Abstract:Objective To investigate the pathological role of MIF/HIF-1α reciprocal effects in regulating the differentiation of pericytes to myofibroblasts in SSc-PAH.Methods Forty male rabbits were divided into four groups (n =10) by random number method: control group, model group, MIF inhibitor group and HIF-1α inhibitor group. the MIF inhibitor group and HIF-1α group were injected intraperitoneally using ISO and 2-ME2. The right ventricular hypertrophy index (RVHI) and mean pulmonary artery pressure (mPAP) were recorded in rabbits. ELISA was performed to detect the levels of HIF-1α and MIF in the serum of rabbits in each group; the pathological changes of rabbit skin and lung tissue sections were observed by HE staining, and the expression of MIF and HIF-1α in lung tissues of each group was observed by IHC staining; the expression of MIF and HIF-1α in pericytes was detected by Western blot. The expression changes of MIF, HIF-1α, α-SMA and Col1A1 were detected by Western blot in pericytes.Results Compared with the control group, the RVHI and mPAP of rabbits in the MIF inhibitor group and the HIF-1α inhibitor group were increased; compared with the model group, the RVHI and mPAP of rabbits in the MIF inhibitor group and the HIF-1α inhibitor group were decreased; compared with the control group, the serum levels of HIF-1α and MIF were increased in rabbits; compared with the model group, the expression of MIF and HIF-1α decreased in the MIF inhibitor group and HIF-1α inhibitor group; there was a positive correlation between HIF-1α and MIF (r = 0.853, P = 0.026); compared with the control group, the thickening of skin and blood vessel wall in rabbits in the MIF/HIF-1α inhibitor group was less than that in the model group, which had thickened skin dermis, fewer subcutaneous appendages, and significantly increased lung tissue lumen narrowing, irregular small pulmonary artery walls and interstitial lung mass; compared with the control group, the expression of both MIF and HIF-1α was increased in the inhibitor group, and compared with the model group, the expression of MIF and HIF-1α expression was decreased in the inhibitor group compared with the model group; HIF-1α was highly expressed in the lung tissue of rabbits in the model group. The expression of pericyte α-SMA and Col1A was elevated in the MIF/HIF-1α inhibitor group compared with the control group (P < 0.05); the expression of pericyte α-SMA and Col1A was decreased in the MIF/HIF-1α inhibitor group compared with the model group (P < 0.05).Conclusions MIF and HIF-1α may interact and participate in the pathological process of systemic sclerosis pulmonary hypertension by promoting the differentiation of microvascular pericytes to fibroblasts.