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1 University of Arkansas for Medical Sciences
2 Medical College of Wisconsin
3 Zablocki Veterans Administration Medical Center
4 Children's Hospital of Wisconsin
* To whom correspondence should be addressed. E-mail: nrusch{at}uams.edu.
Inhibition of voltage-gated, L-type Ca2+ (CaL) channels by clinical calcium channel blockers provides symptomatic improvement to some pediatric patients with pulmonary arterial hypertension (PAH). The present study investigated whether abnormalities of vascular CaL channels contribute to the pathogenesis of neonatal PAH using a newborn piglet model of hypoxia-induced PAH. Neonatal piglets exposed to chronic hypoxia (CH) developed PAH by 21 days, which was evident as a 2.1-fold increase in pulmonary vascular resistance in vivo compared to piglets raised in normoxia (N). Transpulmonary pressures (
PT) in the corresponding isolated perfused lungs were 20.5 ± 2.1 mm Hg (CH) and 11.6 ± 0.8 mm Hg (N). Nifedipine reduced the elevated
PT in isolated lungs of CH piglets by 6.4 ± 1.3 mm Hg, but only reduced
PT in lungs of N piglets by 1.9 ± 0.2 mm Hg. Small pulmonary arteries from CH piglets also demonstrated accentuated Ca2+-dependent contraction, and Ca2+ channel current was 3.94-fold higher in the resident vascular muscle cells. Finally, although the level of mRNA encoding the pore-forming
1C subunit of the CaL channel was similar between small pulmonary arteries from N and CH piglets, a profound and persistent upregulation of the vascular
1C protein was detected by 10 days in CH piglets at a time when pulmonary vascular resistance was only mildly elevated. Thus, chronic hypoxia in the neonate is associated with the anomalous upregulation of CaL channels in small pulmonary arteries in vivo, and the resulting abnormal Ca2+-dependent resistance may contribute to the pathogenesis of PAH.
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