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A4366 - An Implication of NOX4 in Pulmonary Vascular Remodeling Contributes to Pulmonary Hypertension in COPD
Author Block: C. Jieda1, X. Guo2, Y. Fan2, J. Chen2, X. Liu3, Lung immunology research group; 1Ningxia Medical University, Yinchuan, China, 2Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, Yinchuan, China, 3General Hospital, Ningxia Medical University, Yinchuan, China.
Background: Pulmonary hypertension (PH) in chronic obstructive pulmonary disease (COPD) has been suggested as a result of emphysematous destruction of vascular bed and pulmonary hypoxia microenvironment. However mechanisms underpinning the pathogenesis of PH remain elusive. The dysregulated expression of nicotinamide adenine dinucleotide phosphate (NADPH)-oxidases and superoxide generation of pulmonary vasculatures are involved in hypoxia-induced PH. Methods: In this study, the involvement of NADPH oxidase subunit 4 (NOX4) in pulmonary arteriolar remodeling of PH in COPD was investigated by ascertaining the morphological alteration of pulmonary arteries and pulmonary blood flow using cardiac magnetic resonance imaging (cMRI), and the expression of NOX4 and its correlation with pulmonary vascular remodeling and pulmonary functions in COPD lungs. Results: Results demonstrated that an augmented expression of NOX4 was correlated with the increased volume of pulmonary vascular wall in COPD. Of note, the volume of distal pulmonary arteries was inversely correlated with pulmonary functions, but positively correlated with the main pulmonary artery distensibility, right ventricular myocardial mass end-systolic and right ventricular myocardial mass end-diastolic in COPD patients. In addition, an increased malondialdehyde and a decreased superoxide dismutase was observed in sera of COPD patients. Mechanistically, transforming growth factor-beta (TGF-β) could dynamically induce the expression of NOX4 and production of reactive oxygen species (ROS) in pulmonary artery smooth muscle cells and lead pulmonary arteriolar remodeling in COPD lungs. Conclusion: These results thus suggest that the NOX4-derived ROS production may play a key role in the development of PH in COPD by promoting distal pulmonary vascular remodeling.