(Circulation. 2000;102:2861.)
© 2000 American Heart Association, Inc.
Basic Science Reports |
From the Department of Medicine, Emory University (D.G., E.I., Z.S.G.), and the Georgia Tech/Emory Department of Biomedical Engineering (C.J., R.M., Z.S.G.), Atlanta, Ga.
Correspondence to Zorina S. Galis, PhD, Division of Cardiology, Department of Medicine, Emory University School of Medicine, 1639 Pierce Dr, WMB #319, Atlanta, GA 30322. E-mail zgalis{at}emory.edu
| Abstract |
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Methods and ResultsWe triggered remodeling of the carotid artery in C57BL/6 mice by blood flow cessation to study the relationship with gelatinases MMP-9 and MMP-2. Ligated and contralateral carotid arteries from ligated and sham-operated mice were harvested fresh, for biochemical analyses, or were perfusion-fixed, for histological studies, at 0, 1, 3, 7, 14, and 28 days after ligation. An early statistically significant (P<0.01) 4- to 5-fold increase in MMP-9 expression detected by SDS-PAGE zymography and Western blotting in tissue homogenates of ligated carotid arteries 1 day after flow cessation was maintained through day 7, after which expression gradually fell. Maximal MMP-9 levels were higher than MMP-2 levels, which became significantly increased 7 days after ligation. Proliferating cells, identified by bromodeoxyuridine incorporation, were detectable at day 1 in the adventitia and subsequently throughout the wall. Neointima was visible in 3-day specimens of ligated arteries. Suggested by morphology and predicted by theoretical considerations, maximal MMP-9 expression coincided with cell migration into the neointima, supporting its enabling role. Morphological measurements also demonstrated positive lumen remodeling up to 7 days after ligation.
ConclusionsMMP-9 induction is associated with the formation of intimal hyperplasia and does not require frank mechanical injury. Our data also show that a significant increase in MMP-9 expression preceded the positive geometrical remodeling of arteries, suggesting a potentially beneficial role for this matrix-degrading enzyme.
Key Words: metalloproteinases carotid arteries remodeling
| Introduction |
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| Methods |
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Immunostaining
MMP-9 was detected with the use of rabbit anti-mouse MMP-9
polyclonal antibody (generously provided by Drs Senior and Shipley,
Washington University, St. Louis, Mo), followed by biotinylated
goat anti-rabbit IgG (Fisher Biotech), streptavidinhorseradish
peroxidase (Dako), and diaminobenzidine (DAB kit, Vector Laboratories),
and counterstained with Gills hematoxylin (Fisher Scientific)
and Scotts solution. For negative controls, primary antibody was
replaced with nonimmune rabbit serum. Cellular proliferation was
detected as nuclear incorporation of BrdU with use of a monoclonal
antibody (Cappel), in combination with the M.O.M. kit (Vector),
followed by horseradish peroxidase or Texas redconjugated donkey
anti-mouse (Jackson); counterstaining was achieved with 0.5 mg/mL
Hoechst (bis-benzimide, Sigma). Images were collected by use of a Zeiss
Axioscope microscope.
Morphometric Analysis
Perimeters of the lumen, internal elastic lamina (IEL), and
external elastic lamina (EEL) were obtained by tracing the contours on
digitized images. Intimal thickness (distance between lumen and IEL),
medial thickness (distance between IEL and EEL), and adventitial
thickness (distance between EEL and the outer edge between tightly
packed and surrounding loose tissue) were automatically calculated by
ImagePro Plus 3.0 software (Media Cybernetics) as the mean
perpendicular distance between 2 bordering tracings. All the areas were
back-calculated with the assumption of circular structures.
Proliferation indices were calculated as a percentage of BrdU-positive
cells (pink nuclei) of the total number of cells (blue-counterstained
nuclei) per arterial cross section.
Biochemical Analyses
Fresh carotid arteries were collected separately, pulverized
under liquid nitrogen, and extracted with the use of ice-cold lysis
buffer (10 mmol/L sodium phosphate, pH 7.2, containing 150
mmol/L NaCl [PBS], and 1% Triton X-100, 0.1% SDS, 0.5% sodium
deoxycholate, and 0.2% sodium azide) for 1 hour at 4°C;
centrifugation was at 10 000g for 5
minutes. For detection of MMP-2 and MMP-9, equal amounts of tissue
extract protein (20 µg), assayed by using the DC protein assay
(Bio-Rad), were loaded on each lane and run in parallel with prestained
molecular weight markers (Bio-Rad) in 10% SDS-PAGE gels containing 1%
gelatin, as described in detail previously.8 The
optical volume-density product of individual lytic bands in
Coomassie bluestained gels was quantified by use of the Molecular
Analyst (Bio-Rad). A single value was derived for MMP-9 and for MMP-2
by adding the bands associated with both pro and activated
forms.
For Western blotting, samples (20 µg protein) were loaded on 10% SDS-PAGE mini gels and transferred onto nitrocellulose with use of a SemiDry system (Bio-Rad). MMP-9 was detected with rabbit anti-mouse MMP-9 polyclonal antibodies, followed by enhanced chemiluminescence (ECL kit, Amersham). Signals on x-ray films were quantified by use of the Multi-Analyst (BioRad).
Data Analysis
Average values were obtained per time point from image
analysis of the apex section of each of the 4 or 5 carotid
arteries. Densitometric data from Western blotting and SDS-PAGE
zymography were generated through analysis of 4 or 5 individual
carotid arteries per each time point. Comparisons were made by ANOVA
followed by the Tukey protected t test to compare the means
of multiple groups. Means were considered significantly different at
P<0.05.
| Results |
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Expression of Gelatinases During Mouse Carotid Artery
Remodeling
MMP gelatinolytic activity in the carotid
artery was increased after ligation (Figure 3
). At day 1, MMP-9 activity had already
increased 4- to 5-fold (P<0.01) in the ligated arteries.
MMP-9 activity was detected also in sham-operated arteries at day 1
(this activity was likely stimulated by the surgical injury) and then
returned to baseline levels but remained significantly elevated in
ligated arteries through day 7. In contrast, activity corresponding to
MMP-2 apparent molecular weight became significantly increased only
after 7 days and remained lower than absolute MMP-9 levels. Pro-MMP-2
activation was detectable in 14- and 28-day specimens.
Immunoblotting confirmed significant MMP-9 protein
upregulation in ligated arteries up to 7 days after ligation (Figure 4
). By immunocytochemistry, MMP-9 was not
detectable in normal mouse carotid arteries and had very low levels in
sham-operated arteries at all time points. In contrast, MMP-9
expression was clearly detectable by day 3 in many adventitial and
medial cells of ligated arteries. MMP-9positive cells appeared to be
engaged in migration (Figure 5
, inset). Scattered MMP-9positive cells were detected in contralateral
arteries as well. By day 7, intense MMP-9 staining was visible in the
well-developed neointima of ligated arteries.
Neointimal cells remained highly positive for MMP-9 in the
ligated arteries harvested at day 28. Adventitial MMP-9 expression was
also maintained.
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We analyzed the dynamics of cell accumulation and proliferation
within the 3 layers of the ligated artery. BrdU-positive cells were
detected throughout the wall (Figure 5
). For each time point,
average individual layer proliferation indices (intimal, medial, and
adventitial) and the average overall arterial wall index
were calculated (Figure 6
). The
proliferation index was maximal at day 1 in the adventitia, where it
subsequently decreased sharply. Up to 14 days, proliferation slowly
increased in both intimal and medial layers and then decreased in the
medial layer, while being sustained in the intimal layer. Comparison of
total cell counts (Figure 2
) and proliferation index data
(Figure 6
) produces a picture of cell dynamics within different
layers. In the intima, the total cell count continued to increase
throughout day 28, consistent with the increased proliferation
index. In contrast, the total medial cell number initially modestly
increased and then tapered off, in spite of sustained proliferation.
Similarly, the adventitial cell number initially increased and then
decreased after 14 days. The decrease observed in the outer 2 layers is
compatible with cells migrating into the intimal layer.
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The murine carotid artery does not contain intimal SMCs under normal
conditions; thus, cell migration is an absolute requirement for
neointimal development. MMP-9positive cells appeared to
be engaged in migration, which is thought to require MMP activity.
However, such an in situ association remains circumstantial, inasmuch
as to date there are no definitive markers of cell migration. The
number of neointimal cells is also influenced by the rate
of cell proliferation and cell loss. To gain further insight regarding
the specific contribution of migration to neointimal
formation, we made some theoretical considerations. With the use of
data recorded from cell proliferation analysis, for the
intimal layer these data were fit to a log curve (Figure 6
) with
the following equation: r=-0.015+0.032 ln(t), where
r is the proliferation rate, and t is daysxdoublings per
day. The cell number, plotted with use of actual neointimal
proliferation rates (Figure 6
), and doubling times reported for
mouse cells9 were compared with the actual
neointimal cell numbers counted in the specimens (Figure 2
). Because of the simplicity of our model, we limited
calculations to early proliferation rates (up to 7 days). We confirmed
that the actual cell number detected in the neointima up to
day 7 was higher than what was possible solely through proliferation,
indicating that additional cells had to have migrated from other wall
layers. The time course obtained is similar to that of MMP-9, which is
consistent with MMP-9 contribution to cell migration.
| Discussion |
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As in the case of healthy human carotid and coronary arteries,17 we found in normal murine carotid arteries that the gelatinolytic activity likely associated with MMP-2 was constitutively expressed, whereas MMP-9associated activity was undetectable in uninjured vessels. However, both activities were significantly upregulated during injury-induced remodeling. Levels of MMP-9, quickly induced by flow cessation, were higher than levels of MMP-2, as revealed by gelatin zymography. This detected difference is likely underestimated, inasmuch as MMP-2 digests gelatin twice as fast as does MMP-9.18 As expected, we found that flow cessation rapidly induced the formation of a neointima. Maximal upregulation of MMP-9 preceded and then occurred along with cell migration and positive arterial remodeling. Similarly, although not examined in detail, the late increase in MMP-2 activity may be associated with carotid artery shrinkage.
Interestingly, our analysis revealed that the ligated mouse carotid artery undergoes initially positive and then late negative remodeling, another nice feature of this model, reminiscent of the evolution of the human restenotic artery. Arterial lumen stenosis after mechanical injury was shown to be a combination of intimal thickening and a reduction in the total wall circumference. Expression of matrix components and integrins characteristic of wound healing suggests that tissue contraction contributes to lumen constriction at sites of arterial reconstruction.19 Recent reexamination of angiographic studies of human lesions20 and of deep vascular injury in animal models21 suggests that negative geometrical remodeling may be of greater importance in arterial lumen narrowing than the development of intimal mass.
The potential implications of the obvious adventitial upregulation of MMP-9 expression during mouse carotid artery remodeling are several. Recent observations support the participation of differentiated adventitial myofibroblasts to the formation of intimal thickening through migration across the wall,22 23 especially in vessels in which the EEL has been compromised24 or is lacking.25 MMP-9 could provide the elastolytic activity26 necessary for the migration of cells through the elastic laminae. Whether adventitial cells actually migrate into the developing neointima in the flow cessation model, in which carotid artery integrity is not compromised, has yet to be determined, along with such adventitial contribution to the formation of intimal hyperplasia in human arteries. The extensive perivascular fibrosis leading to wall shrinkage during pathological vascular remodeling may also be related to the regulation of adventitial MMP-9. Recently reported actions of MMP-9 include proteolytic modification of biological activity of important nonmatrix substrates, such as interleukin-1ß and several inhibitors of serine proteases,27 which in turn modulate vascular cells, suggesting that MMP-9 may influence vascular remodeling beyond matrix degradation.
Our present study of murine carotid artery remodeling suggests that MMP-9 participates in positive remodeling, an initial beneficial phase after vascular injury. Additionally supporting this finding was the result of analysis of contralateral carotid arteries, which experience increased blood flow after ligation. We found that MMP-9 gelatinolytic activity was also doubled in contralateral arteries 1 day after ligation (not shown). After 7 days, the lumen of arteries contralateral to ligated arteries had increased on average by 30% (P<0.01), and the total wall areas increased >50% (P<0.05) compared with arteries contralateral to sham-operated carotid arteries. The potential role of MMP-9 in positive remodeling is of great interest, inasmuch as therapeutic inhibition of vascular MMPs is currently contemplated in restenosis. Currently available strategies, including the administration of chemical or biological MMP inhibitors28 and the overexpression of TIMPs,29 suffer from inescapable limitations, such as poor efficiency or tissue access, and also from nonspecific effects. A definitive confirmation of the role of MMP-9 in vascular remodeling proposed by the present and previous studies awaits the development and utilization of better experimental tools, including the recent availability of MMP-deficient animals.
| Acknowledgments |
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Received April 7, 2000; revision received June 12, 2000; accepted June 30, 2000.
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