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* Terrence Donnelly Research Laboratories, Division of Cardiology, St. Michaels Hospital, Toronto, Ontario, Canada MB5 1W8; the
Institute of Medical Science; and the
McLaughlin Centre for Molecular Medicine, University of Toronto, Toronto, Ontario, Canada
1To whom requests for reprints should be addressed at University of Toronto, Room 6-050k, Queen Wing, Terrence Donnelly Heart Centre, St. Michaels Hospital, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8. E-mail: stewartd{at}smh.toronto.on.ca
Abstract
Endothelin-1 (ET-1) is increasingly recognized as a proinflammatory mediator in various diseases, such as atherosclerosis and acute respiratory distress syndrome (ARDS). Angiopoietin-1 (Ang-1), a ligand of the endothelial receptor Tie2, inhibits endothelial apoptosis, reduces vascular leakage, and suppresses the induction of inflammatory markers, indicating that it has diverse vasoprotective, anti-inflammatory actions. Thus, we examined the effects of Ang-1 on ET-1 production in vitro and in vivo and investigated cell-based gene transfer of Ang-1 in a rat model of lipopolysaccharide (LPS)-induced ARDS. Cultured human endothelial cells were treated with recombinant Ang-1 with or without tumor necrosis factor-
(TNF-
) (100 U/ml). ET-1 release into the culture medium after 24 hrs was determined by enzyme-linked immunosorbent assay. Levels of preproendothelin-1 (ppET-1) mRNA were measured by quantitative reverse transcriptionpolymerase chain reaction. Fisher344 rats were subjected to cell-based gene transfer to the lung circulation by injecting syngeneic fibroblasts transfected with Ang-1 cDNA or a null plasmid vector. After 24 hrs, LPS (100 µg/kg body wt) was instilled intratracheally to induce pulmonary inflammation. Bronchoalveolar lavage was performed 6 hrs later, and lungs were harvested for histologic and molecular analyses. ET-1 release from cultured endothelial cells was dose-dependently reduced by Ang-1, which also prevented induction of ET-1 release by TNF-
(P < 0.05). RNA expression of ppET-1 was similarly reduced. In LPS-challenged lungs, ppET-1 RNA was induced 3.4-fold, and ET-1 protein in lavage fluid was increased 5.6-fold (P < 0.05). Ang-1 gene transfer attenuated the LPS-induced increases in ppET-1 RNA and lavage ET-1 protein by 34% and 33%, respectively (P < 0.05). The downregulation of ET-1 correlated with the amelioration of pulmonary inflammation, as indicated by reductions in leukocyte infiltration (by 43%) and intra-alveolar septal thickening (by 40%). These results show that ET-1 transcript and protein levels are downregulated by Ang-1 in both in vitro and in vivo systems and that cell-based Ang-1 gene transfer markedly ameliorated inflammation in vivo in an experimental model of ARDS. Thus, cell-based gene transfer of Ang-1 may provide a novel treatment strategy for ARDS by attenuating vascular inflammation via suppression of ET-1.
Key Words: endothelin-1 angiopoietin-1 pulmonary inflammation acute respiratory distress syndrome acute lung injury cell-based gene therapy
Introduction
Endothelin-1 (ET-1) is a mediator of vascular inflammation, cell proliferation, and fibrosis in addition to being a potent vasoconstrictor (13). In various experimental models of vascular and inflammatory diseases, treatment with ET-1 antagonists has resulted in marked beneficial effects. In particular, treatment with ET-1 antagonists has been shown to reduce pulmonary vascular leak and inflammation in several models of lung injuries and in experimental acute respiratory distress syndrome (ARDS) (47). Moreover, patients who died from ARDS were shown to have high plasma and lung ET-1 expression compared to control patients (2, 8, 9).
Angiopoietin-1 (Ang-1) is a ligand of the endothelial-specific tyrosine-kinase receptor Tie2 and is an essential mediator of angiogenesis (1012). Ang-1 is also an endothelial survival factor (13) and was recently shown to protect blood vessels against plasma leakage in vivo and to inhibit endothelial permeability in vitro (1416). As well, Ang-1 inhibits leukocyte adhesion to vascular endothelium and reduces the expression of tissue factor and various adhesion molecules in endothelial cells stimulated by inflammatory cytokines (1619). These findings strongly support a crucial anti-inflammatory role for this pro-angiogenic and antiapoptotic factor, perhaps with the capacity to maintain endothelial function and prevent pathologic changes in endothelial gene expression.
In this study, we hypothesized that the downregulation of ET-1 expression by Ang-1 is an important mechanism of its homeostatic effects on the vascular endothelium. We further explored whether delivery of Ang-1 to the lungs by cell-based gene transfer (20) can suppress cytokine induction of ET-1, thereby reducing vascular inflammation in a rat model of lipopolysaccharide (LPS)-induced ARDS.
Materials and Methods
Cell Culture.
HMEC-1 human dermal microvascular endothelial cells (21) were cultured in MCDB131 medium supplemented with 10% fetal bovine serum, 100 U/ml penicillin, 100 µg/ml streptomycin, 10 mM glutamine (all from Invitrogen, Burlington, Canada), 1 µg/ml hydro-cortisone (Sigma Chemical, Oakville, Canada), and 10 µg/ml epidermal growth factor (BD Collaborative Biomedical, Mississauga, Canada). Prior to treatments, cells were treated overnight with medium containing 1% serum and no supplements of growth factor or hormones. Cells were then treated with Ang-1 (R&D, Minneapolis, MN) and/or tumor necrosis factor
(TNF-
; R&D or Roche, Laval, Canada) prepared in the same medium with 1% serum.
Animal Model.
All animal studies were conducted under protocols approved by the animal care committee at St. Michaels Hospital and in accordance with guidelines from the Canadian Council of Animal Care. Syngeneic male Fisher344 rats (Charles River Co., St. Constant, Canada) were anesthetized (200 mg/kg ketamine, 10 mg/kg xylazine). Fibroblast cells were cultured using an explant technique from skin biopsy. Cells between the fifth and eighth passages were transfected with the null plasmid vector, pFLAG-CMV-1 (pFLAG), or the same plasmid vector containing the full-length cDNA for human Ang-1 (pAng-1) using Superfect (Qiagen, Mississauga, Canada). After 24 hrs, cells were trypsinized, washed, and suspended in Dulbeccos phosphate-buffered saline (PBS) for injection into the pulmonary circulation.
Male Fisher344 rats (250 ± 30 g) were anesthetized and randomly assigned to one of four experimental groups. The left exterior jugular vein was isolated by blunt dissection and cannulated with PE50 polyethylene tubing. Rats were injected with transfected fibroblasts (1.5 x 106 cells in 1 ml of Dulbeccos PBS) and allowed to recover in an incubator. Twenty-four hours after cell administration, rats were reanesthetized, orally intubated using a 14-gauge intravenous catheter, and subsequently received intratracheal instillation of LPS (from Escherichia coli 026:B6; 100 µg/kg body wt; 1 mg/ml) or an equivalent volume of saline. Six hours after LPS challenge, rats were reanesthetized and tracheotomized, and bronchoalveolar lavage was performed by gently inflating and deflating lungs with 1 ml of saline three times. Lavage total cells were counted using a hemocytometer, and the percentages of neutrophils, monocytes, and alveolar macrophages were determined by counting hematoxylin and eosin-stained cells on a smear. Lung tissue was then harvested and flash-frozen in liquid nitrogen for later reverse transcriptionpolymerase chain reaction (RT-PCR) analysis. In separate rats, lung tissue was then harvested by paraformaldehyde-inflation for paraffin embedding and subsequent histologic analysis. The average intra-alveolar septal thickness was quantified in hematoxylin and eosin-stained sections using ImageJ software (National Institutes of Health).
RNA Extraction and Quantitative RT-PCR (qRT-PCR).
Total RNA was extracted from confluent cultures using the GenElute RNA Kit (Sigma Chemical), following the manufacturers protocols. Total RNA was extracted from whole rat lung using Trizol extraction (Invitrogen) following the manufacturers protocols. Fifty nanograms of RNA extracted from cell cultures or 2 µg of RNA extracted from rat lung and Omniscript Reverse Transcriptase (Qiagen) were used in RT reactions, which were terminated by heating at 85°C for 10 mins; samples were then diluted 1:10 in PCR-grade water.
Each diluted RT was then used in PCRs in duplicate to assess the RNA abundance of human ppET-1 (sense primer: 5'-GCT CGT CCC TGA TGG ATA AA-3'; antisense primer: 5'-CTG TTG CCT TTG TGG GAA GT-3') and ß-actin (sense primer: 5'-AGC CTC GCC TTT GCC GA-3'; antisense primer: 5'-CTG GTG CCT GGG GCG-3' [22]) for cell culture experiments and rat ppET-1 (sense primer: 5'-GCT TCT ACA GTT TCT TGT TCA GAC-3'; antisense primer: 5'-GGA TGC AAA CGA AGA CAG GTT AGG-3'), rat and human Ang-1 (sense primer: 5'-GAG CTC CTT GAG AAT TAC ATT GTG G-3'; antisense primer: 5'-CGA GTT GAT TTA GTA CCT GGG TCT C-3'), and rat 18S (sense primer: 5'-GAC GAT CAG ATA CCG TCG TAG TTC-3'; antisense primer: 5'-GTT TCA GCT TTG CAA CCA TAC TCC-3') for rat experiments, using the SYBR Green I PCR Master Mix and the ABI PRISM 7900HT sequence detection system (Applied Biosystems, Foster City, CA). RTs and PCRs with various dilutions of total RNA were done in parallel to determine the amplification efficiencies (E) according to the equation:
![]() | ((23, 24),) |
where the slope is that of the standard curve plot (threshold cycle or crossing point [CP] vs. RNA input) generated by the ABI PRISM system. Relative ppET-1 RNA expression was then calculated in comparison to ß-actin RNA expression for cell culture experiments using Pfaffls formula:
![]() | ((24).) |
The relative abundance of ppET-1 RNA in untreated control cells was expressed as 100% for comparative purposes. Similarly, rat ppET-1 RNA expression and rat and human Ang-1 RNA expression were calculated in comparison to 18S for rat experiments. The relative abundance of rat ppET-1 and rat and human Ang-1 RNA in rats that received pFLAG-transfected fibroblast cells and intratracheal instillation of saline (pFLAG+Saline) was expressed as 100% for comparative purposes.
ET-1 Enzyme-Linked Immunosorbent Assay (ELISA).
HMEC-1 cells were seeded in twelve-well plates and grown to confluence in 34 days. After overnight serum-starvation, medium in each well was changed to include Ang-1 and/or TNF-
. In each set of experiments, there was also one well with no cells and medium with no Ang-1 (blank). Medium in each well was collected after 6 or 24 hrs of incubation and was briefly centrifuged to remove floating cellular debris that was present. Supernatants were transferred to fresh Eppendorf tubes and stored frozen at 70°C. ET-1 ELISA was conducted using a kit from ALPCO Diagnostics (Salem, NH) following the manufacturers instructions. For normalization purposes, cells in each well were lysed in 0.2 N NaOH and quantitated for protein content using a modified Lowrys Method (BioRad, Mississauga, Canada). ET-1 ELISA was also performed on precipitated bronchoalveolar lavage fluid collected from rat lung and spun at 3000 g for 20 mins at 4°C to remove any cellular debris.
Statistics.
Data are represented as mean ± standard error of the mean. Differences between groups were assessed using analysis of variance (with post hoc comparisons using Student-Newman-Keuls test). A value of P < 0.05 was considered statistically significant.
Results
Effects of Ang-1 on ET-1 Expression in Cultured Endothelial Cells.
ET-1 release from HMEC-1 cells, as determined by ELISA, was only marginally reduced by 250 ng/ml of Ang-1 after 6 hrs, but a marked reduction was observed after 24 hrs, displaying a dose-dependent suppression by as much as 30% (Fig. 1
). Co-treatment with 100 U/ml of TNF-
for 24 hrs resulted in an increase in ET-1 release, which was also dose-dependently reduced by Ang-1 (Fig. 2
). The expression of ppET-1 mRNA in cells treated with various doses of Ang-1 and TNF for 6 hrs was assessed by quantitative RT-PCR. Although ppET-1 RNA was not reduced by Ang-1 under basal conditions, Ang-1 dose-dependently attenuated the ET-1 induction by TNF-
. (Fig. 3
).
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Ang-1 clearly reduced the amount of ET-1 released into the culture medium from cultured human microvascular endothelial cells in a dose-dependent manner. The reduction in both protein and RNA levels indicates that Ang-1 actively downregulates the expression of the ET-1 gene. Moreover, the increase in ET-1 expression induced by the proinflammatory cytokine TNF-
(25) was suppressed by Ang-1, a result that is consistent with an important anti-inflammatory activity.
In a rat model of LPS-induced ARDS, rats were pretreated with the injection of pAng-1transfected fibroblast cells into the pulmonary microcirculation. This cell-based angiopoietin-1 gene therapy restored whole lung Ang-1 RNA expression to levels consistent with controls and resulted in the attenuation of ET-1 expression in the rat lung and lavage fluid. As a result, there was decreased airspace inflammation, as evidenced by a decrease in total cells, neutrophils, and monocytes in bronchoalveolar lavage and by a decrease in the intra-alveolar septal thickness 6 hrs after LPS challenge. These results are in contrast to those of previous reports utilizing the dual ET-1 receptor antagonist bosentan or selective ETB receptor antagonists in animal models of ARDS. While ET-1 receptor antagonists improve pulmonary artery pressure (6) and pulmonary vascular leak (4, 26), the effects on airspace inflammation were not explored in these reports. In addition, it was reported that bosentan and a selective ETB receptor antagonist reduced airspace neutrophil accumulation but increased airspace mononuclear cells, for no net change in total lavage cells (5).
It remains to be determined to what extent the decrease in airspace inflammation induced by Ang-1 cell-based gene therapy was attributable to decreased ET-1 expression or whether the decrease in ET-1 is secondary to reduced lung inflammation by Ang-1. Moreover, the mechanisms by which ET-1 is reduced by Ang-1 remain to be elucidated. The in vitro data showed that Ang-1 directly downregulated endothelial ET-1 expression and release; however, the decrease in ET-1 observed in vivo may also be due to a reduction in leukocyte infiltration, since inflammatory cells are an important source of ET-1. Importantly, ET-1 has been implicated in the pathophysiology of ARDS (27), and both bosentan and ETB receptor antagonists were unable to reduce airspace cell accumulation in ARDS (5). It may be postulated that cell-based gene transfer of Ang-1 provides protection to the lung over and above that obtained by blocking ET-1 alone, or it may be postulated that the reduction in ET-1 expression from cell-based gene transfer of Ang-1 is more effective in countering inflammation than currently available ET-1 receptor antagonists. These questions are being addressed in ongoing studies.
The data presented here are consistent with an important anti-inflammatory role for Ang-1 in both cell culture conditions and in experimental ARDS in vivo, and they indicate that the anti-inflammatory properties of Ang-1 may be attributable to downregulation of ET-1. Importantly, cell-based gene transfer of Ang-1 may provide a novel treatment strategy for ARDS by attenuating vascular inflammation via a reduction in ET-1.
Acknowledgments
The authors would like to thank Drs. QiuWang Zhang and YuPu Deng for their technical assistance, as well as Dr. Gerald A. Proteau for providing PCR primers for the amplification of human ppET-1 sequences.
Footnotes
This work was supported by the Canadian Institutes of Health Research (CIHR, Grant MOP-74752). S.D.M. is supported by the Heart & Stroke Foundation of Canada/Pfizer Canada Fellowship Award and the TACTICS Strategic Training Program in Cardiovascular Research. R.S.S. holds a studentship and travel award from CIHR/Canadian Hypertension Society/Pfizer, as well as a travel award from the Ninth International Conference on Endothelin.
Received for publication October 3, 2005. Accepted for publication December 8, 2005.
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