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Molecular Research Landscape of Pulmonary Arterial Hypertension

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Biology".

Deadline for manuscript submissions: 20 June 2025 | Viewed by 3825

Special Issue Editor


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Guest Editor
Department of Surgery and Physiology, Cardiovascular Research and Development Center-UnIC, Faculty of Medicine, University of Porto, Al. Prof. Hernaˆni Monteiro, 4200-319 Porto, Portugal
Interests: pulmonary hypertension; cardiac pathology; cardiovascular pathophysiology; cardiac function; heart failure

Special Issue Information

Dear Colleagues,

Pulmonary arterial hypertension (PAH) is a complex, progressive disease marked by high blood pressure in the lung arteries, often leading to heart failure if left untreated. The molecular research landscape for PAH aims to unravel the underlying mechanisms and identify potential therapeutic targets.

Recent studies underscore the pivotal roles of genetic mutations, epigenetic modifications, and abnormal signaling pathways in PAH pathogenesis. Notable genetic factors include mutations in the BMPR2 gene and others like ALK-1, ENG, CAV1, and KCNK3, which disrupt normal vascular function and drive disease progression. Epigenetic changes, such as DNA methylation and histone modifications, also significantly impact PAH by altering gene expression and promoting abnormal cellular behavior and vascular remodeling.

Classical signaling pathways, including the endothelin, nitric oxide, and prostacyclin pathways, are essential for maintaining vascular tone and integrity. Dysregulation of these pathways leads to vasoconstriction and smooth muscle cell proliferation, characteristic of PAH. Additionally, novel signaling pathways involved in vascular modulation are being explored as therapeutic targets.

Current research efforts focus on developing precision medicine strategies that integrate genetic, epigenetic, and molecular insights to create targeted therapies. This comprehensive approach holds promise for improving patient outcomes and advancing PAH treatment. This Special Issue will spotlight recent advances in molecular PAH research. We encourage investigators to submit original (basic and translational) research articles and reviews to address molecular mechanistic insights, novel diagnostic tools, and new treatments for PAH. Topics of interest include:

  • Cellular and molecular mechanisms involved in the pathophysiology of PAH;
  • The role of epigenetics in PAH pathogenesis;
  • Potential new biomarkers and treatments based on molecular mechanisms;
  • New perspectives on direct therapies for right heart failure in PAH based on molecular mechanisms

Dr. Cármen Brás-Silva
Guest Editor

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Keywords

  • pulmonary arterial hypertension
  • right ventricle
  • right heart failure
  • molecular mechanisms
  • vascular disease
  • translational research
  • therapy

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Published Papers (2 papers)

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14 pages, 2382 KiB  
Article
Chloroquine Restores eNOS Signaling in Shunt Endothelial Cells via Inhibiting eNOS Uncoupling
by Ying Liang, Wojciech Ornatowski, Qing Lu, Xutong Sun, Manivannan Yegambaram, Anlin Feng, Yishu Dong, Saurabh Aggarwal, Hoshang J. Unwalla, Jeffrey R. Fineman, Stephen M. Black and Ting Wang
Int. J. Mol. Sci. 2025, 26(3), 1352; https://doi.org/10.3390/ijms26031352 - 5 Feb 2025
Viewed by 993
Abstract
Pulmonary arterial hypertension (PAH) is characterized by increased lung vascular stiffness and impaired vessel relaxation, primarily due to reduced nitric oxide (NO) production in endothelial cells. Recent studies indicate that chloroquine, an autophagy inhibitor, may help lower pulmonary arterial pressure and enhance lung [...] Read more.
Pulmonary arterial hypertension (PAH) is characterized by increased lung vascular stiffness and impaired vessel relaxation, primarily due to reduced nitric oxide (NO) production in endothelial cells. Recent studies indicate that chloroquine, an autophagy inhibitor, may help lower pulmonary arterial pressure and enhance lung vascular function. This study investigates the mechanisms underlying the chloroquine-mediated restoration of NO bioavailability in endothelial cells derived from aortopulmonary shunt lambs, a relevant model for congenital heart defect (CHD)-associated PAH. We found that NO production was significantly reduced in shunt pulmonary artery endothelial cells (PAECs), attributable to decreased levels of tetrahydrobiopterin (BH4) and diminished expression of GTP cyclohydrolase 1 (GCH1), despite a slight increase in endothelial nitric oxide synthase (eNOS) levels. Chloroquine robustly restored endothelial NO production, which correlated with increased BH4 levels and restored GCH1 expression. The mechanistically upregulated carboxyl terminus of Hsp70-interacting protein (CHIP) in shunt PAECs is responsible for heightened GCH1 degradation, and chloroquine disrupted the assembly of the GCH1-HSP70-CHIP complex to preserve cellular GCH1. Similarly, another autophagy inhibitor, bafilomycin A1, demonstrated comparable effects. These findings suggest that autophagy inhibition can effectively enhance NO synthesis in endothelial cells experiencing depleted NO bioavailability, presenting a potential therapeutic strategy for managing PAH. Full article
(This article belongs to the Special Issue Molecular Research Landscape of Pulmonary Arterial Hypertension)
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20 pages, 5205 KiB  
Article
Unraveling the Impact of miR-146a in Pulmonary Arterial Hypertension Pathophysiology and Right Ventricular Function
by Joana Santos-Gomes, Pedro Mendes-Ferreira, Rui Adão, Carolina Maia-Rocha, Beatriz Rego, Manu Poels, Anaïs Saint-Martin Willer, Bastien Masson, Steeve Provencher, Sébastien Bonnet, David Montani, Frédéric Perros, Fabrice Antigny, Adelino F. Leite-Moreira and Carmen Brás-Silva
Int. J. Mol. Sci. 2024, 25(15), 8054; https://doi.org/10.3390/ijms25158054 - 24 Jul 2024
Cited by 2 | Viewed by 1967
Abstract
Pulmonary arterial hypertension (PAH) is a chronic disorder characterized by excessive pulmonary vascular remodeling, leading to elevated pulmonary vascular resistance and right ventricle (RV) overload and failure. MicroRNA-146a (miR-146a) promotes vascular smooth muscle cell proliferation and vascular neointimal hyperplasia, both hallmarks of PAH. [...] Read more.
Pulmonary arterial hypertension (PAH) is a chronic disorder characterized by excessive pulmonary vascular remodeling, leading to elevated pulmonary vascular resistance and right ventricle (RV) overload and failure. MicroRNA-146a (miR-146a) promotes vascular smooth muscle cell proliferation and vascular neointimal hyperplasia, both hallmarks of PAH. This study aimed to investigate the effects of miR-146a through pharmacological or genetic inhibition on experimental PAH and RV pressure overload animal models. Additionally, we examined the overexpression of miR-146a on human pulmonary artery smooth muscle cells (hPASMCs). Here, we showed that miR-146a genic expression was increased in the lungs of patients with PAH and the plasma of monocrotaline (MCT) rats. Interestingly, genetic ablation of miR-146a improved RV hypertrophy and systolic pressures in Sugen 5415/hypoxia (SuHx) and pulmonary arterial banding (PAB) mice. Pharmacological inhibition of miR-146a improved RV remodeling in PAB-wild type mice and MCT rats, and enhanced exercise capacity in MCT rats. However, overexpression of miR-146a did not affect proliferation, migration, and apoptosis in control-hPASMCs. Our findings show that miR-146a may play a significant role in RV function and remodeling, representing a promising therapeutic target for RV hypertrophy and, consequently, PAH. Full article
(This article belongs to the Special Issue Molecular Research Landscape of Pulmonary Arterial Hypertension)
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