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From the Department of Anatomy and Embryology, University of Leiden, Netherlands (J.S., A.C.G. de G., J.C. van M.); Laboratoire de Physiopathologie du Développement, CNRS (URA 1337) et Ecole Normale Supérieure, Paris, France (M.A.G., V.E.K.); Department of Pathology, General Hospital Middelheim, Antwerp, Belgium (M.M.K.); and Department of Pathology, University of Washington, Seattle (S.M.S.).
Correspondence to Prof Dr A.C. Gittenberger-de Groot, Department of Anatomy and Embryology, University of Leiden, PO Box 9602, 2300 RC Leiden, The Netherlands. E-mail acgitten{at}rullf2.leidenuniv.nl
Abstract Differentiation of vascular smooth muscle cells (SMCs) is characterized by several molecular transitions. As differentiation proceeds, proteins of the cytoskeletal and contractile apparatus, such as
-smooth muscle actin, smooth muscle myosin, calponin, and heavy caldesmon, and the expression of the membrane-related protein smooth muscle phosphoglucomutaserelated protein increase, whereas the expression of other proteins, such as fibronectin splice variants with extradomains A (EDA) and B (EDB), decreases. In this study, we investigated the differentiation of the SMCs of the ductus arteriosus during the development of intimal thickening. Ascending and descending aortas of the same age were used for comparison because these vessels lack intimal thickening. In the fetal ductus arteriosus, a relatively early differentiation of the contractile apparatus was observed compared with the ascending and descending aortas. EDA and EDB expression was already low, being similar in the ductus and descending aorta and even lower in the ascending aorta. In the neonatal ductus, SMCs of the media and outer intima were well differentiated and comparable with SMCs of the ascending aorta. Dedifferentiated SMCs, with a low expression of cytoskeletal and contractile proteins and a high expression of EDA and EDB, were found in regions in the inner intima that show features of progression of intimal thickening and in areas of cytolytic necrosis in the media. With a technique using in situ end labeling of DNA fragments, we found extensive apoptosis in the area of cytolytic necrosis and to a lesser extent in these areas of the inner intima. In conclusion, SMCs of the fetal ductus arteriosus have an advanced differentiation of the contractile apparatus compared with the adjacent aorta. Reexpression of fetal characteristics is seen in a number of cells in inner intima and media of the neonatal ductus arteriosus. The finding of apoptosis in these areas suggests that dedifferentiation and apoptosis are associated processes that may play a role in vascular remodeling.
Key Words: smooth muscle cells (de)differentiation ductus arteriosus aorta apoptosis
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