Therapeutic potential of KLF2-induced exosomal microRNAs in pulmonary hypertension

Nat Commun. 2020 Mar 4;11(1):1185. doi: 10.1038/s41467-020-14966-x.

Abstract

Pulmonary arterial hypertension (PAH) is a severe disorder of lung vasculature that causes right heart failure. Homoeostatic effects of flow-activated transcription factor Krüppel-like factor 2 (KLF2) are compromised in PAH. Here, we show that KLF2-induced exosomal microRNAs, miR-181a-5p and miR-324-5p act together to attenuate pulmonary vascular remodelling and that their actions are mediated by Notch4 and ETS1 and other key regulators of vascular homoeostasis. Expressions of KLF2, miR-181a-5p and miR-324-5p are reduced, while levels of their target genes are elevated in pre-clinical PAH, idiopathic PAH and heritable PAH with missense p.H288Y KLF2 mutation. Therapeutic supplementation of miR-181a-5p and miR-324-5p reduces proliferative and angiogenic responses in patient-derived cells and attenuates disease progression in PAH mice. This study shows that reduced KLF2 signalling is a common feature of human PAH and highlights the potential therapeutic role of KLF2-regulated exosomal miRNAs in PAH and other diseases associated with vascular remodelling.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Animals
  • Cell Proliferation / genetics
  • Disease Models, Animal
  • Disease Progression
  • Endothelial Cells
  • Exosomes / genetics
  • Exosomes / metabolism
  • Female
  • Gene Expression Regulation
  • Genetic Therapy / methods*
  • Humans
  • Kruppel-Like Transcription Factors / genetics
  • Kruppel-Like Transcription Factors / metabolism*
  • Lung / blood supply
  • Lung / cytology
  • Lung / pathology
  • Male
  • Mice
  • MicroRNAs / metabolism
  • MicroRNAs / therapeutic use*
  • Middle Aged
  • Mutation, Missense
  • Primary Cell Culture
  • Pulmonary Arterial Hypertension / genetics
  • Pulmonary Arterial Hypertension / pathology
  • Pulmonary Arterial Hypertension / therapy*
  • Pulmonary Artery / cytology
  • Pulmonary Artery / pathology
  • Signal Transduction / genetics
  • Vascular Remodeling / genetics
  • Young Adult

Substances

  • KLF2 protein, human
  • Kruppel-Like Transcription Factors
  • MIRN324 microRNA, human
  • MIrn181 microRNA, human
  • MicroRNAs