In recent years, the study of endothelial cell (EC) metabolism has led to the discovery of novel regulatory mechanisms and potential new targets for vascular-related diseases. Despite the fact that... Show moreIn recent years, the study of endothelial cell (EC) metabolism has led to the discovery of novel regulatory mechanisms and potential new targets for vascular-related diseases. Despite the fact that ECs have readily available oxygen in the blood, they mainly generate ATP via anaerobic glycolysis rather than Krebs cycle. In the context of atherosclerosis, there has been growing interest in understanding how EC metabolism affects plaque formation and intraplaque (IP) angiogenesis, which has been identified as a contributing factor for plaque vulnerability in human atherosclerosis.Among the enzymes involved in glycolytic flux modulation, PFKFB3 plays a critical role for the proliferation and migration of ECs. PFKFB3 is upregulated in atheroprone regions of arterial vessels and in carotid plaques of patients with elevated levels of lipoprotein(a). The experimental work of this thesis focuses on PFKFB3 as a modulator of EC glycolysis and its effects on atherosclerosis progression and IP angiogenesis.In the first part of this thesis, a pharmacological study with partial glycolysis inhibitor 3PO in the context of advanced atherosclerotic plaques is described. 3PO treatment restrains IP angiogenesis and plaque frequency but it does not affect plaque size and composition in ApoE-/-Fbn1C1039G+/- mice. In addition, a 3PO-mediated reduction in plaque formation is also observed in ApoE-/- mice that develop plaques without IP neovascularization.Furthermore, EC-specific PFKFB3 deletion leads to a significant reduction in plaque size, IP angiogenesis and hemorrhagic complications in a vein graft model. These findings suggest that endothelial glycolysis inhibition may represent a new therapeutic strategy to slow down plaque progression in vein grafts.A study performed in collaboration with the University of Aberdeen is also presented in this thesis. Here the development of a new PFKFB3-targeted PET radiotracer, [18F]ZCDD083, for in vivo plaque imaging is described. The specificity of the tracer for atherosclerotic plaques is demonstrated by a combination of ex vivo autoradiography and en face Oil Red O staining. This tracer is a promising non-invasive diagnostic tool to detect rupture-prone atherosclerotic plaques,Finally, a novel imaging method for a three-dimensional reconstruction of the IP vessel network is presented. This method is based on iDISCO immunolabeling and confocal microscopy. It may represent a novel tool to investigate the causal relationship between IP angiogenesis and atherogenesis.Overall, the experimental data generated in this thesis strongly argue for a critical role of EC metabolism in the formation and progression of atherosclerosis in addition to IP angiogenesis. Show less
Multiple lines of evidence suggest that intraplaque (IP) neovascularization promotes atherosclerotic plaque growth, destabilization, and rupture. However, pharmacological inhibition of IP... Show moreMultiple lines of evidence suggest that intraplaque (IP) neovascularization promotes atherosclerotic plaque growth, destabilization, and rupture. However, pharmacological inhibition of IP neovascularization remains largely unexplored due to the limited number of animal models that develop IP neovessels and the lack of reliable methods for visualizing IP angiogenesis. Here, we applied 3D confocal microscopy with an optimized tissue-clearing process, immunolabeling-enabled three-dimensional imaging of solvent-cleared organs, to visualize IP neovessels in apolipoprotein E-deficient (ApoE(-/-)) mice carrying a heterozygous mutation (C1039+/-) in the fibrillin-1 gene. Unlike regular ApoE(-/-) mice, this mouse model is characterized by the presence of advanced plaques with evident IP neovascularization. Plaques were stained with antibodies against endothelial marker CD31 for 3 days, followed by incubation with fluorescently labeled secondary antibodies. Subsequent tissue clearing with dichloromethane (DCM)/methanol, DCM, and dibenzyl ether allowed easy visualization and 3D reconstruction of the IP vascular network while plaque morphology remained intact. Show less
During my PhD we have investigated different approaches to block intraplaque angiogenesis in atherosclerosis. Intraplaque angiogenesis is a physiological response to the increased oxygen demand in... Show moreDuring my PhD we have investigated different approaches to block intraplaque angiogenesis in atherosclerosis. Intraplaque angiogenesis is a physiological response to the increased oxygen demand in the plaque but also has adverse effects by facilitating intraplaque hemorrhage and influx of inflammatory mediators, resulting in plaque instability and consequent rupture. To study this phenomenon we used in vitro assays as well as the accelerated atherosclerosis vein graft model in ApoE3*Leiden mice, a unique model in which the formed plaque shows characteristics that highly resemble human atherosclerotic lesions, including intraplaque angiogenesis and hemorrhage and a high inflammatory cell content. We focused on different approaches to restore plaque stability via improving intraplaque oxygen levels as well as via blocking different growth factors signaling. Moreover we studied the effects of our treatments on the interaction between angiogenesis and inflammation both in vitro and in vivo. Show less