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Hypertension and Cardiovascular Research Laboratory, Fundación Jiménez Díaz, 28040 Madrid, Spain
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ABSTRACT |
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Despite the evidence that cytokines stimulate
nitric oxide (NO) production by inducible nitric oxide synthase (iNOS),
several reports recently demonstrated that the hypotensive response
related to endothelial nitric oxide synthase (eNOS) activity could be inhibited by the same cytokines. The aim of the present work was to
analyze whether NO generated by vascular smooth muscle cells (VSMC)
could modify eNOS protein expression in endothelial cells. Bovine
aortic endothelial cells (BAEC) and bovine VSMC (BVSMC) in coculture
were used for the study. Interleukin-1
(IL-1
, 10 ng/ml)-treated
BVSMC, which expressed iNOS protein, decreased eNOS protein expression
in BAEC. The presence of NO antagonists N
-nitro-L-arginine methyl ester
(10
3 mol/l) or
NG-monomethyl-L-arginine
(10
3 mol/l) prevented the
decrease in eNOS protein expression induced by IL-1
-treated BVSMC.
Surprisingly, two different NO donors, 3-morpholinosydnonimine
(10
4 mol/l) and
S-nitroso-N-acetyl-D,L-penicillamine
(10
4 mol/l), failed to
modify eNOS expression in BAEC, suggesting the existence of a
diffusible mediator released from IL-1
-treated BVSMC that acts on
endothelial cells by reducing eNOS expression. The presence of NO
antagonists reduced tumor necrosis factor-
(TNF-
) production by
IL-1
-stimulated BVSMC. This effect was also produced in the presence
of a protein kinase G inhibitor, guanosine-5'-O-(2-thiodiphosphate) trilithium salt. A polyclonal antibody against TNF-
prevented eNOS expression in the BAEC-BVSMC coculture. In conclusion, NO by itself failed to modify eNOS protein expression in endothelial cells but increased TNF-
generation by
IL-1
-stimulated BVSMC and, in this way, reduced eNOS expression in
the endothelium.
coculture; endothelial dysfunction; interleukin-1
; nitric oxide
donors; tumor necrosis factor-
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INTRODUCTION |
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NITRIC OXIDE (NO) is a multifunctional molecule with an important role in the relations among the cells that make up the microvascular environment (21, 27). In the endothelium, the activity of an endothelial nitric oxide synthase (eNOS) mediates NO production. eNOS activity generates small amounts of NO for short periods of time and is dependent on calcium-increasing agents (20, 21). NO released by the eNOS activity is mainly responsible for the so-called endothelium-dependent vasorelaxing response (5).
eNOS activity could be regulated by a variety of factors, including cofactor availability and intracellular localization (10, 38). However, during the last few years different studies have suggested that the ability of the endothelium to produce NO could be also regulated by the level of eNOS expression (14, 18, 40).
It has been shown that vascular smooth muscle cells (VSMC) not only
respond to NO but also are capable of producing it. Stimulation of VSMC
with cytokines induces NO release from these cells by stimulating the
expression of an inducible nitric oxide synthase (iNOS) isoform (4,
31). iNOS expression requires several hours, and its activity generates
large amounts of NO over long periods of time (20, 21, 31). The
induction of iNOS protein has been proposed to occur in a variety of
inflammation-related cardiovascular diseases, e.g., cardiac allograft
rejection, septic shock, heart failure, and atherosclerosis (9, 15, 34,
35), in which different cytokines, i.e., interleukin-1
(IL-1
) and tumor necrosis factor-
(TNF-
), have been reported to be present (23, 30, 33).
In contrast to the evidence that cytokines stimulate NO production by
iNOS activity, several reports recently demonstrated that the
hypotensive response related to eNOS activity could be inhibited by the
same cytokines (24, 25). In this regard, it was recently demonstrated
that TNF-
reduces eNOS protein expression in cultured endothelial
cells (1, 40). Moreover, the vasodilatation related to eNOS activity
was shown to be impaired in atherosclerotic arteries, whereas the
release of NO and cytokines was markedly increased (7, 19, 23, 35).
Because NO by itself has been shown to regulate the expression and
synthesis of several proteins, including growth factors, leukocyte
adhesive proteins, and extracellular matrix proteins (11, 12, 41), the
aim of the present work was to analyze whether NO generated by VSMC
could modify eNOS protein expression in endothelial cells.
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MATERIALS AND METHODS |
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Chemicals.
Interleukin-1
,
N
-nitro-L-arginine methyl ester
(L-NAME) and
NG-monomethyl-L-arginine
(L-NMMA) were purchased from
Sigma (St. Louis, MO). 3-Morpholinosydnonimine hydrochloride (SIN-1)
and S-nitroso-N-acetyl-D,L-penicillamine
(SNAP) were obtained from Alexis (Läufelfingen, Switzerland). All
other chemicals were of the highest commercially available quality from
Sigma. The monoclonal antibodies against iNOS and eNOS were purchased
from Transduction Laboratories (Lexington, KY). The polyclonal
antibodies against TNF-
(10 ml neutralizes 1,000 U) and IL-1
(1 mg neutralizes 1,000 U) were purchased from Genzyme Diagnostics
(Cambridge, MA).
Bovine aortic endothelial cell cultures.
Bovine aortic endothelial cells (BAEC) were obtained and cultured as
previously described (17). In brief, the aortic lumen was filled with
500 mg/l type II collagenase (Sigma) and incubated at 37°C for 20 min. BAEC were harvested in RPMI 1640 medium supplemented with 10%
FCS, 5 mmol/l glutamine, 2 × 10
5 U/l penicillin, and 2 × 10
5 µg/l
streptomycin. Cells were seeded into six-well plates and used at one or
three passages. BAEC exhibited the typical cobblestone appearance and
were positive for von Willebrand factor immunofluorescence.
Bovine VSMC cultures.
After collagenase digestion to isolate the endothelium, the aortic
lumen was scraped to remove contaminating endothelial material. Bovine
aortic media tissue was then removed in small strips and transferred to
tissue culture flasks containing the RPMI medium described in
Bovine aortic endothelial cell
cultures. Once bovine VSMC (BVSMC)
migrated and grew from the explants, the cells were transferred to
collagen type I-coated microporous membrane transwell inserts (0.4-µm
pore size, Millipore). BVSMC were used at one and three passages. As
described (16), the cells exhibited typical "hill and valley"
growth morphology and reacted with anti-
-actin monoclonal antibody
(Boehringer Mannheim).
BAEC-BVSMC coincubation experiments.
The coculture system was prepared as previously described (16) by
placing the transwell inserts containing the BVSMC into wells
containing the BAEC. Before coincubation, BVSMC were stimulated with
IL-1
(10 ng/ml, which corresponds to 0.03 U/l) for 8 h. BVSMC were
then rinsed twice and cocultured with BAEC for a further period of 18 h. Therefore, only BVSMC were pretreated with IL-1
. To assess that
IL-1
was efficiently washed from BVSMC, the level of IL-1
was
determined in the last recovered washed medium by an ELISA kit
(Boehringer Ingelheim, Vienna, Austria). The intra- and interassay
variability of the IL-1
ELISA kit were 9.1 and 8.1%, respectively,
and the low detection limit was 1.6 pg/ml. In the last recovered medium
from the washed BVSMC, IL-1
was undetectable.
3 mol/l) or
L-NMMA
(10
3 mol/l) were
added to the coculture system. In addition, the involvement of TNF-
was tested with an anti-TNF-
polyclonal antibody. As reported
previously (32), the dilution of anti-TNF-
antibody (1:400) used was
sufficient to completely neutralize TNF-
bioactivity in the standard
L929 cell cytotoxicity.
Determination of iNOS and eNOS protein expression.
eNOS protein expression was determined in BAEC coincubated with
IL-1
-treated BVSMC as described in BAEC-BVSMC
coincubation experiments. After the different
experimental maneuvers, BAEC were collected and boiled in Laemmli
buffer (13) containing 2-mercaptoethanol. Equal amounts of protein (20 µg/lane) measured by bicinchoninic acid reagent (Pierce, Rockford,
IL) were loaded. To verify the equal amounts of proteins loaded in the
gel, a parallel gel was run and stained with Coomassie blue and the
intensities of the protein bands were examined. Proteins were separated
on denaturing SDS-10% polyacrylamide gels and blotted onto
nitrocellulose (Immobilon-P, Millipore). Blots were blocked overnight
at 4°C with 5% nonfat dry milk in TBS-T (20 mmol/l
Tris · HCl, 137 mmol/l NaCl, 0.1% Tween 20). Western blot
analysis was performed with a monoclonal antibody against eNOS protein.
Blots were incubated with the first antibody (1:2,500) for 1 h at room
temperature and, after extensive washing, with the second antibody
(horseradish peroxidase-conjugated anti-mouse immunoglobulin antibody)
at a dilution of 1:1,500 for another hour. Specific eNOS protein was detected by enhanced chemiluminescence (ECL, Amersham) and evaluated by
densitometry (Molecular Dynamics).
Measurement of NO production.
NO release by the NO donors was assessed as nitrite generation. BAEC
were incubated with the NO donors SIN-1
(10
4 mol/l) and SNAP
(10
4 mol/l). After 18 h of
incubation the supernatants were recovered, and after centrifugation
(2,500 rpm, 10 min), nitrite accumulation was measured with a
commercial kit (Cayman Chemical, Ann Arbor, MI) based in the Griess
reaction after the conversion of nitrate to nitrite with nitrate
reductase. Nitrite concentrations were determined at an optical density
of 554 nm by comparison with standard solutions of sodium nitrite
prepared in the same incubation culture medium.
TNF-
determinations.
BVSMC were stimulated with IL-1
(10 ng/ml) for 18 h. In similar
experiments, the L-arginine
antagonists L-NMMA
(10
3 mol/l) and
L-NAME
(10
3 mol/l), the NO donors
SIN-1 (10
4 mol/l) and SNAP
(10
4 mol/l), the
cGMP analog dibutyryl cGMP
(10
4 mol/l), and the
protein kinase G inhibitor guanosine
5'-O-(2-thiodiphosphate) (GDP-
-S,
10
4 mol/l) were also added.
TNF-
was measured in the BVSMC incubation medium by an ELISA Kit
(Chromogenix). The intra- and interassay variability of the ELISA kit
were 1.1 and 4.7%, respectively.
Statistical methods Results are expressed as means ± SE. Unless otherwise stated, each value corresponds to a minimum of six experiments done in triplicate. Comparisons were done by ANOVA or paired and unpaired Student's t-test when appropriate. Bonferroni's correction for multiple comparisons was used to determine the level of significance of the P value.
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RESULTS |
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Effects of IL-1
-stimulated BVSMC on eNOS protein
expression in BAEC.
To analyze whether the NO produced by BVSMC could modify eNOS protein
expression in adjacent BAEC, IL-1
-treated BVSMC plated on
six-transwell inserts were placed over a monolayer of BAEC for 18 h. In
these assays, BVSMC were rinsed twice before coincubation (see
MATERIALS AND METHODS); therefore,
only BVSMC were activated by the exogenous cytokine.
for 8 h,
these cells still expressed the iNOS protein 18 h after being
coincubated with BAEC (Fig. 1). The
presence of IL-1
-treated BVSMC decreased eNOS protein expression in
BAEC (Fig. 1), indicating that mediators released from IL-1
-treated
BVSMC decreased eNOS protein expression in BAEC. Under basal conditions
(BAEC coincubated with nontreated BVSMC), no effect of BVSMC on eNOS
expression was observed different from that found in BAEC incubated
alone (Fig. 1).
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-treated BVSMC could be involved in the reduction of
eNOS expression observed in the adjacent BAEC. For this purpose, two
different L-arginine
competitors, L-NAME
(10
3 mol/l) and
L-NMMA
(10
3 mol/l), were added to
the coculture system. The above-mentioned decrease in eNOS protein
expression in BAEC elicited by IL-1
-treated BVSMC was fully
prevented by blocking NO generation with either L-NAME or
L-NMMA (Fig.
2). In the absence of IL-1
- treated
BVSMC, L-NAME and
L-NMMA failed to modify eNOS
protein expression in BAEC (Fig.
3).
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Importance of BVSMC for effects of NO on eNOS protein expression in
BAEC.
Once we verified the decrease elicited by IL-1
-treated BVSMC on eNOS
protein expression in BAEC and its prevention by the L-arginine antagonists, we
further tested the ability of exogenous NO donors to reduce eNOS
protein expression in BAEC.
4 mol/l) and SNAP
(10
4 mol/l), failed to
reduce the expression of eNOS in BAEC, strongly suggesting that the
presence of BVSMC is essential for the effects of NO on eNOS protein
expression (Fig. 4,
A and
B). The ability of the NO donors to
generate NO was assessed by measuring the nitrite concentration in the
incubation medium. As shown in Fig. 4C, both SNAP and SIN-1 produced
higher amounts of nitrite than those obtained in the coculture of BAEC
with IL-
-treated BVSMC.
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-treated BVSMC could act on the BVSMC themselves, releasing a
diffusible factor that could be responsible for the decreased eNOS
protein expression in BAEC.
TNF-
as mediator of interaction between BVSMC and
BAEC.
TNF-
was proposed as the mediator involved in the above-mentioned
effects, on the basis of recent data that demonstrated that exogenous
TNF-
reduced eNOS mRNA stability in endothelial cells (1,
40).
antibody could prevent the
decrease in eNOS expression mediated by IL-1
-treated BVSMC. The
addition of a polyclonal anti-TNF-
antibody to the BAEC-BVSMC coculture abolished the decreased eNOS protein expression in BAEC mediated by IL-1
-treated BVSMC (Fig. 5).
This effect was not observed when a nonspecific IgG was used (Fig. 5).
The efficacy of the polyclonal antibody to inhibit TNF-
activity was
confirmed by its ability to prevent the reduction of eNOS protein
expression produced by the addition of exogenous TNF-
even at
concentrations >5,000 pg/ml (data not shown).
|
. Under basal
conditions the production of TNF-
by BVSMC was 22 ± 3 pg/ml, and
it increased to 40 ± 2 pg/ml after IL-1
incubation. Because the
reactivity of bovine TNF-
in the TNF-
ELISA used may not reach
100%, the values obtained could not be quantitative; therefore, they
were expressed as percent change from the basal value. The addition of
L-NAME
(10
3 mol/l) or
L-NMMA
(10
3 mol/l) inhibited the
release of TNF-
induced by IL-1
(Fig. 6A).
Addition of the NO donors SIN-1
(10
4 mol/l) or SNAP
(10
4 mol/l) alone did not
modify the generation of TNF-
by BVSMC (Fig.
6B). However, these NO donors
enhanced IL-1
-stimulated TNF-
production by BVSMC (Fig.
6C).
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4 mol/l), to
IL-1
-stimulated BVSMC significantly enhanced TNF-
production by
BVSMC (% increase in TNF-
released with respect to basal level: 46 ± 3; n = 5, P < 0.05). In the absence of
IL-1
, the analog of cGMP failed to modify TNF-
production by
BVSMC (% increase 4 ± 1; n = 5, P = not significant). A protein kinase
G inhibitor, GDP-
-S (10
4
mol/l), reduced the release of TNF-
by IL-1
- stimulation of BVSMC
in a degree similar to that observed with
L-NAME and
L-NMMA (% increase in TNF-
released with respect to basal level: 13 ± 4;
n = 5, P < 0.05 with respect to
IL-1
-stimulated BVSMC).
Finally, we tested the ability of exogenous TNF-
to decrease eNOS
protein expression in BAEC. TNF-
reduced eNOS protein expression in
BAEC in a dose-dependent manner (Fig. 7).
The threshold dose of exogenous TNF-
to decrease eNOS protein was 50 pg/ml (Fig. 7), which was higher than that endogenously produced by IL-1
-stimulated BVSMC (40 ± 2 pg/ml), suggesting the involvement of other agents released from BVSMC, which could favor the effect of
TNF-
on BAEC. In this regard, TNF-
has been reported to induce the release of other cytokines, including IL-1
, from VSMC
(37). Therefore, we further determined the effect of
exogenous IL-1
on eNOS protein expression in BAEC. The external
addition of IL-1
diminished eNOS protein expression in a
dose-dependent manner (Fig. 8). The
threshold dose of exogenous IL-1
to decrease eNOS protein was >100
ng/ml (Fig. 8), which was higher than that of TNF-
(Fig. 7).
Moreover, the same dose of IL-1
provoked a significantly lesser
reduction of eNOS protein expression than TNF-
in BAEC.
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|
antibody
(0.1 mg/ml) to the BAEC-BVSMC coculture inhibited the decrease in eNOS
protein expression mediated by IL-1
-treated BVSMC (Fig.
9). The efficacy of the polyclonal antibody
to inhibit IL-1
activity was confirmed by its ability to prevent the
induction of iNOS protein expression by IL-1
-stimulated BVSMC (Fig.
10). It was noteworthy that the levels of
eNOS expression achieved in the presence of anti-IL-1
were lower
than in the presence of anti-TNF-
(Figs.
5A and
9A). In this regard, levels of
anti-IL-1
antibody >0.1 mg/ml failed to increase its
above-described effects on eNOS expression in the coculture of BAEC and
BVSMC (data not shown).
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DISCUSSION |
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The present study provides new evidence about the interaction of the
two major constituents of the vascular wall, i.e., endothelial cells
and smooth muscle cells. The main findings of the present work indicate
that IL-1
-treated BVSMC decrease eNOS protein expression in BAEC by
a mechanism in which NO and TNF-
are involved.
Several reports have shown that the vasodilator response to endothelial
receptor-dependent agonists, which is related to eNOS activity, is
substantially decreased after endotoxemia (23, 24), a pathological
situation accompanied by increased iNOS activity in a variety of cell
types, including VSMC (3, 31). In the same line of evidences, Minor et
al. (19) showed an impaired endothelium-dependent vasorelaxation in
atherosclerotic rabbits that was accompanied by an increased NO release
from the vessel wall. Furthermore, Aoki et al. (2), by in vitro
exposure of carotid arteries to TNF-
, a cytokine that stimulates
iNOS gene expression (8), provided functional evidences of impaired
agonist-dependent NO release. Moreover, NO by itself regulates the
expression of several proteins (11, 12, 41). Therefore, we determined whether the NO released from VSMC through iNOS activity could affect
eNOS protein expression in the adjacent endothelial cells. Our results
showed that when iNOS protein expression was stimulated in BVSMC by
IL-1
, eNOS protein expression in the coincubated BAEC was markedly
reduced. The finding that eNOS protein expression was protected by
antagonists of the L-arginine-NO
pathway suggested that IL-1
-treated BVSMC decreased eNOS protein
expression by NO-dependent mechanisms. It should be noted that the
blockade of NO synthesis by IL-1
-treated BVSMC not only preserved
but also increased eNOS protein expression in the endothelial cells above baseline levels.
Despite the fact that the incubation medium of the cells contained
antibiotics and we failed to find bacteria and endotoxin in it, a weak
iNOS protein expression in the absence of IL-1
was observed. This
slight iNOS expression could be caused by agents contained in the FCS,
i.e., cytokines.
Because both L-arginine
antagonists, L-NAME and
L-NMMA, reversed the effect of
IL-1
-treated BVSMC on eNOS protein expression in endothelial cells,
we hypothesized that NO released from BVSMC could be the responsible
mediator of the effects of BVSMC on eNOS decrease in the adjacent BAEC.
To further support this suggestion, two different NO donors, SIN-1 and
SNAP, were directly added to BAEC and eNOS protein expression was
determined. Despite the fact that the amount of NO generated by the two
NO donors was higher than the amount produced by the IL-1
-stimulated
BVSMC, surprisingly, none of the NO donors modified eNOS protein
expression in BAEC. Furthermore, in the absence of BVSMC, the blockade
of NO synthesis by BAEC failed to modify eNOS protein expression. These
results suggested that the direct action of NO on endothelial cells was not the mechanism by which IL-1
-treated BVSMC decreased eNOS expression in the endothelial cells. These paradoxical results could
indicate that NO released by BVSMC interacts with BVSMC themselves,
favoring the production of other mediator(s) that act on endothelial
cells, reducing the expression of the eNOS protein.
In the blood vessel, smooth muscle cells are a local source of TNF-
,
which contributes substantially to the inflammatory response within the
microenvironment of the vascular wall (28, 37). It was also
demonstrated that TNF-
decreases eNOS expression in endothelial
cells (40). In this regard, we recently demonstrated (1) that the
reduction of eNOS mRNA stability, through the binding of endothelial
cytosolic proteins to the 3'-unstranslated region of the eNOS
mRNA, is the mechanism by which TNF-
regulates eNOS protein
expression in BAEC. Therefore, TNF-
was proposed as a potential
mediator involved in the observed BVSMC- and NO-dependent reduction of
eNOS expression in endothelial cells. The addition of an anti-TNF-
antibody to BAEC-BVSMC cocultures completely prevented the inhibition
of IL-1
-treated BVSMC on eNOS protein expression in endothelial cells.
Therefore, we determined whether NO produced by the cytokine-stimulated
BVSMC modulates TNF-
production by these cells. We first observed
that TNF-
production by BVSMC was stimulated in the presence of
IL-1
. Furthermore, the two NO antagonists,
L-NAME and
L-NMMA, significantly decreased
IL-1
-induced TNF-
production by BVSMC. However, NO was only a
potentiator of TNF-
generation by IL-1
-stimulated BVSMC because
it was unable by itself to stimulate TNF-
production in the absence
of IL-1
. In this regard, the NO donors SIN-1 and SNAP enhanced
IL-1
-induced TNF-
release by BVSMC.
The underlying mechanisms by which NO enhanced IL-1
-induced TNF-
release by BVSMC were further analyzed, keeping in mind that a main
pathway of intracellular signal transduction of NO is cGMP (20, 21,
27). Moreover, it has been demonstrated that cGMP favors TNF-
production in macrophages by increasing TNF-
gene transcription
(29). In the present work, the involvement of cGMP in the regulation of
TNF-
production by BVSMC was suggested by the fact that a cGMP
analog potentiated the release of TNF-
. Furthermore, a protein
kinase G inhibitor reduced the release of TNF-
by IL-1
-stimulated
BVSMC to a degree similar to that observed with the
L-arginine antagonists.
It should also be noted that although
L-NAME and
L-NMMA partially inhibited
TNF-
production by IL-1
-stimulated BVSMC, this was enough to
maintain eNOS protein expression in BAEC, supporting the important role
of NO released from BVSMC in the control of eNOS expression in
endothelial cells.
An interesting observation was that the amount of exogenous TNF-
needed to directly reduce eNOS protein expression in BAEC was higher
than that endogenously generated by IL-1
-stimulated BVSMC. The
reactivity of bovine TNF-
in the TNF-
ELISA kit used was not
100%, and therefore we could not assess the exact amount of TNF-
generated by IL-1
-stimulated BVSMC. However, we could not discard
the possibility that TNF-
produced by BVSMC could itself act on
BVSMC and induce them to produce other agents that would contribute to
sensitizing the endothelium to the action of endogenous TNF-
. In
this sense, a number of studies have demonstrated that TNF-
induces
the synthesis and release of agents such as cytokines and free radicals
from smooth muscle cells (36, 37, 39). In this regard, IL-1
also
diminished eNOS protein expression in the endothelium, although with a
lesser ability than TNF-
, suggesting that NO and TNF-
are
required but probably are not the only BVSMC-released mediators that
decrease eNOS protein expression in the endothelium. Therefore, the
regulation by cytokine-stimulated smooth muscle cells of the eNOS
expression in the endothelium could be a multifactorial phenomenon, in
which TNF-
and NO could be some of the main mediators. Further
studies are needed to clarify whether other inhibitors released from
the smooth muscle cells might be implicated in the above-described effects.
In conclusion, we have shown that IL-1
-stimulated BVSMC reduce eNOS
protein expression in endothelial cells by at least an NO- and
TNF-
-dependent mechanism. The loss of eNOS expression by the
endothelium and, therefore, the resulting decrease in its capability
to produce NO in response to physiological stimuli, could
compromise the ability of these cells to protect against thrombosis and leukocyte adhesion and favor the impaired
endothelium-dependent hypotensive response described in a variety of
cardiovascular diseases (20, 21, 26, 27). Increased levels of
cytokines, which are stimulators of iNOS expression, have been also
demonstrated in these pathological situations (23, 30, 33), in which an
endothelial dysfunction seems to have a main role in their development.
Thus the present work points out the potential importance of VSMC in
the regulation of eNOS protein expression in endothelial cells and,
therefore, the putative involvement of VSMC in the regulation of
inflammation-related endothelial dysfunction.
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ACKNOWLEDGEMENTS |
|---|
The authors thank María Begoña Ibarra for secretarial assistance.
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FOOTNOTES |
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This work was supported by grants from SAF 97/0022 of Plan Nacional de Investigación + Desarrollo, Fundación Mapfre Medicina, and Sociedad Española de Cardiología. T. De Frutos, M. García-Durán, F. González-Fernández, J. A. Rodríguez-Feo, and J. Guerra are fellows of Fundación Conchita Rábago de Jiménez Díaz. M. Montón and L. Sánchez de Miguel are postdoctoral fellows of Laboratories Bayer and Hypertension and Cardiovascular Research Laboratory.
The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. §1734 solely to indicate this fact.
Address for reprint requests and other correspondence: A. López-Farré, Hypertension and Cardiovascular Research Laboratory, Fundación Jiménez Díaz, Avda Reyes Católicos, 2, 28040 Madrid, Spain (E-mail: alopez{at}uni.fjd.es).
Received 17 September 1998; accepted in final form 19 May 1999.
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