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Circulation Research. 1996;78:405-414

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(Circulation Research. 1996;78:405-414.)
© 1996 American Heart Association, Inc.


Articles

Migration of Arterial Wall Cells

Expression of Plasminogen Activators and Inhibitors in Injured Rat Arteries

Michael A. Reidy, Colleen Irvin, Volkhard Lindner

From the Department of Pathology (M.A.R., C.I.), University of Washington, Seattle, and the Maine Medical Center Research Institute (V.L.), South Portland, Me.

Correspondence to Michael A. Reidy, PhD, University of Washington/Department of Pathology, Vascular Biology/Box 357335, Seattle, WA 98195-7335.


*    Abstract
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*Abstract
down arrowIntroduction
down arrowMaterials and Methods
down arrowResults
down arrowDiscussion
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Abstract The expression of plasminogen activators and inhibitors was examined in denuded arteries. Within 5 days, smooth muscle cells (SMCs) on the luminal surface expressed the mRNA for tissue-type plasminogen activator (TPA), urokinase-type plasminogen activator (UPA), the receptor for UPA (UPAR), and plasminogen activator inhibitor type-1 (PAI-1). Similar results were seen after 8 days. Six weeks later, only TPA mRNA was still expressed by SMCs on the luminal surface. En face casein zymograms revealed a net fibrinolytic activity in areas covered with luminal SMCs. Reverse zymography showed no antifibrinolytic activity in these zones. Quiescent endothelial cells did not express TPA, UPA, UPAR, or PAI-1 mRNA. Regenerating endothelium at the wound edge strongly expressed TPA, UPA, and UPAR, as well as PAI-1. UPA and UPAR expression was highly restricted to cells at the wound edge and was not present elsewhere. En face zymography showed no plasmin activity in endothelialized areas, and reverse zymography showed a net antifibrinolytic activity in endothelialized zones. These results suggest that plasminogen activator and inhibitor expression correlates with the migration of both SMCs and endothelial cells into an arterial wound.


Key Words: arterial injury • plasminogen activators • smooth muscle cells • endothelium


*    Introduction
up arrowTop
up arrowAbstract
*Introduction
down arrowMaterials and Methods
down arrowResults
down arrowDiscussion
down arrowReferences
 
Plasminogen activators have been shown to be important in the regeneration of large-vessel endothelium and in angiogenesis.1 2 3 In vitro endothelial cells at wound edges express both UPA and TPA. These same cells exhibit lytic activity as assessed by casein zymograms.3 4 The plasminogen activators convert plasma-derived inactive plasminogen to active plasmin, which can degrade a variety of matrix proteins and activate metalloproteinases,5 and activation of these enzymes is associated with the ability of cells to migrate through the extracellular matrix.6 7

Plasminogen activator expression is not restricted to the endothelium, and the invasion of many cancer cells is linked to the presence of plasminogen activators.6 7 8 9 These cells have also been found to express UPAR, which binds UPA and allows the activation of plasminogen at sites where it is protected from PAIs.10 11 Nonmalignant cells also express UPAR, and recently this receptor has been shown to play an important role in endothelial cell migration.4

In a previous report, we showed that the SMCs of injured arteries express both TPA and UPA within days after injury and that plasmin activity is significantly increased at this time. Furthermore, the migration of SMCs into the arterial intima was inhibited by a plasmin inhibitor.12 These data have led us to propose that, like endothelial cells, the medial SMCs need to express plasminogen activators to migrate into the intima. The aim of this article, therefore, was to document the expression of both plasminogen activators and PAIs (PAI-1 and PAI-2) in both regenerating endothelium and migrating SMCs by in situ hybridization in arteries injured with a balloon catheter. We also wished to correlate the expression of UPA with the expression of its receptor.


*    Materials and Methods
up arrowTop
up arrowAbstract
up arrowIntroduction
*Materials and Methods
down arrowResults
down arrowDiscussion
down arrowReferences
 
Arterial Injury Model
All animal studies were approved by the animal care committee of the University of Washington. Forty-eight male Sprague-Dawley rats (400 g, 3 to 4 months old) (Bantin & Kingman, Edmonds, Wash) were used in all the experiments. All surgical procedures were carried out with the animals under general anesthesia by intraperitoneal injection of xylazine (2.2 mg/kg, AnaSed, Lloyd Laboratories) and ketamine (50 mg/kg body wt, Ketaset, Aveco Co, Inc). For time points of 5 days and later, the left carotid artery and the aorta were denuded completely with a 2F balloon catheter (Fig 1Down). This results in endothelial outgrowth from intercostal arteries. For studying early time points of wounded endothelium up to 3 days, the aortic endothelium was only partially denuded by passing an uninflated balloon catheter along the aorta (Fig 1Down). SMCs were studied in normal and balloon-injured carotid arteries. This allowed us to study SMCs in cross-sectional (embedded in paraffin, 5 µm thick) and en face preparations during neointimal formation as well as in chronically denuded vessels. Deendothelialized segments of arteries were identified by intravenous injection of Evans blue (0.3 mL of 5% solution in saline) 10 minutes before death. For in situ hybridization, all animals were perfusion fixed with phosphate (0.1 mol/L, pH 7.4)-buffered 4% paraformaldehyde. Four or more rats were studied per time point (between 2 hours and 6 weeks after injury). Vessels from the same animal were used for incubation with the sense and antisense probes of TPA, UPA, UPAR, and PAI-1. A total of 153 specimens were analyzed, of which 35 were incubated with sense probes.



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Figure 1. Model of endothelium in rat aorta wounded with a balloon catheter. On the left, total balloon denudation leads to regrowth from intercostals and multiple wound edges. On the right, uninflated catheter scrape leaves denuded streak for early changes in gene expression (0.5 hours to 3 days after injury).

In Situ Hybridization
Arteries were prepared for en face in situ hybridization according to our published protocol.13 Arterial segments were cut open longitudinally, and the tissue was pinned out flat on polytetrafluoroethylene cards (luminal side facing up). Incubation with proteinase K (1 µg/mL, 37°C, Boehringer Mannheim) was 15 minutes, followed by prehybridization for 2 hours with 0.3 mol/L NaCl, 20 mmol/L Tris (pH 7.5), 5 mmol/L EDTA, 1x Denhardt's solution, 10% dextran sulfate, 10 mmol/L dithiothreitol, and 50% formamide. T3, Sp6, and T7 polymerases (Promega) were used to generate corresponding sense and antisense strands of [35S]UTP-labeled riboprobes from linearized cDNA. An equal number of counts of sense or antisense probe was applied to the specimens. After hybridization (at 55°C overnight), the specimens were washed with 2x SSC (1x SSC contains 150 mmol/L NaCl and 15 mmol/L sodium citrate, pH 7.0), 10 mmol/L ß-mercaptoethanol, and 1 mmol/L EDTA (twice for 10 minutes each), treated with RNase A (20 µg/mL, 30 minutes at 37°C, Sigma Chemical Co), and washed in 2x SSC (as above). This procedure was followed by a high-stringency wash at 55°C for 2 hours (0.1x SSC, 10 mmol/L ß-mercaptoethanol, and 1 mmol/L EDTA). Subsequent steps followed the protocol described previously.14 The Häutchen procedure for en face preparations15 was carried out after the probe hybridization. All slides were coated with autoradiographic emulsion (Kodak, NTB2), exposed for 3 weeks, and then developed (Kodak, D-19). Sections and Häutchen preparations were observed under the light microscope using dark-field, bright-field, and a combination of epiluminescence and bright-field illumination (reflective light). Shown are the representative results of three or four independent runs of in situ hybridization carried out in parallel with antisense and the corresponding sense probes.

cDNA Probes Used for In Situ Hybridization
Rat cDNAs for TPA and UPA (both {approx}350 bp) were kindly provided by Dr Jay L. Degen (Cincinnati, Ohio). A rat cDNA for PAI-1 was received from Dr Gelehrter (Ann Arbor, Mich).16 A 1.35-kb Pst I–Kpn I fragment of PAI-1 was subcloned into pBluescript SK+ (Stratagene) for in situ hybridization. A rat PAI-2 cDNA was kindly provided by Dr Grundmann (Behring Werke, Marburg, Germany). Rat UPA receptor was cloned by reverse transcription–polymerase chain reaction using RNA isolated from rat SMCs. RNA was reverse transcribed using random hexamer primers, and cDNA was amplified with rat UPAR-specific primers based on the published sequence.17 The 5' primer (position 123) was CTGCCTGGTGGAGGAGTG, and the 3' primer (position 513) was CTGCCACAGCCTTTGGTG. These primers amplified a 400-bp sequence of coding region that is present in all splice variants of the UPAR. The identity of the sequence was verified using multiple restriction digests and sequencing.

En Face Zymography
Plasminogen (human plasma, Sigma), 1 mg protein/mL in 50 mmol/L Tris (pH 8.1), and urokinase (high molecular weight, Calbiochem) in 50 mmol/L Tris (pH 8.1) were aliquoted and kept at -80°C. Nonfat dry milk (8% in 0.1 mol/L Tris, pH 8.1) and agar (2.5% in distilled water) were boiled for 20 minutes, cooled, centrifuged, and used immediately. Glass slides, Pasteur pipettes, and glass beakers were all warmed in a 50°C oven as were the above solutions, with the exception of plasminogen and urokinase. Balloon-injured or unmanipulated arteries were perfused with cold lactated Ringer's solution in situ, removed from the animals, and placed on ice until the gels had been prepared.

The gel was prepared in a warmed glass beaker in the following proportions: milk 25%, 1 mol/L Tris 10%, dH2O 15%, and agar 50%, with the addition of 40 µg of plasminogen per milliliter of gel. This mixture was poured, avoiding bubble formation, onto warmed glass slides and spread quickly with the side of a Pasteur pipette to form a uniform opaque layer. Slides were removed from the 50°C oven and allowed to cool at room temperature. Segments of opened arteries were laid flat onto the gel surface, with the lumen side in contact with the gel. Slides were then incubated in a humid chamber at 37°C for 3 to 5 hours. Consistent results were obtained from all 16 independent experiments, and representative examples are shown.

For reverse zymography, the gel was made as above but with the addition of urokinase (0.8 U/mL of gel). These gels were incubated at 37°C for 4 to 6 hours and visualized under dark-field illumination. The data shown reflect consistent and representative examples of eight independent experiments.


*    Results
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowMaterials and Methods
*Results
down arrowDiscussion
down arrowReferences
 
Gene expression by SMCs was examined in carotid arteries, because these vessels, in contrast to the aorta, do not completely reendothelialize after endothelial denudation. This allowed us to examine SMCs at times when they are known to be replicating and migrating (ie, 5 to 8 days after balloon catheter injury) and at a time when these cells have returned to quiescence in the chronically denuded vessel (6 weeks after injury).18 19 We were unable to study SMCs of uninjured arteries with the en face technique, since only the luminal cell layer, which in uninjured arteries is the intact endothelium, can be studied by this technique. Endothelial cells were studied in the rat aorta at various times after total or partial denudation, ranging from 2 hours to 6 weeks (Fig 1Up).

En Face In Situ Hybridization
SMCs
Expression of TPA was not detectable in cross sections from normal animals (Fig 2aDown), but strong expression of TPA was seen in SMCs on the luminal surface of carotid arteries after balloon injury. The earliest time examined was 5 days after injury, but a similar result was obtained after 8 days (Fig 2bDown). Six weeks after injury, TPA was still expressed by these cells (Fig 2cDown), although the vast majority of these luminal SMCs were no longer replicating.



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Figure 2. Representative photomicrographs of in situ hybridization for TPA carried out in rat carotid artery. a, Cross sections of normal carotid arteries showed no hybridization with the [35S]UTP-labeled antisense riboprobe for rat TPA. b, Strong expression is seen on en face preparations in SMCs migrating into the intima at 5 days after injury. c, SMCs on the denuded surface still express TPA at 6 weeks, when cells are no longer migrating and replicating. d and e, Hybridization with the sense probe on cross sections (d) and on en face preparations (e) shows very low background. Specimens are seen under dark-field illumination. Original magnification x630, nuclear counterstain with hematoxylin.

UPA was not expressed in uninjured arteries (Fig 3aDown); however, many luminal SMCs at 5 and 8 days after injury showed expression of UPA mRNA (Fig 3bDown). At later times after injury (6 weeks), only a very few luminal SMCs were positive for UPA mRNA (Fig 3cDown). The expression of UPAR was similar to that of UPA in that no expression was detectable in normal carotid arteries (Fig 4aDown), and 5 and 8 days after injury, large numbers of luminal SMCs expressed this transcript (Fig 4bDown). By 6 weeks, no mRNA for UPAR was detected in luminal SMCs (Fig 4cDown). The hybridization signal seen with the UPAR probe was the weakest among all the genes studied, which may explain our inability to detect this transcript by Northern blot analysis of total RNA extracted from the entire vessel wall (data not shown).



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Figure 3. Representative photomicrographs of in situ hybridization for UPA carried out in rat carotid artery. a, Cross sections of normal carotid arteries showed no hybridization with the [35S]UTP-labeled antisense riboprobe for rat UPA. b, Expression is seen on en face preparations in the majority of SMCs migrating into the intima at 5 days after injury. c, Only background levels of hybridization are found in SMCs on the denuded surface at 6 weeks, when cells are no longer migrating and replicating. d and e, Hybridization with the sense probe on cross sections (d) and on en face preparations (e) shows very low background. Specimens are seen under dark-field illumination. Original magnification x630, nuclear counterstain with hematoxylin.



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Figure 4. Representative photomicrographs of in situ hybridization for UPAR carried out in rat carotid artery. a, Cross sections of normal carotid arteries showed no hybridization with the [35S]UTP-labeled antisense riboprobe for rat UPAR. b, Expression is seen on en face preparations in the majority of SMCs migrating into the intima at 5 days after injury. c, No expression is detectable in SMCs on the denuded surface at 6 weeks, when cells are no longer migrating and replicating. d and e, Hybridization with the sense probe on cross sections (d) and on en face preparations (e) shows very low background. Specimens are seen under dark-field illumination. Original magnification x630, nuclear counterstain with hematoxylin.

The expression of both PAI-1 and PAI-2 was also examined in SMCs from unmanipulated arteries and at various times after injury. PAI-1 mRNA was not detected in normal vessels (Fig 5aDown). The majority of the luminal SMCs at 5 and 8 days expressed PAI-1 (Fig 5bDown), but at 6 weeks after injury only a few cells were still positive (Fig 5cDown). PAI-2 mRNA was not detected in any artery.



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Figure 5. Representative photomicrographs of in situ hybridization for PAI-1 carried out in rat carotid artery. a, Cross sections of normal carotid arteries showed no hybridization with the [35S]UTP-labeled antisense riboprobe for rat PAI-1. b, Strong expression of PAI-1 mRNA is seen on en face preparations in the majority of SMCs migrating into the intima at 5 days after injury. c, Very few SMCs (arrowhead) on the denuded surface still express PAI-1 at 6 weeks after injury. d and e, Hybridization with the sense probe on cross sections (d) and on en face preparations (e) shows very low background. Specimens are seen under dark-field illumination. Original magnification x630, nuclear counterstain with hematoxylin.

Endothelial Cells
The endothelial monolayers were examined in the unmanipulated rat aorta and at various times after injury. Since defined zones of the aorta were denuded, we were able to examine the regenerating cells within hours after injury. Control quiescent endothelial cells did not express TPA (Fig 6aDown), but within 24 hours, those cells adjacent to the wound edge showed strong expression (Fig 6bDown). At both 5 and 8 days after injury, TPA was expressed at the leading edge of the endothelial wound and {approx}20 cells back from the wound edge (Fig 6cDown). TPA mRNA, however, was not observed in other areas of the endothelium, nor was it detected in the regenerated endothelium of arteries 6 weeks after balloon injury (Fig 6dDown). Expression of TPA mRNA was also seen in some inflammatory cells adhering to the endothelium (data not shown).



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Figure 6. Representative photomicrographs of in situ hybridization for TPA carried out on en face preparations of rat aorta. a, Normal aortic endothelium showed no hybridization with the [35S]UTP-labeled antisense riboprobe for rat TPA. b, Strong expression is seen in endothelial cells at the leading edge 24 hours after wounding. c, Migrating and replicating endothelium at the wound edge at 8 days expresses high levels of TPA mRNA. d, Expression is no longer seen in regenerated endothelium at 6 weeks after injury. e, Hybridization with the sense probe shows very low background. Arrows mark the denuded zone. Specimens are seen under dark-field illumination. Original magnification x630, nuclear counterstain with hematoxylin.

The mRNA for UPA was detected in the regenerating endothelium after 24 hours (Fig 7bDown) but was tightly restricted to a few rows of endothelium directly adjacent to the leading edge. A similar pattern of expression was observed in the endothelium at 5 and 8 days after injury (Fig 7cDown). No UPA expression was seen in the endothelium 6 weeks after injury (Fig 7dDown) or in endothelial cells from control uninjured arteries (Fig 7aDown). Adhering inflammatory cells also frequently showed expression of UPA mRNA (not shown).



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Figure 7. Representative photomicrographs of in situ hybridization for UPA carried out on en face preparations of rat aorta. a, Normal aortic endothelium showed no hybridization with the [35S]UTP-labeled antisense riboprobe for rat UPA. b, Strong expression is seen in endothelial cells at the leading edge 24 hours after wounding. c, Migrating and replicating endothelium at the wound edge at 8 days expresses high levels of UPA mRNA, but expression is seen only in very few cell rows near the leading edge. d, Expression is no longer seen in regenerated endothelium at 6 weeks after injury. e, Hybridization with the sense probe shows very low background. Arrows mark the denuded area. Specimens are seen under dark-field illumination. Original magnification x630, nuclear counterstain with hematoxylin.

No expression of UPAR mRNA was found in uninjured aortic endothelium (Fig 8aDown), but this transcript was observed within 24 hours in the leading edge cells. Expression was restricted to a few rows adjacent to the leading edge at both 5 and 8 days after injury (Fig 8bDown). At later times, when endothelium had stopped regenerating (6 weeks), no expression was detected (Fig 8cDown).



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Figure 8. Representative photomicrographs of in situ hybridization for UPAR carried out on en face preparations of rat aorta. a, Normal aortic endothelium showed no hybridization with the [35S]UTP-labeled antisense riboprobe for rat UPAR. b, Strong expression is seen in endothelial cells within a few rows near the leading edge at 5 days after wounding, when endothelial cells are migrating and replicating. c, Expression is no longer seen in regenerated endothelium at 6 weeks after injury. d, Hybridization with the sense probe revealed low levels of background. Arrow marks the denuded area. Specimens are seen under dark-field illumination. Original magnification x630, nuclear counterstain with hematoxylin.

No expression of PAI-1 mRNA was detectable in normal endothelium (Fig 9aDown). A marked increase in PAI-1 expression occurred as early as 2 hours after injury in those cells adjacent to the leading edge (Fig 9bDown). Replicating endothelium at the leading edge at 8 days showed high levels of PAI-1 mRNA that extended several cell rows into the monolayer (Fig 9cDown). Regenerated endothelium at 6 weeks again showed no detectable levels of PAI-1 expression (Fig 9dDown). Expression of PAI-2 mRNA was not detected at any time in endothelial cells.



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Figure 9. Representative photomicrographs of in situ hybridization for PAI-1 carried out on en face preparations of rat aorta. a, Normal aortic endothelium showed no detectable expression with the [35S]UTP-labeled antisense riboprobe for rat PAI-1. b, Strong expression is seen in endothelial cells at the leading edge at 8 hours after wounding. c, Migrating and replicating endothelium at the wound edge at 8 days expresses high levels of PAI-1 mRNA. d, No detectable levels of PAI-1 expression were seen in regenerated endothelium at 6 weeks after injury. e, Evaluation of background with the sense probe showed little hybridization. Arrows mark the denuded area. Specimens are seen under dark-field illumination. Original magnification x630, nuclear counterstain with hematoxylin.

En Face Zymography
To determine the net balance of the fibrinolytic activities on the luminal surface of these rat arteries, en face zymography was used. With this technique, arteries were cut open longitudinally and placed (luminal side down) on slides coated with substrate gels containing casein and plasminogen. Lysis of this substrate was indicative of net plasmin activity. In injured arteries, at both 1 and 6 weeks the zones covered by luminal SMCs caused marked lysis of the gel, whereas those areas covered by new endothelium showed no lysis (Fig 10ADown and 10CDown). Control uninjured arteries did not lyse the plasminogen gel.



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Figure 10. Whole-mount in situ casein zymography (A and C) and reverse zymography (B and D) of carotid arteries after balloon injury (left side of gel). Control uninjured arteries are shown on the right side of each gel. Seven days after injury (A), the still-denuded arteries, determined by positive Evans blue staining, show lytic activity on casein zymograms and no activity in control uninjured artery (outline of artery shown by black lines). After 6 weeks (C), there is partial regrowth of endothelium on the denuded arteries, and the zone with luminal SMCs (Evans blue positive) shows lytic activity (dark zone). The area covered by endothelium shows no activity (white zone). The control artery (outlined with black line) also shows no activity. Seven days after injury (B), antifibrinolytic activity was seen in the control arteries (white zone) but not in the denuded arteries (outlined by white dotted line). After 6 weeks, there is partial endothelial cell regrowth (D) determined by the absence of Evans blue staining, and those areas with endothelium show antifibrinolytic activity. The still-denuded zones of the artery show no activity. The control artery (D) shows marked antifibrinolytic activity.

The antifibrinolytic activity of the arteries was measured by reverse zymography. A known amount of urokinase was added to the substrate gel that would initiate lysis. Inhibition of lysis, presumably by the action of PAIs, was visualized as a light undigested zone in contrast to the dark lytic zone seen throughout the remainder of the gel (Fig 10BUp and 10DUp). At 1 and 6 weeks after injury, those denuded areas with luminal SMCs and no overlying endothelium showed no inhibition of lysis. Inhibition of gel lysis was observed in those zones repopulated by new endothelial cells (Fig 10DUp) and was also observed in control arteries, which had a confluent endothelium (Fig 10BUp and 10DUp). The resolution of this procedure, however, did not allow us to make any judgments on the lytic activity of those endothelial cells at the leading edge.


*    Discussion
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up arrowAbstract
up arrowIntroduction
up arrowMaterials and Methods
up arrowResults
*Discussion
down arrowReferences
 
Plasminogen activators, important in the generation of plasmin, have now been shown to be important mediators of cell migration. This is true for metastatic cells, for invading cells during embryonic development, and in wound healing.4 6 7 8 9 20 More recent data show that the expression of UPAR is also important in this process.11 21 The presence of UPAR on the migrating cell and the expression of UPA either by the same cell or by adjacent cells provide an environment in which the latent UPA can bind to its receptor and be activated at a site where it is protected from inactivation by plasmin inhibitors, which are often present in excess concentrations.4 12 The cellular localization of UPAR is also important, since this receptor and its ligand are concentrated in the region of the cell where movement occurs and where, presumably, lysis of the matrix and cell attachment is required.11 22 23 24 25 The present study was focused on the role of plasminogen activators and inhibitors as well as UPAR in the movement of both SMCs and endothelial cells into an arterial wound.

SMC Migration and UPA/UPAR Expression
The presence of plasminogen activators in endothelial cells in vitro has been well documented,3 26 27 28 29 but there are few data with respect to migrating SMCs, especially in vivo. In part, this is because measurement of SMC migration is difficult; furthermore, it has been unclear what role SMC migration plays in the repair of arterial wounds. We have recently shown that both TPA and UPA are expressed in rat carotid arteries at early times after arterial denudation, and an overall increase in plasmin activity has been detected.12 The upregulation of plasminogen activators was associated with the onset of SMC migration into the intima, and inhibition of SMC migration was linked with a decrease in plasminogen activators and plasmin generation.12 This association of plasminogen activators with the ability of SMCs to migrate to the intima was strengthened by an experiment by Jackson et al12 in which plasmin inhibitors blocked SMC migration. In that study, the plasmin inhibitor tranexamic acid was given to rats immediately before and after balloon injury, and the number of SMCs that had migrated into the intima was significantly reduced. In contrast to our in vivo data, Grainger and coworkers30 31 have reported that plasmin may have inhibitory effects on cultured SMCs via its ability to activate TGF-ß1, which acts as an inhibitor of SMC proliferation in vitro. It is questionable, however, whether these in vitro data are relevant to the rat balloon injury model, since infusion of TGF-ß1 into rats after balloon injury caused an increase in SMC replication.32 Furthermore, using the same model, a neutralizing antibody against TGF-ß1 inhibited intimal lesion formation.33

In the present study, we examined the expression of plasminogen activators and inhibitors by the luminal cells present in injured arteries using en face in situ hybridization.13 We chose to examine arteries at times when migration and intimal lesion growth are known to occur.18 19 The en face technique was used because it is sensitive and can detect low-abundance mRNA and because it allowed us to sample all those cells on the luminal surface of arteries that were actively migrating. Our results show that those SMCs that migrated onto the luminal surface of the injured arteries express both TPA and UPA. This result agrees with our data obtained from Northern blots in an earlier experiment,12 although in that study we were not able to identify the location of the plasminogen activator–expressing cells.

An interesting further aspect of the present study was the apparent coordinated expression of UPA and UPAR. Inactive prourokinase binds to the UPAR, where it can be activated. The presence of UPA and its receptor on the same cell serves to regulate cell surface proteolytic activity and focalizes plasmin generation at a site where it is protected from the plasma inhibitor {alpha}2-antiplasmin.34 35 UPAR has been shown to be expressed by invasive cancer cells,36 although these same cells do not necessarily have to express UPA while maintaining their metastatic property. Indeed, it now appears that cancer cells frequently express UPAR while the surrounding stromal cells synthesize UPA.36 With regard to the vessel wall, expression of UPAR was recently reported in macrophages and SMCs in atherosclerotic lesions of rabbit and human arteries.37 Our data show that within days after injury, when SMCs are known to be migrating into the intima, these cells express both UPA and UPAR, although it is unclear if the same cell expresses the ligand and the receptor. The fact that both UPA and UPAR are coordinately expressed suggests that the same factors may trigger their synthesis. In the injured artery, both basic FGF-2 and platelet-derived growth factor significantly increase TPA and UPA activities,38 and both these factors would be present in the injured artery.8 39 40 Mignatti et al22 have shown that FGF-2 also induces UPAR in vascular endothelial cells. One possibility, therefore, is that after balloon catheter injury, released FGF-2 from traumatized SMCs is the stimulus for UPA and UPAR expression. This may explain why UPA and UPAR were noted only at 5 and 8 days after injury but not after 6 weeks. Thus, the absence of UPA and UPAR at this later time may be explained by the fact that there is no FGF-2 in the extracellular pool of these arteries.41 42

The present study shows that SMCs express PAI-1 at the time when migration occurs; therefore, both plasmin inhibitors and activators are present in these arteries. The finding of PAI-1 expression does not necessarily mean that the inhibitor is dominant, since PAI-1 can exist in an inactive form43 and the relative amounts of active inhibitor and active plasminogen activators cannot be determined by in situ techniques. A more realistic evaluation of the balance of plasminogen factors on the surface of these arteries perhaps may be obtained from the result with en face zymograms. Presumably, in these assays we are detecting the fibrinolytic activity of the arterial surface cells, although it is possible that factors could diffuse to the luminal surface from deep within the arterial wall. The data obtained with this technique suggest that plasmin generation is favored in areas with no endothelium and where SMCs form the luminal surface. Thus, the cells that have migrated from the media and are present in the intima would have the ability to digest a variety of matrix extracellular proteins either by direct lysis by plasmin or indirectly via activation of matrix metalloproteinases.5 In contrast to our findings, Schneiderman et al44 reported that diseased human arteries show an increase in PAI-1 expression and suggested that this may relate to the severity of the atherosclerotic lesions. The rat arteries in the present study are markedly different from human atherosclerotic lesions in that there is neither ulceration nor calcification. Furthermore, the rat lesions in the present study contain mostly SMCs, which may well be different from the mesenchymal-appearing intimal cells that dominate human lesions.

One interesting observation is that at early and late times after injury, SMCs still express TPA. We believe that TPA is also important in SMC migration, but the fact that it is expressed at times when intimal SMCs have long stopped migrating (6 weeks) may suggest an alternative action. TPA is known to be synthesized by endothelial cells, and this activity is normally associated with fibrinolysis.45 One possible function for SMC TPA is to maintain a nonthrombogenic surface. As we have noted in previous work,19 46 47 the surface of these still-denuded arteries is surprisingly nonthrombogenic and devoid of fibrin. Therefore, this property may be attributed to the active fibrinolytic activity of the luminal SMCs. It should be noted, however, that intimal SMCs can also synthesize nitric oxide and prostacyclin, which will undoubtedly contribute to the nonthrombogenicity of this surface.48 49

Endothelial Cell Proliferation and Protease Expression
The pattern of TPA and UPA expression by the endothelium in vivo is very similar to data from an earlier study by Pepper et al3 in which plasminogen activators, especially UPA, were found to be expressed at the leading edge of the wounded endothelial monolayers in vitro. Later work by this group showed that the endothelial cells at the leading edge bound 125I-labeled UPA and expressed UPAR.4 Our data would confirm these findings, since UPA, UPAR, and TPA were all expressed by endothelial cells at the wound edge and only at times when endothelial cells were replicating. Furthermore, when endothelial cell replication stopped, UPA, UPAR, and TPA were not expressed. These data would strongly support the hypothesis that plasmin and plasminogen activators are necessary for in vivo endothelial cell proliferation over a denuded surface.

In light of the above data, it was interesting to note that both the control and regenerated endothelium in these arteries did not lyse the casein gel, and antifibrinolytic activity was observed using reverse zymograms. Contrary to normal endothelium, those endothelial cells at the leading edge strongly expressed UPA, UPAR, and TPA, as well as PAI-1 and thus might be expected to possess a net caseinolytic activity. In the gel overlay assay, however, we were not able to discriminate the leading edge endothelial cells from the abutting SMCs, which also express UPA and TPA; therefore, we cannot accurately comment on the fibrinolytic activity of endothelium at these interfaces. Endothelial cells have been shown to express PAI-1,50 and PAI-1 activity has been detected by reverse zymography in confluent endothelial cells in vitro.3 In fact, in vivo studies have shown PAI-1 expression in endothelial cells in both diseased and healthy arteries.43 50 51 Therefore, it would seem that endothelial cells in vivo normally have net antifibrinolytic activity corresponding to undetectable levels of UPA and TPA expression. The balance of proteolytic factors with their inhibitors is regulated in favor of fibrinolysis at sites with active endothelial regeneration where UPA, UPAR, and TPA are expressed.

In summary, a marked expression of UPA, UPAR, TPA, and PAI-1 was observed by in situ hybridization in arterial SMCs that had recently migrated to the intimal surface after balloon injury. After 6 weeks, however, only TPA was still expressed by these cells. En face zymography of these denuded arteries showed lysis of casein gels and no antifibrinolytic activity on reverse zymograms. These data would suggest that plasminogen activators, especially UPA and UPAR, are strongly associated with the migration of SMCs from the media into the intima. Those endothelial cells bordering arterial wounds (5 and 8 days) express UPA, UPAR, PAI-1, and TPA. In particular, UPA, TPA, and UPAR were restricted to those cells adjacent to the wound edge. At a later time after injury (6 weeks) and in normal endothelium, no expression of the plasminogen activator was observed. Zymography revealed no lytic activity associated with confluent endothelium, although a marked antifibrinolytic activity was noted in these same endothelialized areas.


*    Selected Abbreviations and Acronyms
 
FGF = fibroblast growth factor
PAI = plasminogen activator inhibitor
SMC = smooth muscle cell
TGF = transforming growth factor
TPA = tissue-type plasminogen activator
UPA = urokinase-type plasminogen activator
UPAR = UPA receptor


*    Acknowledgments
 
This study was supported by National Institutes of Health grants HL-41103 and HL-03174 and by a Grant-in-Aid from the American Heart Association, with funds contributed in part by the American Heart Association, Alaska Affiliate, Inc. The authors thank Dr Degen for the TPA and UPA probes, Dr Gelehrter for PAI-1, and Dr Grundmann for the PAI-2 probe. The technical assistance of Veronica Poppa is greatly appreciated.

Received September 6, 1995; accepted November 28, 1995.


*    References
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*References
 
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P. Carmeliet, L. Moons, R. Lijnen, S. Janssens, F. Lupu, D. Collen, and R. D. Gerard
Inhibitory Role of Plasminogen Activator Inhibitor-1 in Arterial Wound Healing and Neointima Formation : A Gene Targeting and Gene Transfer Study in Mice
Circulation, November 4, 1997; 96(9): 3180 - 3191.
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Arterioscler. Thromb. Vasc. Bio.Home page
F. Peiretti, M.-C. Alessi, M. Henry, F. Anfosso, I. Juhan-Vague, and G. Nalbone
Intracellular Calcium Mobilization Suppresses the TNF-{alpha}–Stimulated Synthesis of PAI-1 in Human Endothelial Cells : Indications That Calcium Acts at a Translational Level
Arterioscler Thromb Vasc Biol, August 1, 1997; 17(8): 1550 - 1560.
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Cardiovasc ResHome page
M. R Garvin, M. Labinaz, K. Pels, V. M Walley, H. F Mizgala, and E. R O'Brien
Arterial expression of the plasminogen activator system early after cardiac transplantation
Cardiovasc Res, August 1, 1997; 35(2): 241 - 249.
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V. Lindner and M. A. Reidy
Expression of VEGF Receptors in Arteries After Endothelial Injury and Lack of Increased Endothelial Regrowth in Response to VEGF
Arterioscler Thromb Vasc Biol, November 1, 1996; 16(11): 1399 - 1405.
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S. S. Okada, S. R. Grobmyer, and E. S. Barnathan
Contrasting Effects of Plasminogen Activators, Urokinase Receptor, and LDL Receptor–Related Protein on Smooth Muscle Cell Migration and Invasion
Arterioscler Thromb Vasc Biol, October 1, 1996; 16(10): 1269 - 1276.
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Z.-q. Yan, T. Yokota, W. Zhang, and G. K. Hansson
Expression of Inducible Nitric Oxide Synthase Inhibits Platelet Adhesion and Restores Blood Flow in the Injured Artery
Circ. Res., July 1, 1996; 79(1): 38 - 44.
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