Abstract 650: Disrupting Neointimal Formation In Mouse And Human Vascular Tissues Through Targeting Connexin 43

Abstract

Vascular damage caused by stent placement triggers smooth muscle cell (SMC) de-differentiation, leading to an aggressively proliferating phenotype that thickens the vessel wall and blocks the artery, which contributes to stent failure. We have identified the gap junction protein connexin 43 (Cx43) as a significant contributor to neointima progression. Phosphorylation of Cx43 by mitogen-activated protein kinase (MAPK) promotes its binding to the cell cycle regulator cyclin E and its kinase CDK2, promoting SMC proliferation. Beyond this, we do not know how these proteins regulate SMC proliferation in humans. We tested the hypothesis that disrupting Cx43-cyclin E binding could reduce neointima formation in human blood vessels. We used peptide arrays to identify cyclin E binding sites on Cx43 and to define critical Cx43 MAPK-phosphorylation residues that control their interactions. Based on this, we created a 15 amino acid, stearate-linked, cell-permeable, connexin mimetic peptide termed CycliCx that binds cyclin E. Experiments were controlled using Cx43 mimetic peptides designed against regions not bound by cyclin E. In cultured human coronary artery SMC, the CycliCx peptide reduces Cx43 MAPK-phosphorylation, disrupts Cx43-cyclin E interactions, and prevents PDGF-induced SMC proliferation. Application of the CycliCx peptide to mouse carotid arteries inhibits neointima formation in a 14-day ligation-induced neointima model (n=8, male and female). We developed an ex vivo model of PDGF-induced neointimal formation in excess human saphenous vein tissues recovered after CABG surgery. In the human saphenous vein preparations treated with PDGF, the CycliCx peptide disrupts neointima formation after 14 days (n=9). In conclusion, our data suggest that disrupting Cx43-cyclin E interactions provides protection against pathological SMC proliferation. These data highlight Cx43 as a potential drug target to prevent human neointima development.