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on March 13, 2006

Circulation. 2006
Published online before print March 13, 2006, doi: 10.1161/CIRCULATIONAHA.105.583732
A more recent version of this article appeared on March 21, 2006
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Submitted on August 18, 2005
Revised on December 17, 2005
Accepted on January 20, 2006

Important Role of Endogenous Erythropoietin System in Recruitment of Endothelial Progenitor Cells in Hypoxia-Induced Pulmonary Hypertension in Mice

Kimio Satoh MD, Yutaka Kagaya MD, PhD, Makoto Nakano MD, Yoshitaka Ito MD, Jun Ohta MD, PhD, Hiroko Tada MD, PhD, Akihiko Karibe MD, PhD, Naoko Minegishi MD, PhD, Norio Suzuki PhD, Masayuki Yamamoto MD, PhD, Masao Ono MD, PhD, Jun Watanabe MD, PhD, Kunio Shirato MD, PhD, Naoto Ishii MD, PhD, Kazuo Sugamura MD, PhD, and Hiroaki Shimokawa MD, PhD*

From the Departments of Cardiovascular Medicine (K. Satoh, Y.K., M.N., Y.I., J.O., H.T., A.K., J.W., K. Shirato, H.S.), Pathology (M.O.), and Microbiology and Immunology (N.I., K. Sugamura), Tohoku University Biomedical Engineering Research Organization (TUBERO) (N.M.), Tohoku University Graduate School of Medicine, Sendai, Japan, and the Center for Tsukuba Advanced Research Alliance (N.S., M.Y.), University of Tsukuba, Tsukuba, Japan.

* To whom correspondence should be addressed. E-mail: shimo{at}cardio.med.tohoku.ac.jp.

Background--Recent studies have suggested that endogenous erythropoietin (Epo) plays an important role in the mobilization of bone marrow-derived endothelial progenitor cells (EPCs). However, it remains to be elucidated whether the Epo system exerts protective effects on pulmonary hypertension (PH), a fatal disorder encountered in cardiovascular medicine.

Methods and Results--A mouse model of hypoxia-induced PH was used for study. We evaluated right ventricular systolic pressure, right ventricular hypertrophy, and pulmonary vascular remodeling in mice lacking the Epo receptor (EpoR) in nonerythroid lineages (EpoR-/- rescued mice) after 3 weeks of exposure to hypoxia. Those mice lack EpoR in the cardiovascular system but not in the hematopoietic system. The development of PH and pulmonary vascular remodeling were accelerated in EpoR-/- rescued mice compared with wild-type mice. The mobilization of EPCs and their recruitment to the pulmonary endothelium were significantly impaired in EpoR-/- rescued mice. By contrast, reconstitution of the bone marrow with wild-type bone marrow cells ameliorated PH in the EpoR-/- rescued mice. Hypoxia enhanced the expression of EpoR on pulmonary endothelial cells in wild-type but not EpoR-/- rescued mice. Finally, hypoxia activated endothelial nitric oxide synthase in the lungs in wild-type mice but not in EpoR-/- rescued mice.

Conclusions--These results indicate that the endogenous Epo/EpoR system plays an important role in the recruitment of EPCs and prevents the development of PH during chronic hypoxia in mice in vivo, suggesting the therapeutic importance of the system for the treatment of PH.


Key words: hypertension, pulmonary • hypoxia • endothelium • vasculature • remodeling




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