Aim: Recent interest in cardiogenesis has focused on the epicardium, the outer epithelial layer that envelops the heart. Epicardial-derived cells (EPDCs) contribute vascular smooth muscle to developing coronary vessels and provide critical signalling cues to facilitate myocardial functionality. However, the precise molecular mechanisms that underpin epicardial biology remain unclear. Ablation of Myh10 in the EHC mouse results in embryonic lethal cardiac malformations, including epicardial and coronary defects. We sought to establish the role of Myh10 in epicardial cell function to further dissect the coronary vessel developmental pathway, a deeper understanding of which may inform the design of therapeutics to regenerate and repair the injured heart. Methods: Utilising multiple cell and developmental biology techniques, we generated a pathological evaluation of the EHC phenotype. EPDC migration was investigated in vivo with Wt1 immunohistochemistry, and in vitro by performing scratch wound assays on epicardial cell cultures. Congruently, we examined the ability of epicardial cells to undergo EMT in vivo by employing Snail and Phosphohistone-H3 immunohistochemistry. Results: Our studies reveal that EHC epicardial cells have a reduced capacity to invade the ventricular myocardium. Furthermore, we discovered increased proliferation and reduced Snail expression specifically within the EHC epicardium, consistent with EMT dysregulation. Interestingly, epicardial cell function did not appear to be disrupted in vitro. Conclusion: These results demonstrate a novel role for Myh10 in both EPDC migration and the promotion of epicardial EMT. Our finding that migration is unaffected in vitro suggests that the unique properties of the in vivo epicardial microenvironment dictate a requirement for Myh10 in order to elicit correct epicardial function. Together, this research enhances our understanding of the dysfunctional processes that contribute to abnormal cardiogenesis; these insights may aid our ability to determine the molecular regulators of coronary vessel development, and create therapeutics to regenerate vessel growth and repair injured cardiac tissue in cardiovascular disease.

Clinical thermal therapies are widespread and gaining in appeal due to improved technology of heating devices and promising results. Outcomes of thermal treatment are often unpredictable and suboptimal, however, due in part to a lack of appreciation of the underlying biothermomechanics. There is a pressing need, therefore, to understand better the role of clinically-controllable parameters on the thermal damage processes of tissue. Heretofore, researchers have primarily sought to understand this process through various uniaxial experiments on tissues containing collagen as their primary constituent. Most biological tissues experience multiaxial loading, however, with complex boundary constraints inclusive of both isotonic and isometric conditions. The primary focus of this work is on the isothermal denaturation of fibrillar collagen subjected to a biaxial isometric constraint. Results from our tests reveal a complicated process, the kinetics of which are not easily measured. Evolving isometric contraction forces during heating do not correlate with resultant mechanical behaviors, as thermal shrinkage does in biaxial isotonic tests. Furthermore, resultant mechanical behaviors at variousdurations of heating reveal a two phase process with a rate dependent on the amount of isometric stretch. For tissues heated at 75oC for 15 minutes, at which point the first phase of mechanical alteration dominates for all constraints herein, resultant mechanical behaviors correlate well with the amount of isometric stretch. The correlation is similar to that between isotonic loads and resultant mechanical behaviors from previous studies. In light of the need for a better measure of thermal damage in isometric tests, we performed a histological analysis of tissues heated under varying constraints. Results show a good correlation between the level of isometric constraint and thermally-induced histological aberrations. Finally, we demonstrate that our seemingly limited and qualitative knowledge can be applied well to a specific clinical application: namely, the use of glycerol as a clearing agent for laser therapies. Our results suggest that glycerol is safe to use for such therapies because it increases the thermal stability of fibrillar collagen, and its hyperosmotic effects on mechanical behavior are fully reversed upon rehydration.

Cardiovascular and heart diseases are the leading causes of death worldwide. In mammals, when heart damage occurs this organ is unable to regenerate itself. Understanding how to induce a regenerative process has been the focus of a great deal of attention recently. The understanding of heart development and the initial formation of several heart lineages could be used in finding a regenerative approach to heart damage that can mimic developmental processes. The Wilms’ tumour 1 gene (Wt1) is essential in the epicardium, the outer layer of cells around the heart, which during development has a multipotent potential and is the source of progenitors for several heart cell lineages such as: cells of the coronary vasculature, fibroblasts and cardiomyocytes. In my thesis I have focused on using an in-vitro (immortalized epicardial cells where Wt1 can be deleted by adding tamoxifen), and an in-vivo approach (genome wide expression analyses of Wt1 control and Wt1 knock-out epicardial enriched cells), to identify novel targets of Wt1 in the epicardium during development. I found that the chemokines Cxcl10 and Ccl5 are up-regulated in tamoxifen induced immortalized Wt1 knock-out epicardial cells and ex-vivo in heart explants when Wt1 is down-regulated. Ccl5 was found to be able to inhibit cardiomyocyte proliferation and Cxcl10 also inhibited epicardial cell migration, which could further explain ventricular thinning in Wt1 mutant mouse hearts. Wt1 is able to bind directly to the promoter of a chemokine and interferon response regulator gene, Irf7, which is also up-regulated in our in-vivo model. This could provide a mechanism by which Wt1 can inhibit chemokine expression during development, and could link Wt1 with immunological responses, which recently have been shown to play a role in the physiology and development of cells outside immunity, as well as being involved in physiological roles during damage and repair in adult tissues. I have also identified two Wt1-GFP populations (Wt1GFP++ and Wt1GFP+) in the ventricles of Wt1-GFP knock-in mice. The Wt1GFP++ population is enriched for epicardial cells, and a genome wide transcriptome analysis of these cells from E11.5 to E16.5 demonstrates they have a very dynamic regulation of a wide variety of genes, and also it indicates the existence of an early, transient and late Wt1GFP++ gene expression programs. The transcriptome analysis of Wt1GFP++ control and Wt1GFP++ Wt1 knock-out cells, from Gata5-Cre Wt1loxP/gfp mice at E13.5, reveals that Wt1 could regulate a number of previously un-described Wt1 targets related to the early Wt1GFP++ program, and gene ontology analyses indicate that many targets are related to cell to cell signalling and interaction, cell to extracellular matrix interaction, tissue development and morphogenesis. The Wt1GFP+ cell population is positive for a number of cardiomyocyte specific markers and has a low or negative expression of endothelial, epithelial and mesenchymal markers according to my transcriptome analysis. The findings I have described here shed light on the variety of targets of Wt1 and further reveal the function of Wt1 during epicardial development, which could be used in finding a regenerative approach to heart disease.

Coronary heart disease is a prevalent issue in developed countries throughout the world. It can have crippling effects on the quality of life and even lead to mortality, in the case of myocardial infarction. Part of the problem is the lack of a robust regenerative response in mammals after injury. Zebrafish have an amazing ability to regenerate after injury, and studies have demonstrated that the regenerative response recapitulates embryonic development. Our lab previously reported the first analysis of coronary vessel development in zebrafish and demonstrated that coronary endothelial cells undergo angiogenesis to form a vascular network. The roles of perivascular cells in this process have not been examined in zebrafish. Using a transgenic reporter line marking pdgfrb expression, I found that pdgfrb is first observed in epicardium at the AV canal. At later stages of coronary vessel development, pdgfrb positive cells become localized to the perivascular region of mature vessels. I also observe that early in development, Tcf21 and pdgfrb co-express, which suggests a close relationship between the epicardium and pdgfrb+ cells. Previous findings from our lab revealed that cxcl12b+ cells localize to large coronary vessels during development. My findings reveal that pdgfrb+ marks perivascular cells of both capillaries and large coronary vessels. Lineage tracing analysis revealed that a subset of pdgfrb+ perivascular cells derive from tcf21 labeled epicardial cells. To see if disruption of Pdgfrb signaling impacts coronary development, I examined pdgfrb mutant hearts. In the Pdgfrb mutant, a mature coronary vessel network fails to form, and instead we observe isolated endothelial cell islands. Lastly, I characterized a transgenic line that expresses a dominant negative form of Pdgfrb (dnpdgfrb) and can be potentially used for later developmental and/or regenerative studies. My findings indicate strong dnpdgfrb induction can be achieved at adult stages. My studies will greatly enhance our current understanding of coronary vessel development, and can be used as the basis for studying perivascular cells and their interactions with endothelial cells after cardiac injury in regeneration.

<p>The teleost zebrafish (danio rerio) has a highly elevated regenerative capacity compared to mammals, with the ability to quickly and correctly regenerate complex organs such as the fin and the heart following amputation. Studies in other highly regenerative systems suggest that regenerative capacity is directly related to the homeostatic demands of a given tissue, such as high basal levels of cell turnover or the ability to modify tissue size in response to homeostatic changes. However, it is not known if this relationship is present in vertebrate tissues with blastema-based regeneration. To test this idea, we investigated whether markers associated with regeneration are expressed in uninjured zebrafish tissues, and if treatments that block regeneration also lead to homeostatic defects over long periods.</p><p>We found that regenerative capacity is generally required for homeostasis in the fin, as multiple genetic treatments that block regeneration also led to a degenerative loss of distal fin tissue in uninjured animals. In addition, we found that there is extensive cell turnover in the distal fin tissues, accompanied by expression of critical effectors of blastemal regeneration. Both cell proliferation and gene expression were sensitive to changes in Fgf signaling, a factor that is critical for fin regeneration.</p><p>In the heart, we found that although there is little cell turnover in uninjured adult animals, the zebrafish heart can undergo rapid, dramatic cardiogenesis in response to animal growth. These growth conditions induce cardiomyocyte hyperplasia similar to regeneration, and induce gene expression changes in the epicardium, a tissue that is critical for cardiac regeneration. We find that the epicardium continually contributes cells to the uninjured heart, even in the absence of cardiac growth. If this contribution is prevented via a long-term block of Fgf signals, scarring can result, indicating that continual activity of epicardium derived cells (EPDCs) is critical for cardiac homeostasis. We have generated reagents that allow us to visualize EPDCs, and find that they contribute cardiac fibroblasts and perivascular cells during rapid cardiac growth. Uncovering the fate of EPDCs during cardiac homeostasis and regeneration will allow us to better understand their function, and may lead to the development of regenerative therapies for human cardiovascular diseases.</p> / Dissertation

Epithelial to mesenchymal transition (EMT) is an essential process during embryogenesis for the development of organ systems, including the heart and its vasculature. The development of both coronary vessels and heart valves depends on EMT. In this dissertation, we first present data demonstrating that increasedoligosaccharide hyaluronan (o-HA) levels after EMT induction within atrioventricular (AV) valves leads to a decrease in EMT due to the induction of VEGF expression. Regulated EMT inhibition prevents the formation of hyperplastic valves. Next, we show that the proepicardium, which provides the precursor cells required for epicardial and coronary vessel development, migrates to the developing heart via direct contact of multicellular proepicardial villi to the developing myocardium. This shifts the paradigm from a migration consisting of floating cysts to one of direct contact and differential adhesion forces to form the initial epicardium. A subset of epicardial cells undergoes EMT, migrates into the developing heart, and differentiates into cardiac fibroblast, vascular endothelial, and smooth muscle cells. In order to more effectively study epicardial EMT in vitro, we developed several new methods for the in vitro study of coronary vessel development. We developed an improved protocol for isolating embryonic myocyte cells, for use in co-cultures with epicardial cells. This co-culture system allows investigation into the effects of myocyte derived soluble factors uponepicardial EMT and mesenchymal cell differentiation. We also present a protocol for isolating epicardial clonal colonies from an epicardial cell line derived from the ImmortoMouse. These clones provided direct evidence that the epicardium is a heterogeneous population of cells. These unique clones allow for to study into specific epicardial cell lineages and phenotypes. Finally, we provide data defining the expression of Wnts within the developing heart and the role may play during epicardial EMT. We conclude that canonical Wnts are both necessary and sufficient to inhibit epicardial EMT. These results provide the first direct evidence for a role of Wnt proteins during coronary vessel development. Collectively our results provide significant advancements in our understanding of EMT regulation during cardiac development.

The epicardium is a single layer of epithelial (mesothelial) cells that covers the entire heart surface, but whose function in adult mammals is poorly understood. Defining the role of epicardial cells during homeostasis, growth and injury has potential to provide new treatment strategies for human diseases that result in heart failure, due to extensive loss of viable cardiac tissue. We hypothesized that epicardial cells contribute to repair as transplantable progenitor cells for cellular regeneration and as a source of secreted growth factors for cell protection after myocardial infarction. Adult epicardial cells were prospectively isolated as uncommitted epithelial cells using epithelial-specific beta-4 integrin (CD104). These cells underwent epithelial to mesenchymal transformation in culture to generate epicardial cell derivatives (EPDCs). We demonstrate that the C-terminal peptide from Connective Tissue Growth Factor (CTGF-D4), when combined with insulin, effectively primes EPDCs for robust cardiac engraftment in rats and contributes to improvement in cardiac function at one month after MI. Furthermore, we define a signaling axis comprised of CTGF-D4, low density lipoprotein receptor-related protein 6 (LRP6), sex determining region Y-box 9 (Sox9) and Endothelin Receptor B (ETBR) that controls several key processes that impact EPDC graft success: cell survival, proliferation and migration. Interestingly, conditional deletion of ETBR using epicardial-specific transgenic mice prevented epicardial cell proliferation and migration into myocardium after MI. We therefore observed a congruence in the signals and signaling pathways that control the proliferation and migration of endogenous EPDCs after MI and EPDCs that can be generated in cell culture and grafted back to the heart. To gain additional insight into the cellular contribution of the epicardium, we utilized a non-injurious running exercise model to evaluate epicardial activity as a consequence of cardiac hypertrophy (i.e. myocardial growth model). We employed an inducible lineage-tracing system to specifically label and track epicardial cells by GFP expression. Prolonged exercise resulted in a significant number of GFP-positive proliferating epicardial cells and epicardial-derived GFP-positive endothelial cells and few GFP-positive smooth muscle cells in the heart. These observations highlight the cellular plasticity of the adult epicardium and its function as a cardiac progenitor cell niche, maintaining a source of replacement cells. To investigate the paracrine properties of adult epicardial cells for their role in cell protection after MI and reperfusion, human epicardial cells were isolated from donor atrial tissue explants. We predicted that medium conditioned by cultured epicardial cells (EPI CdM) contained secreted reparative factors that would promote endothelial cell survival. Administration of EPI CdM promoted endothelial cell survival in culture and in vivo, 24 hours after ischemia-reperfusion injury. By screening EPI CdM, we detected protein complexes containing hepatocyte growth factor (HGF) with polyclonal IgG that imparted vascular protection in vivo in a manner similar to EPI CdM. Overall, the studies presented here illustrate the unique biology of epicardial cells, their signaling networks, and their contribution to cardiac cell protection and regeneration. Importantly, these properties have the potential to be exploited in translational applications for cardiac repair.

Background:     The microdialysis (MD) technique is widely spread and used both experi­mentally and in clinical practice. The MD technique allows continuous collection of small molecules such as glucose, lactate, pyruvate and glycerol. Samples are often analysed using the CMA 600 analyser, an enzymatic and colorimetric analyser.  Data evaluating the performance of the CMA 600 analysis system and associated sample han­dling are sparse. The aim of this work was to identify sources of variability related to han­dling of microdialysis samples and sources of error associated with use of the CMA 600 analyser. Further, to develop and compare different application techniques of the micro­dialysis probes both within an organ and on the surface of an organ.  Material and Methods:  Papers I and II are mainly in vitro studies with the exception of the No Net Flux calibration method in paper I where a pig model (n=7) was used to exam­ine the true concen­tration of glucose and urea in subcutaneous tissue. Flow rate, sampling time, vial and caps material and performance of the analyser device (CMA 600) were examined. In papers III and IV normoventilated anaesthetised pigs (n=33) were used. In paper III, heart ischemia was used as intervention to compare microdialysis measurements in the myocardium with corresponding measurements on the heart surface. In paper IV, microdialysis measurements in the liver parenchyma were compared with measurements on the liver surface in associa­tion with induced liver ischemia. All animal studies were approved by the Animal Experi­mental Ethics Committee at Umeå University Sweden. Results:  In paper I we succeeded to measure true concentrations of glucose (4.4 mmol/L) and Urea (4.1 mmol/L) in subcutaneous tissue. Paper II showed that for a batch analyse of 24 samples it is preferred to store microdialysis samples in glass vials with crimp caps. For reliable results, samples should be centrifuged before analysis. Paper III showed a new application area for microdialysis sampling from the heart, i.e. surface sampling. The sur­face probe and myocardial probe (in the myocardium) showed a similar pattern for glucose, lactate and glycerol during baseline, short ischemic and long ischemic interventions. In paper IV, a similar pattern was observed as in paper III, i.e. data obtained from the probe on the liver surface showed no differences compared with data from the probe in liver paren­chyma for glucose, lactate and glycerol concentrations during baseline, ischemic and reperfusion interven­tions. Conclusion:  The MD technique is adequate for local metabolic monitoring, but requires methodological considerations before starting a new experimental serie. It is important to consider factors such as flow rate, sampling time and handling of samples in association with the analysis device chosen. The main finding in this thesis is that analyses of glucose, lactate and glycerol in samples from the heart surface and liver surface reflect concentra­tions sampled from the myocardium and liver parenchyma, respectively.

The epicardium, a cell layer enveloping the heart muscle, drives embryonic heart development and heart repair in the adult zebrafish. Previous studies found the epicardium to consist of multiple cell populations with distinct phenotypes and functions. Here, I investigated epicardial heterogeneity in the developing zebrafish heart, focusing on the developmental gene program that is also reactivated during adult heart regeneration. Transcription factor 21 (Tcf21), T-box 18 (Tbx18) and Wilms' tumor suppressor 1b (Wt1b) are often used interchangeably to identify the zebrafish epicardium. Analyzing newly generated reporter lines and endogenous gene expression, I showed that the epicardial expression of tcf21, tbx18 and wt1b during development is heterogeneous. I then collected epicardial cells from newly generated reporter lines at 5 days-post-fertilization and performed single-cell RNA sequencing. I identified three distinct epicardial subpopulations with specific gene expression profiles. The first subpopulation expressed tcf21, tbx18 and wt1b and appeared to represent the main epicardial layer. The second subpopulation expressed tbx18, but not tcf21 or wt1b. Instead, it expressed smooth muscle markers and seemed restricted to the bulbus arteriosus. The third epicardial subpopulation only expressed tcf21 and resided within the epicardial layer. I compared the single-cell subpopulations with transcriptomic bulk data and visualized the expression of marker genes to investigate their spatial distribution. Using ATAC sequencing, I additionally identified open regulatory regions located in proximity to subpopulation-specific marker genes and showed subpopulation-specific activity in vivo. My results detail distinct cell populations in the developing zebrafish epicardium, likely to fulfil distinct and specific cellular functions. Future experiments will involve targeting signature genes enriched within each epicardial subpopulation, such as those encoding Adrenomedullin a (first subpopulation), Alpha Smooth Muscle Actin (second subpopulation) and Claudin 11a (third subpopulation), employing cell type-specific genome editing to test whether and how the identified heterogeneity underlies distinct epicardial cell fates and functions. Taken together, my work adds significantly to the understanding of the cellular and molecular basis of epicardial development and can offer novel insights in the context of heart regeneration.

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