Die NO/cGMP-vermittelte Signalkaskade ist im vaskulären System entscheidend an der Regulation des Blutdrucks beteiligt. Innerhalb der Kaskade nimmt die NO-sensitive Guanylyl-Cyclase (NO-GC) eine Schlüsselfunktion als wichtigster Rezeptor für das Signalmolekül Stickstoffmonoxids (NO) ein. NO wird endogen von verschiedenen Isoformen der NO Synthase produziert. Die Bindung von NO an die NO GC führt zur Produktion des sekundären Botenstoffs cyclisches Guanosinmonophosphat (cGMP). Dieser Botenstoff aktiviert verschiedene Effektor-Moleküle und bewirkt letztlich eine Relaxation der glatten Muskulatur. Ein weiterer sekundärer Botenstoff, das Signalmolekül cyclisches Adenosinmonophosphat (cAMP), ist ebenfalls an der Regulation des Tonus der glatten Muskulatur und dadurch an der Blutdruckregulation beteiligt. Unterschiedliche Phosphodiesterasen (PDE) bauen die sekundären Botenstoffe ab und beenden dadurch die Signalkaskaden. Die PDE3 spielt hierbei eine besondere Rolle, da sie eine gemischte Substratspezifität besitzt. Um den Einfluss der NO-GC auf das kardiovaskuläre System zu untersuchen, wurden NO-GC Knockout(KO)-Mäuse mit globaler (GCKO) oder Glattmuskel-spezifischer (SMC-GCKO) Deletion der NO-GC generiert. Um das Zusammenspiel von cAMP und cGMP näher zu beleuchten, wurde im ersten Teil dieser Arbeit die PDE3 genauer untersucht. Im Gefäßsystem wird lediglich die PDE3A und nicht die PDE3B exprimiert. Die Aorten von GCKO- und SMC-GCKO-Tieren reagieren sensitiver auf PDE3A-Blockade als die Kontroll-Tiere. Auch die akute Blockade der NO-GC führt zu diesem Sensitivitätseffekt. Die PDE3A ist in Folge der NO-GC-Deletion sowohl in ihrer Expression, als auch ihrer Aktivität um die Hälfte reduziert. Dies dient vermutlich kompensatorisch dazu, das cAMP-Signal weitgehend zu erhalten und so eine cAMP-induzierte Relaxation der Gefäße zu gewährleisten. Ohne Rückkopplung zwischen den beiden Signalwegen käme es vermutlich zu weiteren negativen Konsequenzen für das Herz-Kreislaufsystem. Diese Daten weisen auf eine direkte Regulation der PDE3 in glatten Muskelzellen durch die NO/cGMP-Signalkaskade und einen PDE3-vermittelten cAMP/cGMP-Crosstalk hin. Der genaue Mechanismus dieser Expressionsregulation ist noch unklar. Denkbar wäre eine cGMP-vermittelte Transkriptionsregulation oder eine Modulation der Translation der PDE3A. Der Verlust der NO-GC führt in GCKO- und SMC-GCKO-Mäusen zu einem erhöhten systolischen Blutdruck von ~30 mmHg. Bei der Entwicklung der arteriellen Hypertonie könnte eine erhöhte Aortensteifigkeit beteiligt sein, die im zweiten Teil dieser Arbeit näher untersucht wurde. In GCKO-Mäusen ist die aortale Steifigkeit und daraus resultierend die Pulswellengeschwindigkeit (PWV) deutlich erhöht. Die Steigerung der PWV wird in den GCKO-Tieren zusätzlich durch den verminderten Aorten-Durchmesser bedingt. Außerdem weisen die Aorten dieser Tiere eine veränderte Wandstruktur auf, die zu einer Verminderung der aortalen Windkesselfunktion führt. Diese Veränderungen könnten die Blutdruckerhöhung in GCKO-Mäusen erklären. In SMC-GCKO-Tieren tritt keine dieser Gefäß-Modifikationen auf. Eine Aortensteifigkeit als mögliche Ursache für den erhöhten systolischen Blutdruck in den SMC-GCKO-Tieren kann somit ausgeschlossen werden. Zur Aufklärung müssen weitere Versuche zum Aufbau der Gefäßwände und zur Bestimmung des peripheren Widerstands gemacht werden. Auch der Einfluss anderer Zelltypen, wie z.B. Perizyten oder Fibroblasten, auf die Blutdruckregulation sollte untersucht werden. / The NO/cGMP-mediated signaling cascade is crucially involved in the regulation of blood pressure. Within the cascade, NO-sensitive guanylyl cyclase (NO-GC) plays a key role as the most important receptor for the signaling molecule nitric oxide (NO). NO is endogenously produced by three different isoforms of NO synthase. Binding of NO to NO-GC stimulates the production of the second messenger cyclic guanosine monophosphate (cGMP). cGMP, in turn, activates various effector molecules, finally leading to smooth muscle relaxation. Another second messenger, the signalling molecule cyclic adenosine monophosphate (cAMP), also participates in the regulation of smooth muscle tone and is thus also involved in the regulation of blood pressure. Phosphodiesterases (PDE) degrade cyclic nucleotides thereby ending their signalling. In order to investigate the effect of NO-GC on the cardiovascular system, mice with global (GCKO) or smooth muscle-specific (SMC-GCKO) deletion of NO-GC have been generated. To shed light into the interplay of cAMP and cGMP, PDE3 was studied in the first part of this thesis. PDE3 plays a special role in cGMP/cAMP crosstalk based on its mixed substrate specificity. From the two PDE3 isoenzymes (PDE3A and PDE3B), only PDE3A is expressed in the aorta. The aortas of GCKO- and SMC-GCKO animals are more sensitive to PDE3A inhibition than those from control animals. The acute blockade of NO-GC using ODQ also leads to this sensitivity effect. As a result of NO-GC deletion, PDE3A expression and activity are reduced by approx. 50%. This is probably a compensatory response in order to maintain functional cAMP signalling and to guarantee cAMP-induced relaxation of blood vessels. These results indicate a direct regulation of PDE3A in smooth muscle cells by the NO/cGMP-signalling cascade and a PDE3-mediated cAMP/cGMP crosstalk. The exact mechanism how NO-GC/cGMP regulates PDE3A expression remains unclear; conceivable options are a cGMP-mediated regulation of transcription or a modulation of PDE3A translation. Loss of NO-GC in GCKO and SMC-GCKO mice leads to an elevated systolic blood pressure by around 30 mmHg. In the second part of this thesis, stiffness of aortae from these KO animals was examined. In GCKO mice, the pulse wave velocity (PWV) was significantly faster than in control animals indicating an increased aortic stiffness. The increase in PWV in GCKO animals is likely to be explained by a reduced aortic diameter. Even though elastin and collagen content were unchanged, the aortas of these animals have an altered wall structure. SMC-GCKO animals show neither an increase in PWV nor morphological changes of the aorta. Thus, an increased aortic stiffness can be excluded as cause for the elevated systolic blood pressure in GCKO animals.

Abstract not available

Na+/Ca2+ exchanger (NCX) is a membrane protein which can mediate either Ca2+ entry (reverse mode) or exit (forward mode) in cells. As one of the major Ca2+ transport systems, NCX is postulated to play a critical role in the vascular smooth muscle cell. The aims of the present study are to firstly demonstrate the functional existence of NCX in vascular smooth muscle (including aorta and arteriole); to clarify the modulation of NCX; to explore the selectivity of NCX inhibitor KB-R7943; and lastly to investigate the role of NCX in the myogenic response. KB-R7943 has been widely used as a NCX inhibitor. The study investigated its pharmacological actions in rat aorta on a variety of Ca2+ dependent systems. Rat aortic rings were used. The constriction to low extracellular [Na+] is a functional response mediated by NCX operating in reverse mode. The data demonstrate that 10 µM KB-R7943 inhibited L-type Ca2+ channel, the capacitative Ca2+ entry and  adrenergic receptor pathway. Nevertheless, KB-R7943 can be used as a selective inhibitor of NCX at the lower concentration of 1 µM in rat aortic rings. The study investigated whether the endothelium could modulate NCX in rat aortic rings. Lowering extracellular [Na+] to 1.18 mM induced constriction in endothelium denuded rat aortic rings, but only a small constriction in endothelium intact rat aortic rings. In endothelium intact rat aortic rings, the guanylate cyclise inhibitor ODQ (1 µM) and the nitric oxide synthase inhibitor L-NAME (50 µM) greatly amplified the vasoconstriction to lowering extracellular [Na+], but had no effect when the endothelium was removed. The adenylate cyclise inhibitor SQ 22536 (100 µM) and the cyclooxygenase inhibitor indomethacin (10 M) showed no significant effect on the low-Na+ induced vasoconstriction in either endothelium denuded or intact aortic rings. The results suggest that endothelium modulated the NCX operation via the nitric oxide/guanylate cyclase, not the adenylate cyclase system; further prostanoids including prostacyclin was not involved. The interaction between nitric oxide and NCX was furt her explored using the nitric oxide donor sodium nitroprusside. Endothelium denuded rat aortic rings were preconstricted to the same extent with either low Na+ (1.18 mM), or the thromboxane A2 agonist U46619 (0.1 µM) or high K+ (80 mM). The vasorelaxation of SNP (30 nM) in low Na+ constriction was significantly larger compared to other agents. This indicates that NO has a special antagonism of low Na+ constriction and a hypothesis is proposed involving Na+/K+ ATPase. The investigation of NCX is mainly conducted in large vessels; much less evidence is available for small resistance vessels. The study investigated the role of NCX on myogenic response in pressurized cremaster muscle arterioles. Reducing extracellular [Na+] resulted in graded vasoconstriction which was inhibited by NCX inhibitor SEA0400 (1 µM). Myogenic vasoconstriction and the concomitant rise in internal [Ca2+] were induced by a transmural pressure increase from 70 to 120 mmHg which was prevented by NCX inhibitor: SEA0400 (1 µM). In conclusion, the present study suggests that NCX contributes to the myogenic response in cremaster arteriole.

Amyloidoses are a group of protein misfolding diseases characterized by deposits of insoluble fibrillar protein aggregates. Medin amyloid, which is the focus of this thesis, appears in the media of the thoracic aorta in nearly all individuals over 50 years. The fibrils are derived from a 50 amino acid residue fragment of the precursor protein lactadherin. How medin amyloid arises is unknown, but in paper I we demonstrated, with immunohistochemical and in vitro binding experiments, that both lactadherin and medin interact with elastin, implying that the elastic fibre is central in amyloid formation. In paper II, we further showed that the last 18-19 amino acid residues constitute the amyloid-promoting region. In paper III, the consequence of medin deposition was investigated. Aortic specimens from patients with thoracic aorta aneurysm and dissection were examined for medin content. The tissue findings indicated that the two disease groups contained more medin oligomers than normal aortas. Interestingly, recent reports demonstrate that the toxicity of amyloid proteins is attributed to prefibrillar oligomeric aggregates rather than to mature fibrils. In support of this finding, we observed that prefibrillar medin, in contrast to medin fibrils, was toxic in cell culture. Amyloid formation is a nucleation-dependent process. Addition of preformed fibrils to an amyloid protein solution dramatically accelerates fibrillation, a phenomenon called seeding. In paper IV, serum amyloid A-derived (AA) amyloid was found co-localized with medin deposits in the aorta. In vitro, medin fibrils enhanced the formation of AA fibrils, indicative of a seeding mechanism. The data are of great importance as they suggest that one type of amyloid is capable of inducing fibrillation and deposition of another amyloid type. In conclusion, the results of this thesis shed light on how medin is formed, the function of lactadherin and the consequences of medin deposition for aortic pathology.

published_or_final_version / Pharmacology and Pharmacy / Doctoral / Doctor of Philosophy

The purpose of this master thesis was to evaluate the estimation of pulse wave velocity (PWV) in the aorta using 4D flow MRI. PWV is the velocity of the pressure wave generated by the heart during systole and is a marker of arterial stiffness and a predictor of cardiovascular disease (CVD). PWV can in principle be estimated based on the time (travel-time) it takes for the pulse wave to travel a fixed distance (travel-distance), or based on the distance the pulse wave travels during a fixed time. In the commonly used time-to-travel-a-fixed-distance approach, planes are placed at two or more locations along the aorta. The travel-time is found by studying velocity waveforms at these pre-defined locations over time and thereby by estimating the time-difference for the pressure wave to reach each of these locations. In the distance-travelled-in-a-fixed-time approach, the pulse wave is located by studying at the velocity along the aorta at pre-defined instances in time. The travel-distance for the pulse wave between two instances in time is set as the difference in location of the pulse wave, where the location is identified as the location when the velocity has reached a predefined baseline. The specific aims of this thesis was to investigate the effect of using multiple locations as well as the effects of temporal and spatial resolution in the time-to-travel-a-fixed-distance approach, and to evaluate the possibility of using the distance-travelled-in-a-fixed-time approach. Additionally, the possibility of combining the two approaches was investigated. The study of using multiple locations revealed that more planes reduces the uncertainty of PWV estimation. Temporal resolution was found to have a major impact on PWV estimation, whereas spatial resolution had a more minor effect. A method for estimating PWV using 4D flow MRI using the distance-travelled-in-a-fixed-time approach was presented. Values obtained were compared favourably against previous findings and reference values, in the case of healthy young volunteers. The combination of the time-to-travel-a-fixed-distance and distance-travelled-in-a-fixed-time approaches appears feasible.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2008. / Härtill 4 uppsatser.

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, 2004. / Bibliyografya var.

Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 5 uppsatser.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2007. / Description based on contents viewed June 24, 2007; title from title screen. Includes bibliographical references (p. 76-80).