Adipokines: Deciphering the cardiovascular signature of adipose tissue

Obesity and hypertension are intimately linked due to the various ways that the important cell types such as vascular smooth muscle cells (VSMC), endothelial cells (EC), immune cells, and adipocytes, communicate with one another to contribute to these two pathologies. Adipose tissue is a very dynamic organ comprised primarily of adipocytes, which are well known for their role in energy storage. More recently adipose tissue has been recognized as the largest endocrine organ because of its ability to produce a vast number of signaling molecules called adipokines. These signaling molecules stimulate specific types of cells or tissues with many adipokines acting as indicators of adipocyte healthy function, such as adiponectin, omentin, and FGF21, which show anti-inflammatory or cardioprotective effects, acting as regulators of healthy physiological function. Others, like visfatin, chemerin, resistin, and leptin are often altered during pathophysiological circumstances like obesity and lipodystrophy, demonstrating negative cardiovascular outcomes when produced in excess. This review aims to explore the role of adipocytes and their derived products as well as the impacts of these adipokines on blood pressure regulation and cardiovascular homeostasis.

Loss of cardiomyocyte CYB5R3 impairs redox equilibrium and causes sudden cardiac death

Sudden cardiac death (SCD) in patients with heart failure (HF) is allied with an imbalance in reduction and oxidation (redox) signaling in cardiomyocytes; however, the basic pathways and mechanisms governing redox homeostasis in cardiomyocytes are not fully understood. Here, we show that cytochrome b5 reductase 3 (CYB5R3), an enzyme known to regulate redox signaling in erythrocytes and vascular cells, is essential for cardiomyocyte function. Using a conditional cardiomyocyte-specific CYB5R3-knockout mouse, we discovered that deletion of CYB5R3 in male, but not female, adult cardiomyocytes causes cardiac hypertrophy, bradycardia, and SCD. The increase in SCD in CYB5R3-KO mice is associated with calcium mishandling, ventricular fibrillation, and cardiomyocyte hypertrophy. Molecular studies reveal that CYB5R3-KO hearts display decreased adenosine triphosphate (ATP), increased oxidative stress, suppressed coenzyme Q levels, and hemoprotein dysregulation. Finally, from a translational perspective, we reveal that the high-frequency missense genetic variant rs1800457, which translates into a CYB5R3 T117S partial loss-of-function protein, associates with decreased event-free survival (~20%) in Black persons with HF with reduced ejection fraction (HFrEF). Together, these studies reveal a crucial role for CYB5R3 in cardiomyocyte redox biology and identify a genetic biomarker for persons of African ancestry that may potentially increase the risk of death from HFrEF.

Angiotensin II augments renal vascular smooth muscle soluble GC expression via an AT1 receptor-forkhead box subclass O transcription factor signalling axis

BACKGROUND AND PURPOSE

Reduced renal blood flow triggers activation of the renin-angiotensin-aldosterone system (RAAS) leading to renovascular hypertension. Renal vascular smooth muscle expression of the NO receptor, soluble GC (sGC), modulates the vasodilator response needed to control renal vascular tone and blood flow. Here, we tested if angiotensin II (Ang II) affects sGC expression via an AT₁ receptor-forkhead box subclass O (FoxO) transcription factor dependent mechanism.

EXPERIMENTAL APPROACH

Using a murine two-kidney-one-clip (2K1C) renovascular hypertension model, we measured renal artery vasodilatory function and sGC expression. Additionally, we conducted cell culture studies using rat renal pre-glomerular smooth muscle cells (RPGSMCs) to test the in vitro mechanistic effects of Ang II treatment on sGC expression and downstream function.

KEY RESULTS

Contralateral, unclipped renal arteries in 2K1C mice showed increased NO-dependent vasorelaxation compared to sham control mice. Immunofluorescence studies revealed increased sGC protein expression in 2K1C contralateral renal arteries over sham controls. RPGSMCs treated with Ang II caused a significant up-regulation of sGC mRNA and protein expression as well as downstream sGC-dependent signalling. Ang II signalling effects on sGC expression occurred through an AT₁ receptor and FoxO transcription factor-dependent mechanism at both the mRNA and protein expression levels.

CONCLUSION AND IMPLICATIONS

Renal artery smooth muscle, in vivo and in vitro, up-regulates expression of sGC following RAAS activity. In both cases, up-regulation of sGC leads to increased downstream cGMP signalling, suggesting a previously unrecognized protective mechanism to improve renal blood flow in the uninjured contralateral renal artery.

LINKED ARTICLES

This article is part of a themed issue on cGMP Signalling in Cell Growth and Survival. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.11/issuetoc.

Abstract 392: C-C Chemokine Receptor Type 5 Deficiency Exacerbates The Severity Of Vasculitis In A Mouse Model Of Kawasaki Disease

Kawasaki disease (KD) is an acute vasculitis and a common cause of acquired heart disease in children. C-C chemokine receptor type 5 (CCR5) is a receptor involved in the resolution of inflammation by eliminating chemical mediators and recruiting anti-inflammatory cells into the inflammatory site. Whether CCR5 plays a vascular protective effect in KD, it is still to be clarified. We tested the hypothesis that CCR5 reduces the vasculitis by decreasing the chemokine and cytokine vascular signaling. KD was induced by the Candida albicans water-soluble fraction model (CAWS, 4mg per injection/day for 5 days) in male control (CCR5+/+) and CCR5 deficient (CCR5-/-) mice. Mice were divided in 3 CAWS treatment groups: 1 single CAWS injection(G1) to identify the chemokines and cytokines levels, 2-days post CAWS treatment (G7) to understand the acute effects of KD, and 28-days post CAWS treatment (G28) to study the chronic effects of KD. Heart and abdominal aorta (AA) were harvested for vascular characterization. We found 4 to 10-times fold increase in C-C Motif Chemokine Ligand (CCL) 1, 3, and 5 (CCR5 ligands) and CCR5 gene expression in hearts and AA from CCR5+/+ in G1. Circulating IL1β and CCL5 levels were elevated in CCR5+/+ G1, which was worsened in CCR5-/-, this pattern persisted in G7 and G28, but in less intensity. No sign of vasculitis in coronary arteries and aortic root (scored by immune cells infiltration) or abdominal aorta aneurysm (AAA) were detected in G7 in CCR5+/+ and CCR5-/-, but a vascular dysfunction, reduced relaxation to acetylcholine and increased contractility to thromboxane in AA, was found, such changes were pronounced in CCR5-/-[Maximal response (mN): CCR5+/+: 4.65 ± 0.2; CCR5+/+ G7: 6.795 ± 0.3*; CCR5-/- G7: 9.750 ± 0.7 # , *P<0.05 vs CCR5+/+; # P<0.05 vs CCR5+/+ G1]. Vasculitis in coronary arteries, aortic root, AAA formation, and a drastic loss of vascular contractility in AA were observed in CCR5+/+ and CCR5-/- G28 but was more exacerbated in later.Initial data show that CCR5 plays a protective role in the genesis of vasculitis in a mouse model of KD by regulating the chemokines and cytokines availability and signaling. For future directions, we hope to identify the vascular signaling activated by this intensified availability of chemokines and cytokines.

FoxO4 controls sGCβ transcription in vascular smooth muscle

Nitric oxide (NO) binds soluble guanylyl cyclase β (sGCβ) to produce cGMP and relax vascular smooth muscle cells (SMCs) needed for vasodilation. Although the regulation of NO-stimulated sGC activity has been well characterized at the posttranslational level, the mechanisms that govern sGC transcription remain incompletely understood. Recently, we identified Forkhead box subclass O (FoxO) transcription factors as essential for expression of sGC; however, the specific FoxO family member responsible for the expression of sGCβ in SMC remains unknown. Using FoxO shRNA knockdown adenovirus treatment in rat aortic SMCs, we show that FoxO1 or FoxO3 knockdown causes greater than twofold increases in Gucy1a3 and Gucy1b3 mRNA expression, without changes in NO-dependent cGMP production or cGMP-dependent phosphorylation. FoxO4 knockdown produced a 50% decrease in Gucy1a3 and Gucy1b3 mRNA with 70% loss of sGCα and 50% loss of sGCβ protein expression. Knockdown of FoxO4 expression decreased cGMP production and downstream protein kinase G-dependent phosphorylation more than 50%. Triple FoxO knockdown exacerbated loss of sGC-dependent function, phenocopying previous FoxO inhibition studies. Using promoter luciferase and chromatin immunoprecipitation assays, we find that FoxO4 acts as a transcriptional activator by directly binding several FoxO DNA motifs in the promoter regions of GUCY1B3 in human aortic SMCs. Collectively, our data show FoxO4 is a critical transcriptional regulator of sGCβ expression in SMC.NEW & NOTEWORTHY One of the key mechanisms of vascular smooth muscle cell (SMC) dilation occurs through nitric oxide (NO)-dependent induction of soluble guanylyl cyclase (sGC) by means of its β-subunit. Herein, we are the first to identify Forkhead box subclass O protein 4 (FoxO4) as a key transcriptional regulator of GUCY1B3 expression, which codes for sGCβ protein in human and animal SMCs. This discovery will likely have important implications for the future usage of antihypertensive and vasodilatory therapies which target NO production, sGC, or FoxO transcription factors.

Redox Switches Controlling Nitric Oxide Signaling in the Resistance Vasculature and Implications for Blood Pressure Regulation: Mid-Career Award for Research Excellence 2020

The arterial resistance vasculature modulates blood pressure and flow to match oxygen delivery to tissue metabolic demand. As such, resistance arteries and arterioles have evolved a series of highly orchestrated cell-cell communication mechanisms between endothelial cells and vascular smooth muscle cells to regulate vascular tone. In response to neurohormonal agonists, release of several intracellular molecules, including nitric oxide, evokes changes in vascular tone. We and others have uncovered novel redox switches in the walls of resistance arteries that govern nitric oxide compartmentalization and diffusion. In this review, we discuss our current understanding of redox switches controlling nitric oxide signaling in endothelial and vascular smooth muscle cells, focusing on new mechanistic insights, physiological and pathophysiological implications, and advances in therapeutic strategies for hypertension and other diseases.

Antagonism of Forkhead Box Subclass O Transcription Factors Elicits Loss of Soluble Guanylyl Cyclase Expression

Nitric oxide (NO) stimulates soluble guanylyl cyclase (sGC) activity, leading to elevated intracellular cyclic guanosine 3',5'-monophosphate (cGMP) and subsequent vascular smooth muscle relaxation. It is known that downregulation of sGC expression attenuates vascular dilation and contributes to the pathogenesis of cardiovascular disease. However, it is not well understood how sGC transcription is regulated. Here, we demonstrate that pharmacological inhibition of Forkhead box subclass O (FoxO) transcription factors using the small-molecule inhibitor AS1842856 significantly blunts sGC α and β mRNA expression by more than 90%. These effects are concentration-dependent and concomitant with greater than 90% reduced expression of the known FoxO transcriptional targets, glucose-6-phosphatase and growth arrest and DNA damage protein 45 α (Gadd45α). Similarly, sGC α and sGC β protein expression showed a concentration-dependent downregulation. Consistent with the loss of sGC α and β mRNA and protein expression, pretreatment of vascular smooth muscle cells with the FoxO inhibitor decreased sGC activity measured by cGMP production following stimulation with an NO donor. To determine if FoxO inhibition resulted in a functional impairment in vascular relaxation, we cultured mouse thoracic aortas with the FoxO inhibitor and conducted ex vivo two-pin myography studies. Results showed that aortas have significantly blunted sodium nitroprusside-induced (NO-dependent) vasorelaxation and a 42% decrease in sGC expression after 48-hour FoxO inhibitor treatment. Taken together, these data are the first to identify that FoxO transcription factor activity is necessary for sGC expression and NO-dependent relaxation.

Abstract 103: Cytochrome b5 Reductase 3 Regulates Myoglobin Redox State and Controls Cardiac Function

Oxidative stress contributes to the adverse pathophysiology of cardiac remodeling in heart failure. During oxidative stress, hemoprotein heme-iron can be oxidized, often altering the function of these proteins. We previously reported that cytochrome b5 reductase 3 (Cyb5R3) regulates heme iron redox in the vascular wall. While conducting vasoreactivity studies with a small-molecule Cyb5R3 inhibitor, we unexpectedly observed inhibition resulted in dilated cardiomyopathy (DCM) with reduced ejection fraction. Based on this study, we generated the first cardiomyocyte Cyb5R3 knockout mouse. Heart specific Cyb5R3 knockout resulted in DCM with >50% lethality in 15 days. H&E staining, wheat germ agglutinin immunofluorescence staining, transmission electron microscopy and diffusion tensor MRI shows that loss of Cyb5R3 causes myocardial atrophy and fibrosis. Due to the known heme iron reducing function of Cyb5R3, electron paramagnetic resonance (EPR) was used to assess the abundance of reduced and oxidized myoglobin ex vivo. Cyb5R3 knockout hearts had approximately 30% more oxidation relative to controls. Hypoxyprobe staining, which senses tissue pO2 below 5mmHg, showed Cyb5R3 expression is required for maintaining intra-cardiomyocyte pO 2 , likely through myoglobin heme-iron reduction. Decreased pO 2 was supported by altered mitochondrial dynamics. Complex IV activity was significantly reduced, along with decreased mitochondrial size and total ATP. Heme degradation protein, heme oxygenase-1 (HO-1) was significantly upregulated, suggesting that Cyb5R3 knockout may result in increased free-heme toxicity leading to intracellular damage. To translate these findings to humans, we conducted a retrospective study using a high-frequency T117S variant in African Americans. T117S carriers had significantly accelerated mortality post-first acute cardiac event. A T117S mouse was generated and received trans-aortic constriction (TAC) for 2 weeks. Preliminary results suggest T117S TAC mice have accelerated cardiac remodeling and time to death after pressure overload relative to C57B6/J TAC controls. Together, these data support Cyb5R3 expression may have an important role as a heme-iron reductase in cardiomyocyte function.

Abstract 506: Pharmacological Inhibition of Forkhead-box Class O Transcription Factors Reduces Nitric Oxide Signaling Through Downregulation of Soluble Guanylate Cyclase

Dysregulated vascular tone contributes to hypertension. Nitric oxide (NO) activated soluble guanylate cyclase (sGC) is an integral player in the regulation of vasodilation capacity through production of the secondary messenger cyclic guanosine monophosphate (cGMP) to induce vasorelaxation. Impaired NO-stimulated cGMP production through sGC has previously been shown to significantly contribute to the development and acceleration of hypertension. To date, little is understood concerning the transcriptional regulation of sGC expression in vascular smooth muscle cells (VSMCs). It has been established that the class O forkhead-box (FoxO) family of transcription factors play important roles in the regulation of cell growth, proliferation, metabolism, survival, lifespan, and tissue differentiation. Therefore, we hypothesize that FoxO transcription factors play an important role in sGC regulation and hypertension. Here we show that pan-pharmacological inhibition of FoxO transcription factors using AS1842856 significantly reduced sGC mRNA expression rapidly and in a dose dependent manner. Similarly, sGC protein expression significantly decreased quickly and dose-dependently upon FoxO protein inhibition. Furthermore, VSMC FoxO inhibitor pre-treatment significantly decreased cGMP production under basal and after stimulation with DEA-NONOate, a NO-donor molecule. Functionally, Ex vivo two-pin myography experiments show that FoxO inhibitor-treated C57BL/6 mouse aortas have significantly blunted sodium nitroprusside (SNP)-induced (NO-dependent) vasorelaxation. Taken together, our data suggest FoxO transcription factor activity is necessary for the maintenance of sGC expression and NO-dependent vascular tone modulation.

Targeting Pulmonary Endothelial Hemoglobin α Improves Nitric Oxide Signaling and Reverses Pulmonary Artery Endothelial Dysfunction

Pulmonary hypertension is characterized by pulmonary endothelial dysfunction. Previous work showed that systemic artery endothelial cells (ECs) express hemoglobin (Hb) α to control nitric oxide (NO) diffusion, but the role of this system in pulmonary circulation has not been evaluated. We hypothesized that up-regulation of Hb α in pulmonary ECs contributes to NO depletion and pulmonary vascular dysfunction in pulmonary hypertension. Primary distal pulmonary arterial vascular smooth muscle cells, lung tissue sections from unused donor (control) and idiopathic pulmonary artery (PA) hypertension lungs, and rat and mouse models of SU5416/hypoxia-induced pulmonary hypertension (PH) were used. Immunohistochemical, immunocytochemical, and immunoblot analyses and transfection, infection, DNA synthesis, apoptosis, migration, cell count, and protein activity assays were performed in this study. Cocultures of human pulmonary microvascular ECs and distal pulmonary arterial vascular smooth muscle cells, lung tissue from control and pulmonary hypertensive lungs, and a mouse model of chronic hypoxia-induced PH were used. Immunohistochemical, immunoblot analyses, spectrophotometry, and blood vessel myography experiments were performed in this study. We find increased expression of Hb α in pulmonary endothelium from humans and mice with PH compared with controls. In addition, we show up-regulation of Hb α in human pulmonary ECs cocultured with PA smooth muscle cells in hypoxia. We treated pulmonary ECs with a Hb α mimetic peptide that disrupts the association of Hb α with endothelial NO synthase, and found that cells treated with the peptide exhibited increased NO signaling compared with a scrambled peptide. Myography experiments using pulmonary arteries from hypoxic mice show that the Hb α mimetic peptide enhanced vasodilation in response to acetylcholine. Our findings reveal that endothelial Hb α functions as an endogenous scavenger of NO in the pulmonary endothelium. Targeting this pathway may offer a novel therapeutic target to increase endogenous levels of NO in PH.