Epidermal growth factor receptor blockade mediates smooth muscle cell apoptosis and improves survival in rats with pulmonary hypertension

Sandra L. Merklinger, Peter L. Jones, Eliana Cecilia Martinez Valencia, Marlene Rabinovitch

Research output: Contribution to journalArticle

165 Citations (Scopus)

Abstract

Background - We previously reported that administration of elastase inhibitors reverses fatal pulmonary arterial hypertension (PAH) in rats by inducing smooth muscle cell (SMC) apoptosis. We showed in pulmonary artery (PA) organ culture that the mechanism by which elastase inhibitors induce SMC apoptosis involves repression of matrix metalloproteinase (MMP) activity and subsequent signaling through α vβ 3-integrins and epidermal growth factor receptors (EGFRs). This suggests that blockade of these downstream effectors may also induce regression of PAH. Methods and Results - In this study, we first showed in PA organ culture that MMP inhibition or α vβ 3-integrin blockade with agents in clinical and preclinical use (SC-080 and cilengitide, respectively) mediates SMC apoptosis and regression of medial hypertrophy. We also documented similar results with an EGFR tyrosine kinase inhibitor. We then induced PAH in rats by injection of monocrotaline and, at day 21, began a 2-week treatment with SC-080, cilengitide, or the EGFR inhibitor PKI166. No vehicle- or cilengitide-treated animal survived beyond 2 weeks. Administration of SC-080 resulted in 44% survival at 2 weeks, and PKI166 therapy resulted in 78% and 54% survival in daily or 3-times-weekly treated animals, respectively. Four weeks after cessation of PKI166, we documented survivals of 50% and 23% in the 2 treatment groups, associated with reductions in pulmonary pressure, right ventricular hypertrophy, and abnormally muscularized distal arteries. Conclusion - We propose that selective blockade of EGFR signaling may be a novel strategy to reverse progressive, fatal PAH.

Original languageEnglish (US)
Pages (from-to)423-431
Number of pages9
JournalCirculation
Volume112
Issue number3
DOIs
StatePublished - Jul 19 2005
Externally publishedYes

Fingerprint

Epidermal Growth Factor Receptor
Pulmonary Hypertension
Smooth Muscle Myocytes
Apoptosis
Pancreatic Elastase
Organ Culture Techniques
Matrix Metalloproteinases
Integrins
Pulmonary Artery
Monocrotaline
Right Ventricular Hypertrophy
Protein-Tyrosine Kinases
Hypertrophy
Therapeutics
Arteries
Pressure
Lung
Injections
PKI 166
ErbB Receptors

Keywords

  • Cells
  • Hypertension, pulmonary
  • Integrins
  • Metalloproteinases
  • Pulmonary heart disease

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Epidermal growth factor receptor blockade mediates smooth muscle cell apoptosis and improves survival in rats with pulmonary hypertension. / Merklinger, Sandra L.; Jones, Peter L.; Martinez Valencia, Eliana Cecilia; Rabinovitch, Marlene.

In: Circulation, Vol. 112, No. 3, 19.07.2005, p. 423-431.

Research output: Contribution to journalArticle

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AB - Background - We previously reported that administration of elastase inhibitors reverses fatal pulmonary arterial hypertension (PAH) in rats by inducing smooth muscle cell (SMC) apoptosis. We showed in pulmonary artery (PA) organ culture that the mechanism by which elastase inhibitors induce SMC apoptosis involves repression of matrix metalloproteinase (MMP) activity and subsequent signaling through α vβ 3-integrins and epidermal growth factor receptors (EGFRs). This suggests that blockade of these downstream effectors may also induce regression of PAH. Methods and Results - In this study, we first showed in PA organ culture that MMP inhibition or α vβ 3-integrin blockade with agents in clinical and preclinical use (SC-080 and cilengitide, respectively) mediates SMC apoptosis and regression of medial hypertrophy. We also documented similar results with an EGFR tyrosine kinase inhibitor. We then induced PAH in rats by injection of monocrotaline and, at day 21, began a 2-week treatment with SC-080, cilengitide, or the EGFR inhibitor PKI166. No vehicle- or cilengitide-treated animal survived beyond 2 weeks. Administration of SC-080 resulted in 44% survival at 2 weeks, and PKI166 therapy resulted in 78% and 54% survival in daily or 3-times-weekly treated animals, respectively. Four weeks after cessation of PKI166, we documented survivals of 50% and 23% in the 2 treatment groups, associated with reductions in pulmonary pressure, right ventricular hypertrophy, and abnormally muscularized distal arteries. Conclusion - We propose that selective blockade of EGFR signaling may be a novel strategy to reverse progressive, fatal PAH.

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