| First Author | Ghosh MC | Year | 2021 |
| Journal | Blood | Volume | 137 |
| Issue | 18 | Pages | 2509-2519 |
| PubMed ID | 33512384 | Mgi Jnum | J:327650 |
| Mgi Id | MGI:6724698 | Doi | 10.1182/blood.2020009138 |
| Citation | Ghosh MC, et al. (2021) Therapeutic inhibition of HIF-2alpha reverses polycythemia and pulmonary hypertension in murine models of human diseases. Blood 137(18):2509-2519 |
| abstractText | Polycythemia and pulmonary hypertension are 2 human diseases for which better therapies are needed. Upregulation of hypoxia-inducible factor-2alpha (HIF-2alpha) and its target genes, erythropoietin (EPO) and endothelin-1, causes polycythemia and pulmonary hypertension in patients with Chuvash polycythemia who are homozygous for the R200W mutation in the von Hippel Lindau (VHL) gene and in a murine mouse model of Chuvash polycythemia that bears the same homozygous VhlR200W mutation. Moreover, the aged VhlR200W mice developed pulmonary fibrosis, most likely due to the increased expression of Cxcl-12, another Hif-2alpha target. Patients with mutations in iron regulatory protein 1 (IRP1) also develop polycythemia, and Irp1-knockout (Irp1-KO) mice exhibit polycythemia, pulmonary hypertension, and cardiac fibrosis attributable to translational derepression of Hif-2alpha, and the resultant high expression of the Hif-2alpha targets EPO, endothelin-1, and Cxcl-12. In this study, we inactivated Hif-2alpha with the second-generation allosteric HIF-2alpha inhibitor MK-6482 in VhlR200W, Irp1-KO, and double-mutant VhlR200W;Irp1-KO mice. MK-6482 treatment decreased EPO production and reversed polycythemia in all 3 mouse models. Drug treatment also decreased right ventricular pressure and mitigated pulmonary hypertension in VhlR200W, Irp1-KO, and VhlR200W;Irp1-KO mice to near normal wild-type levels and normalized the movement of the cardiac interventricular septum in VhlR200Wmice. MK-6482 treatment reduced the increased expression of Cxcl-12, which, in association with CXCR4, mediates fibrocyte influx into the lungs, potentially causing pulmonary fibrosis. Our results suggest that oral intake of MK-6482 could represent a new approach to treatment of patients with polycythemia, pulmonary hypertension, pulmonary fibrosis, and complications caused by elevated expression of HIF-2alpha. |
