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Genetic blockade of lymphangiogenesis does not impair cardiac function after myocardial infarction
T.C. Stevenson Keller IV, Lillian Lim, Swapnil V. Shewale, Kendra McDaid, Íngrid Martí-Pàmies, Alan T. Tang, Carl Wittig, Andrea A. Guerrero, Stephanie Sterling, N. Adrian Leu, Marielle Scherrer-Crosbie, Phyllis A. Gimotty, Mark L. Kahn
T.C. Stevenson Keller IV, Lillian Lim, Swapnil V. Shewale, Kendra McDaid, Íngrid Martí-Pàmies, Alan T. Tang, Carl Wittig, Andrea A. Guerrero, Stephanie Sterling, N. Adrian Leu, Marielle Scherrer-Crosbie, Phyllis A. Gimotty, Mark L. Kahn
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Research Article Cardiology Vascular biology

Genetic blockade of lymphangiogenesis does not impair cardiac function after myocardial infarction

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Abstract

In recent decades, treatments for myocardial infarction (MI), such as stem and progenitor cell therapy, have attracted considerable scientific and clinical attention but failed to improve patient outcomes. These efforts indicate that more rigorous mechanistic and functional testing of potential MI therapies is required. Recent studies have suggested that augmenting post-MI lymphatic growth via VEGF-C administration improves cardiac function. However, the mechanisms underlying this proposed therapeutic approach remain vague and untested. To more rigorously test the role of lymphatic vessel growth after MI, we examined the post-MI cardiac function of mice in which lymphangiogenesis had been blocked genetically by pan-endothelial or lymphatic endothelial loss of the lymphangiogenic receptor VEGFR3 or global loss of the VEGF-C and VEGF-D ligands. The results obtained using all 3 genetic approaches were highly concordant and demonstrated that loss of lymphatic vessel growth did not impair left ventricular ejection fraction 2 weeks after MI in mice. We observed a trend toward excess fluid in the infarcted region of the left ventricle, but immune cell infiltration and clearance were unchanged with loss of expanded lymphatics. These studies refute the hypothesis that lymphangiogenesis contributes significantly to cardiac function after MI, and suggest that any effect of exogenous VEGF-C is likely to be mediated by nonlymphangiogenic mechanisms.

Authors

T.C. Stevenson Keller IV, Lillian Lim, Swapnil V. Shewale, Kendra McDaid, Íngrid Martí-Pàmies, Alan T. Tang, Carl Wittig, Andrea A. Guerrero, Stephanie Sterling, N. Adrian Leu, Marielle Scherrer-Crosbie, Phyllis A. Gimotty, Mark L. Kahn

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Figure 1

Pan-endothelial deletion of Flt4 severely reduces lymphangiogenesis in the infarct zone without affecting cardiac function.

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Pan-endothelial deletion of Flt4 severely reduces lymphangiogenesis in t...
(A) Epicardial lymphatics in a Flt4fl/fl control heart were immunostained for LYVE1 (magenta) and VEGFR3 (orange). Myocardium is autofluorescent (green); nuclei are marked with DAPI (blue). Individual LYVE1 and VEGFR3 channels are shown. (B and C) Infarcts from Flt4fl/fl animals 14 days after MI were examined using Masson’s trichrome stain (B) and immunostained for lymphatic endothelial markers LYVE1 and PROX1 (C, representative images are from one animal). (D) Epicardial lymphatics in a Flt4fl/fl; Cdh5-CreERT2 heart were examined for LYVE1 and VEGFR3 expression, with individual LYVE1 and VEGFR3 channels shown. Note the loss of VEGFR3 protein signal. (E and F) Infarcts from Flt4fl/fl; Cdh5-CreERT2 hearts 14 days after MI were examined using Masson’s trichrome stain (E) and immunostained for LYVE1 and PROX1 (F). (G) The number of LYVE1+PROX1+ lymphatic endothelial cells was measured per infarct area (n = 6, 8). (H) Representative 2D (top) and M-mode (bottom) echocardiographic images of the left ventricles of sham-operated Flt4fl/fl animals and Flt4fl/fl and Flt4fl/fl; Cdh5-CreERT2 animals that underwent LAD ligation. Note the dilated left ventricle (dia. denotes diastole and sys. denotes systole in M-mode images). (I) Infarct size 14 days after MI was determined histologically for Flt4fl/fl and Flt4fl/fl; Cdh5-CreERT2 animals (n = 6, 7). (J–L) The cardiac functional parameters ejection fraction (J), end diastolic volume (K), and end systolic volume (L) were measured 14 days after MI (n = 18, 15). Insets in C and F are higher magnification of boxed regions. In B, C, E, and F, a yellow line denotes the infarct border, “epi” denotes epicardium, and “myo” denotes live myocardium. In H, the dashed yellow lines show the locations of M-mode images. Triangles represent female animals in I–L. Bar graphs represent mean ± SEM. Comparisons were made with a 2-tailed t test.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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