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Integrative Physiology |
From the Myocardial Biology Unit and Cardiovascular Section, Boston Medical Center, Boston Veterans Affairs Medical Center and Boston University School of Medicine (N.A.T., Z.X., C.C., F.S., S.N., J.W., D.B.S., O.H.L.B., C.S.A., W.S.C., K.S.), Boston, Mass; the Maine Medical Research Center (L.L.), South Portland, Maine; and Bates College (A.W.J.), Lewiston, Maine.
Correspondence to Krishna Singh, PhD, Myocardial Biology Unit, 650 Albany St, X-706, Boston, MA 02118. E-mail krishna.singh{at}bmc.org
| Abstract |
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3-fold and
7-fold in remote and infarcted regions, respectively,
of WT hearts after MI but not in KO hearts
(P<0.01 versus WT hearts).
Likewise, Northern analyses showed increased collagen
I(
1) mRNA after MI in remote regions of WT
hearts but not in KO hearts. Thus, increased OPN expression plays an
important role in regulating post-MI LV remodeling, at least in part,
by promoting collagen synthesis and accumulation.
Key Words: extracellular matrix proteins osteopontin collagen myocyte slippage myocyte elongation
| Introduction |
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Vß3,
Vß1, and
Vß5) and the CD44 receptor in an RGD-dependent
manner.4 7 OPN appears capable of mediating diverse biological functions, including cell adhesion, chemotaxis, and
signaling.4 8 OPN has also been shown to interact with fibronectin and collagen, suggesting its possible role in matrix organization and/or stability.9 10 11 Recently, using a mammary cell line, we observed that suppression of OPN synthesis leads to increased activity of matrix metalloproteinase (MMP)-2.12 In fact, there is increased expression of OPN in several tissues in response to injury, suggesting a role in wound healing. Using a skin incision model, Liaw et al13 observed disorganization of the matrix and alteration of collagen fibrillogenesis, leading to collagen fibrils with smaller diameters in OPN knockout (KO) mice. Similarly, OPN has been shown to play a critical role in the generation of interstitial fibrosis in the kidney after obstructive nephropathy.14
Remodeling after myocardial infarction (MI) is associated with left ventricular (LV) dilation, decreased cardiac function, and increased mortality.15 Early dilation of the LV is likely due to scar expansion in the infarcted region,16 17 18 followed later by progressive remodeling19 in the noninfarcted (remote) LV, which is possibly due to myocyte elongation and/or side-to-side slippage of myocytes.20 21 Early after MI, the infarcted region of the LV undergoes myocyte necrosis, apoptosis,18 22 and ECM reorganization.23 24 25 26 27 Late remodeling in the remote LV may also involve changes in ECM.28 Alterations in ECM, in particular, increased collagen accumulation29 30 and changes in the activity of MMPs and tissue inhibitors of metalloproteinase,2 have been observed in the remote myocardium after MI. These ECM changes may contribute to LV chamber dilation via myocyte lengthening and/or slippage.20 21 28 However, the underlying mechanisms responsible for matrix reorganization are not clear.
Because OPN expression is increased in pathophysiological conditions and may play an important role in the ECM organization, we hypothesized that OPN is involved in myocardial remodeling after MI. We tested this hypothesis by assessing myocardial structural and functional remodeling with the use of OPN KO mice.
| Materials and Methods |
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Myocardial Infarction
MI was performed on age-matched mice as previously
described.19 31
After anesthesia, the left coronary artery was
occluded with a 7-0 silk suture. Sham-operated animals underwent the
same procedure without ligation of the coronary artery. All the
experimental measurements were carried out 1 month after MI, except for
the measurement of OPN expression in the myocardium after
MI (see time-point details in figure legends).
Langendorff Preparation
LV function was measured from the isolated
blood-perfused heart preparation as
described.19 31 The
hearts were perfused retrogradely via a 20-gauge cannula at a constant
perfusion pressure of 70 mm Hg and were paced at 7 Hz. The
perfusate consisted of Krebs-Henseleit buffer containing bovine
red blood cells adjusted to a hematocrit of
40%.31 A small fluid-filled
balloon was placed in the LV and connected to a pressure transducer for
determination of LV pressures. The balloon was then progressively
filled in 5-µL increments to generate LV filling and function curves.
The chamber stiffness constant
(Kc) was
determined by fitting the end-diastolic pressure-volume
curves from individual hearts to an exponential function as
described33 :
P=b ·
exp(KcV),
where V is volume, and P is LV pressure.
Fixation for Morphometry
After Langendorff studies, the intra-LV balloon was
filled to a distending pressure of 5 mm Hg, and the hearts were
arrested in diastole with KCl (30 mmol/L), followed by
perfusion fixation with 10% buffered formalin. Infarct size was
determined in a manner similar to that of Pfeffer et
al.15 MI size was calculated
as the percentage of circumference occupied by scar
tissue.
Myocyte Isolation and Length
Measurement
Myocytes were isolated by enzyme digestion, as
previously reported.5 Isolated
myocytes were fixed in 2% glutaraldehyde and
visualized by light microscopy. Myocyte length was determined from a
group of hearts (WT-sham, n=3; WT-MI, n=4; KO-sham, n=3; and KO-MI,
n=4) by using Bioquant Image analysis software.
Approximately100 myocytes were measured from each
heart.
TUNEL Staining
To detect apoptosis, terminal
deoxynucleotidyl transferasemediated dUTP nick
end-labeling (TUNEL) staining followed by Hoechst 33258 staining was
carried out in 4-µm-thick sections from the LV apex, mid cavity, and
base, as previously
described.19 TUNEL-positive
nuclei that appeared within the cardiac myocytes were counted. The
total number of nuclei per unit area of the heart was estimated by
counting the number of Hoechst-positive nuclei under ultraviolet
illumination. The number of apoptotic cardiac myocyte nuclei in
15 fields was averaged, and the data were calculated as the percentage
of apoptotic myocyte nuclei/total number of
nuclei.
Northern Analysis
LV tissue was dissected into infarcted and
noninfarcted zones, and total RNA was isolated from the LV according to
the method of Chomczynski and
Sacchi.32 Northern
analysis was carried out with the use of
OPN5 or collagen
I(
1) (courtesy of Dr Peter Brecher,
Boston University School of Medicine, Boston) cDNA probes. To normalize
the loading differences, blots were probed with an 18S
oligonucleotide end-labeled by T4
polynucleotide
kinase.5 Differences in mRNA
signal intensity were determined by using a PhosphorImager
(Bio-Rad).
In Situ Hybridization
In situ hybridization for OPN was performed as
previously described.3 Hearts
were perfusion-fixed with 4% paraformaldehyde, and
4-µm-thick sections were hybridized with single-stranded sense or
antisense RNA probes transcribed from a linearized full-length OPN cDNA
with the use of
[
-35S]UTP.
Immunohistochemistry
Sections (4 µm thick) from mice hearts were
deparaffinized and stained with rabbit collagen type I (Calbiochem) and
monoclonal anti-OPN antibodies, as described
previously.3
Electron Microscopy
Hearts were perfusion-fixed with
glutaraldehyde/paraformaldehyde
(2%/1%) in 0.1 mol/L phosphate buffer. The LV was then dissected into
infarcted and remote regions. For scanning electron microscopy (SEM),
the tissue was dehydrated and frozen in liquid nitrogen, followed by
freeze fracture. The fractured samples were dried to critical point
with CO2 and sputtered-coated with
gold-palladium (60% gold/40% palladium) to 20 nm (Anatech). Samples
were examined with a JOEL-6100 SEM at 5 kV. For transmission electron
microscopy (TEM, images not shown), tissue slices were postfixed and
embedded in Epon plastic. Sections were stained with 1% uranyl acetate
and photographed by use of a Philips TEM operating at 120
kV.
Statistical Analysis
Data are reported as mean±SE. Student
t tests or 2-way ANOVAs
followed by Student-Newman-Keuls post hoc tests were used for
establishing significant differences among groups. A value of
P<0.05 was considered
significant.
An expanded Materials and Methods section can be found in the online data supplement available at http://www.circresaha.org.
| Results |
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In situ hybridization using an antisense OPN riboprobe
7 days after MI likewise showed abundant expression of OPN message in
the area of infarction
(Figure 2
). The expression of OPN in the infarcted
region was diffuse within the interstitial space, with
numerous areas of more focal expression. Diffuse OPN message was also
detectable in the remote LV, with more focal message associated with
blood vessels, possibly in endothelial and/or smooth
muscle cells
(Figure 2A
). No grains were visible with a sense OPN probe
(not shown).
|
Immunohistochemical analysis demonstrated low
levels of immunoreactivity for OPN in the interstitial
cells of WT-sham hearts
(Figure 2B
). In WT-MI hearts, increased staining for OPN was
detected in both remote and infarcted regions of the LV. Most of the
staining was observed in the interstitium.
Myocardial Infarction, Mortality, and
Morphometry
MI size, as a percentage of the LV circumference, was
not different between WT and KO-MI groups
(P=NS,
Figure 3A
). The infarcted LV (anterior) free walls were of
similar thickness in the 2 MI groups
(P=NS,
Table
).
Interestingly, LV mid-papillary circumference, as determined by
histology, was increased in the KO-MI group
(P<0.05 versus WT-MI group,
Table
).
A greater LV circumference in the KO-MI group indicates that although
relative infarct size was similar between groups, absolute infarct size
was greater in the KO-MI group than in the WT-MI group. The mortality
rates in the first 48 hours after MI were 29% and 24% in WT and KO
mice, respectively (P=NS).
There were 2 deaths due to cardiac rupture in each post-MI group, and
total mortality 1 month after MI was the same in the 2 groups (53% and
52% in WT and KO mice, respectively,
Figure 3B
). The lung wet weight/dry weight ratio was
increased (10%) in the KO mice but not in WT mice after MI
(P<0.005 versus KO-sham,
Figure 3C
).
|
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The heart weight/body weight ratio and septal wall
thickness
(Table
)
increased to a similar degree in WT and KO mice after MI
(P=NS).
LV Pressure-Volume Relationships
LV systolic and diastolic functions
were assessed from the LV end-systolic and
end-diastolic pressure-volume relationships measured by the
isovolumic Langendorff technique. The LV end-diastolic
pressure-volume relationship was shifted rightward in WT mice after MI
(P<0.0001 versus sham-operated
mice). The rightward shift was approximately twice as large in KO mice
as in WT mice (P<0.0001)
(Figure 4A
). The LV developed pressure-volume relationship
was likewise shifted rightward in WT mice after MI
(P<0.01 versus sham-operated
mice), and this shift was greater for the KO mice
(P<0.05 versus WT mice after
MI,
Figure 4B
). However, the maximal LV developed pressure was
depressed to a similar degree in both WT and KO mice after MI (108±8
in WT-MI mice versus 102±10 mm Hg in KO-MI mice,
P=NS), and the relationship
between LV end-diastolic pressure and developed pressure
was depressed to a similar degree in WT and KO mice after MI
(Figure 4C
).
|
The ratio of LV volume (determined from the
Langendorff at an end-diastolic pressure of 10 mm Hg)
to heart weight was not increased after MI in WT mice (12.8±1.2 in
WT-MI mice versus 11.6±1.9 in WT-sham mice,
P=NS), suggesting that there
had been compensatory hypertrophy. In contrast, the LV
volume/heart weight ratio was increased in KO mice after MI (19.2±2.5
in KO-MI mice versus 12.0±1.9 in KO-sham mice,
P<0.05;
P<0.05 for KO-MI mice versus
WT-MI mice;
Figure 5A
). The chamber stiffness constant,
Kc,33
decreased after MI in KO mice but not in WT mice, suggesting increased
LV diastolic compliance in KO versus WT mice after MI
(P=0.09,
Table
).
|
Myocyte Length
Isolated myocyte length was increased 33% in WT hearts
after MI (P<0.001 versus
sham-operated hearts)
(Figure 5B
). In KO hearts, myocyte length increased only 9%
after MI (P=NS versus
sham-operated hearts; P<0.001
versus WT-MI hearts).
Apoptosis
The number of apoptotic myocytes (calculated as
the percentage of apoptotic myocyte nuclei/total number of
nuclei) was not different in the myocardium of WT and KO
mice 1 month after MI (0.17±0.03 for KO mice, 0.24±0.06 for WT-MI
mice;
P=NS).
Changes in Collagen Content
To evaluate the quality of collagen organization in the
remote LV, SEM and TEM were performed. Increases in total fibrillar
collagen and an increase in the size and frequency of large collagen
fibers (struts) were observed in WT-MI mice (compared with WT-sham
mice) as analyzed by SEM
(Figure 6
). Furthermore, total fibrillar collagen appeared
reduced in hearts from KO-MI mice compared with hearts from WT-MI mice.
Specifically, there was a marked decrease in thin collagen filaments
(weave) between cells, as well as a lack of the larger collagen fibers
seen in the WT-MI mice. Similarly, KO-sham mice also appeared to have
fewer single collagen filaments between cells compared with WT-sham
mice. TEM also exhibited reduced collagen content in KO-MI mice (data
not shown).
|
Immunohistochemical staining of 1-month post-MI heart
sections for collagen I demonstrated increases in collagen I content in
WT-MI hearts but not in KO-MI hearts
(Figure 7A
). Quantitative image analysis indicated an
3-fold increase in collagen I protein in the remote
(P<0.001 versus WT-sham mice)
and
7 fold increase in the infarcted myocardium
(P<0.01) of WT-MI mice
(Figure 7B
). KO-MI mice showed no increases in collagen I
content (P<0.01, WT-MI mice
versus KO-MI mice). Likewise, Northern analysis of total RNA
isolated from remote LV with the use of a collagen
I(
1) probe demonstrated no significant
increase in collagen I mRNA expression in KO-MI hearts. However,
collagen I(
1) mRNA was increased 3-fold in
the remote LV of WT-MI hearts 1 month after MI
(Figure 7C
).
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| Discussion |
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Interstitial Expression of OPN
After MI
We and others have observed increased myocardial
expression of OPN with
hypertrophy3 34
and, particularly, with the transition from hypertrophy to
failure.3 In the present
study, we found increased OPN expression in both the infarct and in the
myocardium remote from the ischemic injury. In the
infarct, OPN expression increased markedly, peaking 3 days after MI,
and gradually decreased over the next 28 days. This time course is
consistent with an injury response and is similar to that
reported by Murry et al35
after observing thermal injury to the heart. OPN has also been shown to
increase in response to injury in other tissues, including lung,
skeletal muscle, and
skin.13 35 36
In contrast to the infarcted area, OPN expression demonstrated a different temporal pattern in remote myocardium. There was a transient increase in OPN mRNA at 3 days. OPN expression returned to sham levels at 7 and 14 days but again increased modestly at 28 days after MI. The expression of OPN in remote myocardium is not likely to reflect an injury response because it was not subjected to a direct injury. Furthermore, the temporal pattern of OPN expression (ie, with a late increase) in remote myocardium would not be consistent with an injury response. Although the stimulus for OPN expression in remote myocardium remains to be determined, both angiotensin6 and inflammatory cytokines5 can stimulate OPN expression in cardiac cells in vitro and are known to be increased in remote myocardium after MI.37 38 39 In this regard, it is noteworthy that we observed a similar biphasic temporal pattern for the expression of NO synthase 2, which is induced by inflammatory cytokines,40 in remote myocardium after MI in the mouse.41
In situ hybridization revealed that increased expression of OPN in the infarct region was localized primarily to nonmuscle cells and, possibly, infiltrating cells. In the remote region, increased OPN expression was detected primarily in the perivascular space. Increased staining for OPN protein was observed in both the infarct and remote LV of WT-MI hearts. Similar to the in situ hybridization, most of the staining was observed in the interstitial space. This localization is consistent with our prior findings in spontaneously hypertensive myocardium,3 where the major localization was in nonmyocytes in the interstitium and perivascular space. Likewise, Murry et al35 and Williams et al36 found increased OPN expression in the interstitium in rats with thermal injury and in cardiomyopathic hamsters, respectively.
Increased Chamber Dilation After MI in OPN
KO Mice
LV chamber volume, as reflected by the Langendorff LV
end-diastolic pressure-volume relationship, was
significantly increased in WT mice after MI (versus sham).
Interestingly, because both heart weight and chamber volume increased
to a similar degree in WT-MI animals, the LV volume/heart weight ratio
(dilation/hypertrophy index) was not increased in these
post-MI animals (versus WT sham-operated animals). However, the chamber
volume increase in OPN KO mice was twice as much as in WT-MI mice.
Because heart weight increased to a similar degree in WT and KO mice
after MI, the LV volume/heart weight ratio increased in KO versus WT
mice after MI. Therefore, these data indicate that (1) the degree of LV
dilation in WT mice may have been effectively compensated for by LV
hypertrophy, (2) there was a mismatch between chamber
dilation and overall myocardial hypertrophy in KO mice
after MI, and (3) this mismatch was due to excessive dilation rather
than impaired hypertrophy.
LV chamber enlargement after MI is due to (1) infarct expansion, which occurs in the first several days after MI, and (2) dilation of the remote (ie, noninfarcted) myocardium, a progressive process that occurs over weeks to months. Infarct size, measured morphometrically as a fraction of the total LV circumference, was the same in OPN KO and WT mice after MI, suggesting that the increase in chamber volume was due to dilation of both the infarcted and remote regions.
An important aspect of early infarct healing is the
deposition of collagen, which stabilizes the damaged
myocardium.23 In
the WT mice, there was an
7-fold increase in type I collagen in the
infarcted region. In striking contrast, this increase in type I
collagen was completely absent in the infarcts of the OPN KO mice. The
impaired collagen response in OPN KO mice after MI was associated with
a lack of increase in collagen I(
1) mRNA,
suggesting that this lack of collagen accumulation after MI is, at
least in part, due to decreased expression of collagen I. These data
support the thesis that excessive infarct expansion in OPN KO mice was
due to impairment of the reparative process. The increase in LV
compliance, likewise, may reflect decreased collagen accumulation. In
this regard, it is perhaps surprising that cardiac rupture was not more
common in KO mice after MI.
After healing of the infarct scar, there is often
progressive LV dilation due to remodeling of the remote
region.19 This process may be
due to a number of mechanisms, including the loss of myocytes as a
result of
apoptosis,18 19 22
myocyte lengthening,21 and/or
side-to-side slippage of
myocytes.20 After MI, there
was an
3-fold increase in type I collagen in the remote region of WT
hearts. These findings suggest that there is increased collagen
accumulation in remote myocardium during post-MI
remodeling.29 The marked
decrease in collagen accumulation in the KO mice suggests that OPN
plays an important role in the regulation of post-MI collagen turnover
during remodeling.
There is relatively little increase in myocyte
apoptosis in remote myocardium at 1 month after
MI,19 and there was no
difference in the frequency of apoptotic myocytes between OPN
KO and WT mice. Myocyte length increased by
33% in the remote
myocardium of the WT mice after MI. This degree of myocyte
lengthening adequately explains the degree of chamber dilation in WT
mice, suggesting that myocyte lengthening may be one of the primary
mechanisms of dilation in 1-month post-MI mice. In striking contrast,
there was no myocyte lengthening in the OPN KO mice after MI. Thus, it
is unlikely that myocyte apoptosis or lengthening contributed
to excessive chamber dilation after MI in OPN KO mice. Therefore, the
present data suggest that the major mechanism responsible for
increased chamber dilation after MI in the OPN KO mice is a decrease in
interstitial collagen deposition leading to the
side-to-side slippage of
myocytes.20 These data
further raise the possibility that the absence of myocyte lengthening
in the OPN KO mice reflects a decrease in cell-to-cell mechanical
forces that is due to decreased collagen.
Our findings are consistent with the evidence that OPN plays an important role in regulating the synthesis and/or turnover of ECM proteins, including collagen.13 14 In the models of skin incision/wound healing and in obstructive uropathy, disorganization of collagen and decreases in collagen I content were observed in mice lacking OPN.13 14 OPN can bind directly to collagen I and interacts with collagen II, III, IV, V, and fibronectin.9 10 11 42 Furthermore, OPN can affect the expression and activity of matrix metalloproteinases.12 43 Accordingly, it should be emphasized that our data for collagen I expression were obtained from 1-month post-MI hearts. A thorough time-course analysis of different isoforms of collagen and/or MMPs will be necessary to obtain further insight into the regulation of collagen content by OPN.
After MI in the mouse, LV chamber dilation is associated with a progressive decrease in LV systolic function, as reflected by maximal LV developed pressure, and a progressive increase in the frequency of apoptosis in remote myocardium.19 In the present study, maximal isovolumic LV developed pressure (ie, maximal LV force generation) was depressed to a similar degree after MI in WT and KO mice, and there was no difference in the frequency of apoptotic myocytes in remote myocardium from WT and KO mice. Taken together, these observations suggest that OPN does not play a direct role in systolic dysfunction or apoptosis of remote region myocytes during post-MI remodeling.
Implications
These data indicate that increased OPN expression after
MI protects against LV dilation by promoting collagen synthesis in the
infarcted and remote myocardium and, thus, plays an
important role in the regulation of post-MI remodeling. These findings
have additional, broader implications with regard to the role of
collagen in myocardial remodeling. Interstitial fibrosis is
a common feature in many forms of cardiomyopathy,
and beneficial therapeutic strategies, including ACE inhibition and
ß-adrenergic receptor blockade, are associated with a net decrease in
interstitial
fibrosis.44 45
Therefore, it might be assumed that increased collagen deposition is
detrimental. However, these observations in the OPN KO mouse suggest
that the relationship between collagen accumulation and increased
chamber dilation may not be that simple. An "appropriate" increase
in collagen deposition may be an important compensatory response with
regard to both infarct repair and the stabilization of myocytes in the
remote
myocardium.
| Acknowledgments |
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| Footnotes |
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