Vascular cell‐specific roles of mineralocorticoid receptors in pulmonary hypertension

Abnormalities that characterize pulmonary arterial hypertension include impairment in the structure and function of pulmonary vascular endothelial and smooth muscle cells. Aldosterone levels are elevated in human pulmonary arterial hypertension and in experimental pulmonary hypertension, while inhib...

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Main Authors: Divya P. Menon, Guanming Qi, Seung K. Kim, M. Elizabeth Moss, Krishna C. Penumatsa, Rod R. Warburton, Deniz Toksoz, Jamie Wilson, Nicholas S. Hill, Iris Z. Jaffe, Ioana R. Preston
Format: Article
Language:English
Published: Wiley 2021-07-01
Series:Pulmonary Circulation
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Online Access:https://doi.org/10.1177/20458940211025240
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author Divya P. Menon
Guanming Qi
Seung K. Kim
M. Elizabeth Moss
Krishna C. Penumatsa
Rod R. Warburton
Deniz Toksoz
Jamie Wilson
Nicholas S. Hill
Iris Z. Jaffe
Ioana R. Preston
author_facet Divya P. Menon
Guanming Qi
Seung K. Kim
M. Elizabeth Moss
Krishna C. Penumatsa
Rod R. Warburton
Deniz Toksoz
Jamie Wilson
Nicholas S. Hill
Iris Z. Jaffe
Ioana R. Preston
author_sort Divya P. Menon
collection DOAJ
description Abnormalities that characterize pulmonary arterial hypertension include impairment in the structure and function of pulmonary vascular endothelial and smooth muscle cells. Aldosterone levels are elevated in human pulmonary arterial hypertension and in experimental pulmonary hypertension, while inhibition of the aldosterone‐binding mineralocorticoid receptor attenuates pulmonary hypertension in multiple animal models. We explored the role of mineralocorticoid receptor in endothelial and smooth muscle cells in using cell‐specific mineralocorticoid receptor knockout mice exposed to sugen/hypoxia‐induced pulmonary hypertension. Treatment with the mineralocorticoid receptor inhibitor spironolactone significantly reduced right ventricular systolic pressure. However, this is not reproduced by selective mineralocorticoid receptor deletion in smooth muscle cells or endothelial cells. Similarly, spironolactone attenuated the increase in right ventricular cardiomyocyte area independent of vascular mineralocorticoid receptor with no effect on right ventricular weight or interstitial fibrosis. Right ventricular perivascular fibrosis was significantly decreased by spironolactone and this was reproduced by specific deletion of mineralocorticoid receptor from endothelial cells. Endothelial cell‐mineralocorticoid receptor deletion attenuated the sugen/hypoxia‐induced increase in the leukocyte‐adhesion molecule, E‐selectin, and collagen IIIA1 in the right ventricle. Spironolactone also significantly reduced pulmonary arteriolar muscularization, independent of endothelial cell‐mineralocorticoid receptor or smooth muscle cell‐mineralocorticoid receptor. Finally, the degree of pulmonary perivascular inflammation was attenuated by mineralocorticoid receptor antagonism and was fully reproduced by smooth muscle cell‐specific mineralocorticoid receptor deletion. These studies demonstrate that in the sugen/hypoxia pulmonary hypertension model, systemic‐mineralocorticoid receptor blockade significantly attenuates the disease and that mineralocorticoid receptor has cell‐specific effects, with endothelial cell‐mineralocorticoid receptor contributing to right ventricular perivascular fibrosis and smooth muscle cell‐mineralocorticoid receptor participating in pulmonary vascular inflammation. As mineralocorticoid receptor antagonists are being investigated to treat pulmonary arterial hypertension, these findings support novel mechanisms and potential mineralocorticoid receptor targets that mediate therapeutic benefits in patients.
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spelling doaj-art-3bd289a1759d4c7eab24592dde2d3cab2025-08-20T02:14:16ZengWileyPulmonary Circulation2045-89402021-07-0111311310.1177/20458940211025240Vascular cell‐specific roles of mineralocorticoid receptors in pulmonary hypertensionDivya P. Menon0Guanming Qi1Seung K. Kim2M. Elizabeth Moss3Krishna C. Penumatsa4Rod R. Warburton5Deniz Toksoz6Jamie Wilson7Nicholas S. Hill8Iris Z. Jaffe9Ioana R. Preston10Pulmonary, Critical Care and Sleep DivisionTufts Medical CenterBostonMAUSAPulmonary, Critical Care and Sleep DivisionTufts Medical CenterBostonMAUSAMolecular Cardiology Research InstituteTufts Medical CenterBostonMAUSAMolecular Cardiology Research InstituteTufts Medical CenterBostonMAUSAPulmonary, Critical Care and Sleep DivisionTufts Medical CenterBostonMAUSAPulmonary, Critical Care and Sleep DivisionTufts Medical CenterBostonMAUSAPulmonary, Critical Care and Sleep DivisionTufts Medical CenterBostonMAUSAPulmonary, Critical Care and Sleep DivisionTufts Medical CenterBostonMAUSAPulmonary, Critical Care and Sleep DivisionTufts Medical CenterBostonMAUSAMolecular Cardiology Research InstituteTufts Medical CenterBostonMAUSAPulmonary, Critical Care and Sleep DivisionTufts Medical CenterBostonMAUSAAbnormalities that characterize pulmonary arterial hypertension include impairment in the structure and function of pulmonary vascular endothelial and smooth muscle cells. Aldosterone levels are elevated in human pulmonary arterial hypertension and in experimental pulmonary hypertension, while inhibition of the aldosterone‐binding mineralocorticoid receptor attenuates pulmonary hypertension in multiple animal models. We explored the role of mineralocorticoid receptor in endothelial and smooth muscle cells in using cell‐specific mineralocorticoid receptor knockout mice exposed to sugen/hypoxia‐induced pulmonary hypertension. Treatment with the mineralocorticoid receptor inhibitor spironolactone significantly reduced right ventricular systolic pressure. However, this is not reproduced by selective mineralocorticoid receptor deletion in smooth muscle cells or endothelial cells. Similarly, spironolactone attenuated the increase in right ventricular cardiomyocyte area independent of vascular mineralocorticoid receptor with no effect on right ventricular weight or interstitial fibrosis. Right ventricular perivascular fibrosis was significantly decreased by spironolactone and this was reproduced by specific deletion of mineralocorticoid receptor from endothelial cells. Endothelial cell‐mineralocorticoid receptor deletion attenuated the sugen/hypoxia‐induced increase in the leukocyte‐adhesion molecule, E‐selectin, and collagen IIIA1 in the right ventricle. Spironolactone also significantly reduced pulmonary arteriolar muscularization, independent of endothelial cell‐mineralocorticoid receptor or smooth muscle cell‐mineralocorticoid receptor. Finally, the degree of pulmonary perivascular inflammation was attenuated by mineralocorticoid receptor antagonism and was fully reproduced by smooth muscle cell‐specific mineralocorticoid receptor deletion. These studies demonstrate that in the sugen/hypoxia pulmonary hypertension model, systemic‐mineralocorticoid receptor blockade significantly attenuates the disease and that mineralocorticoid receptor has cell‐specific effects, with endothelial cell‐mineralocorticoid receptor contributing to right ventricular perivascular fibrosis and smooth muscle cell‐mineralocorticoid receptor participating in pulmonary vascular inflammation. As mineralocorticoid receptor antagonists are being investigated to treat pulmonary arterial hypertension, these findings support novel mechanisms and potential mineralocorticoid receptor targets that mediate therapeutic benefits in patients.https://doi.org/10.1177/20458940211025240pulmonary hypertensionexperimentalright ventriclespironolactonemineralocorticoid receptorendothelial cell
spellingShingle Divya P. Menon
Guanming Qi
Seung K. Kim
M. Elizabeth Moss
Krishna C. Penumatsa
Rod R. Warburton
Deniz Toksoz
Jamie Wilson
Nicholas S. Hill
Iris Z. Jaffe
Ioana R. Preston
Vascular cell‐specific roles of mineralocorticoid receptors in pulmonary hypertension
Pulmonary Circulation
pulmonary hypertension
experimental
right ventricle
spironolactone
mineralocorticoid receptor
endothelial cell
title Vascular cell‐specific roles of mineralocorticoid receptors in pulmonary hypertension
title_full Vascular cell‐specific roles of mineralocorticoid receptors in pulmonary hypertension
title_fullStr Vascular cell‐specific roles of mineralocorticoid receptors in pulmonary hypertension
title_full_unstemmed Vascular cell‐specific roles of mineralocorticoid receptors in pulmonary hypertension
title_short Vascular cell‐specific roles of mineralocorticoid receptors in pulmonary hypertension
title_sort vascular cell specific roles of mineralocorticoid receptors in pulmonary hypertension
topic pulmonary hypertension
experimental
right ventricle
spironolactone
mineralocorticoid receptor
endothelial cell
url https://doi.org/10.1177/20458940211025240
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