Visualization of apo B, fibrinogen/fibrin, and fibronectin in the intima of normal human aorta and large arteries and during atherosclerosis

Parainfectious cerebral vasculopathy complicating bacterial meningitis: Acute-short lived vasospasm followed by delayed-long lasting vasculitis

Bacterial meningitis is a serious, life-threatening infection of the meninges. Several radiological studies highlight prominent structural alterations occurring in the cerebral vasculature, leading to significant cerebrovascular consequences during bacterial meningitis. Beginning with reflexive arterial vasospasm , cerebrovascular disease during bacterial meningitis proceeds through a orderly sequence of arterial vasculitis with inflammatory cell infiltration, medial smooth muscle migration and proliferation, medial necrosis, adventitial fibrosis and eventual intimal stenosis. As such, this review focuses on changes occurring within cerebral arteries during disease progression, highlighting the various structural modifications occurring in the arterial vessels that contribute to disturbances in cerebral hemodynamics and, ultimately, cerebrovascular consequences during bacterial meningitis.

Decorin synthesized by arterial smooth muscle cells is retained in fibrin gels and modulates fibrin contraction

Fibrin serves as a provisional extracellular matrix (ECM) for arterial smooth muscle cells (ASMC) after vascular injury, yet little is known about the effect of fibrin on ECM remodeling by these cells. To address this question, monkey ASMC were grown on fibrin gels and tissue culture (TC) plastic, and proteoglycan synthesis and accumulation were assessed by radiolabeling. Initial rates of (35)S-sulfate incorporation into proteoglycans were identical for both groups, but increased proteoglycan accumulation was observed in cultures grown for 48 h on fibrin. This increased accumulation on fibrin was due to reduced proteoglycan turnover and retention within the fibrin gel. Decorin and biglycan constituted 40 and 14% of the total proteoglycan in the fibrin gels, whereas their combined contribution was only 12% in control matrices. To explore whether the retention of decorin in fibrin had any influence on the properties of the fibrin gel, ASMC-mediated fibrin contraction assays were performed. Both de novo synthesis of decorin as well as decorin added during polymerization inhibited the ability of the cells to contract fibrin. In contrast, decorin added exogenously to mature fibrin matrices had no effect on fibrin gel contraction. This study illustrates that decorin derived from ASMC selectively accumulates in fibrin and modifies fibrin architecture and mechanical properties. Such an accumulation may influence wound healing and the thrombotic properties of this provisional pro-atherosclerotic ECM.

Fibrinogen-coated chylomicrons in gastrointestinal lymph: a new rationale regarding the arterial deposition of postprandial lipids

The recent discovery that fibrinogen binds to chylomicrons in gastrointestinal lymph has prompted a new rationale regarding the arterial deposition of postprandial lipids, i.e., dietary fat. According to this new rationale, fibrinogen bound to chylomicrons in the gastrointestinal lymph renders those lipid particles and/or their remnants an adhesive potential, even before the particles reach the arterial system. It is proposed that such an adhesive potential, if realized in the vicinity of the arterial wall, can contribute to the nucleation and growth of atherosclerotic plaques, especially during and immediately following a fat-rich meal. Arguments in support of this proposal are made based on the proximity of the lymph outflow tract to the arteries most susceptible to atherosclerosis, and on the tissue distributions and activities of heparin, diamine oxidase, and lipoprotein lipase. This new rationale reconciles existing theories on atherosclerosis, and it also suggests novel means by which to prevent/treat the disease.

Role of beta1 and beta3 integrins in human smooth muscle cell adhesion to and contraction of fibrin clots in vitro

The degree of lumen narrowing in advanced lesions correlates poorly with the amount of intimal mass accumulated in the atherosclerotic plaque. As an alternate mechanism of stenosis, we propose that human smooth muscle cells bind to fibrin deposited in the matrix and exert contractile forces to cause a narrowing of the lumen. In the present study we demonstrated in vitro that human newborn aortic smooth muscle cell lines can contract and adhere to fibrin clots composed of either fibronectin-depleted plasma ("plasma") or recombinant fibrin. By using neutralizing antibodies and RGD peptides, we showed that members of the integrin family mediated the interaction between human newborn smooth muscle cells and fibrin. Neutralizing antibodies against the integrin alphavbeta3 (c7E3 Fab and LM609) did not inhibit either plasma clot contraction or recombinant fibrin clot contraction by human newborn smooth muscle cells. In contrast, antibodies against alpha5, beta1, and alpha5/beta1 inhibited contraction of clots composed of either plasma or recombinant fibrin. Anti-alphavbeta3, anti-alphav, anti-alpha5, anti-beta1, and anti-alpha5beta1 antibodies inhibited human newborn smooth muscle cell adhesion to plasma clots; however, only anti-alpha5, anti-beta1, and anti-alpha5beta1 antibodies significantly inhibited adhesion to recombinant fibrin. While the linear RGD peptides had no effect, the cyclic peptide penRGD inhibited adhesion to plasma clots and recombinant fibrin. However, it did not block contraction of recombinant fibrin clots. These results suggest that during the interaction of human newborn smooth muscle cell lines with fibrin, alpha5beta1 plays a significant role. This interaction is of potential interest as a target for efforts to block vascular contraction.

Binding of basic fibroblast growth factor to fibrinogen and fibrin

Fibrin is formed at sites of tissue injury and provides the temporary matrix needed to support the initial endothelial cell responses needed for vessel repair. Basic fibroblast growth factor (bFGF) also acts at sites of injury and stimulates similar vascular cell responses. We have, therefore, investigated whether there are specific interactions between bFGF and fibrinogen and fibrin that could play a role in coordinating these actions. Binding studies were performed using bFGF immobilized on Sepharose beads and soluble 125I-labeled fibrinogen and also using Sepharose-immobilized fibrinogen and soluble 125I-bFGF. Both systems demonstrated specific and saturable binding. Scatchard analysis indicated two classes of binding sites for each with Kd values of 1.3 and 260 nM using immobilized bFGF; and Kd values of 0.9 and 70 nM using immobilized fibrinogen. After conversion of Sepharose-immobilized fibrinogen to fibrin by treatment with thrombin, bFGF also demonstrated specific and saturable binding with two classes of binding sites having Kd values of 0.13 and 83 nM. Fibrin binding was also investigated by clotting a solution of bFGF and fibrinogen, and two classes of binding sites were demonstrated using this system with Kd values of 0.8 and 261 nM. The maximum molar binding ratios of bFGF to fibrinogen were between 2.0 and 4.0 with the four binding systems. We conclude that bFGF binds specifically and saturably to fibrinogen and fibrin with high affinity, and this may have implications regarding the localization of its effect at sites of tissue injury.

Migration of cultured vascular smooth muscle cells into non-crosslinked fibrin gels

We evaluated the migration of vascular smooth muscle cells into fibrin gels, using an in vitro assay system. Vascular smooth muscle cells from bovine fetal aorta migrated into fibrin gels and showed a characteristic elongated spindle-shaped appearance with long cytoplasmic processes. Varying the concentration of thrombin (0.05-1 NIHU/ml) used to form the fibrin gel had little effect on cell migration although higher concentrations of thrombin inhibited the migration. Migration of the cells into fibrin gels was dependent on RNA and protein synthesis but not on DNA synthesis. The addition of antithrombin III, hirudin, and D-phenylalanyl-L-prolyl-L-arginine chloromethyl ketone after gel formation had no effect, suggesting that residual thrombin in fibrin gels had no influence on subsequent cell migration. Neither the factor XIII-induced crosslinking of fibrin nor the fibrinopeptides released during gel formation were involved in the present migration assay system. Tranexamic acid, an inhibitor of plasminogen activator, or aprotinin, a plasmin inhibitor, also had no significant effect, suggesting that fibrinolysis induced by plasmin was not involved in this system. These findings showed that fibrin gels themselves induce the migration of vascular smooth muscle cells (haptotaxis) without other chemotactic or chemokinetic substances, suggesting an important role for fibrin in the development and progression of such vascular diseases as atherosclerosis, thrombosis and the development of restenosis following balloon angioplasty.

Platelet-derived growth factor (PDGF): actions and mechanisms in vascular smooth muscle

1. PDGF is a highly hydrophilic cationic glycoprotein (M(r) 28-35kDa) produced by platelets, monocyte/macrophages, endothelial cells and vascular smooth muscle cells under some conditions. 2. Since its original description, PDGF has attracted much attention and it is currently believed to play a role in atherosclerosis and other vascular pathologies. 3. This review describes the vascular biology of PDGF. It particularly focuses on recent findings regarding the intracellular signals activated by PDGF in the context of vascular smooth muscle cell proliferation, migration and, contraction.

The localization of tissue factor and apolipoprotein(a) in atherosclerotic lesions of the human aorta and their relation to fibrinogen-fibrin transition

We examined the immunohistochemical distribution of tissue factor (TF), apolipoprotein (a) (apo(a)) in atherosclerotic intimas of human thoracic aortas obtained from 51 autopsies in order to analyze the mechanism of fibrinogen-fibrin transition as a part of thrombogenic properties of atherosclerotic intimas. TF was overexpressed mainly by macrophages in both fatty streaks and more advanced lesions, while it was also scatteringly deposited in the matrix of advanced lesions, especially in the atheromatous gruel. TF-positive macrophages were frequently intermingled at the base of fibrin thrombi formed on the eroded intimas. On the other hand, apo(a) was localized in the stroma and within some macrophages, and also in the mural thrombi. Fibrinogen and fibrin were more frequently detected in the matrix of advanced lesions than in that of early lesions. Fibrin was occasionally co-located with cell- and matrix-associated TF and apo(a) deposited in matrix. These findings suggest that the overexpressed TF in the atherosclerotic intima plays a critical role in the initiation of fibrin formation. This could result from either fibrinogen permeating into the intima or from rupture of the fibrous cap overlying atheromas. Apo(a) deposited in the atherosclerotic intima may also participate in the persistent deposition of fibrin.

Evidence for loss of apo B from LDL in human atherosclerotic lesions: extracellular cholesteryl ester lipid particles lacking apo B

Previous studies have demonstrated the accumulation of low density lipoprotein (LDL) in the extracellular spaces of the intima of normal and atherosclerotic human vessels. In this study we have assessed the degree of colocalization in vessels of apolipoprotein B (apo B), the major protein of LDL, with cholesteryl ester, the predominant lipid of LDL. Apo B was detected immunohistochemically and cholesteryl ester was detected after its enzymatic hydrolysis and staining with the fluorescent probe, filipin. Most normal intima showed apo B staining without associated cholesteryl ester staining. This result would be expected with LDL having intact apo B; intact apo B interferes with hydrolysis and filipin staining of LDL cholesteryl ester. Fatty streaks and fibrous plagues showed regions of congruent apo B and cholesteryl ester staining in the extracellular space, suggesting fragmentation of apo B without loss of its immunoreactivity. Still other areas of lesions showed cholesteryl ester staining in the extracellular space without apo B staining. This staining pattern suggests loss of apo B from LDL leaving only the cholesteryl ester-rich core of LDL. Progressive loss of apo B from LDL can explain the patterns of apo B and cholesteryl ester colocalization that occur in vessel wall intima. The distribution of these patterns in normal and atherosclerotic lesions suggests that loss of apo B from the cholesteryl ester core of LDL is associated with lesion development.

Recent observations on the role of hemostatic determinants in the development of the atherothrombotic plaque

Recent evidence suggests that hemostatic determinants play a major role in the evolution of the atherothrombotic plaque. Platelets can serve as cholesterol donors for macrophages, thereby facilitating foam cell formation. Lipoprotein(a) inhibits fibrinolysis and may also contribute to atherogenesis by serving as a ligand for the scavenger receptor. By complexing with fibrin(ogen) in atheromatous lesions, lipoprotein(a) attenuates clearance of this protein, promoting atherogenesis and vascular dysfunction. These observations suggest that thrombotic determinants are critical for the development of the atheromatous plaque, and may guide the appropriate selection of potential therapeutic options in the future.

Immunodetection of human atherosclerotic plaque with 125I-labeled monoclonal antifibrin antibodies

To test the affinity of a new F(ab')2 monoclonal antibody (TRF1) against human fragment D dimer of cross-linked fibrin for atherosclerotic plaques free of detectable thrombi, 6 atherosclerotic segments of carotid and femoral artery, and as a control 5 segments of atherosclerosis-free internal mammary artery, were drawn from 11 male patients undergoing bypass surgery. All segments were carefully washed in order to remove possible endoluminal thrombi, and cut to obtain pairs of intimal fragments of similar weight, containing either plaques (n = 16), or fatty streaks (n = 12), or normal endothelium (n = 20). Each fragment underwent a direct binding test to TRF1, or to a non-specific antibody, both labeled with 125I. The activity in each fragment was measured after 3 h of incubation at 37 degrees C, and after washing the fragments every hour for 3 h. TRF1 binding (as percentage of initial activity) was significantly higher (P < 0.001) in atherosclerotic than in normal fragments (26% +/- 11.5%, vs. 9.2% +/- 3.9% in fatty streaks, and 1.9% +/- 0.6% in normal endothelium), and indirect immunofluorescence confirmed TRF1 uptake within the plaque wall. By contrast, the non-specific antibody did not show any significant binding. These preliminary results demonstrate the high specific affinity of TRF1 for atherosclerotic plaques, probably due to the hemorheologic phenomena that activate platelets and provoke the formation of fragment D dimers of cross-linked fibrin on the plaque surface.