Neovascularization, or the formation of blood vessels, is important in both normal physiological processes as well as pathophysiological processes. The main players in neovascularization, endothelial cells (EC), are highly influenced by hemodynamic shear stress and this may play an important role in neovascularization. Two typical types of shear stress found in the vascular system are a unidirectional laminar shear stress (LS) found in straight regions and a disturbed, oscillatory shear stress (OS) found at branches or curves. At the cellular level, LS is thought to promote EC quiescence whereas OS is thought to promote EC dysfunction. Oscillatory sheared EC are pro-proliferative, pro-migratory, and secrete growth factors, all functions important in neovascularization. There are several diseases that involve both disturbed shear stress and neovascularization, such as atherosclerosis, aortic valve disease, and occlusive vascular disease. In these pathophysiological scenarios fluid shear stress may provide a driving force for neovascularization. Therefore, we hypothesized that oscillatory shear stress promotes greater neovascularization compared to unidirectional laminar shear stress through the secretion of angiogenic factors, which play a physiological role in neovascularization in vivo. To test this hypothesis, we first performed tubule formation and migration assays, two important functions in neovessel formation. We found that OS promotes greater tubule formation and migration of EC as compared to LS and this was mediated through secreted factors. Using gene and protein array analysis, we identified Angiopoietin-2 (Ang2) as being upregulated by OS compared to LS in EC. We found that inhibiting Ang2 blocked OS-mediated tubule formation and migration and that LS-inhibited tubule formation could be rescued by addition of Ang2. In addition, Ang2 was found to be upregulated at sites of disturbed flow in vivo, implicating a physiological role for Ang2. To further investigate the physiological role of Ang2 in neovascularization, we examined the effects of inhibiting Ang2 in a mouse model of hindlimb ischemia, which involves both disturbed flow and neovascularization. We found that Ang2 was upregulated in the ischemic adductor muscle suggesting that it plays a role in recovery during hindlimb ischemia. In addition, we found that inhibiting Ang2 decreased blood flow recovery. Ang2 inhibition resulted in decreased smooth muscle cell coverage of vessels as well as decreased macrophage infiltration. These findings suggest that Ang2 promotes blood flow recovery through the recruitment of smooth muscle cells and formation of collaterals, as well as the recruitment of macrophages that secrete important growth factors and help degrade the extracellular matrix in order for neovascularization to occur. In conclusion, this work illustrates the shear stress regulation of neovessel formation through the expression of Ang2, and the role of Ang2 in neovascularization in vivo. By understanding how angiogenic factors are regulated and what role they play in vivo, we can better understand human disease and develop important therapeutic targets.

University of Macau / Institute of Chinese Medical Sciences

[Truncated abstract] Bone remodeling is an important process to maintain mechanical integrity. It is accomplished by two important steps, bone resorption followed by new bone formation. Osteoclasts and osteoblasts are the principal cells in bone resorption and bone formation, respectively. A multitude of local and systemic factors regulates this process by controlling the cellular activities in bone remodeling compartments (BRC). An imbalance of osteoblastic bone formation and osteoclastic bone destruction will result in the development of skeletal diseases. Recent studies suggested that angiogenesis is closely associated with bone remodeling. The vasculature in bone is important for skeletal development, growth and repair. During endochondral ossification, cartilage is invaded by blood vessels which bring in osteoblast and osteoclast precursor cells, nutrients, growth factors and differentiation factors. During fracture repair, it has been demonstrated that mature osteoclasts produce heparanase which can degrade heparin sulfate proteoglycans, a major component in extracellular matrix (ECM). The process leads to the release of heparin-binding growth factors including vascular endothelial growth factor (VEGF), a potent angiogenic factor which contributes largely to local angiogenesis. In recent studies, endothelial cells have been found to produce bone morphogenetic protein (BMP)-2 and BMP-4 when they are subjected to mechanical stimuli, or a hypoxia environment. Conversely, inhibition of angiogenesis has been shown to prevent fracture healing. In a distraction osteogenesis model, either inhibition of angiogenesis or disruption of the mechanical environment prevents normal osteogenesis and results in fibrous nonunion. .... A total of 42 mice from F1 and F2 generations were genotyped as transgene positive. Preliminary analysis using radiography did not reveal any difference between the gross structures of transgenic and wild type mice. Interestingly, the preliminary histology revealed a decrease in trabecular bone and an increase of lipid space in metaphysis of transgenic mice overexpressing EGFL6. However, further studies will need to be carried out to investigate the role of EGFL6 in angiogenesis and adipogenesis using a transgenic mice model. This will be a prime focus of future work. Collectively, the results presented in this thesis have identified EGFL6, a member of the EGF-like family, as a potential angiogenic factor which may play an important role in bone remodeling. EGFL6 has been found to be expressed highly in calvarial osteoblasts and upregulated during primary murine osteoblast differentiation. EGFL6 has been 8 characterized to be a secreted homomeric complex. More importantly, EGFL6 has been shown to induce angiogenic activity in endothelial cell migration, tube formation and in vivo chick embryo chorioallantoic membrane assay. Furthermore, conditioned medium containing the EGFL6 recombinant protein was shown to induce phosphorylation of ERK in endothelial cells. Inhibition of ERK impaired EGFL6-induced ERK activation and endothelial cell migration. Taken together these studies raise the possibility that EGFL6 has a potential role in angiogenesis, and mediates a paracrine mechanism of cross-talk between vascular endothelial cells and osteoblasts during osteogenesis. An understanding of this process offers the potential to facilitate the development of therapeutic treatments for bone disease.