Abstract
The pathogenesis of chronic thromboembolic pulmonary hypertension may be multifactorial and requires further studies. We explored alterations in pulmonary artery endothelial cells under the hypoxic and elevated interleukin-17 conditions that are commonly present in patients with chronic thromboembolic pulmonary hypertension. We measured the serum interleukin-17 levels in 10 chronic thromboembolic pulmonary hypertension patients and 10 healthy control persons. The expressions and localisations of hypoxia-inducible factor-1α and endothelial nitric oxide synthase were detected in tissues. The levels of hypoxia-inducible factor-1α, endothelial nitric oxide synthase, nitric oxide, and reactive oxygen species in cultured pulmonary artery endothelial cells were examined under hypoxia and/or interleukin-17 treatment. The serum interleukin-17 level was increased in chronic thromboembolic pulmonary hypertension patients. Hypoxia-inducible factor-1α was increased, and endothelial nitric oxide synthase was decreased in chronic thromboembolic pulmonary hypertension pulmonary vascular tissue. After receiving the hypoxia combined with interleukin-17 treatment, pulmonary artery endothelial cells showed increased levels of hypoxia-inducible factor-1α and phospho-endothelial nitric oxide synthase (Thr495) (p = 0.001 and 0.063, respectively) and a decreased level of endothelial nitric oxide synthase (p < 0.001). In addition, the nitric oxide level was significantly decreased (p = 0.001), whereas the reactive oxygen species level was insignificantly increased in pulmonary artery endothelial cells. Chronic thromboembolic pulmonary hypertension patients might experience increased inflammation and hypoxia due to dysregulation of the hypoxia-inducible factor-1α/endothelial nitric synthase pathway in pulmonary artery endothelial cells under inflammation and hypoxia, contributing to the pathogenesis of chronic thromboembolic pulmonary hypertension.