Somatic chromosome abnormalities in the lungs of patients with pulmonary arterial hypertension

Micheala A. Aldred, Suzy A. Comhair, Marileila Varella-Garcia, Kewal Asosingh, Weiling Xu, George P. Noon, Patricia A. Thistlethwaite, Rubin M. Tuder, Serpil C. Erzurum, Mark W. Geraci, Christopher D. Coldren

Research output: Contribution to journalArticle

94 Scopus citations

Abstract

Rationale: Vascular remodeling in pulmonary arterial hypertension (PAH) involves proliferation and migration of endothelial and smooth muscle cells, leading to obliterative vascular lesions. Previous studies have indicated that the endothelial cell proliferation is quasineoplastic, with evidence of monoclonality and instability of short DNA microsatellite sequences. Objectives: To assess whether there is larger-scale genomic instability. Methods: We performed genome-wide microarray copy number analysis on pulmonary artery endothelial cells and smooth muscle cells isolated from the lungs of patients with PAH. Measurements and Main Results: Mosaic chromosomal abnormalities were detected in PAEC cultures from five of nine PAH lungs but not in normal (n = 8) or disease control subjects (n = 5). Fluorescent in situ hybridization analysis confirmed the presence of these abnormalities in vivo in two of three cases. One patient harbored a germline mutation of BMPR2, the primary genetic cause of PAH, and somatic loss of chromosome-13, which constitutes a second hit in the same pathway by deleting Smad-8. In two female subjects with mosaic loss of the X chromosome, methylation analysis showed that the active X was deleted. One subject also showed completely skewed X-inactivation in the nondeleted cells, suggesting the pulmonary artery endothelial cell population was clonal before the acquisition of the chromosome abnormality. Conclusions: Our data indicate a high frequency of genetically abnormal subclones within PAH lung vessels and provide the first definitive evidence of a second genetic hit in a patient with a germline BMPR2 mutation. We propose that these chromosome abnormalities may confer a growth advantage and thus contribute to the progression of PAH.

Original languageEnglish (US)
Pages (from-to)1153-1160
Number of pages8
JournalAmerican journal of respiratory and critical care medicine
Volume182
Issue number9
DOIs
StatePublished - Nov 1 2010

Keywords

  • Chromosome deletion
  • Endothelium
  • Somatic genetics

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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    Aldred, M. A., Comhair, S. A., Varella-Garcia, M., Asosingh, K., Xu, W., Noon, G. P., Thistlethwaite, P. A., Tuder, R. M., Erzurum, S. C., Geraci, M. W., & Coldren, C. D. (2010). Somatic chromosome abnormalities in the lungs of patients with pulmonary arterial hypertension. American journal of respiratory and critical care medicine, 182(9), 1153-1160. https://doi.org/10.1164/rccm.201003-0491OC