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Myostatin in the Arterial Wall of Patients with End-Stage Renal Disease

Authors
  • Esposito, Pasquale1, 2
  • Verzola, Daniela2
  • La Porta, Edoardo1, 2
  • Milanesi, Samantha2
  • Grignano, Maria Antonietta1
  • Avella, Alessandro1
  • Gregorini, Marilena1
  • Abelli, Massimo3
  • Ticozzelli, Elena3
  • Rampino, Teresa1
  • Garibotto, Giacomo2
  • 1 Department of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo, and University of Pavia, Pavia, Italy.
  • 2 Department of Internal Medicine, Nephrology, Dialysis and Transplantation Clinics, Genoa University and IRCCS Ospedale Policlinico San Martino, Genova, Italy.
  • 3 Service of Surgery, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Type
Published Article
Journal
Journal of Atherosclerosis and Thrombosis
Publisher
Japan Atherosclerosis Society
Publication Date
Oct 01, 2020
Volume
27
Issue
10
Pages
1039–1052
Identifiers
DOI: 10.5551/jat.51144
PMID: 32173683
PMCID: PMC7585912
Source
PubMed Central
Keywords
License
Green

Abstract

Aim: Myostatin (Mstn) has been described as a trigger for the progression of atherosclerosis. In this study, we evaluated the role of Mstn in arterial remodeling in patients with end-stage renal disease (ESRD). Methods: Vascular specimens were collected from 16 ESRD patients (56.4 ± 7.9 years) undergoing renal transplant (recipients) and 15 deceased kidney non-uremic donors (55.4 ± 12.1 years). We studied gene and protein expression of Mstn, ubiquitin ligases, Atrogin-1, and muscle ring finger protein-1 (MuRF-1), inflammatory marker CCL2, cytoskeleton components, and Klotho by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. Moreover, we assessed vascular calcification and collagen deposition. Finally, we studied the effects of recombinant Mstn on rat vascular smooth muscle cells (VSMCs, A7r5) and evaluated the effects of uremic serum (US) on primary human VSMCs. Results: Myostatin mRNA was upregulated in the arterial vascular wall of recipients compared with donors (∼15-folds, p < 0.05). This response was accompanied by the upregulation of gene expression of Atrogin-1 and MuRF-1 (+2.5- and +10-fold) and CCL2 (+3-fold). Conversely, we found downregulation of protein expression of Smoothelin, α -smooth muscle actin ( α -SMA), vimentin, and Klotho (−85%, −50%, −70%, and −80%, respectively; p < 0.05) and gene expression of vimentin and Klotho. Exposition of A7r5 to Mstn induced a time-dependent SMAD 2/SMAD 3 phosphorylation and expression of collagen-1 and transforming growth factor β (TGF β ) mRNA, while US induced overexpression of Mstn and Atrogin-1 and downregulation of Smoothelin and Klotho. Conclusions: Our data suggest that uremia might induce vascular Mstn gene expression together with a complex pathway of molecular and structural changes in the vascular wall. Myostatin, in turn, can translate the metabolic alterations of uremia into profibrotic and stiffness inducing signals.

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