Plasma Exosomes Confer Hypoxic Pulmonary Hypertension by Transferring
LOX-1 Cargo
Abstract
ABSTRACT Background and Purpose The pulmonary vascular remodeling (PVR),
the pathological basis of pulmonary hypertension (PH), entails pulmonary
artery smooth muscle cells (PASMCs) phenotypic switching, but
appreciation of the underlying mechanisms is incomplete. Exosomes, a
novel transfer machinery enabling delivery of its cargos to recipient
cells, have been recently implicated in PH. The two critical questions
of whether plasma-derived exosomes drive PASMCs phenotypic switching and
what cargo the exosomes transport, however, remain unclear. Experimental
Approach PH is induced by exposure of rats to chronic hypoxia (10% O2,
3 weeks). Exosomes were isolated and purified from rat plasma by
ultracentrifugation. Exosomal LOX-1 was assessed by transmission
electron microscopy and Western blotting. PASMCs phenotypic switching
was determined by Western blotting, immunofluorescence staining and flow
cytometry. Key Results We characterized lectin like oxidized low-density
lipoprotein receptor-1 (LOX-1) as a novel cargo of plasma-derived
exosomes in PH. With LOX-1 knockout (Olr1-/-) rats-derived exosomes, we
demonstrated that exosomal LOX-1 could be transferred into PASMCs and
thus elicited cell phenotypic switching. Of importance, Olr1-/- rats
exhibited no cell phenotypic switching and developed less severe PH, but
administration of wild type rather than Olr1-/- exosomes to Olr1-/- rats
recapitulated the phenotype of PH with robust PASMCs phenotypic
switching. We also revealed that exosomal LOX-1 triggered PASMCs
phenotypic switching, PVR and ultimately PH via ERK1/2-KLF4 signaling
axis. Conclusion and Implications This study has generated proof that
plasma-derived exosomes confer PH by delivering LOX-1 into PASMCs.
Hence, exosomal LOX-1 represents a novel exploitable target for PH
prevention and treatment.