Sildenafil inhibits calcineurin/NFATc2-mediated cyclin A expression in pulmonary artery smooth muscle cells

Aims To examine whether calcineurin/NFAT signaling pathway leads to proliferation of pulmonary artery smooth muscle cells (PASMCs) by regulating cell cycle proteins and whether the phosphodiesterase-5 (PDE5) inhibitor sildenafil affects calcineurin/NFAT-induced cell proliferation. Main methods A [3H]thymidine incorporation assay was used to examine DNA synthesis (cell proliferation); cyclin A and NFATc2 expressions were determined by Western blot. Cyclin-dependent kinase 2 (CDK2) activity was measured with an in vitro kinase activity assay, and calcineurin and NFAT activity were evaluated using a calcineurin assay kit and a luciferase activity assay, respectively. A chemical inhibitor or siRNA transfection was used to inhibit calcineurin/NFAT signaling pathway. Key findings Serotonin dose-dependently stimulated cyclin A expression in PASMCs. This effect was accompanied by dose-dependent increases in CDK2 activity and the rate of DNA synthesis. At the same time, PASMCs treated with serotonin showed dose-dependent activation of calcineurin/NFAT signaling pathway. Inhibition of calcineurin activity by cyclosporine A or loss of NFATc2 protein by siRNA transfection abolished serotonin-induced cyclin A expression and consequent CDK2 activation and DNA synthesis. We further found that pretreatment of cells with sildenafil suppressed serotonin-triggered activation of calcineurin/NFATc2 signaling pathway and resultant cyclin A expression, CDK2 activation and cell proliferation, while the presence of DT-3 [a specific protein kinase G (PKG) peptide inhibitor] reversed the effects of sildenafil on PASMCs. Significance Our study suggests that enhanced PKG activity suppresses calcineurin/NFATc2 cascade-mediated cyclin A expression, CDK2 activation and PASMC proliferation to contribute to the overall effects of sildenafil in the treatment of pulmonary hypertension.