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Objective— Arteriogenesis is the major mechanism of vascular growth, which is able to compensate for blood flow deficiency after arterial occlusion. Endothelial nitric oxide synthase (eNOS) activity is essential for neovascularization, however its specific role in arteriogenesis remains unclear. We studied the role of eNOS in arteriogenesis using 3 mouse strains with different eNOS expression. Methods and Results— Distal femoral artery ligation was performed in eNOS-overexpressing mice (eNOStg), eNOS-deficient (eNOS −/− ) mice, and wild type (WT) controls. Tissue perfusion and collateral-dependent blood flow were significantly increased in eNOStg mice compared with WT only immediately after ligation. In eNOS −/− mice, although tissue perfusion remained significantly decreased, collateral-dependent blood flow was only decreased until day 7, suggesting normal, perhaps delayed collateral growth. Histology confirmed no differences in collateral arteries of eNOStg, eNOS −/− , and WT mice at 1 and 3 weeks. Administration of an NO donor induced vasodilation in collateral arteries of eNOS −/− mice, but not in WT, identifying the inability to vasodilate collateral arteries as main cause of impaired blood flow recovery in eNOS −/− mice. Conclusions— This study demonstrates that eNOS activity is crucial for NO-mediated vasodilation of peripheral collateral vessels after arterial occlusion but not for collateral artery growth.

Objective— HDL plays a key role in protection against development of atherosclerosis by promoting reverse cholesterol transport from peripheral tissues to the liver for secretion into bile. Phospholipid transfer protein (PLTP) promotes the transfer of phospholipids between lipoproteins and modulates HDL size and composition, thereby having a crucial role in HDL metabolism. We investigated the effect of increased PLTP activity on removal of cholesterol from the body. Methods and Results— On a chow diet, transgenic mice overexpressing human PLTP have a 15-fold increased plasma PLTP activity compared with wild-type mice (572.4±59.2 versus 38.6±3.6 μmol/mL per h). Plasma cholesterol, mainly present in HDL, is strongly decreased (−92%), caused by a rapid clearance from the circulation by the liver and leading to a 1.8-fold increase in hepatic cholesteryl esters. This results in a 2-fold increase in biliary bile acid secretion without changing the bile saturation index. Consequently, the transgenic mice show a 1.4-fold increase in the amount of excreted fecal bile acids compared with wild-type mice, whereas fecal neutral sterol excretion is unchanged. Conclusions— Our data show that elevation of PLTP activity results in rapid disposal of cholesterol from the body via increased conversion into bile acids and subsequent excretion.

Endothelial dysfunction due to deficient nitric oxide (NO) generation cause progressive vascular complications in diabetes. Our earlier findings revealed that Inhibitor kappa B kinase beta (IKK-beta) -an upstream regulator of an inflammatory mediator, nuclear factor kappa-B (NF-kB), competitively inhibits endothelial nitric oxide synthase (eNOS), the chief source of NO in blood vessels. Therefore, we investigated the influence of an inhibitor of IKK beta, salsalate in augmenting eNOS activity. The co-operative effect of L-arginine supplementation (substrate of eNOS) with salsalate intake in enhancing eNOS activity has been evaluated. Both in vitro cell cultures and diabetic/transgenic animal models were used. Human aortic endothelial cells incubated with 25 mM glucose with or without L-arginine (2mM), the cofactor sepiapterin (100uM) and salsalate(50uM) were examined for NO production. Combined L-arginine and salsalate treatment enhanced NO production, phospho eNOS expression and eNOS-dimer vs monomer ratio. For in vivo assays, diabetic Ins2Akita mice were fed with L-arginine and salsalate for 15 weeks. Aortae of these mice exhibited increased phospho eNOS expression and increased eNOS dimer/monomer ratio. Arterial ring assays showed improved acetylcholine mediated vasodialation. Transgenic-Akita mice that overexpress human eNOS in endothelial cells (Tie-2eNOS-Ins2 Akita) generated in-house showed improved vasodialation. In conclusion, enhancing eNOS activity in diabetic mice either by genetic modification as seen in Tie-2 eNOS-Akita mice or by nutritional approach (supplementation of L-arginine with simultaneous inhibition of IKK beta) restores normal vasodialatory function.

Plasma phospholipid transfer protein (PLTP) transfers phospholipids between lipoprotein particles and alters high density lipoprotein (HDL) subfraction patterns in vitro, but its physiological function is poorly understood. Transgenic mice that overexpress human PLTP were generated. Compared with wild-type mice, these mice show a 2.5- to 4.5-fold increase in PLTP activity in plasma. This results in a 30% to 40% decrease of plasma levels of HDL cholesterol. Incubation of plasma from transgenic animals at 37 degrees C reveals a 2- to 3-fold increase in the formation of pre-beta-HDL compared with plasma from wild-type mice. Although pre-beta-HDL is normally a minor subfraction of HDL, it is known to be a very efficient acceptor of peripheral cell cholesterol and a key mediator in reverse cholesterol transport. Further experiments show that plasma from transgenic animals is much more efficient in preventing the accumulation of intracellular cholesterol in macrophages than plasma from wild-type mice, despite lower total HDL concentrations. It is concluded that PLTP can act as an antiatherogenic factor preventing cellular cholesterol overload by generation of pre-beta-HDL.

Alteration in post-ischemic neovascularization is a common complication of atherosclerotic disease. This results, at least in part, from abrogation of bone-marrow mononuclear cells (BM-MNC) pro-angiogenic potential. Overexpression of eNOS has been shown to promote vessel growth in the setting of ischemia. We hypothesized that eNOS overexpression could restore impaired neovascularization in atherosclerotic (ApoE KO) mice. Hind limb ischemia was induced in mice by right femoral artery ligation. After two weeks we evaluated tissue perfusion of the foot by Laser Doppler, vessel density in the hind limb by micro-angiography and histology, and atherosclerotic plaque size. In vitro BM-MNC cell culture assays were performed. Tissue perfusion and vessel density were 1.5-fold increased in transgenic mice overexpressing eNOS (eNOStg) as compared to wild type (WT) (P Conclusion: eNOS overexpression in the endothelium improves post-ischemic neovascularization in both physiological as atherosclerotic settings. Furthermore, eNOS overexpression in the bone marrow restores the impaired pro-angiogenic potential of atherosclerotic BM-MNC without adverse effects on plaque size. Therefore, overexpression of eNOS could play a vital part in the development of therapeutic angiogenesis for atherosclerotic disease.

We thank Dr Jankowski for his interest in our article.1 The major conclusions from our work are that both reduced and oscillating shear stress are proatherogenic but that they induce different plaque compositions. Reduced shear stress induces vulnerable plaques, and oscillating shear stress induces stable plaques. In addition, we found that high shear stress is atheroprotective. Dr Jankowski challenges our last conclusion, referring to the …