Combined effects of an 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor and angiotensin II receptor antagonist on nitric oxide bioavailability and atherosclerotic change in myocardial infarction-prone Watanabe heritable hyperlipidemic rabbits.

We investigated the effects of co-administration of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor and angiotensin II type 1 receptor blocker (ARB) on nitric oxide (NO) bioavailability in genetically hyperlipidemic rabbits with our newly developed NO sensor. A total of 36 myocardial infarction-prone Watanabe heritable hyperlipidemic (WHHLMI) rabbits equally derived (n=6 per group) were treated with 1) vehicle (control), 2) hydralazine (15 mg/kg/d), 3) the HMG-CoA reductase inhibitor pitavastatin (P: 0.5 mg/kg/d), 4) the ARB valsartan (V: 5 mg/kg/d), and 5) pitavastatin+valsartan (P+V) together without or 6) with N(G)-nitro-L-arginine methyl ester (L-NAME) for 8 weeks. After treatment, acetylcholine (ACh)-induced NO production was measured as a surrogate for endothelium protective function, and vascular peroxynitrite (a product of superoxide and NO) was measured for assessing dysfunctional endothelial NO synthase activity. Plaque area was quantified by histology as well as optical coherence tomography (OCT). Intra-aortic infusion of ACh produced an increase in plasma NO concentration, which was significantly greater with all drug treatments than with the control. P+V increased ACh-induced NO by 4.1 nmol/L significantly more than either P or V singly. The vascular peroxynitrite concentration was 1.6 pmol/mg protein in the control group and significantly less than those in the P- and V-monotherapy-groups. The lowest peroxynitrite concentration was observed in the P+V group (0.4 pmol/mg protein), which was significantly lower than those in the P- and the V-monotherapy-groups. OCT and histology of the thoracic aorta revealed that the plaque area decreased significantly more with the combination than with the monotherapy. In conclusion, the combined treatment with an HMG-CoA reductase inhibitor and an ARB may have additive protective effects on endothelial function as well as atherosclerotic change.

Pioglitazone inhibits angiotensin II-induced senescence of endothelial progenitor cell.

We investigated whether a peroxisome proliferator-activated receptor (PPAR) agonist would effect the angiotensin II (Ang II)-induced senescence of endothelial progenitor cells (EPCs). EPCs were isolated from peripheral blood and characterized. Both reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting were used to assess gp91phox expression and angiotensin type 1 receptor (AT1R) levels. Immunofluorescence of nitrotyrosine provided evidence of peroxynitrite formation. Our data indicate that Ang II increased the expression of gp91phox mRNA, which was significantly diminished by pioglitazone, a PPARgamma agonist. Western blotting revealed that Ang II stimulated an increase in the gp91phox protein, whereas co-treatment with pioglitazone significantly reduced this increase. In addition, pioglitazone also inhibited Ang II-induced peroxynitrite formation. Interestingly, pioglitazone decreased the expressions of AT1R mRNA and protein. The exposure of cultured EPCs to Ang II (100 nmol/L) significantly accelerated the rate of senescence compared to that of the control cells during 14 d in culture, as determined by acidic beta-galactosidase staining. Ang II-induced EPC senescence was significantly inhibited by co-treatment with pioglitazone. Because cellular senescence is critically influenced by telomerase, which elongates telomeres, we also measured telomerase activity by means of PCR-ELISA-based assay. The results showed that Ang II significantly diminished telomerase activity, and this effect was significantly abolished by co-treatment with pioglitazone. In conclusion, pioglitazone inhibited Ang II-induced senescence of EPCs via down-regulation of the expression of AT1R.

Effects of angiotensin converting enzyme inhibitor and angiotensin II receptor antagonist combination on nitric oxide bioavailability and atherosclerotic change in Watanabe heritable hyperlipidemic rabbits.

We investigated the effects of co-administration of an angiotensin-converting enzyme inhibitor (ACEI) and angiotensin type 1 receptor blocker (ARB) on nitric oxide (NO) bioavailability in genetically hyperlipidemic rabbits with our newly developed NO sensor. Plasma NO was measured using the new NO sensor in the abdominal aorta of anesthetized Watanabe heritable hyperlipidemic (WHHL) rabbits. Acetylcholine (ACh)-stimulated (20 microg in 5 min into the aortic arch) NO production was recorded after an 8 week per os pretreatment with 1) vehicle (control), 2) the ACEI enalapril (E: 3 mg/kg/day), 3) the ARB losartan (L: 30 mg/kg/day) and 4) enalapril (1.5 mg/kg/day)+losartan (15 mg/kg/day) (E+L). Intra-aortic infusion of ACh produced an increase in plasma NO concentration, which was significantly greater with all the drug treatments than with the control. E increased ACh-induced NO significantly more than L (by 6.9 nmol/L, and 4.7 nmol/L, respectively). E+L increased ACh-induced NO by 9.5 nmol/L, significantly more than either E or L. Plasma peroxynitrite concentration was 1.2 pmol/mg protein in the control group and significantly less than in the E- and L-group. The lowest peroxynitrite concentration was observed in the E+L group (0.5 pmol/mg protein), which was significantly lower than in the E-group and the L-group. Optical coherence tomography and histology of the thoracic aorta revealed that the plaque area decreased significantly more with the combination than with the monotherapy (p<0.01). In conclusion, the combined treatment with an ACEI and an ARB may have additive protective effects on endothelial function as well as atherosclerotic change.

Effects of telmisartan, a unique angiotensin receptor blocker with selective peroxisome proliferator-activated receptor-gamma-modulating activity, on nitric oxide bioavailability and atherosclerotic change.

OBJECTIVE: Telmisartan is a unique angiotensin II (Ang II) receptor blocker (ARB) with selective peroxisome proliferator-activated receptor-gamma (PPAR gamma). We therefore investigated the effects of telmisartan on endothelial function and atherosclerotic change in genetically hyperlipidemic rabbits, compared with candesartan, an ARB without PPAR gamma activity. METHODS: A total of 30 Watanabe heritable hyperlipidemic (WHHL) rabbits equally derived (n = 6 each) were treated with (1) vehicle (control), (2) GW9662, a PPAR gamma antagonist (0.5 mg/kg per day), (3) telmisartan (5 mg/kg per day), (4) telmisartan + GW9662, (5) candesartan (5 mg/kg per day) for 8 weeks. After treatment, acetylcholine (ACh)-induced nitric oxide production was measured as a surrogate for endothelium protective function, and vascular nitrotyrosine (a product of superoxide and nitric oxide) was measured for assessing dysfunctional endothelial nitric oxide synthase activity. Plaque area was quantified by histology. RESULTS: Telmisartan increased ACh-induced nitric oxide by 5.5 nmol/l, significantly more than control. Interestingly, cotreatment with GW9662 significantly attenuated telmisartan-induced ACh-induced nitric oxide almost to the levels observed with candesartan. Vascular nitrotyrosine concentration was 1.4 pmol/mg protein in the control group and significantly higher than that in the telmisartan or candesartan group. The lowest nitrotyrosine concentration was observed in the telmisartan group, which was significantly lower than that in the candesartan or telmisartan + GW9662 group. Histology of the thoracic aorta revealed that the plaque area was more significantly decreased in the telmisartan group than in the candesartan or telmisartan + GW9662 group. CONCLUSION: In addition to a class effect of ARBs, telmisartan may have additional effects on nitric oxide bioavailability and atherosclerotic change through its PPAR gamma-mediated effects in genetically hyperlipidemic rabbits.

Effects of pioglitazone on nitric oxide bioavailability measured using a catheter-type nitric oxide sensor in angiotensin II-infusion rabbit.

Recently, peroxisome proliferator-activated receptor gamma (PPARgamma) ligands have been reported to increase nitric oxide (NO) bioavailability in vitro but not in vivo because of the difficulty of measuring plasma NO. Here, we investigated the effects of PPARgamma on plasma NO concentrations using the newly developed NO sensor in angiotensin II (Ang II)-infused rabbits. Male New Zealand rabbits were randomized for infusion with Ang II, either alone or in combination with pioglitazone (a PPARgamma agonist). Plasma NO concentration was measured using the catheter-type NO sensor placed in the aorta. We then infused N(G)-methyl-L-arginine (L-NMMA) and acetylcholine (ACh) into the aortic arch to measure the basal and ACh-induced plasma NO concentration. Vascular nitrotyrosine levels were examined by enzyme-linked immunoassay (ELISA). Both an immunohistochemical study and Western blotting were performed to examine the PPARgamma and gp91phox expression. The cotreatment with pioglitazone significantly suppressed the negative effects of Ang II, that is, the decreases in basal and ACh-induced NO production and the increase in vascular nitrotyrosine levels. Both the immunohistochemical study and Western blotting demonstrated that pioglitazone treatment enhaced PPARgamma expression and greatly inhibited Ang II-induced up-regulation of gp91phox. In conclusion, the PPARgamma agonist pioglitazone significantly improved NO bioavailability in Ang II-infused rabbits, most likely by attenuating nitrosative stresses.

Addition of eplerenone to an angiotensin-converting enzyme inhibitor effectively improves nitric oxide bioavailability.

Angiotensin II and aldosterone both promote endothelial dysfunction and atherosclerosis. We investigated the effect of a combination of eplerenone, a selective aldosterone antagonist, and enalapril, an angiotensin-converting enzyme inhibitor, on NO bioavailability and spontaneous atherosclerotic changes. Twenty-four myocardial infarction-prone Watanabe heritable hyperlipidemic rabbits were treated with vehicle (control), eplerenone (50 mg/kg per day), enalapril (3 mg/kg per day), or eplerenone plus enalapril for 8 weeks (n=6 in each group). After treatment, acetylcholine-induced NO production was measured as a surrogate for endothelium-protective function, and vascular peroxynitrite (a product of superoxide and NO) was measured to assess dysfunctional endothelial NO synthase activity. Plaque area was quantified by histology. Intra-aortic infusion of acetylcholine produced an increase in plasma NO concentration that was significantly higher with all of the drug treatments compared with the control. Eplerenone and enalapril, in combination, increased acetylcholine-induced NO by 7.9 nM, which was significantly higher than with either eplerenone or enalapril alone. Vascular peroxynitrite was significantly higher in the control group (1.3 pmol/mg of protein) and significantly lower with combination treatment (0.4 pmol/mg of protein) compared with the enalapril or eplerenone group. The highest tetrahydrobiopterin levels were observed after cotreatment with eplerenone and enalapril. Histology of the thoracic aorta showed a significantly decreased plaque area with combination therapy compared with monotherapy. Combined treatment with a selective aldosterone antagonist and an angiotensin-converting enzyme inhibitor has additive protective effects on endothelial function and on atherosclerotic changes via decreased nitrosative stress.

Effects of angiotensin II on NO bioavailability evaluated using a catheter-type NO sensor.

We investigated the acute or chronic effects of angiotensin (Ang) II on the bioavailability of NO in Ang II-infused rabbits using the catheter-type NO sensor. Male New Zealand White rabbits were infused with vehicle (sham), Ang II at a rate of 200 ng/kg per minute, either alone or in combination with hydralazine, Ang II type I receptor antagonist (valsartan), or an antioxidant (tempol) for 24 hours or 14 days. Plasma NO concentration was measured using the catheter-type NO sensor located in the aorta. We then infused saline (vehicle) and acetylcholine (ACh) into the aortic arch with or without pretreatment with N(G)-methyl-l-arginine. An increase in plasma NO levels in response to ACh was significantly attenuated in the Ang II group compared wit the control group. The decrease in the basal plasma NO concentration was significantly lower in the Ang II group than in the control group. Plasma peroxynitrite concentrations in Ang II group were significantly higher than in the control group. The negative effects of Ang II, that is, the decrease in basal and ACh-induced NO production and the increase in oxidative stress, were significantly suppressed by the cotreatment with either valsartan or tempol. Short-term treatment with Ang II significantly increased the ACh-induced increase in plasma NO concentration, as well as basal NO release. Although Ang II stimulates release of NO in the short term, chronic treatment with Ang II elicits the decreased NO bioavailability in the aorta of the Ang II-infusion rabbit model.

Endothelial progenitor cell differentiation and senescence in an angiotensin II-infusion rat model.

The ability of endothelial progenitor cells (EPCs) to participate in endothelial repair is impaired by angiotensin II (Ang II) and other atherogenic factors. Therefore, we investigated the effects of Ang II on the differentiation and senescence of EPCs derived from bone marrow (BM-EPCs) in an Ang II-infusion rat model. Wistar rats (n=40) were infused with Ang II or vehicle, either alone or in combination with an Ang II type 1 receptor (AT(1)R) blocker (valsartan). Bone marrow cells were obtained from the tibias and femurs. Rats of the Ang II treatment group had a significantly lower number of differentiated, adherent BM-EPCs than those of the non-treated control group. Addition of valsartan restored the level of attached, differentiated BM-EPCs to the level in the non-treated controls. The number of senescent BM-EPCs, as assessed by acidic beta-galactosidase staining, was significantly greater in the Ang II-alone group than the control group, and addition of valsartan dramatically delayed the senescence of BM-EPCs in the Ang II-alone group. A polymerase chain reaction (PCR)-ELISA-based assay revealed that telomerase activity was significantly lower in BM-EPCs from the Ang II-alone group than in those from the control group, and addition of valsartan significantly augmented this activity. An MTS assay revealed that Ang II treatment significantly decreased the functional activity in BM-EPCs, and this effect was significantly reversed by valsartan. In conclusion, Ang II decreased the differentiation and accelerated the senescence of BM-EPCs via AT(1)R.

Hyperglycemia accelerated endothelial progenitor cell senescence via the activation of p38 mitogen-activated protein kinase.

BACKGROUND: Both the number and function of bone marrow-derived endothelial progenitor cells (EPCs) have been shown to be impaired in patients with diabetes mellitus. Therefore, we investigated the effect of glucose on the senescence of EPCs. METHODS AND RESULTS: EPCs were isolated from human peripheral blood and characterized to evaluate the effect of glucose (in 5-12.5 mmol/L) on the rate of senescence by acidic beta-galactosidase staining. The phosphorylation of p38 mitogen-activated protein kinase (MAPK) level was analyzed by ELISA. The exposure of cultured EPC to high glucose (HG; 12.5 mmol/L) significantly accelerated the rate of senescence compared with that in osmolar control (L-glucose) during 10 days culture. An inhibitory effect of HG on EPC proliferation disclosed by an MTS assay. The phosphorylation of p38 MAPK in EPCs was also increased by glucose compared with control in a dose-dependent manner. HG-induced EPC senescence was significantly inhibited by the addition of an inhibitor of the p38 MAPK, SB203580. CONCLUSIONS: HG accelerates the onset of EPCs senescence leading to the impairment of proliferative activity, which might be related to the phosphorylation of p38 MAPK.

Sirolimus accelerates senescence of endothelial progenitor cells through telomerase inactivation.

BACKGROUND: Sirolimus-eluting stent (SES) is commonly used to prevent in-stent restenosis but is not infrequently complicated by late angiographic stent thrombosis (LAST). On the other hand, circulating endothelial progenitor cells (EPCs) play a significant role in the maintenance of endothelial integrity. AIM: We examined whether sirolimus affects differentiation, proliferative activity, senescence, colony formation, and network formation in EPCs originated from mononuclear cells (MNCs). METHODS AND RESULTS: MNCs were isolated from peripheral blood of healthy volunteers. EPCs outgrew from the culture of MNCs in the presence of vascular endothelial growth factor. When MNCs were incubated with sirolimus at 0.01, 0.1, and 1 ng/ml for 4 days, sirolimus dose-dependently reduced the number of differentiated, adherent EPCs, as assessed by an in vitro culture assay. After ex-vivo cultivation, EPCs became senescent as determined by acidic beta-galactosidase staining. When MNCs were treated with sirolimus, sirolimus dose-dependently accelerated the onset of EPCs senescence. RT-PCR analysis demonstrated that FK506-binding protein 12 (FKBP12), a receptor of sirolimus, was expressed in MNCs. To obtain an insight into the underlying downstream effects of sirolimus, we measured telomerase activity and the expression of p27(kip1). Sirolimus decreased telomerase activity dose-dependently, which was accompanied with down-regulation of the catalytic subunit, telomerase reverse transcriptase (TERT). Furthermore, sirolimus up-regulated the cell cycle inhibitor p27(kip1). Having demonstrated that sirolimus accelerated the onset of senescence, we examined whether that translated into a decrease in proliferative activity and clonal expansion. Both MTS assay and BrdU incorporation assay have shown that sirolimus treatment significantly diminished the proliferative activity in EPCs. In addition, colony forming unit assay revealed that sirolimus dramatically decreased colony formation as compared to control (no treatment). Finally, in a Matrigel assay, EPCs treated with sirolimus were shown to be less integrated into the network formation than control (no treatment). CONCLUSION: The inhibitory effects of sirolimus on circulating EPCs potently may affect re-endotheliazation after SES implantation.

Effect of estrogen on differentiation and senescence in endothelial progenitor cells derived from bone marrow in spontaneously hypertensive rats.

The functional impairment associated with atherogenic factors, including hypertension, constitutes a limitation to the ability of endothelial progenitor cells (EPCs) to repair. In addition, estrogens have been shown to play a role in reendothelialization after vascular injury. We investigated the effects of estrogens on differentiation and senescence of EPCs derived from bone marrow (BM-EPCs) in spontaneously hypertensive rats (SHR/Izm). Bone marrow (BM) cells were obtained from the tibias and femurs of age-matched, male SHR/Izm and Wistar-Kyoto rats (WKY/Izm). The number of differentiated, adherent BM-EPCs derived from SHR/Izm was significantly smaller than the number derived from WKY/Izm. 17beta-Estradiol (E2) significantly increased the number of adherent BM-EPCs from SHR/Izm, and this effect was significantly attenuated by pharmacological phosphatidylinositol 3-kinase (PI3-K) blockers. Immunoblotting analysis revealed that E2 treatment led to phosphorylation of Akt. Senescence, as assessed by acidic beta-galactosidase staining, occurred at a significantly greater rate in the BM-EPCs from SHR/Izm than in those from WKY/Izm, but E2 treatment dramatically delayed the senescence of BM-EPCs from SHR/Izm. A polymerase chain reaction (PCR)-ELISA based assay revealed that telomerase activity in BM-EPCs from SHR/Izm was significantly lower than in those from WKY/Izm, but that E2 treatment significantly augmented it. Both MTS and colony forming unit assay revealed that E2 treatment significantly augmented the functional activity in BM-endothelial cell (EC)-like cells from SHR/Izm compared to that in control BM-EC-like cells (no treatment). In conclusion, the differentiation of BM-EPCs derived from SHR/Izm was significantly decreased compared with that of BM-EPCs from WKY/Izm. In addition, the rate of senescence was significantly greater in the BM-EPCs from SHR/Izm than in those from WKY/Izm. Estrogen was shown to augment differentiation and delay the onset of senescence in BM-EPCs from SHR/Izm.