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Modulation of pulmonary endothelial endothelin B receptor expression and signaling: implications for experimental hepatopulmonary syndrome

¹Department of Internal Medicine and Liver Center and ²Department of Pathology, University of Alabama at Birmingham, and ³Birmingham Veterans Administration Medical Center, Birmingham, Alabama

Submitted 10 November 2006 ; accepted in final form 22 February 2007

The hepatopulmonary syndrome (HPS) results from intrapulmonary vasodilation in the setting of cirrhosis and portal hypertension. In experimental HPS, pulmonary endothelial endothelin B (ET_B) receptor overexpression and increased circulating endothelin-1 (ET-1) contribute to vasodilation through enhanced endothelial nitric oxide synthase (eNOS)-derived nitric oxide (NO) production. In both experimental cirrhosis and prehepatic portal hypertension, ET_B receptor overexpression correlates with increased vascular shear stress, a known modulator of ET_B receptor expression. We investigated the mechanisms of pulmonary endothelial ET_B receptor-mediated eNOS activation by ET-1 in vitro and in vivo. The effect of shear stress on ET_B receptor expression was assessed in rat pulmonary microvascular endothelial cells (RPMVECs). The consequences of ET_B receptor overexpression on ET-1-dependent ET_B receptor-mediated eNOS activation were evaluated in RPMVECs and in prehepatic portal hypertensive animals exposed to exogenous ET-1. Laminar shear stress increased ET_B receptor expression in RPMVECs without altering mRNA stability. Both shear-mediated and targeted overexpression of the ET_B receptor enhanced ET-1-mediated ET_B receptor-dependent eNOS activation in RPMVECs through Ca²⁺-mediated signaling pathways and independent of Akt activation. In prehepatic portal hypertensive animals relative to control, ET-1 administration also activated eNOS independent of Akt activation and triggered HPS. These findings support that increased pulmonary microvascular endothelial ET_B receptor expression modulates ET-1-mediated eNOS activation, independent of Akt, and contributes to the development of HPS.

endothelial nitric oxide synthase; Akt; shear stress

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				R. Rodriguez-Roisin and M. J. Krowka Hepatopulmonary Syndrome -- A Liver-Induced Lung Vascular Disorder N. Engl. J. Med., May 29, 2008; 358(22): 2378 - 2387. [Full Text] [PDF]