.R.China
| | - Hu Deng
- Respiratory Department, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, NO.33 Beiling Street, Huanggu District, Shenyang, 110032, Liaoning, P.R.China
| | - Sijia Li
- Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, Liaoning, P.R.China
| | - Yibing Qin
- Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, Liaoning, P.R.China
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Kwapiszewska G, Markart P, Dahal BK, Kojonazarov B, Marsh LM, Schermuly RT, Taube C, Meinhardt A, Ghofrani HA, Steinhoff M, Seeger W, Preissner KT, Olschewski A, Weissmann N, Wygrecka M. PAR-2 Inhibition Reverses Experimental Pulmonary Hypertension. Circ Res 2012; 110:1179-91. [DOI: 10.1161/circresaha.111.257568] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rationale:
A hallmark of the vascular remodeling process underlying pulmonary hypertension (PH) is the aberrant proliferation and migration of pulmonary arterial smooth muscle cells (PASMC). Accumulating evidence suggests that mast cell mediators play a role in the pathogenesis of PH.
Objective:
In the present study we investigated the importance of protease-activated receptor (PAR)–2 and its ligand mast cell tryptase in the development of PH.
Methods and Results:
Our results revealed strong increase in PAR-2 and tryptase expression in the lungs of idiopathic pulmonary arterial hypertension (IPAH) patients, hypoxia-exposed mice, and monocrotaline (MCT)–treated rats. Elevated tryptase levels were also detected in plasma samples from IPAH patients. Hypoxia and platelet-derived growth factor (PDGF)–BB upregulated PAR-2 expression in PASMC. This effect was reversed by HIF (hypoxia inducible factor)–1α depletion, PDGF-BB neutralizing antibody, or the PDGF-BB receptor antagonist Imatinib. Attenuation of PAR-2 expression was also observed in smooth muscle cells of pulmonary vessels of mice exposed to hypoxia and rats challenged with MCT in response to Imatinib treatment. Tryptase induced PASMC proliferation and migration as well as enhanced synthesis of fibronectin and matrix metalloproteinase-2 in a PAR-2- and ERK1/2-dependent manner, suggesting that PAR-2-dependent signaling contributes to vascular remodeling by various mechanisms. Furthermore, PAR-2
−/−
mice were protected against hypoxia-induced PH, and PAR-2 antagonist application reversed established PH in the hypoxia mouse model.
Conclusions:
Our study identified a novel role of PAR-2 in vascular remodeling in the lung. Interference with this pathway may offer novel therapeutic options for the treatment of PH.
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Affiliation(s)
- Grazyna Kwapiszewska
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Philipp Markart
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Bhola Kumar Dahal
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Baktybek Kojonazarov
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Leigh Matthew Marsh
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Ralph Theo Schermuly
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Christian Taube
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Andreas Meinhardt
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Hossein Ardeschir Ghofrani
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Martin Steinhoff
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Werner Seeger
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Klaus Theo Preissner
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Andrea Olschewski
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Norbert Weissmann
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
| | - Malgorzata Wygrecka
- From the Departments of Internal Medicine (G.K., P.M., B.K.D., B.K., R.T.S., H.A.G., W.S., N.W.), Anatomy (A.M.), and Biochemistry (K.T.P., M.W.), University of Giessen Lung Centre, Giessen, Germany; Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria (G.K., L.M.M., A.O.); Department of Pulmonary Medicine, Leiden University Medical Center, Leiden, The Netherlands (C.T.); Department of Dermatology and Surgery, University of California, San Francisco, San Francisco, CA (M.S.)
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