Abstract

Inflammation promotes endothelial dysfunction, but the underlying mechanisms remain poorly defined in vivo. Using translational vascular function testing in myocardial infarction patients, a situation where inflammation is prevalent, and knock-out (KO) mouse models we demonstrate a role for mitogen-activated-protein-kinases (MAPKs) in endothelial dysfunction. Myocardial infarction significantly lowers mitogen and stress kinase 1/2 (MSK1/2) expression in peripheral blood mononuclear cells and diminished endothelial function. To further understand the role of MSK1/2 in vascular function we developed in vivo animal models to assess vascular responses to vasoactive drugs using laser Doppler imaging. Genetic deficiency of MSK1/2 in mice increased plasma levels of pro-inflammatory cytokines and promoted endothelial dysfunction, through attenuated production of nitric oxide (NO), which were further exacerbated by cholesterol feeding. MSK1/2 are activated by toll-like receptors through MyD88. MyD88 KO mice showed preserved endothelial function and reduced plasma cytokine expression, despite significant hypercholesterolemia. MSK1/2 kinases interact with MAPK-activated proteins 2/3 (MAPKAP2/3), which limit cytokine synthesis. Cholesterol-fed MAPKAP2/3 KO mice showed reduced plasma cytokine expression and preservation of endothelial function. MSK1/2 plays a significant role in the development of endothelial dysfunction and may provide a novel target for intervention to reduce vascular inflammation. Activation of MSK1/2 could reduce pro-inflammatory responses and preserve endothelial vasodilator function before development of significant vascular disease.

Highlights

  • Inflammation is a major driver in the development of atherosclerosis [1,2,3]

  • MSK1 and MSK2 gene expression was significantly lower in peripheral blood mononuclear cells (PBMCs) from ST-Elevation Myocardial Infarction (STEMI) patients when compared to healthy volunteer (HV) controls (STEMI MSK1 (p < 0.0001) and MSK2 (p < 0.001) vs. HV) (Figure 1A,B, respectively)

  • We assessed endothelial function by measuring flow-mediated dilatation (FMD) in our STEMI patients and found they had significantly lower vascular responses compared with HV controls (3.7 ± 1.3% vs. 6.8 ± 1.9%, p < 0.0001) (Figure 1C)

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Summary

Introduction

Inflammation is a major driver in the development of atherosclerosis [1,2,3] It promotes early endothelial dysfunction [4] as well as playing an important role in ischemia reperfusion following acute myocardial infarction (AMI). Blood cytokines are predictive of future adverse cardiovascular events [5,6,7] and local inflammation in tissues is associated with tissue injury and immune cell recruitment. TLRs are upregulated on peripheral blood monocytes following AMI [9] and on activated endothelial cells [10,11]. The regulation of cytokine expression downstream of TLRs is complex and involves recruitment of myeloid differentiation primary response-88 (MyD88), initiating downstream signals through multiple signalling pathways, including p38α mitogen-activated protein kinase (MAPK). Clinical trials of p38 inhibition have shown no therapeutic effect on cardiovascular disease (CVD) outcome [14]

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