Objective—
The Cxcl12/Cxcr4 chemokine ligand/receptor axis mediates the mobilization of smooth muscle cell progenitors, driving injury-induced neointimal hyperplasia. This study aimed to investigate the role of endothelial Cxcr4 in neointima formation.
Approach and Results—
β-Galactosidase staining using bone marrow x kinase (
Bmx
)
-CreER
T2
reporter mice and double immunofluorescence revealed an efficient and endothelial-specific deletion of
Cxcr4
in
Bmx-CreER
T2+
compared with
Bmx-CreER
T2−
Cxcr4-floxed
apolipoprotein E–deficient (
Apoe
−/−
) mice (referred to as
Cxcr4
EC-KO
ApoE
−/−
and
Cxcr4
EC-WT
ApoE
−/−
, respectively). Endothelial
Cxcr4
deficiency significantly increased wire injury–induced neointima formation in carotid arteries from
Cxcr4
EC-KO
ApoE
−/−
mice. The lesions displayed a higher number of macrophages, whereas the smooth muscle cell and collagen content were reduced. This was associated with a significant reduction in reendothelialization and endothelial cell proliferation in injured
Cxcr4
EC-KO
ApoE
−/−
carotids compared with
Cxcr4
EC-WT
ApoE
−/−
controls. Furthermore, stimulation of human aortic endothelial cells with chemokine (C-X-C motif) ligand 12 (CXCL12) significantly enhanced their wound-healing capacity in an in vitro scratch assay, an effect that could be reversed with the CXCR4 antagonist AMD3100. Also, flow cytometric analysis showed a reduced mobilization of Sca1
+
Flk1
+
Cd31
+
and of Lin
−
Sca1
+
progenitors in
Cxcr4
EC-KO
ApoE
−/−
mice after vascular injury, although Cxcr4 surface expression was unaltered. No differences could be detected in plasma concentrations of Cxcl12, vascular endothelial growth factor, sphingosine 1-phosphate, or Flt3 (fms-related tyrosine kinase 3) ligand, all cytokines with an established role in progenitor cell mobilization. Nonetheless, double immunofluorescence revealed a significant reduction in local endothelial Cxcl12 staining in injured carotids from
Cxcr4
EC-KO
ApoE
−/−
mice.
Conclusions—
Endothelial
Cxcr4
is crucial for efficient reendothelialization after vascular injury through endothelial wound healing and proliferation, and through the mobilization of Sca1
+
Flk1
+
Cd31
+
cells, often referred to as circulating endothelial progenitor cells.