Inhibition of Sodium/Hydrogen Exchanger‐1 in the Right Ventricle and Lung Dysfunction Induced by Experimental Pulmonary Arterial Hypertension in Rats

Background Life‐threatening pulmonary arterial hypertension (PAH) still lacks a direct therapeutic approach targeted to the molecular defects associated with the disease. Here, we focus on the impaired regulation of intracellular acidity and sodium/calcium overload by testing the hypothesis that inh...

Full description

Saved in:
Bibliographic Details
Main Authors: Giuseppina Milano, Melanie Reinero, Julien Puyal, Piergiorgio Tozzi, Michele Samaja, Florence Porte‐Thomé, Maurice Beghetti
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.036859
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849734888632090624
author Giuseppina Milano
Melanie Reinero
Julien Puyal
Piergiorgio Tozzi
Michele Samaja
Florence Porte‐Thomé
Maurice Beghetti
author_facet Giuseppina Milano
Melanie Reinero
Julien Puyal
Piergiorgio Tozzi
Michele Samaja
Florence Porte‐Thomé
Maurice Beghetti
author_sort Giuseppina Milano
collection DOAJ
description Background Life‐threatening pulmonary arterial hypertension (PAH) still lacks a direct therapeutic approach targeted to the molecular defects associated with the disease. Here, we focus on the impaired regulation of intracellular acidity and sodium/calcium overload by testing the hypothesis that inhibiting NHE‐1 (sodium/hydrogen exchanger isoform 1) with rimeporide enables the recovery of pulmonary and right ventricular dysfunctions in the Sugen5416/hypoxia PAH model in rats. Methods and Results Adult Sprague–Dawley male rats (n=44) rats were divided into 2 broad groups: control and Sugen5416/hypoxia. After verifying PAH insurgence in the Sugen5416/hypoxia group by transthoracic echocardiography and pulse‐wave Doppler analysis, rats were treated with either 100 mg/kg per day rimeporide or placebo in drinking water for 3 weeks. The functional, morphological (fibrosis and hypertrophy), and biochemical (inflammation, signaling pathways) dysfunctions caused by PAH were partially reverted by rimeporide in both the lungs and myocardium, where the most striking effects were observed in the right ventricle. Rimeporide improved hemodynamics in the pulmonary circulation and in the right ventricle, with decrease in right ventricle hypertrophy, pulmonary vascular remodeling, inflammation, and fibrosis. No effect of rimeporide was detected in control rats. The protective effect of rimeporide was accompanied by decreased p‐Akt/Akt (phosphorylated protein kinase B/protein kinase B) ratio and increased autophagy flux mainly in the right ventricle. Conclusions By specifically inhibiting NHE‐1, rimeporide at the selected dosage revealed remarkable anti‐PAH effects by preventing the functional, morphological, and biochemical deleterious effects of PAH on the right ventricle and lungs. Rimeporide should be considered as a potential treatment for PAH.
format Article
id doaj-art-53dd231a80d44b44a7c45dedc0ffb46f
institution DOAJ
issn 2047-9980
language English
publishDate 2025-03-01
publisher Wiley
record_format Article
series Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
spelling doaj-art-53dd231a80d44b44a7c45dedc0ffb46f2025-08-20T03:07:41ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-03-0114610.1161/JAHA.124.036859Inhibition of Sodium/Hydrogen Exchanger‐1 in the Right Ventricle and Lung Dysfunction Induced by Experimental Pulmonary Arterial Hypertension in RatsGiuseppina Milano0Melanie Reinero1Julien Puyal2Piergiorgio Tozzi3Michele Samaja4Florence Porte‐Thomé5Maurice Beghetti6Department Cœur‐Vaisseaux, Cardiac Surgery Center University Hospital of Lausanne SwitzerlandDepartment Cœur‐Vaisseaux, Cardiac Surgery Center University Hospital of Lausanne SwitzerlandDepartment of Fundamental Neurosciences University of Lausanne SwitzerlandDepartment Cœur‐Vaisseaux, Cardiac Surgery Center University Hospital of Lausanne SwitzerlandUniversity of Milan ItalyEspeRare Foundation Geneve SwitzerlandUnité de Cardiologie Pédiatrique University Hospital of Geneva, University of Geneva SwitzerlandBackground Life‐threatening pulmonary arterial hypertension (PAH) still lacks a direct therapeutic approach targeted to the molecular defects associated with the disease. Here, we focus on the impaired regulation of intracellular acidity and sodium/calcium overload by testing the hypothesis that inhibiting NHE‐1 (sodium/hydrogen exchanger isoform 1) with rimeporide enables the recovery of pulmonary and right ventricular dysfunctions in the Sugen5416/hypoxia PAH model in rats. Methods and Results Adult Sprague–Dawley male rats (n=44) rats were divided into 2 broad groups: control and Sugen5416/hypoxia. After verifying PAH insurgence in the Sugen5416/hypoxia group by transthoracic echocardiography and pulse‐wave Doppler analysis, rats were treated with either 100 mg/kg per day rimeporide or placebo in drinking water for 3 weeks. The functional, morphological (fibrosis and hypertrophy), and biochemical (inflammation, signaling pathways) dysfunctions caused by PAH were partially reverted by rimeporide in both the lungs and myocardium, where the most striking effects were observed in the right ventricle. Rimeporide improved hemodynamics in the pulmonary circulation and in the right ventricle, with decrease in right ventricle hypertrophy, pulmonary vascular remodeling, inflammation, and fibrosis. No effect of rimeporide was detected in control rats. The protective effect of rimeporide was accompanied by decreased p‐Akt/Akt (phosphorylated protein kinase B/protein kinase B) ratio and increased autophagy flux mainly in the right ventricle. Conclusions By specifically inhibiting NHE‐1, rimeporide at the selected dosage revealed remarkable anti‐PAH effects by preventing the functional, morphological, and biochemical deleterious effects of PAH on the right ventricle and lungs. Rimeporide should be considered as a potential treatment for PAH.https://www.ahajournals.org/doi/10.1161/JAHA.124.036859autophagypulmonary arterial hypertensionright ventriclesodium/hydrogen exchanger type 1Sugen5416/hypoxia
spellingShingle Giuseppina Milano
Melanie Reinero
Julien Puyal
Piergiorgio Tozzi
Michele Samaja
Florence Porte‐Thomé
Maurice Beghetti
Inhibition of Sodium/Hydrogen Exchanger‐1 in the Right Ventricle and Lung Dysfunction Induced by Experimental Pulmonary Arterial Hypertension in Rats
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
autophagy
pulmonary arterial hypertension
right ventricle
sodium/hydrogen exchanger type 1
Sugen5416/hypoxia
title Inhibition of Sodium/Hydrogen Exchanger‐1 in the Right Ventricle and Lung Dysfunction Induced by Experimental Pulmonary Arterial Hypertension in Rats
title_full Inhibition of Sodium/Hydrogen Exchanger‐1 in the Right Ventricle and Lung Dysfunction Induced by Experimental Pulmonary Arterial Hypertension in Rats
title_fullStr Inhibition of Sodium/Hydrogen Exchanger‐1 in the Right Ventricle and Lung Dysfunction Induced by Experimental Pulmonary Arterial Hypertension in Rats
title_full_unstemmed Inhibition of Sodium/Hydrogen Exchanger‐1 in the Right Ventricle and Lung Dysfunction Induced by Experimental Pulmonary Arterial Hypertension in Rats
title_short Inhibition of Sodium/Hydrogen Exchanger‐1 in the Right Ventricle and Lung Dysfunction Induced by Experimental Pulmonary Arterial Hypertension in Rats
title_sort inhibition of sodium hydrogen exchanger 1 in the right ventricle and lung dysfunction induced by experimental pulmonary arterial hypertension in rats
topic autophagy
pulmonary arterial hypertension
right ventricle
sodium/hydrogen exchanger type 1
Sugen5416/hypoxia
url https://www.ahajournals.org/doi/10.1161/JAHA.124.036859
work_keys_str_mv AT giuseppinamilano inhibitionofsodiumhydrogenexchanger1intherightventricleandlungdysfunctioninducedbyexperimentalpulmonaryarterialhypertensioninrats
AT melaniereinero inhibitionofsodiumhydrogenexchanger1intherightventricleandlungdysfunctioninducedbyexperimentalpulmonaryarterialhypertensioninrats
AT julienpuyal inhibitionofsodiumhydrogenexchanger1intherightventricleandlungdysfunctioninducedbyexperimentalpulmonaryarterialhypertensioninrats
AT piergiorgiotozzi inhibitionofsodiumhydrogenexchanger1intherightventricleandlungdysfunctioninducedbyexperimentalpulmonaryarterialhypertensioninrats
AT michelesamaja inhibitionofsodiumhydrogenexchanger1intherightventricleandlungdysfunctioninducedbyexperimentalpulmonaryarterialhypertensioninrats
AT florenceportethome inhibitionofsodiumhydrogenexchanger1intherightventricleandlungdysfunctioninducedbyexperimentalpulmonaryarterialhypertensioninrats
AT mauricebeghetti inhibitionofsodiumhydrogenexchanger1intherightventricleandlungdysfunctioninducedbyexperimentalpulmonaryarterialhypertensioninrats