Rationale
Mice lacking the EF-hand Ca2+ sensor S100A1 display endothelial dysfunction due to distorted Ca2+ activated NO generation.
Objective
To determine the pathophysiological role of S100A1 in endothelial cell (EC) function in experimental ischemic revascularization.
Methods and Results
Patients with chronic critical lower limb ischemia (CLI) showed almost complete loss of S100A1 expression in hypoxic tissue. Ensuing studies in S100A1 knockout (SKO) mice subjected to femoral artery resection (FAR) unveiled insufficient perfusion recovery and high rates of autoamputation. Defective in vivo angiogenesis prompted cellular studies in SKO ECs and human ECs with siRNA-mediated S100A1 knockdown demonstrating impaired in vitro and in vivo proangiogenic properties (proliferation, migration, tube formation), and attenuated vascular endothelial growth factor (VEGF)- and hypoxia-stimulated eNOS activity. Mechanistically, S100A1 deficiency compromised eNOS activity in ECs both by interrupted stimulatory S100A1/eNOS interaction and PKC hyperactivation that resulted in inhibitory eNOS phosphorylation and enhanced VEGF-receptor 2 (VEGFR2) degradation with attenuated VEGF signaling. Ischemic SKO tissue recapitulated the same molecular abnormalities with insufficient in vivo NO generation. Unresolved ischemia entailed excessive VEGF accumulation in SKO mice with aggravated VEGFR2 degradation and blunted in vivo signaling through the proangiogenic PI3K/Akt/eNOS cascade. NO supplementation strategies rescued defective angiogenesis and salvaged limbs in SKO mice post-FAR.
Conclusions
Our study shows for the first time downregulation of S100A1 expression in patients with CLI and identifies S100A1 as critical for EC function in postnatal ischemic angiogenesis. These findings link its pathological plasticity in CLI to impaired neovascularization prompting further studies to probe S100A1’s microvascular therapeutic potential.
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