Stem/Progenitor Cells and Pulmonary Arterial Hypertension

Arterioscler Thromb Vasc Biol. 2021 Jan;41(1):167-178. doi: 10.1161/ATVBAHA.120.315052. Epub 2020 Oct 8.

Abstract

Pulmonary arterial hypertension (PAH) is a progressive disease characterized by endothelial dysfunction and vascular remodeling. Despite significant advancement in our understanding of the pathogenesis of PAH in recent years, treatment options for PAH are limited and their prognosis remains poor. PAH is now seen as a severe pulmonary arterial vasculopathy with structural changes driven by excessive vascular proliferation and inflammation. Perturbations of a number of cellular and molecular mechanisms have been described, including pathways involving growth factors, cytokines, metabolic signaling, elastases, and proteases, underscoring the complexity of the disease pathogenesis. Interestingly, emerging evidence suggests that stem/progenitor cells may have an impact on disease development and therapy. In preclinical studies, stem/progenitor cells displayed an ability to promote endothelial repair of dysfunctional arteries and induce neovascularization. The stem cell-based therapy for PAH are now under active investigation. This review article will briefly summarize the updates in the research field, with a special focus on the contribution of stem/progenitor cells to lesion formation via influencing vascular cell functions and highlight the potential clinical application of stem/progenitor cell therapy to PAH.

Keywords: endothelial cells; hyperplasia; neointima; pulmonary arterial hypertension; syndrome.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Arterial Pressure
  • Endothelial Progenitor Cells / metabolism
  • Endothelial Progenitor Cells / transplantation*
  • Endothelium, Vascular / metabolism
  • Endothelium, Vascular / pathology*
  • Endothelium, Vascular / physiopathology
  • Humans
  • Induced Pluripotent Stem Cells / metabolism
  • Induced Pluripotent Stem Cells / transplantation*
  • Mesenchymal Stem Cell Transplantation*
  • Phenotype
  • Pulmonary Arterial Hypertension / metabolism
  • Pulmonary Arterial Hypertension / pathology
  • Pulmonary Arterial Hypertension / physiopathology
  • Pulmonary Arterial Hypertension / surgery*
  • Pulmonary Artery / metabolism
  • Pulmonary Artery / pathology*
  • Pulmonary Artery / physiopathology
  • Vascular Remodeling*