(Circulation. 2001;104:790.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
From the Department of Medicine (N.W.M., X.Y., P.D.U., K.B.J., N.M., K.K.S.), University of Cambridge, Addenbrookes and Papworth Hospitals, Cambridge, United Kingdom; and Division of Clinical Genetics (R.C.T.), University of Leicester, Leicester, United Kingdom.
Correspondence to Dr Nicholas W. Morrell, Department of Medicine, University of Cambridge School of Clinical Medicine, Addenbrookes Hospital, Box 157, Hills Rd, Cambridge CB2 2QQ, UK. E-mail nwm23{at}cam.ac.uk
Background Mutations in the type II receptor for bone morphogenetic protein (BMPR-II), a receptor member of the transforming growth factor-ß (TGF-ß) superfamily, underlie many cases of familial and sporadic primary pulmonary hypertension (PPH). We postulated that pulmonary artery smooth muscle cells (PASMCs) from patients with PPH might demonstrate abnormal growth responses to TGF-ß superfamily members.
Methods and Results For studies of 3H-thymidine incorporation or cell proliferation, PASMCs (passages 4 to 8) were derived from main pulmonary arteries. In control cells, 24-hour incubation with TGF-ß1 (10 ng/mL) or bone morphogenetic protein (BMP)-2, -4, and -7 (100 ng/mL) inhibited basal and serum-stimulated 3H-thymidine incorporation, and TGF-ß1 and BMPs inhibited the proliferation of serum-stimulated PASMCs. In contrast, TGF-ß1 stimulated 3H-thymidine incorporation (200%; P<0.001) and cell proliferation in PASMCs from PPH but not from patients with secondary pulmonary hypertension. In addition, BMPs failed to suppress DNA synthesis and proliferation in PASMCs from PPH patients. Reverse transcriptionpolymerase chain reaction of PASMC mRNA detected transcripts for type I (TGF-ßRI, Alk-1, ActRI, and BMPRIB) and type II (TGF-ßRII, BMPR-II, ActRII, ActRIIB) receptors. Receptor binding and cross-linking studies with 125I-TGF-ß1 confirmed that the abnormal responses in PPH cells were not due to differences in TGF-ß receptor binding. Mutation analysis of PASMC DNA failed to detect mutations in TGF-ßRII and Alk-1 but confirmed the presence of a mutation in BMPR-II in 1 of 5 PPH isolates.
Conclusions We conclude that PASMCs from patients with PPH exhibit abnormal growth responses to TGF-ß1 and BMPs and that altered integration of TGF-ß superfamily growth signals may contribute to the pathogenesis of PPH.
Key Words: hypertension, pulmonary muscle, smooth growth substances proteins
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