H19/miRNA-675 axis: a possible new strategy to alleviate pulmonary vascular remodelling in COPD by Qibai Pingfei Capsule

Chronic obstructive pulmonary disease (COPD) poses a significant socio-economic and health burden. Long-term hypoxia-induced pulmonary vascular remodelling serves as a critical pathological basis of COPD. Hypoxia is known to elevate long non-coding RNA (lncRNA) H19 levels. The abnormal expression of H19 in hypoxic conditions and the mechanism of how it mediates pulmonary vascular remodelling in COPD requires further investigation. Qibai Pingfei Capsule, a characteristic formula of Xin'an Medicine, has been used for over 20 years in clinical practice to improve COPD lung function and alleviate pulmonary vascular remodelling. It confers unique advantages in the treatment of COPD and has obtained national clinical drug approval. Despite this, the underlying mechanism of its formula in alleviating pulmonary vascular remodelling of COPD remains unclear. In vivo and in vitro studies revealed that H19 positively regulated its splice variant microRNA-675 (miRNA-675), influencing the expression of the downstream target, Phosphatase and TENsin homolog (PTEN) gene and other factors related to pulmonary vascular remodelling. This study demonstrated that Qibai Pingfei Capsule significantly improved pulmonary vascular remodelling in COPD by targeting and inhibiting the H19/miRNA-675 axis. This study unveiled a novel therapeutic mechanism of this traditional Chinese medicine formulation in treating COPD.