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Blood, 1 July 2004, Vol. 104, No. 1, pp. 3-4.
Atherogenic role of the type EIIIA fibronectin domainINSTITUTO DE BIOMEDICINA DE VALENCIA
Compared with "healthy" vessels, the extracellular matrix of atheromatous plaques includes increased content of type-EIIIA-domaincontaining fibronectin. Apolipoprotein E-null mice engineered to produce fibronectin lacking this alternatively spliced exon exhibit reduced atherosclerosis. Diminished hypercholesterolemia and reduced macrophage foam cell formation may contribute to this phenotype.
Although a causal link between fibronectin and cardiovascular pathobiology has been difficult to establish because null mutations for fibronectin cause embryonic lethality,3 evidence exists implicating fibronectin in cardiovascular pathobiology2,4,5: (1) EIIIA-positive fibronectin (EIIIA-FN) up-regulation is associated with clinical and experimental hypertension; (2) expression of EIIIA-FN, EIIIB-FN, and fibronectin lacking both alternative exons is rapidly induced after myocardial infarction in both humans and animal models; (3) EIIIA-FN and EIIIB-FN forms, which are not normally present in "healthy" vessels, are induced in neointimal lesions; (4) elevated plasma levels of circulating cFN have been described in clinical syndromes with vascular damage; and (5) in vivo studies using blocking antibodies have implicated the alternative fibronectin V/CS-1 segment in leukocyte recruitment during murine atherosclerosis.
Recently, analysis of fibronectin conditional knock-out mice revealed a role of pFN in thrombus initiation, growth, and stability.6 Now, Tan and colleagues (page 11) directly test the function of EIIIA-FN in atherosclerosis by engineering EIIIA-null (EIIIA/) mice lacking the EIIIA exon. They crossed EIIIA/ mice with atherosclerosis-prone apolipoprotein Enull (ApoE/) mice and found as much as a 67% reduction in aortic atherosclerosis in doubly deficient fat-fed EIIIA/ApoE/ mice compared with ApoE/ controls. An intriguing observation that deserves further examination is that EIIIA/ApoE/ females display significant protection at all time points assayed (8, 12, and 16 weeks of fat feeding), while males are protected only after 16 weeks. Compared with ApoE/ controls, both male and female EIIIA/ApoE/ mice displayed diminished total plasma cholesterol levels, a reduction that is specific to the very low density lipoprotein fraction. Increased EIIIA-FN expression was found in both the plasma and in endothelial cells and macrophages within atherosclerotic lesions of ApoE/ mice. Moreover, in vitro foam cell formation by ApoE/ macrophages was associated with increased EIIIA-FN mRNA expression, and lipid accumulation in EIIIA/ApoE/ macrophages was reduced by 31% compared with ApoE/ controls.
Collectively, the study by Tan and colleagues convincingly demonstrates an atherogenic role of EIIIA-FN and suggests that this form of fibronectin is functional in both plasma lipoprotein metabolism and in macrophage foam cell formation. Future studies are warranted to elucidate additional systemic mechanisms and processes within the vessel wall by which EIIIA-FN may contribute to atherosclerosis. For example, the possibility that EIIIA-FN may interact with specific lipoprotein fractions and may affect leukocyte recruitment should be investigated. Moreover, because endothelial and smooth muscle cells cultured on different ECM components display significant differences in proliferation, migration, and apoptosis, comparing the phenotypic properties of vascular cells cultured on EIIIA-FN, EIIIB-FN, and fibronectin lacking both EIII segments may shed significant insight into the role of distinct variants of fibronectin in atherosclerosis. References
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