Potassium channel dysfunction plays a role in the pathogenesis of a number of vascular diseases including pulmonary and systemic hypertension, diabetes, and complications of atherosclerosis. Two types of K+ channels that are known to be prevalent and contribute significantly to the repolarization of vascular smooth muscle cell (SMC) membranes are the high-conductance Ca2+- and voltage-activated K+ (BKCa) channels, and the voltage-gated K+ (KV) channels. Alterations in either BKCa or KV channel function can have dramatic effects on vascular tone. To date, hereditary and congenital mutations in genes encoding K+ channels, abnormalities in transcription, posttranslational modifications, and altered responses to intracellular second messengers have been described as potential mechanisms for several cardiovascular diseases. Comprehensive approaches including genetic, biochemical, molecular biological, and electrophysiological analyses are necessary to identify the levels at which K+ channel expression patterns or function are disrupted. Additionally, reproducing clinical pathologies in animal, organ, and virtual models has been important in studying the discrete mechanisms by which the structure and function of these channels are altered in pathophysiological conditions. This article will describe approaches that are currently used to identify abnormalities in BKCa and KV channels that may exist in diseases involving vascular dysfunction.
Activation of endothelial cells by proinflammatory stimuli results in increased migration of leukocytes across the endothelium, which contributes to the progression of atherosclerosis. Thus, control of the inflammatory status of endothelial cells, which is achieved by a balance of pro- and antiinflammatory signals, is crucial to limiting the disease. The mitogen-activated protein kinases (MAPKs) are a family of central signaling molecules that respond to numerous stimuli by phosphorylating a variety of substrates including transcription factors, enzymes, and other kinases. While the extracellular signal-related kinases (ERK1/2) and big MAPK-1 (BMK1) are primarily involved in growth and cytoprotective functions, Jun amino-terminal kinases (JNK) and p38 proteins play an important role in inflammatory and stress responses. Because they have contradictory roles, the relative activation of these proteins is important to the inflammatory status of the cell. Additionally, there is known to be a crosstalk between MAPK cascades whereby the activity of one MAPK can be influenced by another. Thus, these proteins collectively integrate the pro- and antiinflammatory stimuli acting on the cell to produce the appropriate downstream effects. Here we review the roles of the MAPKs and the implications of MAPK crosstalk on endothelial activation.
(1) Chemokines play a central role in the pathogenesis of atherosclerosis, contributing to leukocyte recruitment, angiogenesis and also proliferation and migration of smooth muscle cells into atherosclerotic plaques. (2) Leukocytes and endothelial cells are an important source of chemokines, and many of the risk factors associated with atherosclerosis increase chemokine expression. There is now a body of evidence to suggest that interactions between cells such as leukocytes and endothelial cells amplify chemokine release, and this may contribute to sustained chemokine generation in inflammatory conditions. (3) This article summarises, briefly, what is currently known about chemokines release. A number of important pharmacological strategies used in the treatment of atherosclerosis inhibit chemokine release and the extent to which this may contribute to their therapeutic effect will be discussed. Understanding the mechanisms controlling chemokine expression is essential for the design of specific therapeutic interventions in atherosclerosis.
Altered function of K+ channels associated with hypertension has been inferred from the effects of K+ channel blockers on contraction of arterial smooth muscle cells (SMCs) and from K+ efflux measurements. Of the classes of K+ channels known to exist in the smooth muscle, the contribution of voltage-gated (KV) and high-conductance, Ca2+ gated K+ (BKCa) channels to the regulation of arterial SMC contractile function has been the most studied in hypertension. The effects of selective and nonselective K+ channel blockers on tonic contraction suggest that these two K+ channel gene families contribute differently to total K+ conductance in arterial SMCs from normal and hypertensive subjects. Direct measurements of K+ channel properties by electrophysiological methods generally support this conclusion. Studies have demonstrated larger BKCa currents in SMCs from several arteries of hypertensive rats, which have been reported to result from a greater Ca2+ sensitivity of BKCa channels and/or from greater protein expression. Some, but not all, studies have shown decreased KV currents in arterial SMCs from hypertensive animals measured under Ca(2+)-replete conditions. However, when external Ca2+ is removed or when Ca2+ influx is inhibited, KV currents are larger in SMCs exposed to chronic hypertension. Gene expression studies of Shaker KV1 transcripts have shown that of the dominant species present in arterial SMCs, KV1.2 expression is higher, whereas KV1.5 is the same in SMCs from hypertensive compared to normal animals. This finding is consistent with the larger KV currents in vascular SMCs from hypertensive animals under low Ca2+ conditions and suggests that Ca2+ influx and/or intracellular Ca2+ per se exerts a greater inhibitory effect on KV currents in the myocytes from these animals. The pathways by which these K+ channel differences are produced during hypertension remain to be elucidated, as does the potential for these channel proteins to be targeted by novel antihypertensive therapies.
Recent studies evidence that peroxynitrite is spontaneously formed when nitric oxide (NO) and superoxide coexist and suggest that it is likely to be involved in the destruction of the pancreatic beta cells. We examined whether drugs that inhibit nitric oxide synthase (NOS) or scavenge peroxynitrite could abrogate STZ-induced hyperglycemia in rats. Blood glucose levels were measured before (0 h) and 24, 48, and 72 h following intraperitoneal administration of 60 mg/kg streptozotocin (STZ). The levels of blood sugar in STZ-treated control animals were significantly elevated at all time points of observation with a peak increase at 48 h. The hyperglycemic response of STZ was found to be significantly reduced in animals pretreated with aminoguanidine (50 mg/kg i.p.), an inducible isoform-selective NOS (iNOS) inhibitor with antioxidant property, and by melatonin (6 mg/kg i.p.), an antioxidant that also prevents peroxynitrite formation but not by Nw-nitro-L-arginine methyl ester (L-NAME, 10 mg/kg i.p.), and 7-nitroindazole (7-NI, 50 mg/kg i.p.), the constitutive inhibitors of endothelial and neuronal NOS, respectively. These findings indicate the possible participation of iNOS-derived NO as well as oxygen free radicals in STZ-induced pancreatic beta cell destruction and compounds that act as scavengers of peroxynitrite may offer protection against such a damage.
The complement system is an important component of innate immunity that contributes to the host defence against bacteria] infections and promotes clearance of immune complexes. Components of this system are synthesized by many cell types including hepatocytes and macrophages and are widely distributed both in the circulation and in the extravascular fluids. Complement activation products released in the fluid phase may interact with endothelial cells on the luminal and abluminal sides and activate these cells to express surface proteins (adhesion molecules, tissue factor) and to release molecules (chemokines) involved in the promotion of the inflammatory and coagulation processes as well as in modication of the vascular tone. Another effect of biologically active complement products on endothelial cells is to remove from the cell surface molecules, which, like heparan sulfate, protect from the formation of trombi. Some of the complement components bind to receptors present on the surface of endothelial cells and this is the case of C1q and C5a. Endothelial cells also interact with the terminal complement complex even in the cytolytically inactive form through a mechanism that has not been completely elucidated. The consequences of the complement-dependent activation of endothelial cells vary from a transient and reversible stimulation to a more persistent activation which may lead to endothelial cell and vascular alterations.
The incidence of erectile dysfunction (ED), defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance, increases with age and with risk factors for vascular disease, including smoking, diabetes and hypertension. Penile erection results from an arousal-induced synthesis of nitric oxide (NO) in nonadrenergic-noncholinergic nerves (NANC), endothelial cells and cavernosal smooth muscle cells (SMCs). Vasodilation and relaxation of cavernosal SMCs engorges the corpora cavernosa with blood at arterial pressure. The subcellular mechanism by which tumescence occurs involves NO-induced activation of soluble guanylate cyclase, increased cyclic guanosine monophosphate (cGMP) levels and activation of cGMP-dependent protein kinase (PKG). PKG phosphorylates numerous ion channels and pumps, each promoting a reduction in cytosolic calcium. In particular, PKG activates high-conductance Ca2+(-)sensitive K+ (BKCa) channels, which hyperpolarize the arterial and cavernosal SMC membranes, causing relaxation. This mechanism appears to be compromised with age and with vascular disease, leading to ED. Thus, increasing cavernosal nitric oxide synthase (NOS) expression, cGMP levels and/or BKCa channel expression is an effective therapy for experimental ED. Future therapies may involve augmenting K+ channel expression by gene transfer or increasing channel function through the use of Type 5 phosphodiesterase (Type 5 PDE) inhibitors or phosphatase inhibitors.
Anorectic drugs are widely used for the treatment of obesity. They are thought to decrease appetite through their effects on catecholamine or 5-hydroxytryptamine (5-HT) levels in the brain. Their use has been associated with epidemics of pulmonary hypertension and the development of valvular heart disease, hypertension, stroke and digital or mesenteric ischemia. Understanding the mechanism of the cardiovascular toxicity of anorectic drugs is important because of the modern epidemic of obesity and the resulting plethora of new anorexigens, many of which share similar mechanisms with those that have previously caused cardiovascular disease. In addition, the mechanism by which anorexigens cause vascular disease has relevance to the etiology and treatment of pulmonary and systemic hypertension. Recent discoveries have clarified how the anorexigens cause vasoconstriction and hypertension. Most anorexigens directly inhibit voltage-gated K+ (KV) channels in vascular smooth muscle cells (SMCs). This reduced K+ efflux leads to depolarization, the opening of voltage-sensitive Ca2+ channels, an increase in intracellular Ca2+ and vasoconstriction. Endothelial dysfunction appears to be a predisposing factor for the development of anorectic-induced vascular complications. Vasoconstriction is weak at clinically relevant doses of anorectic drugs. However, when nitric oxide synthase is inhibited, vasoconstriction is significantly enhanced. Anorexigens are the only drugs in widespread clinical use that have KV-channel-blocking properties and it is probable that much of their cardiovascular toxicity relates to this mechanism. Investigators need to examine new anorexigens and other therapeutic molecules for inhibitory effects on KV channels, as this effect may be a marker of drugs that will elicit vascular complications.
The endothelium synthesizes and releases nitric oxide (NO) to maintain homeostatic function. Under basal conditions, endothelium-derived NO maintains a nonthrombogenic surface, prohibits leukocyte attachment, and promotes vascular relaxation. In the setting of clinical syndromes associated with the development of atherothrombosis, there is decreased bioavailable NO owing to diminished synthesis and release in addition to increased generation of reactive oxygen species. These biochemical changes perturb significantly vascular homeostatic mechanisms and promote platelet aggregation, inflammatory cell diapedesis, and vasoconstriction. Endothelial dysfunction may be evaluated using invasive and/or noninvasive techniques, including coronary artery reactivity to acetylcholine and brachial artery ultrasonography, respectively. NO replacement therapies may be initiated to restore deficits associated with dysfunctional endothelium. Strategies to replenish bioavailable NO include the administration of organic nitrosovasodilators or NO donor compounds, therapies to improve NO synthase function, and gene therapy.
Experiments on hypercholesterolemic rabbits and hamsters (HH) showed that hyperlipemia induces initial activation of endothelial cells (EC) expressed by modulation of constitutive functions: increased transcytosis of low-density lipoproteins (LDL) and enhanced synthesis of basal lamina. Accumulated LDL appears in the meshes of basal lamina as modified and reassembled lipoproteins (MRL) that, together with hyperlipemia, triggers EC dysfunction. This induces monocyte recruitment, adhesion, diapedesis and residence within the subendothelium where upon activation become macrophages, take up MRL and turn into foam cells. With time, EC overlaying atheroma alter their nonthrombogenic surface and become loaded with lipid droplets, resulting as marks of EC injury. Simvastatin administration to HH increased the antioxidant potential of the serum, diminished transcytosis of lipoproteins (Lp) and restored the endothelium-dependent relaxation.
Enhanced oxidative stress, particularly an excess production of superoxide, has been implicated in the altered vasomotor responsiveness observed in diabetes mellitus (DM). Recent evidence suggests that an altered regulation of K+ channel activity by enhanced oxidative stress may participate in the abnormal vascular responses. This review examines the mechanism of hyperglycemia-induced superoxide production and describes the consequences on hyperpolarization-mediated vasodilation. Several pathways have been proposed as mechanisms for hyperglycemia-induced superoxide overproduction, including increased flux through the polyol pathway, depletion of nicotinamide adenine dinucleotide phosphate (NADPH), altered endogenous antioxidant enzymes, and reduced availability of tetrahydrobiopterin, an essential cofactor for nitric oxide synthase (NOS). The resulting excess production of superoxide has been implicated in the impaired dilator responses to ATP-sensitive K+ (KATP) channel openers in aorta and in mesenteric and cerebral arteries of streptozotocin-induced diabetic rats. This may have important implications for ischemia-mediated vasodilation. Potential alterations in voltage-sensitive K+ (KV) channel regulation also have been implicated in the vascular pathogenesis of DM. For example, incubation of small rat coronary arteries in high glucose for 24 h greatly reduces KV channel activity and functional responses, both of which can be partially restored by antioxidant treatment. However, not all K+ channels are adversely affected by reactive oxygen species (ROS). For example, high-conductance Ca2+-activated K+ (BKCa) channels may compensate for the loss of other vasodilator mechanisms in disease states such as atherosclerosis where ROS generation is increased. Therefore, BKCa channels may be refractory to superoxide, providing a compensatory mechanism for partially reversing the reduced dilator responses attributed to the dysfunction of other K+ channel types. In summary, determining the effect of ROS on K+ channel-mediated dilation will be important for understanding the pathophysiology of diabetic vascular dysfunction and for developing therapies to improve tissue perfusion in this disease.
Hyperhomocysteinemia (hH(e)) in the general population is associated with incidence and progression of arterial occlusive disease, although the underlying mechanisms are not well defined. Current research supports a role for homocysteine (H(e))-mediated endothelial damage and endothelial dysfunction. This mechanism appears to be a key factor in subsequent impaired endothelial-dependent vasoreactivity and decreased endothelium thromboresistance. These consequences may predispose hyperhomocysteinemic vessels to the development of increased atherogenesis. Additional mechanisms of H(e)-mediated vascular pathology, including protein homocysteinylation and vascular smooth muscle cell proliferation may also play a role. Continued investigation into the mechanisms contributing to H(e) toxicity will provide further insight into the processes by which hH(e) may increase atherosclerosis.
The effects of moricizine on Na+ channel currents (INa) were investigated in guinea-pig atrial myocytes and its effects on INa in ventricular myocytes and on cloned hH1 current were compared using the whole-cell, patch-clamp technique. Moricizine induced the tonic block of INa with the apparent dissociation constant (Kd,app) of 6.3 microM at -100 mV and 99.3 microM at -140 mV. Moricizine at 30 microM shifted the h infinity curve to the hyperpolarizing direction by 8.6 +/- 2.4 mV. Moricizine also produced the phasic block of INa, which was enhanced with the increase in the duration of train pulses, and was more prominent with a holding potential (HP) of -100 mV than with an HP of -140 mV. The onset block of INa induced by moricizine during depolarization to -20 mV was continuously increased with increasing the pulse duration, and was enhanced at the less negative HP. The slower component of recovery of the moricizine-induced INa block was relatively slow, with a time constant of 4.2 +/- 2.0 s at -100 mV and 3.0 +/- 1.2 s at -140 mV. Since moricizine induced the tonic block of ventricular INa with Kd,app of 3.1 +/- 0.8 microM at HP = -100 mV and 30.2 +/- 6.8 microM at HP = -140 mV, and cloned hH1 with Kd,app of 3.0 +/- 0.5 microM at HP = -100 mV and 22.0 +/- 3.2 microM at HP = -140 mV, respectively, either ventricular INa or cloned hH1 had significantly higher sensitivity to moricizine than atrial INa. The h infinity curve of ventricular INa was shifted by 10.5 +/- 3.5 mV by 3 microM moricizine and that of hH1 was shifted by 5.0 +/- 2.3 mV by 30 microM moricizine. From the modulated receptor theory, we have estimated the dissociation constants for the resting and inactivated state to be 99.3 and 1.2 microM in atrial myocytes, 30 and 0.17 microM in ventricular myocytes, and 22 and 0.2 microM in cloned hH1, respectively. We conclude that moricizine has a higher affinity for the inactivated Na+ channel than for the resting state channel in atrial myocytes, and moricizine showed the significant atrioventricular difference of moricizine block on INa. Moricizine would exert an antiarrhythmic action on atrial myocytes, as well as on ventricular myocytes, by blocking Na+ channels with a high affinity to the inactivated state and a slow dissociation kinetics.
An important factor in the development of vascular wall alterations is degradation of the elastic fiber major protein–elastin. Elastin peptides derived from this degradation are present in the circulating blood and they are a stimulus for increased production of anti-elastin antibodies (AEAb). The aim of the present study was to examine the possible association between serum elastin AEAb and the development of diabetic vascular complications. Levels of AEAb (IgG, IgM and IgA) were determined by ELISA in sera of 28 children with Type 1 (insulin-dependent) diabetes mellitus (mean age 11.6±2.8 years, diabetes duration 5.1±2.5 years). None of the children had clinical or laboratory evidence of vascular complications. The children were followed over a period of 7 years, and 24 healthy children of similar age and sex served as a control group. During the study, four diabetics developed retinopathy, six microalbuminuria and two both retinopathy and microalbuminuria. Anti-elastin IgG showed correlation with diabetes duration (r=.48, P=.0007), HbA1c (r=.28, P=.05), triglycerides (r=.28, P=.05) and antibodies to advanced glycation endproducts (AGE) (r=.41, P=.005). Anti-elastin IgM correlated with HbA1c (r=.26, P=.038) and IgA with retinopathy (r=.32, P=.017). Our results suggest an association between the level of anti-elastin IgA antibodies and the development of diabetic retinopathy.
The alpha-thrombin peptide, TP508, accelerates the healing of full-thickness wounds in both normal and ischemic skin. In wounds treated with TP508, a pattern of increased vascularization is consistently observed both grossly and microscopically when compared to wounds treated with saline. One possible mechanism by which the peptide accelerates wound healing is by promoting revascularization of granulation tissue at the injured site. To evaluate the angiogenic potential of TP508, the peptide was tested in the chick embryo chorioallantoic membrane (CAM), where it increased the density and size of CAM blood vessels relative to controls. Additionally, TP508 stimulated chemokinesis and chemotaxis in a dose-dependent fashion in cultured human aortic and human microvascular endothelial cells. Taken together, these in vivo and in vitro data support an angiogenic role for TP508 in wound healing. A working model is presented to explain how this 23-amino-acid peptide, which lacks proteolytic activity, is generated during wound healing and contributes to the nonproteolytic functions associated with alpha-thrombin during tissue repair.
