Muscular dystrophy is a disease characterized by skeletal muscle weakness and wasting, but little is known of alterations in the vascular system that occur with this disease. The culprit in many muscular dystrophies is a defective dystrophin-glycoprotein complex (DGC). The DGC is a group of transmembrane proteins that connects the cytoskeleton of muscle cells to the extracellular matrix; it plays a role in mechanotransduction and the maintenance of structural integrity of these cells, and includes the proteins dystrophin and sarcoglycan-delta. The absence of these proteins results in severe muscular dystrophies in humans, and thus knockout mice lacking the genes encoding for dystrophin (mdx mice) and sarcoglycan-delta (sgcd-/- mice) were studied to detect any vascular alterations that occur as a result of a defective DGC. Acute biaxial biomechanical data were obtained through pressure-diameter and axial force-length tests on common carotid arteries of mdx, sgcd-/-, and wild-type mice in the active and passive smooth muscle state. Functional response to the vasoreactive compounds phenylephrine, carbamylcholine chloride, and sodium nitroprusside was also tested. We found significant biomechanical differences between the knockout and wild-type mouse arteries: the mdx and sgcd-/- arteries had decreased distensibilities in pressure-diameter tests, with mdx arteries also having increased circumferential stresses, and the knockout arteries generated increased axial loads and stresses in the axial force-length tests. The mdx and sgcd-/- arteries also differed from the wild-type in that their ‘homeostatic’ axial stretch, at which the axial force remains constant upon pressurization, was significantly decreased. We conclude that the loss of DGC proteins does trigger changes in vascular smooth muscle cells or their interactions with the extracellular matrix, yet that the altered vascular system was able to adapt and function without the DGC. Knowledge of alterations to the vascular system (and adaptations to these changes) of patients with muscular dystrophy could help physicians customize their treatment to extend and enhance their lives, especially as medical advances extend the lifespan of these patients and they begin to suffer from diseases such as hypertension and atherosclerosis that affect the normal aging population.

Gap junctions are intercellular channels that permit passage of electrical and chemical signals between neighbouring cells. Vascular endothelium typically co-expresses Cx37 and Cx40, but may downregulate its expression of Cx37 (and upregulate Cx43) in response to changes in flow. The specific regulatory roles mediated by vascular endothelial connexins, and the consequences of altered connexin expression, remain unclear. In this study, we hypothesized that Cx37 and Cx40 regulate distinct vascular responses. We further hypothesize that Cx37 is predominantly involved in vascular growth control, whereas vascular growth is not affected by ablation of Cx40 expression. We show herein that Cx37, but not Cx40 or Cx43, suppresses growth of a highly-proliferative cancer cell line by inducing G1 cell cycle accumulation. We further show that Cx37-deficient mice, lacking Cx37's putative growth inhibitory effect on the vasculature, exhibit a more extensive native and post-ischemic collateral circulation, and greater ischemia-induced microvascular density. In addition, Cx37-/- mice demonstrate a functional improvement in recovery over wild-type animals in two models of hindlimb ischemia. By contrast, Cx40-/- mice fail to recover distal limb flow following unilateral hindlimb ischemia, resulting in necrosis. Long-term angiotensin II antagonism normalized post-ischemic hindlimb bloodflow, reduced macrophage infiltration, and delayed (but did not reverse) the necrotic phenotype of these animals. In summary, we show a distinct role for each of the endothelial connexins, Cx37 and Cx40, in regulating post-ischemic vascular responses.

A hipertensão arterial é uma condição clínica grave acompanhada por alterações estruturais do aparelho cardiovascular. Os antagonistas dos receptores 1-adrenérgicos são drogas usadas na terapêutica anti-hipertensiva. O nebivolol é um antagonista seletivo dos receptores 1 de terceira geração, que estimula a liberação endotelial de NO e diminui a ativação da -nicotinamida adenosina dinucleotído fosfato (NAD(P)H) oxidase. O metoprolol é um antagonista seletivo dos receptores 1de segunda geração, que não apresenta efeitos vasodilatadores. As metaloproteinases da matriz (MMPs), principalmente a MMP-2, são enzimas que participam ativamente do processo de remodelamento vascular. Elas passam de seu estado latente para seu estado ativo pela ação de proteases e espécies reativas de oxigênio (EROs). Como na hipertensão há aumento de EROs, de MMPs e remodelamento vascular, é possível que o nebivolol impeça o aumento dos níveis de MMPs vasculares e o remodelamento vascular hipertrófico associados à hipertensão, além do seu efeito de antagonismo do receptor 1. Primeiro, realizamos uma avaliação das alterações aórticas da hipertensão 2-rins,1-clipe (2R-1C), pois há poucas informações sobre essas alterações durante o desenvolvimento da hipertensão. Para isso, ratos hipertensos e controles foram estudados com 2, 4, 6 e 10 semanas após a indução da hipertensão. A pressão arterial sistólica foi monitorada semanalmente. As alterações na parede aórtica foram estudadas em hematoxilina/eosina (H&E), picrosirius e orceína. Foram avaliados também a atividade da NAD(P)H oxidase, a produção de ânion superóxido, a atividade gelatinolítica por zimografia in situ; os níveis e localização de MMP-2, MMP-14 e TIMP-2 por imunofluorescência zimografia e imunohistoquímica. No segundo protocolo, após 6 semanas de hipertensão foi iniciado o tratamento com metoprolol (Meto -20/mg/kg/dia) ou nebivolol (Nebi -10mg/kg/dia), realizado durante 4 semanas. Foram avaliados a pressão arterial sistólica, as alterações na parede aórtica por H&E, a atividade da NAD(P)H oxidase, produção de ânion superóxido, a atividade gelatinolítica, os níveis e localização de MMP-2 por imunofluorescência e zimografia em gel, e os níveis de nitrotirosina por imunohistoquímica. Observamos no protocolo temporal que a pressão foi gradualmente aumentada nos animais hipertensos quando comparado aos controles. Houve hiperplasia e hipertrofia da aorta, com aumento da deposição de colágeno e elastina. Observamos aumento nos níveis de estresse oxidativo, MMPs e atividade gelatinolítica em todas as semanas de estudo. Ao final do tratamento com metoprolol e nebivolol, observamos que a pressão diminuiu nos animais hipertensos, e que essa redução da pressão ocorreu de modo semelhante com os diferentes tratamentos. Os animais hipertensos apresentaram hipertrofia da aorta, aumento nos níveis de EROs, de MMP-2 e da atividade gelatinolítica. Essas alterações foram revertidas apenas pelo tratamento com nebivolol, mas não pelo metoprolol. Assim, o remodelamento da hipertensão 2R-1C parece estar estabelecido com duas semanas de hipertensão arterial, com elevados níveis de espécies reativas de oxigênio e MMPs, e o tratamento com nebivolol, mas não o metoprolol, atenuou o estresse oxidativo e o remodelamento vascular associado à hipertensão. / Hypertension is a serious clinical condition with structural changes in the cardiovascular system. Beta-adrenoreceptor antagonists are used in hypertension therapy. Nebivolol is a third-generation selective 1-adrenoreceptor antagonist that stimulates endothelial cell NO production and prevents vascular NAD(P)H oxidase activation. Metoprolol is a second-generation selective 1-adrenoreceptor antagonist, without vasodilatory effect. The matrix metalloproteinases (MMPs), especially MMP-2, participate actively in the vascular remodeling process, and are activated by reactive oxygen species (ROS). There are increases in ROS, of MMPs, and vascular remodeling in hypertension. Because of these, it´s possible that nebivolol prevent MMP increases and vascular remodeling associated with hypertension beyond its 1-receptorblocking properties. First, structural aortic changes in the development of two-kidney, one-clip hypertension (2K-1C) were evaluated. Sham or 2K1C hypertensive rats were studied after 2, 4, 6, and 10 weeks of hypertension. Systolic blood pressure (SBP) was monitored weekly. Morphometry of structural changes in the aortic wall was studied in hematoxylin/eosin, orcein and picrosirius red sections. Aortic NAD(P)H activity and superoxide production was evaluated. Aortic gelatinolytic activity was determined by in situ zymography, and MMP-2, MMP-14, and tissue inhibitor of MMPs (TIMP)-2 levels were determined by gelatin zymography, immunofluorescence and immunohistochemistry. Six weeks after surgery, hypertensive and sham rats were treated with metoprolol (20 mg/kg/ day) or nebivolol (10 mg/kg/day), for four weeks, in the second-protocol. Systolic blood pressure (SBP) was monitored weekly Aortic structural were studied in hematoxylin/eosin sections. NAD(P)H oxidase activity and ROS and nitrotyrosine production were evaluated. MMPs levels and activity were determined by zymography and in situ zymography. In the temporal study, 2K-1C hypertension was associated with increased aortic collagen and elastin content in the early phase of hypertension, which was associated with vascular hypertrophy, increased vascular MMPs levels, and increased gelatinolytic activity, possibly as a result of increased vascular NAD(P)H oxidase activity and oxidative stress. In the second-protocol, similar reductions in SBP were found with both metoprolol and nebivolol treatments. However, only Nebi reversed aortic hypertrophy, the increases in aortic NAD(P)H oxidase activity, in aortic ROS levels, in nitrotyrosine staining, in aortic MMP-2 levels and in aortic MMP activity. These results indicate that vascular remodeling of renovascular hypertension is an early process associated with increases in MMPs activities, enhanced matrix deposition and oxidative stress, and that treatment with Nebi attenuate the oxidative stress and the vascular remodeling associated with 2K-1C hypertension.

A administração crônica de ouabaína (OUA) induz hipertensão arterial (HA) em ratos, alterações funcionais e remodelamento em artérias mesentéricas de resistência (AMR). A literatura sugere que a resposta pressórica da OUA pode ser bloqueada pelo antagonismo do receptor AT1 e pela inibição COX-2. No entanto, não se conhece a participação dessas vias no remodelamento arterial nesse modelo de HA. O presente estudo teve como objetivo investigar o papel do sistema renina-angiotensina (SRA) e da COX no remodelamento das AMR induzido pela OUA. Em AMR de ratos OUA, o SRA e a COX-2 participam da resposta pressórica, do remodelamento hipotrófico para dentro e da rigidez. Esses ajustes estão associados ao stress oxidativo e a deposição de colágeno na parede vascular estimulados pela capacidade da OUA em promover a ativação do receptor AT1 e da COX-2. / The chronic administration of ouabain (OUA) induces hypertension in rats, functional and structural alterations in mesenteric resistance arteries (MRA). It is well known that OUA-induced hypertension is blocked by AT1 receptor antagonism and the COX-2 inhibition. However, the participation of these pathways in MRA remodeling in this model of hypertension remains unknown. This study aimed to investigate the role of the renin angiotensin system (RAS) and COX pathways on MRA remodeling induced by OUA. In AMR from OUA rats, RAS and COX-2 participate in the pressor response, the inward hypotrophic remodeling and stiffness. These adjustments are the result of oxidative stressand increasing collagen deposition in the vascular wall stimulated by the OUA ability to stimulate the activation of AT1 receptor and COX-2.

A hipertensão arterial é uma condição clínica grave acompanhada por alterações estruturais do aparelho cardiovascular. Os antagonistas dos receptores 1-adrenérgicos são drogas usadas na terapêutica anti-hipertensiva. O nebivolol é um antagonista seletivo dos receptores 1 de terceira geração, que estimula a liberação endotelial de NO e diminui a ativação da -nicotinamida adenosina dinucleotído fosfato (NAD(P)H) oxidase. O metoprolol é um antagonista seletivo dos receptores 1de segunda geração, que não apresenta efeitos vasodilatadores. As metaloproteinases da matriz (MMPs), principalmente a MMP-2, são enzimas que participam ativamente do processo de remodelamento vascular. Elas passam de seu estado latente para seu estado ativo pela ação de proteases e espécies reativas de oxigênio (EROs). Como na hipertensão há aumento de EROs, de MMPs e remodelamento vascular, é possível que o nebivolol impeça o aumento dos níveis de MMPs vasculares e o remodelamento vascular hipertrófico associados à hipertensão, além do seu efeito de antagonismo do receptor 1. Primeiro, realizamos uma avaliação das alterações aórticas da hipertensão 2-rins,1-clipe (2R-1C), pois há poucas informações sobre essas alterações durante o desenvolvimento da hipertensão. Para isso, ratos hipertensos e controles foram estudados com 2, 4, 6 e 10 semanas após a indução da hipertensão. A pressão arterial sistólica foi monitorada semanalmente. As alterações na parede aórtica foram estudadas em hematoxilina/eosina (H&E), picrosirius e orceína. Foram avaliados também a atividade da NAD(P)H oxidase, a produção de ânion superóxido, a atividade gelatinolítica por zimografia in situ; os níveis e localização de MMP-2, MMP-14 e TIMP-2 por imunofluorescência zimografia e imunohistoquímica. No segundo protocolo, após 6 semanas de hipertensão foi iniciado o tratamento com metoprolol (Meto -20/mg/kg/dia) ou nebivolol (Nebi -10mg/kg/dia), realizado durante 4 semanas. Foram avaliados a pressão arterial sistólica, as alterações na parede aórtica por H&E, a atividade da NAD(P)H oxidase, produção de ânion superóxido, a atividade gelatinolítica, os níveis e localização de MMP-2 por imunofluorescência e zimografia em gel, e os níveis de nitrotirosina por imunohistoquímica. Observamos no protocolo temporal que a pressão foi gradualmente aumentada nos animais hipertensos quando comparado aos controles. Houve hiperplasia e hipertrofia da aorta, com aumento da deposição de colágeno e elastina. Observamos aumento nos níveis de estresse oxidativo, MMPs e atividade gelatinolítica em todas as semanas de estudo. Ao final do tratamento com metoprolol e nebivolol, observamos que a pressão diminuiu nos animais hipertensos, e que essa redução da pressão ocorreu de modo semelhante com os diferentes tratamentos. Os animais hipertensos apresentaram hipertrofia da aorta, aumento nos níveis de EROs, de MMP-2 e da atividade gelatinolítica. Essas alterações foram revertidas apenas pelo tratamento com nebivolol, mas não pelo metoprolol. Assim, o remodelamento da hipertensão 2R-1C parece estar estabelecido com duas semanas de hipertensão arterial, com elevados níveis de espécies reativas de oxigênio e MMPs, e o tratamento com nebivolol, mas não o metoprolol, atenuou o estresse oxidativo e o remodelamento vascular associado à hipertensão. / Hypertension is a serious clinical condition with structural changes in the cardiovascular system. Beta-adrenoreceptor antagonists are used in hypertension therapy. Nebivolol is a third-generation selective 1-adrenoreceptor antagonist that stimulates endothelial cell NO production and prevents vascular NAD(P)H oxidase activation. Metoprolol is a second-generation selective 1-adrenoreceptor antagonist, without vasodilatory effect. The matrix metalloproteinases (MMPs), especially MMP-2, participate actively in the vascular remodeling process, and are activated by reactive oxygen species (ROS). There are increases in ROS, of MMPs, and vascular remodeling in hypertension. Because of these, it´s possible that nebivolol prevent MMP increases and vascular remodeling associated with hypertension beyond its 1-receptorblocking properties. First, structural aortic changes in the development of two-kidney, one-clip hypertension (2K-1C) were evaluated. Sham or 2K1C hypertensive rats were studied after 2, 4, 6, and 10 weeks of hypertension. Systolic blood pressure (SBP) was monitored weekly. Morphometry of structural changes in the aortic wall was studied in hematoxylin/eosin, orcein and picrosirius red sections. Aortic NAD(P)H activity and superoxide production was evaluated. Aortic gelatinolytic activity was determined by in situ zymography, and MMP-2, MMP-14, and tissue inhibitor of MMPs (TIMP)-2 levels were determined by gelatin zymography, immunofluorescence and immunohistochemistry. Six weeks after surgery, hypertensive and sham rats were treated with metoprolol (20 mg/kg/ day) or nebivolol (10 mg/kg/day), for four weeks, in the second-protocol. Systolic blood pressure (SBP) was monitored weekly Aortic structural were studied in hematoxylin/eosin sections. NAD(P)H oxidase activity and ROS and nitrotyrosine production were evaluated. MMPs levels and activity were determined by zymography and in situ zymography. In the temporal study, 2K-1C hypertension was associated with increased aortic collagen and elastin content in the early phase of hypertension, which was associated with vascular hypertrophy, increased vascular MMPs levels, and increased gelatinolytic activity, possibly as a result of increased vascular NAD(P)H oxidase activity and oxidative stress. In the second-protocol, similar reductions in SBP were found with both metoprolol and nebivolol treatments. However, only Nebi reversed aortic hypertrophy, the increases in aortic NAD(P)H oxidase activity, in aortic ROS levels, in nitrotyrosine staining, in aortic MMP-2 levels and in aortic MMP activity. These results indicate that vascular remodeling of renovascular hypertension is an early process associated with increases in MMPs activities, enhanced matrix deposition and oxidative stress, and that treatment with Nebi attenuate the oxidative stress and the vascular remodeling associated with 2K-1C hypertension.

Diameters of microvessels undergo continuous structural adaptation in response to hemodynamic and metabolic stimuli. To ensure adequate flow distribution, metabolic responses are needed to increase diameters of vessels feeding poorly perfused regions. Possible modes of metabolic control include release of signaling substances from vessel walls, from the supplied tissue and from red blood cells (RBC). Here, a theoretical model was used to compare the abilities of these metabolic control modes to provide adequate tissue oxygenation, and to generate blood flow velocities in agreement with experimental observations. Structural adaptation of vessel diameters was simulated for an observed mesenteric network structure in the rat with 576 vessel segments. For each mode of metabolic control, resulting distributions of oxygen and deviations between simulated and experimentally observed flow velocities were analyzed. It was found that wall-derived and tissue-derived growth signals released in response to low oxygen levels could ensure adequate oxygen supply, but RBC-derived signals caused inefficient oxygenation. Closest agreement between predicted and observed flow velocities was obtained with wall-derived growth signals proportional to vessel length. Adaptation in response to oxygen-independent release of a metabolic signal substance from vessel walls or the supplied tissue was also shown to be effective for ensuring tissue oxygenation due to a dilution effect if growth signal substances are released into the blood. The present results suggest that metabolic signals responsible for structural adaptation of microvessel diameters are derived from vessel walls or from perivascular tissue.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第18880号 / 医博第3991号 / 新制||医||1008(附属図書館) / 31831 / 京都大学大学院医学研究科医学専攻 / (主査)教授 山下 潤, 教授 篠原 隆司, 教授 斎藤 通紀 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Objective: Midlife obesity is a risk factor for dementia development. Obesity has also been linked to hyperaldosteronism, and this can be modeled in rats by high fat (HF) feeding from weaning. Aldosterone, or activation of the mineralocorticoid receptor (MR) causes cerebrovascular injury in lean hypertensive rats. We hypothesized that rats fed a HF diet would show inward middle cerebral artery (MCA) remodeling that could be prevented by MR antagonism. We further proposed that the cerebral artery remodeling would be associated with white mater injury. Methods: Three-week-old male Sprague-Dawley rats were fed a HF diet ± the MR antagonist canrenoic acid (Canr) for 17 weeks. Control rats received normal chow (control NC). MCA structure was assessed by pressure myography. Results: The MCAs from HF fed rats had smaller lumens and thicker walls when compared to arteries from control NC rats; Canr prevented the MCA remodeling associated with HF feeding. HF feeding increased the mRNA expression of markers of cell proliferation and vascular inflammation in cerebral arteries and Canr treatment prevented this. White mater injury was increased in the rats fed the HF diet and this was reduced by Canr treatment. The expression of doublecortin, a marker of new and immature neurons was reduced in HF fed rats, and MR antagonism normalized this. Conclusions: These data suggest that HF feeding leads to MR dependent remodeling of the MCA and this is associated with markers of dementia development.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20606号 / 医博第4255号 / 新制||医||1023(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 羽賀 博典, 教授 篠原 隆司, 教授 近藤 玄 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Transition of the cardiopulmonary circulation at birth requires functional closure of the ductus arteriosus (DA). The DA is an arterial shunt that is vital in the fetus for diverting the pulmonary circulation away from the uninflated lungs. Failure of the vessel to functionally close after birth is known as patent DA, which is the second most common congenital heart disease. Patent DA may seriously compromise neonatal health and current pharmacological treatments are often limited by serious complications or a significant failure rate, thereby increasing the necessity for surgical intervention. Recently, we were the first to show that genetic or pharmacological inactivation of cyclooxygenase (COX) -2 produces postnatal patent DA in mice. We also demonstrated that the DA expresses high levels of COX-2 during normal closure after birth, suggesting novel contractile actions of COX-2-dependent prostanoids in the DA. In humans, patent DA is more common in preterm infants than those born at full-term, however, mechanism(s) responsible for the reduced DA closure have not been identified. In the current studies, we examined COX-1 and COX-2 expression in the DA at multiple stages of gestation to determine whether alterations in the expression of these enzymes contribute to patent DA in preterm mice. Using real-time PCR, analysis of the time-course of COX-2 mRNA in the fetal mouse DA indicated that COX-2 expression significantly increased with advancing gestational age. The preterm (day 17.5) neonatal mouse DA showed attenuated COX-2 expression, as compared to the full-term (day 19.5) neonatal DA at 3 hours after birth. Furthermore, the DA of preterm neonatal mice showed incomplete closure after 3 hours of birth, a time-point when the DA of full-term neonates was completely remodeled. These data indicate a correlation between reduced DA closure and attenuated COX-2 expression. Additionally, COX-2 expression was significantly attenuated in the DA of mice deficient in the prostanoid receptor EP4, which also show a patent DA phenotype, suggesting the importance of this receptor for the induction of COX-2 required for DA closure. Overall, these studies suggest that attenuated expression of COX-2 may contribute to increased patent DA at preterm gestation.