(Hypertension. 1999;34:950-957.)
© 1999 American Heart Association, Inc.
Scientific Contributions |
From the Hypertension and Vascular Disease Center, Wake Forest University School of Medicine, Winston-Salem, NC.
Correspondence to E. Ann Tallant, PhD, The Hypertension and Vascular Disease Center, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1032. E-mail atallant{at}wfubmc.edu
| Abstract |
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Key Words: angiotensin-(1-7) angiotensin II muscle, smooth vascular injury vascular proliferation hyperplasia
| Regulation of Vascular Growth |
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VSMC growth is stimulated by factors produced by neighboring ECs; released from circulating platelets, neutrophils, and monocytes; and secreted by fibroblasts and VSMCs in an autocrine fashion. Factors that promote vascular growth include platelet-derived growth factor (PDGF), basic fibroblast growth factor, angiotensin II (Ang II), and endothelin.1 2 3 4 The mitogenic actions of Ang II may play an important role in vascular proliferation, because inhibition of its formation or activity attenuates neointimal formation after balloon injury of rat arteries.5 6 Daemen et al7 showed that Ang II infusions into rats markedly stimulated DNA synthesis in both neointimal and medial smooth muscle cells. Su et al8 recently reported that the Ang IIinduced proliferative effects were independent of the Ang IIinduced pressor response.
In contrast, atrial natriuretic factor (ANF), prostacyclin, prostaglandin (PG) E2, PGE1, PGD2, and nitric oxide (NO) inhibit the growth of cultured VSMCs.9 10 11 12 13 14 15 ANF inhibited the growth of cultured VSMCs through stimulation of guanylate cyclase and the production of cGMP.9 10 Overexpression of prostacyclin synthase in rat VSMCs increased prostacyclin production and decreased DNA synthesis in response to stimulation by serum.16 Pharmacological agents that increase the intracellular concentration of cAMP or cGMP (membrane-permeant cyclic nucleotide analogues, forskolin, or phosphodiesterase inhibitors) reduced serum-stimulated growth of rabbit and rat VSMCs.17 18 Collectively, these results suggest that ANF, NO, and prostaglandins inhibit VSMC growth through an increase in the cellular content of cyclic nucleotides.
The number of factors that may modulate or antagonize the proliferative effects of Ang II was enriched by the discovery that the N-terminal heptapeptide angiotensin-(1-7) [Ang-(1-7)] acts as an antitrophic agent.19 20 These observations are important, because they indicate that the renin-angiotensin system has evolved a mechanism to intrinsically control the agonistic actions of Ang II on both short- and long-term regulation of arterial pressure and vascular growth. Because Ang II stimulates the release of arachidonic acidderived autacoids and modulates the activity of NO and bradykinin, Ang-(1-7) may be a link to explain the multilevel interaction between proliferative and antiproliferative signal transduction systems. This review describes our continuing investigation of the role of Ang-(1-7) in the regulation of arterial pressure and vascular wall function.
| Ang-(1-7) Is a Novel Hormone of the Renin-Angiotensin System |
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| Antitrophic Actions of Ang-(1-7) |
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40% of the response to 1% FBS, which is similar to the growth
inhibition previously reported for ANF.10 Total cell
number in response to treatment with Ang-(1-7) was also determined with
a Coulter counter. The number of cells per well increased to 142% of
basal after treatment with 1% serum, as shown in Figure 1.
Treatment of serum-stimulated cells with 1 µmol/L Ang-(1-7)
significantly reduced the number of cells per well (to 109% of basal).
By comparison, Ang II caused a dose-dependent increase in
[3H]thymidine incorporation, with a maximal
increase of 314% above basal with 1 µmol/L Ang II, and
increased the number of cells per well to 145% of basal
values.19
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It is possible that the EC50 for Ang-(1-7) determined in these experiments is much higher than the actual concentration required to induce antimitogenic effects. This interpretation is based on the finding that 125I-Ang-(1-7) incubated with cultured cells was rapidly degraded to free tyrosine, Val-Tyr, or Ang-(37) with only 15% of the initial 125I-Ang-(1-7) remaining intact after a 90-minute incubation.39 These data are consistent with the in vivo findings of a half-life of 9 seconds for Ang-(1-7), which is 1/6 that of Ang II in the circulation.40 Abell et al9 reported a similar rapid degradation of the growth-inhibitory peptide ANF in VSMCs. These data suggest that the antitrophic effects of Ang-(1-7) in VSMCs may be underestimated by its rapid metabolism in intact cells. The antitrophic effects of Ang-(17) may, in fact, be due to metabolic fragments of the heptapeptide.
| Reduction of Neointimal Formation by Ang-(1-7) After Vascular Injury |
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Histological examination of carotid artery cross sections showed that balloon-catheter injury resulted in the formation of a neointima in both the saline- and Ang-(1-7)infused rats, as shown in Figure 2. Morphometric analysis indicated that Ang-(1-7) infusion had no effect on the medial area of the injured or the contralateral uninjured artery compared with saline controls (Figure 3). In contrast, Ang-(1-7) infusion significantly reduced the neointimal area compared with rats infused with saline (0.10±0.009 versus 0.063±0.011 mm2, n=6 to 8, P<0.05). Thus, exogenous Ang-(1-7) infusion reduced neointimal formation after vascular injury. Most importantly, the effects of Ang-(1-7) on the vasculature occurred in the absence of changes in blood pressure and at concentrations of the peptide only 2-fold higher than in saline-treated rats.
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In previous studies, we showed that infusions of Ang-(1-7) at the same concentration increased urinary prostaglandin excretion.41 Thus, one potential mechanism for our observations in the injured carotid artery is that Ang-(1-7) stimulated prostaglandin production to inhibit vascular proliferation. Ang-(1-7) increased prostaglandin formation in rat,38 porcine,37 and rabbit42 VSMCs. Consistent with this, infusion of prostacyclin analogues was antiproliferative after vascular injury.43 Because prostacyclin receptors on VSMCs activated adenylate cyclase to produce cAMP44 and compounds that increased the intracellular concentration of cAMP reduced mitogen-activated protein kinase activity in VSMCs and fibroblasts,45 Ang-(1-7) may inhibit growth by stimulating prostacyclin production, increasing cellular cAMP, and reducing mitogen-activated protein kinase activity. Furthermore, the vasodilation of pial arteries by Ang-(1-7) and the depressor component of the response to Ang-(1-7) in the pithed rat were reduced by prior treatment with the cyclooxygenase inhibitor indomethacin, indicating that these hemodynamic responses to Ang-(1-7) were also mediated by prostaglandins.46 47 Thus, an increase in prostacyclin production in response to Ang-(1-7) may mediate both the antihypertensive and antitrophic effect of the peptide.
Our results suggest that the signal transduction mechanism for the antiproliferative effects of Ang-(1-7) entail liberation of prostacyclin through an AT(1-7) receptormediated event. Muthalif et al42 reported that Ang-(1-7) activated a cytosolic phospholipase A2 (cPLA2) in rabbit VSMCs to release arachidonic acid. We showed that the Ang-(1-7)mediated release of prostaglandins occurs via a pathway that involves no changes in cellular inositol phosphate concentrations or mobilization of intracellular calcium.37 48 49 Thus, Ang-(1-7) may also activate a calcium-independent PLA2 to release arachidonic acid for prostacyclin production. Alternatively, the heptapeptide may be operating on a receptor subtype that is either linked to activation of a potassium channel50 or may stimulate the secondary release of kinin. In this context, studies by us51 and others31 showed that Ang-(1-7) augments the vasodepressor actions of bradykinin. This action may be related in part to the observation that Ang-(1-7) functions as an endogenous inhibitor of the C-terminal domain of somatic ACE. We confirmed this finding, first demonstrated by use of isolated somatic ACE,33 in intact normal and hypertensive rats.36 It is evident that further studies are necessary to dissect the signal transduction pathway that is activated by Ang-(1-7). Studies in this direction may uncover important intracellular sites regulating the interplay between second messenger molecules and kinases in the regulation of trophic functions.
| What Receptor Is Activated by Ang-(1-7)? |
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Recently, we studied the effect of the Ang-(1-7)selective antagonist [D-Ala7]-Ang-(1-7) on the antiproliferative response to Ang-(1-7). [D-Ala7]-Ang-(1-7) is a modified form of Ang-(1-7) in which proline at position 7 is replaced with D-alanine. This amino acid substitution results in a molecule that has no agonistic activity,55 although it selectively blocks hemodynamic and renal responses to Ang-(1-7). Moreover, [D-Ala7]-Ang-(1-7) did not compete for binding of 125I-Ang II to rat adrenal AT1 or AT2 receptors.55 [D-Ala7]-Ang-(1-7) competed for 125I-Ang-(1-7) binding to bovine aortic ECs (BAECs) with high affinity.56 The addition of 10 µmol/L [D-Ala7]-Ang-(1-7) to VSMCs pretreated with 0.5% FBS blocked the growth-inhibitory response to 1 µmol/L Ang-(1-7), as shown in Figure 4A, right. These data indicate that Ang-(1-7) inhibits VSMC growth through activation of a non-AT1, non-AT2 receptor that is sensitive to either [Sar1-Thr8]-Ang II or [D-Ala7]-Ang-(1-7).
Ang II stimulation of [3H]thymidine incorporation was attenuated by the AT1-selective antagonists losartan and L158,809, whereas the AT2 antagonist PD123177 was ineffective (Figure 4B), confirming that the AT1 receptor mediates the mitogenic response to Ang II. However, addition of Ang II to VSMCs in the presence of the AT1 antagonist losartan or L158,809 caused a significant reduction in the incorporation of [3H]thymidine compared with the unstimulated control (to 71.0% and 60.5% of basal, respectively). Micromolar concentrations of the AT2 antagonist PD123319 blocked Ang IImediated inhibition of the proliferation of ECs,52 VSMCs transfected with the AT2 receptor,53 and VSMCs from embryonic or neonatal rats.54 These findings suggest that the Ang IImediated inhibition of VSMC growth that we observed in VSMCs from adult rats might also be mediated by an AT2 receptor. However, if Ang II inhibited [3H]thymidine incorporation in VSMCs from adult rats through activation of an AT2 receptor, then thymidine incorporation would be increased when AT2 receptors were blocked, as observed in endothelial cells52 and VSMCs transfected with the AT2 receptor.53 We did not observe an increase in [3H]thymidine incorporation in the presence of Ang II and 10 µmol/L PD123177 or CGP42112A (Figure 3B). Furthermore, high concentrations of CGP42112A have agonistic properties at some AT2 receptors; 10 µmol/L CGP42112A reduced thymidine incorporation and potentiated the antimitogenic properties of Ang II in rat coronary ECs.52 We did not observe an agonistic effect of CGP42112A in adult rat VSMCs or a potentiation of the response to Ang II, suggesting that Ang II did not inhibit vascular growth through activation of an AT2 receptor in adult VSMCs. Thus, we hypothesize that Ang II inhibited growth of VSMCs from adult rats through activation of a non-AT1, non-AT2 receptor when AT1 receptors are blocked. Because Ang II competed for 125I-Ang-(1-7) binding to BAECs, albeit with a lower affinity than Ang-(1-7),56 Ang II may inhibit growth of losartan-treated VSMCs through activation of the non-AT1, non-AT2 receptor that is activated by Ang-(1-7). Consistent with this interpretation is the possibility that Ang II may be rapidly converted into Ang-(1-7) in experiments using cultured cells. We previously showed the presence of Ang-(1-7)-forming enzymes in ECs and VSMCs.29 30 The time of exposure needed to measure a change in the incorporation of thymidine (>30 minutes) is more than sufficient for Ang II to be converted into Ang-(1-7). Further work is clearly required to understand the pharmacological mechanism and receptor subtype at which Ang II is acting when binding to the AT1 receptor is prevented. Furthermore, the potential interactions between the AT2 and AT(1-7) receptors will require a precise definition of alternative receptor mechanisms and a more thorough evaluation of the effects of PD123319 on angiotensin receptors.
Recognition of the physiological responses to Ang-(1-7) occurred concurrently with the identification of subtype-selective ligands for different molecular forms of Ang II receptors. Characterization of physiological or cellular responses to Ang-(1-7) was thus accompanied by attempts to define the receptor subtype mediating these responses. Although some of the characterized responses to Ang-(1-7) were blocked by AT1 or AT2 receptor antagonists,47 48 57 58 59 Ang-(1-7) is a poor competitor at the prototypical AT1 receptor in VSMCs37 38 or the AT2 receptor in differentiated NG108-15 or pancreatic cells.60 61 The majority of responses to Ang-(1-7) were not blocked by an AT1 or AT2 receptor antagonist.37 47 51 62 63 These include release of prostaglandins from C6 glioma cells and porcine endothelial cells,37 62 relaxation of canine coronary artery rings,51 63 and the reduction in blood pressure in the pithed rat.47 These responses were inhibited, however, by [Sar1-Thr8]-Ang II but not by AT1 or AT2 receptor antagonists. In the SHR given a combination of lisinopril and losartan for 9 days to increase Ang-(1-7) concentrations, a pressor response was observed in response to an intravenous infusion of [Sar1-Thr8]-Ang II, an Ang-(1-7) antibody, or an inhibitor of Ang-(1-7) formation (neprilysin).34 35 Pretreatment of these rats with the AT2 antagonist PD123319 had no effect on blood pressure, nor did administration of [Sar1-Thr8]-Ang II after treatment with the Ang-(1-7) antibody. Thus, [Sar1-Thr8]-Ang II reversed the antihypertensive effects of lisinopril and the AT1 antagonist losartan, even in the presence of an AT2 receptor antagonist. These results suggest that Ang-(1-7) activates a novel non-AT1, non-AT2 angiotensin receptor to produce effects that are opposite to those produced by Ang II.
We identified an Ang-(1-7) binding site on BAECs.56 The 125I-Ang-(1-7) binding site on BAECs was competed for by [Sar1-Ile8]-Ang II and [D-Ala7]-Ang-(1-7) but not by losartan or PD123319. A similar 125I-Ang-(1-7) binding site, sensitive to Ang-(1-7) and [D-Ala7]-Ang-(1-7), was visualized on the endothelium of canine coronary artery rings,21 consistent with functional effects of Ang-(1-7) in canine and porcine coronary arteries.51 63 In more recent studies of vessels from rats treated with the combination of lisinopril and losartan for 9 days as described above,34 35 we found evidence of non-AT1, non-AT2 binding in the endothelial layer of the aorta as well as within the smooth muscle and adventitial layers (Figure 5). Using the ligand 125I-[Sar1-Thr8]-Ang II in the presence of micromolar concentrations of losartan and PD123319, we showed that the remaining binding sites were competed for by [D-Ala7]-Ang-(1-7) (Figure 5). Thus, the effects of [D-Ala7]-Ang-(1-7) to selectively block responses to Ang-(1-7) in VSMCs are consistent with the pharmacological characterization of an Ang-(1-7) binding site within the vasculature. We propose that this non-AT1, non-AT2 receptor mediates the antihypertensive and antitrophic effects of Ang-(1-7). We refer to this receptor as the AT(1-7) receptor, in accordance with the guidelines established by the International Union of Pharmacology Nomenclature Subcommittee for Angiotensin Receptors.64 65 The AT(1-7) receptor is defined by its sensitivity to Ang-(1-7), its antagonism by [Sar1-Thr8]-Ang II and [D-Ala7]-Ang-(1-7), and its lack of response, either functional or in competition for binding, to losartan or PD123319, as shown in the Table.
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| Concluding Remarks |
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| Acknowledgments |
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Received June 22, 1999; first decision July 23, 1999; accepted August 2, 1999.
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