Can dietary changes help treat pulmonary hypertension?

Amino acids, the building blocks of proteins, play crucial roles in cellular structures, biological functions, and tissue regulation. In hypertensive pulmonary blood vessels, metabolism of glutamine and serine yields proline and glycine, key components of collagen protein. Elevated levels of proline and glycine due to increased glutamine and serine metabolism drive collagen overproduction in hypertensive vessels, resulting in stiffening and impaired function characteristic of pulmonary hypertension.

Dietary changes can potentially impact pulmonary hypertension by influencing factors such as inflammation, oxidative stress, and vascular function. For instance, a diet rich in antioxidants, omega-3 fatty acids, and phytonutrients from fruits and vegetables may help reduce inflammation and oxidative stress, which are known contributors to pulmonary hypertension. Additionally, reducing sodium intake can help manage fluid retention and lower blood pressure, which are important considerations in pulmonary hypertension management.

In rodent models of the disease, researchers found that drugs inhibiting glutamine and serine cellular uptake prevented hypertensive pulmonary blood vessels from craving these amino acids. Consequently, the diminished metabolism of glutamine and serine halted the excessive production of collagen building blocks and collagen itself. Additionally, by reducing dietary intake of glutamine- and serine-rich foods, collagen overproduction was mitigated.

“This marks the first instance where a dietary intervention could potentially function as a viable therapy for the condition. For patients with pulmonary hypertension, avoiding foods rich in serine and glutamine, or eating foods with these amino acids depleted, might bolster the effectiveness of current medications. “It opens up a new way that we could treat this disease, because now—instead of just relying on medications and transplantation—there are possibly effective lifestyle interventions,” says Stephen Chan, University of Pittsburgh researcher.

Reference: Nesrine S. Rachedi, Ying Tang, Yi-Yin Tai, Dietary intake and glutamine-serine metabolism control pathologic vascular stiffness, Cell Metabolism, 2024, ISSN 1550-4131; https://doi.org/10.1016/j.cmet.2024.04.010.