Pulmonary hypertension and insulin resistance: a mechanistic overview
Pulmonary arterial hypertension (PAH) is a vascular remodeling disease, characterized by increased blood pressure levels in pulmonary circulation, leading to a restriction in the circulation flow and heart failure. Although the emergence of new PAH therapies has increased survival rates, this diseas...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1283233/full |
| _version_ | 1797366589441441792 |
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| author | Tamires M. Zanotto Tamires M. Zanotto Any Elisa de Souza Schmidt Gonçalves Mario J. A. Saad Mario J. A. Saad |
| author_facet | Tamires M. Zanotto Tamires M. Zanotto Any Elisa de Souza Schmidt Gonçalves Mario J. A. Saad Mario J. A. Saad |
| author_sort | Tamires M. Zanotto |
| collection | DOAJ |
| description | Pulmonary arterial hypertension (PAH) is a vascular remodeling disease, characterized by increased blood pressure levels in pulmonary circulation, leading to a restriction in the circulation flow and heart failure. Although the emergence of new PAH therapies has increased survival rates, this disease still has a high mortality and patients that receive diagnosis die within a few years. The pathogenesis of PAH involves multiple pathways, with a complex interaction of local and distant cytokines, hormones, growth factors, and transcription factors, leading to an inflammation that changes the vascular anatomy in PAH patients. These abnormalities involve more than just the lungs, but also other organs, and between these affected organs there are different metabolic dysfunctions implied. Recently, several publications demonstrated in PAH patients a disturbance in glucose metabolism, demonstrated by higher levels of glucose, insulin, and lipids in those patients. It is possible that a common molecular mechanism can have a significant role in this connection. In this regard, this narrative review intends to focus on the recent papers that mainly discuss the molecular determinants between insulin resistance (IR) associated PAH, which included obesity subclinical inflammation induced IR, PPAR gamma and Adiponectin, BMPR2, mitochondrial dysfunction and endoplasmic reticulum stress. Therefore, the following review will summarize some of the existing data for IR associated PAH, focusing on the better understanding of PAH molecular mechanisms, for the development of new translational therapies. |
| first_indexed | 2024-03-08T17:05:57Z |
| format | Article |
| id | doaj.art-71ad890da6034254865e72ff925f6371 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-08T17:05:57Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-71ad890da6034254865e72ff925f63712024-01-04T04:51:08ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922024-01-011410.3389/fendo.2023.12832331283233Pulmonary hypertension and insulin resistance: a mechanistic overviewTamires M. Zanotto0Tamires M. Zanotto1Any Elisa de Souza Schmidt Gonçalves2Mario J. A. Saad3Mario J. A. Saad4Department of Internal Medicine, State University of Campinas (UNICAMP), Campinas, SP, BrazilDepartament of Medical Clinics, Obesity and Comorbidities Research Centre (O.C.R.C.), State University of Campinas (UNICAMP), Campinas, SP, BrazilDepartment of Internal Medicine, State University of Campinas (UNICAMP), Campinas, SP, BrazilDepartment of Internal Medicine, State University of Campinas (UNICAMP), Campinas, SP, BrazilDepartament of Medical Clinics, Obesity and Comorbidities Research Centre (O.C.R.C.), State University of Campinas (UNICAMP), Campinas, SP, BrazilPulmonary arterial hypertension (PAH) is a vascular remodeling disease, characterized by increased blood pressure levels in pulmonary circulation, leading to a restriction in the circulation flow and heart failure. Although the emergence of new PAH therapies has increased survival rates, this disease still has a high mortality and patients that receive diagnosis die within a few years. The pathogenesis of PAH involves multiple pathways, with a complex interaction of local and distant cytokines, hormones, growth factors, and transcription factors, leading to an inflammation that changes the vascular anatomy in PAH patients. These abnormalities involve more than just the lungs, but also other organs, and between these affected organs there are different metabolic dysfunctions implied. Recently, several publications demonstrated in PAH patients a disturbance in glucose metabolism, demonstrated by higher levels of glucose, insulin, and lipids in those patients. It is possible that a common molecular mechanism can have a significant role in this connection. In this regard, this narrative review intends to focus on the recent papers that mainly discuss the molecular determinants between insulin resistance (IR) associated PAH, which included obesity subclinical inflammation induced IR, PPAR gamma and Adiponectin, BMPR2, mitochondrial dysfunction and endoplasmic reticulum stress. Therefore, the following review will summarize some of the existing data for IR associated PAH, focusing on the better understanding of PAH molecular mechanisms, for the development of new translational therapies.https://www.frontiersin.org/articles/10.3389/fendo.2023.1283233/fullpulmonary arterial hypertensioninsulin resistanceoxidative stressendoplasmic reticulum stressmitochondria dysfunction |
| spellingShingle | Tamires M. Zanotto Tamires M. Zanotto Any Elisa de Souza Schmidt Gonçalves Mario J. A. Saad Mario J. A. Saad Pulmonary hypertension and insulin resistance: a mechanistic overview Frontiers in Endocrinology pulmonary arterial hypertension insulin resistance oxidative stress endoplasmic reticulum stress mitochondria dysfunction |
| title | Pulmonary hypertension and insulin resistance: a mechanistic overview |
| title_full | Pulmonary hypertension and insulin resistance: a mechanistic overview |
| title_fullStr | Pulmonary hypertension and insulin resistance: a mechanistic overview |
| title_full_unstemmed | Pulmonary hypertension and insulin resistance: a mechanistic overview |
| title_short | Pulmonary hypertension and insulin resistance: a mechanistic overview |
| title_sort | pulmonary hypertension and insulin resistance a mechanistic overview |
| topic | pulmonary arterial hypertension insulin resistance oxidative stress endoplasmic reticulum stress mitochondria dysfunction |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1283233/full |
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