Cleavage and Polyadenylation Specificity Factor Subunit 5 Regulates Pulmonary Artery Smooth Muscle Expansion and Hypoxic Response

Scott D. Collum , Lisha Zhu , Tingting W. Mills , Rene Girard , Jamie Tran , Tinne C. J. Mertens , Cory Wilson , Nancy Wareing , Erik E. Suarez , Howard J. Huang , Rahat Hussain , Bindu Akkanti , Wenjin J. Zheng , Hari K. Yalamanchili , Bela Patel , Eric J. Wagner , Sandeep Agarwal , Harry Karmouty-Quintana

MedComm ›› 2026, Vol. 7 ›› Issue (2) : e70610

PDF
MedComm ›› 2026, Vol. 7 ›› Issue (2) :e70610 DOI: 10.1002/mco2.70610
ORIGINAL ARTICLE
Cleavage and Polyadenylation Specificity Factor Subunit 5 Regulates Pulmonary Artery Smooth Muscle Expansion and Hypoxic Response
Author information +
History +
PDF

Abstract

Pulmonary hypertension (PH) is a fatal condition that affects individuals with systemic sclerosis (SSc), a multiorgan fibrotic disease with limited treatment options. A central feature of PH is vascular remodeling, defined by the narrowing of the arteriole lumen due to cell proliferation and extracellular matrix deposition. Herein, we identify a central mechanism that can regulate multiple transcripts important for vascular remodeling. The highlight of our study is the demonstration that reduced pulmonary artery smooth muscle (PASMC) Nudt21, which codes for the RNA binding protein Cleavage and Polyadenylation Specificity Factor Subunit 5 (CPSF5) The, known to regulate alternative polyadenylation, results in heightened right ventricle systolic pressures in mice exposed to hypoxia–sugen. We also report that increased PASMC proliferation is present in mice with reduced PASMC Nudt21 under normoxic conditions, recapitulating features of hypoxia–sugen exposure. Our studies reveal that reduced CPSF5 leads to 3′ untranslated region shortening of PTGER3 and CBFB, the latter contributing to increased levels of proliferative transcription factor RUNX1. We also identify miR-3163 as novel negative regulator of NUDT21 expression in PH. These observations are validated in remodeled vessels from patients with SSc associated with PH and in and point to common mechanisms of RNA processing deficits that contribute to vascular remodeling in PH.

Keywords

pulmonary arterial hypertension / RUNX1 / cell proliferation / prostaglandin E receptor 3 (PTGER3) / EP3 / vascular tone / systemic sclerosis / CPSF5 / SSc-ILD

Cite this article

Download citation ▾
Scott D. Collum, Lisha Zhu, Tingting W. Mills, Rene Girard, Jamie Tran, Tinne C. J. Mertens, Cory Wilson, Nancy Wareing, Erik E. Suarez, Howard J. Huang, Rahat Hussain, Bindu Akkanti, Wenjin J. Zheng, Hari K. Yalamanchili, Bela Patel, Eric J. Wagner, Sandeep Agarwal, Harry Karmouty-Quintana. Cleavage and Polyadenylation Specificity Factor Subunit 5 Regulates Pulmonary Artery Smooth Muscle Expansion and Hypoxic Response. MedComm, 2026, 7(2): e70610 DOI:10.1002/mco2.70610

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

A. Mocumbi, M. Humbert, A. Saxena, et al., “Pulmonary Hypertension,” Nature Reviews Disease Primers 10, no. 1 (2024): 1.

[2]

H. D. Poor, R. Girgis, and S. M. Studer, “World Health Organization Group III Pulmonary Hypertension,” Progress in Cardiovascular Diseases 55, no. 2 (2012): 119–127.

[3]

C. E. Ventetuolo and J. R. Klinger, “WHO Group 1 Pulmonary Arterial Hypertension: Current and Investigative Therapies,” Progress in Cardiovascular Diseases 55, no. 2 (2012): 89–103.

[4]

R. A. Dweik, S. Rounds, S. C. Erzurum, et al., “An Official American Thoracic Society Statement: Pulmonary Hypertension Phenotypes,” American Journal of Respiratory and Critical Care Medicine 189, no. 3 (2014): 345–355.

[5]

F. Ingegnoli, N. Ughi, and C. Mihai, “Update on the Epidemiology, Risk Factors, and Disease Outcomes of Systemic Sclerosis,” Best Practice & Research Clinical Rheumatology 32, no. 2 (2018): 223–240.

[6]

C. Ferri, G. Valentini, F. Cozzi, et al., “Systemic Sclerosis: Demographic, Clinical, and Serologic Features and Survival in 1,012 Italian Patients,” Medicine 81, no. 2 (2002): 139–153.

[7]

F. Verrecchia, J. Laboureau, O. Verola, et al., “Skin Involvement in Scleroderma–where Histological and Clinical Scores Meet,” Rheumatology 46, no. 5 (2007): 833–841.

[8]

Y. Asano, “Systemic Sclerosis,” The Journal of Dermatology 45, no. 2 (2018): 128–138.

[9]

B. Lechartier and M. Humbert, “Pulmonary Arterial Hypertension in Systemic Sclerosis,” Presse Medicale (Paris, France: 1983) 50, no. 1 (2021): 104062.

[10]

S. I. Nihtyanova, B. E. Schreiber, V. H. Ong, et al., “Prediction of Pulmonary Complications and Long-term Survival in Systemic Sclerosis,” Arthritis & Rheumatology (Hoboken, NJ) 66, no. 6 (2014): 1625–1635.

[11]

T. A. Winstone, D. Assayag, P. G. Wilcox, et al., “Predictors of Mortality and Progression in Scleroderma-associated Interstitial Lung Disease: A Systematic Review,” Chest 146, no. 2 (2014): 422–436.

[12]

S. R. Schoenfeld and F. V. Castelino, “Interstitial Lung Disease in Scleroderma,” Rheumatic Diseases Clinics of North America 41, no. 2 (2015): 237–248.

[13]

S. Hansdottir, D. J. Groskreutz, and B. K. Gehlbach, “WHO's in Second?: A Practical Review of World Health Organization Group 2 Pulmonary Hypertension,” Chest 144, no. 2 (2013): 638–650.

[14]

R. F. Machado, “Pulmonary Hypertension in Chronic respiratory Disorders: We Need to Learn More,” Jornal Brasileiro de Pneumologia: Publicacao Oficial da Sociedade Brasileira de Pneumologia e Tisilogia 34, no. 2 (2008): 65–66.

[15]

A. R. Tonelli, V. Arelli, O. A. Minai, et al., “Causes and Circumstances of Death in Pulmonary Arterial Hypertension,” American Journal of Respiratory and Critical Care Medicine 188, no. 3 (2013): 365–369.

[16]

M. Quatredeniers, M. K. Nakhleh, S. J. Dumas, et al., “Functional Interaction Between PDGFβ and GluN2B-containing NMDA Receptors in Smooth Muscle Cell Proliferation and Migration in Pulmonary Arterial Hypertension,” American Journal of Physiology Lung Cellular and Molecular Physiology 316, no. 3 (2019): L445–l455.

[17]

T. V. Kudryashova, S. Dabral, S. Nayakanti, et al., “Noncanonical HIPPO/MST Signaling via BUB3 and FOXO Drives Pulmonary Vascular Cell Growth and Survival,” Circulation Research 130, no. 5 (2022): 760–778.

[18]

C. Veith, I. Vartürk-Özcan, M. Wujak, et al., “SPARC, a Novel Regulator of Vascular Cell Function in Pulmonary Hypertension,” Circulation 145, no. 12 (2022): 916–933.

[19]

A. Lu, C. Zuo, Y. He, et al., “EP3 receptor Deficiency Attenuates Pulmonary Hypertension Through Suppression of Rho/TGF-β1 Signaling,” Journal of Clinical Investigation 125, no. 3 (2015): 1228–1242.

[20]

R. Savai, H. M. Al-Tamari, D. Sedding, et al., “Pro-proliferative and Inflammatory Signaling Converge on FoxO1 Transcription Factor in Pulmonary Hypertension,” Nature Medicine 20, no. 11 (2014): 1289–1300.

[21]

E. M. Jeong, M. Pereira, E. Y. So, et al., “Targeting RUNX1 as a Novel Treatment Modality for Pulmonary Arterial Hypertension,” Cardiovascular Research 118, no. 16 (2022): 3211–3224.

[22]

H. Ma, S. Jiang, Y. Yuan, et al., “RUNX1 promotes Proliferation and Migration in Non-small Cell Lung Cancer Cell Lines via the mTOR Pathway,” FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology 37, no. 11 (2023): e23195.

[23]

M. Humbert, C. Guignabert, S. Bonnet, et al., “Pathology and Pathobiology of Pulmonary Hypertension: State of the Art and Research Perspectives,” European Respiratory Journal 53, no. 1 (2019): 1801887.

[24]

S. S. Pullamsetti, A. Mamazhakypov, N. Weissmann, W. Seeger, and R. Savai, “Hypoxia-inducible Factor Signaling in Pulmonary Hypertension,” Journal of Clinical Investigation 130, no. 11 (2020): 5638–5651.

[25]

H. Deng, X. Tian, H. Sun, H. Liu, M. Lu, and H. Wang, “Calpain-1 Mediates Vascular Remodelling and Fibrosis via HIF-1α in Hypoxia-induced Pulmonary Hypertension,” Journal of Cellular and Molecular Medicine 26, no. 10 (2022): 2819–2830.

[26]

L. J. Garcia-Morales, N. Y. Chen, T. Weng, et al., “Altered Hypoxic-Adenosine Axis and Metabolism in Group III Pulmonary Hypertension,” American Journal of Respiratory Cell and Molecular Biology 54, no. 4 (2016): 574–583.

[27]

M. M. Hickey, T. Richardson, T. Wang, et al., “The von Hippel-Lindau Chuvash Mutation Promotes Pulmonary Hypertension and Fibrosis in Mice,” Journal of Clinical Investigation 120, no. 3 (2010): 827–839.

[28]

H. Karmouty-Quintana, K. Philip, L. F. Acero, et al., “Deletion of ADORA2B From Myeloid Cells Dampens Lung Fibrosis and Pulmonary Hypertension,” Faseb Journal 29, no. 1 (2015): 50–60.

[29]

H. Karmouty-Quintana, H. Zhong, L. Acero, et al., “The A2B Adenosine Receptor Modulates Pulmonary Hypertension Associated With Interstitial Lung Disease,” Faseb Journal 26, no. 6 (2012): 2546–2557.

[30]

H. Kojima, T. Tokunou, Y. Takahara, et al., “Hypoxia-inducible Factor-1 α Deletion in Myeloid Lineage Attenuates Hypoxia-induced Pulmonary Hypertension,” Physiological Reports 7, no. 7 (2019): e14025.

[31]

B. Lechartier, N. Berrebeh, A. Huertas, M. Humbert, C. Guignabert, and L. Tu, “Phenotypic Diversity of Vascular Smooth Muscle Cells in Pulmonary Arterial Hypertension: Implications for Therapy,” Chest 161, no. 1 (2022): 219–231.

[32]

M. Bisserier, P. Mathiyalagan, S. Zhang, et al., “Regulation of the Methylation and Expression Levels of the BMPR2 Gene by SIN3a as a Novel Therapeutic Mechanism in Pulmonary Arterial Hypertension,” Circulation 144, no. 1 (2021): 52–73.

[33]

J. Meloche, F. Potus, M. Vaillancourt, et al., “Bromodomain-Containing Protein 4: The Epigenetic Origin of Pulmonary Arterial Hypertension,” Circulation Research 117, no. 6 (2015): 525–535.

[34]

J. Zhang, Y. Li, J. Zhang, et al., “ADAR1 regulates Vascular Remodeling in Hypoxic Pulmonary Hypertension Through N1-methyladenosine Modification of circCDK17,” Acta Pharm Sin B 13, no. 12 (2023): 4840–4855.

[35]

V. Tseng, S. D. Collum, A. Allawzi, et al., “3'UTR Shortening of HAS2 Promotes Hyaluronan Hyper-synthesis and Bioenergetic Dysfunction in Pulmonary Hypertension,” Matrix Biology 111 (2022): 53–75.

[36]

A. Parnigoni, M. Viola, E. Karousou, et al., “Hyaluronan in Pathophysiology of Vascular Diseases: Specific Roles in Smooth Muscle Cells, Endothelial Cells, and Macrophages,” American Journal of Physiology-Cell Physiology 323, no. 2 (2022): C505–C519.

[37]

T. C. J. Mertens, A. Hanmandlu, L. Tu, et al., “Switching-Off Adora2b in Vascular Smooth Muscle Cells Halts the Development of Pulmonary Hypertension,” Front Physiol 9 (2018): 555.

[38]

S. D. Collum, J. G. Molina, A. Hanmandlu, et al., “Adenosine and Hyaluronan Promote Lung Fibrosis and Pulmonary Hypertension in Combined Pulmonary Fibrosis and Emphysema,” Dis Model Mech 12, no. 5 (2019): dmm038711.

[39]

S. D. Collum, N. Y. Chen, A. M. Hernandez, et al., “Inhibition of Hyaluronan Synthesis Attenuates Pulmonary Hypertension Associated With Lung Fibrosis,” British Journal of Pharmacology 174, no. 19 (2017): 3284–3301.

[40]

R. Elkon, A. P. Ugalde, and R. Agami, “Alternative Cleavage and Polyadenylation: Extent, Regulation and Function,” Nature Reviews Genetics 14, no. 7 (2013): 496–506.

[41]

D. C. Di Giammartino, K. Nishida, and J. L. Manley, “Mechanisms and Consequences of Alternative Polyadenylation,” Molecular cell 43, no. 6 (2011): 853–866.

[42]

E. Beaudoing, S. Freier, J. R. Wyatt, J. M. Claverie, and D. Gautheret, “Patterns of Variant Polyadenylation Signal Usage in human Genes,” Genome Research 10, no. 7 (2000): 1001–1010.

[43]

C. P. Masamha, Z. Xia, J. Yang, et al., “CFIm25 links Alternative Polyadenylation to Glioblastoma Tumour Suppression,” Nature 510, no. 7505 (2014): 412–416.

[44]

T. Kubo, T. Wada, Y. Yamaguchi, A. Shimizu, and H. Handa, “Knock-Down of 25 kDa Subunit of Cleavage Factor IM in Hela Cells Alters Alternative Polyadenylation Within 3'-UTRs,” Nucleic acids research 34, no. 21 (2006): 6264–6271.

[45]

O. D. Liang, E. Y. So, P. C. Egan, et al., “Endothelial to Haematopoietic Transition Contributes to Pulmonary Arterial Hypertension,” Cardiovascular research 113, no. 13 (2017): 1560–1573.

[46]

T. Darwiche, S. D. Collum, W. Bi, et al., “Alterations in Cardiovascular Function in an Experimental Model of Lung Fibrosis and Pulmonary Hypertension,” Experimental physiology 104, no. 4 (2019): 568–579.

[47]

K. C. H. Ha, B. J. Blencowe, and Q. Morris, “QAPA: A New Method for the Systematic Analysis of Alternative Polyadenylation From RNA-seq Data,” Genome biology 19, no. 1 (2018): 45.

[48]

Z. Xia, L. A. Donehower, T. A. Cooper, et al., “Dynamic Analyses of Alternative Polyadenylation From RNA-seq Reveal a 3'-UTR Landscape Across Seven Tumour Types,” Nature communications 5 (2014): 5274.

[49]

S. Liu, J. Yang, G. Sun, et al., “RUNX1 Upregulates CENPE to Promote Leukemic Cell Proliferation,” Frontiers in Molecular Biosciences 8 (2021): 692880.

[50]

S. Goyama, G. Huang, M. Kurokawa, and J. C. Mulloy, “Posttranslational Modifications of RUNX1 as Potential Anticancer Targets,” Oncogene 34, no. 27 (2015): 3483–3492.

[51]

R. B. Day, J. A. Hickman, Z. Xu, et al., “Proteogenomic Analysis Reveals Cytoplasmic Sequestration of RUNX1 by the Acute Myeloid Leukemia–initiating CBFB::MYH11 Oncofusion Protein,” The Journal of Clinical Investigation 134, no. 4 (2024): e176311.

[52]

G. Huang, K. Shigesada, K. Ito, H. J. Wee, T. Yokomizo, and Y. Ito, “Dimerization With PEBP2β Protects RUNX1/AML1 From Ubiquitin–proteasome-mediated Degradation,” The EMBO journal 20, no. 4 (2001): 723–733.

[53]

X. Qin, Q. Jiang, Y. Matsuo, et al., “Cbfb Regulates Bone Development by Stabilizing Runx family Proteins,” Journal of Bone and Mineral Research 30, no. 4 (2015): 706–714.

[54]

J. Ko, T. Mills, J. Huang, et al., “Transforming Growth Factor β1 Alters the 3′-UTR of mRNA to Promote Lung Fibrosis,” Journal of Biological Chemistry 294, no. 43 (2019): 15781–15794.

[55]

J. Le Pavec, R. E. Girgis, and N. Lechtzin, “Systemic Sclerosis-related Pulmonary Hypertension Associated With Interstitial Lung Disease: Impact of Pulmonary Arterial Hypertension Therapies,” Arthritis and rheumatism 63, no. 8 (2011): 2456–2464.

[56]

H. J. Hassan, M. Naranjo, N. Ayoub, et al., “Improved Survival for Patients With Systemic Sclerosis-associated Pulmonary Arterial Hypertension: The Johns Hopkins Registry,” American journal of respiratory and critical care medicine 207, no. 3 (2023): 312–322.

[57]

S. C. Mathai and P. M. Hassoun, “Pulmonary Arterial Hypertension Associated With Systemic Sclerosis,” Expert Rev Respir Med 5, no. 2 (2011): 267–279.

[58]

N. F. Ruopp and B. A. Cockrill, “Diagnosis and Treatment of Pulmonary Arterial Hypertension: A Review,” Jama 327, no. 14 (2022): 1379–1391.

[59]

P. M. Hassoun, “Pulmonary Arterial Hypertension,” New England Journal of Medicine 385, no. 25 (2021): 2361–2376.

[60]

V. Cottin, C. Valenzuela, and M. Humbert, “Inhaled Treprostinil for Interstitial Lung Disease-associated Pulmonary Hypertension: A Silver Lining on a Very Dark Cloud,” European Respiratory Journal 61, no. 6 (2023): 2300944.

[61]

A. Smukowska-Gorynia, W. Gościniak, P. Woźniak, et al., “Recent Advances in the Treatment of Pulmonary Arterial Hypertension Associated With Connective Tissue Diseases,” Pharmaceuticals 16, no. 9 (2023): 1252.

[62]

O. Sitbon, R. Channick, K. M. Chin, et al., “Selexipag for the Treatment of Pulmonary Arterial Hypertension,” New England Journal of Medicine 373, no. 26 (2015): 2522–2533.

[63]

R. Paulin, J. Meloche, A. Courboulin, et al., “Targeting Cell Motility in Pulmonary Arterial Hypertension,” European Respiratory Journal 43, no. 2 (2014): 531–544.

[64]

G. Cao, X. Xuan, J. Hu, R. Zhang, H. Jin, and H. Dong, “How Vascular Smooth Muscle Cell Phenotype Switching Contributes to Vascular Disease,” Cell Communication and Signaling 20, no. 1 (2022): 180.

[65]

S. Hu, Y. Zhao, C. Qiu, and Y. Li, “RAS Protein Activator Like 2 Promotes the Proliferation and Migration of Pulmonary Artery Smooth Muscle Cell Through AKT/Mammalian Target of Rapamycin Complex 1 Pathway in Pulmonary Hypertension,” Bioengineered 13, no. 2 (2022): 3516–3526.

[66]

T. Weng, J. Ko, C. P. Masamha, et al., “Cleavage Factor 25 Deregulation Contributes to Pulmonary Fibrosis Through Alternative Polyadenylation,” Journal of Clinical Investigation 129, no. 5 (2019): 1984–1999.

[67]

T. Weng, J. Huang, E. J. Wagner, et al., “Downregulation of CFIm25 Amplifies Dermal Fibrosis Through Alternative Polyadenylation,” Journal of Experimental Medicine 217, no. 2 (2020).

[68]

J. Zhang, W. Zhong, T. Cui, et al., “Generation of an Adult Smooth Muscle Cell-targeted Cre Recombinase Mouse Model,” Arteriosclerosis, thrombosis, and vascular biology 26, no. 3 (2006): e23–e24.

[69]

C. Y. Hart, J. C. Burnett,, and M. M. Redfield, “Effects of Avertin versus Xylazine-ketamine Anesthesia on Cardiac Function in Normal Mice,” American journal of physiology Heart and circulatory physiology 281, no. 5 (2001): H1938–45.

[70]

D. K. Chu, M. C. Jordan, J. K. Kim, M. A. Couto, and K. P. Roos, “Comparing isoflurane With Tribromoethanol Anesthesia for Echocardiographic Phenotyping of Transgenic Mice,” Journal of the American Association for Laboratory Animal Science: JAALAS 45, no. 4 (2006): 8–13.

[71]

D. M. Roth, J. S. Swaney, N. D. Dalton, E. A. Gilpin, and J. Ross, “Impact of Anesthesia on Cardiac Function During Echocardiography in Mice,” American journal of physiology Heart and circulatory physiology 282, no. 6 (2002): H2134–40.

[72]

K. J. Lee, L. Czech, G. B. Waypa, and K. N. Farrow, “Isolation of Pulmonary Artery Smooth Muscle Cells From Neonatal Mice,” Journal of visualized experiments: JoVE 80 (2013): e50889.

[73]

V. Tseng, K. Ni, A. Allawzi, et al., “Extracellular Superoxide Dismutase Regulates Early Vascular Hyaluronan Remodeling in Hypoxic Pulmonary Hypertension,” Scientific reports 10, no. 1 (2020): 280.

[74]

A. Dobin, C. A. Davis, F. Schlesinger, et al., “STAR: Ultrafast Universal RNA-seq Aligner,” Bioinformatics (Oxford, England) 29, no. 1 (2012): 15–21.

[75]

S. Anders, P. T. Pyl, and W. Huber, “HTSeq–a Python Framework to Work With High-throughput Sequencing Data,” Bioinformatics (Oxford, England) 31, no. 2 (2015): 166–169.

[76]

M. D. Robinson, D. J. McCarthy, and G. K. Smyth, “edgeR: A Bioconductor Package for Differential Expression Analysis of Digital Gene Expression Data,” Bioinformatics (Oxford, England) 26, no. 1 (2009): 139–140.

RIGHTS & PERMISSIONS

2026 The Author(s). MedComm published by Sichuan International Medical Exchange & Promotion Association (SCIMEA) and John Wiley & Sons Australia, Ltd.

PDF

9

Accesses

0

Citation

Detail

Sections
Recommended

/