STAT6 deficiency mitigates the severity of pulmonary arterial hypertension caused by chronic intermittent hypoxia by suppressing Th2-inducing cytokines

Respir Res. 2025 Jan 13;26(1):13. doi: 10.1186/s12931-024-03062-z.

Abstract

Background: Obstructive sleep apnea (OSA) is frequently associated with increased incidence and mortality of pulmonary hypertension (PH). The immune response contributes to pulmonary artery remodeling and OSA-related diseases. The immunologic factors linked to OSA-induced PH are not well understood. STAT6 is crucial in the signaling pathway that modulates immune response. However, the status of phosphorylated STAT6 (p-STAT6) in an OSA-induced PH mouse model remains largely unexplored.

Methods: Chronic intermittent hypoxia (CIH) plays a crucial role in the progression of OSA. This study utilized a in vivo CIH model to examine the role of STAT6 in CIH-induced PH.

Results: CIH mice exhibited pulmonary artery remodeling and pulmonary hypertension, indicated by increased right ventricular systolic pressure (RVSP), higher right ventricular to left ventricular plus septum (RV/LV + S) ratios, and significant morphological alterations compared to normoxic (Nor) mice. Increased p-STAT6 in the lungs and elevated p-STAT6 + IL-4 + producing T cells in CIH mice. STAT6 deficiency (STAT6-/-) improved PH and PA remodeling in CIH-induced PH mouse models.STAT6 deficiency impaired the T helper 2 (Th2) immune response, affecting IL-4 and IL-13 secretion. IL-4, rather than IL-13, activated STAT6 in human pulmonary artery smooth muscle cells (hPASMCs). STAT6 knockdown decreased the proliferation in IL-4 treated hPASMCs.

Conclusion: These findings exhibit the critical role of STAT6 in the pathogenesis of CIH induced PH by regulating Th2 immune response.STAT6 could be a significant therapeutic target for OSA-related PH.

Keywords: Chronic intermittent hypoxia; Pulmonary hypertension; STAT6; Th2 immune response.

MeSH terms

  • Animals
  • Cells, Cultured
  • Chronic Disease
  • Cytokines* / metabolism
  • Disease Models, Animal
  • Humans
  • Hypertension, Pulmonary / immunology
  • Hypertension, Pulmonary / metabolism
  • Hypoxia* / complications
  • Hypoxia* / metabolism
  • Male
  • Mice
  • Mice, Inbred C57BL*
  • Mice, Knockout
  • Pulmonary Arterial Hypertension / metabolism
  • Pulmonary Artery / immunology
  • Pulmonary Artery / metabolism
  • Pulmonary Artery / pathology
  • STAT6 Transcription Factor* / deficiency
  • STAT6 Transcription Factor* / metabolism
  • Severity of Illness Index
  • Th2 Cells* / immunology
  • Th2 Cells* / metabolism
  • Vascular Remodeling / physiology

Substances

  • STAT6 Transcription Factor
  • Stat6 protein, mouse
  • Cytokines