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Oxford University Press, Human Molecular Genetics, 18(22), p. 3667-3679, 2013

DOI: 10.1093/hmg/ddt216

Oxford University Press (OUP), Human Molecular Genetics, 25(22), p. 5296-5296

DOI: 10.1093/hmg/ddt492

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The lysosomal inhibitor, chloroquine, increases cell surface BMPR-II levels and restores BMP9 signalling in endothelial cells harbouring BMPR-II mutations

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Pulmonary arterial hypertension (PAH) is characterised by dysregulated pulmonary artery endothelial cell (PAEC) proliferation, apoptosis and permeability. Loss of function mutations in the bone morphogenetic protein receptor type-II (BMPR-II) are the commonest cause of heritable PAH, usually resulting in haploinsufficiency. We previously showed that BMPR-II expression is regulated via a lysosomal degradative pathway. Here we show that the antimalarial drug, chloroquine, markedly increased cell surface expression of BMPR-II protein independent of transcription in PAECs. Inhibition of protein synthesis experiments revealed a rapid turnover of cell surface BMPR-II, which was inhibited by chloroquine treatment. Chloroquine enhanced PAEC expression of BMPR-II following siRNA knockdown of the BMPR-II transcript. Using blood outgrowth endothelial cells (BOECs), we confirmed that signalling in response to the endothelial BMPR-II ligand, BMP9, is compromised in BOECs from patients harbouring BMPR-II mutations, and in BMPR-II mutant pulmonary artery endothelial cells (PAECs). Chloroquine significantly increased gene expression of BMP9-BMPR-II signalling targets Id1, miR21 and miR27a in both mutant BMPR-II PAECs and BOECs. These findings provide support for the restoration of cell surface BMPR-II with agents such as chloroquine as a potential therapeutic approach for heritable PAH.