Yes / Increased cardiovascular morbidity and mortality in individuals with type 2 diabetes (T2DM) is a significant clinical problem. Despite advancements in achieving good glycaemic control, this patient population remains susceptible to macrovascular complications. We previously discovered that vascular smooth muscle cells (SMC) cultured from T2DM patients exhibit persistent phenotypic aberrancies distinct from those of individuals without a diagnosis of T2DM. Notably, persistently elevated expression levels of microRNA-145 co-exist with characteristics consistent with aging, DNA damage and senescence. We hypothesised that increased expression of microRNA-145 plays a functional role in DNA damage signalling and subsequent cellular senescence specifically in SMC cultured from the vasculature of T2DM patients. In this study, markers of DNA damage and senescence were unambiguously and permanently elevated in native T2DM versus non-diabetic (ND)-SMC. Exposure of ND cells to the DNA-damaging agent etoposide inflicted a senescent phenotype, increased expression of apical kinases of the DNA damage pathway and elevated expression levels of microRNA-145. Overexpression of microRNA-145 in ND-SMC revealed evidence of functional links between them; notably increased secretion of senescence-associated cytokines and chronic activation of stress-activated intracellular signalling pathways, particularly the mitogen-activated protein kinase, p38a. Exposure to conditioned media from microRNA-145 overexpressing cells resulted in chronic p38a signalling in naïve cells, evidencing a paracrine induction and reinforcement of cell senescence. We conclude that targeting of microRNA-145 may provide a route to novel interventions to eliminate DNA-damaged and senescent cells in the vasculature and to this end further detailed studies are warranted.

Yes / (1) Abdominal aortic aneurysm (AAA) is a silent, progressive disease with significant mortality from rupture. Whilst screening programmes are now able to detect this pathology early in its development, no therapeutic intervention has yet been identified to halt or retard aortic expansion. The inability to obtain aortic tissue from humans at early stages has created a necessity for laboratory models, yet it is essential to create a timeline of events from EARLY to END stage AAA progression. (2) We used a previously validated ex vivo porcine bioreactor model pre-treated with protease enzyme to create "aneurysm" tissue. Mechanical properties, histological changes in the intact vessel wall, and phenotype/function of vascular smooth muscle cells (SMC) cultured from the same vessels were investigated. (3) The principal finding was significant hyperproliferation of SMC from EARLY stage vessels, but without obvious histological or SMC aberrancies. END stage tissue exhibited histological loss of α-smooth muscle actin and elastin; mechanical impairment; and, in SMC, multiple indications of senescence. (4) Aortic SMC may offer a therapeutic target for intervention, although detailed studies incorporating intervening time points between EARLY and END stage are required. Such investigations may reveal mechanisms of SMC dysfunction in AAA development and hence a therapeutic window during which SMC differentiation could be preserved or reinstated. / This research was funded in part by The Leeds Teaching Hospitals Charitable Foundation (R11/8002). E.R.C. was supported by a PhD studentship from the Engineering and Physical Sciences Research Council (EPSRC; EP/F500513/1). R.J.H. was the recipient of an Intercalated Batchelor of Science Degree in Science award from the Royal College of Surgeons of England. M.A.B.(FS/18/12/33270 and FS/12/54/29671), K.I.B. (FS/12/26/29395), and K.J.G. (FS/11/91/29090) were supported by BHF Clinical Research Training Fellowships.

Yes / Early vascular ageing (EVA) is a pathological phenomenon whereby the vascular system ages more quickly than chronological age. This underpins many cardiovascular diseases including the complications of type 2 diabetes, aneurysm formation and hypertension. Smooth muscle cells (SMC) are the principal cell type in the vascular wall and maintain vascular tone. EVA-related phenotypic switching of these cells contributes towards disease progression. EVA is distinct from chronological ageing, and research is ongoing to identify a definitive molecular signature of EVA. This will facilitate the discovery of new clinical tests for early detection of EVA and identify therapeutic targets to halt (or prevent) EVA in SMC, thus reducing macrovascular morbidity and mortality.

Yes / Coronary microvascular dysfunction (CMD) is an under-diagnosed condition characterized by functional alteration of the small coronary arterioles and the cardiac capillary bed. The vessels do not dilate appropriately in response to changes in cardiac oxygen demand, leading to chest pain and symptoms of angina. These blood vessels contain two major cell types: the endothelial cells, which line the blood vessels and detect changes in oxygen demand, and smooth muscle cells (SMC) which respond to these changes by contracting or relaxing to provide an optimal blood supply to the cardiac tissue. Many CMD studies have focused on the endothelial cells as these cells secrete vasorelaxants and vasoconstrictors. However, comparably fewer studies have examined SMC despite their functional role in contracting and relaxing. A variety of health conditions and lifestyle choices, such as diabetes, hypertension and cigarette smoking, can promote the development of both CMD and macrovascular coronary artery disease; a condition where SMC have been studied extensively. This review article will consider the influence of CMD on SMC phenotype. It will discuss the structural, cellular and molecular changes in CMD, and will summarise how co-morbidities can have differing effects on micro- and macro-vascular SMC phenotype and function, which complicates the development of new therapeutic avenues for CMD.

Das Ziel dieser Studie war es, die Beteiligung der nichtmuskulären schweren Myosinketten an der Kontraktion der glatten Muskeln unter physiologischen Bedingungen zu untersuchen. Als Versuchsmodell wurde die Harnblase von neugeborenen Wildtyp und transgenen Mäusen verwendet, bei denen das Gen für die glattmuskelspezifischen schweren Myosinketten durch "Gene Targeting" funktionell eliminiert wurde (Knock-Out). Das Fehlen der Expression der glattmuskelspezifischen schweren Myosinketten wurde durch Elektrophorese und Immunfärbung bestätigt. Im Gegensatz dazu blieb die Expression der nichtmuskulären schweren Myosinketten unverändert. Die mechanische Analyse des glatten Muskels wurde mit intakten Muskelpräparaten aus der Harnblase durchgeführt. Das Muskelpräparat wurde in KCl-Lösung oder mit Phorbolester stimuliert. Die Aktivierung mittels depolarisierender KCl-Lösung führte bei neugeborenen Wildtyp Mäusen zuerst zu einer transienten Kontraktion (Phase 1) mit hoher Kraftentwicklung und maximaler Verkürzungsgeschwindigkeit, und danach zu einer tonischen Kontraktion (Phase 2) mit niedrigerer Kraftentwicklung und maximaler Verkürzungsgeschwindigkeit. Blasenpräparate neugeborener Knock-Out Mäuse dagegen zeigten keine Phase 1, sondern nur eine tonische Kontraktion, die mit Wildtyp Mäusen vergleichbar war. Daher scheint nichtmuskuläres Myosin an der tonischen Kontraktion des glatten Muskels beteiligt zu sein. Durch Stimulierung mit Phorbolester waren ähnliche tonische Muskelkontraktionen der Blasenpräparate sowohl bei Wildtyp als auch bei Knock-Out Mäusen zu beobachten. Vermutlich wird also das nichtmuskuläre Myosin durch Stimulierung mit Phorbolester aktiviert. Intrazelluläre Filamente wurden durch Immunfluoreszenz mit einem spezifischen Antikörper gegen nichtmuskuläre schwere Myosinketten in kultivierten primären glatten Muskelzellen untersucht. Dabei zeigten die Muskelzellen sowohl von Wildtyp als auch von Knock-Out Mäusen intrazelluläre dicke Myosinfilamente, was für die Beteiligung des nichtmuskulären Myosins an der glatten Muskelkontraktion spricht. Entsprechend wurden intrazelluläre Filamente mit einem Antikörper gegen glattmuskelspezifische schwere Myosinketten in kultivierten primären glatten Muskelzellen untersucht. Wie erwartet, konnten nur in glatten Muskelzellen von Wildtyp Mäusen intrazelluläre Filamente nachgewiesen werden, nicht aber in denen von Knock-Out Mäusen. In dieser Arbeit konnte zum ersten Mal gezeigt werden, dass nichtmuskuläres Myosin zumindest an der tonischen Kontraktion glatter Muskelzellen beteiligt sein kann. / The aim of the present study was to investigate the involvement of non-muscle myosin heavy chain in smooth muscle contraction under physiological conditions. As an experimental model urinary bladder from neonatal wild-type mice as well as from neonatal mice with disrupted smooth muscle myosin heavy chain expression was used. This animal model was established through gene targeting technology, resulting in complete elimination of the expression of smooth muscle myosin heavy chains. The lack of expression of smooth muscle myosin heavy chains was confirmed by electrophoresis and immunoblotting. On the other hand, non-muscle myosin heavy chain expression remained normal, as verified by Western blot analysis. The mechanical analysis of smooth muscle was performed with intact urinary bladder preparations, stimulated using prolonged KCl depolarization or with phorbol ester. Prolonged activation by KCl depolarization of intact bladder preparations from wild-type neonatal mice produced an initial transient state (phase 1) of high force generation and maximal shortening velocity, followed by a sustained state (phase 2) with lower force generation and maximal shortening velocity. In contrast, bladder preparations from homozygous knockout neonatal mice did not exhibit phase 1, but phase 2 could be observed, i.e. a similar isometric force and maximal shortening velocity, compared to wild-type phase 2. Thus, non-muscle myosin appears to be recruited in the sustained phase of smooth muscle contraction during prolonged KCl depolarization in the animal model used. Upon stimulation with phorbol ester a similar sustained contraction was observed in both wild-type and knockout smooth muscle preparations. Therefore, non-muscle myosin may also be recruited during phorbol ester stimulation in both wild-type and knockout muscle preparations. The participation of non-muscle myosin in smooth muscle contraction was further supported by the finding of longitudinally arranged intracellular filaments in cultivated smooth muscle cells from both wild-type and knockout mice by immunofluorescence microscopy, using a specific antibody raised against non-muscle myosin heavy chain. In a similar way, smooth muscle myosin heavy chain structures were investigated in cultivated smooth muscle cells. As expected, longitudinally arranged intracellular filamentous structures of smooth muscle myosin were observed in wild-type smooth muscle cells, but not in smooth muscle cells from knockout mice. In conclusion, in neonatal smooth muscle the initial phase of contraction elicited by KCl depolarization is generated by smooth muscle myosin heavy chain recruitment. Upon prolonged KCl depolarization non-muscle myosin is recruited in the sustained phase of contraction, as well as upon stimulation with phorbol ester. Thus, it was possible, for the first time, to verify the involvement of the non-muscle myosin in smooth muscle contraction in vivo. The results of the present study contribute to the understanding of the regulatory mechanisms of smooth muscle contraction.

Cardiovascular disease secondary to atherosclerosis is the most common cause of human morbidity and mortality. An early and fundamental event in the development of atherosclerosis is abnormal vascular endothelial and smooth muscle function. This can be measured by flow mediated dilatation and glyceryl trinitrate mediated dilatation in children at risk of atherosclerosis. Folic acid improves endothelial function (flow mediated dilatation) in adults with coronary artery disease. No studies have previously investigated the effects of folic acid on vascular function in at risk children with diabetes or obesity. In a cross sectional study an evaluation of vascular endothelial and smooth muscle function and their determinants was performed in 159 children with type 1 diabetes, 58 children with obesity, and 53 healthy children. Children with type 1 diabetes and children with mild to moderate obesity had comparable and severe vascular dysfunction but different determinants. Vascular function in healthy and obese children related to both body mass index and weight (adjusted for age and sex), and blood glucose. Children with obesity had lower folate levels and higher homocysteine levels than children with type 1 diabetes, an abnormal lipid profile and raised inflammatory markers. A randomised double blind placebo controlled cross over trial of 8 weeks of folic acid supplementation was performed in 38 children with type 1 diabetes. In these children, folic acid improved endothelial function with a sustained increase in folate levels but independent of homocysteine levels. Folic acid did not improve smooth muscle function. A randomised double blind placebo controlled parallel trial of 8 weeks folic acid supplementation was performed including 53 obese children. Folic acid did not improve vascular function in obese children in spite of sustained increase in folate levels, and a decrease in homocysteine levels. It was concluded that children with type 1 diabetes and obesity have comparable and severe endothelial and smooth muscle function. Determinants of vascular function in children, including weight and glucose, represent a continuum effect. Folic acid supplementation improved endothelial function in children with type 1 diabetes but not in children with obesity, whose metabolic changes causing endothelial dysfunction differ from children with diabetes. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1317003 / Thesis (Ph.D.) -- University of Adelaide, School of Paediatrics and Reproductive Health, 2008

An injured vascular system has a substantial impact on an individuals overall health, and an understanding of the mechanisms that underlie blood vessel pathophysiology is required for the development of rational and effective treatment strategies. The phenotypic modulation of smooth muscle cells (SMC) during vascular injury, characterized by altered adhesion, migration and synthetic behavior, plays an important role in the eventual outcome. Specifically, the ability of SMCs to adhere to and remodel their extracellular environment via regulation of the syndecan class of cell adhesion molecules dictates the response of the vascular wall to local injury. The effect of in vitro syndecan-4 regulation on SMC adhesion was investigated through the use of a glass microsphere centrifugation assay, and an antisense-mediated reduction in gene expression was found to correlate with decreased adhesive strength. Regulation of syndecan-1, syndecan-2, and syndecan-4 gene expression was observed experimentally by mechanical strain of SMCs. Using real-time polymerase chain reaction (PCR), the kinetics of both static and cyclic mechanical strain were found to modify the gene expression in a time and strain magnitude-dependent manner unique to each syndecan. In particular, the responses of syndecan-4 were acute, but transient, while the evolution of syndecan-1 and syndecan-2 regulation was delayed by comparison. Mechanical strain also modulated syndecan-4 protein expression and ectodomain shedding, as measured by Western immunoblotting, and this effect was found, through selective inhibition, to be at least in part dependent on mitogen-activated protein (MAP) kinase signaling. In particular, intact extracellular signal-regulated MAP kinase (ERK) 1/2 and c-Jun NH2-terminal kinase / stress-activated protein kinase (JNK/SAPK) signaling pathways were found to be required for the observed strain-induced shedding. These findings offer a better understanding of syndecan function in response to mechanical strain and suggest potential new mechanisms by which physical forces may modulate vascular SMC behavior and regulation during normal physiology, pathologic conditions, and engineered arterial substitute development.

Cardiovascular disease secondary to atherosclerosis is the most common cause of human morbidity and mortality. An early and fundamental event in the development of atherosclerosis is abnormal vascular endothelial and smooth muscle function. This can be measured by flow mediated dilatation and glyceryl trinitrate mediated dilatation in children at risk of atherosclerosis. Folic acid improves endothelial function (flow mediated dilatation) in adults with coronary artery disease. No studies have previously investigated the effects of folic acid on vascular function in at risk children with diabetes or obesity. In a cross sectional study an evaluation of vascular endothelial and smooth muscle function and their determinants was performed in 159 children with type 1 diabetes, 58 children with obesity, and 53 healthy children. Children with type 1 diabetes and children with mild to moderate obesity had comparable and severe vascular dysfunction but different determinants. Vascular function in healthy and obese children related to both body mass index and weight (adjusted for age and sex), and blood glucose. Children with obesity had lower folate levels and higher homocysteine levels than children with type 1 diabetes, an abnormal lipid profile and raised inflammatory markers. A randomised double blind placebo controlled cross over trial of 8 weeks of folic acid supplementation was performed in 38 children with type 1 diabetes. In these children, folic acid improved endothelial function with a sustained increase in folate levels but independent of homocysteine levels. Folic acid did not improve smooth muscle function. A randomised double blind placebo controlled parallel trial of 8 weeks folic acid supplementation was performed including 53 obese children. Folic acid did not improve vascular function in obese children in spite of sustained increase in folate levels, and a decrease in homocysteine levels. It was concluded that children with type 1 diabetes and obesity have comparable and severe endothelial and smooth muscle function. Determinants of vascular function in children, including weight and glucose, represent a continuum effect. Folic acid supplementation improved endothelial function in children with type 1 diabetes but not in children with obesity, whose metabolic changes causing endothelial dysfunction differ from children with diabetes. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1317003 / Thesis (Ph.D.) -- University of Adelaide, School of Paediatrics and Reproductive Health, 2008

Indiana University-Purdue University Indianapolis (IUPUI) / Intestinal smooth muscle development involves complex transcriptional regulation leading to cell differentiation of the circular, longitudinal and muscularis mucosae layers. Differentiated intestinal smooth muscle cells express high levels of smooth muscle-specific contractile and regulatory proteins, including telokin. Telokin is regulatory protein that is highly expressed in visceral smooth muscle. Analysis of cis-elements required for transcriptional regulation of the telokin promoter by using hypoxanthine-guanine phosphoribosyltransferase (Hprt)-targeted reporter transgenes revealed that a 10 base pair large CC(AT)₆GG ciselement, called CArG box is required for promoter activity in all tissues. We also determined that an additional 100 base pair region is necessary for transgene activity in intestinal smooth muscle cells. To examine how transcriptional regulation of intestinal smooth muscle may be altered under pathological conditions we examined the effects of diabetes on colonic smooth muscle. Approximately 76% of diabetic patients develop gastrointestinal (GI) symptoms such as constipation due to intestinal dysmotility. Mice were treated with low-dose streptozotocin to induce a type 1 diabetes-like hyperglycemia. CT scans revealed decreased overall GI tract motility after 7 weeks of hyperglycemia. Acute (1 week) and chronic (7 weeks) diabetic mice also had decreased potassium chloride (KCl)-induced colon smooth muscle contractility. We hypothesized that decreased smooth muscle contractility at least in part, was due to alteration of contractile protein gene expression. However, diabetic mice showed no changes in mRNA or protein levels of smooth muscle contractile proteins. We determined that the decreased colonic contractility was associated with an attenuated intracellular calcium increase, as measured by ratio-metric imaging of Fura-2 fluorescence in isolated colonic smooth muscle strips. This attenuated calcium increase resulted in decreased myosin light chain phosphorylation, thus explaining the decreased contractility of the colon. Chronic diabetes was also associated with increased basal calcium levels. Western blotting and quantitative real time polymerase chain reaction (qRT-PCR) analysis revealed significant changes in calcium handling proteins in chronic diabetes that were not seen in the acute state.These changes most likely reflect compensatory mechanisms activated by the initial impaired calcium response. Overall my results suggest that type 1 diabetes in mice leads to decreased colon motility in part due to altered calcium handling without altering contractile protein expression.

The purpose of this manuscript is to establish a unified theory of porohyperelasticity with transport and growth and to demonstrate the capability of this theory using a finite element model developed in MATLAB. We combine the theories of volumetric growth and mixed porohyperelasticity with transport and swelling (MPHETS) to derive a new method that models growth of biological soft tissues. The conservation equations and constitutive equations are developed for both solid-only growth and solid/fluid growth. An axisymmetric finite element framework is introduced for the new theory of growing MPHETS (GMPHETS). To illustrate the capabilities of this model, several example finite element test problems are considered using model geometry and material parameters based on experimental data from a porcine coronary artery. Multiple growth laws are considered, including time-driven, concentrationdriven, and stress-driven growth. Time-driven growth is compared against an exact analytical solution to validate the model. For concentration-dependent growth, changing the diffusivity (representing a change in drug) fundamentally changes growth behavior. We further demonstrate that for stress-dependent, solid-only growth of an artery, growth of an MPHETS model results in a more uniform hoop stress than growth in a hyperelastic model for the same amount of growth time using the same growth law. This may have implications in the context of developing residual stresses in soft tissues under intraluminal pressure. To our knowledge, this manuscript provides the first full description of an MPHETS model with growth. The developed computational framework can be used in concert with novel in-vitro and in-vivo experimental approaches to identify the governing growth laws for various soft tissues.