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From the Franz Volhard Clinic,*
Medical Faculty of the
Charité, Humboldt University of Berlin, Berlin, Germany; the
Institute of Biomedicine,
University of
Helsinki, Helsinki, Finland; the Max Delbrück Center for
Molecular Medicine,
Berlin, Germany; the
Medical School Hannover,§
Hannover, Germany; F.
Hoffmann-La Roche,¶
Basel, Switzerland; the
Institute of Pathology,||
Technische
Universität Dresden, Dresden, Germany; and the Department
of Immunology,**
Scripps Research Institute, La
Jolla, California
Tissue factor (TF), a main initiator of clotting,
is up-regulated in vasculopathy. We tested the hypothesis that chronic
in vivo angiotensin (ANG) II receptor AT1
receptor blockade inhibits TF expression in a model of ANG II-induced
cardiac vasculopathy. Furthermore, we explored the mechanisms
by examining transcription factor activation and analyzing the TF
promoter. Untreated transgenic rats overexpressing the human renin and
angiotensinogen genes (dTGR) feature hypertension and severe left
ventricular hypertrophy with focal areas of necrosis, and die
at age 7 weeks. Plasma and cardiac ANG II was three- to fivefold
increased compared to Sprague-Dawley rats. Chronic treatment with
valsartan normalized blood pressure and coronary resistance
completely, and ameliorated cardiac hypertrophy
(P < 0.001). Valsartan prevented
monocyte/macrophage infiltration, nuclear factor-
B
(NF-
B) and activator protein-1 (AP-1) activation, and c-fos
expression in dTGR hearts. NF-
B subunit p65 and TF expression was
increased in the endothelium and media of cardiac vessels and markedly
reduced by valsartan treatment. To analyze the mechanism of TF
transcription, we then transfected human coronary artery smooth
muscle cells and Chinese hamster ovary cells overexpressing the
AT1 receptor with plasmids containing the human TF promoter
and the luciferase reporter gene. ANG II induced the full-length TF
promoter in both transfected cell lines. TF transcription was abolished
by AT1 receptor blockade. Deletion of both AP-1 and NF-
B
sites reduced ANG II-induced TF gene transcription completely,
whereas the deletion of AP-1 sites reduced transcription. Thus,
the present study clearly shows an aberrant TF expression in the
endothelium and media in rats with ANG II-induced vasculopathy. The
beneficial effects of AT1 receptor blockade in this model
are mediated via the inhibition of NF-
B and AP-1 activation,
thereby preventing TF expression, cardiac vasculopathy,
and microinfarctions.
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