Abstract not available

The vascular endothelium is a single cell layer that lines the lumen of the entire vasculature. It is the site of synthesis of nitric oxide (NO), a vasodilatory compound synthesized by endothelial nitric oxide synthase (eNOS). NO causes intracellular calcium sequestration of the vascular smooth muscle cells, relaxing and dilating the arteries. Age profoundly affects endothelium-dependent vasodilation, leading to specific losses of NO. We sought to determine what causes the age-specific loss of endothelial NO. This was accomplished by investigating whether there are differences in markers of eNOS post-translational regulation elements in the aortic endothelium of young (2-4 months; corresponding to an adolescent human adult) and old (32-34 months; corresponding to a 65-75 year-old human). F 344 x Brown Norway hybrid rats. Results show that maximal eNOS activity significantly declines with age (n=4;p���0.05) though there was no change in eNOS protein levels in the aortic endothelium. Endothelial NOS exists in two distinct subcellular fractions. No alterations were detected in the soluble, inactive fraction while significantly less eNOS protein is detected in the active, plasma membrane fraction of the endothelium (n=4;p���0.02). Endothelial NOS activation is also controlled by its phosphorylation state. In this work we demonstrate that free ceramides and ceramide-activated phosphatase (PP2A) activity are significantly elevated with age in the endothelium and correlate with specific alterations in eNOS phosphorylation status consistent with its inactivation. These changes were concomittent with an age-associated decline in endothelial glutathione (GSH) and increased sphingomyelinase activity which liberates ceramides from membrane sphingolipids. In previously published reports we demonstrated that the dithiol compound R-��-lipoic acid (LA) increased maximal NO synthesis in cultured endothelial cells and that LA improved age-associated loss of eNOS stimulatory phosphorylation in rats. Therefore, we administered pharmacologic doses of LA (40 mg/kg, i.p. over 24 h) to old rats to determine whether it restored NO-dependent vasomotor function. Results show that LA significantly increased endothelial GSH (p���0.05 compared to saline controls), decreased sphingomyelinase activity and reversed the age-related increase in ceramide (p���0.01) in old animals. Finally, LA significantly improved endothelium-dependent vasodilation, suggesting that it might be a good therapeutic agent for age-related vascular endothelial dysfunction. / Graduation date: 2005

Cardiac transplantation is governed by complex immunological mechanisms contributing to different types of allograft rejection. Early non-specific graft failure and chronic rejection (cardiac allograft vasculopathy) represent the main limitations for the recipients’ short- and long-term survival respectively. To date, the pathogenesis of both rejection types remains ill-defined. However, it is believed that they are related to an immunologically mediated potent inflammatory process, occurring whether early after transplantation (acute), or lasting for the lifetime of the graft (chronic). The initiating mechanisms of chronic rejection in solid organ transplantation remain ill-defined. Emerging evidence sustains that graft vasculopathy is primarily driven by alloreactive CD4+ T lymphocytes sensitized by the indirect pathway of allorecognition. To date, whereas the nature of APCs involved in this particular pathway has yet to be identified, it appears challenging to speculate that recipient-derived endothelial cells (ECs) repopulating the graft may represent the main cell targets recognized by indirectly primed alloreactive CD4+ T cells to mediate the rejection of cardiac transplants. In the first part of this thesis, we specifically studied the indirect pathway of allorecognition with a transgenic mice (Marilyn mice) model that expresses a T cell receptor (TCR) transgene which recognizes the male antigen H-Y in an I-Ab-restricted fashion. Our results provide evidence that graft endothelium replacement by recipient-type cells expressing MHC Class II molecules is required for the chronic rejection of vascularized cardiac transplants mediated by indirect pathway alloreactive CD4+ T cells. The purpose of the second part of the thesis was to investigate the potential implication of interleukin-22 (IL-22), an early phase secreted proinflammatory cytokine of the IL-10 family, in the acute rejection of cardiac allografts. IL-22 was recently described as an effector key modulator of the inflammatory process produced mainly by differentiated CD4+ T cells of the Th17 lineage. As being closely related to IL-10 and IL-17, both involved in the rejection process of vascularized heart allografts, we attempted to determine the precise role of IL-22 in this process. Experiments were conducted with a recently developed murine model deficient for the IL-22 gene (IL-22KO). The results of the second part of the thesis show that IL-22 is not an effector cytokine in cardiac allograft rejection. In contrast, as being early expressed into the allograft, likely IL-22 plays a protective role in the inflammation leading to acute cardiac rejection, probably depending on a neutrophil-related mechanism. In conjunction with current understanding of inflammatory and antigen-specific events in allografts, overall, our results provide new insights into the mechanisms of chronic and acute cardiac rejection, thus prompting to further interrogations and appealing novel therapeutic strategies. Pharmacologic manipulation of endothelium is challenging. Given their capacity to sense and rapidly respond to the local environment, ECs are the ideal targets for rapid systemic delivery of therapeutic agents. Combination therapy is required to reduce inflammatory reaction and endothelial activation, to modulate endothelial dysfunction and promote endothelial survival. Also, given that IL-22 may alleviate tissue destruction during inflammatory responses, therapies that enhance its production and protective action in the transplanted organs seem attractive to specifically affect tissue responses, without exerting direct effects on the immune response.

The importance of shear stress in vascular biology and pathophysiology has been highlighted by the focal development patterns of atherosclerosis, abdominal aortic aneurysms, and heart valve disease in regions exposed to disturbed flow leading to low or oscillatory shear stress at the wall of the blood vessel or the surface of the valve leaflet. The novel and significant finding of this study is that mouse aortic endothelial cell exposure to pro-atherogenic oscillatory shear stress (OS) (+/- 5 dynes/cm2) increased their production of cathepsins, the family of lysosomal cysteine proteases that are potent elastases and collagenases leading to protease degradation and remodeling of the extracellular matrix structural components. Conversely, atheroprotective unidirectional laminar shear stress (LS) (15 dynes/cm2) decreased elastase and gelatinase activities of endothelial cells through a shear stress mediated reduction in cathepsins K, L, and S activity. Their endogenous inhibitor, cystatin C, was found to be inversely regulated by shear stress; LS increased its secretion by endothelial cells while OS decreased it. Binding of free cystatin C in the conditioned media to carboxymethylated papain coated agarose beads led to an increase in cathepsin activity since the available cathepsin was not inhibited. To verify these findings in human samples, immunohistochemical analysis of cystatin C and cathepsin K was performed on human coronary arteries. Cathepsin K stained strongly in the endothelial layer of vessels with degraded internal elastic lamina while cystatin C staining intensity was strongest overlying minimally diseased vessels. Additional roles for cathepsins K, L, and S were found in endothelial cell alignment in response to unidirectional laminar shear stress, endothelial cell migration, and programmed cell death. We conclude that there is an inverse regulation of cathepsins and cystatin C in endothelial cells by LS and OS and identify the cathepsin family of proteases as potential targets for therapeutic intervention of cardiovascular disease development at sites of disturbed flow.

Thesis (Ph. D.)--University of Missouri--Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 141-150). Also available on the Internet.

Thesis (M. Phil.)--University of Hong Kong, 2009. / Includes bibliographical references (leaves 79-95). Also available in print.

published_or_final_version / Medicine / Doctoral / Doctor of Philosophy

published_or_final_version / Pharmacology and Pharmacy / Doctoral / Doctor of Philosophy

Liver transplantation is the best therapy for patients with end-stage liver diseases and unresectable early hepatocellular carcinoma (HCC). Living donor liver transplantation (LDLT) has been successfully implemented as an alternative to deceased donor liver transplantation (DDLT) and likewise offers comparable excellent survival rate. However, the inferior post-transplant oncological outcomes are found in LDLT recipients with HCC. The liver grafts used in LDLT are usually small-for-size and less effective in coping with shear stress from transient portal hypertension, which results in small-for-size liver graft injury. Acute phase small-for-size liver graft injury may promote late phase tumor recurrence, whereas the underlying mechanism remains unclear. CXCL10, an inflammatory chemokine, initiates liver inflammatory response during hepatic ischemia-reperfusion (IR) injury and may link acute phase small-for-size liver graft injury and late phase tumor recurrence, yet the precise mechanisms remain elusive. Endothelial progenitor cells (EPCs) participate in tissue repair for graft recovery and also provide an angiogenic environment for tumor growth. Myeloid derived suppressor cells (MDSCs) and regulatory T cells (Tregs) can suppress the activation of the immune system and play a critical role in graft rejection and cancer development. We here established the rat orthotopic liver transplantation with whole graft or small-for-size graft model to study the impact of acute phase small-for-size liver graft injury on the mobilization of EPCs, MDSCs and Tregs, and intragraft CXCL10 and its receptor, CXCR3,gene expressions. We further subjected CXCL10-/-mice and CXCR3-/-mice to hepatic IR injury and major hepatectomy to study the role of CXCL10/CXCR3 signaling on the mobilization of EPCs, MDSCs and Tregs. We also investigated the effect of CXCL10 on EPC migration and tube formation in vitroas well as intratumoral microvessel density (MVD) in the rat liver transplantation with tumor growth model and EPCs on tumor growth in nude mice. Key findings: 1. Liver transplantation with small-for-size graft resulted in severe intragraft vascular injury and higher CXCL10 andCXCR3 gene expressions as well as more EPC, MDSC and Treg cell mobilizationin circulation than whole graft. 2. CXCL10-/-mice and CXCR3-/-mice had less circulating EPCs, MDSCs and Tregs than WT mice after hepatic IR injury and major hepatectomy. 3. CXCL10 recruited EPCs in dose-dependent and CXCR3-dependent manners and promoted EPC tube formation in vitro. 4. Higher intratumoral MVD was observed in small-for-size graft than in whole graft in liver transplantation with tumor growth model. 5. Tumor grew more quickly by combining EPC infusionin nude mouse orthotopic liver tumor model. In conclusion, acute phase small-for-size liver graft injury significantly mobilizes EPCs, MDSCs and Tregs after transplantation through CXCL10/CXCR3 signaling. More EPC mobilization and intragraft differentiation after transplantation with small-for-size liver graft may be related to higher intratumoral MVD in small-for-size liver graft after transplantation with tumor development. Therefore, targeting at post-transplant CXCL10/CXCR3 signaling may not only attenuate early phase liver graft injury but also prevent late phase tumor recurrence. / published_or_final_version / Surgery / Doctoral / Doctor of Philosophy

published_or_final_version / Pathology / Master / Master of Philosophy