(Circulation. 2000;102:2569.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
From INSERM U321, Lipoproteins and Atherogenesis (I.B., D.S., E.N.); Laboratoire Central dAnatomie Pathologique (I.B., Y.L.); and Département de Chirurgie Vasculaire (F.K.), Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Wallenberg Laboratory, Sahlgrenska University Hospital, Göteborg, Sweden (L.M.-H., O.W.); and Service dImmunologie, Département de Pédiatrie, Faculté de Médecine, Université de Sherbrooke, Quebec, Canada (J.S., M.R.-P.). Drs Brochériou, Stengel, and Ninio are now at INSERM U525, Génétique épidemiologique et moléculaire des pathologies cardiovasculaires, Institut Fédératif "Muscle Coeur et Vaisseaux," Groupe Hospitalier Pitié-Salpêtrière and UFR Médecine Sud (Université Pierre et Marie Curie), Paris, France.
Correspondence to Ewa Ninio, INSERM U525, Faculté de Médecine Pitié-Salpêtrière, 91, Bd. de lHôpital, 75634 Paris, Cedex 13, France. E-mail eninio{at}infobiogen.fr
| Abstract |
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Methods and ResultsWe show that PAF-R was expressed at low levels in foam cells compared with monocyte/macrophages in plaques, as assessed by immunohistochemical staining and in situ hybridization. In addition, low levels of mRNA were also detected by RT-PCR in isolated human carotid foam cells. A prominent finding of our study was the demonstration that contractile SMCs were positive for PAF-R, and its mRNA was extracted from primary cultures of umbilical SMCs.
ConclusionsAs macrophages loose their inflammatory phenotype on transformation into foam cells, they may equally loose their capacity of defense against aggression. We postulate that the diminished expression of PAF-R may be deleterious in the context of plaque formation and progression. The observation that arterial SMCs of contractile phenotype express PAF-R opens new avenues concerning the migration of these cells from media to intima and atherosclerotic plaque formation.
Key Words: atherosclerosis macrophages muscle, smooth cells lipoproteins
| Introduction |
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induced
angiogenesis.11 The presence of mRNA specific for PAF-R was detected in several tissues, including heart, brain, liver, lung, and circulating cells such as monocytes (exclusively PAF-R) and macrophages.3 In previous studies, we have demonstrated that human monocyte-derived macrophages and macrophage-derived foam cells represent a potential source of PAF in arterial intima.2 An earlier study also showed that PAF was extracted from endarterectomy samples taken from the coronary arteries of patients with severe atherosclerosis.12 We have shown, using reverse transcriptionpolymerase chain reaction (RT-PCR) and Northern blot analysis, that human monocyte-derived macrophages constitutively express PAF-R mRNA transcripts and specific binding sites for this mediator.13 Circulating monocytes, which infiltrate the subendothelial space of arterial wall, mature into tissue macrophages and acquire the ability to recognize and to internalize various forms of oxidized LDL (oxLDL), leading to intracellular cholesterol accumulation and foam cell formation, and thus are involved in the development of atherosclerosis (see review14 ). The treatment of macrophages with oxLDL in vitro is accompanied by a marked decrease in both mRNA expression and PAF-R binding.13 The question thus arose as to whether PAF-R was expressed and eventually modulated in human arteries and in atherosclerotic lesions. For this purpose, we determined, by use of immunohistochemical staining and in situ hybridization, the expression of PAF-R in macrophages and macrophage-derived foam cells in human carotid atherosclerotic plaques in regions containing necrotic and fibrous areas. In addition, we report here for the first time that PAF-R is expressed in arterial SMCs in the media.
| Methods |
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Antibodies
For immunohistochemistry, the following monoclonal
antibodies were used: anti-CD68 (KP-1 clone, Dako) at 1:500 dilution
for macrophage identification; anti
-smooth muscle actin
(1A4 clone, Sigma), anti-desmin (D33 clone, Dako), and anti-myosin
(smooth, HSM-V clone, Sigma) at 1:1000, 1:100, and 1:300 dilution,
respectively, for SMC identification;
antiPAF-R15 at
1:200 to 1:500 dilution and mouse IgG1 (Dako) at 1:10 to 1:500 dilution
as negative control; and polyclonal antibody anti-CD3 (Dako) at 1:50
dilution for lymphocyte identification.
Immunohistochemistry
Deparaffinized and rehydrated sections after
microwave treatment (2x5 minutes at 900 W in citrate buffer) were
incubated for 30 minutes at room temperature with primary antibodies,
washed, and incubated for 30 minutes with a Multilink kit (Biosys) for
polyclonal antibodies and ABC Vector kit (Biosys) for monoclonal
antibodies. After washing, the alkaline phosphatase/antialkaline
phosphatase complexes (Dako) were added. Fast Red TR substrate system
(Dako), gave a red precipitate on positive cells. Slides were
counterstained with aqueous hematoxylin and mounted with Immuno-mount
(Shandon). Negative controls were obtained by replacing primary
antibodies by either mouse IgG1 or an irrelevant
antibody.
Isolation and Culture of Human Monocyte-Derived
Macrophages
Mononuclear cells were isolated from the blood of
healthy, normolipidemic volunteers as
described.2 Cells
were plated at a density of 3x106 per well
into 6-well Primaria culture dishes (Becton Dickinson) in RPMI medium
containing gentamicin (40 mg/mL), glutamine (0.05%), and human serum
(10%). At day 12 of culture, monocytes were differentiated into
macrophages and were free of lymphocytes as assessed by
negative anti-CD3 staining and scanning electron microscopy (data not
shown). Total cellular RNA was isolated with RNA Plus
(Bioprobe).
Isolation of Macrophages and SMCs
From Human Arteries
Human arteries with atherosclerotic lesions, obtained
on carotid endarterectomy, were immediately placed
into Hanks balanced salt solution and were digested with
collagenase. Macrophages were isolated by use of
monoclonal antibodies and magnetic
microspheres.16
Primary cultures of human arterial SMCs from the inner media of human uterine arteries were established by explant technique.17 Total cellular RNA was isolated by SNAP isolation kit (Invitrogen).
cRNA Synthesis
A 2-kb fragment of human PAF-R cDNA in pBluescript (a
gift from Dr Shimizu, Tokyo, Japan) was used for antisense or sense
cRNA probes13
labeled with digoxigenin-UTP (Boehringer). Before use, the
dig-cRNA probes were diluted and denatured at 100°C for 5
minutes.
In Situ Hybridization
Before hybridization, the sections were dewaxed and
treated for 15 minutes with 0.4% pepsin/0.04 mol/L HCl, washed, and
treated with 0.1 mol/L EDTA for 45 minutes at room temperature. Some of
the slides were pretreated with DNAse 1 U/µL at 37°C for 15 minutes
or with RNAse (20 µg/mL RNAase A + 1 U RNAase H + 10 U RNase 1) for
60 minutes at 65°C; pretreatments were blocked with 0.1 mol/L EDTA (5
minutes), and slides were washed and dehydrated in 100%
ethanol.18 19
Before labeling, sections were rehydrated and prehybridized in
hybridization buffer with formamide (1:1; Amersham). The hybridizations
were started by adding digoxigenin-UTPlabeled riboprobe (30 µL per
slide, 1:10 to 1:30) and were incubated overnight at 65°C in a
humidified box. Washes were performed with 2xSSC with 50% formamide
at 65°C for 60 minutes and with decreasing concentrations of SSC up
to 0.1xSSC for 30 minutes at room temperature. After 3 washes in TBS
containing 0.1% Tween 20, pH 7.5, sections were treated with 1%
anti-digoxigenin alkaline phosphatase goat serum for 90 minutes at room
temperature. Specific labeling was revealed with 4.5 µL/mL
tetrazolium nitro blue chloride/3.5 µL/mL 5-bromo-4-chloro-3-indolyl
phosphate in 0.1 mol/L Tris buffer (pH 9.5) containing 0.1 mol/L NaCl,
0.05 mol/L MgCl2, and 0.1% Tween 20 for 1 to 24
hours in the dark. Reaction was stopped by washing in the same buffer;
air-dried slides were mounted with Eukitt.
Reverse TranscriptionPolymerase Chain
Reaction
First-strand cDNA was obtained with total RNA (0.12
to 5 µg), and PCR was performed in the presence of specific
oligonucleotides for ß-actin, PAF-R (L1/C1, H1/C1),
as in Reference 1313 . The RT-PCR products were analyzed by
fractionation of 10-µL aliquots on a 2% agarose/TAE gel. Control
samples analyzed in the absence of reverse transcriptase were
free of genomic DNA.
| Results |
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For this purpose, full-thickness resections of common
carotid arteries were obtained from surgical intervention and were
characterized as intact vessels composed of well-defined intima, media,
and adventitia layers. Atherosclerotic plaques were localized in both
intima and media and were composed of a necrotic core adjacent to
cholesterol cleft, covered by a fibrous cap. Selected
specimens showed neither plaque rupture nor thrombus formation
(Figure 1A
).
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Macrophages and foam cells were dispersed or grouped
within the fibrous cap, the base and the shoulder region of the plaque,
and the necrotic core. The specimens showed different stages of plaque
progression. Some of them were fibrous, others were rich in foam cells
in areas adjacent to necrotic core. Monocytes were observed in the
lumen and adherent to endothelial cells. The presence
of monocyte/macrophages and macrophage-derived foam
cells was confirmed by immunohistochemical staining with monoclonal
antibodies against CD68
(Figure 1A
). Microscopic and transmission electron
microscopic observations showed that monocytes and macrophages
did not contain lipid droplets in their cytoplasm, in contrast to foam
cells, which were much bigger and contained such droplets (data not
shown).
Monocytes located in the lumen and adjacent to
endothelial cells were strongly stained with the
monoclonal antibodies directed against PAF-R
(Figure 1B
). Small macrophages in the
subendothelium and within the atherosclerotic plaques
expressed more diffuse and heterogeneous cytoplasmic
staining. In contrast, the macrophage-derived foam cells
found in plaque and necrotic areas were only weakly stained or even
negative
(Figure 1B
). These results confirm our former in vitro
observation that the expression of PAF-R is downregulated in
monocyte/macrophage primary cultures after treatment with
oxLDL.13 Similar
results were observed in specimens from 5 different
patients.
The expression of PAF-R mRNA was visualized by in situ hybridization using cRNA labeled with digoxigenin coupled to UTP. The optimal conditions for in situ hybridization have been established for both PAF-R and scavenger receptors, the latter serving as a positive control. Scavenger receptor labeling showed a strong nuclear staining in macrophages and foam cells (data not shown).
The specific labeling of nuclei of macrophages and
foam cells was obtained with antisense riboprobe for PAF-R in the
presence of DNAse
(Figure 2A
). The negative controls performed with the sense
RNA probe or the antisense RNA probe with RNAse treatment resulted in
no labeling
(Figure 2B
). Similar results were obtained with
monocyte-derived macrophages in culture (data not
shown).
|
Finally, the presence of PAF-R expression in CD14-positive
macrophages isolated from human plaques was confirmed by
RT-PCR. Strong signals corresponding to PAF-R mRNA expression are shown
in specimens obtained from 2 different patients
(Figure 3
). The primers used for amplification of cDNA
corresponded to the promoter 1 of PAF-R, which is characteristic for
macrophages.
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SMCs located in the media were strongly stained with the
specific myosin, desmin, and
-actin SMC antibodies
(Figure 4A
, 4B
, and 4C
) and were equally positively stained
with monoclonal antibodies against PAF-R
(Figure 4D
). The signal was located in the cytoplasm of SMCs,
and the extracellular matrix was negative. In contrast, the cells of
SMC origin present in the plaque were solely positive for
-actin
and did not express PAF-R
(Figure 5
). Such cells corresponded to dedifferentiated SMCs,
because they contained neither myosin nor desmin.
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These results were further confirmed by in situ
hybridization with the antisense cRNA probe of PAF-R
(Figure 6A
). Several SMCs in the media were stained, and the
pattern of positive cells was comparable to the
immunostaining performed with antiPAF-R antibodies
(Figure 4C
); again, the dedifferentiated SMCs in plaque areas
were negative
(Figure 6B
).
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To confirm the presence of PAF-R mRNA in SMCs, we have
extracted total mRNA from primary cultures of human
arterial SMCs isolated from the inner media of human
uterine arteries. We show in
Figure 7
the presence of PAF-R mRNA both in human SMCs and
in monocyte-derived macrophages, as visualized by RT-PCR.
Because SMCs contained more ß-actin mRNA than did
macrophages, we deduced that they expressed less PAF-R
mRNA.
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| Discussion |
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Recent studies indicated increased levels of nuclear factors
of the peroxisome proliferatoractivated receptor (PPAR)
family in arterial cells in atherosclerotic
plaques.21 Because
they transactivate not only genes bearing the PPRE response
elements, they may equally inhibit several inflammatory genes
containing nuclear factor (NF)-
B and STAT motifs by protein-protein
interactions.22 23
Because the PAF-R promoter 1 contains 3 NF-
Bbinding
elements,24 it is
potentially a good target for the PPAR-mediated suppression of
transcription. Our recent unpublished data indicate that PPAR-
is
readily involved in such PAF-R gene repression (Hourton et al, under
revision in Biochem J). In recent studies, PAF-R gene
expression was shown to be transcriptionally modulated by
cytokines,25 26
and TNF-
was found to activate PAF-R transcription via
NF-
B.27
Our present observation that the arterial SMCs of contractile phenotype in human carotid arteries are positive for PAF-R suggests that the expression of PAF-R may be important in their proliferation and migration from arterial media into intima; such migration has been described in the development of human atherosclerotic lesions (see review28 ). Thus, neointimal dedifferentiated SMCs promote plaque formation, because they actively participate in extracellular matrix excretion and deposition of calcium.29 30 Two recent theories explaining the SMC heterogeneity and different proliferative, migrating, and matrix-producing capabilities are based on (1) the clonal reversion of the adult medial SMCs to an immature phenotype, expressing genes characteristic of a synthetic/proliferative SMC,31 or (2) the existence of different lineage on embryonic development.1 32 In this context, the acquisition and/or expression of PAF-R by SMCs could be a decisive step in their migratory and proliferative potential in the intimal space. Indeed, a recent study showed that mechanical stress induces PAF-R expression in aortic SMCs.33 We anticipate that in atherosclerosis, the inflammatory reaction in the intima of vessels will favor PAF formation by macrophages and foam cells2 and equally the generation of PAF and its analogues from oxidized lipoproteins.8 34 The diffusion of PAF and/or its active analogues into the media may thus allow the PAF-Rbearing SMCs to be attracted into the intimal space, where they become PAF-Rnegative and loose their contractile phenotype.
Only few in situ studies have been reported on PAF-R expression in vessels, and they were mainly related to PAF-induced increases in vascular permeability, showing a widespread PAF-R in microvascular beds and especially its ubiquitous presence on endothelia and in pericytes, fibroblasts, and macrophages associated with microvessels.35 36 None of the latter studies have explored the pattern of PAF-R expression in human atherosclerotic lesions. Earlier work using polyclonal antiPAF-R antibodies showed the presence of PAF-R in human monocytes, neutrophils, B cells, and differentiated myeloid cell lines.26 37 Recently, mice lacking PAF-R were generated and showed a marked reduction in systemic anaphylactic symptoms but remained sensitive to endotoxic shock.38 This model should be helpful to further elucidate the potential role of PAF-R in atherosclerosis.
In conclusion, our data indicate that the in vivo expression of PAF-R in vascular wall is readily diminished in macrophage-derived foam cells of atherosclerotic plaques compared with monocyte/macrophages located in healthy areas. The carotid arteries of all patients studied contained a significant amount of PAF-Rpositive SMCs in the media; however, the dedifferentiated SMCs in the plaque areas were negative, as assessed by both immunohistochemical and in situ hybridization detection. The latter finding may be of importance in relation to SMC migration on atherogenesis. We anticipate that the PAF-R expression may be useful as a marker for arterial wall disease, and it may become a valid target for intervention.
| Acknowledgments |
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These studies were supported by INSERM and in part by the European Community Biomed Program BMH4-CT96-0134 and BMH4-CT96-1115 and by a Group Grant on Immuno-vascular Interactions from the Medical Research Council of Canada to Drs Stankova and Rola-Pleszczynski. We are grateful to Dr M.J. Chapman for helpful discussion. We also thank A. Lesot, N. Vignot, and M. Quignon for expert immunohistochemical analyses and G. Le Naour for scanning and transmission electron microscopy.
Received May 1, 2000; revision received July 7, 2000; accepted July 14, 2000.
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H. Hudry-Clergeon, D. Stengel, E. Ninio, and I. Vilgrain Platelet-activating factor increases VE-cadherin tyrosine phosphorylation in mouse endothelial cells and its association with the PtdIns3'-kinase FASEB J, April 1, 2005; 19(6): 512 - 520. [Abstract] [Full Text] [PDF] |
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D. J. Dupre, Z. Chen, C. Le Gouill, C. Theriault, J.-L. Parent, M. Rola-Pleszczynski, and J. Stankova Trafficking, Ubiquitination, and Down-regulation of the Human Platelet-activating Factor Receptor J. Biol. Chem., November 28, 2003; 278(48): 48228 - 48235. [Abstract] [Full Text] [PDF] |
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S. Russo, B. Bussolati, I. Deambrosis, F. Mariano, and G. Camussi Platelet-Activating Factor Mediates CD40-Dependent Angiogenesis and Endothelial-Smooth Muscle Cell Interaction J. Immunol., November 15, 2003; 171(10): 5489 - 5497. [Abstract] [Full Text] [PDF] |
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A. D. Tselepis, S.-A. P. Karabina, D. Stengel, R. Piedagnel, M. J. Chapman, and E. Ninio N-linked glycosylation of macrophage-derived PAF-AH is a major determinant of enzyme association with plasma HDL J. Lipid Res., October 1, 2001; 42(10): 1645 - 1654. [Abstract] [Full Text] [PDF] |
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