Activation of Autophagy Induces Monocrotaline-Induced Pulmonary Arterial Hypertension by FOXM1-Mediated FAK Phosphorylation

Lung. 2022 Oct;200(5):619-631. doi: 10.1007/s00408-022-00569-4. Epub 2022 Sep 15.

Abstract

Purpose: It has been shown that activation of autophagy promotes the development of pulmonary arterial hypertension (PAH). Meanwhile, forkhead box M1 (FOXM1) has been found to induce autophagy in several types of cancer. However, it is still unclear whether FOXM1 mediates autophagy activation in PAH, and detailed mechanisms responsible for these processes are indefinite.

Method: PAH was induced by a single intraperitoneal injection of monocrotaline (MCT) to rats. The right ventricle systolic pressure (RVSP), right ventricular hypertrophy index (RVHI), percentage of medial wall thickness (%MT), α-smooth muscle actin (α-SMA) staining, and Ki67 staining were performed to evaluate the development of PAH. The protein levels of FOXM1, phospho-focal adhesion kinase (p-FAK), FAK, and LC3B were determined by immunoblotting or immunohistochemistry.

Results: FOXM1 protein level and FAK activity were significantly increased in MCT-induced PAH rats, this was accompanied with the activation of autophagy. Pharmacological inhibition of FOXM1 or FAK suppressed MCT-induced autophagy activation, decreased RVSP, RVHI and %MT in MCT-induced PAH rats, and inhibited the proliferation of pulmonary arterial smooth muscle cells and pulmonary vessel muscularization in MCT-induced PAH rats.

Conclusion: FOXM1 promotes the development of PAH by inducing FAK phosphorylation and subsequent activation of autophagy in MCT-treated rats.

Keywords: Autophagy; Focal adhesion kinase (FAK); Forkhead box M1 (FOXM1); Pulmonary arterial hypertension; Pulmonary vascular remodeling.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actins / metabolism
  • Animals
  • Autophagy
  • Disease Models, Animal
  • Familial Primary Pulmonary Hypertension
  • Forkhead Box Protein M1 / metabolism
  • Forkhead Box Protein M1 / therapeutic use
  • Hypertension, Pulmonary* / drug therapy
  • Hypertrophy, Right Ventricular / chemically induced
  • Hypertrophy, Right Ventricular / metabolism
  • Ki-67 Antigen / metabolism
  • Monocrotaline / metabolism
  • Monocrotaline / toxicity
  • Phosphorylation
  • Pulmonary Arterial Hypertension* / chemically induced
  • Pulmonary Artery
  • Rats
  • Rats, Sprague-Dawley

Substances

  • Actins
  • Forkhead Box Protein M1
  • Foxm1 protein, rat
  • Ki-67 Antigen
  • Monocrotaline