Interaction of wall shear stress magnitude and gradient in the prediction of arterial macromolecular permeability

Sinner or Saint?: Nck Adaptor Proteins in Vascular Biology

The Nck family of modular adaptor proteins, including Nck1 and Nck2, link phosphotyrosine signaling to changes in cytoskeletal dynamics and gene expression that critically modulate cellular phenotype. The Nck SH2 domain interacts with phosphotyrosine at dynamic signaling hubs, such as activated growth factor receptors and sites of cell adhesion. The Nck SH3 domains interact with signaling effectors containing proline-rich regions that mediate their activation by upstream kinases. In vascular biology, Nck1 and Nck2 play redundant roles in vascular development and postnatal angiogenesis. However, recent studies suggest that Nck1 and Nck2 differentially regulate cell phenotype in the adult vasculature. Domain-specific interactions likely mediate these isoform-selective effects, and these isolated domains may serve as therapeutic targets to limit specific protein-protein interactions. In this review, we highlight the function of the Nck adaptor proteins, the known differences in domain-selective interactions, and discuss the role of individual Nck isoforms in vascular remodeling and function.

A 3-dimensional microfluidic platform for modeling human extravillous trophoblast invasion and toxicological screening

Placental trophoblast cells invasion into the maternal uterus is an essential and complex event in the formation of the maternal-fetal interface. Commonly used two-dimensional (2D) cell invasion tools do not accurately represent the in vivo cell invasion microenvironment. Three-dimensional (3D) silicone polymer polydimethylsiloxane (PDMS) microfluidic platforms are an emerging technology in developing organ-on-a-chip models. Here, we present a placenta-on-a-chip platform that enables the evaluation of trophoblast invasion with intraluminal flow within an engineered PDMS 3D microfluidic chip. This platform reproduces key elements of the placental microenvironment, including endothelial and trophoblast cells, layered with an extracellular matrix, and incorporates dynamic medium flow while allowing for real-time monitoring, imaging, evaluation of trophoblast cell invasion, and heterocellular cell-to-cell interactions. Coupled with fluorescent cell tagging and flow cytometry, this platform also allows collection of the invasive cells. This will help our understanding of pathways that regulate trophoblast cell invasion and may prove important for toxicological screening of exposures that interfere with invasiveness in a complex organ such as the placenta.

Nck1, But Not Nck2, Mediates Disturbed Flow-Induced p21-Activated Kinase Activation and Endothelial Permeability

Background

Alteration in hemodynamic shear stress at atheroprone sites promotes endothelial paracellular pore formation and permeability. The molecular mechanism remains unknown.

Methods and Results

We show that Nck (noncatalytic region of tyrosine kinase) deletion significantly ameliorates disturbed flow‐induced permeability, and selective isoform depletion suggests distinct signaling mechanisms. Only Nck1 deletion significantly reduces disturbed flow‐induced paracellular pore formation and permeability, whereas Nck2 depletion has no significant effects. Additionally, Nck1 re‐expression, but not Nck2, restores disturbed flow‐induced permeability in Nck1/2 knockout cells, confirming the noncompensating roles. In vivo, using the partial carotid ligation model of disturbed flow, Nck1 knockout prevented the increase in vascular permeability, as assessed by Evans blue and fluorescein isothiocyanate dextran extravasations and leakage of plasma fibrinogen into the vessel wall. Domain swap experiments mixing SH2 (phosphotyrosine binding) and SH3 (proline‐rich binding) domains between Nck1 and Nck2 showed a dispensable role for SH2 domains but a critical role for the Nck1 SH3 domains in rescuing disturbed flow‐induced endothelial permeability. Consistent with this, both Nck1 and Nck2 bind to platelet endothelial adhesion molecule‐1 (SH2 dependent) in response to shear stress, but only Nck1 ablation interferes with shear stress–induced PAK2 (p21‐activated kinase) membrane translocation and activation. A single point mutation into individual Nck1 SH3 domains suggests a role for the first domain of Nck1 in PAK recruitment to platelet endothelial cell adhesion molecule‐1 and activation in response to shear stress.

Conclusions

This work provides the first evidence that Nck1 but not the highly similar Nck2 plays a distinct role in disturbed flow‐induced vascular permeability by selective p21‐activated kinase activation.

Influencing factors of vascular endothelial function in patients with non-obstructive coronary atherosclerosis: a 1-year observational study

BACKGROUND

Endothelial dysfunction may play a key role in non-obstructive coronary artery atherosclerosis. Our study aimed to evaluate the vascular endothelial function and its influencing factors in patients with non-obstructive coronary artery atherosclerosis.

METHODS

A total of 131 consecutive patients with non-obstructive coronary artery atherosclerosis were enrolled. Flow-mediated dilatation (FMD) was measured at baseline and 1-year follow-up. Endothelial progenitor cells (EPCs) were counted by staining the fasting venous blood with antibodies against CD34 and vascular endothelial growth factor receptor 2.

RESULTS

Systolic blood pressure, pulse pressure and the levels of HbA1c in participants with baseline FMD < 6% (n = 65) were significantly higher than those with baseline FMD ≥ 6% (n = 66). Baseline FMD was negatively associated with EPC counts (r = - 0.199, P < 0.05) and systolic blood pressure (r = - 0.315, P < 0.01). The 1-year FMD was significantly increased compared to the baseline FMD [(9.31 ± 5.62) % vs (7.31 ± 5.26) %, P < 0.001]. Independent predictors of FMD improvement included elevated EPC counts (OR = 1.104, 95% CI: 1.047-1.165, P < 0.001) and decreased levels of serum creatinine (OR = 0.915, 95% CI: 0.843-0.993, P = 0.034).

CONCLUSIONS

Family history of premature cardiovascular diseases, hypertension, elevated systolic pressure, and HbA1c > 6.5% are independent risk factors for endothelial dysfunction in non-obstructive atherosclerotic patients. Elevated peripheral blood EPC counts and decreased levels of serum creatinine are independent predictors of endothelial function improvement.

Endothelial permeability, LDL deposition, and cardiovascular risk factors-a review

Early atherosclerosis features functional and structural changes in the endothelial barrier function that affect the traffic of molecules and solutes between the vessel lumen and the vascular wall. Such changes are mechanistically related to the development of atherosclerosis. Proatherogenic stimuli and cardiovascular risk factors, such as dyslipidaemias, diabetes, obesity, and smoking, all increase endothelial permeability sharing a common signalling denominator: an imbalance in the production/disposal of reactive oxygen species (ROS), broadly termed oxidative stress. Mostly as a consequence of the activation of enzymatic systems leading to ROS overproduction, proatherogenic factors lead to a pro-inflammatory status that translates in changes in gene expression and functional rearrangements, including changes in the transendothelial transport of molecules, leading to the deposition of low-density lipoproteins (LDL) and the subsequent infiltration of circulating leucocytes in the intima. In this review, we focus on such early changes in atherogenesis and on the concept that proatherogenic stimuli and risk factors for cardiovascular disease, by altering the endothelial barrier properties, co-ordinately trigger the accumulation of LDL in the intima and ultimately plaque formation.

Low Wall Shear Stress Is Associated with Local Aneurysm Wall Enhancement on High-Resolution MR Vessel Wall Imaging

BACKGROUND AND PURPOSE

Some retrospective studies have found that the aneurysm wall enhancement on high-resolution MR vessel wall postgadolinium T1WI has the potential to distinguish unstable aneurysms. This study aimed to identify hemodynamic characteristics that differ between the enhanced and nonenhanced areas of the aneurysm wall on high-resolution MR vessel wall postgadolinium T1WI.

MATERIALS AND METHODS

TOF-MRA and high-resolution MR vessel wall T1WI of 25 patients were fused to localize the enhanced area of the aneurysm wall. Using computational fluid dynamics, we studied the aneurysm models. Mean static pressure, mean wall shear stress, and oscillatory shear index were compared between the enhanced and nonenhanced areas.

RESULTS

The aneurysmal enhanced area had lower wall shear stress (P < .05) and a lower oscillatory shear index (P = .021) than the nonenhanced area. In addition, the whole aneurysm had lower wall shear stress (P < .05) and a higher oscillatory shear index (P = .007) than the parent artery.

CONCLUSIONS

This study suggests that there are hemodynamic differences between the enhanced and nonenhanced areas of the aneurysm wall on high-resolution MR vessel wall postgadolinium T1WI.

Non-invasive Evaluation of Fluid Dynamic of Aortoiliac Atherosclerotic Disease: Impact of Bifurcation Angle and Different Stent Configurations

Objectives

To non-invasively evaluate by computational fluid dynamic (CFD) analysis the physiology and rheology of aortoiliac bifurcation disease at different angles and different stent configurations.

Material and methods

For the analysis, we considered a physiologic model of abdominal aorta with an iliac bifurcation set at 30°, 45° and 70° without stenosis. Subsequently, a bilateral ostial common iliac stenosis of 80% was considered for each type of bifurcation. For the stent simulation, we reconstructed Zilver vascular self-expanding (Zilver; Cook, Bloomington, MN) and Palmaz Genesis Peripheral (Cordis, Miami, FL) stents.

Results

The physiologic model, across the different angles, static pressure, Reynolds number and stream function, were lower for the 30° bifurcation angle with a gradient from 70° to 30° angles, whereas all the other parameters were inversely higher. After stenting, all the fluid parameters decreased homogenously independent of the stent type, maintaining a gradient in favour of 30° compared to 45° and 70° angles. The absolute greater deviation from physiology was observed for low kissing when self-expandable stents were used across all angles; in particular, the wall shear stress was high at at 45° angle.

Conclusion

Bifurcation angle deeply impacts the physiology of aortoiliac bifurcations, which are used to predict the fluid dynamic profile after stenting. CFD, having the potential to be derived both from computed tomography scan or invasive angiography, appears to be an ideal tool to predict fluid dynamic profile before and after stenting in aortoiliac bifurcation.

Non-invasive Evaluation of Fluid Dynamic of Aortoiliac Atherosclerotic Disease: Impact of Bifurcation Angle and Different Stent Configurations

Objectives

To non-invasively evaluate by computational fluid dynamic (CFD) analysis the physiology and rheology of aortoiliac bifurcation disease at different angles and different stent configurations.

Material and methods

For the analysis, we considered a physiologic model of abdominal aorta with an iliac bifurcation set at 30°, 45° and 70° without stenosis. Subsequently, a bilateral ostial common iliac stenosis of 80% was considered for each type of bifurcation. For the stent simulation, we reconstructed Zilver vascular self-expanding (Zilver; Cook, Bloomington, MN) and Palmaz Genesis Peripheral (Cordis, Miami, FL) stents.

Results

The physiologic model, across the different angles, static pressure, Reynolds number and stream function, were lower for the 30° bifurcation angle with a gradient from 70° to 30° angles, whereas all the other parameters were inversely higher. After stenting, all the fluid parameters decreased homogenously independent of the stent type, maintaining a gradient in favour of 30° compared to 45° and 70° angles. The absolute greater deviation from physiology was observed for low kissing when self-expandable stents were used across all angles; in particular, the wall shear stress was high at at 45° angle.

Conclusion

Bifurcation angle deeply impacts the physiology of aortoiliac bifurcations, which are used to predict the fluid dynamic profile after stenting. CFD, having the potential to be derived both from computed tomography scan or invasive angiography, appears to be an ideal tool to predict fluid dynamic profile before and after stenting in aortoiliac bifurcation.

Discussion: "Comparison of Statistical Methods for Assessing Spatial Correlations Between Maps of Different Arterial Properties" (Rowland, E. M., Mohamied, Y., Chooi, K. Y., Bailey, E. L., and Weinberg, P. D., 2015, ASME J. Biomech. Eng., 137(10), p. 101003): An Alternative Approach Using Segmentation Based on Local Hemodynamics

The biological response of living arteries to mechanical forces is an important component of the atherosclerotic process and is responsible, at least in part, for the well-recognized spatial variation in atherosusceptibility in man. Experiments to elucidate this response often generate maps of force and response variables over the arterial surface, from which the force-response relationship is sought. Rowland et al. discussed several statistical approaches to the spatial autocorrelation that confounds the analysis of such maps and applied them to maps of hemodynamic stress and vascular response obtained by averaging these variables in multiple animals. Here, we point out an alternative approach, in which discrete surface regions are defined by the hemodynamic stress levels they experience, and the stress and response in each animal are treated separately. This approach, applied properly, is insensitive to autocorrelation and less sensitive to the effect of confounding hemodynamic variables. The analysis suggests an inverse relation between permeability and shear that differs from that in Rowland et al. Possible sources of this difference are suggested.

Effect of Different Rotational Directions of BJUT-II VAD on Aortic Swirling Flow Characteristics: A Primary Computational Fluid Dynamics Study

Background

The BJUT-II VAD is a novel left ventricular assist device (LVAD), which is thought to have significant effects on the characteristics of aortic swirling flow. However, the precise mechanism of the rotational direction of BJTU-II VAD in the aortic swirling flow is unclear.

Material/Methods

A patient-specific aortic geometric model was reconstructed based on the CT data. Three pump’s output flow profiles with varied rotational direction, termed “counterclockwise”, “flat profile”, and “clockwise”, were used as the boundary conditions. The helicity density, area-weighted average of helicity density (Ha), localized normalized helicity (LNH), wall shear stress (WSS), and WSS spatial gradient (WSSG) were calculated to evaluate the swirling flow characteristics in the aorta.

Results

The results demonstrated that the swirling flow characteristics in the aorta and 3 branches are directly affected by the output blood flow of BJUT-II VAD. In the aortic arch, the helicity density, supported by the clockwise case, achieved the highest value. In the 3 branches, the flat profile case achieved the highest helicity density, whereas the maximum WSS and WSSG generated by clockwise case were lower than in other cases.

Conclusions

The outflow of the BJUT-II VAD has significant effects on the aortic hemodynamics and swirling flow characteristics. The helical blood profiles can enhance the strength of aortic swirling flow, and reduce the areas of low WSS and WSSG regions. The clockwise case may have a benefit for preventing development of atherosclerosis in the aorta.

Vascular endothelium - Gatekeeper of vessel health

The vascular endothelium is an interface between the blood stream and the vessel wall. Changes in this single cell layer of the artery wall are believed of primary importance in the pathogenesis of vascular disease/atherosclerosis. The endothelium responds to humoral, neural and especially hemodynamic stimuli and regulates platelet function, inflammatory responses, vascular smooth muscle cell growth and migration, in addition to modulating vascular tone by synthesizing and releasing vasoactive substances. Compromised endothelial function contributes to the pathogenesis of cardiovascular disease; endothelial 'dysfunction' is associated with risk factors, correlates with disease progression, and predicts cardiovascular events. Therapies for atherosclerosis have been developed, therefore, that are directed towards improving endothelial function.

A comparative review of the hemodynamics and pathogenesis of cerebral and abdominal aortic aneurysms: lessons to learn from each other

OBJECTIVE

Cerebral aneurysms (CAs) and abdominal aortic aneurysms (AAAs) are degenerative vascular pathologies that manifest as abnormal dilations of the arterial wall. They arise with different morphologies in different types of blood vessels under different hemodynamic conditions. Although treated as different pathologies, we examine common pathways in their hemodynamic pathogenesis in order to elucidate mechanisms of formation.

MATERIALS AND METHODS

A systematic review of the literature was performed. Current concepts on pathogenesis and hemodynamics were collected and compared.

RESULTS

CAs arise as saccular dilations on the cerebral arteries of the circle of Willis under high blood flow, high wall shear stress (WSS), and high wall shear stress gradient (WSSG) conditions. AAAs arise as fusiform dilations on the infrarenal aorta under low blood flow, low, oscillating WSS, and high WSSG conditions. While at opposite ends of the WSS spectrum, they share high WSSG, a critical factor in arterial remodeling. This alone may not be enough to initiate aneurysm formation, but may ignite a cascade of downstream events that leads to aneurysm development. Despite differences in morphology and the structure, CAs and AAAs share many histopathological and biomechanical characteristics. Endothelial cell damage, loss of elastin, and smooth muscle cell loss are universal findings in CAs and AAAs. Increased matrix metalloproteinases and other proteinases, reactive oxygen species, and inflammation also contribute to the pathogenesis of both aneurysms.

CONCLUSION

Our review revealed similar pathways in seemingly different pathologies. We also highlight the need for cross-disciplinary studies to aid in finding similarities between pathologies.

A computational fluid dynamics study on hemodynamics for different locations of the distal anastomosis of a bypass nearby a collateral vessel in the femoropopliteal area

Revascularization of the femoropopliteal sector is often performed by the placement of a bypass. In this paper, we have studied the effects of hemodynamics on patency of the bypass for different positions of the distal anastomosis close to a collateral artery. Computational fluid dynamics (CFD) are used for this study. The cardiac cycle-averaged wall shear stress (WSS) and oscillation index (OSI) have been analyzed. Low WSS and high OSI may increase the risk of intimal hyperplasia (IH), which may reduce bypass patency. From the CFD simulations, spots of low WSS and high OSI are found within and near the entrance of the collateral artery, near the suture line, at the floor, toe, and heel. We regarded flow ratios of 20:80 and of 35:65. It is found that for the high flow ratio anastomosis located proximal to the collateral artery is clearly more advantageous. However for the low flow ratio anastomosis located distal to the collateral artery seems to be slightly more advantageous, the results are less conclusive. One of the studied flow geometries has been validated by in vitro experiments using a time resolved particle image velocimetry technique. Velocity fields from these experiments are in good agreement with the CFD results.

Endothelial injury preceding intracranial aneurysm formation in rabbits

OBJECTIVE

This study investigates the change of endothelial cell morphology and function at the rabbit basilar bifurcations in response to sustained high blood flow after bilateral common carotid artery ligation.

METHODS

Fifteen adult female New Zealand white rabbits were divided into experimental and sham control groups. The experimental group was subjected to bilateral common carotid artery ligation to increase the compensatory basilar artery flow. Basilar artery flow was monitored by transcranial Doppler after surgery. The endothelial cells at the arterial bifurcations were studied morphologically by electron microscopy and immunohistochemistry using β-catenin antibodies. Basilar artery flow increased significantly following common carotid artery ligation.

RESULTS

Early-stage basilar artery bifurcation aneurysms were present in all rabbits at three months after ligation. The endothelial cells changed from a fusiform to column shape at the basilar artery bifurcation. Gaps between endothelial cells of the experimental group appeared wider in the electron microscopic photographs compared with those of the control group. The expression of endothelial β-catenin at the arterial bifurcations also decreased.

CONCLUSION

This study is the first to present endothelial cell changes of basilar artery bifurcation in response to sustained high blood flow in rabbits. Endothelial cell impairment possibly initiates aneurysm formation.

New techniques for determining the longitudinal effects of local hemodynamics on the intima-media thickness in arteriovenous fistulae in an animal model

Remodeling in the arteriovenous fistulas (AVFs) is believed to be a hemodynamic-driven process, which results in extreme changes in the diameter and intima-media thickening (IMT) of vessels over time. This study aims to describe the successful development of techniques that enabled correlation of changes in local and longitudinal wall shear stress (WSS) with the temporal variations of the diameter and IMT in the venous segment of AVFs. An AVF was created between the femoral artery and vein of a 50-kg pig. We have previously shown the successful use of CT-scan and ultrasound techniques for anatomical and flow measurements in AVFs, respectively. In this study, we developed new techniques involving markers (both in vivo and ex vivo), casting (ex vivo), and micro-MRI (ex vivo; 7 Tesla). A radiopaque marker (ROM) was sutured to the AVF at the day of surgery, which was visible in the CT-scan images, micro-MRI, and histology sections. Therefore, ROM served as a fixed local reference for both in vivo and ex vivo states of AVFs. Immediately after sacrificing the pig, a procedure was developed to create a cast from the AVF and thus, maintaining the in vivo state of the AVF during the histology process. Then, micro-MRI and histology techniques were conducted on the AVF to measure IMT in the vein. Along the ROM, the local changes in WSS levels for two cross-sections were tracked at 2D (D: days) and 28D post surgery. WSS levels reduced from 2D to 28D for both cross-sections. Also, the recirculation zones, which formed at 2D for both sections, became smaller in size at 28D. These hemodynamic changes were then mapped onto the corresponding IMT measurements from histology and micro-MRI. It was observed that the recirculation zones at 2D and 28D corresponded to the largest IMT in the two sections. In summary, the new methodologies allowed us to define a fixed local reference at all time points in the AVF, which enabled accurate tracking of local changes in hemodynamics (WSS), configuration (diameter), and structure (IMT) of the venous segment over time. This also empowered study of the interactions between these parameters, which could improve our understanding about the hemodynamic-driven remodeling in AVFs. From a clinical point of view, this information could be translated into local and early therapeutic interventions for dialysis patients.

Adaptive response of vascular endothelial cells to an acute increase in shear stress magnitude

The adaptation of vascular endothelial cells to shear stress alteration induced by global hemodynamic changes, such as those accompanying exercise or digestion, is an essential component of normal endothelial physiology in vivo. An understanding of the transient regulation of endothelial phenotype during adaptation to changes in mural shear will advance our understanding of endothelial biology and may yield new insights into the mechanism of atherogenesis. In this study, we characterized the adaptive response of arterial endothelial cells to an acute increase in shear stress magnitude in well-defined in vitro settings. Porcine endothelial cells were preconditioned by a basal level shear stress of 15 ± 15 dyn/cm(2) at 1 Hz for 24 h, after which an acute increase in shear stress to 30 ± 15 dyn/cm(2) was applied. Endothelial permeability nearly doubled after 40-min exposure to the elevated shear stress and then decreased gradually. Transcriptomics studies using microarray techniques identified 86 genes that were sensitive to the elevated shear. The acute increase in shear stress promoted the expression of a group of anti-inflammatory and antioxidative genes. The adaptive response of the global gene expression profile is triphasic, consisting of an induction period, an early adaptive response (ca. 45 min) and a late remodeling response. Our results suggest that endothelial cells exhibit a specific phenotype during the adaptive response to changes in shear stress; this phenotype is different than that of fully adapted endothelial cells.

Patient-specific three-dimensional simulation of LDL accumulation in a human left coronary artery in its healthy and atherosclerotic states

We calculate low-density lipoprotein (LDL) transport from blood into arterial walls in a three-dimensional, patient-specific model of a human left coronary artery. The in vivo anatomy data are obtained from computed tomography images of a patient with coronary artery disease. Models of the artery anatomy in its healthy and diseased states are derived after segmentation of the vessel lumen, with and without the detected plaque, respectively. Spatial shear stress distribution at the endothelium is determined through the reconstruction of the arterial blood flow field using computational fluid dynamics. The arterial endothelium is represented by a shear stress-dependent, three-pore model, taking into account blood plasma and LDL passage through normal junctions, leaky junctions, and the vesicular pathway. Intraluminal pressures of 70 and 120 mmHg are employed as the normal and hypertensive operating pressures, respectively. By applying our model to both the healthy and diseased states, we show that the location of the plaque in the diseased state corresponds to one of the two sites with predicted high-LDL concentration in the healthy state. We further show that, in the diseased state, the site with high-LDL concentration has shifted distal to the plaque, which is in agreement with the clinical observation that plaques generally grow in the downstream direction. We also demonstrate that hypertension leads to increased number of regions with high-LDL concentration, elucidating one of the ways in which hypertension may promote atherosclerosis.

Endothelial cell layer subjected to impinging flow mimicking the apex of an arterial bifurcation

Little is known about endothelial responses to the impinging flow hemodynamics that occur at arterial bifurcation apices, where intracranial aneurysms usually form. Such hemodynamic environments are characterized by high wall shear stress (WSS >40 dynes/cm(2)) and high wall shear stress gradients (WSSG >300 dynes/cm(3)). In this study, confluent bovine aortic endothelial cells were exposed to impinging flow in a T-shaped chamber designed to mimic a bifurcation. After 24-72 h under flow, cells around the stagnation point maintained polygonal shapes but cell density was reduced, whereas cells in adjacent downstream regions exposed to very high WSS and WSSG were elongated, aligned parallel to flow, and at higher density. Such behavior was not blocked by inhibiting proliferation, indicating that cells migrated downstream from the stagnation point in response to impinging flow. Furthermore, although the area of highest cell density moved downstream and away from the impingement point over time, it never moved beyond the WSS maximum. The accumulation of cells upstream of maximal WSS and downstream of maximal WSSG suggests that positive WSSG is responsible for the observed migration. These results demonstrate a unique endothelial response to aneurysm-promoting flow environments at bifurcation apices.

Flow in the well: computational fluid dynamics is essential in flow chamber construction

A perfusion system was developed to generate well defined flow conditions within a well of a standard multidish. Human vein endothelial cells were cultured under flow conditions and cell response was analyzed by microscopy. Endothelial cells became elongated and spindle shaped. As demonstrated by computational fluid dynamics (CFD), cells were cultured under well defined but time varying shear stress conditions. A damper system was introduced which reduced pulsatile flow when using volumetric pumps. The flow and the wall shear stress distribution were analyzed by CFD for the steady and unsteady flow field. Usage of the volumetric pump caused variations of the wall shear stresses despite the controlled fluid environment and introduction of a damper system. Therefore the use of CFD analysis and experimental validation is critical in developing flow chambers and studying cell response to shear stress. The system presented gives an effortless flow chamber setup within a 6-well standard multidish.

Individual and combined effects of shear stress magnitude and spatial gradient on endothelial cell gene expression

The apparent tendency of atherosclerotic lesions to form in complex blood flow environments has led to many theories regarding the importance of hemodynamic forces in endothelium-mediated atherosusceptibility. The effects of shear stress magnitude and spatial shear stress gradient on endothelial cell gene expression in vitro were examined in this study. Converging-width flow channels were designed to impose physiological ranges of shear stress gradient and magnitude on porcine aortic endothelial cells, and real-time quantitative PCR was performed to evaluate their expression of five genes of interest. Although vascular cell adhesion molecule-1 expression was insensitive to either variable, each of the remaining genes exhibited a unique dependence on shear stress magnitude and gradient. Endothelial nitric oxide synthase showed a strong positive dependence on magnitude but was insensitive to gradient. The expression of c-jun was weakly correlated with magnitude and gradient, without an interaction effect. Monocyte chemoattractant protein-1 expression varied inversely with gradient and also depended on the interaction of gradient with magnitude. Intercellular adhesion molecule-1 expression also exhibited an interaction effect, and increased with shear magnitude. These results support the notion that vascular endothelial cells are able to sense shear gradient and magnitude independently.

Distinct profiles of endothelial gene expression in hyperpermeable regions of the porcine aortic arch and thoracic aorta

Among the early events associated with atherosclerotic lesion development are increased macromolecular permeability of the endothelium and expression of genes that affect inflammation and oxidative state. The purpose of this study was to measure the expression of several atherosclerosis-related genes in endothelial cells scraped from arch and thoracic regions of the porcine aorta exhibiting elevated permeability. Aortae were collected from six swine that were exposed to circulating Evans blue dye (EBD), a marker of transendothelial albumin permeability. Endothelial cells were scraped from (1) white regions in the thoracic aorta, (2) light blue streaks and blue regions near ostia in the thoracic aorta, and (3) dark blue regions in the aortic arch. Expression levels of several genes were analyzed by real-time quantitative PCR. There were modest differences between the expression levels of several genes in cells from the light blue regions relative to those from white regions. In the dark blue regions, eNOS was drastically downregulated and MCP-1 was upregulated relative to their expression in both the white and light blue regions. The distinct levels of permeability and differences in gene expression profiles exhibited by cells from these different regions of the aorta may reflect corresponding differences in their hemodynamic environments.

Complex hemodynamics at the apex of an arterial bifurcation induces vascular remodeling resembling cerebral aneurysm initiation

BACKGROUND AND PURPOSE

Arterial bifurcation apices are common sites for cerebral aneurysms, raising the possibility that the unique hemodynamic conditions associated with flow dividers predispose the apical vessel wall to aneurysm formation. This study sought to identify the specific hemodynamic insults that lead to maladaptive vascular remodeling associated with aneurysm development and to identify early remodeling events at the tissue and cellular levels.

METHODS

We surgically created new branch points in the carotid vasculature of 6 female adult dogs. In vivo angiographic imaging and computational fluid dynamics simulations revealed the detailed hemodynamic microenvironment for each bifurcation, which were then spatially correlated with histologic features showing specific tissue responses.

RESULTS

We observed 2 distinct patterns of vessel wall remodeling: (1) hyperplasia that formed an intimal pad at the bifurcation apex and (2) destructive remodeling in the adjacent region of flow acceleration that resembled the initiation of an intracranial aneurysm, characterized by disruption of the internal elastic lamina, loss of medial smooth muscle cells, reduced proliferation of smooth muscle cells, and loss of fibronectin.

CONCLUSIONS

Strong localization of aneurysm-type remodeling to the region of accelerating flow suggests that a combination of high wall shear stress and a high gradient in wall shear stress represents a "dangerous" hemodynamic condition that predisposes the apical vessel wall to aneurysm formation.

Lipoproteins and protection of the arterial wall against infection: the "response to the threat of infection" hypothesis

The exact reason why lipoproteins are found in the arterial intima is not understood. On the basis of recent findings presented in the literature, we are proposing a hypothesis that the accumulation of lipoprotein in the arterial intima is originally a physiological process, part of our defences against infection designed to protect susceptible segments of the arterial wall from microbial invasion. In addition to the intrinsic antimicrobial activities of the deposited lipids, the formation of fibrin-based matrices within the intima is promoted, fibrinolysis is inhibited, the lipid content exerts a vasoconstrictive influence and smooth muscle cells are mobilised into the intima, all these phenomenons being instrumental in fighting off an infectious menace. Oxidized lipids (including oxysterols and lysophosphatidylcholine) resulting from the oxidation of lipoproteins close to sites of infection and inflammation are disseminated through the circulatory system and act as alarm signals at arterial walls, promoting the penetration and retention of lipoproteins in the intimal tissue of the most susceptible segments of the arterial network. Oxidized lipids in the intima constitute part of first-line antimicrobial defences and their presence acts as a signal to immune effector cells (notably macrophages and lymphocytes) which trigger the acquired immune response when foreign antigens are encountered.

Statistical hemodynamics: a tool for evaluating the effect of fluid dynamic forces on vascular biology in vivo

BACKGROUND

In vivo experimentation is the most realistic approach for exploring the vascular biological response to the hemodynamic stresses that are present in life. Post-mortem vascular casting has been used to define the in vivo geometry for hemodynamic simulation; however, this procedure damages or destroys the tissue and cells on which biological assays are to be performed.

METHOD OF APPROACH

Two statistical approaches, regional (RSH) and linear (LSH) statistical hemodynamics, are proposed and illustrated, in which flow simulations from one series of experiments are used to define a best estimate of the hemodynamic environment in a second series. As an illustration of the technique, RSH is used to compare the gene expression profiles of regions of the proximal external iliac arteries of swine exposed to different levels of time-average shear stress.

RESULTS

The results indicate that higher shears promote a more atheroprotective expression phenotype in porcine arterial endothelium.

CONCLUSION

Statistical hemodynamics provides a realistic estimate of the hemodynamic stress on vascular tissue that can be correlated against biological response.

Matrix-specific p21-activated kinase activation regulates vascular permeability in atherogenesis

Elevated permeability of the endothelium is thought to be crucial in atherogenesis because it allows circulating lipoproteins to access subendothelial monocytes. Both local hemodynamics and cytokines may govern endothelial permeability in atherosclerotic plaque. We recently found that p21-activated kinase (PAK) regulates endothelial permeability. We now report that onset of fluid flow, atherogenic flow profiles, oxidized LDL, and proatherosclerotic cytokines all stimulate PAK phosphorylation and recruitment to cell-cell junctions. Activation of PAK is higher in cells plated on fibronectin (FN) compared to basement membrane proteins in all cases. In vivo, PAK is activated in atherosclerosis-prone regions of arteries and correlates with FN in the subendothelium. Inhibiting PAK in vivo reduces permeability in atherosclerosis-prone regions. Matrix-specific PAK activation therefore mediates elevated vascular permeability in atherogenesis.

A Novel Culture System Shows that Stem Cells Can be Grown in 3D and Under Physiologic Pulsatile Conditions for Tissue Engineering of Vascular Grafts

BACKGROUND

Currently available vascular grafts have been limited by variable patency rates, material availability, and immunological rejection. The creation of a tissue-engineered vascular graft (TEVG) from autologous stem cells would potentially overcome these limitations. As a first step in creating a completely autologous TEVG, our objective was to develop a novel system for culturing undifferentiated mouse embryonic stem cells (mESC) in a three-dimensional (3D) configuration and under physiological pulsatile flow and pressure conditions.

MATERIALS AND METHODS

A bioreactor was created to provide pulsatile conditions to a specially modified four-well Labtek Chamber-Slide culture system. Undifferentiated mESC were either suspended in a 3D Matrigel matrix or suspended only in cell-culture media within the culture system. Pulsatile conditions were applied to the suspended cells and visualized by video microscopy.

RESULTS

Undifferentiated mESC were successfully embedded in a 3D Matrigel matrix and could withstand physiological pulsatile conditions. Video microscopy demonstrated that the mESC in the 3D matrix were constrained to the wells of the culture system, moved in unison with the applied flows, and were not washed downstream; this was in contrast to the mESC suspended in media alone.

CONCLUSIONS

Undifferentiated mESC can be grown in 3D and under pulsatile conditions. We will use these results to study the effects of long-term pulsatile conditions on the differentiation of mESC into endothelial cells, smooth muscle cells, and fibroblast cells with the long-term goal of creating a completely autologous TEVG.

Effect of hypercholesterolemia on transendothelial EBD-albumin permeability and lipid accumulation in porcine iliac arteries

Hypercholesterolemia is associated with increased cardiovascular mortality and is known to promote the advancement of atherosclerotic lesions in experimental animal models. Juvenile swine were fed a normal or high-cholesterol diet, and the transendothelial macromolecular permeability of the external iliac arteries of these animals was assessed by measuring the uptake rate of circulating Evans blue dye (EBD). The extent and patterns of lipid-containing lesions were also determined using en face staining with Oil Red O (ORO). Sites of ORO staining often excluded EBD, possibly via the fragmentation of the internal elastic lamina, to which EBD binds. By spatially averaging the EBD uptake in arterial segments relatively free of ORO-positive lesions, it was found that endothelial permeability to albumin was greater in hypercholesterolemic pigs than in those on a normal diet (p=0.056).