In pulmonary arterial hypertension, reduced BMPR2 promotes rndothelial-to-mesenchymal transition via HMGA1 and its target slug

Background—We previously reported high-throughput RNA sequencing analyses that identified heightened expression of the chromatin architectural factor High Mobility Group AT-hook 1 (HMGA1) in pulmonary arterial endothelial cells (PAECs) from patients who had idiopathic pulmonary arterial hypertension (PAH) in comparison with controls. Because HMGA1 promotes epithelial-to-mesenchymal transition in cancer, we hypothesized that increased HMGA1 could induce transition of PAECs to a smooth muscle (SM)–like mesenchymal phenotype (endothelial-to-mesenchymal transition), explaining both dysregulation of PAEC function and possible cellular contribution to the occlusive remodeling that characterizes advanced idiopathic PAH. Methods and Results—We documented increased HMGA1 in PAECs cultured from idiopathic PAH versus donor control lungs. Confocal microscopy of lung explants localized the increase in HMGA1 consistently to pulmonary arterial endothelium, and identified many cells double-positive for HMGA1 and SM22α in occlusive and plexogenic lesions. Because decreased expression and function of bone morphogenetic protein receptor 2 (BMPR2) is observed in PAH, we reduced BMPR2 by small interfering RNA in control PAECs and documented an increase in HMGA1 protein. Consistent with transition of PAECs by HMGA1, we detected reduced platelet endothelial cell adhesion molecule 1 (CD31) and increased endothelial-to-mesenchymal transition markers, αSM actin, SM22α, calponin, phospho-vimentin, and Slug. The transition was associated with spindle SM-like morphology, and the increase in αSM actin was largely reversed by joint knockdown of BMPR2 and HMGA1 or Slug. Pulmonary endothelial cells from mice with endothelial cell–specific loss of Bmpr2 showed similar gene and protein changes. Conclusions—Increased HMGA1 in PAECs resulting from dysfunctional BMPR2 signaling can transition endothelium to SM-like cells associated with PAH

The Role of Neutrophils and Neutrophil Elastase in Pulmonary Arterial Hypertension

Pulmonary arterial hypertension (PAH) is a severe vasculopathy characterized by the presence of fibrotic lesions in the arterial wall and the loss of small distal pulmonary arteries. The vasculopathy is accompanied by perivascular inflammation and increased protease levels, with neutrophil elastase notably implicated in aberrant vascular remodeling. However, the source of elevated elastase levels in PAH remains unclear. A major source of neutrophil elastase is the neutrophil, an understudied cell population in PAH. The principal function of neutrophils is to destroy invading pathogens by means of phagocytosis and NET formation, but proteases, chemokines, and cytokines implicated in PAH can be released by and/or prime and activate neutrophils. This review focuses on the contribution of inflammation to the development and progression of the disease, highlighting studies implicating neutrophils, neutrophil elastase, and other neutrophil proteases in PAH. The roles of cytokines, chemokines, and neutrophil elastase in the disease are discussed and we describe new insight into the role neutrophils potentially play in the pathogenesis of PAH

Wnt/frizzled pathway in vasculogenesis and angiogenesis : frizzled-7, a new actor of vessel formation

L’obstruction des vaisseaux est responsable d’ischémie tissulaire dans différents territoires périphériques, cardiaques et cérébraux. Un des mécanismes d’adaptation du tissu à l’ischémie est la formation de néo-vaisseaux. Plusieurs données récentes mettent en évidence un rôle de la voie de signalisation Wnt/Frizzled (Fzd) dans le développement vasculaire. Le travail de cette thèse s’est focalisé sur l’étude du récepteur Frizzled7 (Fzd7) et de son rôle dans la formation des vaisseaux. Le modèle des corps embryoïdes, un modèle de différenciation des cellules souches embryonnaires vers le phénotype endothélial, nous a permis de démontrer que Fzd7 était exprimé au cours des différentes étapes de différenciation endothéliale. Des études sur des cellules endothéliales matures nous ont permis de montrer que Fzd7 régulait différentes propriétés des cellules endothéliales dont la migration et la formation de tubes endothéliaux, mais pas la prolifération. De plus, Fzd7 participe à la stabilité des jonctions cellulaires en interagissant avec la VE-cadhérine. Concernant les mécanismes moléculaires mis en jeu par Fzd7, nous avons pu montrer que celui-ci était capable d’activer la voie Wnt/PCP via la phosphorylation de la protéine JNK. Enfin, une étude in vivo dans le modèle du poisson Zèbre, nous a permis de mettre en évidence un rôle de Fzd7 dans la formation des vaisseaux intersomitiques. La deuxième partie de ce travail concerne le rôle de la voie Wnt/Fzd dans les propriétés angiogèniques des cellules souches mésenchymateuses (CSM). L’objectif de cette étude était de définir comment les CSM participaient à la formation des vaisseaux et si le système Wnt/Frizzled était nécessaire. Nous avons pu montrer que sFRP1, un modulateur de la voie Wnt, améliore la fonction cellulaire des CSM et contribue à la maturation des néo-vaisseaux. De plus, nous avons pu montrer que les CSM implantées dans un modèle d’ischémie du membre inférieur amélioraient la réponse angiogénique lorsque celles-ci étaient préconditionnées en hypoxie. Nous avons mis en évidence le rôle de Wnt4 dans ce processus.The obstruction of the vessels is responsible for ischemia in various outlying areas, heart and brain. One of the mechanisms of tissue adaptation to ischemia is the formation of neo-vessels. Several recent data show a role of Wnt/Frizzled (Fzd) pathway in vascular development.The work of this thesis focused on the study of receptor Frizzled7 (Fzd7) and its role in vessel formation. Using the model of embryoid bodies, a model of embryonic stem cell differentiation toward the endothelial lineage, we demonstrated that Fzd7 was expressed during different stages of endothelial cell differentiation. Studies on mature endothelial cells have shown that Fzd7 regulates endothelial cells properties including migration and endothelial tube formation but not proliferation. In addition, Fzd7 participates in the stability of cell junctions by interacting with VE-cadherin. Regarding the molecular mechanisms involved in Fzd7 signalling, we could show that this receptor was capable of activating the Wnt/PCP pathway via phosphorylation of JNK protein. Finally, an in vivo study in zebrafish model, allowed us to highlight a role of Fzd7 in intersomitic vessel formation.The second part of this work concerns the role of the Wnt/Fzd pathway in the angiogenic properties of mesenchymal stem cells (MSC). The objective of this study was to determine how CSM participated in vessel formation and if the Wnt/Frizzled pathway was necessary. We show that sFRP1, a modulator of the Wnt pathway, improves cellular function of MSCs and contributes to the maturation of neo-vessels. In addition, we have shown that MSCs implanted in a model of lower limb ischemia improved the angiogenic response when they were preconditioned by hypoxia. We have highlighted the role of Wnt4 in this process

Wnt/frizzled pathway in vasculogenesis and angiogenesis : frizzled-7, a new actor of vessel formation

L’obstruction des vaisseaux est responsable d’ischémie tissulaire dans différents territoires périphériques, cardiaques et cérébraux. Un des mécanismes d’adaptation du tissu à l’ischémie est la formation de néo-vaisseaux. Plusieurs données récentes mettent en évidence un rôle de la voie de signalisation Wnt/Frizzled (Fzd) dans le développement vasculaire. Le travail de cette thèse s’est focalisé sur l’étude du récepteur Frizzled7 (Fzd7) et de son rôle dans la formation des vaisseaux. Le modèle des corps embryoïdes, un modèle de différenciation des cellules souches embryonnaires vers le phénotype endothélial, nous a permis de démontrer que Fzd7 était exprimé au cours des différentes étapes de différenciation endothéliale. Des études sur des cellules endothéliales matures nous ont permis de montrer que Fzd7 régulait différentes propriétés des cellules endothéliales dont la migration et la formation de tubes endothéliaux, mais pas la prolifération. De plus, Fzd7 participe à la stabilité des jonctions cellulaires en interagissant avec la VE-cadhérine. Concernant les mécanismes moléculaires mis en jeu par Fzd7, nous avons pu montrer que celui-ci était capable d’activer la voie Wnt/PCP via la phosphorylation de la protéine JNK. Enfin, une étude in vivo dans le modèle du poisson Zèbre, nous a permis de mettre en évidence un rôle de Fzd7 dans la formation des vaisseaux intersomitiques. La deuxième partie de ce travail concerne le rôle de la voie Wnt/Fzd dans les propriétés angiogèniques des cellules souches mésenchymateuses (CSM). L’objectif de cette étude était de définir comment les CSM participaient à la formation des vaisseaux et si le système Wnt/Frizzled était nécessaire. Nous avons pu montrer que sFRP1, un modulateur de la voie Wnt, améliore la fonction cellulaire des CSM et contribue à la maturation des néo-vaisseaux. De plus, nous avons pu montrer que les CSM implantées dans un modèle d’ischémie du membre inférieur amélioraient la réponse angiogénique lorsque celles-ci étaient préconditionnées en hypoxie. Nous avons mis en évidence le rôle de Wnt4 dans ce processus.The obstruction of the vessels is responsible for ischemia in various outlying areas, heart and brain. One of the mechanisms of tissue adaptation to ischemia is the formation of neo-vessels. Several recent data show a role of Wnt/Frizzled (Fzd) pathway in vascular development.The work of this thesis focused on the study of receptor Frizzled7 (Fzd7) and its role in vessel formation. Using the model of embryoid bodies, a model of embryonic stem cell differentiation toward the endothelial lineage, we demonstrated that Fzd7 was expressed during different stages of endothelial cell differentiation. Studies on mature endothelial cells have shown that Fzd7 regulates endothelial cells properties including migration and endothelial tube formation but not proliferation. In addition, Fzd7 participates in the stability of cell junctions by interacting with VE-cadherin. Regarding the molecular mechanisms involved in Fzd7 signalling, we could show that this receptor was capable of activating the Wnt/PCP pathway via phosphorylation of JNK protein. Finally, an in vivo study in zebrafish model, allowed us to highlight a role of Fzd7 in intersomitic vessel formation.The second part of this work concerns the role of the Wnt/Fzd pathway in the angiogenic properties of mesenchymal stem cells (MSC). The objective of this study was to determine how CSM participated in vessel formation and if the Wnt/Frizzled pathway was necessary. We show that sFRP1, a modulator of the Wnt pathway, improves cellular function of MSCs and contributes to the maturation of neo-vessels. In addition, we have shown that MSCs implanted in a model of lower limb ischemia improved the angiogenic response when they were preconditioned by hypoxia. We have highlighted the role of Wnt4 in this process

Co-dependence of BMPR2 and TGFβ in elastic fiber assembly and its perturbation in pulmonary arterial hypertension

Objective—We determined in patients with pulmonary arterial (PA) hypertension (PAH) whether in addition to increased production of elastase by PA smooth muscle cells previously reported, PA elastic fibers are susceptible to degradation because of their abnormal assembly. Approach and Results—Fibrillin-1 and elastin are the major components of elastic fibers, and fibrillin-1 binds bone morphogenetic proteins (BMPs) and the large latent complex of transforming growth factor-β1 (TGFβ1). Thus, we considered whether BMPs like TGFβ1 contribute to elastic fiber assembly and whether this process is perturbed in PAH particularly when the BMP receptor, BMPR2, is mutant. We also assessed whether in mice with Bmpr2/1a compound heterozygosity, elastic fibers are susceptible to degradation. In PA smooth muscle cells and adventitial fibroblasts, TGFβ1 increased elastin mRNA, but the elevation in elastin protein was dependent on BMPR2; TGFβ1 and BMP4, via BMPR2, increased extracellular accumulation of fibrillin-1. Both BMP4- and TGFβ1-stimulated elastic fiber assembly was impaired in idiopathic (I) PAH-PA adventitial fibroblast versus control cells, particularly those with hereditary (H) PAH and a BMPR2 mutation. This was related to profound reductions in elastin and fibrillin-1 mRNA. Elastin protein was increased in IPAH PA adventitial fibroblast by TGFβ1 but only minimally so in BMPR2 mutant cells. Fibrillin-1 protein increased only modestly in IPAH or HPAH PA adventitial fibroblasts stimulated with BMP4 or TGFβ1. In Bmpr2/1a heterozygote mice, reduced PA fibrillin-1 was associated with elastic fiber susceptibility to degradation and more severe pulmonary hypertension. Conclusions—Disrupting BMPR2 impairs TGFβ1- and BMP4-mediated elastic fiber assembly and is of pathophysiologic significance in PAH

In Pulmonary Arterial Hypertension, Reduced BMPR2 Promotes Endothelial-to-Mesenchymal Transition via HMGA1 and Its Target Slug

Background-We previously reported high-throughput RNA sequencing analyses that identified heightened expression of the chromatin architectural factor High Mobility Group AT-hook 1 (HMGA1) in pulmonary arterial endothelial cells (PAECs) from patients who had idiopathic pulmonary arterial hypertension (PAH) in comparison with controls. Because HMGA1 promotes epithelial-to-mesenchymal transition in cancer, we hypothesized that increased HMGA1 could induce transition of PAECs to a smooth muscle (SM)-like mesenchymal phenotype (endothelial-to-mesenchymal transition), explaining both dysregulation of PAEC function and possible cellular contribution to the occlusive remodeling that characterizes advanced idiopathic PAH. Methods and Results-We documented increased HMGA1 in PAECs cultured from idiopathic PAH versus donor control lungs. Confocal microscopy of lung explants localized the increase in HMGA1 consistently to pulmonary arterial endothelium, and identified many cells double-positive for HMGA1 and SM22 alpha in occlusive and plexogenic lesions. Because decreased expression and function of bone morphogenetic protein receptor 2 (BMPR2) is observed in PAH, we reduced BMPR2 by small interfering RNA in control PAECs and documented an increase in HMGA1 protein. Consistent with transition of PAECs by HMGA1, we detected reduced platelet endothelial cell adhesion molecule 1 (CD31) and increased endothelial-to-mesenchymal transition markers, alpha SM actin, SM22 alpha, calponin, phospho-vimentin, and Slug. The transition was associated with spindle SM-like morphology, and the increase in alpha SM actin was largely reversed by joint knockdown of BMPR2 and HMGA1 or Slug. Pulmonary endothelial cells from mice with endothelial cell-specific loss of Bmpr2 showed similar gene and protein changes. Conclusions-Increased HMGA1 in PAECs resulting from dysfunctional BMPR2 signaling can transition endothelium to SM-like cells associated with PAH

Hypoxia Preconditioned Mesenchymal Stem Cells Improve Vascular and Skeletal Muscle Fiber Regeneration After Ischemia Through a Wnt4-dependent Pathway

Mesenchymal stem cells (MSC) are multipotent postnatal stem cells, involved in the treatment of ischemic vascular diseases. We investigate the ability of MSC, exposed to short-term hypoxic conditions, to participate in vascular and tissue regeneration in an in vivo model of hindlimb ischemia. Transplantation of hypoxic preconditioned murine MSC (HypMSC) enhanced skeletal muscle regeneration at day 7, improved blood flow and vascular formation compared to injected nonpreconditioned MSC (NormMSC). These observed effects were correlated with an increase in HypMSC engraftment and a putative role in necrotic skeletal muscle fiber clearance. Moreover, HypMSC transplantation resulted in a large increase in Wnt4 (wingless-related MMTV integration site 4) expression and we demonstrate its functional significance on MSC proliferation and migration, endothelial cell (EC) migration, as well as myoblast differentiation. Furthermore, suppression of Wnt4 expression in HypMSC, abrogated the hypoxia-induced vascular regenerative properties of these cells in the mouse hindlimb ischemia model. Our data suggest that hypoxic preconditioning plays a critical role in the functional capabilities of MSC, shifting MSC location in situ to enhance ischemic tissue recovery, facilitating vascular cell mobilization, and skeletal muscle fiber regeneration via a paracrine Wnt-dependent mechanism

Codependence of Bone Morphogenetic Protein Receptor 2 and Transforming Growth Factor-beta in Elastic Fiber Assembly and Its Perturbation in Pulmonary Arterial Hypertension

Objective-We determined in patients with pulmonary arterial (PA) hypertension (PAH) whether in addition to increased production of elastase by PA smooth muscle cells previously reported, PA elastic fibers are susceptible to degradation because of their abnormal assembly. Approach and Results-Fibrillin-1 and elastin are the major components of elastic fibers, and fibrillin-1 binds bone morphogenetic proteins (BMPs) and the large latent complex of transforming growth factor-beta 1 (TGF beta 1). Thus, we considered whether BMPs like TGF beta 1 contribute to elastic fiber assembly and whether this process is perturbed in PAH particularly when the BMP receptor, BMPR2, is mutant. We also assessed whether in mice with Bmpr2/1a compound heterozygosity, elastic fibers are susceptible to degradation. In PA smooth muscle cells and adventitial fibroblasts, TGF beta 1 increased elastin mRNA, but the elevation in elastin protein was dependent on BMPR2; TGF beta 1 and BMP4, via BMPR2, increased extracellular accumulation of fibrillin-1. Both BMP4-and TGF beta 1-stimulated elastic fiber assembly was impaired in idiopathic (I) PAH-PA adventitial fibroblast versus control cells, particularly those with hereditary (H) PAH and a BMPR2 mutation. This was related to profound reductions in elastin and fibrillin-1 mRNA. Elastin protein was increased in IPAH PA adventitial fibroblast by TGF beta 1 but only minimally so in BMPR2 mutant cells. Fibrillin-1 protein increased only modestly in IPAH or HPAH PA adventitial fibroblasts stimulated with BMP4 or TGF beta 1. In Bmpr2/1a heterozygote mice, reduced PA fibrillin-1 was associated with elastic fiber susceptibility to degradation and more severe pulmonary hypertension. Conclusions-Disrupting BMPR2 impairs TGF beta 1-and BMP4-mediated elastic fiber assembly and is of pathophysiologic significance in PAH. Visual Overview-An online visual overview is available for this article