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1Department of Pediatrics, Northwestern University, Chicago, Illinois; 2Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, Montana; and 3Department of Pediatrics, State University of New York at Buffalo, Buffalo, New York
Submitted 1 October 2004 ; accepted in final form 29 May 2005
| ABSTRACT |
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reactive oxygen species; vasodilation; guanosine 3',5'-cyclic monophosphate
Abnormal regulation of endothelial function is implicated in the pathophysiology of a number of pulmonary hypertensive disorders. In persistent pulmonary hypertension of the newborn (PPHN), pulmonary vascular resistance does not decrease normally at birth, resulting in pulmonary hypertension, right-to-left shunting and hypoxemia (23). Newborns who die of PPHN exhibit an increase both in the thickness of the smooth muscle layer within small pulmonary arteries and an extension of this muscle to nonmuscular arteries (9). Often, microvascular thrombi occlude these arteries, and there is proliferation of adventitial tissues (17).
Surgical ligation of the ductus arteriosus in the fetal lamb generates a model of PPHN that resembles the human condition (1, 3, 18, 32). In this model, similar to infants born with PPHN, there is an increase in the expression of the genes that induce pulmonary vasoconstriction and a reduction in those that induce vasodilation (3). In addition, we have previously shown that ET-1 stimulates H2O2 levels in isolated pulmonary arterial smooth muscle cells (PASMC). However, the effects of increased generation of H2O2 on vasodilator signaling in PPHN are not well understood. Thus the objective of this study was to determine whether there is relationship between increased reactive oxygen species (ROS) production in PPHN lambs and to determine whether this is associated with decreases in cGMP signaling. Finally, we wished to determine whether ROS scavenging could help to alleviate the abnormal vasodilator responses observed in the pulmonary arteries of the PPHN lambs.
| MATERIALS AND METHODS |
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Cell culture.
Primary cultures of fetal (F) PASMC from sheep were isolated by the explant technique as described previously (24, 26, 29). In brief, a segment of the main pulmonary artery from 136-day-old fetal lambs was excised and placed in a sterile 10-cm dish containing DMEM supplemented with 1 g/l of glucose. The segment was stripped of adventitia with a sterile forceps. The main pulmonary artery segment was then cut longitudinally to open the vessel, and the endothelial layer was removed by gentle rubbing with a cell scraper. The vessel was then cut into 2-mm segments, inverted, and placed on a collagen-coated 35-mm tissue culture dish. A drop of DMEM containing 10% fetal bovine serum (HyClone), antibiotics (MediaTech), and antimycotics (MediaTech) was then added, and the cells were grown overnight at 37°C in a humidified atmosphere with 5% CO2-95% air. The next day, an additional 2 ml of complete medium were added. The growth medium was subsequently changed every 2 days. When SMC islands could be observed under the microscope, the tissue segment was removed, and the individual cell islands were subcloned. Identity was confirmed as FPASMC by immunostaining (>99% positive) with antibodies against
-smooth muscle actin, calponin, and caldesmon. This was taken as evidence that cultures were not contaminated with fibroblasts or with endothelial cells. All cultures for subsequent experiments were maintained in DMEM supplemented with 10% fetal calf serum (Hyclone), antibiotics (MediaTech), and antimycotics (MediaTech) at 37°C in a humidified atmosphere with 5% CO2-95% air. Cells were utilized at passage 3. The Laboratory Animal Care Committee at Northwestern University approved all protocols.
In situ detection of H2O2. Fifth-generation pulmonary arteries (with first generation being the main branch of the pulmonary artery, 23 mm in diameter) were obtained from control and ductal ligation lambs. These were embedded in tissue freezing medium [Tris-buffered saline (TBS), Fisher], frozen, then cut into 30-µm-thick sections, and placed on glass slides. Slides were stored at 80°C until used. The sections were exposed to 5 µM dichlorodihydrofluorescein diacetate (H2DCF-DA, Molecular Probes) with or without 250 U/ml polyethylene glycol (PEG)-catalase (Sigma) or the NOS inhibitor nitro-L-arginine methyl ester (L-NAME, 1 mM) in PBS. PEG-catalase was used to confirm that the oxidation of H2DCF-DA is H2O2 dependent, and L-NAME was used to determine whether an uncoupled NOS was involved in the generation of H2O2 in the lung sections. Slides were incubated in a light-protected humidified chamber at 37°C for 30 min. Slides were washed three times in PBS and observed under a Nikon Eclipse TE-300 fluorescent microscope with excitation at 485 nm and emission at 530 nm. Fluorescent images were captured with a CoolSnap digital camera, and the average fluorescent intensities (to correct for differences in cell number due to variability in slice thickness) were quantified with Metamorph imaging software (Fryer). Data are presented as PEG-catalase-inhibitable H2DCF-DA fluorescence.
Protein preparation and Western blotting. For Western blot analyses in the PPHN model, peripheral lung parenchyma and fifth-generation pulmonary arteries and veins were rapidly isolated and frozen in liquid nitrogen. Protein extracts were prepared as previously described (3). Proteins were separated on polyacrylamide gels and transferred to Hybond-polyvinylidene difluoride (PVDF) membranes. After blocking, the membranes were incubated for 1 h at room temperature with the appropriate dilution of antibody: catalase (RBI, 1:2,000) and glutathione peroxidase-1 (GPX-1, 1:500). The rabbit polyclonal GPX-1-specific antiserum was prepared by Biosynthesis (Lewisville, TX) using the sequence NH2-CDIETLLSQQSGNS-OH as previously described (15).
For Western blot analyses in FPASMC, cells were seeded on a six-well plate at a density of 500,000 cells/well and allowed to attach overnight. Subsequently, cells were treated or not with 0.015 U/ml glucose oxidase (from Aspergillus niger, Recombinant; Calbiochem, La Jolla, CA) for 12 h. Cells were then harvested in lysis buffer containing 5% (vol/vol) protease inhibitor cocktail and allowed to lyse for 15 min on ice. Samples were then centrifuged at 12,000 g for 10 min, and supernatant was collected. Samples were loaded on a 420% gradient gel and transferred to a PVDF membrane. Blots were blocked overnight at 4°C with 5% nonfat milk in TBS-Tween. A polyclonal antibody raised against soluble guanylate cyclase-
(sGC-
, 1:500 dilution) was used to probe the membrane for 3 h at room temperature.
After being washed to remove excess primary antibody, the membranes were incubated with an appropriate secondary antibody conjugated with horseradish peroxidase. The protein bands were visualized by chemiluminescent procedures (3). Band intensities were determined with Kodak ImageStation software.
Determination of GPX and catalase activity. Catalase and total GPX activities were measured as previously described (15). In brief, for the catalase assay peripheral lung or fifth-generation arterial or vein tissues were homogenized in assay buffer containing 1:1.55 KH2/Na2 (pH 7.0). Each sample containing 40 µg of protein was added to 1 ml of buffer and 1 ml of H2O2 solution. Absorbance was measured at 260 nm at room temperature for 30 s. For total GPX activity, peripheral lung or fifth-generation arterial or vein tissues were homogenized in Tris·HCl, pH 7.2, (vol 3:1). Homogenate was centrifuged at 3,000 g for 10 min at 4°C. Supernatant was removed and further centrifuged at 12,000 g for 15 min at 4°C. Samples containing 40 µg of protein were added to the assay buffer consisting of 100 mM Tris·HCl, pH 7.2, 3 mM EDTA, 1 mM sodium azide (Sigma Chemical, St. Louis, MO), 1.2 mM cumene hydroperoxide, 0.5 mM NADPH, and 1 unit GSH reductase (Sigma Chemical) in a final volume of 1 ml. The rate of NADPH oxidation was measured spectrophotometrically at 340 nm.
Determination of cGMP levels. FPASMC were seeded on a six-well plate at a density of 500,000 cells/well and allowed to attach overnight. Subsequently, cells were treated or not with 0.015 U/ml glucose oxidase for 12 h. Just before being harvested, cells were treated with or without spermine NONOate (50 µM) in the presence of 4-{[3',4'-(methylenedioxy)benzyl]amino}-6-methoxyquinazoline [1 µM, a phosphodiesterase (PDE) 5 inhibitor] for 30 min to determine total cGMP accumulation. Cells were harvested in enzyme immunoassay buffer provided by the enzyme immunoassay kit and allowed to freeze-thaw through three cycles. Samples were then centrifuged at 12,000 g for 10 min, and supernatant was collected. The samples were tested for cGMP levels according to the manufacturer's directions (Cayman Chemical).
Isolated vessel protocol.
We have previously described the techniques for the study of isolated vessels in detail (4). Here we used fifth-generation pulmonary arteries with inside diameters of
500 µm. Vessel rings were mounted on stainless steel hooks and placed in water-jacketed chambers containing Krebs-Ringer solution. The buffer was maintained at 37°C and aerated with a gas mixture of 94% O2 and 6% CO2 to maintain a pH of 7.40, a PCO2 of 38 Torr and a PO2 of >500 Torr. Vessels were pretreated for 20 min with 105 M indomethacin and 106 M propranolol to prevent the formation of vasoactive prostaglandins and
-adrenergic receptor activation, respectively. Vessels were preconstricted with a submaximal concentration of norepinephrine. Cumulative concentration-response curves for S-nitrosyl-acetyl-penicillamine (SNAP, 109 to 5 x 106 M) were developed. Some vessels were pretreated for 20 min with PEG-bound catalase (1,200 U/ml) before relaxation with SNAP.
Statistical analysis. The relative fluorescent intensity was calculated for H2DCF-DA and expressed as fold change (vs. untreated cells) ± SD. Chemiluminescence intensities were determined for secondary antibodies and expressed ± SD. Catalase and GPX activities were determined and expressed ± SD. Comparisons between treatment groups were made by the unpaired t-test using the GB-STAT software program. A P < 0.05 was considered statistically significant.
| RESULTS |
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expression and the generation of cGMP in response to challenge with an NO donor (Fig. 5).
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| DISCUSSION |
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We have previously shown that ET-1 stimulates the proliferation of FPASMC via a pathway involving ETA-mediated superoxide synthesis (29), and superoxide production is increased in the smooth muscle layer of pulmonary arteries of ductal ligation PPHN lambs (4). Because ROS appear to play a central role in PPHN, we also examined the effects of scavenging ROS on the vasodilator response of pulmonary arteries to exogenous NO. We chose to look at the effects of H2O2 since this ROS is more stable than superoxide and may be a more likely intercellular signaling molecule between FPASMC and fetal pulmonary arterial endothelial cells (FPAEC). Indeed our recently published study indicates that ET-1-mediated increases in H2O2 within the SMC can produce decreases in eNOS gene expression in cocultured EC (25). Thus, in this study, we determined whether the development of PPHN in vivo also resulted in an increase in H2O2 levels. In addition, we wished to determine whether increases in H2O2 levels could also account for the decreased cGMP signaling associated with PPHN both in the lamb model of ductal ligation (3) and in children born with the disease (5).
Our finding that H2O2 levels are elevated in isolated ductal ligation vessels is in agreement with our previous studies looking at levels of superoxide (4). However, in that study, we found that SOD activity was decreased in ductal ligation arteries (4), which would be predicted to yield less H2O2. Because catalase and GPX activities are not altered in the PPHN vessels, elevated superoxide generation likely accounts for the increased levels of H2O2, despite the lower SOD activity. However, Cys55 in bovine CuZn-SOD is involved in the formation of an internal disulfide bond that is essential for activity. It has been suggested that this cysteine residue is sensitive to oxidative modification, which can result in enzyme inhibition (20). Thus the reduction in SOD activity may be simply a function of an overtaxed enzymatic system (4). However, aberrations in alternative pathways of H2O2 catalysis in PPHN cannot be ruled out.
In the ductal ligation lamb, ETA receptor blockade attenuates pulmonary hypertension and SMC growth (12). Conversely, prolonged infusion of fetal lambs with an ETB receptor antagonist generates increases in pulmonary artery pressure, pulmonary vascular resistance, and muscularization of small pulmonary arteries (11). Our data complement these studies by demonstrating that scavenging ROS can attenuate the altered vasodilator response in the pulmonary arteries of hypertensive lambs. These data suggest a central role for ROS in producing the altered vasodilator responses seen in PPHN. In our proposed pathway, the increased ET-1 released during the development of PPHN activates ETA receptors on FPASMC, resulting in increased ROS generation through NADPH oxidase activation. The subsequent increase in ROS induces FPASMC proliferation (29) and vascular remodeling. In addition, the H2O2 released may result in the decreased expression of the vasodilator proteins eNOS and sGC. Indeed we have recently shown that the ET-1-mediated elevation of H2O2 levels in FPASMC leads to a concomitant increase in cocultured FPAEC, which produces a decrease in eNOS transcription and subsequent decrease in eNOS protein expression and activity (25). In addition, our new data presented in this study indicate that increased generation of H2O2 in PASMC results in a decrease in sGC-
expression and a reduction in NO-dependent cGMP accumulation. Both of these events would result in a reduction in NO signaling, and we speculate that the increased H2O2 generation in the lungs of ductal ligation lambs may explain the apparent coordinated increases in vasoconstrictor gene expression with decreased vasodilator gene expression. Indeed previous studies have shown that oxidative stress will increase ET-1 gene expression (13, 14). However, further studies will be required to determine whether H2O2 can also increase the expression of the ETA receptor and PDE5 that are vasoconstrictor proteins and decrease the expression of the vasodilator protein ETB receptor.
In addition, less NO signaling to the FPASMC to stimulate vasodilation and inhibit SMC growth would result in an increase in vasoconstriction and potentially a stimulation of SMC proliferation. Indeed, we have recently shown that exogenous NO attenuates FPASMC proliferation by stimulating G0/G1 growth (28). Furthermore, activation of NO production in rat aortic EC inhibits the proliferation of rat aortic SMC in coculture (10), suggesting that endothelium-derived NO can influence the growth of adjacent SMC. Overall, the predicted effects of these events are reduced NO-mediated vasodilation, elevated ET-1-mediated vasoconstriction, and increased ROS-mediated vascular remodeling. Indeed our data demonstrate that fifth-generation pulmonary arteries isolated from PPHN lambs had significantly decreased relaxations to the NO donor SNAP compared with controls. The addition of PEG-catalase to pulmonary arteries isolated from PPHN lambs significantly enhanced their relaxations to SNAP. As PEG-catalase had no effect in control pulmonary arteries, this enhancement appears to be unique to PPHN. These data demonstrate that excess ROS inhibit relaxations in PPHN, and indicate that our in vitro data are recapitulated in vivo.
In conclusion our data establish a link between increased H2O2 generation and the abnormal vasodilator responses of the pulmonary arteries in lambs with PPHN. In addition, we speculate that increased generation of H2O2 in the lungs of ductal ligation lambs may explain the apparent coordinated increases in vasoconstrictor gene expression with decreased vasodilator gene expression. Our data suggest that antioxidants could be a potential therapy to reduce or prevent the pulmonary vascular remodeling associated with PPHN. Indeed, we have previously found that antioxidants and inhibitors of NADPH oxidase attenuate ET-1-mediated FPASMC proliferation (29), and recently we showed that EUK-134, a synthetic SOD/catalase mimetic, inhibits serum-induced FPASMC growth (26). However, the effect of this type of treatment in vivo is unknown and will require new studies utilizing the ductal ligation model to directly assess this issue.
| GRANTS |
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| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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