Idowu Temitayo O, Etzrodt Valerie, Pape Thorben, Heineke Joerg, Stahl Klaus, Haller Hermann, David Sascha
Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
Department of Cardiovascular Physiology, European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Intensive Care Med Exp. 2021 Aug 2;9(1):38. doi: 10.1186/s40635-021-00402-x.
Reduced endothelial Tie2 expression occurs in diverse experimental models of critical illness, and experimental Tie2 suppression is sufficient to increase spontaneous vascular permeability. Looking for a common denominator among different critical illnesses that could drive the same Tie2 suppressive (thereby leak inducing) phenotype, we identified "circulatory shock" as a shared feature and postulated a flow-dependency of Tie2 gene expression in a GATA3 dependent manner. Here, we analyzed if this mechanism of flow-regulation of gene expression exists in vivo in the absence of inflammation.
To experimentally mimic a shock-like situation, we developed a murine model of clonidine-induced hypotension by targeting a reduced mean arterial pressure (MAP) of approximately 50% over 4 h. We found that hypotension-induced reduction of flow in the absence of confounding disease factors (i.e., inflammation, injury, among others) is sufficient to suppress GATA3 and Tie2 transcription. Conditional endothelial-specific GATA3 knockdown (B6-Gata3 VE-Cadherin(PAC)-cerERT2) led to baseline Tie2 suppression inducing spontaneous vascular leak. On the contrary, the transient overexpression of GATA3 in the pulmonary endothelium (jet-PEI plasmid delivery platform) was sufficient to increase Tie2 at baseline and completely block its hypotension-induced acute drop. On the functional level, the Tie2 protection by GATA3 overexpression abrogated the development of pulmonary capillary leakage.
The data suggest that the GATA3-Tie2 signaling pathway might play a pivotal role in controlling vascular barrier function and that it is affected in diverse critical illnesses with shock as a consequence of a flow-regulated gene response. Targeting this novel mechanism might offer therapeutic opportunities to treat vascular leakage of diverse etiologies.
在多种危重病实验模型中,内皮细胞Tie2表达降低,且实验性抑制Tie2足以增加自发性血管通透性。为了寻找不同危重病之间可能导致相同Tie2抑制(从而引发渗漏)表型的共同因素,我们确定“循环性休克”为共同特征,并推测Tie2基因表达存在GATA3依赖性的血流依赖性。在此,我们分析了在无炎症情况下,这种基因表达的血流调节机制在体内是否存在。
为了通过实验模拟休克样情况,我们建立了一种可乐定诱导低血压的小鼠模型,在4小时内将平均动脉压(MAP)降低约50%。我们发现,在没有混杂疾病因素(即炎症、损伤等)的情况下,低血压诱导的血流减少足以抑制GATA3和Tie2转录。条件性内皮细胞特异性GATA3敲低(B6-Gata3 VE-Cadherin(PAC)-cerERT2)导致基线Tie2抑制,引发自发性血管渗漏。相反,肺内皮细胞中GATA3的瞬时过表达(jet-PEI质粒递送平台)足以在基线时增加Tie2,并完全阻断其低血压诱导的急性下降。在功能水平上,GATA3过表达对Tie2的保护作用消除了肺毛细血管渗漏的发生。
数据表明,GATA3-Tie2信号通路可能在控制血管屏障功能中起关键作用,并且在以休克为特征的多种危重病中,由于血流调节的基因反应而受到影响。针对这一新机制可能为治疗多种病因引起的血管渗漏提供治疗机会。