Targeting Vascular Remodeling to Treat Pulmonary Arterial Hypertension

Trends Mol Med. 2017 Jan;23(1):31-45. doi: 10.1016/j.molmed.2016.11.005. Epub 2016 Dec 16.

Abstract

Pulmonary arterial hypertension (PAH) describes a group of conditions with a common hemodynamic phenotype of increased pulmonary artery pressure, driven by progressive remodeling of small pulmonary arteries, leading to right heart failure and death. Vascular remodeling is the key pathological feature of PAH, but treatments targeting this process are lacking. In this review, we summarize important advances in our understanding of PAH pathogenesis from novel genetic and epigenetic factors, to cell metabolism and DNA damage. We show how these processes may integrate and highlight exploitable targets that could alter the relentless vascular remodeling in PAH.

Keywords: BMPR2; hypoxia; miRNA; pulmonary hypertension; vascular remodeling.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bone Morphogenetic Protein Receptors, Type II / genetics
  • Bone Morphogenetic Protein Receptors, Type II / metabolism
  • Drug Discovery
  • Humans
  • Hypertension, Pulmonary / drug therapy
  • Hypertension, Pulmonary / genetics*
  • Hypertension, Pulmonary / metabolism
  • Hypertension, Pulmonary / physiopathology*
  • Hypoxia / drug therapy
  • Hypoxia / genetics
  • Hypoxia / metabolism
  • Hypoxia / physiopathology
  • MicroRNAs / genetics
  • MicroRNAs / metabolism
  • Molecular Targeted Therapy
  • Pulmonary Artery / drug effects
  • Pulmonary Artery / metabolism
  • Pulmonary Artery / pathology*
  • Signal Transduction / drug effects
  • Vascular Remodeling* / drug effects

Substances

  • MicroRNAs
  • BMPR2 protein, human
  • Bone Morphogenetic Protein Receptors, Type II