Abstract

Sickle Cell Disease (SCD) is characterized, in part, by vascular endothelial cell activation, increased oxidative stress and sickle cell adhesion. Excess levels of the vasoconstrictor, endothelin-1 (ET-1), activate endothelial cells, induce oxidative stress and inflammation in the vascular wall and regulate erythrocyte homeostasis, in part, via activation of protein disulfide isomerase (PDI). We measured circulating ET-1, TGFβ1 and PDI activity in two sickle transgenic knockout mouse models expressing human sickle hemoglobin (Hb), BERK and βS Antilles . We observed significant increases in all three markers (n=6; p<0.01) when compared to either C57BL/J6 mice or knockout mice expressing normal human Hb A. We then intraperitoneally injected BERK mice for 14 days with ET-1 receptor antagonists and observed significant reductions in these circulating markers (n=6; p<0.05). These studies are important as PDI is proposed to control hemostasis, thrombosis and is reported to regulate the major histocompatibility complex (MHC). In addition, activated endothelial cells express PDI and MHC. However, the relationship between ET-1 and MHC in SCD remains unclear. We characterized the role of ET-1 on MHC expression in the endothelial cell line, EA.hy926. We observed dose-dependent increases in the expression of MHC class I (HLA-A2 4.8 ± 2.1 folds p<0.01 n=4), MHC class II (HLA-DR 4.4 ± 1.7 folds p<0.01 n=4) and MHC transcription factor (CIITA 3.5 ± 1.8 folds p<0.05 n=4) in EA.hy926 cells. Increased expression of MHC was significantly blocked by co-incubation of cells with 10μM BQ788, a selective blocker of ET-1 type B receptors. Chromatin immunoprecipitation studies showed that ET-1 incubation produced an increase in Histone H3 acetylation of the promoter in MHC molecules (HLA-A2 4.6 ± 1.4 folds, HLA-DRB 6.0 ± 0.7 folds, p<0.01, n=3) in these cells; an event that was likewise blocked by BQ788. In addition, ET-1 stimulated recruitment of CIITA to the promoter of HLA-A2 (1.9 ± 0.7 folds, p<0.05, n=3) and HLA-DRB (3.0 ± 0.6 folds, p<0.01, n=3). These results implicate ET-1 as a novel regulator of MHC promoter activity and suggest that ET-1 receptor blockade represents an important therapeutic approach to improve both the inflammatory and vascular complications of SCD.

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