贝前列素促进野百合碱诱导肺动脉高压大鼠肺动脉细胞凋亡

目的 探讨前列环素对肺动脉细胞凋亡的影响.方法 30只大鼠,随机分为对照组、野百合碱(MCT)组及贝前列素组.MCT组及贝前列素组腹腔注射60 mg/kg MCT,对照组腹腔注射等体积0.9％氯化钠注射液;第2天起,贝前列素组每天200μg/kg贝前列素灌胃.所有大鼠饲养21 d后,观察肺动脉血流动力学及右心肥厚、肺组织HE和TUNEL染色分别观察肺动脉重塑和肺动脉细胞凋亡,实时定量PCR及Western blot观察肺动脉内BAX、BCL-2和PDK mRNA和蛋白水平的改变.结果 贝前列素组大鼠的平均肺动脉压力,右心肥厚指数及肺动脉管壁厚度均明显低于MCT组(P＜0.05).贝前列素组大鼠肺动脉细胞凋亡较MCT组增加,肺动脉组织中BAX mRNA和蛋白水平均高于MCT组,而BCL-2与PDK mRNA和蛋白水平均显著降低.结论 贝前列素可以通过促进肺动脉细胞凋亡改善野百合碱诱导肺动脉高压大鼠的肺动脉重塑.     

牛磺酸抗缺氧及防治肺动脉高压的研究及其细胞机制初探

目的通过动物模型观察牛磺酸对缺氧性肺动脉高压的治疗作用,同时观察其对体外培养牛肺动脉平滑肌细胞(PASMC)和内皮细胞(PAEC)增殖的影响。方法采用模拟高原5 000 m制作缺氧大鼠模型,缺氧2周。设平原(C组)及缺氧对照组(H组),观察牛磺酸治疗后(T组)的肺动脉压(mPAP)、血浆乳酸脱氢酶(LDH)活性、脂质过氧化产物丙二醛(MDA)、肺匀浆一氧化氮(NO)含量、右心室肥大指数的变化。体外培养PASMC和PAEC用3H-TdR掺入法比较牛磺酸对缺氧PASMC和PAEC增殖的影响。结果H组大鼠LDH活性升高为C的10.1倍(P<0.01);肺匀浆NO含量降低为C组的32%(P<0.01);血浆MDA含量显著升高为C组的1.64倍(P<0.01);mPAP显著增高,约为C组的2.74倍(P<0.01);右心室肥大指数是C组的1.56倍(P<0.01)。T组与H组相比较:LDH活性、血浆MDA、右心室肥大指数均显著降低(P<0.01);mPAP显著降低(P<0.05)。高浓度(10～20 mmol/L)的牛磺酸抑制缺氧内皮及平滑肌细胞的3H-TdR掺入,而低浓度的牛磺酸促进缺氧时PAEC的3H-TdR掺入(P<0.05),抑制缺氧时PASMC的3H-TdR掺入(P<0.05)。结论牛磺酸有抗缺氧及防治肺动脉高压的作用。缺氧抑制内皮细胞的增殖而促进平滑肌细胞的增殖,适当剂量的牛磺酸可以对抗缺氧对PAEC和PASMs的作用:减弱缺氧对PAEC的增殖抑制作用,抑制缺氧的促PASMC增殖作用,使之接近常氧水平。这可能是牛磺酸防治肺动脉高压的细胞机制。提示牛横酸对于高山病缺氧性肺血管收缩和血管结构改建的预防和治疗,可能具有广阔的应用前景。     

FIZZ1在炎症相关性肺动脉高压中的作用

低氧诱导促有丝分裂因子(hypoxia-induced mitogenic factor,HIMF)是一类富含半胱氨酸的分泌蛋白.HIMF首先在炎症区域被发现,并且扮演着炎症细胞标志物的角色,HIMF同时又称作发现于炎症区域1(found in inflammatory zone 1,FIZZ1).由于该蛋白家族成员在低氧与炎症相关生理病理过程中起不可忽视的作用,国内外对该蛋白家族的研究越来越多.目前该因子在血管生长、平滑肌增殖、气道炎症、肠道免疫等方面的作用已有相关研究.     

钙激活性氯离子通道与高肺血流性肺动脉高压

Pulmonary hypertension induced by high pulmonary blood flow involves a variety of complex mechanisms, including endothelial damage, pulmonary artery smooth muscle relaxation-contraction disorder and vascular remodeling. Besides, the factor of ion channels in pulmonary artery smooth muscle cells is also highly correlated to vasoconstriction. In recent years, many studies have shown that activation of Ca²⁺-activated Cl^- channels is responsible for the membrane depolarization of pulmonary artery smooth muscle cells, and plays an important role in the regulation of vascular tone and vasoconstriction. This article reviews the biophysical and pharmacological characteristics of Ca²⁺-activated Cl^- channels as well as the influence of Ca²⁺-activated Cl^- channels in high pulmonary blood flow-induced pulmonary hypertension.     

Cytoskeletal features of immature pulmonary vascular smooth muscle cells: the influence of pulmonary hypertension on normal development

Using an immunohistochemical technique, the development of the cytoskeletal proteins desmin, vimentin, and actin (using alpha isotype and non-isotype specific antibodies) was assessed using a semi-quantitative grading system in the pulmonary vascular smooth muscle of nine normal pigs and 19 normal humans at different ages, and in 13 children with pulmonary hypertensive congenital heart disease. In the normal of both species, immunostaining for vimentin decreased after birth and then increased gradually while immunostaining for desmin and alpha actin increased steadily with age. In pulmonary hypertension, immunostaining for alpha actin and vimentin showed an accelerated increase at between 2 and 8 months. Also, the media showed regional differences in immunostaining which preceded the development of intimal proliferation. The inner media showed less immunoreactivity for all cytoskeletal proteins studied than did the outer media. Within areas of intimal proliferation many cells were immunonegative. These results suggest that the cytoskeletal features of medial smooth muscle cells are remodelled in the normal infant; that this process is altered from at least 2 months in the pulmonary hypertensive infant; and that the smooth muscle cells immediately beneath the internal elastic lamina are remodelled before migrating to form intimal proliferation. Changes in cytoskeletal composition can be related to the previously described postnatal maturation of pulmonary vascular smooth muscle cells.     

Autophagy contributes to BMP type 2 receptor degradation and development of pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is characterised by an increase in mean pulmonary arterial pressure which almost invariably leads to right heart failure and premature death. More than 70% of familial PAH and 20% of idiopathic PAH patients carry heterozygous mutations in the bone morphogenetic protein (BMP) type 2 receptor (BMPR2). However, the incomplete penetrance of BMPR2 mutations suggests that other genetic and environmental factors contribute to the disease. In the current study, we investigate the contribution of autophagy in the degradation of BMPR2 in pulmonary vascular cells. We demonstrate that endogenous BMPR2 is degraded through the lysosome in primary human pulmonary artery endothelial (PAECs) and smooth muscle cells (PASMCs): two cell types that play a key role in the pathology of the disease. By means of an elegant HaloTag system, we show that a block in lysosomal degradation leads to increased levels of BMPR2 at the plasma membrane. In addition, pharmacological or genetic manipulations of autophagy allow us to conclude that autophagy activation contributes to BMPR2 degradation. It has to be further investigated whether the role of autophagy in the degradation of BMPR2 is direct or through the modulation of the endocytic pathway. Interestingly, using an iPSC-derived endothelial cell model, our findings indicate that BMPR2 heterozygosity alone is sufficient to cause an increased autophagic flux. Besides BMPR2 heterozygosity, pro-inflammatory cytokines also contribute to an augmented autophagy in lung vascular cells. Furthermore, we demonstrate an increase in microtubule-associated protein 1 light chain 3 beta (MAP1LC3B) levels in lung sections from PAH induced in rats. Accordingly, pulmonary microvascular endothelial cells (MVECs) from end-stage idiopathic PAH patients present an elevated autophagic flux. Our findings support a model in which an increased autophagic flux in PAH patients contributes to a greater decrease in BMPR2 levels. Altogether, this study sheds light on the basic mechanisms of BMPR2 degradation and highlights a crucial role for autophagy in PAH. © 2019 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.     

低氧抑制猪肺动脉平滑肌细胞MMP-2和MMP-9的表达

目的探讨低氧对猪肺动脉平滑肌细胞（PASMC）分泌基质金属蛋白酶（MMPs）的影响。方法采用酶谱法测定PASMC培养基中MMP-2和MMP-9的酶活性，免疫印迹法检测培养基中MMP-2和MMP-9的蛋白表达，免疫组化法测定细胞原位MMP-2和MMP-9的蛋白表达，RT-PCR法检测mRNA的表达。结果低氧后PASMC分泌的MMP-2酶活性、细胞内外蛋白表达量、mRNA表达量均下降；MMP-9酶活性、细胞外蛋白表达量下降，而细胞内蛋白表达无变化。结论低氧可抑制PASMC分泌MMP-2和MMP-9的酶活性，其机制可能是低氧影响PASMC中MMP-2基因的转录、影响MMP-9蛋白表达后的分泌与活化，导致MMP-2和MMP-9酶活性的改变。     

Computerized morphometry of the pulmonary vasculature over a range of intravascular pressures

Recent availability of computerized image analysis has fostered hope that barium injection and landmarking of pulmonary arteries would be unnecessary for morphometric assessment when using this technique. We reasoned that if barium injection altered morphometric variables, it would do so in a linear fashion correlating with incremental increases in injection pressure of the barium. The two goals of the present study were to determine whether barium injection into arteries affected morphometric measurements and to determine whether incremental increases in injection pressure correlated with alterations in morphometric measurements in a linear fashion. Computerized image analysis was used to measure the internal elastic lamina (IEL) and external elastic lamina (EEL). Medial area (MA), luminal area (LA), percentage of medial thickness, IEL√MA. and idealized LA were calculated. Barium injection did not alter morphometric variables in a linear fashion correlating with incremental increases in injection pressure of the barium except the percentage of arteries that filled with barium. Maximum recruitment for pre-acinar arteries occurred at 40 mmHg pressure and 60 mmHg distending pressure for intra-acinar arteries. Incremental increases in injection pressure did not affect IEL, EEL, or calculated morphometric variables. However, IEL, medial thickness, and MA were all smaller in injected vessels than in uninjected vessels. IEL√MA and the ratio of measured vs. idealized LA were both increased in injected lungs. We suspect that vascular injection selects for evaluation, a population of smaller, thin-walled vessels, which in the uninjected lungs are collapsed and hence excluded from analysis. Anat. Rec. 252:92–101, 1998. © 1998 Wiley-Liss, Inc.     

慢性低氧性肺动脉高压大鼠肺组织P53表达增高

目的观察P53在低氧性肺动脉高压大鼠肺组织中的表达。方法采用减压低氧方法复制大鼠慢性低氧性肺动脉高压模型;取肺组织,常规SABC免疫组化法染色和Hoechst染色,观察P53表达的变化及细胞凋亡变化。结果P53在慢性肺动脉高压大鼠肺小动脉壁中有少量表达,其中低氧3周组>低氧2周组>正常组。Hoechst染色显示肺组织凋亡细胞增加,其变化趋势与P53的表达变化趋势相同。结论在慢性低氧性肺动脉高压形成过程中,肺小动脉壁发生了增殖和凋亡,程度随低氧时间的延长而增加,同时P53表达增多,提示P53参与了慢性低氧性肺动脉高压肺小血管重建的调控。     

低氧致鼠腺泡内肺动脉PDGF—B链蛋白表达的变化

目的：探讨血小板源性生长因子（ＰＤＧＦ）在低氧肺动脉高压血管构形重建发生中的作用。方法：应用免疫组化技术结合计算机图像分析，检测了低氧大鼠腺泡内肺动脉（ＩＡＰＡ）ＰＤＧＦ－Ｂ链蛋白表达水平。结果：常氧时，ＩＡＰＡ仅有ＰＤＧＦ－Ｂ链蛋白弱表达；低氧１天时，ＩＡＰＡ便有较强的ＰＤＧＦ－Ｂ链蛋白表达，定位于ＩＡＰＡ的内皮和中膜，低氧３天至１４天仅分布于中膜；低氧１、３、５、７、１４天各时间点ＰＤＧＦ－Ｂ链蛋白表达分别为常氧组的１．５３、１．５９、１．５６、１．６２和１．４２倍，差异有显著性（Ｐ＜０．０１）。结论：ＰＤＧＦ－Ｂ链蛋白可能参与了低氧肺动脉高压血管构形重建的发病过程     

Ultrastructure of rat pulmonary arterioles after neonatal exposure to hypoxia and subsequent relief and treatment with monocrotaline

A group of rats was born in and spent the first 4 weeks of life at a simulated altitude of 3550 m. Two animals were killed immediately afterwards and the remaining 16 were allowed to recover for various times up to a maximum of 12 weeks at sea-level atmospheric pressure. On ultrastructural examination, the pulmonary arterioles of hypoxic rats showed muscularization, the new layer of mature smooth muscle cells containing abundant organelles and myofilaments. These cells were bounded by prominent elastic laminae. During the recovery period, the medial layer became progressively thinned, but the cells still retained some characteristics of smooth muscle by 12 weeks' recovery. When a similar group of ten hypoxic rats was allowed to recover for 12 weeks before being given monocrotaline, there was early enlargement of the residual smooth muscle cells in the media of pulmonary arterioles and within 5 weeks there was again a thick layer of medial smooth muscle. This was in contrast to the sparse, weakly muscularized arterioles seen in eight similarly treated rats born under normoxic conditions. The relevance is discussed of these findings to the rare occurrence of primary pulmonary hypertension in people who were born at high altitude but returned to sea-level during childhood.     

Effect of compliance on a time-domain estimate of the characteristic impedance of the pulmonary artery during acute pulmonary hypertension

In 11 pigs under general endotracheal anaesthesia, the time-domain method of determining the pulmonary arterial input impedance was compared with the frequency-domain equivalent under normal conditions as well as acute pulmonary hypertension induced by glass microspheres. The time-domain methods of determining the pulmonary arterial compliance C and pulmonary vascular bed resistance R_p compared favourably with the frequency-domain equivalent (r=0·744, n=60, p<0·001 and r=0·906, n=60, p<0·001, respectively), even at mean pulmonary artery pressures (MPAP) of 35 mmHg and above. A consistent and everincreasing difference between characteristic impedance Z_o(ω), estimated by averaging input impedance modulus values over a selected frequency range, and its time domain equivalent R_o with increasing MPAP was shown to be the cause of the poor fit between the measured and remodelled pulmonary blood flow. By analysing a time-domain estimate of the pulmonary characteristic impedance R_o(C, R_p, t), it was demonstrated that the characteristic impedance was dependent on C. R_o is therefore not an accurate representation of the characteristic impedance, especially under conditions of acute pulmonary hypertension. R_o (C, R_p, t) should therefore be calculated instead.     

The ultrastructure of plexogenic pulmonary arteriopathy

The lungs from 16 cases of plexogenic pulmonary arteriopathy obtained at heart-lung transplantation, half of which had primary pulmonary hypertension, were examined by electron microscopy. From these the probable pathogenesis of pulmonary arterial intimal fibrosis in plexogenic pulmonary arteriopathy was deduced. The earliest detectable change was migration of smooth muscle cells from the media, through the internal elastic lamina into the intima. These cells collected beneath the endothelium and lost many of their myofilaments to become myofibroblasts. They were associated with ground substance but scanty collagen fibrils. As the quantity of interstitial collagen increased, the myofibroblasts reverted to a muscular structure, became elongated, and assumed a regular, circumferential orientation. This later stage coincided with the development of plexiform lesions. At both early and later stages, the muscular pulmonary arteries were contracted but not markedly so, and muscular evaginations were not seen. On the other hand, the cellular intimal proliferations developed early and were occlusive. This suggests that occlusion of small pulmonary arterial vessels by myofibroblasts may be at least as important as vasoconstriction in the early elevation of the pulmonary vascular resistance in primary pulmonary hypertension.     

内源性H2S对LPS所致大鼠急性肺损伤时肺动脉高压的影响及其与一氧化氮的相互作用

目的： 探讨硫化氢（H2S）对脂多糖（LPS）所致急性肺损伤时肺动脉高压（PAH）的影响及H2S/胱硫醚-γ-裂解酶（CSE）体系和一氧化氮（NO）/一氧化氮合酶（NOS）体系在其发生机制中的相互作用。 方法： 将72只大鼠随机分为生理盐水（NS）对照组、LPS组、LPS+L-NAME组、LPS+PPG组，检测给药后2、4、6、8 h的平均肺动脉压（mPAP），以及4、8 h血浆H2S、NO含量和iNOS、cNOS活性、肺组织NO含量和iNOS、cNOS、CSE活性，免疫组化法测定肺组织iNOS蛋白表达，并结合肺光镜形态等指标综合评价肺损伤程度。 结果： LPS组各时点的mPAP显著高于对照组，给药后4、8 h，NO含量、iNOS活性和蛋白表达升高，cNOS活性及H2S含量、CSE活性降低，肺组织损伤较重。预先给予L-NAME可减轻LPS所致上述指标的改变。而预先给予PPG可加重LPS所致肺损伤，但对cNOS活性无明显影响。 结论： LPS使内源性H2S减少导致mPAP升高； H2S/CSE体系与NO/NOS体系共同参与LPS所致急性肺损伤时PAH形成的调控机制，在其中呈相互的负性调节作用。     

Paeoniflorin attenuates monocrotaline-induced pulmonary arterial hypertension in rats by suppressing TAK1-MAPK/NF-κB pathways

Pulmonary arterial hypertension (PAH) characterized by pulmonary vascular remodeling is a lethal disease. Paeoniflorin (PF) is a monoterpene glycoside with numerous beneficial functions, such as vasodilation, anti-inflammation and immunomodulation. This study aims to investigate the effects of PF on monocrotaline (MCT)-induced PAH rats. Our data showed that both prophylactic or therapeutic administration of PF alleviated MCT-induced increasing of right ventricular systolic pressure (RVSP), prevented right ventricle hypertrophy and pulmonary arterial remodeling, as well as inhibited inflammatory cell infiltration around pulmonary arteries. Meanwhile, PF blocked MCT-induced endothelial-mesenchymal transition (EndMT) as indicated by the restored expression of endothelial markers in lung. Moreover, PF inhibited MCT-induced down-regulation of bone morphogenetic protein receptor 2 (BMPR2) and suppressed MCT-induced phosphorylation of transforming growth factor-β (TGFβ) activated kinase 1 (TAK1) in vivo. In vitro studies indicated that PF prevented human pulmonary arterial smooth muscle cells (PASMCs) from platelet-derived growth factor-BB (PDGF-BB)-stimulated proliferation and migration. PF also partially reversed TGFβ1, interleukin-1β (IL-1β) and tumor necrosis factor (TNF-α) co-stimulated endothelial-to-mesenchymal transition (EndMT) in cultured human pulmonary artery endothelial cells (HPAECs). Signaling pathway analysis demonstrated that the underlying mechanism might be associated with the inhibition of TAK1-MAPK/NF-κB pathways. Taken together, our results suggested that PF could be a potential drug for the treatment of PAH.     

低氧对大鼠肺动脉平滑肌细胞血红素加氧酶-1 mRNA 表达及细胞增殖的影响

探讨血红素加氧酶－1（HO－1）mRNA在低氧大鼠肺动脉平滑肌细胞（PASMC0的表达及HO－1／一氧化碳（HO－1／CO）体系对PASMC增殖的影响。应用荧光定量RT－PCR法测定HO－1mRNA表达。用双波长法检测碳氧血红蛋白（HbCO)吸光值。应用免疫细胞化学方法检测细胞增殖核抗原（PCNA）及核转录因子－κB（NF-κB）的表达。发现HO－1 mRNA在常氧大鼠PASMC有低水平的表达，低氧12h HO-1mRNA水平是常氧时的1．5倍，且HbCO产量随之显著增高（P＜0．01）；低氧24h HO-1 mRNA表达呈回落趋势，HbCO产量亦有所减少，但两者仍高于常氧水平。低氧12h及24h PASMC PCNA核阳性反应颗粒表达较常氧时增强（P＜0．01，P＜0．001），使用HO抑制剂ZnPP-9，其PCNA该阳性反应颗粒表达较单纯低氧时增加更多（P＜0．001，P＜0．01）。低氧组核NF－κB阳性染色较常氧组增强（P＜0．001），使用ZnPP-9，其表达则比低氧时更多（P＜0．01）。低氧通过诱导大鼠PASMC的HO－1 mRNA基因表达，上调HO／CO体系活性，使内源性CO含量增高，抑制PASMC增殖；NF－κB参与了PASMC增殖的调控机制。     

Changes in the pulmonary arteries of the rat during recovery from hypoxia-induced pulmonary hypertension.

Pulmonary hypertension has been induced in rats by 2 weeks' exposure to hypoxia, equivalent to an altitude of approximately 5500 m, in a hypobaric chamber. The rats were removed from the chamber and allowed to recover for up to 8 weeks at atmospheric pressure. Precise quantitative microscopic techniques after injection of the pulmonary artery have been used to estimate the regression in the pulmonary artery of the structural changes associated with pulmonary hypertension. During recovery the degree of muscularization of the pulmonary arteries decreases by disappearance of muscle cells from the small arteries and a drop in arterial wall thickness of larger vessels. These changes do not seem to reflect pulmonary artery pressure directly, since right ventricular hypertrophy regresses at a faster rate. In hypertensive rats there is a "loss" of small arteries in the alveolar region and little filling of precapillary vessels. On recovery, some of the vessels fill, suggesting that encroachment on the lumen by muscle and endothelial cells has lessened. Even after 8 weeks' recovery, however, some arteries do not return, suggesting they have completely disappeared and that regions are left with relatively little perfusion. This reduction of vascular reserve presents without there being right ventricular hypertrophy.