Jorna Lysanne M, Nakládal Dalibor, van Heuveln Johannes N, van der Feen Diederik E, Hagdorn Quint A J, Bossers Guido P L, van Oosten Annemieke, Weij Michel, Tkáčiková Ludmila, Tkáčiková Soňa, Henning Robert H, Harmsen Martin C, Berger Rolf M F, Krenning Guido
Department of Pediatric and Congenital Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (CA40), 9713 GZ Groningen, The Netherlands.
Laboratory for Cardiovascular Regenerative Medicine, Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (EA11), 9713 GZ Groningen, The Netherlands.
Int J Mol Sci. 2025 Jul 25;26(15):7181. doi: 10.3390/ijms26157181.
Pulmonary arterial hypertension (PAH) is a rare, progressive, and incurable disease characterized by an elevated pulmonary blood pressure, extensive remodeling of the pulmonary vasculature, increased pulmonary vascular resistance, and culminating in right ventricular failure. Mitochondrial dysfunction has a major role in the pathogenesis of PAH and secondary right ventricular failure, and its targeting may offer therapeutic benefit. In this study, we provide proof-of-concept for the use of the mitochondrially active drug SUL-150 to treat PAH. PAH was induced in rats by monocrotaline, followed by the placement of an aortocaval shunt one week later. The mitoprotective compound SUL-150 (~6 mg·kg·day) or vehicle was administered intraperitoneally via osmotic minipump for 28 days, implanted at the time of aortocaval shunt placement. Vehicle-treated PAH rats had dyspnea and showed pulmonary artery remodeling with increased responsiveness to phenylephrine, in addition to remodeling of the intrapulmonary arterioles. SUL-150 administration mitigated the dyspnea and the remodeling responses. Vehicle-treated PAH rats developed right ventricular hypertrophy, fibrosis, and failure. SUL-150 administration precluded cardiomyocyte hypertrophy and inhibited ventricular fibrogenesis. Right ventricular failure in vehicle-treated PAH rats induced mitochondrial loss and dysfunction associated with a decrease in mitophagy. SUL-150 was unable to prevent the mitochondrial loss but improved mitochondrial health in the right ventricle, which culminated in the preservation of right ventricular function. We conclude that SUL-150 improves PAH-associated morbidity by the amelioration of pulmonary vascular remodeling and right ventricular failure and may be considered a promising therapeutic candidate to slow disease progression in pulmonary arterial hypertension and secondary right ventricular failure.
肺动脉高压(PAH)是一种罕见、进行性且无法治愈的疾病,其特征为肺动脉血压升高、肺血管广泛重塑、肺血管阻力增加,最终导致右心室衰竭。线粒体功能障碍在PAH和继发性右心室衰竭的发病机制中起主要作用,针对线粒体功能障碍进行治疗可能会带来益处。在本研究中,我们为使用线粒体活性药物SUL-150治疗PAH提供了概念验证。通过给予大鼠野百合碱诱导PAH,一周后进行主动脉腔静脉分流术。在放置主动脉腔静脉分流术时,通过渗透微型泵腹腔内给予线粒体保护化合物SUL-150(约6mg·kg·天)或赋形剂,持续28天。接受赋形剂治疗的PAH大鼠出现呼吸困难,除肺内小动脉重塑外,还表现出肺动脉重塑以及对去氧肾上腺素的反应性增加。给予SUL-150可减轻呼吸困难和重塑反应。接受赋形剂治疗的PAH大鼠出现右心室肥大、纤维化和衰竭。给予SUL-150可防止心肌细胞肥大并抑制心室纤维化。接受赋形剂治疗的PAH大鼠的右心室衰竭导致线粒体丢失和功能障碍,伴有线粒体自噬减少。SUL-150无法预防线粒体丢失,但可改善右心室的线粒体健康,最终保留右心室功能。我们得出结论,SUL-150通过改善肺血管重塑和右心室衰竭来改善PAH相关的发病率,可能被认为是减缓肺动脉高压和继发性右心室衰竭疾病进展的有前景的治疗候选药物。
Int J Mol Sci. 2025-7-25
J Cardiovasc Pharmacol. 2024-6-1
J Cardiovasc Pharmacol. 2024-9-1
Am J Physiol Lung Cell Mol Physiol. 2025-7-1
J Cell Mol Med. 2020-5
Nephrol Dial Transplant. 2018-12-1
Am J Physiol Lung Cell Mol Physiol. 2018-1-18