RT Journal Article SR Electronic T1 Caspase inhibition stabilizes progressive vascular remodeling in established pulmonary hypertension JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP PA4912 DO 10.1183/13993003.congress-2015.PA4912 VO 46 IS suppl 59 A1 C.M. Happé A1 R. Szulcek A1 N. Rol A1 M.A. De Raaf A1 I. Schalij A1 A. Vonk-Noordegraaf A1 F.S. De Man A1 G.P. Van Nieuw-Amerongen A1 H.J. Bogaard YR 2015 UL http://erj.ersjournals.com/content/46/suppl_59/PA4912.abstract AB Pulmonary arterial hypertension (PAH) is characterized by exuberant cell growth and vascular remodeling that is believed to be caused by a phenotypic switch of the endothelium towards apoptosis resistance and hyper-proliferation. On the contrary, recent animal models provided evidence that apoptosis rates continue to be high resulting in an increased cell turnover. Therefore we tested, whether ongoing apoptosis is required to maintain high rates of proliferation and vascular remodeling in established PH.Sugen-hypoxia (SuHx) rats with established progressive PH were treated for 2 weeks with the pan-caspase inhibitor Z-Asp (2mg 3x/pw) to inhibit apoptosis. Pulmonary vascular resistance decreased (mmHg/ml.min, 0.83±0.24 vs. 0.45±0.14, p=0.003), along with a decreased intima fraction thickness (28%±4.4% vs. 16%±2.5%, p=0.01) and reduced fraction of occlusions (p=0.0464). Histology revealed a significant decrease in both apoptotic and proliferative activities, as measured by a decrease in cleaved caspase 3 (no. of +-cells, 0.6±0.1 vs. 0.2±0.1, p=0.02) – and proliferating cell nuclear antigen (no. of +-cells, 1.5±.4 vs. 0.8±0.2, p=0.05) lung vascular endothelial cells.In conclusion, we show that caspase inhibition attenuates progressive vascular remodeling in established experimental pulmonary hypertension. This data suggest that new PAH treatment concepts should consider prevention of apoptosis rather than induction.