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Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:e138-e139
Published online before print August 3, 2006, doi: 10.1161/01.ATV.0000239569.99126.37
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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:e138.)
© 2006 American Heart Association, Inc.


Vascular Biology

Blockade of Angiotensin II Receptors Reduces the Expression of Receptors for Advanced Glycation End Products in Human Endothelial Cells

Masashi Fujita; Hiroko Okuda; Osamu Tsukamoto; Yoshihiro Asano; Yulin Liao Akio Hirata; Jiyoong Kim; Takeshi Miyatsuka; Seiji Takashima; Tetsuo Minamino; Hitonobu Tomoike; Masafumi Kitakaze

From the Department of Cardiovascular Medicine (M.F., H.O., O.T., Y.A., Y.L., A.H., T. Miyatsuka, S.T., T. Minamino), Osaka University Graduate School of Medicine, Suita; and Cardiovascular Division of Medicine (H.O., O.T., J.K., H.T., M.K.), National Cardiovascular Center of Japan, Suita, Japan.

Correspondence to Masafumi Kitakaze, MD, PhD, Cardiovascular Division of Medicine, National Cardiovascular Center of Japan, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan. E-mail kitakaze{at}zf6.so-net.ne.jp


*    Abstract
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*Abstract
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down arrowMaterials and Methods
down arrowResults
down arrowDiscussion
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Objectives— Receptors for advanced glycation end products (RAGEs) play crucial roles in atherogenesis. Because tumor necrosis factor {alpha} (TNF{alpha}) is expressed and upregulates RAGE expression in atherosclerotic lesions, the TNF{alpha}-RAGE interaction might be involved in the inflammatory process of atherogenesis. On the other hand, an angiotensin II type-1 receptor blocker (ARB), widely used as an antihypertensive drug, has been reported to have also antiatherosclerotic effects. Thus we investigated whether an ARB exerts antiatherosclerotic effects via inhibiting the TNF{alpha}-RAGE interaction.

Methods and Results— Stimulation of human endothelial cells with candesartan as well as olmesartan decreased TNF{alpha}-induced RAGE expression in both mRNA and protein levels along with the decrease in the activity of nuclear factor {kappa}B and the expression of inflammatory mediators such as vascular cell adhesion molecule (VCAM)-1. Both candesartan and olmesartan inhibited the binding of nuclear factor {kappa}B to the RAGE gene promoter. Furthermore, gene silencing of RAGE by RNA interference decreased the expression of TNF{alpha}-induced VCAM-1 in both mRNA and protein levels.

Conclusions— RAGE contributes at least partially to the TNF{alpha}-induced VCAM-1 expression in both mRNA and protein levels. Blockade of angiotensin II receptors might exert antiatherosclerotic effects via reducing TNF{alpha}-RAGE interaction.

We investigated whether an angiotensin II type-1 receptor blocker (ARB) exerts antiatherosclerotic effects via inhibiting TNF{alpha}-RAGE interaction. ARBs decreased TNF{alpha}-induced RAGE expression in human endothelial cells along with the decrease in the activity of NF-{kappa}B and the expression of inflammatory mediators. ARBs exert antiatherosclerotic effects via reducing TNF{alpha}-RAGE interaction.


Key Words: angiotensin II type-1 receptor blocker (ARB) • receptors for advanced glycation end products (RAGEs) • endothelial cell


*    Introduction
up arrowTop
up arrowAbstract
*Introduction
down arrowMaterials and Methods
down arrowResults
down arrowDiscussion
down arrowReferences
 
The cell surface receptor for advanced glycation end products (RAGEs) is a multiligand member of the immunoglobulin superfamily of molecules and has been reported to play crucial roles in atherogenesis.1 Engagement of RAGEs in endothelial cells leads to the increase in the expression of inflammatory mediators such as monocyte chemoattractant protein (MCP)-1 or vascular cell adhesion molecule (VCAM)-1.2–5 Because tumor necrosis factor (TNF)-{alpha} is expressed and upregulates RAGE expression in atherosclerotic lesions,6,7 the TNF{alpha}-RAGE interaction might be involved in the mechanisms of the inflammatory process of atherogenesis.

On the other hand, an angiotensin II type-1 receptor blocker (ARB), widely used as an antihypertensive drug, has been reported to have also antiatherosclerotic such as attenuating neointimal formation, decreasing vascular smooth muscle cell (VSMC) proliferation and diminishing vascular inflammation.8

Considering these results, we hypothesized that an ARB has antiatherosclerotic effects via inhibiting TNF{alpha}-RAGE interaction, thus leading to the decrease in the inflammatory process of atherosclerosis. We tested this hypothesis using human endothelial cells.


*    Materials and Methods
up arrowTop
up arrowAbstract
up arrowIntroduction
*Materials and Methods
down arrowResults
down arrowDiscussion
down arrowReferences
 
Cell Culture
Human umbilical vein endothelial cells (HUVECs) were purchased from Biochrom and cultured at 37°C, under a humidified atmosphere containing 5% CO2 in EBM-2 medium (Clonetics) supplemented with EGM-2 Single Quotes containing 10% FBS, human fibroblast growth factor-1, vascular endothelial growth factor, ascorbic acid, heparin, and human epidermal growth factor and GA-1000. These cells were used at passages 2 to 10 for all experiments.

Western Blot Analysis
Standard Western blot analysis on total cell lysates was performed using mouse anti-RAGE, VCAM-1, IkB{alpha} antibodies (Santa Cruz). Candesartan and olmesartan were gifts from Takeda Pharm Co Ltd (Osaka, Japan) and Sankyo Co Ltd (Tokyo, Japan), respectively. To ensure equal loading of intact protein, membranes were stripped and restained with antibodies against actin. Densitometric analysis was performed using Scanning Imager (Molecular Dynamics).

Quantitative Real-Time Polymerase Chain Reaction
Total RNA from HUVECs was extracted using RNA-Bee-RNA Isolation Reagent (Tel-Test). Then 1000 ng of total RNA was reverse transcribed and amplified using an Omniscript RT Kit (Qiagen) according to the protocol of the manufacturer. Oligonucleotide primers and TaqMan probes for human RAGE (assay no. Hs00153957_m1), VCAM-1 (Hs00174239_m1), and GAPDH were designed and purchased from Applied Biosystems. Quantitative real-time PCR was performed with an ABI PRISM7700 Sequence Detection System (Applied Biosystems) by the relative standard curve method.

Chromatin Immunoprecipitation Assay
Either TNF{alpha} (10 ng/mL) or vehicle was exposed to HUVECs with and without either candesartan (1 nmol/L) or olmesartan (10 nmol/L) for 2 hours. ChIP assays were performed with a chromatin immunoprecipitation (ChIP) assay kit (Upstate Biotechnology) according to the protocol of the manufacturer with some modifications. The primers for the nuclear factor (NF)-{kappa}B–binding site in the RAGE gene promoter were: forward primer, 5'-GGAGGAGGTTGCAAAAAGCCAGAT-3'; reverse primer, 5'-CATCACACTTCCAACCTGTCCCCA-3'.

NF-{kappa}B p65 Transcription Factor Assay
The activation of NF-{kappa}B binding to the nucleus of HUVECs treated with and without TNF{alpha} (10 ng/mL) in the absence or presence of either candesartan (1 nmol/L) or olmesartan (10 nmol/L) was determined using the nonradioactive NF-{kappa}B p65 transcription factor assay kit (Chemicon International Inc) according to the instructions provided. Nuclear protein extracts were also prepared according to the protocol of the manufacture.

Gene Silencing via RNA Interference
HUVECs were seeded into P6 dishes coated with human fibronectin (Biocoat, BD-Falcon) and grown until {approx}70% to 80% confluence, followed by transfection with 30 pmol of the negative control sequence or RAGE-specific small interference RNA (siRNA) duplex using Lipofectamine 2000 (Invitrogen) according to the instructions of the manufacturer. The following siRNA oligonucleotides for this study were purchased from Dharmacon: human RAGE [1] siRNA (sense, 5'-GCC AGA AGG UGG AGC AGU A-3'; antisense, 5'-UAC UGC UCC ACC UUC UGG C-3'); siRNA human RAGE [2] (sense, 5'-CCU CAA AUC CAC UGG AUG A-3'; antisense, 5'-UCA UCC AGU GGA UUU GAG G-3'). As a negative control, cells were transfected with siControl Non-Targeting siRNA No. 1 (Dharmacon). At 24 hours after transfection quantitative real-time polymerase chain reaction (PCR), 48 hours after transfection Western blot analysis were performed.

Statistical Analysis
Results of the experimental studies are reported as the means±SE. Differences were analyzed by ANOVA followed by the appropriate post hoc test. A probability value of <0.05 was regarded as significant.


*    Results
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowMaterials and Methods
*Results
down arrowDiscussion
down arrowReferences
 
ARB Reduces the Expression of RAGE Protein and mRNA in Human Endothelial Cells
Because TNF{alpha} is known to increase endothelial RAGE protein expression, we first examined the effect of candesartan on TNF{alpha}-induced RAGE protein expression by Western blot analysis. Stimulation of HUVECs with TNF{alpha} (25 ng/mL) for 24 hours led to a 2.9±0.5-fold increase in cell surface RAGE protein expression compared with control (P<0.05, n=4), and, furthermore, concomitant treatment with candesartan significantly reduced the expression of TNF{alpha}-induced RAGE protein in a concentration-dependent manner with a maximal reduction at 1 nmol/L candesartan (Figure 1A). To confirm that this effect is not specific for candesartan alone, we checked the effects of other ARB, olmesartan, on the expression of TNF{alpha}-induced RAGE protein. Treatment with olmesartan also reduced the expression of TNF{alpha}-induced RAGE protein with a maximal reduction at 10 nmol/L olmesartan (Figure 1B). Furthermore, to examine the decrease in endothelial RAGE protein expression by candesartan resulting from reduced mRNA expression, we investigated the RAGE mRNA levels by the quantitative real-time PCR. Treatment with candesartan significantly reduced the TNF{alpha}-induced RAGE mRNA expression (Figure 1C).


Figure 1
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Figure 1. A and B, (upper panel) Representative Western blot analysis of RAGE proteins in HUVECs. (lower panel) Quantitative analysis of RAGE proteins by densitometry. Values are normalized to controls., C, Quantitative real-time PCR measurement of RAGE mRNA levels normalized GAPDH mRNA. D; ChIP assay. *P<0.05 vs TNF{alpha}

ARBs Inhibit the Binding of NF-{kappa}B to the RAGE Promoter
TNF{alpha}-induced endothelial RAGE expression is regulated by activation of the NF-{kappa}B–binding site (nucleotide number –686 to –678) in the RAGE promoter.6,9 To examine whether ARBs may interact with this pathway, we performed ChIP assays to detect the binding of NF-{kappa}B to the RAGE gene promoter. As shown in Figure 1D, both candesartan (1 nmol/L) and olmesartan (10 nmol/L) inhibited the TNF{alpha}-induced binding of NF-{kappa}B to the RAGE promoter.

ARBs Reduced the Activation of NF-{kappa}B in Human Endothelial Cells
Either candesartan (1 nmol/L) or olmesartan(10 nmol/L) reduced the TNF{alpha}-induced activation of NF-{kappa}B detected by not only the degradation of I{kappa}B but also the transcriptional factor assay (Figure 2A and 2B).


Figure 2
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Figure 2. A, (upper panel) Representative Western blot analysis of IkB{alpha} proteins in HUVECs. (lower panel) Quantitative analysis of IkB{alpha} proteins by densitometry. Values are normalized to controls. B, The binding activity of NF-{kappa}B to the nucleus. C, Representative Western analysis of VCAM-1 proteins in HUVECs. D, Quantitative real-time RT-PCR measurement of VCAM-1 mRNA levels normalized GAPDH mRNA. *P<0.05 vs TNF{alpha}. Cande indicates candesartan; Olme, olmesartan.

ARB-Mediated Reduction of Endothelial RAGE Expression Decreases Proinflammatory Effects in Human Endothelial Cells
In human endothelial cells, activation of RAGE has previously been shown to upregulate the expression of proinflammatory mediators such as MCP-1 and VCAM-1.3,4 To assess the functional relevance of reduced endothelial RAGE expression, human endothelial cells were stimulated with TNF{alpha} (25 ng/mL) in the presence or absence of candesartan (1 nmol/L) or olmesartan (10 nmol/L) for 12 hours before investigating VCAM-1 protein expression and for 4 hours before investigating mRNA expression. Stimulation of endothelial cells with TNF{alpha} (25 ng/mL) increased VCAM-1 protein and mRNA expressions as determined by Western blot analysis and quantitative real-time PCR, respectively. Treatment of cells with either candesartan or olmesartan significantly reduced TNF{alpha}-induced VCAM-1 protein and mRNA expressions (Figure 2C and 2D).

Gene Silencing of RAGE via RNA Interference
Adversely, to confirm the involvement of RAGE in the TNF{alpha}-mediated VCAM-1 expression, we performed gene silencing of RAGE via RNA interference. We checked the inhibitory effects of siRNA on the expression of RAGE mRNA levels by quantitative real-time PCR. siRNA against RAGE [1] and [2] (siRAGE [1] and [2]) decreased the expression of RAGE in mRNA levels compared with that of siRNA control (18.8±1.2% and 32.4±2.6%, respectively; Figure 3A). In the transfected cells with siRNA against RAGE using siRAGE [1] and [2], the expression of TNF{alpha}-induced VCAM-1 protein were decreased compared with that of the nontransfected cells (Figure 3B). Furthermore, in the transfected human endothelial cells with siRAGE [1] and [2], TNF{alpha}-induced VCAM-1 mRNA expressions were also significantly decreased compared with the nontransfected cells (Figure 3C). These data suggest that RAGE is involved in the TNF{alpha}-induced VCAM-1 expression in both mRNA and protein levels.


Figure 3
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Figure 3. A, The effects of gene silencing of RAGE via RNA interference decreased RAGE mRNA levels determined by quantitative real-time PCR. We used 2 distinct siRNAs targeting the RAGE (RAGE siRNA, [1] [2]), all of which effectively decreased RAGE mRNA levels. B, (upper) Representative Western blot analysis of TNF{alpha}-induced VCAM-1 proteins in HUVECs transfected with RAGE siRNA, [1]. [2] (lower) Quantitative analysis of VCAM-1 proteins by densitometry. C; Quantitative real-time PCR measurement of VCAM-1 mRNA levels normalized GAPDH mRNA in HUVECs transfected with RAGE siRAGE, [1].[2] * indicates P<0.05 versus siControl.


*    Discussion
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowMaterials and Methods
up arrowResults
*Discussion
down arrowReferences
 
We showed here that angiotensin II receptors blockers (ARBs), such as candesartan or olmesartan, suppressed TNF{alpha}-induced RAGE protein and mRNA expressions at least partially through the inhibition of the binding of NF-{kappa}B to the RAGE gene promoter in human endothelial cells with subsequently reduced the expression of inflammatory mediators such as VCAM-1. Furthermore, we clearly showed that RAGE were involved in the process of TNF{alpha}-induced VCAM-1 mRNA and protein expression using RNA interference technique. These results may propose the novel mechanisms that ARBs exert the antiatherosclerotic effects.

RAGE Are Involved in TNF{alpha}-Induced Inflammatory Process of Atherogenesis
In the atheromatous plaque, TNF{alpha} is released from inflammatory cells.10 TNF{alpha} activates NF-{kappa}B sites in the RAGE promoter to induce endothelial RAGE expression.6 Stimulation of RAGE activates a key signal transduction and is believed to lead to a vicious circle that enhances atherosclerosis. Interestingly, blockade of RAGE with the soluble extracellular domain of RAGE completely suppressed atherosclerosis in diabetic mice.11 Furthermore, blockade of RAGE in the established atherosclerotic plaques suppressed the further progression of atherosclerotic lesion area.12 Taken together, in this study we focused on the TNF{alpha}-RAGE interaction in the vicious circles in the atherogenesis and we showed here that TNF{alpha} increased the RAGE expression in protein and mRNA levels in human endothelial cells, along with the activation of NF-{kappa}B and the increase in VCAM-1 protein and mRNA expression. Furthermore, we demonstrated that gene silencing of RAGE via RNA interference decreased the expression of VCAM-1 protein and mRNA induced by TNF{alpha}. These results suggested that TNF{alpha}-RAGE interaction was involved in the inflammatory process of atherogenesis.

ARBs Reduce the TNF{alpha}-Induced RAGE Protein and mRNA Expression
An ARB was reported to reduce RAGE expression in the kidney of diabetic KK/Ta mice.13 However, to our knowledge, this is the first report that ARBs inhibit TNF{alpha}-induced RAGE expression in human endothelial cells, supporting that ARBs have antiatherogenic effects. TNF{alpha}-induced endothelial RAGE expression is regulated by the activation of the NF-{kappa}B site in the RAGE promoter.6 In this study, we showed that both candesartan and olmesartan inhibited the binding of NF-{kappa}B to the RAGE gene promoter from ChIP assay. These results suggested that ARBs generally reduced TNF{alpha}-induced RAGE protein and mRNA expression via the inhibition of the binding of NF-{kappa}B to the RAGE gene promoter. Thus, we propose the novel mechanisms that ARBs have been demonstrated to attenuate the degree of atherosclerosis and suggest that the reduction of RAGE expression by ARBs might represent a novel strategy to limit RAGE-mediated inflammatory processes in the vessel wall.

Clinical Implications
Our findings might have important pathophysiological and clinical implications for the high-risk patients with atherosclerosis, because these patients have enhanced RAGE expression in the vasculature and TNF{alpha}-RAGE interaction leads to the expression of proatherogenic mediators, such as MCP-1 or VCAM-1. Although further investigation is needed to clarify the precise mechanisms by which ARB inhibit RAGE expression, we believe that this study will throw light on the treatment of the patients with atherosclerosis.


*    Acknowledgments
 
We thank Yoko Nagamachi and Akiko Ogai for technical assistance and Yukari Arino for secretarial work.

Sources of Funding

O.T. and Y.A. are Research Fellows of Japan Society for the Promotion of Science for Young Scientists. This study was supported by a grant from the Japan Cardiovascular Research Foundation.

Disclosure(s)

None.


*    Footnotes
 
M.F. and H.O. contributed equally to this work.

Original received January 26, 2006; final version accepted June 7, 2006.


*    References
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowMaterials and Methods
up arrowResults
up arrowDiscussion
*References
 
1. Neeper M, Schmidt AM, Brett J, Yan SD, Wang F, Pan YC, Elliston K, Stern D, Shaw A. Cloning and expression of a cell surface receptor for advanced glycosylation end products of proteins. J Biol Chem. 1992; 267: 14998–15004.[Abstract/Free Full Text]

2. Basta G, Lazzerini G, Del Turco S, Ratto GM, Schmidt AM, De Caterina R. At least 2 distinct pathways generating reactive oxygen species mediate vascular cell adhesion molecule-1 induction by advanced glycation end products. Arterioscler Thromb Vasc Biol. 2005; 25: 1401–1407.[Abstract/Free Full Text]

3. Basta G, Lazzerini G, Massaro M, Simoncini T, Tanganelli P, Fu C, Kislinger T, Stern DM, Schmidt AM, De Caterina R. Advanced glycation end products activate endothelium through signal-transduction receptor RAGE: a mechanism for amplification of inflammatory responses. Circulation. 2002; 105: 816–822.[Abstract/Free Full Text]

4. Schmidt AM, Hori O, Chen JX, Li JF, Crandall J, Zhang J, Cao R, Yan SD, Brett J, Stern D. Advanced glycation end products interacting with their endothelial receptor induce expression of vascular cell adhesion molecule-1 (VCAM-1) in cultured human endothelial cells and in mice. A potential mechanism for the accelerated vasculopathy of diabetes. J Clin Invest. 1995; 96: 1395–1403.[Medline] [Order article via Infotrieve]

5. Wautier MP, Chappey O, Corda S, Stern DM, Schmidt AM, Wautier JL. Activation of NADPH oxidase by AGE links oxidant stress to altered gene expression via RAGE. Am J Physiol Endocrinol Metab. 2001; 280: E685–E694.[Abstract/Free Full Text]

6. Tanaka N, Yonekura H, Yamagishi S, Fujimori H, Yamamoto Y, Yamamoto H. The receptor for advanced glycation end products is induced by the glycation products themselves and tumor necrosis factor-alpha through nuclear factor-kappa B, and by 17beta-estradiol through Sp-1 in human vascular endothelial cells. J Biol Chem. 2000; 275: 25781–25790.[Abstract/Free Full Text]

7. Mukherjee TK, Mukhopadhyay S, Hoidal JR. The role of reactive oxygen species in TNFalpha-dependent expression of the receptor for advanced glycation end products in human umbilical vein endothelial cells. Biochim Biophys Acta. 2005; 1744: 213–223.[Medline] [Order article via Infotrieve]

8. Wu L, Iwai M, Nakagami H, Li Z, Chen R, Suzuki J, Akishita M, de Gasparo M, Horiuchi M. Roles of angiotensin II type 2 receptor stimulation associated with selective angiotensin II type 1 receptor blockade with valsartan in the improvement of inflammation-induced vascular injury. Circulation. 2001; 104: 2716–2721.[Abstract/Free Full Text]

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11. Park L, Raman KG, Lee KJ, Lu Y, Ferran LJ Jr, Chow WS, Stern D, Schmidt AM. Suppression of accelerated diabetic atherosclerosis by the soluble receptor for advanced glycation endproducts. Nat Med. 1998; 4: 1025–1031.[CrossRef][Medline] [Order article via Infotrieve]

12. Bucciarelli LG, Wendt T, Qu W, Lu Y, Lalla E, Rong LL, Goova MT, Moser B, Kislinger T, Lee DC, Kashyap Y, Stern DM, Schmidt AM. RAGE blockade stabilizes established atherosclerosis in diabetic apolipoprotein E-null mice. Circulation. 2002; 106: 2827–2835.[Abstract/Free Full Text]

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