Isenberg Jeff S, Romeo Martin J, Maxhimer Justin B, Smedley Jeremy, Frazier William A, Roberts David D
Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1500, USA.
Ann Surg. 2008 May;247(5):860-8. doi: 10.1097/SLA.0b013e31816c4006.
Insufficient tissue perfusion underlies many acute and chronic diseases. Tissue perfusion in turn requires adequate blood flow, determined in large part by the relative state of relaxation or constriction of arterial vessels. Nitric oxide (NO) produced by vascular cells modulates blood flow and tissue perfusion by relaxing and dilating arteries. Recently, we reported that the secreted protein thrombospondin-1 (TSP1), through its cell surface receptor CD47, limits the ability of NO to relax and dilate blood vessels and thus decreases tissue perfusion. In the present study, we tested the hypothesis that blocking TSP1-CD47 signaling increases ischemic tissue survival in random cutaneous porcine flaps.
Random cutaneous flaps 2 x 10 cm2 were raised in white hairless Yucatan miniature pigs and were treated with a monoclonal antibody to TSP1, an antisense morpholino oligonucleotide to CD47 or control agents and tissue survival assessed. Primary vascular smooth muscle cell cultured from Yucatan pigs were also treated with the same agents +/- and an NO donor (DEA/NO) and cGMP quantified.
Antibody blockade of TSP1 or morpholino suppression of CD47 dramatically enhanced survival of random tissue flaps. These responses correlated with increased blood vessel patency and tissue blood flow on vessel injection studies. NO-stimulated cGMP flux in Yucatan vascular smooth muscle cell was abrogated after antibody or morpholino treatment.
Antibody ligation of TSP1 or antisense morpholino knock down of CD47 greatly increased tissue survival to ischemia. Given the similarity between porcine and human soft tissues these results suggest significant therapeutic potential for people.
组织灌注不足是许多急慢性疾病的基础。组织灌注又需要充足的血流,而这在很大程度上取决于动脉血管舒张或收缩的相对状态。血管细胞产生的一氧化氮(NO)通过舒张动脉来调节血流和组织灌注。最近,我们报道分泌蛋白血小板反应蛋白-1(TSP1)通过其细胞表面受体CD47限制NO舒张和扩张血管的能力,从而降低组织灌注。在本研究中,我们检验了如下假设:阻断TSP1-CD47信号传导可提高随机型猪皮瓣缺血组织的存活率。
在白色无毛尤卡坦小型猪身上掀起2×10平方厘米的随机型皮瓣,用抗TSP1单克隆抗体、抗CD47反义吗啉代寡核苷酸或对照剂进行处理,并评估组织存活率。从尤卡坦猪分离培养的原代血管平滑肌细胞也用相同的试剂处理,±添加NO供体(DEA/NO),并对cGMP进行定量分析。
对TSP1的抗体阻断或对CD47的吗啉代抑制显著提高了随机组织皮瓣的存活率。这些反应与血管注射研究中血管通畅性增加和组织血流增加相关。抗体或吗啉代处理后,尤卡坦血管平滑肌细胞中NO刺激的cGMP通量被消除。
TSP1的抗体连接或CD47的反义吗啉代敲低极大地提高了组织对缺血的存活率。鉴于猪和人软组织之间的相似性,这些结果表明对人类具有显著的治疗潜力。