Transcriptional switching in macrophages associated with the peritoneal foreign body response.

We previously demonstrated that myeloid cells are the source of fibrotic tissue induced by foreign material implanted in the peritoneal cavity. This study utilised the MacGreen mouse, in which the Csf1r promoter directs myeloid-specific enhanced green fluorescent protein (EGFP) expression, to determine the temporal gene expression profile of myeloid subpopulations recruited to the peritoneal cavity to encapsulate implanted foreign material (cubes of boiled egg white). Cells with high EGFP expression (EGFP(hi)) were purified from exudate and encapsulating tissue at different times during the foreign body response, gene expression profiles determined using cDNA microarrays, and data clustered using the network analysis tool, Biolayout Express(3D). EGFP(hi) cells from all time points expressed high levels of Csf1r, Emr1 (encoding F4/80), Cd14 and Itgam (encoding Mac-1) providing internal validation of their myeloid nature. Exudate macrophages (days 4-7) expressed a large cluster of cell cycle genes; these were switched off in capsule cells. Early in capsule formation, Csf1r-EGFP(hi) cells expressed genes associated with tissue turnover, but later expressed both pro- and anti-inflammatory genes alongside a subset of mesenchyme-associated genes, a pattern of gene expression that adds weight to the concept of a continuum of macrophage phenotypes rather than distinct M1/M2 subsets. Moreover, rather than transdifferentiating to myofibroblasts, macrophages contributing to later stages of the peritoneal foreign body response warrant their own classification as 'fibroblastoid' macrophages.

Electrospinning and crosslinking of low-molecular-weight poly(trimethylene carbonate-co-(L)-lactide) as an elastomeric scaffold for vascular engineering.

The growth of suitable tissue to replace natural blood vessels requires a degradable scaffold material that is processable into porous structures with appropriate mechanical and cell growth properties. This study investigates the fabrication of degradable, crosslinkable prepolymers of l-lactide-co-trimethylene carbonate into porous scaffolds by electrospinning. After crosslinking by γ-radiation, dimensionally stable scaffolds were obtained with up to 56% trimethylene carbonate incorporation. The fibrous mats showed Young's moduli closely matching human arteries (0.4-0.8MPa). Repeated cyclic extension yielded negligible change in mechanical properties, demonstrating the potential for use under dynamic physiological conditions. The scaffolds remained elastic and resilient at 30% strain after 84days of degradation in phosphate buffer, while the modulus and ultimate stress and strain progressively decreased. The electrospun mats are mechanically superior to solid films of the same materials. In vitro, human mesenchymal stem cells adhered to and readily proliferated on the three-dimensional fiber network, demonstrating that these polymers may find use in growing artificial blood vessels in vivo.

Antibody-targeted drug delivery to injured arteries using layered double hydroxide nanoparticles.

Targeted local delivery of a nanoparticle-based, antibody-targeted, and low molecular weight heparin (LMWH) delivery system successfully reduces restenosis and thrombus formation in an animal model. An antibody recognizing cross-linked fibrin (XLF) D-dimer is successfully conjugated to layered double hydroxide nanoparticles. Use of the anti-XLF-conjugated LMWH-carrying layered double hydroxide nanoparticles shows successful targeting of the nanoparticles (red) to the injured artery wall (green), resulting in decreased neointimal thickening and thrombus formation.

Smooth muscle phenotypic modulation--a personal experience.

The idea that smooth muscle cells can exist in multiple phenotypic states depending on the functional demands placed upon them has been around for >5 decades. However, much of the literature today refers to only recent articles, giving the impression that it is a new idea. At the same time, the current trend is to delve deeper and deeper into transcriptional regulation of smooth muscle genes, and much of the work describing the change in biology of the cells in the different phenotypic states does not appear to be known. This loss of historical perspective regarding the biology of smooth muscle phenotypic modulation is what the current article has tried to mitigate.

Engineering pro-angiogenic peptides using stable, disulfide-rich cyclic scaffolds.

Fragments from the extracellular matrix proteins laminin and osteopontin and a sequence from VEGF have potent proangiogenic activity despite their small size (< 10 residues). However, these linear peptides have limited potential as drug candidates for therapeutic angiogenesis because of their poor stability. In the present study, we show that the therapeutic potential of these peptides can be significantly improved by "grafting" them into cyclic peptide scaffolds. Momordica cochinchinensis trypsin inhibitor-II (MCoTI-II) and sunflower trypsin inhibitor-1 (SFTI-1), naturally occurring, plant-derived cyclic peptides of 34 and 14 residues, respectively, were used as scaffolds in this study. Using this approach, we have designed a peptide that, in contrast to the small peptide fragments, is stable in human serum and at nanomolar concentration induces angiogenesis in vivo. This is the first report of using these scaffolds to improve the activity and stability of angiogenic peptide sequences and is a promising approach for promoting angiogenesis for therapeutic uses.

Cross-linked poly(trimethylene carbonate-co-L-lactide) as a biodegradable, elastomeric scaffold for vascular engineering applications.

A series of copolymers of trimethylene carbonate (TMC) and L-lactide (LLA) were synthesized and evaluated as scaffolds for the production of artificial blood vessels. The polymers were end-functionalized with acrylate, cast into films, and cross-linked using UV light. The mechanical, degradation, and biocompatibility properties were evaluated. High TMC polymers showed mechanical properties comparable to human arteries (Young's moduli of 1.2-1.8 MPa and high elasticity with repeated cycling at 10% strain). Over 84 days degradation in PBS, the modulus and material strength decreased gradually. The polymers were nontoxic and showed good cell adhesion and proliferation over 7 days using human mesenchymal stem cells. When implanted into the rat peritoneal cavity, the polymers elicited formation of tissue capsules composed of myofibroblasts, resembling immature vascular smooth muscle cells. Thus, these polymers showed properties which were tunable and favorable for vascular tissue engineering, specifically, the growth of artificial blood vessels in vivo.

Cellular trafficking of low molecular weight heparin incorporated in layered double hydroxide nanoparticles in rat vascular smooth muscle cells.

This paper reports a clear elucidation of the pathway for the cellular delivery of layered double hydroxide (LDH) nanoparticles intercalated with anti-restenotic low molecular weight heparin (LMWH). Cellular uptake of LMWH-LDH conjugates into cultured rat vascular smooth muscle cells (SMCs) measured via flow cytometry was more than ten times greater than that of LMWH alone. Confocal and transmission electron microscopy showed LMWH-LDH conjugates taken up by endosomes, then released into the cytoplasm. We propose that LMWH-LDH is taken up via a unique 'modified endocytic' pathway, whereby the conjugate is internalized by SMCs in early endosomes, sorted in late endosomes, and quickly released from late endosomes/lysosomes, avoiding degradation. Treatment of cells with LMWH-LDH conjugates suppressed the activation of ERK1/2 in response to foetal calf serum (FCS) for up to 24h, unlike unconjugated LMWH which had no significant effect at 24h. Improved understanding of the intracellular pathway of LMWH-LDH nanohybrids in SMC will allow for refinement of design for LDH nanomedicine applications.

Effects of estrogen on stress-induced premature senescence of vascular smooth muscle cells: a novel mechanism for the "time window theory" of menopausal hormone therapy.

OBJECTIVES: To investigate the effects of estrogen on stress-induced premature senescence of vascular smooth muscle cells (VSMCs) and the underlying mechanisms. METHODS: VSMCs of passage 2-3 cultured from young (2 months) and old (18 months) female SD rats were induced into premature senescence by exposure to 150 µmol/L H(2)O(2) in the presence or absence of different concentrations of 17ß-estradiol (E(2)). The expression or activation of senescence-associated beta-galactosidase (SA-ß-Gal), DcR2, oncogene Ras, p38, PRAK, p53, p21, p16 and Rb was detected by flow cytometry, pull-down assay or Western blot. RESULTS: Flow cytometry analysis showed that in the VSMCs from young rats pre-administration of E(2) significantly suppressed the H(2)O(2)-induced premature senescence (reducing both percentage of SA-ß-Gal positive cells and cellular expression of DcR2) in a dose-dependent manner; these senescent-inhibiting effects of E(2) could be blocked by an estrogen receptor antagonist ICI 182,780 (10(-5)mol/L). Pull-down assay or Western blot analysis revealed that pre-administration of 10(-8)mol/L E(2) significantly reduced the H(2)O(2)-induced activation of oncogene Ras, as well as activity of p16 and p38 MAPK, and expression of PRAK, p53, p21 and p-Rb. Unexpectedly, in the VSMCs from old rats the senescent-inhibiting effect of E(2) disappeared and switched to a senescent-promoting action at 10(-8)mol/L. This senescent-promoting effect could be enhanced by ICI 182,780 and eliminated by a cytochrome P450s inhibitor ABT. CONCLUSION: Estrogen inhibits stress-induced premature senescence of VSMCs from young female through its receptor-mediated suppression of both Ras-p38-PRAK-p53-p21-Rb and Ras-p16-Rb pathways, but this effect disappeared and even more switched to a senescent-promoting action in the cells from old body probably due to a side effect of estrogen metabolites.

Enhanced effects of low molecular weight heparin intercalated with layered double hydroxide nanoparticles on rat vascular smooth muscle cells.

Surgical procedures to remove atherosclerotic lesions and restore blood flow also injure the artery wall, promoting vascular smooth muscle cell (SMC) phenotypic change, migration, proliferation, matrix production and ultimately, restenosis of the artery. Hence identification of effective anti-restenotic strategies is a high priority in cardiovascular research, and SMCs are a key target for intervention. This paper presents the in vitro study of layered double hydroxides (LDHs) as drug delivery system for an anti-restenotic drug (low molecular weight heparin, LMWH). The cytotoxicity tests showed that LDH itself had very limited toxicity at concentrations below 50 microg/mL over 6-day incubation. LDH nanoparticles loaded with LMWH (LMWH-LDHs) were prepared and tested on rat vascular SMCs. When conjugated to LDH particles, LMWH enhanced its ability to inhibit SMC proliferation and migration, with greater than above 60% reduction compared with the control (growth medium) over 3 or 7-day incubation. Cellular uptake studies showed that compared with LMWH alone, LMWH-LDH hybrids were internalized by SMCs more rapidly, and uptake was sustained over a longer time, possibly revealing the mechanisms underlying the enhanced biological function of LMWH-LDH. The results suggest the potential of LMWH-LDH as an efficient anti-restenotic drug for clinical application.

Peroxisome proliferator-activated receptor ligands reduce aortic dilatation in a mouse model of aortic aneurysm.

OBJECTIVE: Osteopontin (OPN) is associated with human abdominal aortic aneurysms (AAA) and in vitro studies suggest that this cytokine is downregulated by peroxisome proliferator-activated receptor (PPAR) ligation. We examined the effect of two PPAR ligands within a mouse model of aortic aneurysm. METHODS: At 11 weeks of age apolipoprotein E deficient (ApoE(-/-)) mice were given pioglitazone (n=27), fenofibrate (n=27) or vehicle (n=27) in their drinking water. From 13 weeks of age mice received angiotensin II (1 microg/kg/min) infusion via subcutaneous pumps until death or 17 weeks when the aortas were harvested and maximum aortic diameters were recorded. Suprarenal aortic segments were assessed for OPN concentration and macrophage accumulation. Saline infused mice served as negative controls (n=22). RESULTS: Angiotensin II induced marked dilatation in the suprarenal aorta (>2-fold increase compared to controls) associated with upregulation of the cytokines OPN and macrophage infiltration. Suprarenal aortic expansion was significantly reduced by administration of pioglitazone (mean diameter 1.61+/-0.11 mm, p=0.011) and fenofibrate (mean diameter 1.51+/-0.13 mm, p=0.001) compared to the vehicle control group (mean diameter 2.10+/-0.14 mm). Immunostaining for macrophages was reduced in mice treated with pioglitazone (median staining area 6.2%, interquartile range 4.1-7.2, p<0.001) and fenofibrate (median staining area 4.0%, interquartile range 2.2-6.1, p<0.001) compared to mice receiving vehicle control (median staining area 13.2%, interquartile range 8.4-20.0). CONCLUSION: These findings suggest the potential value of peroxisome proliferator-activated receptor ligation as a therapy for human AAAs.

Cellular plasticity of inflammatory myeloid cells in the peritoneal foreign body response.

Implantation of sterile foreign objects in the peritoneal cavity of an animal initiates an inflammatory response and results in encapsulation of the objects by bone marrow-derived cells. Over time, a multilayered tissue capsule develops with abundant myofibroblasts embedded in extracellular matrix. The present study used the transgenic MacGreen mouse to characterize the time-dependent accumulation of monocyte subsets and neutrophilic granulocytes in the inflammatory infiltrate and within the tissue capsule by their differential expression of the csf1r-EGFP transgene, F4/80, and Ly6C. As the tissue capsule developed, enhanced green fluorescent protein-positive cells changed from rounded to spindle-shaped morphology and began to co-express the myofibroblast marker alpha-smooth muscle actin. Expression increased with time: at day 14, 11.13 +/- 0.67% of tissue capsule cells co-expressed these markers, compared with 50.77 +/- 12.85% of cells at day 28. The importance of monocyte/macrophages in tissue capsule development was confirmed by clodronate-encapsulated liposome removal, which resulted in almost complete abrogation of capsule development. These results confirm the importance of monocyte/macrophages in the tissue response to sterile foreign objects implanted in the peritoneal cavity. In addition, the in vivo plasticity of peritoneal macrophages and their ability to transdifferentiate from a myeloid to mesenchymal phenotype is demonstrated.

Transplanted abdominal granulation tissue induced bone formation--an in vivo study in sheep.

Many wounds to both soft and hard tissues heal via the formation of a granulation tissue bed. This bed is supportive of neoangiogenesis and releases proangiogenic, migratory, and proliferative growth factors and cytokines. In this study granulation tissue was grown on an intraperitoneal implant (4 mm diameter, 20 mm length) in a sheep. After 2 weeks, this implant was removed and transplanted into a femoral bone defect (4 mm diameter, 20 mm length). The sheep were sacrificed after 3 months, and the implant site examined using micro-CT and histology. A bone plaque formed adjacent to the implant, only in the presence of the peritoneal granulation tissue. This suggests that the formation of granulation tissue is a relatively conserved response at various locations in the body and its transplantation from one location to another can be used to induce tissue healing. This technique may prove useful as a method of improving physiological response to biomaterials.

Interaction between angiotensin II, osteoprotegerin, and peroxisome proliferator-activated receptor-gamma in abdominal aortic aneurysm.

BACKGROUND AND AIMS: Osteoprotegerin (OPG) has been associated with abdominal aortic aneurysm (AAA) expansion. Angiotensin II (AngII) receptor blockade has been shown to reduce OPG expression in human AAA tissue. Interaction between vascular AngII and OPG was further examined using cell culture and the AngII-infused ApoE(-/-) mouse AAA model. The ability of peroxisome proliferator-activated receptor-gamma (PPARgamma) activation to target OPG as potential therapy for AAA was also investigated. METHODS AND RESULTS: Human aortic smooth muscle cells (AoSMC) exposed to AngII exhibited dose-dependent increase in the production OPG. A 3-fold increase in suprarenal aortic concentration of OPG was observed in AngII-infused ApoE(-/-) mice. AngII type 1 receptor expression in human AAA tissue, and AoSMC in vitro, was stimulated up 4-fold in the presence of OPG. This effect in AoSMC was counteracted in the presence of the PPARgamma ligand, pioglitazone. Addition of PPARgamma ligand to cultured human AAA explant reduced OPG secretion by 60% and tissue concentration of OPG and metalloproteinase 9 by 2- and 3-fold, respectively. Administration of pioglitazone to AngII-infused ApoE(-/-) mice significantly reduced aortic concentrations of OPG and metalloproteinase 9. CONCLUSIONS: These data support an interaction between AngII and OPG in aneurysm formation. Activation of PPARgamma may have a role in treatment of AAA.

The peritoneal cavity as a bioreactor for tissue engineering visceral organs: bladder, uterus and vas deferens.

Our objective was to produce avascular, myofibroblast-rich tissue capsules for use as autologous grafts for hollow, smooth muscle-walled visceral organs-bladder, uterus and vas deferens. To produce tissue for grafting, templates of the appropriate shape were implanted in the peritoneal cavities of rats or rabbits. After 2-3 weeks, the templates were removed, the encapsulating myofibroblast-rich tissue harvested and grafted to replace resected segments of bladder, vas deferens or uterus of the same animals in which the tissue was grown. Bladder grafts showed 100% patency after 14 months and had developed a morphology similar to normal bladder. Tubes of myofibroblast tissue grafted unilaterally into resected rabbit vasa deferentia developed a morphology resembling native tissue, with sperm in the ejaculate indicative of normal function. At 12 weeks after grafting, uterine graft tissue had increased in thickness and developed the morphology of normal uterus, with endometrium overlying several layers of smooth muscle cells (myometrium-like) which were interspersed with collagen fibrils; grafted uterine horns supported embryos to the late stages of gestation. This study shows that myofibroblast tissue produced in the peritoneal cavity is sufficiently plastic to permit differentiation of cells into bladder, vas deferens or uterine smooth muscle. As a method for producing autologous graft material for repair/replacement of these organs, this approach has many benefits over conventional and current tissue-engineering strategies.

Engineering tissue tubes using novel multilayered scaffolds in the rat peritoneal cavity.

Our aim was to develop novel scaffolds to engineer tissue tubes of smooth muscle-like cells for autologous grafting. Small diameter tubular poly(lactic acid) scaffolds with randomly distributed, interconnected pores up to 100 mum were produced using a thermally induced phase separation method. The scaffolds were surface modified using various biomolecules via a layer-by-layer deposition technique, and implanted in the peritoneal cavities of rats. Histological analysis of scaffolds 3 weeks after implantation showed fully-developed tissue capsules on their outer surfaces, with macrophage-like cells present throughout the internal spaces. Surfaces coated in Matrigel supported the strongest cellular response whereas multilayer coatings with elastin, collagen I, collagen III, or chitosan outermost showed the lowest levels of cellular interaction. Although differences in capsule thickness and the presence or absence of cellularized layers on the inside and outside surfaces of the scaffolds were observed, none of these biomolecule coatings was able to overcome the foreign body response within the peritoneal cavity, even in the presence of a nonadsorptive HA undercoat.

Vascular grafts and the endothelium.

This article discusses the importance of the endothelium for successful vascular grafts derived from both native arteries and synthetic materials. It also discusses the fundamental strategies to endothelialize synthetic grafts in animal experiments and in the clinic, as well as the use of endothelial progenitor cells (EPCs), bone marrow-derived cells, and mesothelium as endothelial substitutes.

Mechanics of cellular adhesion to artificial artery templates.

We are using polymer templates to grow artificial artery grafts in vivo for the replacement of diseased blood vessels. We have previously shown that adhesion of macrophages to the template starts the graft formation. We present a study of the mechanics of macrophage adhesion to these templates on a single cell and single bond level with optical tweezers. For whole cells, in vitro cell adhesion densities decreased significantly from polymer templates polyethylene to silicone to Tygon (167, 135, and 65 cells/mm(2)). These cell densities were correlated with the graft formation success rate (50%, 25%, and 0%). Single-bond rupture forces at a loading rate of 450 pN/s were quantified by adhesion of trapped 2-microm spheres to macrophages. Rupture force distributions were dominated by nonspecific adhesion (forces <40 pN). On polystyrene, preadsorption of fibronectin or presence of serum proteins in the cell medium significantly enhanced adhesion strength from a mean rupture force of 20 pN to 28 pN or 33 pN, respectively. The enhancement of adhesion by fibronectin and serum is additive (mean rupture force of 43 pN). The fraction of specific binding forces in the presence of serum was similar for polystyrene and polymethyl-methacrylate, but specific binding forces were not observed for silica. Again, we found correlation to in vivo experiments, where the density of adherent cells is higher on polystyrene than on silica templates, and can be further enhanced by fibronectin adsorption. These findings show that in vitro adhesion testing can be used for template optimization and to substitute for in-vivo experiments.

Cholestanol: a serum marker to guide LDL cholesterol-lowering therapy.

Statins have been the mainstay of lipid-lowering therapy since their introduction. However, as lower LDL cholesterol targets are sought, adjunct therapies are becoming increasingly important. Few patients reach new targets with statin monotherapy. We propose that the cholestanol:cholesterol ratio can be used to guide lipid-lowering therapy and result in greater numbers of patients reaching target LDL cholesterol. By determining whether a patient is mainly a synthesizer or absorber of cholesterol, customized regimens can be used and are expected to improve patient outcomes and minimize costs of treatment.

Establishment of metanephros transplantation in mice highlights contributions by both nephrectomy and pregnancy to developmental progression.

BACKGROUND: It has been demonstrated that embryonic kidneys (metanephroi) xenotransplanted into the omentum of adult recipients continue to develop and display immune protection due to their more naïve immune presentation. To date, this has been achieved using rat, pig and human metanephroi, with unilateral nephrectomy (UNX) of recipient rats a requisite of renal development. The aim of this study was to adapt this approach for use in mice and examine the parameters affecting successful onward development in this species. METHODS: Metanephroi at embryonic age (E) 13.5 were transplanted either onto the body wall, abdominal fat pads or omentum of recipient isogenic C57/Bl6 mice using either sutures or polyglycolic acid mesh. Having established greatest success with polyglycolic acid mesh on the body wall, E12.5 and 15.5 days metanephroi from C57/Bl6 mice were then transplanted onto the body wall of control (non-pregnant non-UNX), UNX or 12.5 days post-coitum pregnant isogenic recipients. After 7 days, implanted tissue was harvested and examined using histology and immunohistochemistry for markers of renal maturation. The mean number of S-shaped bodies and glomeruli per section were recorded and statistically analysed for significant differences between all recipient groups and untransplanted metanephroi. The degree of development was scored qualitatively. RESULTS: Transplanted E12.5 metanephroi developed S-shaped bodies and glomeruli in all recipient groups, although there were statistically higher numbers of S-shaped bodies in UNX (n = 2) and pregnant recipients (n = 9) than in control recipients (n = 4). Continued development, as indicated by mature vascularized glomeruli, was only observed in those E15.5 metanephroi transplanted into pregnant recipients (n = 11) with a 15.5-fold increase in S-shaped bodies and 4-fold increase in glomeruli compared with control transplants (n = 12). CONCLUSIONS: We have successfully established metanephros transplantation in mice and demonstrated enhancement of onward development of E12.5 metanephroi in response to both pregnancy and UNX. Using E15.5 metanephroi, continued development only occurred in pregnant recipients, implying pregnancy provides an environment conducive to continued organogenesis. This murine assay, when coupled with transgenically-tagged strains of mice, will allow the investigation of the relative contribution of donor and recipient cells to this process.