National Heart and Lung Institute, Imperial College London, London, UK.
VUmc, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Eur Respir J. 2021 Sep 23;58(3). doi: 10.1183/13993003.04172-2020. Print 2021 Sep.
Pulmonary arterial hypertension (PAH) is a progressive disease predominantly targeting pre-capillary blood vessels. Adverse structural remodelling and increased pulmonary vascular resistance result in cardiac hypertrophy and ultimately failure of the right ventricle. Recent whole-genome and whole-exome sequencing studies have identified as a novel risk gene in PAH, with a dominant mode of inheritance and incomplete penetrance. Rare deleterious variants in the gene and more common variants in upstream enhancer sites have both been associated with the disease, and a deficiency of expression may predispose to PAH. This review aims to consolidate the evidence linking genetic variants in to PAH, and explores the numerous targets and effects of the transcription factor, focusing on the pulmonary vasculature and the pathobiology of PAH.
肺动脉高压(PAH)是一种主要针对毛细血管前血管的进行性疾病。不良的结构重塑和肺血管阻力的增加导致心肌肥厚,最终导致右心室衰竭。最近的全基因组和全外显子组测序研究已经确定 为 PAH 的一个新的风险基因,具有显性遗传模式和不完全外显率。该基因的罕见有害变异和上游增强子位点的常见变异都与该疾病有关, 表达缺陷可能使个体易患 PAH。本综述旨在整合将 基因变异与 PAH 联系起来的证据,并探讨转录因子的众多靶点和作用,重点关注肺血管和 PAH 的病理生物学。