ER stress and Rho kinase activation underlie the vasculopathy of CADASIL

Neves, K. B. et al. (2019) ER stress and Rho kinase activation underlie the vasculopathy of CADASIL. JCI Insight, 4(23), e131344. (doi: 10.1172/jci.insight.131344) (PMID:31647781) (PMCID:PMC6962020)

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Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) leads to premature stroke and vascular dementia. Mechanism-specific therapies for this aggressive cerebral small vessel disease are lacking. CADASIL is caused by NOTCH3 mutations that influence vascular smooth muscle cell (VSMC) function through unknown processes. We investigated molecular mechanisms underlying the vasculopathy in CADASIL focusing on endoplasmic reticulum (ER) stress and RhoA/Rho kinase (ROCK). Peripheral small arteries and VSMCs were isolated from gluteal biopsies of CADASIL patients and mesentery of TgNotch3R169C mice (CADASIL model). CADASIL vessels exhibited impaired vasorelaxation, blunted vasoconstriction, and hypertrophic remodeling. Expression of NOTCH3 and ER stress target genes was amplified and ER stress response, Rho kinase activity, superoxide production, and cytoskeleton-associated protein phosphorylation were increased in CADASIL, processes associated with Nox5 upregulation. Aberrant vascular responses and signaling in CADASIL were ameliorated by inhibitors of Notch3 (γ-secretase inhibitor), Nox5 (mellitin), ER stress (4-phenylbutyric acid), and ROCK (fasudil). Observations in human CADASIL were recapitulated in TgNotch3R169C mice. These findings indicate that vascular dysfunction in CADASIL involves ER stress/ROCK interplay driven by Notch3-induced Nox5 activation and that NOTCH3 mutation–associated vascular pathology, typical in cerebral vessels, also manifests peripherally. We define Notch3-Nox5/ER stress/ROCK signaling as a putative mechanism-specific target and suggest that peripheral artery responses may be an accessible biomarker in CADASIL.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Rios, Dr Francisco and Harvey, Dr Adam and Delles, Professor Christian and Moreton, Dr Fiona and Muir, Professor Keith and Nguyen Dinh Cat, Dr Aurelie and Montezano, Dr Augusto and Touyz, Professor Rhian and Neves, Dr Karla
Authors: Neves, K. B., Harvey, A. P., Moreton, F., Montezano, A. C., Rios, F. J., Alves-Lopes, R., Nguyen Dinh Cat, A., Rocchiccioli, P., Delles, C., Joutel, A., Muir, K., and Touyz, R. M.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
Journal Name:JCI Insight
Publisher:American Society for Clinical Investigation
ISSN (Online):2379-3708
Published Online:24 October 2019
Copyright Holders:Copyright © 2019 Neyes et al.
First Published:First published in JCI Insight 4:e1313444
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
190814BHF centre of excellenceRhian TouyzBritish Heart Foundation (BHF)RE/13/5/30177Institute of Cardiovascular & Medical Sciences
303944BHF Centre of ExcellenceRhian TouyzBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science
300689Vascular Noxs as therapeutic targets and biomarkers in hypertensionRhian TouyzBritish Heart Foundation (BHF)CH/12/4/29762CAMS - Cardiovascular Science