Intermittent short-duration reoxygenation relieves high-altitude pulmonary hypertension via NOX4/H2O2/PPAR-γ axis

Clin Sci (Lond). 2024 Feb 7;138(3):103-115. doi: 10.1042/CS20231508.

Abstract

High-altitude pulmonary hypertension (HAPH) is a severe and progressive disease that can lead to right heart failure. Intermittent short-duration reoxygenation at high altitude is effective in alleviating HAPH; however, the underlying mechanisms are unclear. In the present study, a simulated 5,000-m hypoxia rat model and hypoxic cultured pulmonary artery smooth muscle cells (PASMCs) were used to evaluate the effect and mechanisms of intermittent short-duration reoxygenation. The results showed that intermittent 3-h/per day reoxygenation (I3) effectively attenuated chronic hypoxia-induced pulmonary hypertension and reduced the content of H2O2 and the expression of NADPH oxidase 4 (NOX4) in lung tissues. In combination with I3, while the NOX inhibitor apocynin did not further alleviate HAPH, the mitochondrial antioxidant MitoQ did. Furthermore, in PASMCs, I3 attenuated hypoxia-induced PASMCs proliferation and reversed the activated HIF-1α/NOX4/PPAR-γ axis under hypoxia. Targeting this axis offset the protective effect of I3 on hypoxia-induced PASMCs proliferation. The present study is novel in revealing a new mechanism for preventing HAPH and provides insights into the optimization of intermittent short-duration reoxygenation.

Keywords: NADHP oxidase 4; hypobaric hypoxia; intermittent short-duration reoxygenation; pulmonary hypertension.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Altitude
  • Altitude Sickness*
  • Animals
  • Cell Proliferation
  • Cells, Cultured
  • Hydrogen Peroxide / metabolism
  • Hypertension, Pulmonary* / etiology
  • Hypertension, Pulmonary* / metabolism
  • Hypertension, Pulmonary* / prevention & control
  • Hypoxia / metabolism
  • Myocytes, Smooth Muscle / metabolism
  • NADPH Oxidase 4 / genetics
  • NADPH Oxidase 4 / metabolism
  • PPAR gamma / metabolism
  • Pulmonary Artery / metabolism
  • Rats
  • Signal Transduction

Substances

  • Hydrogen Peroxide
  • NADPH Oxidase 4
  • PPAR gamma
  • Nox4 protein, rat

Supplementary concepts

  • Pulmonary edema of mountaineers