The Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is characterized by intraluminal thrombus organization and pulmonary remodeling, increased pulmonary vascular resistence.The consequence is progressive pulmonary arterial hypertension (PAH) and right heart failure with a 3-year mortality rate of 90%.Simultaneously, muscular and elastic pulmonary small vessels have been obstructed and they have also been related to the hypoxia and endothelial disfunction.All these physiopathologic processes were targeted by altered molecular signaling pathways associated with a progressive vacular injury, which is related to change of gene expression and their final proteins. The pos transcriptional control may be induced by microRNAs, which acts like endogen repressor of pos transcriptional gene silencing, blocking of protein translation by RNA degradation. This regulatory mechanism is critical for several biological processes such as cellular proliferation, apoptosis, angiogenesis, fibrogenesis and cellular differentiation. However, some microRNAs are actively released to blood flow after biological stimulus and / or death cell-derived, then they are called circulating microRNA and may be a better candidate to diagnostic and prognostic biomarker of CTEPH. Our aims is to do sequencing of circulating miRNAs and to identify novel markers predicting clinical outcome.
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