Pharmacologic and genetic inhibition of G6PD activity attenuates right
ventricle pressure and hypertrophy elicited by hypoxia and VEGF
inhibitor+hypoxia
Abstract
Background and Purpose: Pulmonary hypertension (PH) is a disease of
hyperplasia of pulmonary vascular cells. The pentose phosphate pathway
(PPP) – a fundamental glucose metabolism pathway – is vital for cell
growth. Because treatment for PH is inadequate, our goal was to
determine whether inhibition of glucose-6-phosphate dehydrogenase
(G6PD), the rate-limiting enzyme of the PPP, prevents maladaptive gene
expression that promotes smooth muscle cell (SMC) growth, reduces
pulmonary artery remodeling, and normalizes hemodynamics in experimental
models of PH. Experimental Approach: PH was induced in mice by exposure
to 10% oxygen (Hx) or weekly injection of vascular endothelial growth
factor receptor blocker (Sugen5416 (SU); 20 mg.kg-1) during exposure to
hypoxia (Hx+SU), and in rats by injecting SU, exposure to 3 weeks Hx,
and then 5 weeks normoxia. G6PD inhibitor (PDD4091;1.5 mg kg-1) was
injected daily during exposure to Hx. We measured right ventricular (RV)
pressure and left ventricular (LV) pressure-volume relationships, and
gene expression in lungs of normoxic, Hx, and Hx+SU, and G6PD
inhibitor-treated, mice and rats. Key Results: RV systolic and
end-diastolic pressures were higher in Hx and Hx+SU than
normoxic-control mice. Hx and Hx+SU decreased expression of epigenetic
modifiers, increased hypomethylation of the DNA, and induced aberrant
gene expression in lungs. G6PD inhibition decreased maladaptive
expression of genes and SMC growth, reduced pulmonary vascular
remodeling, and decreased RV pressures, compared to untreated PH groups.
Conclusions and Implications: Inhibition of G6PD efficaciously reduces
RV pressure overload in Hx and Hx+SU mice and rats and appears to be a
safe pharmacotherapeutic strategy.