Insulin-like growth factor (IGF)-1 is a potent mitogen of vascular smooth muscle cells (SMCs), but its role in pulmonary vascular remodeling associated with pulmonary hypertension (PH) is not clear. In an earlier study, we implicated IGF-1 in the pathogenesis of hypoxia-induced PH in neonatal mice. In this study, we hypothesized that hypoxia-induced up-regulation of IGF-1 in vascular smooth muscle is directly responsible for pulmonary vascular remodeling and PH. We studied neonatal and adult mice with smooth muscle-specific deletion of IGF-1 and also used an inhibitor of IGF-1 receptor (IGF-1R), OSI-906, in neonatal mice. We found that, in neonatal mice, SMC-specific deletion of IGF-1 or IGF-1R inhibition with OSI-906 attenuated hypoxia-induced pulmonary vascular remodeling in small arteries, right ventricular hypertrophy, and right ventricular systolic pressure. Pulmonary arterial SMCs from IGF-1-deleted mice or after OSI-906 treatment exhibited reduced proliferative potential. However, in adult mice, smooth muscle-specific deletion of IGF-1 had no effect on hypoxia-induced PH. Our data suggest that vascular smooth muscle-derived IGF-1 plays a critical role in hypoxia-induced PH in neonatal mice but not in adult mice. We speculate that the IGF-1/IGF-1R axis is important in pathogenesis of PH in the developing lung and may be amenable to therapeutic manipulation in this age group.Keywords: insulin-like growth factor; pulmonary hypertension; vascular smooth muscle; neonatal; hypoxia
Clinical RelevanceWhat this study adds to the field: Using conditional gene deletion in mice, this study shows that loss of insulin-like growth factor (IGF)-1 in smooth muscle cells protects against hypoxia-induced pulmonary vascular remodeling, right ventricular hypertrophy (RVH), and pulmonary hypertension (PH) in neonatal mice. Inhibition of IGF-1 receptor (IGF-1R) with OSI-906 diminished hypoxia-induced RVH and pulmonary vascular remodeling in neonatal mice, indicating that targeting the IGF-1/IGF-1R axis may have therapeutic benefits in the treatment of hypoxic PH in that age group. Pulmonary hypertension (PH) is characterized by a progressive increase in pulmonary arterial pressure accompanied by pulmonary vascular remodeling, leading to right ventricular hypertrophy (RVH) and failure. Proliferation and migration of smooth muscle cells (SMCs) is a characteristic feature of pulmonary vascular remodeling in PH, and dysregulation of many growth factors have been implicated in this process (1, 2). Several growth factors have been implicated in the vascular remodeling and pathogenesis of pulmonary arterial hypertension, and their definitive functions are still being unraveled (reviewed in Refs. 1, 3, 4). Insulin-like growth factor (IGF)-1 is a member of the insulin/IGF family and plays a crucial role in the growth, differentiation, and postnatal development of many tissues and in the regulation of overall growth and metabolism of an organism. IGF-1 is a single-chain polypeptide with a high sequence homology to proinsulin and ...