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Evidence from nonhuman animal models demonstrates an important role for immune cells in hypertension, but immune cell changes in human hypertension are less clear. Using mass cytometry, we demonstrate novel and selective reductions in CCR10(+) regulatory T cells (Tregs) and PD-1(+)CD57(−)CD8(+) memory T cells. RNA sequencing reveals that CCR10(+) Tregs exhibit gene expression changes consistent with enhanced immunosuppressive function. In addition, CITE-Seq demonstrates that PD-1(+)CD57(−)CD8(+) memory T cells exhibit features of T-cell exhaustion. Taken together, these results provide novel evidence for decreases in anti-inflammatory and/or hypofunctional T-cell populations that may contribute to enhanced inflammation in human hypertension.

SH2B3 (SH2B adaptor protein 3) is an adaptor protein that negatively regulates cytokine signaling and cell proliferation. A common missense single nucleotide polymorphism inWe used CRISPR-Cas9 technology to create mice homozygous for the major (Arg/Arg) and minor (Trp/Trp) alleles of thisTrp/Trp mice exhibit 10 mmHg higher systolic BP during chronic Ang II infusion compared to Arg/Arg controls. Renal injury and perivascular fibrosis are exacerbated in Trp/Trp mice compared to Arg/Arg controls following Ang II infusion. Renal and ex vivo stimulated splenic CD8Taken together, these results suggest that the Trp encoding allele of rs3184504 is causal for BP elevation and renal dysfunction, in part through loss of SH2B3-mediated repression of T cell IL-12 signaling leading to enhanced IFNg production.

Background: SH2B3 (SH2B adaptor protein 3) is an adaptor protein that negatively regulates cytokine signaling and cell proliferation. A common missense single nucleotide polymorphism in SH2B3 (rs3184504) results in substitution of tryptophan (Trp) for arginine (Arg) at amino acid 262 and is a top association signal for hypertension in human genome-wide association studies. Whether this variant is causal for hypertension, and if so, the mechanism by which it impacts pathogenesis is unknown. Methods: We used CRISPR-Cas9 technology to create mice homozygous for the major (Arg/Arg) and minor (Trp/Trp) alleles of this SH2B3 polymorphism. Mice underwent angiotensin II (Ang II) infusion to evaluate differences in blood pressure (BP) elevation and end-organ damage including albuminuria and renal fibrosis. Cytokine production and Stat4 phosphorylation was also assessed in Arg/Arg and Trp/Trp T cells. Results: Trp/Trp mice exhibit 10 mmHg higher systolic BP during chronic Ang II infusion compared to Arg/Arg controls. Renal injury and perivascular fibrosis are exacerbated in Trp/Trp mice compared to Arg/Arg controls following Ang II infusion. Renal and ex vivo stimulated splenic CD8 + T cells from Ang II-infused Trp/Trp mice produce significantly more interferon gamma (IFNg) compared to Arg/Arg controls. Interleukin-12 (IL-12)-induced IFNg production is greater in Trp/Trp compared to Arg/Arg CD8 + T cells. In addition, IL-12 enhances Stat4 phosphorylation to a greater degree in Trp/Trp compared to Arg/Arg CD8 + T cells, suggesting that Trp-encoding SH2B3 exhibits less negative regulation of IL-12 signaling to promote IFNg production. Finally, we demonstrated that a multi-SNP model genetically predicting increased SH2B3 expression in lymphocytes is inversely associated with hypertension and hypertensive chronic kidney disease in humans.. Conclusions: Taken together, these results suggest that the Trp encoding allele of rs3184504 is causal for BP elevation and renal dysfunction, in part through loss of SH2B3-mediated repression of T cell IL-12 signaling leading to enhanced IFNg production.

Background: Immune checkpoint inhibitor (ICI) therapy has revolutionized cancer therapy through activating immune cells to overcome tumor immune evasion. Increasing evidence suggests that adaptive immune cells play an important role in blood pressure elevations in the pathogenesis of hypertension. Whether ICI therapy enhances blood pressure remains unclear. Methods: We performed a retrospective cohort study of patients with advanced melanoma treated with ICIs in a single academic center. Baseline and 2-year blood pressure readings after initiation of ICI therapy were compared. To determine the relationship between the demographic and treatment variables and the change in blood pressure at two years, a multivariable linear regression model was used. Results: A total of 259 individuals were identified with 2-year follow-up. Of the entire cohort, 31% were treated with nivolumab, 47% with pembrolizumab, and 23% with ipilimumab and nivolumab combination therapy. In the total cohort, ICIs were not associated with significant changes in systolic (SBP) or diastolic (DBP) blood pressure at 2 years compared to baseline (132.2 mmHg vs . 133.2 mmHg, p=0.17, and 78.6 vs . 78.1 mmHg, p=0.50, respectively). There were also no statistically significant changes in SBP or DBP in patients treated with nivolumab or pembrolizumab alone. However, in those treated with ipilimumab and nivolumab as combination therapy, SBP increased by 5.5 mmHg (128.2 vs. 133.7 mmHg, p=0.005). After adjusting for age, sex, weight, ICI type and duration, steroid and tyrosine kinase inhibitor use, and antihypertensive medication use at baseline and 2-years, combination therapy with ipilimumab and nivolumab remained a significant predictor of SBP change at two years. Holding the baseline SBP constant, the predicted SBP was 6.2 mmHg (95% CI 0.08 - 12.0 mmHg, p=0.047) higher for combined therapy than nivolumab alone. Conclusions: Patients who received combination ICI therapy had a higher SBP compared to those treated with single agent therapy. These findings suggest immune cell activation with ICI therapy contributes to blood pressure elevations and that close follow-up of blood pressure is needed in cancer survivors, particularly those previously treated with combination ICI therapy.

Aims Elevated serum immunoglobulins have been associated with experimental and human hypertension for decades but whether immunoglobulins and B cells play a causal role in hypertension pathology is unclear. In this study, we sought to determine the role of B cells and high-affinity class-switched immunoglobulins on hypertension and hypertensive end-organ damage to determine if they might represent viable therapeutic targets for this disease. Methods and results We purified serum IgG from mice exposed to vehicle or angiotensin (Ang) II to induce hypertension and adoptively transferred these to wild type (WT) recipient mice receiving a subpressor dose of Ang II. We found that transfer of IgG from hypertensive animals leads does not affect blood pressure, endothelial function, renal inflammation, albuminuria, or T cell derived cytokine production compared with transfer of IgG from vehicle infused animals. As an alternative approach to investigate the role of high affinity, class-switched immunoglobulins, we studied mice with genetic deletion of activation-induced deaminase (Aicda-/-). These mice have elevated levels of IgM but virtual absence of class-switched immunoglobulins such as IgG subclasses and IgA. Neither male nor female Aicda-/- mice were protected from Ang II-induced hypertension and renal/vascular damage. To determine if IgM or non-immunoglobulin dependent innate functions of B cells play a role in hypertension, we studied mice with severe global B cell deficiency due to deletion of the membrane exon of the IgM heavy chain (μMT-/-). μMT-/- mice were also not protected from hypertension or end-organ damage induced by Ang II infusion or deoxycorticosterone acetate (DOCA)-salt treatment. Conclusions These results suggest that B cells and serum immunoglobulins do not play a causal role in hypertension pathology. Translational perspective Our results suggest that in most cases of essential hypertension, B cells are not a causal factor in the pathophysiology of disease. Thus, elevated serum immunoglobulins seen in hypertensive animals and humans may reflect a biomarker of aberrant immune activation in hypertension and not a therapeutic target. However, autoantibodies may cause hypertension in special cases, and more work is needed to determine whether specific B cell subsets might play an important role that is masked by global B cell deficiency.

Emerging evidence from animal models has demonstrated the importance of multiple innate and adaptive immune cells in hypertension. We hypothesized that the abundance and phenotype of circulating immune cell subsets are altered in human hypertension. To test this, we performed high dimensional single cell profiling of human peripheral blood mononuclear cells using mass cytometry. Unsupervised computational analysis revealed a 40% decrease in CD8 + memory T cells in hypertensive individuals. Using Phenograph to identify subsets of these cells revealed a selective 60% decrease in PD-1 + CD8 + memory T cells in hypertension. This observation was confirmed in a validation cohort using flow cytometry in which PD-1 + CD8 + memory T cells were significantly decreased 44% in hypertensive compared to control individuals. To determine the phenotype of these PD-1 + CD8 + memory T cells, we performed Cellular Indexing of Transcriptomes and Epitopes by Sequencing (CITE-Seq) on four control and four hypertensive individuals. Using antibodies to identify PD-1 + and PD-1 - CD8 + memory T cells, gene set enrichment analysis of the coordinate single cell transcriptomic data revealed that PD-1 + cells exhibit over-representation of features of both immunologically active effector T cells and hypofunctional exhausted T cells. Thus, clustering analysis of PD-1 + CD8 + memory T cells was performed which demonstrated 4 distinct subclusters. One of these subclusters was decreased in hypertension and exhibited selective expression of multiple inhibitory receptors characteristic of exhausted T cells. At the protein level, this subcluster was marked by expression of the inhibitory receptor LAG3 and low levels of CD57. Combining these markers to identify PD-1 + LAG3 + CD57 - CD8 + memory T cells permitted identification of exhausted cells which demonstrated a significant 35% decrease in hypertensive compared to control individuals using flow cytometry. Taken together, these results demonstrate novel and reproducible decreases in circulating PD-1 + CD8 + memory T cells with features of exhaustion in human hypertension. These findings provide new insights into the pathogenesis of human hypertension including loss and/or re-invigoration of exhausted T cells.

Elevated cardiovascular risk including stroke, heart failure, and heart attack is present even after normalization of blood pressure in patients with hypertension. Underlying immune cell activation is a likely culprit. Although immune cells are important for protection against invading pathogens, their chronic overactivation may lead to tissue damage and high blood pressure. Triggers that may initiate immune activation include viral infections, autoimmunity, and lifestyle factors such as excess dietary salt. These conditions activate the immune system either directly or through their impact on the gut microbiome, which ultimately produces chronic inflammation and hypertension. T cells are central to the immune responses contributing to hypertension. They are activated in part by binding specific antigens that are presented in major histocompatibility complex molecules on professional antigen-presenting cells, and they generate repertoires of rearranged T-cell receptors. Activated T cells infiltrate tissues and produce cytokines including interleukin 17A, which promote renal and vascular dysfunction and end-organ damage leading to hypertension. In this comprehensive review, we highlight environmental, genetic, and microbial associated mechanisms contributing to both innate and adaptive immune cell activation leading to hypertension. Targeting the underlying chronic immune cell activation in hypertension has the potential to mitigate the excess cardiovascular risk associated with this common and deadly disease.

SH2B3, also known as LNK, is an adaptor protein that negatively regulates growth factor and cytokine signaling. The minor allele of a single nucleotide polymorphism in SH2B3 (rs3184504) encodes a tryptophan (Trp) at amino acid 262 as opposed to arginine (Arg) and is strongly associated with hypertension in genome-wide association studies. Whether this variant is causal and how it impacts hypertension development and end-organ damage is unknown. We used CRISPR-Cas9 to engineer mice homozygous for the major and minor alleles of this SH2B3 polymorphism, resulting in Arg/Arg and Trp/Trp mice, respectively. Trp/Trp mice exhibited increased systolic blood pressure (SBP) by radiotelemetry during weeks 3-4 of angiotensin II (Ang II) infusion compared to Arg/Arg mice (nighttime SBP 168 vs 158 mm Hg, respectively). Renal dysfunction was also exacerbated in Ang II-treated Trp/Trp compared to Arg/Arg mice, as evidenced by significantly increased urinary albumin/creatinine ratio (0.41 vs 0.17), renal perivascular fibrosis (fibrosis score 2.0 vs 1.0), and renal macrophages (8,341 vs 6,413 per kidney). In addition, renal CD8 + T cells from Ang II-treated Trp/Trp mice produced significantly more IFNγ compared to Arg/Arg controls (median fluorescence intensity 20,455 vs 14,134), and ex vivo stimulated splenic CD8 + T cells from Trp/Trp compared to Arg/Arg mice made 2.7-fold more IFNγ. To determine a mechanism for increased T cell IFNγ production, dendritic cells and naïve T cells from Trp/Trp and Arg/Arg mice were co-cultured in different combinations. The greatest increase in GM-CSF-induced IFNγ production occurred when both dendritic cells and T cells came from Trp/Trp mice (3.4-fold greater than both cell types from Arg/Arg mice). This effect appears to be due to loss of SH2B3-mediated suppression of GM-CSF signaling, as overexpression of Trp-encoding SH2B3 in HEK cells exhibited significantly less repression of GM-CSF-induced Stat5 activation compared to Arg-encoding SH2B3. Taken together, these findings suggest that the Trp encoding allele of rs3184504 is a causal variant promoting blood pressure elevation and renal dysfunction, at least in part through loss of SH2B3-mediated repression of T cell IFNγ production.

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is the cause of the global pandemic of coronavirus disease‐2019 (COVID‐19). SARS‐CoV‐2 is a zoonotic disease, but little is known about variations in species susceptibility that could identify potential reservoir species, animal models, and the risk to pets, wildlife, and livestock. Certain species, such as domestic cats and tigers, are susceptible to SARS‐CoV‐2 infection, while other species such as mice and chickens are not. Most animal species, including those in close contact with humans, have unknown susceptibility. Hence, methods to predict the infection risk of animal species are urgently needed. SARS‐CoV‐2 spike protein binding to angiotensin‐converting enzyme 2 (ACE2) is critical for viral cell entry and infection. Here we integrate species differences in susceptibility with multiple in‐depth structural analyses to identify key ACE2 amino acid positions including 30, 83, 90, 322, and 354 that distinguish susceptible from resistant species. Using differences in these residues across species, we developed a susceptibility score that predicts an elevated risk of SARS‐CoV‐2 infection for multiple species including horses and camels. We also demonstrate that SARS‐CoV‐2 is nearly optimal for binding ACE2 of humans compared to other animals, which may underlie the highly contagious transmissibility of this virus among humans. Taken together, our findings define potential ACE2 and SARS‐CoV‐2 residues for therapeutic targeting and identification of animal species on which to focus research and protection measures for environmental and public health.

In only a few months, the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic, leaving physicians, scientists, and public health officials racing to understand, treat, and contain this zoonotic disease. SARS-CoV-2 has made the leap from animals to humans, but little is known about variations in species susceptibility that could identify potential reservoir species, animal models, and the risk to pets, wildlife, and livestock. While there is evidence that certain species, such as cats, are susceptible, the vast majority of animal species, including those in close contact with humans, have unknown susceptibility. Hence, methods to predict their infection risk are urgently needed. SARS-CoV-2 spike protein binding to angiotensin converting enzyme 2 (ACE2) is critical for viral cell entry and infection. Here we identified key ACE2 residues that distinguish susceptible from resistant species using in-depth sequence and structural analyses of ACE2 and its binding to SARS-CoV-2. Our findings have important implications for identification of ACE2 and SARS-CoV-2 residues for therapeutic targeting and identification of animal species with increased susceptibility for infection on which to focus research and protection measures for environmental and public health.

The role of B cells and serum immunoglobulins (Ig) in hypertension is unclear. Elevated serum IgG has been observed in some hypertensive patients and in animal models of hypertension. Mice with a severe B cell deficiency due to lack of B cell activating factor receptor (BAFF-R) and mice lacking the cytokine interleukin 21 (IL21) - which is a potent inducer of B cell Ig class switching and high affinity Ig production - are protected from Ang II-induced hypertension and exhibit reduced serum IgG levels. Thus, we sought to determine whether hypertensive IgGs play a causative role in hypertension and end-organ dysfunction. First, we purified serum IgG from normotensive and hypertensive wild type (WT) mice and adoptively transferred equal amounts of IgG by intraperitoneal injection into normotensive recipient mice followed by infusion of a sub-pressor dose of angiotensin II (Ang II) for 2 weeks. Flow cytometric analysis of aortas revealed a modest increase in F4/80+ macrophages (p=0.04) and CD8+ T cells (p=0.02) in mice that received hypertensive IgG. However, there was no difference in endothelial dependent relaxation, renal inflammation, albuminuria, and blood pressure (BP) between the two groups. As an alternative method to investigate the role of class-switched high affinity Igs, we studied mice with genetic deletion of activation-induced deaminase (AID) which is an enzyme necessary for somatic hypermutation (to generate high affinity Igs) and isotype class switching. AID -/- mice exhibit undetectable IgG and higher levels of IgM in serum compared to WT mice. Ang II infusion for 4 weeks revealed no difference in BP, aortic inflammation, renal inflammation, and albuminuria. We also studied mice with deficiency of the IgM heavy chain (uMT). These mice exhibit undetectable levels of all immunoglobulins and are severely deficient in mature B cells. uMT-/- mice are also not protected from hypertension induced by Ang II infusion or deoxycorticosterone acetate (DOCA-salt) treatment. Together, these results demonstrate that while elevated serum immunoglobulins seen in hypertensive animals and humans may represent a biomarker of aberrant immune activation, they are likely not playing a causal role in hypertension pathophysiology.

Hypertension is the leading risk factor for morbidity and mortality worldwide. Emerging evidence in animal models demonstrates the importance of a variety of innate and adaptive immune cells in hypertension. We hypothesized that the abundance and phenotype of specific circulating immune cell subsets is altered in human hypertension reflecting disease pathophysiology. We performed unbiased high dimensional, single cell profiling of peripheral blood mononuclear cells in humans with a panel of 31 cell surface markers using mass cytometry. Unsupervised computational analysis from 11 control and 10 hypertensive individuals matched for age, gender, race, and body mass index revealed consistent increases in a novel memory helper T cell subset in hypertension. Manual two dimensional gating revealed that this CD4 + CD45RO + CD62L + CCR7 - CD161 lo memory cell population is nearly 2-fold increased in hypertensive subjects (1.0 vs 1.9%). As an alternative to starting with unsupervised analysis, manual gating for major known immune cell populations revealed a 40% decrease in memory cytotoxic T cells and a 29% decrease in regulatory T cells in hypertensive individuals (3.2 vs 1.9% and 1.3 vs 0.93%, respectively). Unsupervised analysis of the cellular subsets of these populations using Phenograph revealed a selective 63% decrease in PD-1 + memory cytotoxic T cells and 49% decrease in CCR10 + regulatory T cells in hypertension (0.67 vs 0.25% and 0.37 vs 0.19%, respectively). Taken together, these results demonstrate that in human hypertension there are increases in a novel memory helper T cell subset and decreases in PD-1 + memory cytotoxic and CCR10 + regulatory T cell populations. These findings may provide new insights into hypertension pathogenesis and potential therapeutic targets.

T and B cells have been implicated in hypertension, but the mechanisms by which they produce a coordinated response is unknown. T follicular helper (Tfh) cells that produce interleukin 21 (IL21) promote germinal center (GC) B cell responses leading to immunoglobulin (Ig) production. Here we investigate the role of IL21 and Tfh cells in hypertension. In response to angiotensin (Ang) II-induced hypertension, T cell IL21 production is increased, and Il21-/- mice develop blunted hypertension, attenuated vascular end-organ damage, and decreased interleukin 17A (IL17A) and interferon gamma production. Tfh-like cells and GC B cells accumulate in the aorta and plasma IgG1 is increased in hypertensive WT but not Il21-/-mice. Furthermore, Tfh cell deficient mice develop blunted hypertension and vascular hypertrophy in response to Ang II infusion. Importantly, IL21 neutralization reduces blood pressure (BP) and reverses endothelial dysfunction and vascular inflammation. Moreover, recombinant IL21 impairs endothelium-dependent relaxation ex vivo and decreases nitric oxide production from cultured endothelial cells. Finally, we show in humans that peripheral blood T cell production of IL21 correlates with systolic BP and IL17A production. These data suggest that IL21 may be a novel therapeutic target for the treatment of hypertension and its micro- and macrovascular complications.

Immune checkpoint inhibitors have improved clinical outcomes associated with numerous cancers, but high-grade, immune-related adverse events can occur, particularly with combination immunotherapy. We report the cases of two patients with melanoma in whom fatal myocarditis developed after treatment with ipilimumab and nivolumab. In both patients, there was development of myositis with rhabdomyolysis, early progressive and refractory cardiac electrical instability, and myocarditis with a robust presence of T-cell and macrophage infiltrates. Selective clonal T-cell populations infiltrating the myocardium were identical to those present in tumors and skeletal muscle. Pharmacovigilance studies show that myocarditis occurred in 0.27% of patients treated with a combination of ipilimumab and nivolumab, which suggests that our patients were having a rare, potentially fatal, T-cell-driven drug reaction. (Funded by Vanderbilt-Ingram Cancer Center Ambassadors and others.).

Aortic dissection (AD) is a life-threatening vascular disease with limited treatment strategies. Here, we show that loss of the GWAS-identified SH2B3 gene, encoding lymphocyte adaptor protein LNK, markedly increases susceptibility to acute AD and rupture in response to angiotensin (Ang) II infusion. As early as day 3 following Ang II infusion, prior to the development of AD, Lnk–/– aortas display altered mechanical properties, increased elastin breaks, collagen thinning, enhanced neutrophil accumulation, and increased MMP-9 activity compared with WT mice. Adoptive transfer of Lnk–/– leukocytes into Rag1–/– mice induces AD and rupture in response to Ang II, demonstrating that LNK deficiency in hematopoietic cells plays a key role in this disease. Interestingly, treatment with doxycycline prevents the early accumulation of aortic neutrophils and significantly reduces the incidence of AD and rupture. PrediXcan analysis in a biobank of more than 23,000 individuals reveals that decreased expression of SH2B3 is significantly associated with increased frequency of AD-related phenotypes (odds ratio 0.81). Thus, we identified a role for LNK in the pathology of AD in experimental animals and humans and describe a new model that can be used to inform both inherited and acquired forms of this disease.

Chronic inflammation characterized by vascular T cell and macrophage infiltration is associated with angiotensin II (Ang II)-induced hypertension and end-organ damage. However, the role of B cells in the development of hypertension is not well established. Elevated levels of serum immunoglobulins have been observed in experimental and human hypertension. Prior studies demonstrated that B-cell-activating factor receptor-deficient (BAFF-R -/- ) mice, which lack mature B cells, are protected from Ang II-induced hypertension and vascular remodeling. However, BAFF-R can be expressed on non-B cells as well. Thus, to further investigate the role of B cells in hypertension, we studied mice with targeted disruption of the membrane exon of the immunoglobulin μ heavy chain gene (μMT -/- ) that encodes the constant region of the IgM isotype. In these mice, B cells are arrested at the pre-B cell maturation stage. Serum immunoglobulins were undetectable at a 1:30,000 dilution in μMT -/- mice. Interestingly, μMT -/- mice exhibited similar blood pressure increase in response to 4 weeks of Ang II infusion compared to age-matched wild type (WT) mice (p=0.675). Flow cytometry of aortae from Ang II-treated μMT -/- mice demonstrated fewer CD45+ cells (p=0.047), similar levels of CD8+ and CD4+ T cells (p=0.631 and p=0.721 respectively), a trend for more F4/80+ monocytes/macrophages (p=0.2567), and virtually no CD19+ B cells (p=0.002) compared to WT mice. Endothelium-dependent vasodilatation to acetylcholine was comparable between μMT -/- mice and WT mice after Ang II treatment (p=0.223), however μMT -/- mice displayed enhanced endothelium-independent vasodilatation to sodium nitroprusside than WT mice (p=0.024). Urinary albumin/creatinine ratio was similar between Ang II-treated μMT -/- mice and WT mice (p=0.488), indicating similar renal damage. Taken together, μMT -/- mice are not protected from Ang II-induced hypertension, suggesting that B cells and immunoglobulin production are not critical for hypertension and the associated end-organ damage.

Hypertension is the leading risk factor for global morbidity and mortality. Emerging evidence in animal models implicates a variety of innate and adaptive immune cells in hypertension pathogenesis, and limited studies in humans have demonstrated increased circulating memory and senescent T cells in hypertensive individuals. However, the abundance and role of specific immune cells in human hypertension remains unclear. To perform unbiased high dimensional profiling of peripheral immune cells in humans, we developed and validated a novel approach using mass cytometry to detect 31 extracellular markers at the single cell level. Initial results in a normotensive individual using this panel revealed robust identification of major circulating immune cell subsets including CD4 + cells (60% of CD45 + cells), CD8 + cells (21%), γδ T cells (6%), CD25 + CD127 lo T regulatory cells (5%), CD19 + B cells (3%), and CD11c + myeloid cells (3%). Unsupervised viSNE plots using this panel of 31 markers demonstrates grouping of distinct circulating immune cell subsets based on similarity of marker levels (Figure) . We are extending this analysis to peripheral blood mononuclear cells collected from 16 additional control and 17 hypertensive individuals matched for age, gender, race, and BMI to determine differences in the abundance of known and potentially novel circulating immune cell subsets. The combination of high dimensional mapping and unsupervised computational analysis will permit rigorous immunophenotyping of human hypertension and potentially identify novel therapeutic targets.

Atherosclerosis is a vascular disease characterized by lipid deposition and inflammation within the arterial wall. Oxidized phospholipids (oxPLs), such as 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphorylcholine (oxPAPC) and its constituents 1-palmytoyl-2-(5-oxovaleroyl)-sn-glycero-3-phosphocholine (POVPC) and 1-palmitoyl-2-glutaroyl-sn-glycero-3-phosphocholine (PGPC) are concentrated within atherosclerotic lesions and are known to be potent proinflammatory mediators. Phenotypic switching of smooth muscle cells (SMCs) plays a critical role in the development, progression, and end-stage clinical consequences of atherosclerosis, yet little is known regarding the effects of specific oxPLs on SMC phenotype. The present studies were focused on determining whether oxPLs regulate expression of SMC differentiation marker genes and the molecular mechanisms involved. Results showed that POVPC and PGPC induced profound suppression of smooth muscle (SM) α-actin and SM myosin heavy chain expression while simultaneously increasing expression of MCP-1, MCP-3, and cytolysin. OxPLs also induced nuclear translocation of Krüppel-like transcription factor 4 (KLF4), a known repressor of SMC marker genes. siRNA targeting of KLF4 nearly blocked POVPC-induced suppression of SMC marker genes, and myocardin. POVPC-induced repression of SMC marker genes was also significantly attenuated in KLF4 knockout SMCs. Taken together, these results suggest a novel role for oxPLs in phenotypic modulation of SMCs and indicate that these effects are dependent on the transcription factor, KLF4. These results may have important novel implications for the mechanisms by which oxPLs contribute to the pathogenesis of atherosclerosis.

Background: Immune checkpoint inhibitors have expanded treatment options for a number of cancer types by enhancing anti-tumor immune responses. Specifically, ipilimumab, an anti-cytotoxic T-lymphocyte associated antigen 4 (CTLA-4) antibody, and nivolumab, an anti-programmed death 1 (PD-1) antibody

area and fl ow in the aorta, 1 iliac, 2 and femoral arteries. 2,3 PC-MRI is noninvasive, does not require the use of ionizing radiation or intravenous contrast, does not have acoustic window limitations, and can be performed rapidly after magnetic resonance angiography. To date, the utility and reproducibility of PCMRI for measuring time-dependent changes in arterial area and fl ow after an ischemic stimulus, thus characterizing peripheral arterial endothelial function in medium-sized arteries has not been described. This study was performed for these purposes.  The study was approved by the Institutional Review Board of our University’s School of Medicine and all participants provided written, informed consent. The study population consisted of 10 young healthy men and women (aged 18 to 30 years), and 10 older men and women (aged 50 to 75 years) with New York Heart Association class II heart failure (HF) associated with left ventricular (LV) systolic dysfunction. The young participants did not smoke, had no medical illness, and took no over-the-counter or prescribed medications. All of the young women had normal menstrual cycles and were not taking oral contraceptives. 4,5 Older participants with HF had a LV ejection fraction of 40% measured within 2 months before testing. No subject had a history of claudication or an increase in carotid wall thickness by ultrasound. Participants were ineligible for study if they had intracranial metal, a pacemaker or defi brillator, claustrophobia, or were pregnant. Upon arrival for study, participants rested supinely in a dimly lit room for 30 to 45 minutes. 4 Substances that could affect vascular reactivity, such as theophylline, caffeine, or nicotine were withheld 24 hours before scan. Subjects were then placed into the scanner supine, feet-fi rst, with electrocardiographic monitoring leads, a brachial blood pressure cuff, a large thigh cuff, and a phased array (cardiac) surface coil placed around the left thigh. Before and throughout the course of testing, heart rate and systemic pressure were monitored. Axial, coronal, and sagittal gradient-echo images of the superfi cial femoral artery were obtained 20 cm distal to the femoral head. The purpose of these acquisitions was to obtain a cross-sectional view of the artery along a straight vessel segment perpendicular to its course that would minimize partial volume effects during scanning. To measure area and fl ow, PC-MRI images were acquired in the cross-sectional slice position identifi ed previously. After 3 baseline acquisitions, the thigh cuff was infl ated to 50 mm Hg above the participant’s systolic blood pressure as measured in the forearm. A PC-MRI acquisition was obtained to confi rm absence of fl ow in the superfi cial femoral artery; if fl ow was present, the cuff was infl ated an additional 20 mm Hg and repeat PC-MRI images were acquired to confi rm vessel occlusion. After occluding the artery for 5 minutes, 6,7 the pressure within the thigh cuff was released and PC-MRI scans were re

Exposure of yeast cells to an increase in external osmolarity induces a temporary growth arrest. Recovery from this stress is mediated by the accumulation of intracellular glycerol and the transcription of several stress response genes. Increased external osmolarity causes a transient accumulation of 1N and 2N cells and a concomitant depletion of S phase cells. Hypertonic stress triggers a cell cycle delay in G2 phase cells that appears distinct from the morphogenesis checkpoint, which operates in early S phase cells. Hypertonic stress causes a decrease in CLB2 mRNA, phosphorylation of Cdc28p, and inhibition of Clb2p-Cdc28p kinase activity, whereas Clb2 protein levels are unaffected. Like the morphogenesis checkpoint, the osmotic stress-induced G2 delay is dependent upon the kinase Swe1p, but is not tightly correlated with inhibition of Clb2p-Cdc28p kinase activity. Thus, deletion of SWE1 does not prevent the hypertonic stress-induced inhibition of Clb2p-Cdc28p kinase activity. Mutation of the Swe1p phosphorylation site on Cdc28p (Y19) does not fully eliminate the Swe1p-dependent cell cycle delay, suggesting that Swe1p may have functions independent of Cdc28p phosphorylation. Conversely, deletion of the mitogen-activated protein kinase HOG1 does prevent Clb2p-Cdc28p inhibition by hypertonic stress, but does not block Cdc28p phosphorylation or alleviate the cell cycle delay. However, Hog1p does contribute to proper nuclear segregation after hypertonic stress in cells that lack Swe1p. These results suggest a hypertonic stress-induced cell cycle delay in G2 phase that is mediated in a novel way by Swe1p in cooperation with Hog1p.

Smooth muscle cell (SMC) phenotypic modulation in atherosclerosis and in response to PDGF in vitro involves repression of differentiation marker genes and increases in SMC proliferation, migration, and matrix synthesis. However, SMCs within atherosclerotic plaques can also express a number of proinflammatory genes, and in cultured SMCs the inflammatory cytokine IL-1β represses SMC marker gene expression and induces inflammatory gene expression. Studies herein tested the hypothesis that IL-1β modulates SMC phenotype to a distinct inflammatory state relative to PDGF-DD. Genome-wide gene expression analysis of IL-1β- or PDGF-DD-treated SMCs revealed that although both stimuli repressed SMC differentiation marker gene expression, IL-1β distinctly induced expression of proinflammatory genes, while PDGF-DD primarily induced genes involved in cell proliferation. Promoters of inflammatory genes distinctly induced by IL-1β exhibited over-representation of NF-κB binding sites, and NF-κB inhibition in SMCs reduced IL-1β-induced upregulation of proinflammatory genes as well as repression of SMC differentiation marker genes. Interestingly, PDGF-DD-induced SMC marker gene repression was not NF-κB dependent. Finally, immunofluorescent staining of mouse atherosclerotic lesions revealed the presence of cells positive for the marker of an IL-1β-stimulated inflammatory SMC, chemokine (C-C motif) ligand 20 (CCL20), but not the PDGF-DD-induced gene, regulator of G protein signaling 17 (RGS17). Results demonstrate that IL-1β- but not PDGF-DD-induced phenotypic modulation of SMC is characterized by NF-κB-dependent activation of proinflammatory genes, suggesting the existence of a distinct inflammatory SMC phenotype. In addition, studies provide evidence for the possible utility of CCL20 and RGS17 as markers of inflammatory and proliferative state SMCs within atherosclerotic plaques in vivo.

The vascular smooth muscle cell (SMC) in adult animals is a highly specialized cell whose principal function is contraction. However, this cell displays remarkable plasticity and can undergo profound changes in phenotype during repair of vascular injury, during remodeling in response to altered blood flow, or in various disease states. There has been extensive progress in recent years in our understanding of the complex mechanisms that control SMC differentiation and phenotypic plasticity, including the demonstration that epigenetic mechanisms play a critical role. In addition, recent evidence indicates that SMC phenotypic switching in adult animals involves the reactivation of embryonic stem cell pluripotency genes and that mesenchymal stem cells may be derived from SMC and/or pericytes. This review summarizes the current state of our knowledge in this field and identifies some of the key unresolved challenges and questions that we feel require further study.

SUMMARY A cascade of three protein kinases known as a mitogen-activated protein kinase (MAPK) cascade is commonly found as part of the signaling pathways in eukaryotic cells. Almost two decades of genetic and biochemical experimentation plus the recently completed DNA sequence of the Saccharomyces cerevisiae genome have revealed just five functionally distinct MAPK cascades in this yeast. Sexual conjugation, cell growth, and adaptation to stress, for example, all require MAPK-mediated cellular responses. A primary function of these cascades appears to be the regulation of gene expression in response to extracellular signals or as part of specific developmental processes. In addition, the MAPK cascades often appear to regulate the cell cycle and vice versa. Despite the success of the gene hunter era in revealing these pathways, there are still many significant gaps in our knowledge of the molecular mechanisms for activation of these cascades and how the cascades regulate cell function. For example, comparison of different yeast signaling pathways reveals a surprising variety of different types of upstream signaling proteins that function to activate a MAPK cascade, yet how the upstream proteins actually activate the cascade remains unclear. We also know that the yeast MAPK pathways regulate each other and interact with other signaling pathways to produce a coordinated pattern of gene expression, but the molecular mechanisms of this cross talk are poorly understood. This review is therefore an attempt to present the current knowledge of MAPK pathways in yeast and some directions for future research in this area.

Clinical complications of atherosclerosis arise primarily as a result of luminal obstruction due to atherosclerotic plaque growth, with inadequate outward vessel remodeling and plaque destabilization leading to rupture. IL-1 is a proinflammatory cytokine that promotes atherogenesis in animal models, but its role in plaque destabilization and outward vessel remodeling is unclear. The studies presented herein show that advanced atherosclerotic plaques in mice lacking both IL-1 receptor type I and apolipoprotein E (Il1r1⁻/⁻Apoe⁻/⁻ mice) unexpectedly exhibited multiple features of plaque instability as compared with those of Il1r1⁺/⁺Apoe⁻/⁻ mice. These features included reduced plaque SMC content and coverage, reduced plaque collagen content, and increased intraplaque hemorrhage. In addition, the brachiocephalic arteries of Il1r1⁻/⁻Apoe⁻/⁻ mice exhibited no difference in plaque size, but reduced vessel area and lumen size relative to controls, demonstrating a reduction in outward vessel remodeling. Interestingly, expression of MMP3 was dramatically reduced within the plaque and vessel wall of Il1r1⁻/⁻Apoe⁻/⁻ mice, and Mmp3⁻/⁻Apoe⁻/⁻ mice showed defective outward vessel remodeling compared with controls. In addition, MMP3 was required for IL-1-induced SMC invasion of Matrigel in vitro. Taken together, these results show that IL-1 signaling plays a surprising dual protective role in advanced atherosclerosis by promoting outward vessel remodeling and enhancing features of plaque stability, at least in part through MMP3-dependent mechanisms.

ObjectivesThis study tested the hypothesis that monocyte chemotactic protein 1 (MCP1) is required for abdominal aortic aneurysm (AAA) and smooth muscle phenotypic modulation in a mouse elastase perfusion model.MethodsInfrarenal aortas of C57BL/6 (wild type [WT]) and MCP1 knockout (KO) mice were analyzed at 14 days after perfusion. Key cellular sources of MCP1 were identified using bone marrow transplantation. Cultured aortic smooth muscle cells (SMCs) were treated with MCP1 to assess its potential to directly regulate SMC contractile protein expression and matrix metalloproteinases (MMPs).ResultsElastase perfused WT aortas had a mean dilation of 102% (n = 9) versus 53.7% for MCP1KO aortas (n = 9, P