Evolving structure-function relations during aortic maturation and aging revealed by multiphoton microscopy

Mapping the unicellular transcriptome of the ascending thoracic aorta to changes in mechanosensing and mechanoadaptation during aging

Aortic stiffening is an inevitable manifestation of chronological aging, yet the mechano-molecular programs that orchestrate region- and layer-specific adaptations along the length and through the wall of the aorta are incompletely defined. Here, we show that the decline in passive cyclic distensibility is more pronounced in the ascending thoracic aorta (ATA) compared to distal segments of the aorta and that collagen content increases in both the medial and adventitial compartments of the ATA during aging. The single-cell RNA sequencing of aged ATA tissues reveals altered cellular senescence, remodeling, and inflammatory responses accompanied by enrichment of T-lymphocytes and rarefaction of vascular smooth muscle cells, compared to young samples. T lymphocyte clusters accumulate in the adventitia, while the activation of mechanosensitive Piezo-1 enhances vasoconstriction and contributes to the overall functional decline of ATA tissues. These results portray the immuno-mechanical aging of the ATA as a process that culminates in a stiffer conduit permissive to the accrual of multi-gerogenic signals priming to disease development.

Stiffening of the human proximal pulmonary artery with increasing age

Adverse effects of large artery stiffening are well established in the systemic circulation; stiffening of the proximal pulmonary artery (PPA) and its sequelae are poorly understood. We combined in vivo (n = 6) with ex vivo data from cadavers (n = 8) and organ donors (n = 13), ages 18 to 89, to assess whether aging of the PPA associates with changes in distensibility, biaxial wall strain, wall thickness, vessel diameter, and wall composition. Aging exhibited significant negative associations with distensibility and cyclic biaxial strain of the PPA (p ≤ 0.05), with decreasing circumferential and axial strains of 20% and 7%, respectively, for every 10 years after 50. Distensibility associated directly with diffusion capacity of the lung (R2 = 0.71, p = 0.03). Axial strain associated with right ventricular ejection fraction (R2 = 0.76, p = 0.02). Aging positively associated with length of the PPA (p = 0.004) and increased luminal caliber (p = 0.05) but showed no significant association with mean wall thickness (1.19 mm, p = 0.61) and no significant differences in the proportions of mural elastin and collagen (p = 0.19) between younger (<50 years) and older (>50) ex vivo samples. We conclude that age-related stiffening of the PPA differs from that of the aorta; microstructural remodeling, rather than changes in overall geometry, may explain age-related stiffening.

A Systematic Comparison of Normal Structure and Function of the Greater Thoracic Vessels

The greater thoracic vessels are central to a well-functioning circulatory system and are often targeted in congenital heart surgeries, yet the structure and function of these vessels have not been well studied. Here we use consistent methods to quantify and compare microstructural features and biaxial biomechanical properties of the following six greater thoracic vessels in wild-type mice: ascending thoracic aorta, descending thoracic aorta, right subclavian artery, right pulmonary artery, thoracic inferior vena cava, and superior vena cava. Specifically, we determine volume fractions and orientations of the structurally significant wall constituents (i.e., collagen, elastin, and cell nuclei) using multiphoton imaging, and we quantify vasoactive responses and mechanobiologically relevant mechanical quantities (e.g., stress, stiffness) using computer-controlled biaxial mechanical testing. Similarities and differences across systemic, pulmonary, and venous circulations highlight underlying design principles of the vascular system. Results from this study represent another step towards understanding growth and remodeling of greater thoracic vessels in health, disease, and surgical interventions by providing baseline information essential for developing and validating predictive computational models.

Cardiovascular aging: spotlight on mitochondria

Mitochondria are cellular organelles critical for ATP production and are particularly relevant to cardiovascular diseases including heart failure, atherosclerosis, ischemia-reperfusion injury, and cardiomyopathies. With advancing age, even in the absence of clinical disease, mitochondrial homeostasis becomes disrupted (e.g., redox balance, mitochondrial DNA damage, oxidative metabolism, and mitochondrial quality control). Mitochondrial dysregulation leads to the accumulation of damaged and dysfunctional mitochondria, producing excessive reactive oxygen species and perpetuating mitochondrial dysfunction. In addition, mitochondrial DNA, cardiolipin, and N-formyl peptides are potent activators of cell-intrinsic and -extrinsic inflammatory pathways. These age-related mitochondrial changes contribute to the development of cardiovascular diseases. This review covers the impact of aging on mitochondria and links these mechanisms to therapeutic implications for age-associated cardiovascular diseases.

A custom-built planar biaxial system for soft tissue material testing

Accurate material characterization of soft tissues is crucial for understanding the physiopathology of cardiovascular diseases. However, commercial biaxial testing systems are expensive, prompting the need for affordable custom solutions. This study aimed to develop a low-cost custom biaxial system capable of accurately characterizing the mechanical behavior of soft tissues. The biaxial system was constructed using 3D printing technology and non-captive linear actuators for precise displacement control. A real-time marker tracking system was implemented to estimate dis-placements without the need for costly hardware. The system's performance was evaluated through tests on a calibration spring and frozen porcine aorta samples. The linear actuators demonstrated excellent response to user position input after motor tuning, showing no discrepancies between commands and actual positions. The experimental testing of the calibration spring showed good agreement with the analytical solution, validating the system's ability to accurately test materials. Testing on porcine aorta samples revealed stress-strain responses consistent with existing literature, accounting for potential variations due to tissue preservation and regional material property heterogeneity. Overall, this custom biaxial system demonstrates promising performance in accurately assessing the mechanical behavior of soft tissues, providing researchers with a valuable tool for cardiovascular disease research and tissue engineering applications.

Compromised homeostasis in aged carotid arteries revealed by microstructural studies of elastic lamellae

Healthy arteries are continuously subjected to diverse mechanical stimuli and adapt in order to maintain a mechanical homeostasis which is characterized by a uniform distribution of wall stresses. However, aging may compromise the homeostatic microenvironment within arteries. Structural heterogeneity has been suggested as a potential microstructural mechanism that could lead to homogeneous stress distribution across the arterial wall. Our previous study on the unfolding and stretching of the elastic lamellae revealed the underlying microstructural mechanism for equalizing the circumferential stresses through wall; inner elastic layers are wavier and unfold more than the outer layers which helps to evenly distribute lamellar stretching (Yu et al., 2018). In this study, we investigated the effect of aging on lamellar deformation and its implications for tissue homeostasis. Common carotid arteries from aged mice were imaged under a multi-photon microscope while subjected to biaxial extension and inflation at five different pressures ranging from 0 up to 120 mmHg. Lamellar unfolding during pressurization was then determined from the reconstructed cross-sectional images of elastic lamellae. Tissue-level circumferential stretch was combined with the lamellar unfolding to calculate lamellar stretching. Our results revealed that the straightness gradient of aged elastic lamellae is similar to the young ones. However, during pressurization, the inner elastic lamella of the aged mice unfolded significantly more than the inner layer in young arteries. An important finding of our study is the uneven increase in inter-lamellar space which contributed to a nonuniform stretching of the elastic lamellae of aged mice arteries, elevated stress gradient, and a shifting of the load-bearing component to adventitia. Our results shed light into the complex microstructural mechanisms that take place in aging and adversely affect arterial mechanical behavior and homeostasis.

Biomechanical and transcriptional evidence that smooth muscle cell death drives an osteochondrogenic phenotype and severe proximal vascular disease in progeria

Hutchinson-Gilford Progeria Syndrome results in rapid aging and severe cardiovascular sequelae that accelerate near end-of-life. We found a progressive disease process in proximal elastic arteries that was less evident in distal muscular arteries. Changes in aortic structure and function were then associated with changes in transcriptomics assessed via both bulk and single cell RNA sequencing, which suggested a novel sequence of progressive aortic disease: adverse extracellular matrix remodeling followed by mechanical stress-induced smooth muscle cell death, leading a subset of remnant smooth muscle cells to an osteochondrogenic phenotype that results in an accumulation of proteoglycans that thickens the aortic wall and increases pulse wave velocity, with late calcification exacerbating these effects. Increased central artery pulse wave velocity is known to drive left ventricular diastolic dysfunction, the primary diagnosis in progeria children. It appears that mechanical stresses above ~ 80 kPa initiate this progressive aortic disease process, explaining why elastic lamellar structures that are organized early in development under low wall stresses appear to be nearly normal whereas other medial constituents worsen progressively in adulthood. Mitigating early mechanical stress-driven smooth muscle cell loss/phenotypic modulation promises to have important cardiovascular implications in progeria patients.

FN (Fibronectin)-Integrin α5 Signaling Promotes Thoracic Aortic Aneurysm in a Mouse Model of Marfan Syndrome

BACKGROUND

Marfan syndrome, caused by mutations in the gene for fibrillin-1, leads to thoracic aortic aneurysms (TAAs). Phenotypic modulation of vascular smooth muscle cells (SMCs) and ECM (extracellular matrix) remodeling are characteristic of both nonsyndromic and Marfan aneurysms. The ECM protein FN (fibronectin) is elevated in the tunica media of TAAs and amplifies inflammatory signaling in endothelial and SMCs through its main receptor, integrin α5β1. We investigated the role of integrin α5-specific signals in Marfan mice in which the cytoplasmic domain of integrin α5 was replaced with that of integrin α2 (denoted α5/2 chimera).

METHODS

We crossed α5/2 chimeric mice with Fbn1mgR/mgR mice (mgR model of Marfan syndrome) to evaluate the survival rate and pathogenesis of TAAs among wild-type, α5/2, mgR, and α5/2 mgR mice. Further biochemical and microscopic analysis of porcine and mouse aortic SMCs investigated molecular mechanisms by which FN affects SMCs and subsequent development of TAAs.

RESULTS

FN was elevated in the thoracic aortas from Marfan patients, in nonsyndromic aneurysms, and in mgR mice. The α5/2 mutation greatly prolonged survival of Marfan mice, with improved elastic fiber integrity, mechanical properties, SMC density, and SMC contractile gene expression. Furthermore, plating of wild-type SMCs on FN decreased contractile gene expression and activated inflammatory pathways whereas α5/2 SMCs were resistant. These effects correlated with increased NF-kB activation in cultured SMCs and mgR aortas, which was alleviated by the α5/2 mutation or NF-kB inhibition.

CONCLUSIONS

FN-integrin α5 signaling is a significant driver of TAA in the mgR mouse model. This pathway thus warrants further investigation as a therapeutic target.

Effect of aging on the biaxial mechanical behavior of human descending thoracic aorta: Experiments and constitutive modeling considering collagen crosslinking

Collagen crosslinking, an important contributor to the stiffness of soft tissues, was found to increase with aging in the aortic wall. Here we investigated the mechanical properties of human descending thoracic aorta with aging and the role of collagen crosslinking through a combined experimental and modeling approach. A total of 32 samples from 17 donors were collected and divided into three age groups: <40, 40-60 and > 60 years. Planar biaxial tensile tests were performed to characterize the anisotropic mechanical behavior of the aortic samples. A recently developed constitutive model incorporating collagen crosslinking into the two-fiber family model (Holzapfel and Ogden, 2020) was modified to accommodate biaxial deformation of the aorta, in which the extension and rotation kinematics of bonded fibers and crosslinks were decoupled. The mechanical testing results show that the aorta stiffens with aging with a more drastic change in the longitudinal direction, which results in altered aortic anisotropy. Our results demonstrate a good fitting capability of the constitutive model considering crosslinking for the biaxial aortic mechanics of all age groups. Furthermore, constitutive modeling results suggest an increased contribution of crosslinking and strain energy density to the biaxial stress-stretch behaviors with aging and point to excessive crosslinking as a prominent contributor to aortic stiffening.

A novel constitutive model considering the role of elastic lamellae' structural heterogeneity in homogenizing transmural stress distribution in arteries

Understanding how the homeostatic stress state can be reached in arterial tissues can provide new insights into vascular physiology. Even though the function of maintaining homeostasis is often linked to the concentric layers of medial elastic lamellae, how the lamellae are capable of evenly distributing the stress transmurally remains to be understood. The recent microstructural study by Yu et al. (2018 J. R. Soc. Interface 15, 20180492) revealed that, circumferentially, lamellar layers closer to the lumen are wavier than the ones further away from it and, thus, experience more unfolding when subjected to blood pressure. Motivated by this peculiar finding, the current study, for the first time, proposes a novel approach to model elastic lamellae and such structural heterogeneity using the extensible worm-like chain model. When implemented into the material description of the conventional two-layer artery model, in which adventitial collagen is modelled using the inextensible worm-like chain model, it is demonstrated that structural heterogeneity in elastic lamellae plays an important role in dictating transmural stress distribution and, therefore, the homeostasis of the arterial wall.

Compromised Cardiopulmonary Function in Fibulin-5 Deficient Mice

Competent elastic fibers are critical to the function of the lung and right circulation. Murine models of elastopathies can aid in understanding the functional roles of the elastin and elastin-associated glycoproteins that constitute elastic fibers. Here, we quantify together lung and pulmonary arterial structure, function, and mechanics with right heart function in a mouse model deficient in the elastin-associated glycoprotein fibulin-5. Differences emerged as a function of genotype, sex, and arterial region. Specifically, functional studies revealed increased lung compliance in fibulin-5 deficiency consistent with a histologically observed increased alveolar disruption. Biaxial mechanical tests revealed that the primary branch pulmonary arteries exhibit decreased elastic energy storage capacity and wall stress despite only modest differences in circumferential and axial material stiffness in the fibulin-5 deficient mice. Histological quantifications confirm a lower elastic fiber content in the fibulin-5 deficient pulmonary arteries, with fragmented elastic laminae in the outer part of the wall - likely the reason for reduced energy storage. Ultrasound measurements confirm sex differences in compromised right ventricular function in the fibulin-5 deficient mice. These results reveal compromised right heart function, but opposite effects of elastic fiber dysfunction on the lung parenchyma (significantly increased compliance) and pulmonary arteries (trend toward decreased distensibility), and call for further probing of ventilation-perfusion relationships in pulmonary pathologies. Amongst many other models, fibulin-5 deficient mice can contribute to our understanding of the complex roles of elastin in pulmonary health and disease.

Predicting and understanding arterial elasticity from key microstructural features by bidirectional deep learning

Microstructural features and mechanical properties are closely related in all soft biological tissues. Both yet exhibit considerable inter-individual differences and are affected by factors such as aging and disease and its progression. Histological analysis, modern in situ imaging, and biomechanical testing have deepened our understanding of these complex interrelations, yet two key questions remain: (1) Given the specific microstructure, can one predict the macroscopic mechanical properties without mechanical testing? (2) Can one quantify individual contributions of the different microstructural features to the macroscopic mechanical properties in an automated, systematic and largely unbiased way? Here we propose a bidirectional deep learning architecture to address these two questions. Our architecture uses data from standard histological analyses, two-photon microscopy and biaxial biomechanical testing. Its capabilities are demonstrated by predicting with high accuracy (R²=0.92) the evolving mechanical properties of the murine aorta during maturation and aging. Moreover, our architecture reveals that the extracellular matrix composition and organization are the most prominent factors governing the macroscopic mechanical properties of the tissues studied herein. STATEMENT OF SIGNIFICANCE:  .

Through the cleared aorta: three-dimensional characterization of mechanical behaviors of rat thoracic aorta under intraluminal pressurization using optical clearing method

The media of aortic wall is characterized by altering layers of elastin and smooth muscle cells (SMCs), along with collagen fibers in both layers, and plays a central role in functional and pathological remodeling such as hypertension and atherosclerosis. Because the arterial function is linked closely to the arterial wall internal structure, it is essential to investigate the alteration of the arterial microstructure during macroscopic deformation to understand cardiovascular pathologies. The present study adopted a tissue clearing method in three-dimensional mechanical characterization of rat thoracic aorta, and successfully observed changes in the structure of each of the three primary components of the aorta under intraluminal pressurization while maintaining tissue mechanical integrity and flexibility. Layers of elastic fibers and SMCs deformed greater on the intimal side than those on the adventitial side. Furthermore, there was a structural agreement in the alignment angle between SMC nuclei and elastic fibers on their intimal side, but not on the adventitial side. This is the first study that changes in the microstructure of three primary components of the aorta were visualized and evaluated through the aorta. The method established here would also be useful to understand tissue mechanics of other load-bearing soft tissues.

Simulating progressive intramural damage leading to aortic dissection using DeepONet: an operator-regression neural network

Aortic dissection progresses mainly via delamination of the medial layer of the wall. Notwithstanding the complexity of this process, insight has been gleaned by studying in vitro and in silico the progression of dissection driven by quasi-static pressurization of the intramural space by fluid injection, which demonstrates that the differential propensity of dissection along the aorta can be affected by spatial distributions of structurally significant interlamellar struts that connect adjacent elastic lamellae. In particular, diverse histological microstructures may lead to differential mechanical behaviour during dissection, including the pressure-volume relationship of the injected fluid and the displacement field between adjacent lamellae. In this study, we develop a data-driven surrogate model of the delamination process for differential strut distributions using DeepONet, a new operator-regression neural network. This surrogate model is trained to predict the pressure-volume curve of the injected fluid and the damage progression within the wall given a spatial distribution of struts, with in silico data generated using a phase-field finite-element model. The results show that DeepONet can provide accurate predictions for diverse strut distributions, indicating that this composite branch-trunk neural network can effectively extract the underlying functional relationship between distinctive microstructures and their mechanical properties. More broadly, DeepONet can facilitate surrogate model-based analyses to quantify biological variability, improve inverse design and predict mechanical properties based on multi-modality experimental data.

Progressive Microstructural Deterioration Dictates Evolving Biomechanical Dysfunction in the Marfan Aorta

Medial deterioration leading to thoracic aortic aneurysms arises from multiple causes, chief among them mutations to the gene that encodes fibrillin-1 and leads to Marfan syndrome. Fibrillin-1 microfibrils associate with elastin to form elastic fibers, which are essential structural, functional, and instructional components of the normal aortic wall. Compromised elastic fibers adversely impact overall structural integrity and alter smooth muscle cell phenotype. Despite significant progress in characterizing clinical, histopathological, and mechanical aspects of fibrillin-1 related aortopathies, a direct correlation between the progression of microstructural defects and the associated mechanical properties that dictate aortic functionality remains wanting. In this paper, age-matched wild-type, Fbn1 C1041G/+, and Fbn1 mgR/mgR mouse models were selected to represent three stages of increasing severity of the Marfan aortic phenotype. Ex vivo multiphoton imaging and biaxial mechanical testing of the ascending and descending thoracic aorta under physiological loading conditions demonstrated that elastic fiber defects, collagen fiber remodeling, and cell reorganization increase with increasing dilatation. Three-dimensional microstructural characterization further revealed radial patterns of medial degeneration that become more uniform with increasing dilatation while correlating strongly with increased circumferential material stiffness and decreased elastic energy storage, both of which comprise aortic functionality.

Biophotonic tools for probing extracellular matrix mechanics

The complex, hierarchical and heterogeneous biomechanics of the extracellular matrix (ECM) are central to the health of multicellular organisms. Characterising the distribution, dynamics and above all else origins of ECM biomechanics are challenges that have captivated researchers for decades. Recently, a suite of biophotonics techniques have emerged as powerful new tools to investigate ECM biomechanics. In this mini-review, we discuss how the non-destructive, sub-micron resolution imaging capabilities of Raman spectroscopy and nonlinear microscopy are being used to interrogate the biomechanics of thick, living tissues. These high speed, label-free techniques are implemented during mechanical testing, providing unprecedented insight into the compositional and structural response of the ECM to changes in the mechanical environment.

Biomechanical consequences of compromised elastic fiber integrity and matrix cross-linking on abdominal aortic aneurysmal enlargement

Abdominal aortic aneurysms (AAAs) are characterized histopathologically by compromised elastic fiber integrity, lost smooth muscle cells or their function, and remodeled collagen. We used a recently introduced mouse model of AAAs that combines enzymatic degradation of elastic fibers and blocking of lysyl oxidase, and thus matrix cross-linking, to study progressive dilatation of the infrarenal abdominal aorta, including development of intraluminal thrombus. We quantified changes in biomaterial properties and biomechanical functionality within the aneurysmal segment as a function of time of enlargement and degree of thrombosis. Towards this end, we combined multi-modality imaging with state-of-the art biomechanical testing and histology to quantify regional heterogeneities for the first time and we used a computational model of arterial growth and remodeling to test multiple hypotheses, suggested by the data, regarding the degree of lost elastin, accumulation of glycosaminoglycans, and rates of collagen turnover. We found that standard histopathological findings can be misleading, while combining advanced experimental and computational methods revealed that glycosaminoglycan accumulation is pathologic, not adaptive, and that heightened collagen deposition is ineffective if not cross-linked. In conclusion, loss of elastic fiber integrity can be a strong initiator of aortic aneurysms, but it is the rate and effectiveness of fibrillar collagen remodeling that dictates enlargement. STATEMENT OF SIGNIFICANCE: Precise mechanisms by which abdominal aortic aneurysms enlarge remain unclear, but a recent elastase plus β-aminopropionitrile mouse model provides new insight into disease progression. As in the human condition, the aortic degeneration and adverse remodeling are highly heterogeneous in this model. Our multi-modality experiments quantify and contrast the heterogeneities in geometry and biomaterial properties, and our computational modeling shows that standard histopathology can be misleading. Neither accumulating glycosaminoglycans nor frustrated collagen synthesis slow disease progression, thus highlighting the importance of stimulating adaptive collagen remodeling to limit lesion enlargement.

Mechanisms of Hypoxia-Induced Pulmonary Arterial Stiffening in Mice Revealed by a Functional Genetics Assay of Structural, Functional, and Transcriptomic Data

Hypoxia adversely affects the pulmonary circulation of mammals, including vasoconstriction leading to elevated pulmonary arterial pressures. The clinical importance of changes in the structure and function of the large, elastic pulmonary arteries is gaining increased attention, particularly regarding impact in multiple chronic cardiopulmonary conditions. We establish a multi-disciplinary workflow to understand better transcriptional, microstructural, and functional changes of the pulmonary artery in response to sustained hypoxia and how these changes inter-relate. We exposed adult male C57BL/6J mice to normoxic or hypoxic (FiO₂ 10%) conditions. Excised pulmonary arteries were profiled transcriptionally using single cell RNA sequencing, imaged with multiphoton microscopy to determine microstructural features under in vivo relevant multiaxial loading, and phenotyped biomechanically to quantify associated changes in material stiffness and vasoactive capacity. Pulmonary arteries of hypoxic mice exhibited an increased material stiffness that was likely due to collagen remodeling rather than excessive deposition (fibrosis), a change in smooth muscle cell phenotype reflected by decreased contractility and altered orientation aligning these cells in the same direction as the remodeled collagen fibers, endothelial proliferation likely representing endothelial-to-mesenchymal transitioning, and a network of cell-type specific transcriptomic changes that drove these changes. These many changes resulted in a system-level increase in pulmonary arterial pulse wave velocity, which may drive a positive feedback loop exacerbating all changes. These findings demonstrate the power of a multi-scale genetic-functional assay. They also highlight the need for systems-level analyses to determine which of the many changes are clinically significant and may be potential therapeutic targets.

Optical Microscopy and the Extracellular Matrix Structure: A Review

Biological tissues are not uniquely composed of cells. A substantial part of their volume is extracellular space, which is primarily filled by an intricate network of macromolecules constituting the extracellular matrix (ECM). The ECM serves as the scaffolding for tissues and organs throughout the body, playing an essential role in their structural and functional integrity. Understanding the intimate interaction between the cells and their structural microenvironment is central to our understanding of the factors driving the formation of normal versus remodelled tissue, including the processes involved in chronic fibrotic diseases. The visualization of the ECM is a key factor to track such changes successfully. This review is focused on presenting several optical imaging microscopy modalities used to characterize different ECM components. In this review, we describe and provide examples of applications of a vast gamut of microscopy techniques, such as widefield fluorescence, total internal reflection fluorescence, laser scanning confocal microscopy, multipoint/slit confocal microscopy, two-photon excited fluorescence (TPEF), second and third harmonic generation (SHG, THG), coherent anti-Stokes Raman scattering (CARS), fluorescence lifetime imaging microscopy (FLIM), structured illumination microscopy (SIM), stimulated emission depletion microscopy (STED), ground-state depletion microscopy (GSD), and photoactivated localization microscopy (PALM/fPALM), as well as their main advantages, limitations.