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Published ahead of print on August 17, 2006, doi:10.1164/rccm.200602-304OC
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American Journal of Respiratory and Critical Care Medicine Vol 174. pp. 1025-1033, (2006)
© 2006 American Thoracic Society
doi: 10.1164/rccm.200602-304OC


Original Article

Angiopoietin/Tie2 Pathway Influences Smooth Muscle Hyperplasia in Idiopathic Pulmonary Hypertension

Laurence Dewachter, Serge Adnot, Elie Fadel, Marc Humbert, Bernard Maitre, Anne-Marie Barlier-Mur, Gerald Simonneau, Michel Hamon, Robert Naeije and Saadia Eddahibi

Institut National de la Santé et de la Recherche Médical U651 and Département de Physiologie, Hôpital H. Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; UPRES-EA 2705, Service de Chirurgie Thoracique, Vasculaire, et de Transplantation Cardiopulmonaire, Hôpital Marie Lannelongue, Le Plessis Robinson; Service de Pneumologie, Hôpital A. Béclère, Assistance Publique-Hôpitaux de Paris, Clamart; and UMR 677, Institut National de la Santé et de la Recherche Médical/Université Pierre et Marie Curie, NeuroPsychoPharmacologie, Faculté de Médecine Pitié-Salpêtrière, Paris, France; and Laboratory of Physiology, Faculty of Medicine, Free University of Brussels, Brussels, Belgium

Correspondence and requests for reprints should be addressed to Laurence Dewachter, M.Sc., INSERM U651, Faculté de Médecine, 8, Rue Général Sarrail, 94010 Créteil, France. E-mail: dewachter{at}creteil.inserm.fr

Rationale: Angiopoietins are involved in blood vessel maturation and remodeling.

Objectives: One consequence of endothelium-specific tyrosine kinase-2 (Tie2) receptor activation by angiopoietin-1 (Ang1) is the release of endothelium-derived growth factors that recruit vascular wall cells. We investigated this process in idiopathic pulmonary arterial hypertension (iPAH).

Methods: Ang1, Ang2, and total and phosphorylated Tie2 expression (mRNA and protein) was evaluated in human lung specimens and in cultured pulmonary artery smooth muscle cells (PA-SMCs) and pulmonary endothelial cells (P-ECs) isolated from patients with iPAH and control subjects. Media collected from Ang1-treated P-ECs were assessed for their PA-SMC growth-promoting effect.

Measurements and Main Results: Tie2 receptor was fourfold higher in lungs and P-ECs from patients with iPAH than in those from control subjects, with a parallel increase in phosphorylated lung Tie2 receptor. In contrast, Ang1 and Ang2 expression in lungs, P-ECs, and PA-SMCs did not differ. Incubation of PA-SMCs with medium collected from P-EC cultures induced marked proliferation, and this effect was stronger when using P-ECs from patients with iPAH than from control subjects. Ang1 pretreatment of P-ECs from either patients or control subjects induced a further increase in PA-SMC proliferation. Fluoxetine, an inhibitor of the mitogenic action of serotonin, reduced the growth-promoting effect of P-EC media. Ang1 added to P-ECs from patients with iPAH increased the production of endothelin-1 (ET-1) and serotonin, but not of platelet-derived growth factor-BB or epidermal growth factor, and increased the amount of mRNA encoding tryptophan hydroxylase-1 (the rate-limiting enzyme of serotonin synthesis), preproET-1, and ET-1–converting enzyme.

Conclusions: The Ang1/Tie2 pathway is potentiated in iPAH, contributing to PA-SMC hyperplasia via increased stimulation of endothelium-derived growth factors synthesis by P-ECs.

Key Words: angiopoietin-1 • growth factors • idiopathic pulmonary arterial hypertension • pulmonary artery smooth muscle • pulmonary endothelial cells




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