KLF4 is a key determinant in the development and progression of cerebral cavernous malformations

Cerebral cavernous malformations (CCMs) are vascular malformations located within the central nervous system often resulting in cerebral hemorrhage. Pharmacological treatment is needed, since current therapy is limited to neurosurgery. Familial CCM is caused by loss-of-function mutations in any of Ccm1, Ccm2, and Ccm3 genes. CCM cavernomas are lined by endothelial cells (ECs) undergoing endothelial-to-mesenchymal transition (EndMT). This switch in phenotype is due to the activation of the transforming growth factor beta/bone morphogenetic protein (TGF\u3b2/BMP) signaling. However, the mechanism linking Ccm gene inactivation and TGF\u3b2/BMP-dependent EndMT remains undefined. Here, we report that Ccm1 ablation leads to the activation of a MEKK3-MEK5-ERK5-MEF2 signaling axis that induces a strong increase in Kruppel-like factor 4 (KLF4) in ECs in\ua0vivo. KLF4 transcriptional activity is responsible for the EndMT occurring in CCM1-null ECs. KLF4 promotes TGF\u3b2/BMP signaling through the production of BMP6. Importantly, in endothelial-specific Ccm1 and Klf4 double knockout mice, we observe a strong reduction in the development of CCM and mouse mortality. Our data unveil KLF4 as a therapeutic target for CCM

Differential adhesion drives angiogenesis

New blood vessels sprout from existing vasculature to ensure vascularization of developing organs and tissues. A combination of computational modelling and experimental analysis shows that sprout elongation is mediated by differential adhesion dynamics among endothelial cells. The adhesiveness of an individual endothelial cell is governed by VEGF and Notch signalling. \ua9 2014 Macmillan Publishers Limited

Adherens junctions in endothelial cells regulate vessel maintenance and angiogenesis

Cell to cell junctions direct endothelial responses both in quiescent and angiogenic vessels. Endothelial cells express both tight and adherens junctions. Although different in their specific molecular composition, these junctional complexes present a relatively similar structural and functional arrangement. Transmembrane adhesive proteins that bind homophilically identical molecules on adjacent cells represent the core component in both types of junctions. This intercellular recognition starts a sequence of signaling events. Signal transmission is mediated through the interaction with cytoplasmic and transmembrane partners. Adherens junctions are ubiquitous along the vascular tree. In these structures VE-cadherin and its intracellular partners mediate adhesion. In vitro and in vivo data show that VE-cadherin is required for endothelial integrity in quiescent vessels and for the correct organization of new vessels. VE-cadherin regulates endothelial functions through different mechanisms which include: (i) direct activation of signaling molecules such as PI3kinase and Rac, to sustain survival and organization of the actin cytoskeleton; (ii) regulation of gene transcription, possibly modulating the nuclear level of transcription co-factors such as \u3b2-catenin and p120; (iii) formation of complexes with growth factor receptors, such as the type 2 receptor of VEGF (VEGFR-2) and modulation of their signaling properties

VE-cadherin at a glance

Although being a monolayer the vascular endothelium controls fundamental vessel functions such as permeability, leukocyte extravasation and angiogenesis. The endothelial selective transmembrane constituent of adherens junctions, Vascular Endothelial- (VE-) cadherin plays a crucial role in the regulation of such activities. The signaling pathways controlled by VE-cadherin as well as the ones that regulate VE-cadherin activity start to be elucidated. This delineates a complex network of molecular and functional interactions that can be altered in pathologies

The role of adherens junctions and VE-cadherin in the control of vascular permeability

Endothelial cells control the passage of plasma constituents and circulating cells from blood to the underlying tissues. This specialized function is lost or impaired in several pathological conditions - including inflammation, sepsis, ischemia and diabetes - which leads to severe, and sometimes fatal, organ dysfunction. Endothelial permeability is regulated in part by the dynamic opening and closure of cell-cell adherens junctions (AJs). In endothelial cells, AJs are largely composed of vascular endothelial cadherin (VE-cadherin), an endothelium-specific member of the cadherin family of adhesion proteins that binds, via its cytoplasmic domain, to several protein partners, including p120, beta-catenin and plakoglobin. Endogenous pathways that increase vascular permeability affect the function and organization of VE-cadherin and other proteins at AJs in diverse ways. For instance, several factors, including vascular endothelial growth factor (VEGF), induce the tyrosine phosphorylation of VE-cadherin, which accompanies an increase in vascular permeability and leukocyte diapedesis; in addition, the internalization and cleavage of VE-cadherin can cause AJs to be dismantled. From the knowledge of how AJ organization can be modulated, it is possible to formulate several pharmacological strategies to control the barrier function of the endothelium. We discuss the possible use of inhibitors of SRC and other kinases, of agents that increase cAMP levels, and of inhibitors of lytic enzymes as pharmacological tools for decreasing endothelial permeability

Comparative biological tests on segmented polyurethanes for cardio-vascular applications

In order to select a candidate segmented polyurethane (SPU) elastomer for the preparation of cardio-vascular prostheses, a series of biological tests (namely haemolysis, aPTT and PT coagulation tests, cytotoxicity, human endothelial cells seeding) was carried out on five commercially available biomedical polyurethanes. The tests were performed on solvent cast samples, from THF (Cardiothane 51, Pellethane 2363 80A, Estane 5714 F1, and Estane 58810), or DMAC (Biomer). All the materials were sterilized by gamma-irradiation before being tested. From the results obtained all the polyurethanes used in this study were shown to be devoid of toxicity towards blood (as proved by haemolysis and coagulation time tests) or blood cells (as proved by cytotoxicity and cell adhesion assays). A clear difference among the tested copolymers didn't stand out under our test conditions, although Cardiothane, possibly due to its physico-chemical characteristics, was less effective in promoting endothelial cell adhesio

Von Willebrand factor promotes endothelial cell adhesion via an Arg-Gly-Asp-dependent mechanism

Von Willebrand factor (vWF) is a constitutive and specific component of endothelial cell (EC) matrix. In this paper we show that, in vitro, vWF can induce EC adhesion and promote organization of microfilaments and adhesion plaques. In contrast, human vascular smooth muscle cells and MG63 osteosarcoma cells did not adhere and spread on vWF. Using antibodies to the beta chains of fibronectin (beta 1) and vitronectin (beta 3) receptors it was found that ECs adherent to vWF show clustering of both receptors. The beta 1 receptor antibodies are arranged along stress fibers at sites of extracellular matrix contact while the beta 3 receptor antibodies were sharply confined at adhesion plaques. ECs release and organize endogenous fibronectin early during adhesion to vWF. Upon blocking protein synthesis and secretion, ECs can equally adhere and spread on vWF but, while the beta 3 receptors are regularly organized, the beta 1 receptors remain diffuse. This suggests that the organization of the beta 1 receptors depend on the release of fibronectin and/or other matrix proteins operated by the same cell. Antibodies to the beta 3 receptors fully block EC adhesion to vWF and detach ECs seeded on this substratum. In contrast, antibodies to the beta 1 receptors are poorly active. Overall these results fit with an accessory role of beta 1 receptors and indicate a leading role for the beta 3 receptors in EC interaction with vWF. To identify the EC binding domain on vWF we used monoclonal antibodies produced against a peptide representing the residues Glu1737-Ser1750 of the mature vWF and thought to be important in mediating its binding to the platelet receptor glycoprotein IIb-IIIa. We found that the antibody that recognizes the residues 1,744-1,746, containing the Arg-Gly-Asp sequence, completely inhibit EC adhesion to vWF whereas a second antibody recognizing the adjacent residues 1,740-1,742 (Arg-Gly-Asp-free) is inactive. Both antibodies do not interfere with EC adhesion to vitronectin. This defines the molecular domain on vWF that is specifically recognized by ECs and reaffirms the direct role of the Arg-Gly-Asp sequence as the integrin receptor recognition site also in the vWF molecul

Sulindac metabolites decrease cerebrovascular malformations in CCM3-knockout mice

Cerebral cavernous malformation (CCM) is a disease of the central nervous system causing hemorrhage-prone multiple lumen vascular malformations and very severe neurological consequences. At present, the only recommended treatment of CCM is surgical. Because surgery is often not applicable, pharmacological treatment would be highly desirable. We describe here a murine model of the disease that develops after endothelial-cell\u2013selective ablation of the CCM3 gene. We report an early, cell-autonomous, Wnt-receptor\u2013independent stimulation of \u3b2-catenin transcription activity in CCM3-deficient endothelial cells both in vitro and in vivo and a triggering of a \u3b2-catenin\u2013driven transcription program that leads to endothelial-to-mesenchymal transition. TGF-\u3b2/BMP signaling is then required for the progression of the disease. We also found that the anti-inflammatory drugs sulindac sulfide and sulindac sulfone, which attenuate \u3b2-catenin transcription activity, reduce vascular malformations in endothelial CCM3-deficient mice. This study opens previously unidentified perspectives for an effective pharmacological therapy of intracranial vascular cavernomas