|
|
||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
vβ3 acts downstream of insulin in normalization of interstitial fluid pressure in sepsis and in cell-mediated collagen gel contraction1Department of Biomedicine, University of Bergen, Bergen, Norway; 2Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden; and 3Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
Submitted 15 February 2008 ; accepted in final form 2 June 2008
| ABSTRACT |
|---|
|
|
|---|
vβ3. In C57 black mice (n = 6), LPS lowered PIF from –0.2 ± 0.2 to –1.6 ± 0.3 (P < 0.05) and after insulin averaged –0.8 ± 0.2 mmHg (P = 0.098 compared with after LPS). Corresponding values in wild-type BALB/c mice (n = 5) were –0.8 ± 0.1, –2.1 ± 0.3 (P < 0.05), and –0.8 ± 0.3 mmHg (P < 0.05 compared with LPS) after insulin administration. In BALB/c integrin β3-deficient (β3–/–) mice (n = 6), LPS lowered PIF from –0.1 ± 0.2 to –1.5 ± 0.3 mmHg (P < 0.05). Insulin did not, however, restore PIF in these mice (averaged –1.7 ± 0.3 mmHg after insulin administration). Cell-mediated collagen gel contraction can serve as an in vitro model for in vivo measurements of PIF. Insulin induced
vβ3-integrin-dependent collagen gel contraction mediated by C2C12 cells. Our findings suggest a beneficiary effect of insulin for patients with sepsis with regard to the fluid balance, and this effect may in part be due to a normalization of PIF by a mechanism involving the integrin
vβ3.
glucose-insulin-potassium treatment; tissue fluid balance; inflammation
2β1 IgG to rat dermis causes a lowering of PIF, suggesting that β1-integrins mediate cellular tension on the collagen/microfibrillar network during fluid homeostasis (24). We have proposed a model where we suggest that the lowering of PIF seen in inflammatory reactions is caused by an impairment of β1-integrin function. This results in connective tissue cells releasing their tension on the connective tissue molecules and thereby allowing the ground substance to take up fluid and swell, leading to an edema.
Cell-mediated collagen gel contraction is an in vitro method where the ability of cells to compact a collagen gel is studied. Cell-mediated collagen gel contraction can be used as an in vitro model for cellular control of PIF in vivo. This notion is based on the observation of similarities between the two processes, i.e., a number of substances that have been shown to inhibit collagen gel contraction also lower PIF, and substances that have been shown to stimulate collagen gel contraction also raise a lowered PIF. Thus anti-β1-integrin IgG, prostaglandin E1, and interleukin (IL)-1 inhibit collagen gel contraction (4, 15, 27) and lower PIF (4, 15, 20), whereas PDGF-BB and prostaglandin F2
stimulate collagen gel contraction and restore a lowered PIF to control levels (4, 10, 24). PDGF-BB normalizes a lowered PIF back to control levels in mouse dermis by a process that depends on integrin
vβ3 (15). Furthermore, the stimulation of cells with PDGF-BB enables
vβ3-mediated contraction of collagen gels in vitro (5, 8, 15).
Insulin restores a lowered PIF to control levels (from –0.7 in the control situation to –2.0 after LPS exposure, and then back to –0.4 mmHg after insulin administration) in rat dermis, suggesting that insulin may counteract inflammation-induced edema formation (20). Furthermore, an anti-inflammatory effect of insulin was suggested since the continuous glucose-insulin-potassium treatment lowered plasma and interstitial fluid levels of the proinflammatory cytokines TNF-
and IL-1β in a sepsis model and also reduced the acute albumin extravasation (20).
The clinical trials with insulin therapy in the intensive care unit (ICU) show conflicting results. Intensive insulin therapy was shown to reduce morbidity and mortality in critically ill patients hospitalized in the surgical ICU (29). These results on mortality could not be reproduced in a later study from the medical ICU (28), and the place for insulin therapy is still debated. The Surviving Sepsis Campaign (6) recommends the use of insulin to control hyperglycemia in patients with severe sepsis, after stabilization in the ICU. The potentially beneficial effect of insulin may be direct, as an anti-inflammatory agent (20), or indirect via strict blood glucose control (28).
Considering the similarities between in vitro collagen gel contraction and in vivo measurement of PIF together with the observation that PDGF-BB restores a lowered PIF in a process dependent on
vβ3-integrins, we hypothesized that 1) insulin stimulates cell-mediated collagen gel contraction and 2) insulin restores a lowered PIF in a process dependent on
vβ3-integrins. The present study was performed to test these hypotheses. Briefly, we demonstrated that insulin normalized a PIF lowered by LPS in a process dependent on integrin
vβ3.
| MATERIALS AND METHODS |
|---|
|
|
|---|
Cells and cell culture.
Murine C2C12 myoblast cells, from the American Type Culture Collection, were kindly provided by Dr. A. Starzinski-Powitz. C2C12 cells lack collagen-binding β1-integrins and do not mediate collagen gel contraction in the absence of exogenous stimulators (26). C2C12-
2 cells are C2C12 cells transfected with human full-length integrin
2 cDNA and have been described earlier (26). These cells express integrin
2β1 as the only collagen-binding integrin. Cells were kept in Dulbecco's modified Eagle's medium (DMEM) supplemented with 10% fetal bovine serum (both from GIBCO; Gaithersburg, MD), 60 µg/ml penicillin, and 50 µg/ml streptomycin at 37°C with 5% CO2-95% room air.
Collagen gel contraction.
Collagen gel contractions were performed as previously described (9). Briefly, 96-well plates (Sarstedt, Nümbrecht, Germany) were blocked in BSA overnight at 37°C and washed with PBS. Cells were washed two times in DMEM and mixed with a collagen solution containing five parts 2x DMEM, one part 0.2 mol/l HEPES (pH 8.0), and four parts collagen type I (Vitrogen 100, Cohesion, Palo Alto, CA) to a final concentration of 100,000 cells/ml. When indicated, anti-integrin β1 IgM (10 µg/ml final concentration; Ha2/5, BD Pharmingen, San Diego, CA) and/or an integrin
v inhibitor [10 µmol/l final concentration, cyclo-(Arg-Gly-Asp-D-Phe-Val); Bachem, Bubendorf, Switzerland] were added to the cell/collagen suspension. Cell/collagen suspension (100 µl) was transferred to each well in the 96-well plates, and the plates were left in 37°C for 1.5 h for gels to form. The gels were then detached from the walls of the wells by injection of 100 µl DMEM into each well. When indicated, insulin (Insuman Rapid, Aventis Pharma, Paris, France) was added to the flotation media (0.1 IU/ml final concentration). The relaxed, floating gels were further incubated at 37°C, and gel diameters were measured microscopically at the indicated time points. Contraction is presented as the gel area in percentage of the original gel area. Each experiment was repeated three times with a minimum of six gels per condition.
PIF measurements. PIF was measured using sharpened glass capillaries filled with 0.3 M NaCl colored with Evans blue and connected to a servo-controlled counterpressure system (30). The punctures were performed through intact skin using a stereomicroscope (Wild M5, Heerbrugg, Switzerland). Care was taken not to cause any compression or retraction of the skin while puncturing. The animal was placed in a supine position, and the left hind paw was carefully fixed to the table with surgical tape. Control PIF was measured with the circulation still intact. NaCl (controls) or 10 µg LPS (Sigma, St. Louis, MO) in 0.1 ml 0.9% NaCl was injected intravenously and allowed to circulate for 2 min before circulatory arrest was induced. Circulatory arrest was induced to prevent a potential underestimation of the lowered PIF due to increased interstitial fluid volume as a result of increased transcapillary fluid flux. The PIF was monitored for 30 min, and 0.5 µl insulin, 0.1 IE/ml Actrapid (Novo Nordisk, diluted in 0.9% NaCl) was then injected subdermally using a 10-µl chromatography syringe (Hamilton). Measurements were then continued for another 30 min at the edge of the injected volume, and all measurements were preformed at the same distance from the injection site, visually controlled. The pressure measurements were averaged in 15-min periods. For a measurement to be accepted, the following criteria had to be fulfilled: 1) feedback gain could be changed without changing the pressure, and 2) applying suction to the pipette by the pump increased the resistance in the pipette (this ensured contact between the pipette and the interstitial fluid, i.e., that the pipette was open), and 3) zero pressure did not change during the measurement.
Statistical analysis. One-way ANOVA and subsequent Bonferroni post hoc tests were used for each experimental group, comparing control, 15 to 30 min, and 45 to 60 min. Thereafter, the groups were compared against each other for the specific periods. For the in vitro gel experiments, Student's t-tests were used. Results are presented as means ± SE. P < 0.05 was considered statistically significant.
| RESULTS |
|---|
|
|
|---|
vβ3, abolished the stimulatory effect of insulin (Fig. 1).
|
2-subunit cDNA, which leads to the expression of the collagen-binding integrin
2β1 (C2C12-
2 cells), effectively contracted collagen gels also in the absence of exogenous stimulators (Fig. 2A). Also, these cells were stimulated by insulin, but the cyclic RGD peptide had no inhibitory effect (Fig. 2A).
|
2 cell-mediated contraction, and this inhibition could be partly overcome by insulin (Fig. 2B). The combination of anti-integrin β1 IgM and the cyclic RGD peptide, however, completely inhibited contraction by C2C12-
2 cells (Fig. 2C). As has been shown in rat dermis (20), the intravenous injection of LPS significantly decreased PIF in C57BL/6J mouse dermis (Fig. 3A, and Table 1). After an initial decrease in PIF, the subdermal injection of insulin restored PIF to control levels (Fig. 3A, and Table 1). The subdermal injection of NaCl did not normalize a LPS-induced lowering of PIF, and, in addition, a subdermal injection of insulin in naive dermis had no effect on PIF (Fig. 3A, and Table 1).
|
|
| DISCUSSION |
|---|
|
|
|---|
vβ3 acts downstream of ligand-stimulated insulin receptors and/or insulin-like growth factor receptor-1 (IGF-R1) in normalizing dermal PIF, which had been lowered by LPS-induced inflammation. The mechanism by which insulin normalized PIF most likely involves the contraction of the loose connective tissues surrounding the blood vessels. This notion is based on the present findings as follows: 1) insulin normalized PIF when the blood circulation was arrested during the time of measurement, excluding the possibility that endothelial cells or plasma proteins participated in fluid transport and changes of PIF; and 2) insulin induced integrin
vβ3-mediated collagen gel contraction by in vitro cultured cells lacking collagen-binding β1-integrins.
PDGF-BB (15) and insulin (present study) depend on integrin
vβ3 and have similar effects on PIF and collagen gel contraction, making it likely that the two factors elicit common intracellular signal pathways controlling contraction. Our laboratory (10) has previously shown that the activation of phosphatidylinositol 3-kinase (PI3K) by ligand-stimulated PDGF β-receptors is crucial for PDGF-BB-stimulated normalization of PIF and cell-mediated collagen gel contraction. Similarly, the ability of insulin to normalize a lowered PIF involves the activation of PI3K (20). In addition, the inhibition of PI3K in naive dermis lowers PIF (1). Together, these findings suggest that insulin and PDGF-BB elicit a common PI3K-dependent signaling pathway that promotes cellular contraction and that is of importance in the control of PIF.
Insulin signaling is mediated mainly through the insulin receptor although insulin also binds and stimulates the structurally similar IGF-R1, albeit with substantially lower affinity, as well as the IGF-R1/insulin receptor hybrid receptors (18, 21, 25). IGF-1 that binds and activates IGF-R1 stimulates fibroblast-mediated collagen gel contraction (12, 14). It is currently not known whether insulin exerts its effects on PIF through the stimulation of the insulin receptors or IGF-R1.
The results presented here suggest that insulin, similar to PDGF-BB (15), induced collagen gel contraction by a mechanism that involves integrin
vβ3. Insulin-induced contraction mediated by C2C12 cells that lack collagen-binding β1- integrins was completely dependent on integrin
vβ3. The contraction mediated by C2C12-
2 cells, which express integrin
2β1, also proceeded in the absence of exogenous stimulation (autocontraction). In contrast to C2C12 cells, neither the autocontraction nor the stimulatory effect of insulin on C2C12-
2 cells was dependent on integrin
vβ3. However, C2C12
2-mediated contraction was only partly dependent on integrin
2β1. To completely block the contraction by C2C12-
2 cells, the blockage of both
vβ3 and
2β1 was needed. This suggests a subordinate role for
vβ3-integrins when functional collagen-binding β1-integrins are present. We and others have previously shown that integrin
vβ3 can mediate collagen gel contraction but only when β1-integrins are absent or perturbed, and the results presented here are consistent with that (5, 8, 15). In this study it is demonstrated by the fact that the cyclic RGD peptide does not have an effect on integrin
2β1-mediated contraction, but once that contraction is blocked, the
vβ3-mediated contraction becomes evident.
The collagen gel contraction is an established model for wound contraction and tissue remodeling in vitro (3). We have used this in vitro assay to investigate and evaluate the in vivo control of PIF (4, 10, 15). So far, the results obtained in the collagen gel contraction have been parallel to the in vivo observations, i.e., agents that enhance contraction attenuate a lowering of PIF, whereas agents that slow the contraction will lower PIF. In this study such experiments were performed using the murine myoblastic C2C12 cells. These cells were chosen since they lack the endogenous expression of all collagen-binding integrins. This is a prerequisite to be able to investigate contraction mediated by
vβ3-integrins.
The results discussed above from collagen gel contractions are in agreement with results from in vivo PIF measurements where β1-integrins are responsible for maintenance of PIF under normal conditions, whereas β3-integrins are involved in the restoration of a lowered PIF when β1-integrin function is disrupted (10, 15, 23, 24). As previously demonstrated for PDGF-BB, we now demonstrate that insulin also restored a lowered PIF in an integrin
vβ3-dependent manner. After a sepsis-induced lowering of PIF, insulin restored PIF to control levels in integrin β3 wild-type but not in integrin β3-deficient mice. Thus insulin used the
vβ3-integrin for restoring a lowered PIF. Interestingly, insulin had no effect under normal conditions. Only after the initial drop in PIF as a result of the disruption of the collagen-binding integrin function, the effect of insulin became evident. This is in agreement with the in vitro results where inhibition of
vβ3-integrins had no effect on collagen gel contraction mediated by cells expressing collagen-binding integrins. It is also in agreement with observations using PDGF-BB that, under control conditions, do not influence PIF but will restore a lowered PIF (15, 24). In addition, the expression levels of integrin
vβ3 are low in normal tissues, whereas the expression is elevated in inflamed tissues and in tumor tissues (7, 32), which also supports the hypothesis that the
vβ3-integrins have a subordinate role in the presence of functional β1-integrins.
The PIF measurements, after the measurement of a control in vivo pressure, are performed in mice with arrested circulation. This is done to prevent fluid transport from the capillaries into the surrounding tissues, which would be the result of a lowered PIF in the presence of an intact circulation. This in turn would lead to an underestimation of the lowered PIF (22). PIF remains stable for at least 60 min after cardiac arrest in rat and mouse skin (13, 22). In agreement with previous studies, test substances were injected subdermally and the measurements performed intradermally in close vicinity of the injection site.
Integrin
vβ3 does not bind native triple helical collagen, and the mechanism for its restoration of PIF is not known. One possible mechanism involves fibronectin that could serve as a link between the cells and the collagen fibers. We have shown that PDGF-BB stimulates fibronectin production by cells and that fibronectin can link the cells to the collagen via the
vβ3-integrins in cell-mediated collagen gel contraction (16). When we consider the similarities between PDGF-BB and insulin in stimulating collagen gel contraction and restoring a lowered PIF, it is tempting to speculate that fibronectin could be involved in insulin-stimulated collagen gel contraction as well.
Swelling and edema are some of the cardinal signs of inflammation. During sepsis, extensive plasma leakage, leading to edema, hypotension, and organ dysfunction, may occur. During the last few years, there has been a great focus on the potentially beneficial effect of insulin administration to patients in the ICU. Most of the emphasis has been placed on using insulin to achieve strict blood glucose control in the critically ill patients, but a potentially direct effect of insulin in itself has also been advocated. Given the fact that insulin has a wide variation of responses in different cells and tissues, it is no surprise that the mechanism and organ of target for insulin therapy is still debated. Here we show one of the possible mechanisms for the effects of insulin in sepsis. The fluid filtration over the capillaries is affected by insulin in a mechanism involving the connective tissue and the
vβ3-integrin, and the process will only become evident after perturbing the functions of β1-integrins.
To summarize, the present study has demonstrated that insulin normalized a PIF lowered by LPS in a process dependent on integrin
vβ3.
| GRANTS |
|---|
|
|
|---|
| FOOTNOTES |
|---|
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. Section 1734 solely to indicate this fact.
* Ø. S. Svendsen and Å. Lidén contributed equally to this work. ![]()
| REFERENCES |
|---|
|
|
|---|
analogs on collagen gel compaction in vitro and interstitial pressure in vivo. Am J Physiol Heart Circ Physiol 274: H663–H671, 1998.
2β1A and
vβ3 integrins. J Cell Sci 113: 2375–2383, 2000.[Abstract]
V gene expression in human melanoma tumorigenicity. J Clin Invest 89: 2018–2022, 1992.[Web of Science][Medline]
vβ3 mediates platelet-derived growth factor-BB-stimulated collagen gel contraction in cells expressing signaling deficient integrin
2β1. Exp Cell Res 291: 463–473, 2003.[CrossRef][Web of Science][Medline]
11β1 Integrin is a receptor for interstitial collagens involved in cell migration and collagen reorganization on mesenchymal nonmuscle cells. Dev Biol 237: 116–129, 2001.[CrossRef][Web of Science][Medline]
and transforming growth factor-β 1. J Cell Sci 102: 315–322, 1992.
vβ3 as a target for treatment of rheumatoid arthritis and related rheumatic diseases. Ann Rheum Dis 61, Suppl 2: ii96–ii99, 2002.This article has been cited by other articles:
![]() |
O.S. Svendsen, M.M. Barczyk, S.N. Popova, A Liden, D. Gullberg, and H. Wiig The {alpha}11{beta}1 Integrin Has a Mechanistic Role in Control of Interstitial Fluid Pressure and Edema Formation in Inflammation Arterioscler Thromb Vasc Biol, November 1, 2009; 29(11): 1864 - 1870. [Abstract] [Full Text] [PDF] |
||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Visit Other APS Journals Online |