The Roles of S100A4 and the EGF/EGFR Signaling Axis in Pulmonary Hypertension with Right Ventricular Hypertrophy

• Published in: Biology (Basel, Switzerland) Vol. 11; no. 1; p. 118
• Main Authors: Laggner, Maria, Hacker, Philipp, Oberndorfer, Felicitas, Bauer, Jonas, Raunegger, Thomas, Gerges, Christian, Szerafin, Tamás, Thanner, Jürgen, Lang, Irene, Skoro-Sajer, Nika, Ankersmit, Hendrik Jan, Moser, Bernhard
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 12.01.2022; MDPI
• Subjects: Aortic stenosis; Aortic valve; Biomarkers; Blood pressure; chronic thromboembolic pulmonary hypertension; Congestive heart failure; Coronary artery disease; Disease; Endothelial cells; Enzymes; Epidermal growth factor; epidermal growth factor receptor; Epidermal growth factor receptors; Etiology; Heart failure; Heart surgery; Hypertension; Hypertrophy; Hypoxia; idiopathic pulmonary arterial hypertension; Inflammation; Ligands; Lung diseases; Lungs; Mesenchyme; Pathology; Patients; Proteins; Pulmonary arteries; Pulmonary hypertension; Rheumatic heart disease; S100A4; S100A4 protein; Stenosis; Thoracic surgery; Thromboembolism; Veins & arteries; Ventricle; Hungary; Austria; chronic thromboembolic pulmonary hypertension; endothelial-to-mesenchymal transition; epidermal growth factor receptor; pulmonary hypertension; S100A4; epidermal growth factor; atrial valve stenosis; idiopathic pulmonary arterial hypertension
• ISSN: 2079-7737; 2079-7737
• DOI: 10.3390/biology11010118

Pulmonary hypertension (PH) is characterized by increased pulmonary arterial pressure caused by the accumulation of mesenchymal-like cells in the pulmonary vasculature. PH can lead to right ventricular hypertrophy (RVH) and, ultimately, heart failure and death. In PH etiology, endothelial-to-mesenchymal transition (EndMT) has emerged as a critical process governing the conversion of endothelial cells into mesenchymal cells, and S100A4, EGF, and EGFR are implicated in EndMT. However, a potential role of S100A4, EGF, and EGFR in PH has to date not been elucidated. We therefore quantified S100A4, EGF, and EGFR in patients suffering from chronic thromboembolic pulmonary hypertension (CTEPH) and idiopathic pulmonary arterial hypertension (iPAH). To determine specificity for unilateral heart disease, the EndMT biomarker signature was further compared between PH patients presenting with RVH and patients suffering from aortic valve stenosis (AVS) with left ventricular hypertrophy. Reduced S100A4 concentrations were found in CTEPH and iPAH patients with RVH. Systemic EGF was increased in CTEPH but not in iPAH, while AVS patients displayed slightly diminished EGF levels. EGFR was downregulated in all patient groups when compared to healthy controls. Longitudinal data analysis revealed no effect of surgical therapies on EndMT markers. Pulmonary thrombo-endarterectomized samples were devoid of S100A4, while S100A4 tissue expression positively correlated with higher grades of Heath-Edwards histopathological lesions of iPAH-derived lung tissue. Histologically, EGFR was not detectable in CTEPH lungs or in iPAH lesions. Together, our data suggest an intricate role for S100A4 and EGF/EGFR in PH with right heart pathology.