Reduced BMPR2 expression induces GM-CSF translation and macrophage recruitment in humans and mice to exacerbate pulmonary hypertension

H Sawada, T Saito, NP Nickel, TP Alastalo… - Journal of Experimental …, 2014 - rupress.org
H Sawada, T Saito, NP Nickel, TP Alastalo, JP Glotzbach, R Chan, L Haghighat, G Fuchs
Journal of Experimental Medicine, 2014rupress.org
Idiopathic pulmonary arterial hypertension (PAH [IPAH]) is an insidious and potentially fatal
disease linked to a mutation or reduced expression of bone morphogenetic protein receptor
2 (BMPR2). Because intravascular inflammatory cells are recruited in IPAH pathogenesis,
we hypothesized that reduced BMPR2 enhances production of the potent chemokine
granulocyte macrophage colony-stimulating factor (GM-CSF) in response to an inflammatory
perturbation. When human pulmonary artery (PA) endothelial cells deficient in BMPR2 were …
Idiopathic pulmonary arterial hypertension (PAH [IPAH]) is an insidious and potentially fatal disease linked to a mutation or reduced expression of bone morphogenetic protein receptor 2 (BMPR2). Because intravascular inflammatory cells are recruited in IPAH pathogenesis, we hypothesized that reduced BMPR2 enhances production of the potent chemokine granulocyte macrophage colony-stimulating factor (GM-CSF) in response to an inflammatory perturbation. When human pulmonary artery (PA) endothelial cells deficient in BMPR2 were stimulated with tumor necrosis factor (TNF), a twofold increase in GM-CSF was observed and related to enhanced messenger RNA (mRNA) translation. The mechanism was associated with disruption of stress granule formation. Specifically, loss of BMPR2 induced prolonged phospho-p38 mitogen-activated protein kinase (MAPK) in response to TNF, and this increased GADD34–PP1 phosphatase activity, dephosphorylating eukaryotic translation initiation factor (eIF2α), and derepressing GM-CSF mRNA translation. Lungs from IPAH patients versus unused donor controls revealed heightened PA expression of GM-CSF co-distributing with increased TNF and expanded populations of hematopoietic and endothelial GM-CSF receptor α (GM-CSFRα)–positive cells. Moreover, a 3-wk infusion of GM-CSF in mice increased hypoxia-induced PAH, in association with increased perivascular macrophages and muscularized distal arteries, whereas blockade of GM-CSF repressed these features. Thus, reduced BMPR2 can subvert a stress granule response, heighten GM-CSF mRNA translation, increase inflammatory cell recruitment, and exacerbate PAH.
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