The new study
identified PDZ-binding kinase (PBK) as a promising target for pulmonary
hypertension and assessed two PBK inhibitors.
Researchers at
Augusta University, US, have discovered that a gene that is overexpressed in
some aggressive cancers also appears to be key to the excessive cell
proliferation that thickens the walls of pulmonary arteries and ultimately
causes the right ventricle of the heart to fail, or pulmonary hypertension.
PDZ-binding kinase, or PBK, is known
to be overexpressed in cancers such as bladder, lung, liver and brain tumours
where its high expression is generally associated with a worse prognosis. The
rapid cell division and resulting excessive cell production is similar in
pulmonary hypertension and cancer.
“We were looking for genes involved
in promoting smooth muscle proliferation that also are in cancer,” explained
researcher Dr David Fulton. “It is the uncontrolled proliferation that is the
problem, and we are looking for targets that we could exploit to decrease it.”
Current treatments such as vasodilators and oxygen therapy, address symptoms
but do not halt disease progression.
The
study, funded by the National Institutes of Health (NIH), used rat and mouse
models of pulmonary hypertension and found that two PBK inhibitors – OTS514 and
TOPK-32 – reduce unhealthy remodelling of blood vessels and improve heart and
lung function.
Specifically looking upstream of PBK,
the researchers found that YAP1, yes associated protein 1, known to activate
other genes that enable cell proliferation and quieten those that cause
apoptosis is upregulated in pulmonary hypertension, where it increases the
activity of PBK in those smooth muscle cells inside the walls of pulmonary
arteries. Looking downstream, they found PBK in turn upregulates protein
regulator of cytokinesis 1, or PRC1.
“We think YAP is an upstream driver of proliferation that
activates PBK expression in the pulmonary smooth muscle cells,” Fulton added.
What is driving YAP activation is unknown, however the scientists are more
focused on what is happening downstream. YAP is expressed in a lot of different
cell types, but its unique ability to activate PBK makes PBK itself a good,
druggable target, noted Fulton. They anticipate PBK inhibition would be an
adjunct therapy for patients that will more directly target a clear point of
action in the disease process.
Source: Drug Target Review