title: Pathogenesis of pulmonary arterial hypertension: lessons from cancer.
abstract: Although the causal pathomechanisms contributing to remodelling of the pulmonary vascular bed in pulmonary arterial hypertension (PAH) are still unclear, several analogous features with carcinogenesis have led to the emergence of the cancer-like concept. The major similarities concern the altered crosstalk between cells from different tissue types, unexplained proliferation and survival of pulmonary smooth muscle and endothelial cells, the metabolic (glycolytic) shifts, and the association with the immune system. However, major differences between PAH and cancer exist, including the absence of invasion and metastasis, as well as the pathogenic genes involved and the degrees of angiogenesis impairment and genetic instability. It is clear that PAH is not a cancer, but this cancer-like concept has opened a new field of investigation and raises the possibility that antiproliferative and/or oncological drugs may exert therapeutic effects not only in cancer, but also in PAH. Such analogies and differences are discussed here.
authors.affiliation: INSERM UMRS 999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, 2 Université Paris-Sud, Le Kremlin-Bicêtre, and 3 AP-HP, Service de Pneumologie, DHU Thorax Innovation (DHU TORINO), Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Guignabert
authors.forename: Ly
authors.initials: L
authors.lastname: Tu
authors.forename: Morane
authors.initials: M
authors.lastname: Le Hiress
authors.forename: Nicolas
authors.initials: N
authors.lastname: Ricard
authors.forename: Caroline
authors.initials: C
authors.lastname: Sattler
authors.forename: Andrei
authors.initials: A
authors.lastname: Seferian
authors.forename: Alice
authors.initials: A
authors.lastname: Huertas
authors.forename: Marc
authors.initials: M
authors.lastname: Humbert
authors.forename: David
authors.initials: D
authors.lastname: Montani
mesh_terms: D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015195:Drug Design; D065627:Familial Primary Pulmonary Hypertension; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics / Q000276:immunology / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D058990:Molecular Targeted Therapy; D009369:Neoplasms / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics / Q000276:immunology / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D012307:Risk Factors; D015398:Signal Transduction
chemical_list: D000959:Antihypertensive Agents; D000970:Antineoplastic Agents