Abstract

BackgroundPlasminogen activator inhibitor-1 (PAI-1), a serine protease inhibitor, is expressed and secreted by endothelial cells. Patients with PAI-1 deficiency show a mild to moderate bleeding diathesis, which has been exclusively ascribed to the function of PAI-1 in down-regulating fibrinolysis. We tested the hypothesis that PAI-1 function plays a direct role in controlling vascular integrity and permeability by keeping endothelial cell-cell junctions intact.Methodology/Principal FindingsWe utilized PAI-039, a specific small molecule inhibitor of PAI-1, to investigate the role of PAI-1 in protecting endothelial integrity. In vivo inhibition of PAI-1 resulted in vascular leakage from intersegmental vessels and in the hindbrain of zebrafish embryos. In addition PAI-1 inhibition in human umbilical vein endothelial cell (HUVEC) monolayers leads to a marked decrease of transendothelial resistance and disrupted endothelial junctions. The total level of the endothelial junction regulator VE-cadherin was reduced, whereas surface VE-cadherin expression was unaltered. Moreover, PAI-1 inhibition reduced the shedding of VE-cadherin. Finally, we detected an accumulation of VE-cadherin at the Golgi apparatus.Conclusions/SignificanceOur findings indicate that PAI-1 function is important for the maintenance of endothelial monolayer and vascular integrity by controlling VE-cadherin trafficking to and from the plasma membrane. Our data further suggest that therapies using PAI-1 antagonists like PAI-039 ought to be used with caution to avoid disruption of the vessel wall.

Highlights

  • Endothelia line all blood vessels and form a barrier between the circulation and surrounding tissues

  • Further we show that Plasminogen activator inhibitor-1 (PAI-1) inhibition with the small molecule inhibitors PAI-039 and TM5275 disrupts endothelial cell-cell junctions and causes a loss of transendothelial resistance of human umbilical vein endothelial cell (HUVEC) monolayers and increased vascular permeability in zebrafish

  • To examine if PAI-1 inhibition with PAI-039 can mimick the effects of PAI-1 deficiency in patients, we injected fluorescent TMR-dextran into zebrafish embryos to visualize any leakage from blood vessels

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Summary

Introduction

Endothelia line all blood vessels and form a barrier between the circulation and surrounding tissues. The most important cell adhesion protein in endothelial adherens junctions is VE-cadherin (Vascular Endothelial-cadherin), which ensures that endothelial cells stay connected and restrains the leakage from blood vessels [1]. Apart from the role of PAI-1 as an inhibitor of fibrinolytic activity, other PAI-1 functions for cell adhesion to extracellular matrix, tissue remodeling, migration, proliferation and apoptosis have been described [9,10,11,12,13,14]. Patients with PAI-1 deficiency have an increased risk for hemorrhaging after surgery, menorrhagia and epistaxis [15]. This phenotype has to date been solely ascribed to the function of PAI-1 as an inhibitor of fibrinolysis

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