PROJECT SUMMARY
Pulmonary arterial hypertension (PAH) is an enigmatic and morbid disease where insights are emerging
regarding genetic susceptibility to disease. Genome-wide Association Studies (GWAS) have identified single
nucleotide polymorphisms (SNPs) that are associated with PAH risk and severity. Yet, the GWAS-reported SNPs
are only tags of haplotype SNPs in linkage disequilibrium (LD). Thus, the tag SNP may simply be linked to the
true disease-causing functional SNP (fSNP). GWAS also only reveal statistical associations, and it has been
challenging to define the mechanisms underlying the contribution of the PAH-associated fSNPs, which are
mostly located in the non-coding regions, to the pathogenesis of PAH. Using our recently developed post-GWAS
functional genomics platform, I identified a non-coding fSNP rs4738801 in the genomic locus of SOX17 gene, a
known endothelial effector increasingly being studied in PAH pathogenesis. I identified that the transcription
factor FUBP1 binds to the rs4738801 risk allele C in an allele-imbalanced manner, with lower affinity to risk allele
C than non-risk allele G, providing an underlying mechanism how this fSNP regulates the PAH pathogenic gene
SOX17 and contributes to the PAH risk. FUBP1 controls PAH-associated pathophenotypes in pulmonary arterial
endothelial cells (PAECs). Downregulated by the major acquired PAH trigger hypoxia, FUBP1 and its target
gene SOX17 are decreased in lungs and isolated pulmonary ECs from PAH patients and mouse models. A 3.77-
fold enrichment of fSNP rs4738801 risk allele C was found in patients with PAH induced by hypoxia, supporting
a pathogenic mechanism of a hypoxia-sensitive pathway (FUBP1-SOX17) combined with a disease susceptible
genotype (risk allele C) for clinical manifestation of this disease. Based on these data, I hypothesize that the
allele-imbalanced binding of transcription factor FUBP1 to fSNP rs4738801 defines the genomic architecture
contributing to the SOX17-dependent genetic susceptibility of PAH. I further postulate that the downregulation
of FUBP1-SOX17 by hypoxia contributes to the acquired pathogenesis of PAH. To test this hypothesis, I propose
2 specific aims: 1) To define the allele-specific role of fSNP rs4738801 in promoting endothelial dysfunction in
PAH in gene-edited iPSC-ECs and PAH patient lung tissues; and 2) To determine the role of FUBP1 in controlling
SOX17 and PAH in mouse models. Accomplishing these aims will facilitate my enduing career goal of becoming
an independent physician-scientist in PAH functional genomics research. Immediate scientific development
objectives include: 1) To develop expertise in PAH genetics and functional genomics; 2) To develop expertise in
iPSC-EC biology and CRISPR-Cas9 gene-editing techniques; and 3) To develop skills of in vivo gene expression
manipulation and become proficient in the assessment of PAH in animal models. The proposed training plan will
provide me with the opportunity to expand my knowledge base to include advanced research techniques in PAH
pathogenesis. The resources and expertise of my mentors, contributors, and the rich research environment at
the University of Pittsburgh will assure my successful transition to an independent investigator.