Abstract

BackgroundVascular endothelial cells (ECs) are subject to continuous shear stress due to blood circulation. Mechanical stress due to high shear flow can also cause arteriovenous malformation (AVM) when ECs respond hyper-sensitively to shear flow. This study was conducted to test the hypothesis that angiogenesis could be promoted in response to mechanical stress via regulation of pro-angiogenic factors in AVM cells.MethodsECs were extracted from the tissue samples from six AVM patients and six normal patients. Shear stress at 7 dynes/cm2 were applied for 24 h. Before and after application of shear stress to each group, RT-PCR was performed to access the expression levels of angiopoietin2(AGP2), aquaporin1(AQP1) and TGFβR1. Immunofluorescences was also performed to evaluate the level of protein expressions.ResultsIn both normal and AVM tissues, AGP2 and TGFβR1 under the shear stress showed increased expression in the ECs compared to the non-sheared samples. When AVMs and normal arterial vasculature were compared, the expression levels of both AGP2 and TGFβR1 in AVMs were higher when compared to normal arterial vasculature with or without shear stress. Immunofluorescence-based protein analysis also confirmed shear-induced AGP2 and TGFβR1 in both samples of normal and AVM patients.ConclusionsAVMs exhibited higher sensitivity to shear stress by producing higher expressions of some marked genes and proteins that regulate the endothelial functions upon exposure to shear stress. While the physiological mechanism for AVMs remain elusive, our study shows the plausibility of physical stress imposed by the shearing flow can cause the occurrence of AVMs.

Highlights

  • Vascular endothelial cells (ECs) are subject to continuous shear stress due to blood circulation

  • Because the minimum shear stress per unit area at which morphological changes in cells begins was 4 dynes/cm2, the shear stress was constant at 4.5 dynes/ cm2 which is close to the minimum shear stress value in order to obtain the maximum time to which the shear stress was applied

  • Results of immunofluorescence: Angiopoietin 2, Aquaporin 1, TGFb1 To histologically verify the difference in gene expression, immunofluorescence tests for Angiopoietin2, Aquaporin1, and TGFβR1 were performed on vascular ECs before and after applying shear stress

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Summary

Introduction

Vascular endothelial cells (ECs) are subject to continuous shear stress due to blood circulation. Mechanical stress due to high shear flow can cause arteriovenous malformation (AVM) when ECs respond hypersensitively to shear flow. AVMs occur because of the absence of capillaries between arteries and veins, causing the circulating blood to flow directly from arteries to veins. Blood can either circulate through fistulas which directly connect arteries and veins, or through abnormally connected channel blood vessels from arteries called nidus to the veins. For this reason, AVMs are the most invasive and destructive of the vascular malformations (Kim et al 2017). AVMs are characterized by abnormal channels between arteries and veins, lack of capillaries, and excessive fibrosis (Liu et al 2010)

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