345 Abrogation of Sox9 expression in the endothelium blocks aberrant vascular EndMT and fibrosis

Abstract

The endothelium possesses a profound regenerative capacity to adapt and reorganise in homeostasis and disease. The capacity to regenerate is increasingly attributed to a population of vessel-resident endovascular progenitor (EVP) cells that governs an endothelial hierarchy and have the ability to form vascular networks de novo. Using fate map analysis, we show that two transcription factors Sox9 and Rbpj specifically demarcate the EVP population and regulates progenitor fate choice differentiation. Conditional knock-out of Sox9 from the endothelium drove the depletion of EVP to a mature differentiated endothelial phenotype and enhanced Rbpj expression and Notch signalling. Additionally, skin wound analysis from Sox9 knock-out mice demonstrated a significant reduction in endothelial to mesenchymal transition (EndMT), reducing scar area. The converse was observed with Rbpj conditionally knocked-out from the vasculature, with enhanced Sox9 and key EndMT gene (Snail, Slug, Twist1, Twist 2, TGF-β) expression. Concurrently, vascular sonic hedgehog activation upregulates the expression Sox9 and is key in driving pathological EndMT and vascular fibrosis, resulting in over 3-fold increase in scar area in skin wound healing. In this scenario, we see EVP transitioning towards a mesenchymal fate; with increased Sox9, reduced Rbpj and enhanced EndMT gene expression. Importantly, using topical administration of siRNA against Sox9 on skin wounds significantly reduced scar area by blocking pathological EndMT. The understanding of how vascular resident EVP function opens exciting new avenues for more effective therapies in blocking fibrotic disease.