Abstract

Cerebral Cavernous Malformation (CCM) is a neurovascular disease characterized by abnormal vascular structures associated with defects on vascular lumen formation and vascular fragility, mostly localized in the brain. Lack of KRIT1 protein associated to CCM drives the stable and quiescent endothelium toward an active state characterized by loss of barrier function, increased vascular permeability, loss of adherens junction integrity, increased β-catenin nuclear localization and vascular endothelial growth factor (VEGF) expression and angiogenesis. Multiple pathways are responsible for changes in endothelial phenotype and we contributed to demonstrate that the dysregulation of reactive oxygen species (ROS) production following loss of KRIT1 expression play a key role in increasing vascular permeability and is linked to NADPH oxidase (NOX) up-regulation. By using wt and KRIT1-/- mouse embryonic fibroblasts (MEFs) we showed that loss of KRIT1 induced NOX4 overexpression that is associated with alteration of angiogenic growth factors expression and with the angiogenic switch of endothelial cells. Our data contribute to demonstrate the pivotal role of oxidative stress in the progression of CCM disease, indicating NOX4 and ROS as potential targets for pharmaceutical approaches.

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