Abstract

Neutrophil extracellular traps (NETs) have been observed in multiple diseases of the cardiovascular system, such as myocardial infarction and atherosclerosis. We have recently shown that adenosine (ADO) inhibits NET formation and may be an important endogenous regulator. CD73 is expressed on many cell types and catalyzes the extracellular formation of ADO from AMP. Here, we first attempt to implicate NETs in cardiac injury, and we posit that human NETs negatively impact cardiac function by influencing native leukocyte recruitment and activation. Second, we prototype a CD73-functionalized hydrogel delivery vehicle for adenosine and test its function in vitro. We introduced NETs obtained from stimulated neutrophils into healthy hearts by intramyocardial injection in two-month-old rats. We used echo to assess cardiac function at days 0, 1 and 3 of injection. We measured the abundance of cardiac leukocyte subpopulations by flow cytometry at days 1 and 3 after injection, with immunostaining for CD45 (all leukocytes), myeloperoxidase (MPO, neutrophils), CD68 (macrophages), CD3 (T-cells), B220 (B-cells) and citrullinated histone 3 (citH3, NETs). To deliver adenosine as a NET antagonist, we designed a polyethylene (PEG) hydrogel composed of a 4-armed PEG incorporating a VPM protease-degradable crosslinker for cargo release, and an RGD peptide to enhance gel-tissue attachment. We tested gel polymerization by measuring storage and loss moduli at 4% and 6% PEG content (w/v) and 0, 1 uM and 1mM RGD concentrations. We functionalized the gel with CD73 to test its adenosine production capability. We found a significant decreased in cardiac function assessed by global longitudinal strain at day 1 in the NET group compared to saline. By flow cytometry, we found an increase in neutrophils, macrophages and NET formation at day 1, while B- and T-cells were increased at day 3. We found that increasing the PEG content of our hydrogel, but not RGD, increases gel stiffness. We also found that the CD73 functionalized hydrogel successfully catalyzes the formation of adenosine in vitro. In conclusion, we found that NETs negatively impact cardiac function, and successfully tested an adenosine hydrogel source in vitro. Next, we will study the effect of our gel on NETs in vivo.

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