Role of Fas/Fas-L in vascular cell apoptosis.

Apoptosis of vascular cells is observed in vivo in normal vessel development and a variety of vascular pathologies. Apoptosis occurs in all cell types within the vessel wall, the consequences of which depend on both cell type and the pathology under study. The death receptor Fas is expressed throughout the vessel wall, and increasingly Fas-Fas-L-induced killing has been recognized in the vasculature. This review outlines the current developments in understanding the role, regulation, and consequences of Fas-Fas-L-induced apoptosis in vascular cells.

Endothelin-mediated vasoconstriction in early atherosclerosis is markedly increased in ApoE-/- mouse but prevented by atorvastatin.

We have discovered that endothelin-1 (ET-1) vasoconstriction is significantly enhanced in aortas of young (8-16-week-old) apolipoprotein E-deficient (ApoE-/-) mice devoid of atherosclerotic lesions (maximum response expressed as a percentage of the mean response to 100 mM KCl (E(MAX)) = 55.7% +/- 19.5% KCl, n = 5) compared to age-matched C57BL/6/J control animals (E(MAX) = 12.6% +/- 2.5% KCl, n = 8), indicating that alterations in the endothelin system may contribute to disease progression, at least in this animal model. There was no difference in the potency of ET-1 to contract aorta from the two groups (C57BL/6/J pD2 = 8.74 +/- 0.30; ApoE-/- pD2 = 8.50 +/- 0.15, P > 0.05). This increased response was specific to ET-1, as it was not observed with phenylephrine or U46619, nor was it due to a non-receptor mediated increase in contractile sensitivity, as there was no change in response to KCl between the two groups. [125I]ET-1 bound with subnanomolar affinity (K(D)) to aorta (K(D) = 0.018 +/- 0.002 nM, n = 4) and, with an order of magnitude lower affinity, to heart (K(D) = 0.47 +/- 0.05, n = 5) of C57BL/6/J mice with binding densities (B(MAX)) of 9.3 +/- 2.4 fmol mg(-1)protein and 100 +/- 14 fmol mg(-1) protein, respectively. Alterations in vascular reactivity to ET-1 could not be explained by increased endothelin receptor density or affinity, as these were not altered in aorta (K(D) = 0.011 +/- 0.003 nM; B(MAX) = 10.1 +/- 3.9 fmol mg(-1), n = 4) and heart (K(D) = 0.43 +/- 0.04 nM; B(MAX) = 115 +/- 26 fmol mg(-1), n == 6) of ApoE-/- animals. The ratio of ET(A) to ET(B) receptors in heart of control and ApoE-/- mice was similar, comprising 89% and 85% ET(A) receptors, respectively. In isolated aorta from ApoE-/- mice on the Western diet, which more closely resembled more advanced stages of the disease in man, the augmented ET-1 vasoconstrictor response was maintained (E(MAX) = 25.2% +/- 6.8% KCl, n = 9); however, it was completely prevented in animals that had received 10 weeks of oral atorvastatin (30 mg kg(-1) day(-1)) (E(MAX) = 4.0% +/- 1.5% KCl, n = 5), a concentration that was chosen because it did not affect plasma cholesterol and triglyceride levels. Therefore, this protective prevention of enhanced ET-1 vasoconstriction in ApoE-/- mice by atorvastatin was independent of its lipid-lowering properties.

Role of apoptosis in atherosclerosis and its therapeutic implications.

Atherosclerotic plaques develop as a consequence of the accumulation of circulating lipid and the subsequent migration of inflammatory cells (macrophages and T-lymphocytes) and VSMCs (vascular smooth muscle cells). Advanced plaques consist of a lipid-rich core, separated from the lumen by a fibrous cap composed of VSMCs, collagen and extracellular matrix. Plaque enlargement ultimately narrows the lumen (stenosis) causing angina. However, recent studies have emphasized that acute coronary syndromes (unstable angina/myocardial infarction) are caused by lesion erosion/rupture with superimposed thrombus formation on often small non-stenotic plaques. Thus current therapies work predominantly on stabilization of plaques rather than plaque regression. Apoptosis (programmed cell death) is increasingly observed as plaques develop, although the exact mechanisms and consequences of apoptosis in the development and progression of atherosclerosis are still controversial. Increased endothelial cell apoptosis may initiate atherosclerosis, whereas apoptosis of VSMCs and macrophages localizes in 'vulnerable' lesions, i.e. those most likely to rupture, and at sites of rupture. This review will focus on the regulation of apoptosis of cells within the vasculature, concentrating on the relevance of apoptosis to plaque progression and clinical consequences of vascular cell apoptosis.