Cheng Zhongjian, Garikipati Venkata Naga Srikanth, Nickoloff Emily, Wang Chunlin, Polhemus David J, Zhou Jibin, Benedict Cynthia, Khan Mohsin, Verma Suresh K, Rabinowitz Joseph E, Lefer David, Kishore Raj
From Center for Translational Medicine (Z.C., V.N.S.G., E.N., C.W., J.Z., C.B., M.K., S.K.V., J.E.R., R.K.) and Department of Pharmacology (J.E.R., R.K.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; and Department of Pharmacology and Experimental Therapeutics and Cardiovascular Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, LA (D.J.P., D.L.).
Circulation. 2016 Nov 8;134(19):1467-1483. doi: 10.1161/CIRCULATIONAHA.116.022967. Epub 2016 Sep 22.
Bone marrow cell (BMC)-based treatment for critical limb ischemia in diabetic patients yielded a modest therapeutic effect resulting from cell dysfunction. Therefore, approaches that improve diabetic stem/progenitor cell functions may provide therapeutic benefits. Here, we tested the hypothesis that restoration of hydrogen sulfide (HS) production in diabetic BMCs improves their reparative capacities.
Mouse BMCs were isolated by density-gradient centrifugation. Unilateral hind limb ischemia was conducted in 12- to 14-week-old db/+ and db/db mice by ligation of the left femoral artery. The HS level was measured by either gas chromatography or staining with florescent dye sulfidefluor 7 AM.
Both HS production and cystathionine γ-lyase (CSE), an HS enzyme, levels were significantly decreased in BMCs from diabetic db/db mice. Administration of HS donor diallyl trisulfide (DATS) or overexpression of CSE restored HS production and enhanced cell survival and migratory capacity in high glucose (HG)-treated BMCs. Immediately after hind limb ischemia surgery, the db/+ and db/db mice were administered DATS orally and/or given a local intramuscular injection of green fluorescent protein-labeled BMCs or red fluorescent protein-CSE-overexpressing BMCs (CSE-BMCs). Mice with hind limb ischemia were divided into 6 groups: db/+, db/db, db/db+BMCs, db/db+DATS, db/db+DATS+BMCs, and db/db+CSE-BMCs. DATS and CSE overexpression greatly enhanced diabetic BMC retention in ischemic hind limbs followed by improved blood perfusion, capillary/arteriole density, skeletal muscle architecture, and cell survival and decreased perivascular CD68 cell infiltration in the ischemic hind limbs of diabetic mice. It is interesting to note that DATS or CSE overexpression rescued high glucose-impaired migration, tube formation, and survival of BMCs or mature human cardiac microvascular endothelial cells. Moreover, DATS restored nitric oxide production and decreased endothelial nitric oxide synthase phosphorylation at threonine 495 levels in human cardiac microvascular endothelial cells and improved BMC angiogenic activity under high glucose condition. Last, silencing CSE by siRNA significantly increased endothelial nitric oxide synthase phosphorylation at threonine 495 levels in human cardiac microvascular endothelial cells.
Decreased CSE-mediated HS bioavailability is an underlying source of BMC dysfunction in diabetes mellitus. Our data indicate that HS and overexpression of CSE in diabetic BMCs may rescue their dysfunction and open novel avenues for cell-based therapeutics of critical limb ischemia in diabetic patients.
基于骨髓细胞(BMC)的治疗对糖尿病患者的严重肢体缺血仅产生适度的治疗效果,这是由于细胞功能障碍所致。因此,改善糖尿病干细胞/祖细胞功能的方法可能会带来治疗益处。在此,我们检验了这样一个假设,即恢复糖尿病BMC中硫化氢(HS)的产生可提高其修复能力。
通过密度梯度离心分离小鼠BMC。通过结扎左股动脉,在12至14周龄的db/+和db/db小鼠中造成单侧后肢缺血。通过气相色谱法或用荧光染料硫氟7-AM染色来测量HS水平。
糖尿病db/db小鼠的BMC中HS的产生以及HS酶胱硫醚γ-裂解酶(CSE)的水平均显著降低。给予HS供体二烯丙基三硫化物(DATS)或CSE过表达可恢复HS的产生,并增强高糖(HG)处理的BMC的细胞存活和迁移能力。后肢缺血手术后,立即给db/+和db/db小鼠口服DATS和/或局部肌肉注射绿色荧光蛋白标记的BMC或红色荧光蛋白-CSE过表达的BMC(CSE-BMC)。将后肢缺血的小鼠分为6组:db/+、db/db、db/db+BMC、db/db+DATS、db/db+DATS+BMC和db/db+CSE-BMC。DATS和CSE过表达极大地增强了糖尿病BMC在缺血后肢中的滞留,随后改善了血液灌注、毛细血管/小动脉密度、骨骼肌结构以及细胞存活,并减少了糖尿病小鼠缺血后肢血管周围CD68细胞浸润。有趣的是,DATS或CSE过表达挽救了高糖损害的BMC或成熟人心脏微血管内皮细胞的迁移、管腔形成和存活。此外,DATS恢复了人心脏微血管内皮细胞中一氧化氮的产生,并降低了苏氨酸495水平的内皮型一氧化氮合酶磷酸化,改善了高糖条件下BMC的血管生成活性。最后,用小干扰RNA沉默CSE可显著增加人心脏微血管内皮细胞中苏氨酸495水平的内皮型一氧化氮合酶磷酸化。
CSE介导的HS生物利用度降低是糖尿病中BMC功能障碍的潜在原因。我们的数据表明,糖尿病BMC中HS和CSE过表达可能挽救其功能障碍,并为糖尿病患者严重肢体缺血的细胞治疗开辟新途径。