Adrenomedullin expression and growth inhibitory effects in distinct pulmonary artery smooth muscle cell subpopulations

The vasodilator peptide adrenomedullin is elevated in patients with pulmonary hypertension and has been implicated in the inhibition of vascular remodeling. We questioned whether adrenomedullin is released by human pulmonary artery smooth muscle cells (PASMCs) and inhibits PASMC growth and release of endothelin, a known smooth muscle cell mitogen. The majority of PASMCs isolated from proximal pulmonary arteries and all PASMCs from distal pulmonary arteries released adrenomedullin, although at differing rates (mean, 177 +/- 28 and 62 +/- 11 fmol/10(5) cells/24 h, respectively). These cells were designated ADM+. However, some proximal PASMC isolates did not release adrenomedullin, designated ADM-. Northern blot analysis confirmed adrenomedullin expression in proximal ADM+ but not ADM- isolates. ADM- and distal ADM+ PASMCs proliferated faster in serum than did proximal ADM+ cells. Adrenomedullin potently and dose-dependently (mean EC(50) = 2.2 +/- 0.5 nM) increased intracellular cyclic adenosine monophosphate (cAMP) in ADM- isolates via specific adrenomedullin receptors. In contrast, both adrenomedullin and calcitonin gene-related peptide modestly elevated cAMP in 50% of ADM+ isolates. Adrenomedullin dose-dependently inhibited platelet-derived growth factor-stimulated [3H]thymidine incorporation and endothelin release in ADM- cells but did not affect [3H]thymidine uptake in ADM+ isolates. We conclude that distinct subpopulations of human PASMCs release and respond to adrenomedullin. The heterogeneity of adrenomedullin release and the inhibition of PASMC DNA synthesis and endothelin release suggest that adrenomedullin may function as a paracrine mediator in the inhibition of pulmonary vascular remodeling.     

缺氧内皮细胞培养液对肺动脉平滑肌细胞表型的影响

用细胞培养和形态定量分析方法观察缺氧对肺动脉平滑肌细胞表型的影响。结果显示，缺氧性内皮细胞条件培养液组肺动脉平滑肌细胞的二倍体细胞和α－ｓｍ－ａｃｔｉｎ含量均少于常氧性内皮细胞条件培养液组（Ｐ＜０．０５），尤以肌丝成份减少最明显；粗面内质网和线粒体却显著增多。而直接缺氧组与常氧组无明显差异。提示：缺氧可促使内皮细胞产生和释放某种促平滑肌细胞表型转化的物质或因子，从而改变了肺动脉管壁细胞之间的正常调控关系，导致平滑肌细胞肥大，合成细胞外基质增多。     

HMGB1 enhances smooth muscle cell proliferation and migration in pulmonary artery remodeling

HMGB1 is a necessary and critical mediator of acute lung injury and can act as a chemoattractant and anti-apoptosis factor in injury or repair in diseases. In this study we sought to determine whether HMGB1 is involved in the remodeling of pulmonary artery and investigate the mechanism. A rat model of pulmonary artery remodeling was successful induced with LPS infusion and the increasing of pulmonary arteries media was obviously inhibited in rats treated with thrice inject of HMGB1 neutralizing antibody. The percent of areas of tunica media to total artery wall was (0.53±0.15), (0.81±0.10) and (0.59±0.11) in control, LPS and antibody group respectively (p<0.05). Meanwhile, treatment with HMGB1 neutralizing antibody not only decreased the level of HMGB1 mRNA and protein significantly, but inhibited the expression of PCAN and Bcl-2 as well. On the contrary, Bax, a gen which represented the apoptosis, revealed an absolutely reversed trend to Bcl-2 in pulmonary arteries. Experiments in vitro showed that HMGB1 could stimulate the proliferation of hPASMC in MTT test and increase the number of migrated cells in a concentration-dependent manner in chemotaxis assay using modified Boyden chambers. In conclusion, data from this study support the concept that HMGB1 is involved in the remodeling of pulmonary artery by enhancing proliferation and migration of smooth muscle cell. Inhibiting HMGB1 may be a new target to deal with the remodeling of pulmonary artery.     

牛磺酸抗缺氧及防治肺动脉高压的研究及其细胞机制初探

目的通过动物模型观察牛磺酸对缺氧性肺动脉高压的治疗作用,同时观察其对体外培养牛肺动脉平滑肌细胞(PASMC)和内皮细胞(PAEC)增殖的影响。方法采用模拟高原5 000 m制作缺氧大鼠模型,缺氧2周。设平原(C组)及缺氧对照组(H组),观察牛磺酸治疗后(T组)的肺动脉压(mPAP)、血浆乳酸脱氢酶(LDH)活性、脂质过氧化产物丙二醛(MDA)、肺匀浆一氧化氮(NO)含量、右心室肥大指数的变化。体外培养PASMC和PAEC用3H-TdR掺入法比较牛磺酸对缺氧PASMC和PAEC增殖的影响。结果H组大鼠LDH活性升高为C的10.1倍(P<0.01);肺匀浆NO含量降低为C组的32%(P<0.01);血浆MDA含量显著升高为C组的1.64倍(P<0.01);mPAP显著增高,约为C组的2.74倍(P<0.01);右心室肥大指数是C组的1.56倍(P<0.01)。T组与H组相比较:LDH活性、血浆MDA、右心室肥大指数均显著降低(P<0.01);mPAP显著降低(P<0.05)。高浓度(10～20 mmol/L)的牛磺酸抑制缺氧内皮及平滑肌细胞的3H-TdR掺入,而低浓度的牛磺酸促进缺氧时PAEC的3H-TdR掺入(P<0.05),抑制缺氧时PASMC的3H-TdR掺入(P<0.05)。结论牛磺酸有抗缺氧及防治肺动脉高压的作用。缺氧抑制内皮细胞的增殖而促进平滑肌细胞的增殖,适当剂量的牛磺酸可以对抗缺氧对PAEC和PASMs的作用:减弱缺氧对PAEC的增殖抑制作用,抑制缺氧的促PASMC增殖作用,使之接近常氧水平。这可能是牛磺酸防治肺动脉高压的细胞机制。提示牛横酸对于高山病缺氧性肺血管收缩和血管结构改建的预防和治疗,可能具有广阔的应用前景。     

Hypoxia stimulates the release by bovine pulmonary artery endothelial cells of an inhibitor of pulmonary artery smooth muscle cell growth

The proliferation of smooth muscle cells (SMC) seen in hypoxic pulmonary hypertension is a poorly understood phenomenon but may involve endothelial cell (EC)-SMC interaction. Using bovine pulmonary artery cells, we examined the effect of O2 tension and the role of EC or media conditioned by EC (ECCM) on SMC proliferation. We found no difference in SMC proliferation under 3%, 10%, and 20% O2. EC, co-cultured with SMC in 3% O2, inhibited SMC proliferation consistently by about 40% (versus SMC exposed to hypoxia but not to EC). In normoxia, the degree of inhibition was dependent on EC:SMC ratio. In separate experiments, media from EC exposed to 3% or 20% O2 had a mitogenic activity of 24% and 42%, respectively (compared to 100% mitogenic activity with 5% FCS), on serum-deprived SMC. On the other hand, when SMC were stimulated to grow with FCS, an inhibitory activity (IA) from ECCM on SMC proliferation was observed and was significantly greater in hypoxic versus normoxic ECCM (40% versus 21%, respectively). Amicon concentration showed that the IA was contained in the less than 10 kD fraction of ECCM. Preliminary characterization of this IA indicates that it is unlike any of the known inhibitors of SMC growth, such as lactic acid, prostaglandin derivatives, or heparan sulfate. We conclude that hypoxia causes pulmonary artery EC to release a unique inhibitor of SMC growth.     

低氧对肺动脉平滑肌和内皮细胞蛋白激酶C α mRNA表达的影响

目的：探讨低氧对肺动脉平滑肌和内皮细胞蛋白激酶C(PKC)αmRNA表达的影响。方法：应用原位杂交技术了大鼠不同节段肺动脉平滑肌细胞和内皮细胞PKCαmRNA的分布及低氧对在体和离体肺动脉平滑肌细胞及内皮细胞PKCαmRNA表达的影响。结果：正常大鼠各级肺动脉平滑肌细胞和内皮细胞均有PKCαmRNA的表达,腺泡内肺动脉平滑肌细胞中的表达明显高于肌型肺动脉（P＜0．01）,低氧14d和28d肌型动脉和腺泡内肺动脉内皮细胞的表达均明显增高（P＜0．01）,腺泡内腺动脉平滑肌细胞的表达较对照组明显升高（P＜0．01）,低氧14d肌型肺动脉平滑肌细胞表达升高不明显,但低氧28d明显升高（P＜01）,正常条件下离体培养猪肺动脉平滑肌细胞和内皮细胞均有PKCαmRNA的表达,低氧1h对其表达无明显影响,48,72h表达明显升高,以72h升高最显著（P＜0．001）,结论：低氧可促进肺动脉平滑肌细胞和内皮细胞PKC amRNA 的表达,而以腺泡内肺动脉平滑肌细胞的变化最明显,PCKα在低氧性肺动脉高压的形成中可能起一定作用。     

肺微动脉内皮细胞对肺动脉张力的调节作用

本文研究体外培养的兔肺微动脉内皮细胞对肺动脉张力的调节作用。常氧和缺氧培养24小时后的肺微动脉内皮细胞条件培养液均不能收缩肺动脉条,用乙醚提取后的水相则能引起肺动脉肌条发生明显收缩反应,常氧和缺氧培养组间无明显差异,水相加热后,常氧和缺氧培养组的内皮细胞条件培养液对肺动脉肌条的收缩作用明显下降,但缺氧培养组的收缩幅度明显高于常氧培养组,用胰蛋白酶处理后,各组的收缩活性均消失。用消炎痛、巯甲丙脯酸处理缺氧组的内皮细胞或向收缩反应池内加入FPL55712、BN52021、扑尔敏、哌唑嗪对条件培养液的收缩活性无明显影响。结果提示:在培养的兔肺微动脉内皮细胞产生的长半衰期血管活性物质中,脂溶性物质可能舒张肺动脉,缺氧不影响此物质的产生,水溶性物质包括不耐热的和耐热的,均能收缩肺动脉,前者在缺氧时产生减少,后者可能是一种肽类,缺氧使之产生增加。     

Inhibition of pulmonary artery smooth muscle cell growth by hypoxanthine, xanthine, and uric acid.

We have previously reported that medium conditioned by hypoxic pulmonary artery endothelial cells (ECCM) contains a factor of small molecular weight that inhibits the growth of pulmonary artery smooth muscle cells (SMC). We postulated that this factor might be a breakdown product of ATP and, therefore, measured the levels of hypoxanthine/xanthine (HX/X) and uric acid (UA) in ECCM and cell lysates from endothelial cells (EC) exposed to hypoxia and normoxia. Although hypoxic and normoxic cell lysates contained no UA and an equal amount of HX/X (2.9 +/- 0.3 and 2.9 +/- 0.5 microM, respectively), there was a 5-fold increase in the amount of HX/X present in hypoxic compared with normoxic ECCM (3.4 +/- 0.3 versus 0.6 +/- 0.4 microM, respectively; P less than 0.001) but no difference in UA levels (5 +/- 2 versus 5 +/- 1 microM, respectively). In separate experiments, we examined the effects of exogenous HX, X, and UA (doses ranging from 0.1 to 100 microM) on the proliferation of pulmonary and aortic SMC and pulmonary artery EC. Our results indicate that HX, X, and UA inhibit the proliferation of SMC in a dose-dependent manner without causing injury to the cells. The proliferation of EC, on the other hand, was not affected by UA and was significantly inhibited by HX and X only at doses of 100 microM. In conclusion, we have found that significant amounts of HX/X accumulate in hypoxic ECCM and that HX, X, and UA inhibit the proliferation of SMC. The relevance of these findings to conditions where hypoxia prevails is discussed.     

Generation of neutrophil chemotactic activity by phorbol ester-stimulated calf pulmonary artery endothelial cells

Chemotactic activity for human polymorphonuclear leukocytes (PMNL) was detected in serum-free conditioned media 1 to 4 hr after monolayers of calf pulmonary artery endothelial cells were pretreated with phorbol myristate acetate (PMA). Chemotactic activity was increased in conditioned media following pretreatment with either PMA or the less lipophilic active phorbol ester, 4-beta-phorbol-12,13-dibutyrate (P(Bu)2) in a dose-dependent manner. Chemotactic activity of conditioned media from PMA-treated endothelial cells was confirmed by checkerboard analysis. The chemotactic activity in conditioned media from PMA-pretreated endothelial cells was completely inhibited by pretreating endothelial cells with either cycloheximide, actinomycin D, or the lipooxygenase inhibitor, diethylcarbamazine. Furthermore, the chemotactic activity was heat-stable, inhibited by trypsin treatment, and present in both aqueous and lipid phases after ether extraction. The data demonstrate that pulmonary artery endothelial cells exposed to active phorbol esters release potent chemotactic factor(s) for PMNL. These findings suggest a role for activators of protein kinase C in mediating endothelial cell release of chemotactic factor(s) that may be important in the directed migration of circulating leukocytes to sites of vascular injury.     

Heterotrimeric G proteins and the platelet-derived growth factor receptor-beta contribute to hypoxic proliferation of smooth muscle cells

Hypoxic proliferation of pulmonary arterial smooth muscle cells (PASMC) is mitogen dependent, but the signaling pathways mediating hypoxia-induced cell growth are not well understood. We investigated hypoxic proliferation in primary cultures from porcine pulmonary artery smooth muscle. The cells were grown in medium with or without platelet-derived growth factor (PDGF)-B, a potent smooth muscle cell mitogen. Hypoxia induced upregulation of PDGF receptor-beta expression, the primary receptor for PDGF-B. However, PDGF-B-mediated hypoxic enhancement of proliferation was abolished by pertussis toxin, indicating (1) involvement of heterotrimeric Galpha i proteins and (2) minimal effect of increased PDGF receptor expression in hypoxic enhancement of proliferation. We treated PASMC with labeled, nonhydrolyzable analogs of GTP to determine directly if GTP binding proteins were activated by hypoxia in PASMC. We show that hypoxia stimulates GTP incorporation in PASMC both in the presence and absence of PDGF-B. Serum-starved PASMC are able to increase their incorporation of GTP after only 10 min of hypoxia, and this response is not pertussis toxin sensitive. In serum-starved PASMC, we show that hypoxia stimulates incorporation of GTP into a 44-kD protein. The results show that heterotrimeric G proteins are involved in hypoxia-induced signaling in pulmonary vascular smooth muscle cells.     

连代低氧培养肺动脉平滑肌及内皮细胞的急性低氧反应中环核苷酸的作用

目的:探讨环核苷酸在慢性低氧动物的低氧性肺血管收缩反应(HPV)弱化机制中的作用。方法:用RIA法测定连代常氧与连代低氧培养猪肺动脉平滑肌细胞(PASMC)和内皮细胞(PAEC)的cAMP和cGMP及其在急性低氧时的变化;用图像分析系统检测常氧与低氧培养PASMC在急性低氧时的收缩程度。结果:低氧组PASMC的cAMP、cGMP和PAEC的cGMP基础值较常氧组低(P＜0.01)。急性低氧状态下,低氧组PASMC的cAMP、cGMP含量升高(P＜0.01);低氧组弱收缩反应PASMC的百分率明显高于常氧组。结论:慢性低氧PASMC和PAEC的cAMP、cGMP基础值下降可能与慢性低氧动物肺动脉基础张力增高有关;慢性低氧PASMC在急性低氧反应时cAMP、cGMP含量升高可能是慢性低氧机体HPV弱化的机制之一。     

慢性低氧对肺动脉内皮及平滑肌细胞急性低氧时胞浆游离钙变化的影响

目的和方法:以Fura-2/AM荧光指示剂负载,检测常氧(PO2213kPa)及慢性低氧[PO2(53±07)kPa]培养的大鼠肺内动脉平滑肌细胞及猪肺动脉内皮细胞胞浆游离钙的水平及其对急性低氧刺激反应的变化。结果:慢性低氧条件培养的第6代肺内动脉平滑肌细胞在急性低氧时[Ca²⁺]_i升高的程度明显降低(P<0.05);而慢性低氧条件培养的第5代肺动脉内皮细胞对急性低氧引起的[Ca²⁺]_i升高程度明显增加(P<0.05)。结论:慢性低氧可以减弱肺内动脉平滑肌细胞对急性低氧所致[Ca²⁺]_i升高的反应而增强肺动脉内皮细胞低氧性[Ca²⁺]_i升高的反应。这可能在慢性低氧时肺血管对低氧的反应性降低中起重要作用。     

Low-dose fluvastatin reverses the hypoxic pulmonary adventitial fibroblast phenotype in experimental pulmonary hypertension

Hypoxic pulmonary hypertension is a worldwide public health problem. Statins attenuate hypoxic pulmonary hypertension in animal models, but the mechanism of action and applicability of these results to human treatment are not established. In hypoxic models, pulmonary artery fibroblast proliferation contributes substantially to pulmonary vascular remodeling. We previously showed that acute hypoxic pulmonary adventitial fibroblast proliferation can be selectively inhibited by statins and p38 mitogen-activated protein (MAP) kinase inhibitors. Here we used complementary chronic hypoxic and acute hypoxic coculture models to obtain necessary preclinical information regarding the utility of fluvastatin in the treatment of chronic hypoxic pulmonary hypertension. The effects of fluvastatin, cholesterol pathway intermediates, and related inhibitors on hypoxic adventitial fibroblast proliferation, p38 MAP kinase phosphorylation, and pulmonary artery smooth muscle cell proliferation were determined, using complementary chronic hypoxic rat and acute hypoxic bovine cell models. Fluvastatin reversed the proliferative phenotypic switch in adventitial fibroblasts from chronic hypoxic animals. This effect was circulation-specific, and implicated a Rac1-p38 MAP kinase signaling pathway. Coculture and conditioned media experiments also implicated this statin-sensitive signaling pathway in the release of pulmonary artery smooth muscle cell mitogens by hypoxic pulmonary adventitial fibroblasts. Treprostinil, sildenafil, and bosentan exerted no effect on the hypoxic fibroblast phenotype. Phenotypic changes (increased proliferation and mitogen release) in pulmonary artery fibroblasts during chronic hypoxia are dependent on a Rac1-p38 MAP kinase signaling pathway. The inhibition of these phenotypic changes with fluvastatin may be therapeutically relevant in high-altitude residents and in patients with hypoxic lung disease.     

一氧化氮诱导大鼠肺动脉平滑肌细胞凋亡机制研究

目的:研究一氧化氮(NO)诱导大鼠肺动脉平滑肌细胞(PASMC)凋亡的作用机制。方法:体外培养Wistar大鼠PASMC,加入NO供体硝普钠(SNP)于常氧和低氧条件下孵育12h或24h,通过流式细胞术碘化丙啶染色法观察PASMC细胞周期时段及凋亡亚二倍体峰变化,应用细胞免疫化学法检测PASMCcaspase-3和NF-κB的表达,同时行DNA断裂琼脂糖凝胶电泳。结果:SNP作用后PASMC出现剂量-依赖性促凋亡作用(P＜0.01),表现为凋亡指数与caspase-3表达的不同程度的增强。随凋亡的进展,出现PASMC凋亡核小体DNAladder,同时PASMCNF-κB阳性核表达较对照组少(P＜0.01)。结论:外源性NO诱导大鼠PASMC凋亡,caspase-3与NF-κB可能涉及PASMC凋亡的调控信号途径。     

Iptakalim, a novel ATP-sensitive potassium channel opener, inhibits pulmonary arterial smooth muscle cell proliferation by downregulation of PKC-α

Iptakalim is a new ATP-sensitive potassium (K ATP ) channel opener, and it inhibits the proliferation of pulmonary arterial smooth muscle cells (PASMCs) and pulmonary vascular remodeling. However, the underlying mechanism remains unclear. In the present study, we found that iptakalim significantly decreased pulmonary artery pressure, inhibited pulmonary ariery remodeling and PKC-α overexpression in chronic hypoxia in a rat pulmonary hypertension model. Iptakalim reduced hypoxia-induced expression of PKC-α, and abolished the effect of hypoxia on PASMC proliferation significantly in a dose-dependent manner in vitro. Moreover, these effects were abolished by glibenclamide, a selective K ATP channel antagonist. These results indicate that iptakalim inhibits PASMC proliferation and pulmonary vascular remodeling induced by hypoxia through downregulating the expression of PKC-α. Iptakalim can serve as a novel promising treatment for hypoxic pulmonary hypertension.     

低氧诱导因子1在低氧致肺动脉平滑肌细胞增殖中的作用

目的: 探讨低氧对肺动脉平滑肌细胞(PASMC)增殖和凋亡的影响,以及HIF-1α、P-ERK1/2、iNOS蛋白表达变化在其中的作用与意义。方法: 体外培养大鼠PASMC，设计常氧组、低氧组及ADM、L-NAME、PD98059干预组，用MTT比色法和PCNA的免疫组化法测定细胞增殖反应，用流式细胞仪检测细胞凋亡，用Western blotting法检测HIF-1α、P-ERK1/2、iNOS的蛋白表达。结果: （1）低氧24 h组的A值明显高于常氧组(P<0.01)，而PD98059及ADM干预组明显低于低氧组(P<0.01)， L-NAME干预组明显高于低氧组和常氧组(P<0.01)。（2）免疫组化表明，低氧24 h组呈阳性表达(P<0.01)。PD98059、ADM抑制了PCNA的表达(P<0.01)， L-NAME促进了PCNA的表达(P<0.01)。（3）各组在低氧培养24 h后，凋亡指数差异无显著(均P＞0.05)。（4）Western blotting表明常氧组少量HIF-1α、iNOS、 P-ERK1/2表达，低氧4 h后均表达增高(P<0.01),8 h仍维持在高峰(P<0.01)，而HIF-1α、P-ERK1/2在低氧24 h后表达下调。L-NAME促进了HIF-1α表达(P<0.01),PD98059部分抑制了HIF-1α、iNOS及P-ERK1/2表达(P<0.01)；ADM部分抑制了HIF-1α表达，促进iNOS表达(P<0.01)。结论: 低氧能促进肺动脉平滑肌细胞增殖，对细胞的凋亡无影响；HIF-1在低氧诱导肺动脉平滑肌细胞增殖中起重要作用。     

Kv1.2、Kv1.5、Kv2.1钾通道在缺氧性肺血管收缩中的作用

目的和方法:雄性Wistar大鼠随机分为两组:常氧对照组和低氧组。用酶消化的方法获得单个大鼠肺内动脉平滑肌细胞(PASMC)。采用全细胞膜片钳技术,记录PASMC静息膜电位(Em)和电压门控性钾通道电流(IKv),通过细胞内灌流Kv1.2/Kv1.5/Kv2.1抗体混合液(1∶125),探讨Kv1.2、Kv1.5、Kv2.1钾通道在缺氧性肺血管收缩(HPV)中的作用。结果:①低氧组膜电位明显去极化,由(-51.8±0.8) mV 去极到(-47.2± 0.7) mV,P<0.01,IKv与常氧组相比显著降低,在测试电压-30 mV时, IKv由(6.16±0.58) pA/pF 降为 (3.31±0.37) pA/pF (P<0.01)。②细胞内灌流Kv1.2/Kv1.5/Kv2.1抗体混合液可显著抑制常氧对照组PASMC 的IKv,使Em去极化,然而细胞内灌流Kir2.1/Kir2.3/Kir4.1(1∶125)抗体混合液对常氧对照组PASMC 的IKv和Em无显著影响。③细胞内灌流Kv1.2/Kv1.5/Kv2.1抗体混合液和Kir2.1/Kir2.3/Kir4.1抗体混合液对低氧组PASMC的IKv和Em均无显著影响。结论:Kv1.2、Kv1.5、Kv2.1可能是氧敏感型通道,并介导了低氧性肺血管收缩。     

周期性机械牵张对人肺泡上皮细胞穿透素-3表达的影响

目的探讨人肺泡上皮细胞穿透素-3(PTX3)在呼吸机相关性肺损伤中的可能作用。方法应用FX4000T细胞应变加载系统,对体外培养的人肺泡上皮细胞A549周期性施加20%应变,频率为0.3Hz,加载时间为1、2、4、6h,然后采用实时定量RT-PCR检测肺泡上皮细胞PTX3表达的变化、Western blot检测分泌到培养液上清PTX3蛋白,同时检测细胞活性。结果(1)周期性牵张诱导肺泡上皮细胞表达PTX3;(2)牵张引起肺泡上皮细胞的凋亡;(3)PTX3的水平与肺泡上皮细胞的凋亡水平显著相关。结论本研究提示PTX3在呼吸机相关性肺损伤的发病机制中可能起重要的作用。