Mechanisms of fibrinogen-induced microvascular dysfunction during cardiovascular disease.

Fibrinogen (Fg) is a high molecular weight plasma adhesion protein and a biomarker of inflammation. Many cardiovascular and cerebrovascular disorders are accompanied by increased blood content of Fg. Increased levels of Fg result in changes in blood rheological properties such as increases in plasma viscosity, erythrocyte aggregation, platelet thrombogenesis, alterations in vascular reactivity and compromises in endothelial layer integrity. These alterations exacerbate the complications in peripheral blood circulation during cardiovascular diseases such as hypertension, diabetes and stroke. In addition to affecting blood viscosity by altering plasma viscosity and erythrocyte aggregation, growing experimental evidence suggests that Fg alters vascular reactivity and impairs endothelial cell layer integrity by binding to its endothelial cell membrane receptors and activating signalling mechanisms. The purpose of this review is to discuss experimental data, which demonstrate the effects of Fg causing vascular dysfunction and to offer possible mechanisms for these effects, which could exacerbate microcirculatory complications during cardiovascular diseases accompanied by increased Fg content.

Ciglitazone ameliorates homocysteine-mediated mitochondrial translocation and matrix metalloproteinase-9 activation in endothelial cells by inducing peroxisome proliferator activated receptor-gamma activity.

The activation of peroxisome proliferator activated receptor-gamma (PPARgamma) ameliorates the homocysteine (Hcy)-induced matrix metalloproteinase (MMP) by decreasing reactive oxygen species (ROS) production. However, the mechanism by which Hcy induces ROS generation and MMP activation is unclear. We hypothesize that Hcy increases NADH oxidase (Nox-4) and decreases thioredoxin (Trx). This leads to translocation of Nox-4 into the mitochondria and decrease in Trx. In addition, activation of PPARgamma ameliorates the translocation of Nox-4 into mitochondria and MMP-9 activation. Mouse aortic vascular endothelial cells (MVEC) were cultured in the presence or absence of 100 microM Hcy. The cells were pre-treated with ciglitazone (CZ, 150 microM). Activity of PPARgamma activity was measured by electrophoretic mobility shift assay (EMSA) and antibody super shift assay. In situ generation of ROS was measured using 2,7-dichlorofluorescin (DCF) as a probe. The expression of Nox-4 and Trx were measured by quantitative real-time polymerase chain reaction (Q-RT-PCR). The translocation of Nox-4 was measured by 2-D gel analysis. To determine the levels of Nox-4 and Trx, the mitochondria and cytosol were separated and Western blot analysis was preformed. The MMP-9 activity was measured by gelatin-zymography. The results suggested that CZ activated endothelial PPARgamma in the presence of Hcy. Production of ROS was ameliorated by PPARgamma activation. Expression of Nox-4 was increased, while production of Trx was decreased by Hcy. However, the treatment with CZ normalized the levels of Nox-4 and Trx. Nox-4 was translocated into mitochondria in Hcy-treated endothelial cells. This translocation was associated with decreased production of Trx in mitochondria. The treatment with CZ blocked this translocation and increased Trx levels in mitochondria. Hcy-mediated MMP-9 activity was decreased in cells pre-treated with CZ. These results suggest that Hcy increases NADH oxidase and decreases Trx by translocation of Nox-4 to mitochondria. The data show that indeed, activation of PPARgamma ameliorates the mitochondrial translocation of NOX-4 and MMP-9 activation.

Blood flow shear rates in arterioles of spontaneously hypertensive rats at early and established stages of hypertension.

Alterations of blood rheological properties can affect blood flow shear rates and therefore alter changes in the interactions between blood and vascular wall components during the development of hypertension. This study was done to evaluate alterations of blood flow shear rates in resistance vessels during the development of genetic hypertension in rats. In the current study, measurements were carried out on spontaneously hypertensive rats (SHR) during an early (3 weeks of age) and an established stage (12 weeks of age) of hypertension development. Age matched normotensive Wistar Kyoto (WKY) rats were used as controls. Intravital television microscopy was used to quantitate blood flow shear rates in first-(1A), second-(2A) and third-order (3A) arterioles of the cremaster muscle. In the young SHRs mean arterial blood pressure was not different from age matched WKY rats, but there was a significant increase of shear rate values in all observed (1A, 2A, 3A) arterioles of SHRs. However, shear rate values were significantly less in arterioles (1A, 2A, 3A) of SHRs with an established hypertension compared to the 3-week-old SHR group. We conclude that shear rates are elevated in resistance vessels prior to an increase in mean arterial pressure during the development of genetic hypertension. These results suggest that a change in blood rheology may cause a change in peripheral vascular resistance and thus contribute to the pathogenesis of hypertension.

Platelet thrombus formation in microvessels of young spontaneously hypertensive rats.

We have previously shown an increase in platelet-to-endothelial cell adhesion in microvessels of spontaneously hypertensive rats (SHR) during the established stage of hypertension (12 weeks). The objective of the current study was to determine if the platelet-to-endothelial cell interaction would be altered in the early developmental phase of hypertension. Male weanling (3 weeks old) SHRs (n=6) and age matched normotensive Wistar-Kyoto (WKY) rats (n=6) were used to study platelet thrombus formation. Intravascular fluorescein isothiocyanate tagged to bovine serum albumin was activated with 450-490 nm light to induce thrombus formation in microvessels. Plasma concentrations of von Willebrand factor (vWF), fibrinogen and fibronectin (FN) were measured in rats during both early (3 week) and established stages of hypertension development. Thrombus initiation time in both arterioles (847+/-85 sec) and venules (222+/-40 sec) of young SHRs was significantly shorter (p<0.05) than in arterioles (1270+/-88 sec) and venules (630+/-72 sec) of age matched WKY rats respectively. After thrombus appearance, however, overall time for vessel occlusion in arterioles (2590+/-90 sec) and venules (935+/-131 sec) of SHRs was not different compared to that in arterioles (2650+/-191 sec) and venules (1240+/-93 sec) of age matched WKY rats. The plasma concentration of FN was increased (p<0.05) in both the young (0.9+/-0.1 mg/ml) and mature (1.1+/-0.2 mg/ml) hypertensive rats (n=5) compared to that in young (0.6+/-0.03 mg/ml) and mature (0.5+/-0.1 mg/ml) WKY rats (n=5), while fibrinogen content (3.6 +/-0.3 mg/ml) was elevated (p<0.05) only in mature SHRs (n=5) compared to that (2.7+/-0.02 mg/ml) in age matched WKY rats (n=5). The plasma concentration of vWF was similar to that of controls in either age group of hypertensive animals. These results suggest that changes in platelet-to-endothelial cell interactions occur in the early phase of genetic hypertension development in rats, and appears to result from alteration of plasma concentration of adhesion proteins.

Increased erythrocyte aggregation in spontaneously hypertensive rats.

Alterations of red blood cell (RBC) aggregation and plasma viscosity are major contributors to the changes in blood rheologic properties that cause an increase in peripheral vascular resistance during the development of hypertension. Although basic research and clinical study have provided considerable understanding of the pathophysiology of hypertension, the objective of this study was to determine whether an increase in RBC aggregability and plasma viscosity precede or accompany the development of high arterial blood pressure. To address this question, RBC aggregation and plasma viscosity were studied in spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY) at 3 and 12 weeks of age. The plasma concentrations of fibrinogen and fibronectin (FN) were also analyzed in both age groups. RBC aggregability and plasma viscosity were increased in both young and mature SHR compared to age-matched normotensive WKY rats. Mean arterial blood pressure and diastolic pressures were increased in mature hypertensive rats, whereas in young SHR only diastolic pressure was elevated significantly. The concentration of fibrinogen was higher only in the mature hypertensive rats, whereas plasma FN content was greater in both 3- and 12-week-old SHR compared to age-matched WKY. These results show the existence of increased RBC aggregability and plasma hyperviscosity not only during the established phase of hypertension, but also during the early stage of hypertension development, when mean arterial blood pressure is not yet significantly elevated in the genetically hypertensive rat model. These changes may be related to significant increase in the plasma protein FN, which occurs at the same time as the RBC aggregability and plasma viscosity changes. These results may increase attention to changes in the rheologic properties and to the mechanisms involved in these processes in the early stages of hypertension development.

In vivo platelet thrombus formation in microvessels of spontaneously hypertensive rats.

Sustained high blood pressure causes functional changes in both vascular endothelial cells and platelets. Therefore, we hypothesized that in vivo platelet thrombus formation would be increased in the cremaster muscle microvessels of rats during genetic hypertension. Experiments were carried out on spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY) at 12 weeks of age. Fluorescein isothiocyanate tagged to bovine serum albumin (FITC-BSA) was injected intraarterially and 450 to 490 nm light was used to activate the FITC-BSA and induce a thrombus within the vasculature. In vivo television microscopy was used to quantitate thrombus formation and microvascular diameter changes. The time of platelet thrombus initiation and subsequent time of thrombus growth were studied at wall shear rates of approximately 2000 sec(-1) and 270 sec(-1) in third-order arterioles and venules, respectively. In SHR, times for platelet thrombus initiation and vessel occlusion were significantly less in both arterioles and venules, whereas time for platelet thrombus growth following initiation was significantly prolonged. Greater shear rates in arterioles compared to venules decreased platelet adhesion and subsequently decreased the rate of thrombus formation in both WKY and SHR groups. However, the ratio of WKY to SHR platelet thrombus growth (platelet aggregation) time remained similar (0.83 +/- 0.06 in arterioles and 0.79 +/- 0.06 in venules). These results indicate that there is increased thrombus formation during hypertension and that the platelet adhesion processes may be of greater importance than platelet aggregation in producing this increase.

Von Willebrand factor restores impaired platelet thrombogenesis in copper-deficient rats.

Dietary copper restriction reduces microvascular thrombogenesis. We have now examined the roles of shear forces and von Willebrand factor (vWF) in in vivo thrombus formation in the cremaster microcirculation of copper-deficient rats. Male weanling Sprague-Dawley rats were fed purified diets that were either copper-adequate (6.3 mg Cu/kg) or copper-deficient (0.3 mg Cu/kg) for 4 wk. Intravascular fluorescein isothiocyanate tagged to bovine serum albumin was activated with 450-490 nm light to induce thrombus formation in microvessels. Thrombus initiation time was significantly prolonged in copper-deficient rats; after thrombus appearance, however, vessel occlusion was significantly accelerated. The greater shear rates of arterioles compared with venules significantly increased the thrombus initiation time in both groups. However, vessel occlusion time and thrombus growth time were independent of shear rate. Intravascular vWF (0.2 u/100 g body wt) decreased thrombus initiation time in the CuD group without affecting thrombus growth time. The data suggest that decreased thrombogenesis in copper-deficient rats is not a result of altered rheological factors or arteriolar-venular differences, but appears to result from decreased platelet-to-endothelial cell adhesion.

Antithrombotic and vasorelaxant properties of a novel synthetic RGD peptide containing nitric oxide.

We have developed a novel synthetic peptide containing both the antiadhesive Arg-Gly-Asp (RGD) amino acid sequence and a nitric oxide (NO) moiety well known for its vasorelaxant properties. The main objective of this study was to determine whether this hybrid molecule is concurrently effective with regard to antithrombotic and vasorelaxation actions. Studies of in vitro platelet adhesion and of in vivo platelet thrombus formation in the rat demonstrated that the RGD-NO peptide increased the antithrombotic characteristics of the RGD peptide alone. The RGD-NO peptide also caused relaxation of rat aortic rings, while the RGD peptide did not induce relaxation. These characteristics of Ac-RGDC-SNO suggest that this or similar compounds may have potential as effective antithrombotic agents in coronary and peripheral artery disorders.

Platelet aggregation and adhesion during dietary copper deficiency in rats.

The role of dietary copper deficiency in platelet-to-endothelial cell adhesion and in platelet-to-platelet aggregation was studied in vitro. Platelets were obtained from male, weanling Sprague-Dawley rats fed purified diets which were either copper-adequate (CuA, 6.3 micrograms copper/g of diet) or copper-deficient (CuD, 0.3 microgram/g of diet) for 4 weeks. The platelet adhesion study was performed by adding CuA or CuD platelets either suspended in homologous plasma or in Tyrode buffer salt solution (TBSS) to cultured rate endothelial cells. After a one hour incubation at 37 degrees C non-adhered platelets were removed and counted in a microcytometer. Platelet aggregation in platelet rich plasma (PRP) samples was induced by adding ADP (2 x 10(-4)M) and measured in a turbidometric aggregometer. The content of von Willebrand factor (vWF) in platelets and in plasma and the content of fibrinogen in platelets was determined. Platelet adhesion to rat endothelial cells was significantly lower for platelets from CuD rats than for platelets from CuA rats. ADP induced platelet aggregation from CuD rats was significantly higher than platelet aggregation from CuA rats. The content of vWF in platelets and in plasma from CuD rats was significantly lower than in platelets and plasma from CuA rats. However, the amount of fibrinogen in platelets from ++CuD rats was about 4-fold higher than that in platelets from CuA rats while the plasma fibrinogen was lower in CuD rats than in CuA rats. These studies illustrate that copper deficiency diminishes platelet adhesion to endothelial cells but increases platelet aggregability. The results suggest that these physiological alterations may be the result of decreased platelet vWF and increased platelet fibrinogen during dietary copper deficiency.

L-arginine restores cholesterol-attenuated microvascular responses in the rat cremaster.

The role of L-arginine in the reversal of cholesterol-induced endothelial dysfunction was studied in the cremaster muscle microcirculation. In vivo television microscopy was used to measure microvascular diameters and macromolecular leakage. Male Sprague-Dawley rats were fed either a normal chow diet or a diet supplemented with 1% cholesterol and 0.5% cholic acid for 3 weeks prior to in vivo experimentation. The cholesterol diet caused a decreased third-order arteriole dilator response to both acetylcholine and serotonin. This decreased responsiveness occurred in the presence of a higher plasma concentration of L-arginine and an increased ratio of L-arginine to its metabolite L-citrulline. The attenuation to both agonists was reversed by intravenous infusion of the nitric oxide precursor L-arginine (30-mg/kg bolus and 10-mg/kg/min continuous infusion). The cholesterol diet also decreased the postcapillary macromolecular leakage response to serotonin, and again this effect was reversed by L-arginine infusion. D-Arginine infusion had no restorative effect with either agonist in the cholesterol animals. Further experimentation with the nitric oxide production inhibitor N omega-nitro-L-arginine methyl ester demonstrated an inhibition of aretriolar dilation to acetylcholine, but there was no inhibition of dilation or macromolecular leakage to serotonin. Thus, it is probable that serotonin-induced leakage as well as dilation was not caused by stimulation of nitric oxide. These results suggest that L-arginine restores both nitric oxide-dependent and -independent dilation as well as macromolecular leakage in cholesterol-fed rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Technique for direct and quantitative evaluation of erythrocyte aggregability in blood samples.

An improved technique for the assessment of red blood cell aggregability in human (or animal) blood is proposed, which can provide medical workers and researchers with direct microscopic quantitative data on this essential index of blood rheological properties in the microcirculation. The procedure of treating the blood samples is optimized: the red cells remain in their natural environment (their own blood plasma), while the manipulations and effects that might distort their natural aggregability index is accomplished in glass chambers using an image analyzer. Examples of the erythrocyte aggregability changes in hypertensive patients as compared with those in the healthy control group testify to the significance of the obtainable data.

[Changes of blood flow structure in precapillary microvessels during significant slow-down of flow]. / Izmeneniia v strukture potoka krovi v mikrososudakh prekapilliarnogo tipa pri ego zhachitel'nom zamedlenii.

The experiments were carried out with a special "biological model" in which the rabbits' red blood cell suspension possessing low hematocrit circulated in frogs' mesenterial microvessels. Red blood cell behaviour was investigated in microvessels of 19-45 microns in diameter under conditions of arbitrarily changed flow velocity in mesenterial microvessels. Automatic frame-to-frame analysis of cinematographic films with the texture analysis system (Ernst Leitz, FRG) showed that the velocity fluctuations of individual red blood cells and their radial displacements increased significantly, while their velocity profile became blunt, during slowing-down of flow from 0.7 to 0.2 mm/s. Thus the normal blood flow structure in microvessels becomes disordered under ischemic conditions entailing disturbance of blood rheological properties and creating additionally increased resistance in the vessels.

[Study of the trajectory of erythrocyte movement in microvessels using a method of automatic image analysis]. / Izuchenie traektorii dvizheniia éritrotsitov v mikrososudakh s pomoshch'iu metoda avtomaticheskogo analiza izobrazhenii.

Many physiological and pathological processes in the circulation are related to changes of blood rheological properties. Since blood represents a specific suspension of cells in plasma the mentioned changes are to a great degree dependent on behavior and interaction of red blood cells (RBC). For investigation of blood flow structure in microvessels we developed an algorithm and worked out a program for automatic treatment of RBC movement on the basis of automatic image analysis system "Leitz-TAS" (Ernst Leitz, FRG). The program was based on computation of coordinates of blood cell centers. Further we calculated the following values: the vector of displacements (S), its projection on both axes (dx, dy), their relationship (dy/dx), the relationship of RBC radial coordinate to vessel radius (y/R), and the velocity of RBC movements (V). Proceeding from these data we obtained such parameters, as e.g., the velocity profile, the radial displacements of red cells, etc. by which we could judge on the blood flow regime, the flow structure and changes of blood rheological properties.

[Velocity profiles in the microvessels dependent on the velocity and concentration of erythrocytes]. / Profil' skorostei v mikrososudakh v zavisimosti ot skorosti dvizheniia i kontsentratsii éritrotsitov.

Distribution of velocities of erythrocytes dependent upon their distance from the vascular axis were studied in 25-40 mu large microvessels of the frog mesentery. The method of in vivo cinemicrography with subsequent analysis revealed that with a mean axial velocity of blood flow higher than 0.3-0.4 mm/sec the velocity profile was parabolic, similar to the laminar flow of Newtonian fluids and independent of the erythrocytes concentration in microvessels. With velocities less than 0.3-0.4 mm/sec a chaotic distribution of erythrocytes velocities occurred and the parabolic form of the velocity profiles was rarely observed;--actually only at low erythrocyte concentration (less than 10-11%) in microvessels. The results suggest that an increase in vascular resistance to blood flow must appear during a considerable slow-down of blood flow velocity in microvessels.