| 研究生: |
陳柏升 Chen, Po-Sheng |
|---|---|
| 論文名稱: |
C型凝集素穿膜蛋白在心血管疾病重要性之探討 The Significance of C-type Transmembrane Protein in Cardiovascular Diseases |
| 指導教授: |
劉秉彥
Liu, Ping-Yen 李貽恆 Li, Yi-Heng |
| 學位類別: |
博士 Doctor |
| 系所名稱: |
醫學院 - 臨床醫學研究所 Institute of Clinical Medicine |
| 論文出版年: | 2020 |
| 畢業學年度: | 108 |
| 語文別: | 英文 |
| 論文頁數: | 94 |
| 中文關鍵詞: | group 14 C型凝集素穿膜蛋白 、內皮拓酸蛋白 、凝血酶調節素 、心臟再塑形 |
| 外文關鍵詞: | C-type lectin domain transmembrane protein group 14, endosialin, thrombomodulin, cardiac remodeling |
| 相關次數: | 點閱:71 下載:0 |
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Group 14 C型凝集素(C-type lectin domain)穿膜蛋白的成員包括有內皮拓酸蛋白(endosialin),凝血酶調節素(thrombomodulin),CD93及CLEC14A。這些成員在結構上都有其相似處。過去已知內皮拓酸蛋白主要表現在人類及動物發育胚胎的血管組織及纖維細胞中,但在成年動物的血管組織中表現量極少。之後的研究顯示,內皮拓酸蛋白的表現對腫瘤的成長,腫瘤內新生血管的發生與遠端轉移有重要的影響。先前研究雖然也可以發現內皮拓酸蛋白的mRNA可以表現在成年動物的心臟組織中,但是實際內皮拓酸蛋白在心臟組織的表現型態及功能到目前為止則是未知。我們的研究發現在因嚴重心衰竭接受心臟移植手術的病人取出的心臟切片檢體中內皮拓酸蛋白的表現明顯增加。同時,我們也發現培養的心肌細胞及小鼠的心臟在接受刺激後會明顯誘發內皮拓酸蛋白的表現。外加合成的內皮拓酸蛋白則可以刺激培養中的心肌細胞成長,增生,同時也可以抑制doxorubicin誘發之細胞凋亡。外加合成的內皮拓酸蛋白也會影響心肌細胞內肌動蛋白(actin)排列。此外,我們更進一步的發現外加合成的內皮拓酸蛋白可以改善培養中的心肌細胞因接受doxorubicin刺激而受損的收縮功能。另一方面,我們的研究也發現在先天缺少內皮拓酸蛋白的小鼠中,心臟左心室收縮功能比正常小鼠差,心臟中膠原蛋白的含量也比正常小鼠的心臟少。我們的研究結果顯示,內皮拓酸蛋白不只在心臟受刺激後的反應及再塑型有其重要性,同時對正常心臟組織的組成及功能也有扮演其重要的角色。相較於內皮拓酸蛋白,Group 14 C型凝集素(C-type lectin domain)中的另外一個成員,凝血酶調節素,則有較為徹底及廣泛的研究,在許多正常細胞的功能表現及疾病的發生都有其重要性。我們的研究顯示外加合成的凝血酶調節素可以藉由誘發調節AKT/mTOR相關的訊息傳導路徑,有效減少內皮細胞中自噬反應(autophagy)的相關蛋白,進而減少內皮細胞的凋亡。在有粥狀動脈硬化的人體血管組織可以發現,自噬反應相關的細胞標記較沒有粥狀動脈硬化的血管明顯。我們也藉由動物實驗發現,外加合成的凝血酶調節素可以減少缺乏Apo E小鼠的主動脈中自噬反應相關蛋白的表現,同時減少內皮細胞的凋亡,更可以進一步改善血管粥狀動脈硬化的嚴重程度。由我們的研究,可以看出Group 14 C型凝集素對於心血管系統的重要性,不只在於維持正常心血管系統的結構及功能,在心臟或血管受到刺激與傷害後所進行的反應與心臟及血管的再塑型都有其重要性。
C-type (calcium-dependent) lectin domain (CTLD) transmembrane protein group 14 consists of endosialin, thrombomodulin (TM), CD93 and CLEC14A and shares similar characteristics in structure. Normally, endosialin expresses in embryo but less protein expression is detected in adult vasculature. Upregulated endosialin participates in growth, progression, neoangiogenesis and metastasis of tumors. Although mRNA of endosialin could be detected in normal heart tissue, the pattern of protein expression and substantial function of endosialin in heart had never been investigated. Our present study found abundant endosialin expressed in excised heart specimen of end-stage heart failure patients receiving heart transplantation. In addition, our in vitro and in vivo studies found that the expression of endosialin could be activated under different cardiac stresses. We found recombinant endosialin (r-endosialin) stimulated proliferation and growth of H9c2 cells and prohibited doxorubicin induced apoptosis of H9c2 cells. r-Endosialin re-arranged intracellular actin filaments of H9c2 cells into more parallel array and rescued contractile function of beating cardiomyocytes treated with doxorubicin. On the other hand, endosialin deficit mice had worse ventricular systolic function and less collagen content in heart compared to control mice. These results suggested endosialin might play a role in maintenance of normal cardiac structure and functions. In conclusion, our present study demonstrated that the expression of endosialin was induced under certain stimulus and might have significance in maintenance of normal cardiac function and pathological development of cardiac remodeling. In contrast to endosialin, TM is the most well studied member of CTLD group 14. Our present study found that treatment of recombinant TM (rTM) decreased the expression of serum starvation (SS)-induced autophagy-related proteins, and the formation of autophagosomes in endothelial cells (ECs) through activation of AKT/mTOR pathway. In addition, treatment of rTM decreased SS-induced ECs apoptosis, but this effect of rTM could not be recapitulated by co-treatment with a potent autophagy inducer, rapamycin and in ECs with ATG5 knockdown. In human atherosclerosis specimens, expression of autophagy markers were more abundant in aortic intimal ECs with severe atherosclerosis than those without atherosclerosis. Moreover, compared to saline treatment group, administration of rTM reduced LC3 and ATG13 expression, intimal EC apoptosis, and atherosclerotic lesion severity in the aorta of apolipoprotein E deficient mice. The findings of our study suggested treatment with rTM suppressed stress-induced autophagy overactivation in ECs, provided ECs protective effects, and decreased atherosclerosis in apolipoprotein E deficient mice. In summary, our studies further demonstrated CTLD group 14 proteins are not only crucial in maintenance normal cardiac structure and function but also involved in cardiac and vascular remodeling.
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