Kaposi sarcoma-associated herpesvirus (KSHV) is associated with 3 different human malignancies: Kaposi sarcoma (KS), primary effusion lymphoma, and multicentric Castleman disease. The KS lesion is driven by KSHV-infected endothelial cells and is highly dependent on autocrine and paracrine factors for survival and growth. We report that latent KSHV infection increases the vascular permeability of endothelial cells. Endothelial cells with latent KSHV infection display increased Rac1 activation and activation of its downstream modulator, p21-activated kinase 1 (PAK1). The KSHV-infected cells also exhibit increases in tyrosine phosphorylation of vascular endothelial (VE)-cadherin and -catenin, whereas total levels of these proteins remained unchanged, suggesting that latent infection disrupted endothelial cell junctions. Consistent with these findings, we found that KSHVinfected endothelial cells displayed increased permeability compared with uninfected endothelial cells. Knockdown of Rac1 and inhibition of reactive oxygen species (ROS) resulted in decreased permeability in the KSHV-infected endothelial cells. We further demonstrate that the KSHV K1 protein can activate Rac1. Rac1 was also highly activated in KSHVinfected endothelial cells and KS tumors. In conclusion, KSHV latent infection increases Rac1 and PAK1 activity in endothelial cells, resulting in the phosphorylation of VE-cadherin and -catenin and leading to the disassembly of cell junctions and to increased vascular permeability of the infected endothelial cells. (Blood. 2011;118(19):5344-5354)
IntroductionThe endothelial cell barrier function is regulated by vascular endothelial (VE)-cadherin-containing adherens junctions in addition to tight junctions. 1 VE-cadherin is involved in maintaining the integrity of endothelial cell junctions by preventing the disassembly of the endothelial barrier and regulating the movement of macromolecules through the endothelium. 1-3 However, upon VEGF stimulation, these normal endothelial cell junctions are reorganized to allow the extravasation of cellular factors. 4 This involves the disruption of VE-cadherin at the adherens junction 2,4,5 and internalization of VE-cadherin from the cell surface. 6 VEGF stimulation leads to the induction of Rac1 activity 7,8 and its downstream effector, p21-activated kinase 1 (PAK1). 8 In addition, Rac1 has also been shown to regulate VE-cadherin phosphorylation through the generation of reactive oxygen species (ROS). 9,10 Kaposi sarcoma (KS) is a multifocal vascular tumor of mixed cellular composition. KS lesions are composed of a mixed population of cells, including spindle-shaped endothelial cells and infiltrating leukocytes. 11,12 KS is the most common neoplasm in patients with AIDS. Areas that have the highest HIV burden, such as sub-Saharan Africa, also have the highest rate of KS. KSassociated herpesvirus (KSHV) is the etiological agent found in all epidemiologic forms of KS, 13 and viral genomic DNA is present in AIDS-associated KS, as well as in HIV-negative classic and tra...