Objective
Aortic valve stenosis (AS) is characterized by fibrosis and calcification of valves leading to aortic valve (AV) narrowing, resulting in high wall shear stress (WSS) across the valves. We previously demonstrated that high shear stress can activate platelet-derived transforming growth factor-β1 (TGF-β1), a cytokine implicated inducing fibrosis and calcification. The aim of this study was to invest the role of shear-induced platelet release of TGF-β1 and its activation in AS.
Approach and Results
We studied hypercholesterolemic Ldlr−/−Apob100/100/Mttpfl/fl/Mx1Cre+/+ (Reversa) mice that develop AS on western diet (WD) and a surgical ascending aortic constriction (AAC) mouse model that acutely simulates the hemodynamics of AS to study shear-induced platelet TGF-β1 release and activation. Reversa mice on WD for 6 months had thickening of the AVs, increased WSS and increased plasma TGF-β1 levels. There were weak and moderate correlations between WSS and TGF-β1 levels in the progression and reversed Reversa groups, and a stronger correlation in the AAC model in WT mice, but not in mice with a targeted deletion of megakaryocyte and platelet TGF-β1 (Tgfb1flox). Plasma total TGF-β1 levels correlated with collagen deposition in the stenotic valves in Reversa mice. Although active TGF-β1 levels were too low to be measured directly, we found: 1. canonical TGF-β1 (p-Smad2/3) signaling in the leukocytes and canonical and non-canonical (p-Erk1/2) TGF-β1 signaling in AVs of Reversa mice on a WD, and 2. TGF-β1 signaling of both pathways in the AAC stenotic area in WT, but not Tgfb1flox mice.
Conclusions
Shear-induced, platelet-derived TGF-β1 activation may contribute to AS.