Abstract.Previous results have indicated that mitochondrial ATP-sensitive potassium (mitoK ATP ) channels are associated with the hypoxic proliferation of pulmonary artery smooth muscle cells (PASMCs). However, the mechanism underlying the promotive effects of mitoK ATP channels on cell proliferation in response to hypoxia remains unknown. mitoK ATP channel opening results in a collapse of mitochondrial membrane potential and generation of mitochondrial reactive oxygen species (ROS). As hypoxia-inducible factor-1α (HIF-1α) is a critical oxygen sensor and major transcriptional regulator of the hypoxic adaptive response, the current study assessed whether mitoK ATP opening contributes to the chronic proliferation of human PASMCs (hPASMCs) in collaboration with HIF-1α and its downstream targets under hypoxic conditions. The present study demonstrated that there was crosstalk between mitoK ATP channels and HIF-1α signaling in PASMCs under hypoxic conditions. The results suggest that mitoK ATP channels are involved in the proliferation of PASMCs during hypoxia through upregulation of the ROS/HIF/microRNA-210/iron-sulfur cluster protein signaling pathway.
IntroductionPulmonary arterial hypertension (PAH) is a life-threatening disorder characterized by obstructive remodeling of the pulmonary arteries, which may lead to right-sided heart failure and mortality (1-2). PAH may be defined as a mean pulmonary artery pressure (mPAP) of ≥20 mmHg at rest or >30 mmHg with exercise, along with a pulmonary artery occlusion pressure of ≤15 mmHg (1-2). The estimated incidence of primary pulmonary hypertension is 1-2/million in the global population (1-2). There are currently three treatment pathways, namely phosphodiesterase type 5 inhibitor or soluble guanylate cyclase stimulator, prostacyclin class therapy and endothelium receptor antagonist, which target the imbalances of three substances; nitric oxide, prostacyclin and endothelin, respectively (3). Despite the efficacy of these pharmacological therapies in improving symptoms, they do not prevent the progression of PAH or reduce the mortality rate of patients (3). Therefore, novel approaches that more effectively target PAH are required to control the cellular components associated with pulmonary remodeling. The chronic and continued proliferation of human pulmonary artery smooth muscle cells (hPASMCs), in addition to apoptotic resistance, leads to hypoxic pulmonary arterial remodeling, which is considered to be a key mechanism for the pathological development of PAH (4). ATP-sensitive potassium (K ATP ) channels are located on the cytoplasmic membrane and on subcellular membranes. Subcellular membrane-associated K ATP channels are divided into three types: Sarcolemmal K ATP , mitochondrial K ATP (mitoK ATP ) and nuclear K ATP . MitoK ATP channels, which contribute to the control of mitochondrial volume and energetic status (5-7), exhibit high sensitivity to hypoxia (8