Endothelium and Arteriosclerosis

Targeting endothelial cells with golden spice curcumin: A promising therapy for cardiometabolic multimorbidity

Cardiometabolic multimorbidity (CMM) is an increasingly significant global public health concern. It encompasses the coexistence of multiple cardiometabolic diseases, including hypertension, stroke, heart disease, atherosclerosis, and T2DM. A crucial component to the development of CMM is the disruption of endothelial homeostasis. Therefore, therapies targeting endothelial cells through multi-targeted and multi-pathway approaches hold promise for preventing and treatment of CMM. Curcumin, a widely used dietary supplement derived from the golden spice Carcuma longa, has demonstrated remarkable potential in treatment of CMM through its interaction with endothelial cells. Numerous studies have identified various molecular targets of curcumin (such as NF-κB/PI3K/AKT, MAPK/NF-κB/IL-1β, HO-1, NOs, VEGF, ICAM-1 and ROS). These findings highlight the efficacy of curcumin as a therapeutic agent against CMM through the regulation of endothelial function. It is worth noting that there is a close relationship between the progression of CMM and endothelial damage, characterized by oxidative stress, inflammation, abnormal NO bioavailability and cell adhesion. This paper provides a comprehensive review of curcumin, including its availability, pharmacokinetics, pharmaceutics, and therapeutic application in treatment of CMM, as well as the challenges and future prospects for its clinical translation. In summary, curcumin shows promise as a potential treatment option for CMM, particularly due to its ability to target endothelial cells. It represents a novel and natural lead compound that may offer significant therapeutic benefits in the management of CMM.

Vascular senescence in progeria: role of endothelial dysfunction

Aims

Hutchinson-Gilford progeria syndrome (HGPS) is a pre-mature aging disorder caused by the mutation of the LMNA gene leading to an irreversibly farnesylated lamin A protein: progerin. The major causes of death in HGPS are coronary and arterial occlusive disease. In the murine model of HGPS, vascular smooth muscle cell (VSMC) loss is the primary vascular manifestation, which is different from the arterial occlusive disease seen in older patients.

Methods and results

To identify the mechanisms of HGPS vascular disease in humans, we differentiated isogenic endothelial cells (ECs) and VSMCs from HGPS-induced pluripotent stem cells (iPSCs) and control-iPSCs. Both HGPS-ECs and HGPS-VSMCs manifested cellular hallmarks of aging, including dysmorphic nuclei, impaired proliferation, increased β-galactosidase staining, shortened telomeres, up-regulated secretion of inflammatory cytokines, increased DNA damage, loss of heterochromatin, and altered shelterin protein complex (SPC) expression. However, at similar days after differentiation, even with lower levels of progerin, HGPS-ECs manifested more severe signs of senescence, as indicated in part by a higher percentage of β-galactosidase positive cells, shorter telomere length, and more DNA damage signals. We observed increased γH2A.X binding to RAP1 and reduced TRF2 binding to lamin A in HGPS-ECs but not in HGPS-VSMCs. The expression of γH2A.X was greater in HGPS-ECs than in HGPS-VSMCs and is associated with greater telomere shortening, impaired SPC interactions, and loss of heterochromatin.

Conclusion

Although progerin expression has a deleterious effect on both ECs and VSMCs, the dysfunction is greater in HGPS-ECs compared with HGPS-VSMCs. This study suggests that an endothelial-targeted therapy may be useful for HGPS patients.

Transcriptional Induction of Metallothionein by Tris(pentafluorophenyl)stibane in Cultured Bovine Aortic Endothelial Cells

Vascular endothelial cells cover the luminal surface of blood vessels and contribute to the prevention of vascular disorders such as atherosclerosis. Metallothionein (MT) is a low molecular weight, cysteine-rich, metal-binding, inducible protein, which protects cells from the toxicity of heavy metals and active oxygen species. Endothelial MT is not induced by inorganic zinc. Adequate tools are required to investigate the mechanisms underlying endothelial MT induction. In the present study, we found that an organoantimony compound, tris(pentafluorophenyl)stibane, induces gene expression of MT-1A and MT-2A, which are subisoforms of MT in bovine aortic endothelial cells. The data reveal that MT-1A is induced by activation of both the MTF-1-MRE and Nrf2-ARE pathways, whereas MT-2A expression requires only activation of the MTF-1-MRE pathway. The present data suggest that the original role of MT-1 is to protect cells from heavy metal toxicity and oxidative stress in the biological defense system, while that of MT-2 is to regulate intracellular zinc metabolism.

The effects of anti-obesity intervention with orlistat and sibutramine on microvascular endothelial function

INTRODUCTION

Obesity is associated with impaired microvascular endothelial function. We aimed to determine the effects of orlistat and sibutramine treatment on microvascular endothelial function, anthropometric and lipid profile, blood pressure (BP), and heart rate (HR).

METHODS

76 subjects were recruited and randomized to receive orlistat 120 mg three times daily or sibutramine 10 mg daily for 9 months. Baseline weight, BMI, BP, HR and lipid profile were taken. Microvascular endothelial function was assessed using laser Doppler fluximetry and iontophoresis process. Maximum change (max), percent change (% change) and peak flux (peak) in perfusion to acetylcholine (ACh) and sodium nitroprusside (SNP) iontophoresis were used to quantify endothelium dependent and independent vasodilatations.

RESULTS

24 subjects in both groups completed the trial. After treatment, weight and BMI were decreased for both groups. AChmax, ACh % change and ACh peak were increased in orlistat-treated group but no difference was observed for sibutramine-treated group. BP and total cholesterol (TC) were reduced for orlistat-treated group. HR was reduced for orlistat-treated group but was increased in sibutramine-treated group.

CONCLUSION

9 months treatment with orlistat significantly improved microvascular endothelial function. This was associated with reductions in weight, BMI, BP, HR, TC and low density lipoprotein cholesterol. No effect was seen in microvascular endothelial function with sibutramine.

Zinc diethyldithiocarbamate as an inducer of metallothionein in cultured vascular endothelial cells

Vascular endothelial cells are in direct contact with blood. Inorganic zinc is thought to be incapable of inducing metallothionein, which protects cells from heavy metal toxicity and oxidative stress, in vascular endothelial cells. Here, we aimed to further characterize the induction of metallothionein in vascular endothelial cells. Our results confirmed that inorganic zinc could not induce metallothionein in vascular endothelial cells. Moreover, ZnSO4 could not activate both the metal response element (MRE) transcription factor 1 (MTF-1)/MRE and Nrf2/antioxidant response element (ARE) pathways and was incapable of inducing metallothionein. In addition, bis(L-cysteinato)zincate(II), a zinc complex that activates the MTF-1/MRE pathway, increased MRE promoter activity but failed to induce metallothionein, suggesting that vascular endothelial metallothionein was not induced only by activation of the MTF-1/MRE pathway. Further analysis of a library of zinc complexes showed that zinc(II) bis(diethyldithiocarbamate) activated the MTF-1/MRE pathway but not the Nrf2/ARE pathway, increased MT-1A, MT-1E, and MT-2A mRNA levels, and induced metallothionein proteins. These data indicated that zinc complexes may be excellent tools to analyze metallothionein induction in vascular endothelial cells.

miR-126 Is Involved in Vascular Remodeling under Laminar Shear Stress

Morphology and changes in gene expression of vascular endothelium are mainly due to shear stress and inflammation. Cell phenotype modulation has been clearly demonstrated to be controlled by small noncoding micro-RNAs (miRNAs). This study focused on the effect of laminar shear stress (LSS) on human endothelial cells (HUVECs), with an emphasis on the role of miRNA-126 (miR-126). Exposure of HUVECs in vitro to LSS modified the shape of HUVECs and concomitantly regulated the expression of miR-126, vascular cell adhesion molecule 1 (VCAM-1), and syndecan-4 (SDC-4). A significant upregulation of miR-126 during long-term exposure to flow was shown. Interestingly, LSS enhanced SDC-4 expression on the HUVEC membranes. Overexpression of miR-126 in HUVECs decreased the levels of targets stromal cell-derived factor-1 SDF-1/CXCL12 and VCAM-1 but increased the expression of RGS16, CXCR4, and SDC-4. No significant difference in terms of cell proliferation and apoptosis was observed between scramble, anti-miR-126, and pre-miR-126 transfected HUVECs. In Apo-E KO/CKD mice aortas expressing a high level of miR-126, SDC-4 was concomitantly increased. In conclusion, our results suggest that miR-126 (i) is overexpressed by long-term LSS, (ii) has a role in up- and downregulation of genes involved in atherosclerosis, and (iii) affects SDC-4 expression.

"Vulnerable plaques" — ticking of the time bomb

Atherosclerosis and its sequelae are one of the leading causes of morbidity and mortality, especially in the developed nations. Over the years, treatment protocols have changed with the changing understanding of the disease process. Inflammatory mechanisms have emerged as key players in the formation of the atherosclerotic plaque. For the majority of its life span, the plaque develops silently and only some exhibit overt clinical manifestations. The purpose of this review is to examine the inherent properties of some of these "vulnerable" or symptomatic plaques. Rupture of the plaque is related to the thickness of the fibrous cap overlying the necrotic lipid core. A thin cap is more likely to lead to rupture. Multiple factors broadly grouped as the "determinants of vulnerability" are responsible for directly or indirectly influencing the plaque dynamics. Apoptosis is considered an important underlying mechanism that contributes to plaque instability. Inflammatory reactions within the plaque trigger apoptosis by cell–cell contact and intra cellular death signaling. Once started, the apoptotic process affects all of the components that make up the plaque, including vascular smooth muscle cells, endothelial cells, and macrophages. Extensive research has identified many of the key cellular and molecular regulators that play a part in apoptosis within the atherosclerotic lesion. This information will help us to gain a better understanding of the underlying mechanisms at the cellular and molecular level and enable us to formulate better therapeutic strategies to combat this disease.Key words: apoptosis, atherosclerosis, inflammation, plaque stability, vulnerable plaques.

Growth factors enhance interleukin-1 beta-induced persistent activation of nuclear factor-kappa B in rat vascular smooth muscle cells

OBJECTIVE

Activation of extracellular signal-regulated kinases (ERKs) is required for interleukin-1beta to persistently activate nuclear factor (NF)-kappaB and concomitantly express inducible NO synthase (iNOS) in rat vascular smooth muscle cells (VSMCs). The present study examined whether platelet-derived growth factor (PDGF) or epidermal growth factor (EGF) could influence the VSMC response to interleukin-1beta via an ERK-related signaling pathway.

METHODS AND RESULTS

Treatment of VSMCs with PDGF or EGF alone potently induced ERK phosphorylation and DNA synthesis but did not induce NF-kappaB activation or iNOS expression. However, either PDGF or EGF markedly enhanced interleukin-1beta-induced persistent NF-kappaB activation and iNOS expression but did not affect the early and transient NF-kappaB activation. Growth factor-induced DNA synthesis was attenuated in the presence of interleukin-1beta. Inhibition of ERK phosphorylation with selective inhibitors (PD98059 or U0126) attenuated interleukin-1beta-induced persistent NF-kappaB activation and iNOS expression in either the absence or presence of the growth factors.

CONCLUSIONS

These results indicate that interleukin-1beta-induced expression of NF-kappaB-dependent genes, such as iNOS, is potentiated in the presence of growth factors through a mechanism requiring ERK-dependent enhanced NF-kappaB activation, and the results also suggest that NF-kappaB activation is not required for PDGF or EGF to trigger DNA synthesis in VSMCs.

Genetics of leukoaraiosis

Computed tomography and magnetic resonance imaging of the brains of elderly individuals frequently show areas of altered signal intensity in the periventricular and subcortical white matter, referred to as leukoaraiosis. Although mildly affected individuals appear asymptomatic, larger burdens of leukoaraiosis are associated with deficits of cognition and gait. Histopathologically, areas of leukoaraiosis invariably show sclerosis, luminal narrowing, and tortuosity of small arteries and arterioles, accompanied by variable degrees of gliosis, demyelination, and axonal loss resulting from ischemia. Genetic variation plays a substantial role in interindividual differences in the volume of leukoaraiosis and its associated adverse clinical outcomes. Characterizing genetic factors contributing to interindividual differences in leukoaraiosis has the potential to enhance understanding of molecular determinants of ischemic brain injury and lead to new approaches to the diagnosis, evaluation, treatment, and prevention of this common form of vascular dementia.

Laser balloon angioplasty: potential for reduction of the thrombogenicity of the injured arterial wall and for local application of bioprotective materials

Mitigation of adverse biologic reactivity after balloon angioplasty is necessary before the incidence of restenosis can be appreciably reduced. A brief review of experimental evidence supports the hypothesis that the thrombogenicity of the injured arterial wall can be reduced by a suitable level of thermal denaturation or cross-linking of thrombogenic proteins. In addition, the concept of local pharmacologic therapy, which can be provided with laser balloon angioplasty at the site of arterial injury, is introduced. Preliminary in vitro and in vivo data suggest that guide catheter-injected albumin-heparin conjugates fabricated as water-insoluble microspheres remain adherent to the injured luminal surface and deeper arterial layers after physical trapping by the inflated balloon and subsequent laser/thermal exposure. The combination of initially adequate luminal morphology, reduction of the thrombogenicity of the injured arterial wall and application of local pharmacologic therapy with laser balloon angioplasty may eventually prove helpful in reducing the incidence of restenosis.

Platelet adhesion to exposed endothelial cell extracellular matrixes is influenced by the method of preparation

The relative thrombogenicity of extracellular matrixes (ECMs) produced by cultured human umbilical endothelial cells (ECs) was studied under flow conditions. ECMs were prepared using a number of physical and chemical methods, and their reactivity toward platelets was morphometrically evaluated. von Willebrand factor (vWF), fibronectin (FN), and 13-hydroxy-9-cis,11-trans-octadecadienoic acid (13-HODE) were also determined. We found that platelet adhesion to ECMs differed significantly, both quantitatively and qualitatively, with the method of ECM preparation. Mechanically prepared ECM exposed a less thrombogenic surface compared with ECM prepared by chemical methods (platelet-covered surface of 20% and 50%, respectively). Evaluation of the ECM components vWF, FN, and 13-HODE showed significant changes, both in their concentrations and distribution patterns, depending on the method of ECM preparation. The decrease measured in the levels of ECM-associated vWF (from 108 to 9.2 ng/10(4) cells) and the minor changes observed in the distribution pattern of subendothelial FN did not appear to be sufficient to explain the altered platelet adhesion observed in our model. This suggests that the amount of 13-HODE probably associated to the remaining ECs present in the mechanically exposed ECM could be one factor that specifically contributed to the nonthrombogenic state of these preparations. We conclude that the degree of ECM reactivity toward platelets is dependent on the method of ECM preparation and that this is related to the removal of specific EC/ECM components that modulate their thromboresistant/thrombogenic properties. This fact should be taken into account when ECMs produced by cultured ECs are used in platelet adhesion studies.

Thrombosis and atherosclerosis: regulatory role of interactions among blood components and endothelium

Complex interactions among constituents of blood and components of the vessel wall are involved in the pathogenesis of atherosclerosis and its subsequent thrombotic complications. Alterations in the endothelium are central both to the slowly progressive process of atherogenesis and to the acute events leading to thrombotic occlusion. Recent data, obtained by systematic evaluation of chronologic events that occur in diet-induced atherosclerosis, have extended our understanding of interactive processes among endothelium, monocytes, platelets, vascular smooth muscle cells, and humoral hemostatic elements in atherogenesis.

Role of platelets and thrombosis in mechanisms of acute occlusion and restenosis after angioplasty

The vascular disruption produced by angioplasty initiates platelet deposition through the processes of platelet adhesion and recruitment of circulating platelets to form an enlarging mural platelet thrombus. Thrombin produced by simultaneous activation of the coagulation cascade by subendothelial connective tissue structures enhances platelet deposition and stabilizes the forming thrombus with enmeshing fibrin. Platelet recruitment involves the expression of the glycoprotein IIb/IIIa receptor for fibrinogen and other cytoadhesive proteins including fibronectin, thrombospondin and von Willebrand factor. Platelet deposition and thrombus formation caused by angioplasty appear to be important in the development of 2 complications: acute thrombotic occlusion and restenosis. Experimental mechanical vascular injury produces a predictable, although rather variable, amount of vascular narrowing due to transient smooth muscle cell proliferative intimal lesion formation. This intimal thickening by proliferating smooth muscle cells is in part mediated by platelet mitogens, particularly platelet-derived growth factor, which are released into the damaged vessel from platelets at the time of angioplasty. Platelet-derived growth factor may also be released from other associated vascular and blood cells in response to mechanical injury, e.g., endothelium, monocyte/macrophage and smooth muscle cells themselves. The actual mitogens, and their cells of origin, that mediate restenosis after therapeutic angioplasty remain to be established. Various oral antiplatelet agents have been shown to reduce arterial thrombotic occlusion in a number of controlled clinical trials, e.g., aspirin in transient ischemic attacks and unstable angina, aspirin and dipyridamole in saphenous vein coronary artery bypass and progression of peripheral vascular disease and dipyridamole in artificial heart valves. Acute arterial thrombosis may require more potent, immediate and transient intervention, e.g., monoclonal antibody to platelet receptor expression.(ABSTRACT TRUNCATED AT 250 WORDS)

Thrombocytopenia and lupus-like anticoagulant in a patient with peripheral vascular disease: response to infusion of prostacyclin

A 46 year old man with intermittent claudication due to severe peripheral vascular disease had a circulating lupus like anticoagulant (LLAC), thrombocytopenia (79 X 109/1), markedly reduced platelet survival and a normal bone marrow. He was treated with intravenous prostacyclin (PGI2) infusions which resulted in improvement of the patient's exercise tolerance and normalisation of his platelet count (300 X 109/1) and platelet aggregation could then be assessed. The platelets were markedly hyperaggregable and generated supranormal quantities of thromboxane A2. A diagnosis of consumptive thrombocytopenia secondary to peripheral vascular disease and platelet hyperaggregability was made. Despite therapy with aspirin and dipyridamole, gradual and progressive reduction in platelet count followed and his exercise tolerance declined over the next three months. Immunoglobulin prepared from the patient's serum did not inhibit vascular PGI2 synthesis in vitro. To our knowledge this is the first reported case of consumptive thrombocytopenia due to severe peripheral vascular disease and platelet hyperaggregability. PGI2 administration caused a transient resolution of these features which was not sustained by aspirin and dipyridamole.

The effect of pyridoxal-5-phosphate on the inhibition of platelet aggregation and adenosine-3'-5'-cyclic monophosphate accumulation in human platelets

Platelet adenosine-3'-5'-cyclic monophosphate (c-AMP) was determined in platelet rich plasma and washed platelets by a modification of the c-AMP protein binding assay. Studies were performed in the presence and absence of platelet aggregation inducers (adenosine diphosphate and thrombin) and inhibitors (pyridoxal-5-phosphate (PALP), prostaglandin E1 (PGE1), theophylline and papaverine). At 70% inhibitory concentration of platelet aggregation (PA) induced by papaverine or theophylline, a small but significant increase in platelet c-AMP level was found. With PALP however the inhibition of PA was not associated with a significant increase in the c-AMP level. PALP or theophylline potentiated greatly both the inhibition of PA and c-AMP accumulation induced by PGE1. Yet PALP potentiated the inhibition of PA induced by theophylline without increasing platelet c-AMP level. Our results indicate that the inhibition of PA by PALP is not mediated by c-AMP accumulation. However in the presence of PGE1, the increment in PA inhibition, is mediated by further indirect activation of the adenyl-cyclase.