Increased bone morphogenetic protein 10 in precapillary pulmonary hypertension patients

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Precapillary pulmonary hypertension (precPH) results in increased right atrial (RA) stretch and pressure. The right atrium is the major source of bone morphogenetic protein 10 (BMP10) in adults. Our aim was to investigate BMP10 expression in the right atrium and peripheral blood of precPH patients. BMP10 gene, protein and activity, measured through RT-PCR and immunofluorescent stainings, were significantly increased in the precPH right atrium. BMP10 plasma levels were quantified through ELISA, and BMP10 activity using the BRE-luc assay. PrecPH patients had greater BMP10 plasma levels, but similar BMP10 activity compared to controls. Correlation analyses were performed between plasma BMP10 levels and different clinical parameters. Interestingly, high BMP10 activity correlated with disease severity (RA dilatation, increased RA pressure, high NTproBNP levels and reduced RV ejection fraction). Finally, pressure unloading after PEA in a cohort of Chronic Thromboembolic Pulmonary Hypertension (CTEPH) patients, resulted in reduced BMP10 activity after pulmonary endarterectomy. erj;66/suppl_69/PA4099/F1 F1 F1 In conclusion, RA BMP10 expression and plasma levels are increased in precPH, likely due to excessive RA dilatation and pressure overload. Future studies are needed to identify potential triggers of BMP10 secretion and determine whether increased BMP10 is an adaptive mechanism or a potential therapeutic target.

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