Both 17β-estradiol (E 2 ) and fibroblast growth factor-2 (FGF2) stimulate angiogenesis and endothelial cell migration and proliferation. The first goal of this study was to explore the potential link between this hormone and this growth factor. E 2 -stimulated angiogenesis in SC Matrigel plugs in Fgf2 +/+ mice, but not in Fgf2 −/− mice. Cell cultures from subcutaneous Matrigel plugs demonstrated that E 2 increased both migration and proliferation in endothelial cells from Fgf2 +/+ mice, but not from in Fgf2 −/− mice. Several isoforms of fibroblast growth factor-2 (FGF2) are expressed: the low molecular weight 18-kDa protein (FGF2 lmw ) is secreted and activates tyrosine kinase receptors (FGFRs), whereas the high molecular weight (21 and 22 kDa) isoforms (FGF2 hmw ) remains intranuclear, but their role is mainly unknown. The second goal of this study was to explore the respective roles of FGF2 isoforms in the effects of E 2 . We thus generated mice deficient only in the FGF2 lmw ( Fgf2 lmw−/− ). E 2 stimulated in vivo angiogenesis and in vitro migration in endothelial cells from Fgf2 lmw−/− as it did in Fgf2 +/+ mice. E 2 increased FGF2 hmw protein abundance in endothelial cell cultures from Fgf2 +/+ and Fgf2 lmw−/− mice. As shown using siRNA transfection, these effects were FGFR independent but involved FGF2-Interacting Factor, an intracellular FGF2 hmw partner. This is the first report for a physiological role for the intracellular FGF2 hmw found to mediate the effect of E 2 on endothelial cell migration via an intracrine action.

: Tuesday, June 15, 2004: POSTER SESSIONS: Poster Session 27: Vasoactive Substances and Neurohormones

Hormonal replacement therapy does not prevent cardiovascular events in postmenopausal women. In contrast, the incidence of cardiovascular diseases is higher in men than in premenopausal women but increases in postmenopausal women, and all animal studies demonstrate a prevention of fatty streak deposit by estradiol. Although estradiol improves the lipoprotein profile, this effect can account for only a minor part of the protective effect. Endothelium appears to be an important target for estradiol, because this hormone potentiates endothelial nitric oxide (NO) production, thus promoting the beneficial effects of NO, such as vasorelaxation and inhibition of platelet aggregation. Estradiol accelerates endothelial regrowth, thus favoring vascular healing, and prevents apoptosis of endothelial cells. Estradiol prevents fatty streak deposit through a mechanism which is clearly independent of NO. The immuno-inflammatory system appears to play a key role in the development of fatty streak deposit as well as in atherosclerotic plaque rupture. Mice deficient either in monocyte-macrophages or in lymphocytes are partially protected against fatty streak deposit. Interestingly, the atheroprotective effect of estradiol is absent in mice deficient in T and B lymphocytes. Most of these effects of estradiol are mediated by estrogen receptor alpha, and are independent of estrogen receptor beta. Thus, the inflammatory-immune system appears to be also a major target of estrogens. However, the effects of estrogens on the immuno-inflammatory system appear ambiguous, as in some models, estradiol rather promotes inflammation (by increasing interferon gamma which could elicit plaque destabilization). A better understanding of the mechanisms of estrogens on the normal and atheromatous arteries is required and should help to optimize the prevention of cardiovascular disease after menopause.

High density lipoprotein (HDL) cholesterol in apolipoprotein (apo) E-deficient mice is decreased. It has been suggested that apoA-I is lost from HDL in these mice because it must substitute for apoE as a structural protein for the abnormal cholesterol-rich lipoproteins. Therefore, we examined in vivo the influence of selective apoE expression on plasma HDL cholesterol in apoE-deficient mice. Bone marrow transplantation was used to establish macrophage-specific expression of apoE. Bone marrow transplantation normalized plasma triglycerides and significantly reduced total plasma cholesterol, but it did not increase hepatic apoA-I mRNA levels or total plasma apoA-I. Although total plasma apoA-I was not increased, HDL cholesterol measured following chromatographic separation was elevated twofold. Furthermore, plasma apoA-I was recovered from this HDL in animals expressing macrophage apoE. Compared to HDL of wildtype mice, this HDL had a similar chromatographic size distribution, but it lacked apoE and was more negatively charged. These studies indicated that plasma apoA-I distribution and HDL composition are influenced by apoE and that the abnormal apoA-I lipoprotein distribution of apoE-deficient mice can be altered in vivo by macrophage-derived apoE.

Angiotensin (Ang) II contributes to the development of atherosclerosis, while Ang-(1–7) has atheroprotective actions. Accordingly, angiotensin-converting enzyme 2 (ACE2), which breaks-down Ang II and forms Ang-(1–7), has been suggested as a target against atherosclerosis. Here we investigated the actions of diminazene, a recently developed ACE2 activator compound, in a model of vulnerable atherosclerotic plaque. Atherosclerotic plaque formation was induced in the carotid artery of ApoE-deficient mice by a shear stress (SS) modifier device. The animals were treated with diminazene (15 mg/kg/day) or vehicle. ACE2 was strongly expressed in the aortic root and low SS-induced carotid plaques, but poorly expressed in the oscillatory SS-induced carotid plaques. Diminazene treatment did not change the lesion size, but ameliorated the composition of aortic root and low SS-induced carotid plaques by increasing collagen content and decreasing both MMP-9 expression and macrophage infiltration. Interestingly, these beneficial effects were not observed in the oscillatory SS-induced plaque. Additionally, diminazene treatment decreased intraplaque ICAM-1 and VCAM-1 expression, circulating cytokine and chemokine levels and serum triglycerides. In summary, ACE2 was distinctively expressed in atherosclerotic plaques, which depends on the local pattern of shear stress. Moreover, diminazene treatment enhances the stability of atherosclerotic plaques.

A randomized clinical trial was conducted to compare the results of automated percutaneous discectomy with those of chemonucleolysis in 141 patients with sciatica caused by a disk herniation; 69 underwent automated percutaneous discectomy and 72 were subjected to chemonucleolysis. The principle outcome was the overall assessment of the patient 6 months after treatment. Treatment was considered to be successful by 61% of the patients in the chemonucleolysis group compared with 44% in the automated percutaneous discectomy group. At 1-year follow-up, overall success rates were 66% in the chemonucleolysis group and 37% in the automated percutaneous group. Within 6 months of treatment, 7% of the patients in the chemonucleolysis group and 33% in the discectomy group underwent subsequent open surgery. The complication rates of both treatment groups were low, with the exception of a high rate of low-back pain in the chemonucleolysis group (42%). The results of this trial confirm previous controlled studies on chemonucleolysis and suggest that controlled studies should be carried out before automated percutaneous discectomy can be considered a useful intervention.