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Vasculogenesis as well as angiogenesis are important for postnatal development of blood vessels. Peripheral blood or bone marrow-derived endothelial precursor cells are used in clinical trials for therapeutic enhancement of postnatal neovascularization in patients suffering from coronary artery diseases. The vasculogenic potential of the precursor cell population depends on the appropriate retention of the infused cells to the ischemic tissue. However, cell-autonomous mechanisms regulating the attraction and retention of circulating cells in inflammatory tissue are not well understood. Caspases belong to a family of pro-apoptotic enzymes. Beyond cell death signals, caspase proteases additionally regulate non-apoptotic processes like cell morphology and migration in many cell types. The isoform Caspase-8 is essential for embryonal vasculogenesis in conditional knockout mice. In this study, we identified a novel apoptosis-unrelated role of Caspase-8 in circulating and bone marrow-derived cells for vascular repair. Caspase-8-specific inhibition abrogated the ex vivo formation of EPC from human peripheral blood. Moreover, Caspase-8 inhibition disables EPC migration and adhesion to different matrices and decreases the cell surface expression of the fibronectin receptor subunit integrin alpha 5 and the chemokine receptor CXCR4. In vitro and in vivo studies using bone marrow mononuclear cells derived from inducible Caspase-8- deficient mice revealed an essential role of Caspase-8 for EPC formation and neovascularization enhancing capacities of progenitor cells. Caspase-8 activity appears to be required for maintaining responses to matrix interaction and chemoattractants of EPC. Additional studies showed that the E3 ubiquitin ligase Cbl-b, a negative regulator of cell adhesion molecules including integrin alpha 5, is present in EPC at low protein levels under basal conditions, but markedly increases upon Caspase-8 inhibition. In vitro assays and overexpression studies in intact cells confirmed Caspase-8-dependent degradation of Cbl-b, providing a potential requirement for Caspase-8-regulated adhesion. Indeed, neovascularization of matrigel plugs was enhanced in mice lacking Cbl-b. Moreover, Cbl-b degradation in the presence of active Caspase-8 prevents the down-regulation of integrin alpha 5 and is associated with an enhanced vasculogenic activity of progenitor cells in hind limb ischemia. The identified upstream regulation of caspase-8 by cytokine IL-6 is only one possibility for fine-tuning the non-apoptotic enzymatic activity. In summary, this study shows a novel essential role of Caspase-8 for proper EPC adhesion-related signaling. Caspase-8 is involved in the function of adhesion molecules by regulation the E3 ubiquitin ligase Cbl-b. Strategies to improve survival of therapeutic injected progenitor cells by using caspase inhibitors should be addressed with caution. Because of the broad spectrum of activity of caspase-8, downstream targets of this caspase isoform and Cbl-b should be in more focus for therapeutic pretreatment to improve neovascularization of myocardial and ischemic tissue.
Vascular tumors associated with chronic B. henselae infections are unique examples of infection-associated pathological angiogenesis. The chaotic vascular architecture and prominent myeloid infiltrate of B. henselae induced vascular lesions show many similarities with malignant tumors.
In human cancers infiltrating myeloid cells play a decisive role in tumor progression and vascularization. In particular, tumor associated macrophages (TAMs) transform the tumor microenvironment, drive tumor invasion and vascularization through secretion of pro-angiogenic and immune modulatory cytokines and participation in matrix remodeling processes.
Myeloid angiogenic cells (MACs) are a subset of circulating myeloid progenitors with important roles in regenerative and pathological angiogenesis and a critical involvement in tumor vascularization. The phenotypic plasticity and importance of MACs in pathological angiogenic processes, position these cells as key potential players in B. henselae associated vascular tumor formation.
To investigate the possible role of MACs in B henselae induced pathological angiogenesis, the objective of this study was to examine the interaction of B. henselae with MACs and determine how this may affect their angiogenic capacity.
Building on previous work by Mӓndle (2005) this study has demonstrated that MACs are susceptible to infection with B. henselae and reside in intracellular vacuoles. As in endothelial cells, infection of MACs with B. henselae was associated with inhibition of apoptosis and activation of endogenous angiogenic programs including activation of the angiogenic transcription factor HIF-1.
In addition to angiogenic re-programming on a molecular level B. henselae infection increases MAC functional angiogenic capacity. B. henselae infected MACs were found to integrate into growing endothelium and increase the rate of angiogenic sprouting in a paracrine manner.
When cultured in a Matrigel capillary formation assay, infected MACs were also found to form networks of capillary-like structures that were stable over long periods of time. The B. henselae pathogenicity factor BadA was essential for the induction of this vascular mimicry phenotype as well as the activation of HIF-1 in infected MACs indicating that this factor may play an important role in MAC angiogenic re-programming.
Examination of infected MACs via FACS analysis, cytospin immunohistochemistry and qRT-PCR revealed that endothelial differentiation does not play a role in the B. henselae induced pro-angiogenic phenotype. Instead, MACs were shown to be myeloid in phenotype displaying typical macrophage markers which were upregulated upon B. henselae infection and maintained over long-term culture.
The increased angiogenic activity of B. henselae infected MACs was found to be associated with a broad phenotypic reprogramming in infected cells. In particular, gene expression programs related to angiogenesis, structural organization, apoptosis, sterol metabolism and immune regulation, were upregulated. Further examination of microarray gene expression profiles revealed that B. henselae infected MACs display a predominantly M2 anti-inflammatory macrophage activation status.
Finally, examination of the paracrine microenvironment created by B. henselae infected MACs revealed a diverse cytokine secretion profile dominated by inflammatory-angiogenic cytokines and matrix remodeling elements and lacking expression of some of the most important cytokines involved in the expansion of the inflammatory response. This B. henselae induced activation status was demonstrated to be distinct from the general inflammatory response induced by E. coli LPS treatment.
Comparison of B. henselae infected MACs to TAMs revealed many parallels in functional and phenotypic characteristics. Both TAMs and B. henselae infected MACs demonstrate increased angiogenic capacity, invasive, and immune modulatory phenotypes and the ability to participate in the formation of vascular mimicry phenotypes under angiogenic pressure. Furthermore, the pro-angiogenic paracrine microenvironment created by B. henselae infected MACs shows many similarities to the TAM-created tumor-microenvironment.
In conclusion, these investigations have demonstrated that the infection of MACs with B. henselae results in the phenotypic re-programming towards TAM-like cells with increased pro-angiogenic, invasive and immune-modulatory qualities. The results of this study elucidate new aspects of B. henselae pathogenicity in myeloid cells and highlight the role of these cells as paracrine mediators of B. henselae induced vascular tumor formation. In addition, these findings demonstrate that manipulation of myeloid cells by pathogenic bacteria can contribute to microenvironmental regulation of pathological tissue growth and suggest parallels underlying bacterial infections and cancer.
Die postnatale Neovaskularisierung ist eine wichtige Vorraussetzung um Gewebe vor kritischer Ischämie zu schützen. Eine der Grundlagen dieses Prozesses bilden die Angiogenese, bei der neue Kapillaren durch Proliferation und Migration von Endothelzellen aus bereits vorhandenen Blutgefäßen entstehen. Ein zweiter Eckpfeiler ist die Vaskulogenese, die unter anderem durch zirkulierende endotheliale Vorläuferzellen (EPC) vermittelt wird. Homeobox-Gene der Klasse 1 (Hox) sind Transkriptionsfaktoren, die während der Embryonalentwicklung an der Organogenese und der Entwicklung des kardiovaskulären Systems beteiligt sind. Verschiedene Studien weisen darauf hin, dass Homeobox-Proteine auch im adulten Organismus bei der transkriptionellen Regulation von Genen der Angio- und Vaskulogenese eine wichtige Rolle spielen. Die in dieser Arbeit vorliegenden Ergebnisse zeigen eine essentielle Rolle von HoxA9 für die postnatale Neovaskularisierung sowie für die funktionelle Integrität von Endothelzellen und endothelialen Progenitorzellen. HoxA9-defiziente Mäuse hatten einen signifikant verringerten Blutfluss nach einer Hinterlauflauf-Ischämie. Für die reduzierte Neovaskularisierung des ischämischen Gewebes, genügte der Verlust eines einzigen HoxA9-Wildtypallels. Außerdem zeigen HoxA9-defiziente Endothelzellen in vitro eine stark gehemmte Migration sowie eine verringerte Gefäßstrukturbildung. Zusätzlich war auch deren Interaktion mit EPC im Matrigel verschlechtert. Eine Bestätigung dieser Beobachtung zeigten Untersuchungen an endothelialen Vorläuferzellen, die ebenfalls einen Verlust angiogener Funktionen bei verminderter HoxA9-Expression aufwiesen. Neben der postnatalen Neovaskularisierung konnten erste Untersuchungen embryonaler Allantois zeigen, das HoxA9 vermutlich auch in der embryonalen Gefäßbildung beteiligt ist. Diese Theorie wird durch eine nicht-Mendelsche Verteilung der postnatalen Genotypen nach Kreuzung heterozygoter HoxA9-Mäuse unterstützt. Als molekulare Ursachen der Hemmung angiogener Funktionen bei Endothelzellen, konnte die Regulation verschiedener Gene nachgewiesen werden. So ist HoxA9 für die Expression der endothelialen Stickstoffmonoxidsynthase (eNOS), des VEGF-Rezeptors 2 (VEGF-R2), der Adhäsionsmoleküle VE-Cadherin und Integrin v3 sowie des EphB4-Rezeptors von essentieller Bedeutung. Diese von HoxA9 regulierten Gene spielen für die Angio- und Vaskulogenese alle eine entscheidende Rolle. Der EphB4-Rezeptor, die eNOS und der VEGF-R2 werden durch eine direkte Bindung von HoxA9 an den jeweiligen Promotor auf transkriptioneller Ebene reguliert. Bei den Genen Integrin v3 und VE-Cadherin erfolgt die Regulation durch HoxA9 indirekt über andere Gene oder posttranskriptionell. Zusätzlich zum Nachweis der Kontrolle der Genexpression, konnte für den EphB4-Rezeptor nachgewiesen werden, dass dieser von großer Bedeutung für die HoxA9-regulierte Migration ist. Außerdem besitzt der EphB4-Promotor eine für die Regulation der EphB4-Expression durch HoxA9 wichtige Bindungsstelle. In weiteren Versuchen konnte gezeigt werden, dass HoxA9 Schubspannungs-abhängig reguliert wird und dabei auch in die Regulation der Schubspannungs-induzierten Migration und die Schubspannungs-abhängige Expression der untersuchten Zielgene von HoxA9 eingreift. Zusammenfassend zeigen die hier vorgestellten Daten, dass HoxA9 endotheliale Gene vielfältig reguliert, eine entscheidende Rolle bei der Modulation verschiedener endothelialer Funktionen spielt und essentiell für die postnatale Neovaskularisierung ist.