Stroke is a leading cause of morbidity and long-term neurological disability in the U.S. Ischemic stroke, which accounts for approximately 90% of all strokes, is the result of an occlusion in the arteriole cerebrovascular network. No effective treatment options exist to provide neuroprotection from occlusion, and limited success has been seen clinically when attempting to restore blood flow to vulnerable neural tissue regions. Enhancement of pial collateral remodeling (Arteriogenesis) has recently been shown to improve blood flow and mitigate neural tissue damage following stroke (1-3). Arteriogenesis is the remodeling of pre-existing arteriole vessel which are able to re-route blood to blood-deprived regions of tissue. Arteriogenesis requires endothelial cell (EC) and smooth muscle cell proliferation, extracellular matrix degradation and recruitment of circulating bone marrow-derived cells (4-6). Unlike spouting angiogenesis, which requires weeks following occlusion to develop, arteriogenesis begins as early as 24-48hrs post-stroke (7, 8) and can expeditiously enhance blood flow to ischemic regions, making it an attractive target for therapeutic intervention. Our preliminary studies, in an EphA4 global knockout mouse model, indicated that EphA4 receptor tyrosine kinase severely limits pial arteriole collateral formation. The preliminary work also showed that activation of EC EphA4 receptor in vitro inhibited vascular formation. Additionally, ECs lining the collateral vessel have been shown to play a role in collateral remodeling (9). Taken together, the objective of this dissertation was to elucidate the cell autonomous role of the EphA4 receptor and given the central role of the EC in collateral remodeling, we postulated that EphA4 receptor on ECs the limits pial collateral formations. Using a cell-specific loss-of-function approach, we tested the hypothesis that EC-specific EphA4 plays an important role in pial collateral development and remodeling after induced stroke. The results from this dissertation show that (1) EphA4 expression on ECs suppress the formation of pial collaterals during development and limits EC growth via suppression of p-Akt in vitro (2) EC-specific EphA4 ablation leads to increased collateral remodeling, enhanced blood flow recovery, tissue protection and improved neurological behavioral outcomes after stroke and (3) Mechanistically, EphA4 limits pial collateral remodeling via attenuation of the Tie2/Angiopoietin-2 signaling pathway. The work presented in this dissertation demonstrate that EphA4 can be targeted therapeutically to increase pial collateral remodeling to alleviate neurological deficits after ischemic stroke. / Doctor of Philosophy / Stroke is the fifth leading cause of death in the United States. Ischemic stroke is the most common type of stroke and occurs when blood flow to part of the brain is impeded. Lack of blood results in cell death and tissue damage in the brain. In an effort to restore blood flow, specialized blood vessels in the brain called collaterals remodel and become larger to allow re-routed blood to the blood-deprived region of the brain. The duration it takes to remodel these remarkable blood vessels and re-route blood varies in humans, and sometimes is not able to prevent adequate tissue damage. The current work explores novel therapeutic targets to accelerate collateral remodeling in an effort to reduce tissue loss after stroke. We present studies which show that a protein called EphA4, found on endothelial cells restricts remodeling, and when inhibited in the brain can increase collateral remodeling and reduced adverse effects after ischemic stroke.

Traumatic brain injury (TBI) can cause a number of deleterious effects to the neurovascular system, including reduced cerebral blood flow (CBF), vascular regression, and ischemia, resulting in cognitive decline. Research into therapeutic targets to restore neurovascular function following injury has identified endothelial EphA4 receptor tyrosine kinase as a major regulator of vascular regrowth. The research outlined herein utilizes an endothelial-specific EphA4 knockout mouse model (KO-EphA4flf/Tie2-Cre) to determine the extent to which this receptor may influence vascular regrowth following TBI. Analysis of the colocalization and proximity of endothelial and mural cell markers (i.e. PECAM-1 and PDGFRβ, respectively) in immunohistochemically-stained brain sections demonstrates that EphA4 silencing does not seem to affect the physical association between, nor total amounts of, endothelial cells and pericytes, between genotypes by 4 days post-injury (dpi). Nevertheless, these measures demonstrate that these cell types may preferentially proliferate and/or expand into peri-lesion tissue in both KO-EphA4flf/Tie2-Cre) and WT-EphA4fl/fl mice. These data further suggest that both genotypes experience homogeneity of PECAM-1 and PDGFRβ expression between regions of the injury cavity. Gene expression analysis using mRNA samples from both genotypes reveals that KO-EphA4flf/Tie2-Cre CCI-injured mice experience increased expression of Vegfa, Flt1, and Fn (Fibronectin) compared to sham-injured condition knockouts. These results demonstrate changes in expression of angiogenic factors in the absence of early differences in patterns of vessel formation, which may underlie improved vascular regrowth, as well as outline a potential mechanism wherein the interplay between these factors and EphA4 silencing may lead to improved cognitive outcomes following TBI. / Master of Science / Every day in the United States, an average of 155 people die due to the consequences of traumatic brain injury (TBI), with many survivors suffering life-long debilitating effects, including deficits in behavior, mobility, and cognitive ability. Because of this, there is a need for researchers to identify therapeutic strategies to stimulate recovery and improve patient outcomes. Recent advancements in the field of vascular biology have identified the regrowth of the blood vessels in the brain following TBI-induced damage as an important step in the recovery process, since the resulting increases in blood flow to damaged tissue will provide oxygen and nutrients necessary to fuel recovery. The work presented in this Masters thesis follows in this vein by examining a protein receptor known as EphA4, which is found on cells within blood vessels and has been implicated in reducing the rate of vessel growth under injury conditions. By blocking the activity of EphA4, we hoped to find increased vascular regrowth following brain injury in mice. During the experiments outlined herein, it was found that there were no statistically significant differences in vessel-associated cell densities between mice with or without EphA4 activity 4 days after injury, but there were differences in the levels of proteins and/or signals associated with vessel growth. Based on these results, we conclude that removing EphA4 activity increases expression of these pro-vessel growth proteins in mouse brains following injury at these early time points, potentially leading to increased vessel growth and improved recovery over subsequent weeks following injury.

Yes / Extracellular-signal-regulated kinase 5 (ERK5) is critical for normal cardiovascular development. Previous studies have defined a canonical pathway for ERK5 activation, showing that ligand stimulation leads to MEK5 activation resulting in dual phosphorylation of ERK5 on Thr218/Tyr220 residues within the activation loop. ERK5 then undergoes a conformational change, facilitating phosphorylation on residues in the C-terminal domain and translocation to the nucleus where it regulates MEF2 transcriptional activity. Our previous research into the importance of ERK5 in endothelial cells highlighted its role in VEGF-mediated tubular morphogenesis and cell survival, suggesting that ERK5 played a unique role in endothelial cells. Our current data show that in contrast to EGF-stimulated HeLa cells, VEGF-mediated ERK5 activation in human dermal microvascular endothelial cells (HDMECs) does not result in C-terminal phosphorylation of ERK5 and translocation to the nucleus, but instead to a more plasma membrane/cytoplasmic localisation. Furthermore, the use of small-molecule inhibitors to MEK5 and ERK5 shows that instead of regulating MEF2 activity, VEGF-mediated ERK5 is important for regulating AKT activity. Our data define a novel pathway for ERK5 activation in endothelial cells leading to cell survival. / This research was funded by grants from: North West Cancer Research (NWCR): M.J.C. and A.K.M.; Medical Research Council (MRC DiMeN PhD): M.J.C. and K.A.; Biotechnology and Biological Sciences Research Council (BBSRC DTG Studentship): M.J.C., C.E.P.G., B.W. and G.N.N.; and Wellcome Trust Institutional Strategic Fund: M.J.C. and A.K.M.

Yes / The development of cardiovascular disease (CVD) is the main cause of death among chronic kidney disease (CKD) patients (1). Endothelial injury and dysfunction are critical steps in atherosclerosis, a major CVD (2). Increased production of reactive oxygen species (ROS) has been associated with the pathogenesis of cardiovascular diseases such as atherosclerosis, hypertension and heart failure (3). However, hydrogen peroxide (H2O2) modulates endothelial cell function by intricate mechanisms. Ambient production of O2.− and subsequently H2O2 at low levels, maintained via basal activity of pre-assembled endothelial NAD (P) H oxidases (4). Endothelial cells play an important regulatory role in the circulation as a physical barrier and as a source of a variety of regulatory substances. Dysfunction of the vascular endothelium is thus leading to atherosclerosis which is characterised by overexpression of adhesion molecule expression, comprising vascular cell adhesion molecule 1(VCAM1). This adhesion molecule has been found to be up-regulation in human atherosclerotic lesions. The aim of this study is to evaluate the effect of H2O2 on the endothelial cells adhesion molecules expression. Primary cultures of Human Umbilical Vascular Endothelial Cells (HUVECs) will be maintained in endothelial growth medium supplemented with penicillin-streptomycin and supplement mix of fetal calf serum in a 37C humidified incubator in an atmosphere of 5% v/v CO2. HUVECs will be treated with in the presence and absences of 50 μM of H 2O2 for 2, 6, 12 and 24 h. Intracellular superoxide anion production in HUVECs will be detected by using p-Nitro Blue Tetrazolium (NBT) assay to demonstrate whether H2O2 induce the generation of superoxide anions intracellularly in HUVECs. The formation of blue formazan will be measured spectrophotometrically at 570 nm. Total RNA will be extracted from non-treated and treated cells and RNA quantity and quality will be checked by OD260/280 measurements. VCAM-1 mRNA expression will be assessed using RT-PCR. Our results show that H2O2 could potentially significantly induce EC activation through increased mRNA expression of ICAM-1 adhesion molecules in cultured HUVECs. Treatment with N-acetyl cysteine (NAC) (bulk/nano form) could significantly attenuate the effect of H2O2 administration on adhesion molecule protein expression. This strongly suggests the role of ROS in the endothelial cell damage sustained. Future work is to find reliable methods to test endothelial function. Non-invasive studies such as brachial ultrasound testing are also needed to determine its predictive value as a potential predictor for cardiovascular disease.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 4 uppsatser.

Thesis (PhD)-- Stellenbosch University, 2014. / ENGLISH ABSTRACT: Exposure to harmful stimuli can render vascular endothelial cells dysfunctional, characterised by reduced nitric oxide (NO) bioavailibility. Endothelial dysfunction (ED) is a reversible precursor of ischaemic heart disease (IHD), and understanding the mechanisms underlying the development of ED could lead to clinical strategies in preventing/treating IHD. Very little is known about the responses of cardiac microvascular endothelial cells (CMECs) to pro-ED stimuli, as most studies are conducted on macrovascular endothelial cells. The current dissertation set out to comprehensively investigate the responses of cultured primary adult rat CMECs to known harmful stimuli, viz. hypoxia and tumor necrosis factor-alpha (TNF-α; proinflammatory cytokine). We were interested to investigate whether this distinct endothelial cell type would develop classical features of ED, and if so, what the underlying mechanisms were. First we aimed to establish a baseline characterization of the CMECs under control conditions. Next, we developed a model of hypoxia-induced cell injury and measured apoptosis/necrosis, intracellular NO and reactive oxygen species (ROS), expression and activation of signalling proteins involved with NObiosynthesis, hypoxia and apoptosis, and differential regulation of proteins. Finally, we characterised CMEC responses to treatment with TNF-α. We assessed apoptosis/necrosis, intracellular NO and ROS levels, NO-biosynthesis pathway proteins and large-scale differential protein regulation. The above measurements were performed by morphological assessment (light and fluorescence microscopy), FACS analysis, western blotting and large-scale proteomic analyses. Data showed that CMECs shared many baseline features with other endothelial cell types, including morphological appearance, LDL-uptake, NO-production, and expression of eNOS protein. In a novel observation, proteomic analysis revealed the expression of 1387 proteins. Another novel finding was the high abundance of structural mitochondrial proteins, suggesting that CMECs require mitochondria for non-respiration purposes as well. High expression of vesicle, glycolytic and RAS signalling proteins were other features of the baseline CMECs. CMECs exposed to hypoxia responded by increased apoptosis/necrosis and expression of the hypoxia-marker, HIF-1α. Interestingly, hypoxic CMECs showed increased eNOS-NO biosynthesis, associated with increased mitochondrial ROS and reduced anti-oxidant systems, suggestive of oxidative stress. In accordance with the literature, several glycolytic proteins were up-regulated. A novel finding was the up-regulation of proteins involved with protein synthesis, not usually described in hypoxic cell studies. The CMECs responded to TNF-α-treatment by exhibiting hallmarks of ED, namely attenuated biosynthesis of PKB/Akt-eNOSderived NO and the development of outspoken response to oxidative stress as indicated by the up-regulation of several anti-oxidant systems. The data showed that TNF-α treatment elicited classical TNF-Receptor 1-mediated signalling characterized by the dual activation of pro-apoptotic pathways (BID and caspase-3) as well as the protective, pro-inflammatory IKB-alpha–NF-KB pathway. In conclusion, this is the first study of its kind to describe a comprehensive characterisation of CMECs under baseline and injury-inducing conditions. On the whole, although it appeared as if the CMECs shared many responses and mechanisms with more frequently researched endothelial cell types, the data also supplied several novel additions to the literature, particularly with the application of proteomics. We believe that this dissertation has provided more insights into endothelial heterogeneity in the vascular system and into the mechanisms adopted by CMECs when exposed to stimuli typically associated with cardiovascular risk. / AFRIKAANSE OPSOMMING: Blootstelling aan skadelike stimuli kan tot disfunksionaliteit van vaskulêre endoteelselle lei wat deur verlaagde biobeskikbaarheid van stikstofoksied (NO) gekenmerk word. Endoteeldisfunksie (ED) is ‘n omkeerbare voorganger van isgemiese hartsiekte (IHD), en ‘n beter begrip van die onderliggende meganismes van ED kan lei tot die ontwikkeling van kliniese strategieë vir die voorkoming/behandeling van IHD. Baie min is bekend oor die respons wat in kardiale mikrovaskulêre endoteelselle (CMECs) uitgelok word na blootstelling aan pro-ED stimuli, omdat meeste studies op makrovaskulêre endoteelselle uitgevoer word. Die huidige proefskrif het daarna gemik om die respons van primêre kulture van volwasse rot CMECs op bekende skadelike stimuli, nl. hipoksie en tumor nekrose faktor-alfa (TNF-α; pro-inflammatoriese sitokien) in diepte te ondersoek. Ons was veral geïnteresseerd om vas te stel of hierdie spesifieke endoteelseltipe die klassieke kenmerke van ED sou ontwikkel, en indien wel, wat die onderliggende meganismes sou wees. Eerstens het ons beoog om ‘n basislyn karaterisering van CMECs onder kontrole toestande daar te stel. Vervolgens het ons ‘n model van hipoksie-geïnduseerde selskade gevestig en apoptose/nekrose, intrasellulêre NO en reaktiewe suurstofspesies (ROS), sowel as die uitdrukking en aktivering van proteine betrokke by NO-biosintese, hipoksie en apoptose en differensiële regulering van proteine gemeet. Laastens het ons die respons van CMECs op behandeling met TNF-α gekarakteriseer. Ons het apoptose/nekrose, intrasellulêre NO en ROS vlakke, NO-biosintese-seintransduksieproteïene en grootskaalse differensiele regulering van proteïene gemeet. Bg. metings is uitgevoer deur gebruik te maak van morfologiese evaluasie (lig -en fluoressensiemikroskopie), vloeisitometriese analises, western blot analises en proteomiese analises. Data het getoon dat die basislyn eienskappe van CMECs grootliks met dié van ander endoteelseltipes ooreenstem, insluitende morfologiese voorkoms, LDL-opname, NO-produksie en die uitdrukking van eNOS proteïen. In ‘n nuwe waarneming, het die proteomiese data die uitdrukking van 1387 proteïene aangetoon. ‘n Ander nuwe bevinding was die voorkoms van ‘n groot aantal strukturele mitokondriale proteïene, wat daarop dui dat die CMECs mitokondria ook vir nie-respiratoriese doeleindes gebruik. ‘n Hoë uitdrukking van vesikulêre, glikolitiese en RAS-seintransduksie proteïene was ook kenmerkend van die basislyn CMECs. CMECS wat aan hipoksie blootgestel is, het reageer met ‘n verhoging in apoptose / nekrose en verhoogde uitdrukking van die hipoksie merker, HIF-1α. ‘n Interressante bevinding was dat eNOS-NO biosintese sterk toegeneem het in die hipoksiese CMECs wat met verhoogde mitokondriale ROS en verlaagde anti-oksidant sisteme (aanduidend van oksidatiewe stres) gepaardgegaan het. In ooreenstemming met die literatuur, is verskeie glikolitiese proteïene opgereguleer. ‘n Nuwe waarneming was die opregulering van proteïene wat betrokke is by proteïensintese, iets wat nie normaalweg in hipoksie-studies beskryf word nie. Die CMECs het op TNF-α behandeling gerespondeer deur tekens van ED te toon, naamlik ‘n afname in die NO afkomstig van PKB/Akt-eNOS biosintese en die ontwikkeling van uitgesproke reaksie op oksidatiewe stres soos aangedui deur die opregulering van verskeie anti-oksidant sisteme. Die data het ook aangedui dat TNF-α behandeling tot klassieke TNF-reseptor 1 bemiddelde seintransduksie gelei het, wat gekenmerk was deur die tweeledige aktivering van pro-apoptotiese seintransduksiepaaie (BID en kaspase-3) sowel as die beskermende, pro-inflammatoriese IKB-alpha-NF-KB seintransduksiepad. Ten slotte: hierdie is die eerste studie van sy soort wat die kenmerke en response van CMECs onder basislyn en pro-besering omstandighede in diepte beskryf. Alhoewel dit oor die algemeen wil voorkom asof die CMECs baie in gemeen het met ander, beter nagevorste endoteelseltipes, het die data egter ook verskeie nuwe bevindinge tot die bestaande literatuur gevoeg, spesifiek die data afkomstig van die proteomiese analises. Ons glo dat hierdie proefskrif meer insig verleen t.o.v. die heterogeniteit van vaskulêre endoteelselle asook t.o.v. die megansimes wat deur CMECs aangewend word wanneer hulle aan skadelike stimuli (geassosieer met kardiovaskulêre risiko) blootgestel word.

Arteriosklerose führt zu schwerwiegenden klinischen Komplikationen bei Herz-Kreislauf-erkrankungen, welche die führenden Todesursachen in den westlichen Industrieländern sind. Die Arteriosklerose ist typischerweise eine Erkrankung arterieller Gefäße und betrifft nicht die venöse Gefäßwand. Bei der Entstehung von Arteriosklerose spielen die Endothelzellen als Barrierezellen und Regulatoren der Gefäßfunktion eine Schlüsselrolle. Ein wichtiger Schwerpunkt der Forschung ist die Differenzierung der Endothelzellen. Arterielle und venöse Endothelzellen weisen schon im frühen Embryonalstadium unterschiedliche Phänotypen auf. Ein besseres Verständnis der arterio-venösen Differenzierung wäre von großer Bedeutung für antiarteriosklerotische Therapien. Darüber hinaus könnte eine Reprogrammierung (z.B. von Vene in Arterie) entscheidend für neue Therapieansätze bei der Senkung der Restenoserate venöser Bypässe von Patienten mit koronarer Herzkrankheit und bei AV-Shunt-Operationen von dialysepflichtigen Patienten sein. In dieser Arbeit wurden differenzierte humane primäre arterielle und venöse Endothelzellen nach Genmodulation untersucht. Der Fokus der Genmodulation wurde auf das arterielle Markergen Hey2 und auf das venöse Markergen COUP-TFII gelegt. Das arterielle Markergen Hey2 ist ein Zielgen der Notch-Signalkaskade, während der molekulare Mechanismus der Rolle von COUP-TFII bei der venösen Differenzierung noch nicht bekannt ist. Daher wurde der Einfluss des arteriellen Markergens Hey2 und des venösen Markergens COUP-TFII auf die Notch-Signalkaskade untersucht, um ein besseres Verständnis über die molekularen Mechanismen der arterio-venösen Differenzierung zu gewinnen. Da humane primäre Endothelzellen mit kommerziell verfügbaren Transfektionsmitteln schwer transfizierbar sind, wurde zunächst ein lentivirales Vektorsystem etabliert. Hiermit wurde eine erfolgreiche und stabile Genexpression bzw. Genrepression in arteriellen und venösen Endothelzellen ermöglicht. Die Genmodulationen in arteriellen Endothelzellen, die durch die Expression des venösen Markergen COUP-TFII bzw. durch die Repression des arterellen Markergen Hey2 verursacht wurden, führten zu der neuen Erkenntnis, dass das venöse Markergen COUP-TFII in arteriellen Endothelzellen als ein Repressor des arteriellen Markergens Hey2 fungiert. Diese Repression wird durch eine direkte Bindung von COUP-TFII an den Hey2-Promotor vermittelt. Die COUP-TFII Expression bewirkte keine Veränderung in der Expression von Notch4, Dll4 und Nrp1. Dies könnte bedeuten, dass (i) COUP-TFII in arteriellen Endothelzellen kein Regulator von diesen Genen ist, (ii) Kooperationspartner von COUP-TFII fehlen, die in arteriellen Endothelzellen nicht vorhanden sind, oder (iii) der molekulare Mechanismus dieser Gene aufgrund seiner wichtigen Rolle nicht durch die Modifikation eines einzigen Gens beeinflussbar ist, da die Gene der Notch-Signalkaskade redundant kontrolliert werden. In venösen Endothelzellen wurden Genmodulationen durch Expression des arteriellen Markergens Hey2 bzw. durch die Repression des venösen Markergens COUP-TFII durchgeführt. Eine Expression des arteriellen Markergens Hey2 in venösen Endothelzellen konnte nicht die Expression der Gene der Notch-Signalkaskade aktivieren. Dies bedeutet, dass die Regulation dieser Gene durch einen übergeordneten molekularen Mechanismus gesichert ist. Interessanterweise konnte die Expression von Hey2 eine Reduktion der Hey1 Expression bewirken. Dies ist ein alternativer Effekt von Hey2 im Vergleich zu arteriellen Endothelzellen. Eine Repression des venösen Markergens COUP-TFII konnte die Expression der Gene Dll4, EphrinB2 und EphB4 induzieren. Vermutlich ist die Induktion der EphB4 Expression ein Kompensationsmechanismus auf die reduzierte COUP-TFII Expression. COUP-TFII sichert den venösen Phänotyp wahrscheinlich durch die Repression von EphrinB2 und Dll4, wobei die Reduktion von Dll4 vermutlich eine größere Bedeutung hat. Da Dll4 ein Ligand und Aktivator der Notch-Signalkaskade ist, ist seine Repression entscheidend für venöse Endothelzellen. Das arterielle Markergen Hey2 ist für die normale Embryogenese von großer Bedeutung, jedoch ist Hey2 als eines der Zielgene der Notch-Signalkaskade wahrscheinlich nicht in der Lage, molekulare Mechanismen, die zu unterschiedlichen endothelialen Phänotypen führen, zu aktivieren. Um arterielle Endothelzellen zu einem Reprogramming zu bewegen, wären wahrscheinlich Genmodulationen der Mitglieder der Notch-Signalkaskade, die upstream von Hey2 liegen, nötig. Hingegen ist die Rolle des venösen Markergens COUP-TFII in der Regulation der arterio-venösen Differenzierung von entscheidender Bedeutung. COUP-TFII spielt eine direkte Rolle in der Aufrechterhaltung der venösen Identität. Die Repression von COUP-TFII in venösen Endothelzellen bewirkt, dass sich die Expression des Gens Dll4, das die Notch-Signalkaskade aktiviert, in Richtung des arteriellen Expressionsniveaus bewegt. Für eine Reprogrammierung der venösen Endothelzellen in einen arteriellen Phänotyp ist das venöse Markergen COUP-TFII eines der Zielgene.

Arteriosklerose führt zu schwerwiegenden klinischen Komplikationen bei Herz-Kreislauf-erkrankungen, welche die führenden Todesursachen in den westlichen Industrieländern sind. Die Arteriosklerose ist typischerweise eine Erkrankung arterieller Gefäße und betrifft nicht die venöse Gefäßwand. Bei der Entstehung von Arteriosklerose spielen die Endothelzellen als Barrierezellen und Regulatoren der Gefäßfunktion eine Schlüsselrolle. Ein wichtiger Schwerpunkt der Forschung ist die Differenzierung der Endothelzellen. Arterielle und venöse Endothelzellen weisen schon im frühen Embryonalstadium unterschiedliche Phänotypen auf. Ein besseres Verständnis der arterio-venösen Differenzierung wäre von großer Bedeutung für antiarteriosklerotische Therapien. Darüber hinaus könnte eine Reprogrammierung (z.B. von Vene in Arterie) entscheidend für neue Therapieansätze bei der Senkung der Restenoserate venöser Bypässe von Patienten mit koronarer Herzkrankheit und bei AV-Shunt-Operationen von dialysepflichtigen Patienten sein. In dieser Arbeit wurden differenzierte humane primäre arterielle und venöse Endothelzellen nach Genmodulation untersucht. Der Fokus der Genmodulation wurde auf das arterielle Markergen Hey2 und auf das venöse Markergen COUP-TFII gelegt. Das arterielle Markergen Hey2 ist ein Zielgen der Notch-Signalkaskade, während der molekulare Mechanismus der Rolle von COUP-TFII bei der venösen Differenzierung noch nicht bekannt ist. Daher wurde der Einfluss des arteriellen Markergens Hey2 und des venösen Markergens COUP-TFII auf die Notch-Signalkaskade untersucht, um ein besseres Verständnis über die molekularen Mechanismen der arterio-venösen Differenzierung zu gewinnen. Da humane primäre Endothelzellen mit kommerziell verfügbaren Transfektionsmitteln schwer transfizierbar sind, wurde zunächst ein lentivirales Vektorsystem etabliert. Hiermit wurde eine erfolgreiche und stabile Genexpression bzw. Genrepression in arteriellen und venösen Endothelzellen ermöglicht. Die Genmodulationen in arteriellen Endothelzellen, die durch die Expression des venösen Markergen COUP-TFII bzw. durch die Repression des arterellen Markergen Hey2 verursacht wurden, führten zu der neuen Erkenntnis, dass das venöse Markergen COUP-TFII in arteriellen Endothelzellen als ein Repressor des arteriellen Markergens Hey2 fungiert. Diese Repression wird durch eine direkte Bindung von COUP-TFII an den Hey2-Promotor vermittelt. Die COUP-TFII Expression bewirkte keine Veränderung in der Expression von Notch4, Dll4 und Nrp1. Dies könnte bedeuten, dass (i) COUP-TFII in arteriellen Endothelzellen kein Regulator von diesen Genen ist, (ii) Kooperationspartner von COUP-TFII fehlen, die in arteriellen Endothelzellen nicht vorhanden sind, oder (iii) der molekulare Mechanismus dieser Gene aufgrund seiner wichtigen Rolle nicht durch die Modifikation eines einzigen Gens beeinflussbar ist, da die Gene der Notch-Signalkaskade redundant kontrolliert werden. In venösen Endothelzellen wurden Genmodulationen durch Expression des arteriellen Markergens Hey2 bzw. durch die Repression des venösen Markergens COUP-TFII durchgeführt. Eine Expression des arteriellen Markergens Hey2 in venösen Endothelzellen konnte nicht die Expression der Gene der Notch-Signalkaskade aktivieren. Dies bedeutet, dass die Regulation dieser Gene durch einen übergeordneten molekularen Mechanismus gesichert ist. Interessanterweise konnte die Expression von Hey2 eine Reduktion der Hey1 Expression bewirken. Dies ist ein alternativer Effekt von Hey2 im Vergleich zu arteriellen Endothelzellen. Eine Repression des venösen Markergens COUP-TFII konnte die Expression der Gene Dll4, EphrinB2 und EphB4 induzieren. Vermutlich ist die Induktion der EphB4 Expression ein Kompensationsmechanismus auf die reduzierte COUP-TFII Expression. COUP-TFII sichert den venösen Phänotyp wahrscheinlich durch die Repression von EphrinB2 und Dll4, wobei die Reduktion von Dll4 vermutlich eine größere Bedeutung hat. Da Dll4 ein Ligand und Aktivator der Notch-Signalkaskade ist, ist seine Repression entscheidend für venöse Endothelzellen. Das arterielle Markergen Hey2 ist für die normale Embryogenese von großer Bedeutung, jedoch ist Hey2 als eines der Zielgene der Notch-Signalkaskade wahrscheinlich nicht in der Lage, molekulare Mechanismen, die zu unterschiedlichen endothelialen Phänotypen führen, zu aktivieren. Um arterielle Endothelzellen zu einem Reprogramming zu bewegen, wären wahrscheinlich Genmodulationen der Mitglieder der Notch-Signalkaskade, die upstream von Hey2 liegen, nötig. Hingegen ist die Rolle des venösen Markergens COUP-TFII in der Regulation der arterio-venösen Differenzierung von entscheidender Bedeutung. COUP-TFII spielt eine direkte Rolle in der Aufrechterhaltung der venösen Identität. Die Repression von COUP-TFII in venösen Endothelzellen bewirkt, dass sich die Expression des Gens Dll4, das die Notch-Signalkaskade aktiviert, in Richtung des arteriellen Expressionsniveaus bewegt. Für eine Reprogrammierung der venösen Endothelzellen in einen arteriellen Phänotyp ist das venöse Markergen COUP-TFII eines der Zielgene.

Nitric oxide (NO), a vasoprotective and ubiquitous signaling molecule generated from the endothelial cells (EC) by the enzyme endothelial nitric oxide synthase (eNOS) have a vital role in regulation of vascular function and integrity. However, a significant attenuation of eNOS and NO leads to endothelial dysfunction (ED) and increased risk of cardiovascular disease (CVD) in diabetes. Lipoproteins particularly LDL, undergo glycation in diabetic patients and turns it into pro-atherogenic glycated LDL (glyLDL). However, the impact of glyLDL on eNOS, the transmembrane signalling events, involvement of mitochondrial and endoplasmic reticulum (ER) stress in EC remains unclear. Also, literatures reveal impaired platelet mitochondrial function in diabetes patients; however, the impact of family history of diabetes on platelet mitochondrial bioenergetics still remains unknown. In the present study, we had provided the evidence for diabetes-associated metabolic stress involving glyLDL can attenuate eNOS protein, gene and activity in EC, as well as glyLDL and high glucose attenuates eNOS content in EC. Receptor of advanced glycation end products (RAGE) and H-Ras pathway are implicated in the upstream signalling events in the downregulation of eNOS in EC. In addition, ER stress, impaired mitochondrial function due to significant reduction of complex-specific oxygen consumption and bioenergetics were identified in glyLDL-treated EC. Further, we have also detected significant impairment in platelet mitochondrial bioenergetics in healthy individuals with familial history of diabetes. Identifying the mechanisms involved in diabetes associated metabolic stress induced signaling in EC and early detection of mitochondrial impairment in healthy individuals will help to find new targets for the prevention and treatment of diabetic cardiovascular complications and improve quality of life in diabetic patients. / May 2015

<p>Radiation therapy can cause acute toxicity and long-term side effects in normal tissues. Because part of the acute toxicity of radiation is due to p53-mediated apoptosis, blocking p53 during irradiation can protect some normal tissues from acute radiation injury and might improve the therapeutic ratio of radiation therapy. However, the mechanisms by which p53 regulates late effects of radiation are not well understood. Here, I utilized genetically engineered mouse models to dissect the role of p53 in regulating two of the most clinically significant late effects of radiation: radiation-induced carcinogenesis and radiation-induced myocardial injury. </p><p> It has been well characterized that mice with one allele of p53 permanently deleted are sensitized to radiation-induced cancer. Therefore, temporary inhibition of blocking p53 during irradiation could promote malignant transformation. Experiments with mice lacking functional p53 in which p53 protein can be temporarily restored during total-body irradiation (TBI) suggest that the radiation-induced p53 response does not contribute to p53-mediated tumor suppression. Here, I performed reciprocal experiments and temporarily turned p53 off during TBI using transgenic mice with reversible RNA interference against p53. I found that temporary knockdown of p53 during TBI not only ameliorated acute hematopoietic toxicity, but in both Kras wild-type and tumor-prone KrasLA1 mice also prevented lymphoma development. Mechanistic studies show that p53 knockdown during TBI improves survival of hematopoietic stem and progenitor cells (HSPCs), which maintains HSPC quiescence and prevents accelerated repopulation of surviving cells. Moreover, using an in vivo competition assay I found that temporary knockdown of p53 during TBI maintains the fitness of p53 wild-type HSPCs to prevent the expansion of irradiated mutant cells. Taken together, our data demonstrate that p53 functions during TBI to promote lymphoma formation by facilitating the expansion of irradiated HSPCs with adaptive mutations. </p><p> p53 functions in the heart to promote myocardial injury after multiple types of stress, including ischemic injury, pressure overload and doxorubicin-induced oxidative stress. However, how p53 regulates radiation-induced myocardial injury, which develops after radiation therapy, is not well understood. Here, I utilized the Cre-loxP system to demonstrate that p53 functions in endothelial cells to protect mice from myocardial injury after a single dose of 12 Gy or 10 daily fractions of 3 Gy whole-heart irradiation (WHI). Mice in which both alleles of p53 are deleted in endothelial cells succumbed to heart failure after WHI due to myocardial necrosis, systolic dysfunction and cardiac hypertrophy. Moreover, the onset of cardiac dysfunction was preceded by alterations in myocardial vascular permeability and density. Mechanistic studies using primary cardiac endothelial cells (CECs) irradiated in vitro indicate that p53 signals to cause a mitotic arrest and protects CECs against radiation-induced mitotic catastrophe. Furthermore, mice lacking the cyclin-dependent kinase inhibitor p21, which is a transcriptional target of p53, are also sensitized to myocardial injury after 12 Gy WHI. Together, our results demonstrate that the p53/p21 axis functions to prevent radiation-induced myocardial injury in mice. Our findings raise the possibility that when combining radiation therapy with inhibitors of p53 or other components of the DNA damage response that regulate mitotic arrest, patients may experience increased radiation-related heart disease. </p><p> Taken together, our results demonstrate crucial but distinct roles of p53 in regulating late effects of radiation: p53-mediated apoptosis promotes radiation-induced lymphomagenesis, but p53-mediated cell cycle arrest prevents radiation-induced myocardial injury. These findings indicate that p53 may generally play a protective role from radiation, particularly at high doses, in cells where p53 activation is uncoupled from the induction of the intrinsic pathway of apoptosis. Therefore, selectively inhibiting p53-mediated apoptosis may be a promising approach to ameliorate acute radiation toxicity without exacerbating late effects of radiation.</p> / Dissertation