5-Methylcytosine-modified circRNA-CCNL2 regulates vascular remdeling in hypoxic pulmonary hypertension through...

Pulmonary hypertension (PH) is a malignant cardiovascular disease with a complex etiology. 5-Methylcytosine (m5C) is a post-transcriptional RNA modification identified in both stable and highly abundant RNAs, with a lower frequency of occurrence in circular RNAs (circRNAs). Nevertheless, the function of m5C-modified circRNAs in the pathogenesis of PH remains uncertain. The objective of this study was to investigate the biological role and molecular mechanisms of m5C-modified circRNA-CCNL2 in hypoxic PH pulmonary vascular remodeling. Our findings revealed that hypoxia downregulates circCCNL2 expression, and overexpression of circCCNL2 attenuates PH progression and inhibits the proliferation of pulmonary artery smooth muscle cell (PASMCs). Bioinformatics predictions indicated the presence of m5C modification sites in circCCNL2, which NSUN2 mediated. The downregulation of NSUN2 resulted in a reduction in m5C modification of circCCNL2. It was also observed that the stability of circRNAs was associated with the proliferation of PASMCs. From a mechanistic standpoint, low expression of circCCNL2 resulted in reduced binding of FXR2, while increased association of free FXR2 with CDKL3 led to enhanced proliferation of PASMCs. Notably, circCCNL2 expression was found to be regulated by alternative splicing involving SRSF2, with reduced pre-CCNL2 splicing resulting from low SRSF2 expression, ultimately leading to decreased circCCNL2 expression. This is the first demonstration that m5C-modified circCCNL2 can slow the development of PH and inhibit the proliferation of PASMCs by binding to FXR2. These findings offer new insights into the regulation of circRNAs through m5C modifications and the role of epigenetic reprogramming in PH.