SPARC Preserves Endothelial Glycocalyx Integrity, and Protects
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University of Birmingham SPARC preserves endothelial glycocalyx integrity, and protects against adverse cardiac inflammation and injury during viral myocarditis Rienks, Marieke; Carai, Paolo; Teeffelen, Jurgen van; Eskens, Bart; Verhesen, Wouter; Hemmeryckx, Bianca; Johnson, Daniel M.; Leeuwen, Rick van; Jones, Elizabeth A.; Heymans, Stephane; Papageorgiou, Anna-Pia DOI: 10.1016/j.matbio.2018.04.015 License: Creative Commons: Attribution-NonCommercial-NoDerivs (CC BY-NC-ND) Document Version Publisher's PDF, also known as Version of record Citation for published version (Harvard): Rienks, M, Carai, P, Teeffelen, JV, Eskens, B, Verhesen, W, Hemmeryckx, B, Johnson, DM, Leeuwen, RV, Jones, EA, Heymans, S & Papageorgiou, A-P 2018, 'SPARC preserves endothelial glycocalyx integrity, and protects against adverse cardiac inflammation and injury during viral myocarditis', Matrix Biology, pp. 21-34. https://doi.org/10.1016/j.matbio.2018.04.015 Link to publication on Research at Birmingham portal General rights Unless a licence is specified above, all rights (including copyright and moral rights) in this document are retained by the authors and/or the copyright holders. 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Take down policy While the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive. If you believe that this is the case for this document, please contact [email protected] providing details and we will remove access to the work immediately and investigate. Download date: 30. Sep. 2021 Article SPARC preserves endothelial glycocalyx integrity, and protects against adverse cardiac inflammation and injury during viral myocarditis Marieke Rienks a,b, Paolo Carai b, Jurgen van Teeffelen d, Bart Eskens d, Wouter Verhesen a, Bianca Hemmeryckx c, Daniel M. Johnson b, Rick van Leeuwen b, Elizabeth A. Jones c, Stephane Heymans b,c,e,† and Anna-Pia Papageorgiou b,c,† a - Cardiovascular Department, King's College London, United Kingdom b - Center for Heart Failure Research, Cardiovascular Research Institute Maastricht, The Netherlands c - Molecular and Vascular Biology, Department of Cardiovascular Sciences, KU, Leuven, Belgium d - Department of Physiology, Maastricht University, The Netherlands e - Netherlands Heart Institute, ICIN, Utrecht, The Netherlands Correspondence to Marieke Rienks: Cardiovascular Research Institute Maastricht, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands. [email protected]. https://doi.org/10.1016/j.matbio.2018.04.015 Abstract Myocardial damage as a consequence of cardiotropic viruses leads to a broad variety of clinical presentations and is still a complicated condition to diagnose and treat. Whereas the extracellular matrix protein Secreted Protein Acidic and Rich in Cysteine or SPARC has been implicated in hypertensive and ischemic heart disease by modulating collagen production and cross-linking, its role in cardiac inflammation and endothelial function is yet unknown. Absence of SPARC in mice resulted in increased cardiac inflammation and mortality, and reduced cardiac systolic function upon coxsackievirus-B3 induced myocarditis. Intra-vital microscopic imaging of the microvas- culature of the cremaster muscle combined with electron microscopic imaging of the microvasculature of the cardiac muscle uncovered the significance of SPARC in maintaining endothelial glycocalyx integrity and subsequent barrier properties to stop inflammation. Moreover, systemic administration of recombinant SPARC restored the endothelial glycocalyx and consequently reversed the increase in inflammation and mortality observed in SPARC KO mice in response to viral exposure. Reducing the glycocalyx in vivo by systemic administration of hyaluronidase, an enzyme that degrades the endothelial glycocalyx, mimicked the barrier defects found in SPARC KO mice, which could be restored by subsequent administration of recombinant SPARC. In conclusion, the secreted glycoprotein SPARC protects against adverse cardiac inflammation and mortality by improving the glycocalyx function and resulting endothelial barrier function during viral myocarditis. © 2018 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Introduction biopsy [2], the true incidence is still not precisely known yet, estimating 1 to 10 cases per 100,000 Myocarditis is defined as inflammation of the heart persons each year. muscle and can be caused by a variety of infectious Not only can acute viral myocarditis lead to sudden and non-infectious illnesses. Amongst the infectious cardiac arrest [5], but it is also a major cause of causes, viruses are supposedly the most frequent congestive heart failure [6] and in some cases even pathogens affecting the myocardium. The broad requires cardiac transplantation. Responsible cardi- variety of clinical presentations, make viral myocarditis otropic viruses, such as the entero-coxsackie B a complicated condition to diagnose and treat. Despite viruses, can induce this severe cardiac inflammation combining the standardized criteria for histological in susceptible patients, resulting in heart failure and diagnosis of myocarditis [1] with endomyocardial possibly sudden death. This form of heart disease is 0022-2836/© 2018 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Matrix Biol. (2018) 74,21–34 22 SPARC preserves endothelial glycocalyx integrity particularly devastating as it affects previously healthy [14,15]. The endothelial glycocalyx does not just young adults. In spite of our better understanding of infer the luminal lining of the endothelium but in the causative cardiotropic viruses and consecutive fact encapsulates endothelial cells and expand immunological mechanisms that contribute to the towards the endothelial basement membrane [14]. development of cardiac dysfunction [7], diagnosis and Therefore, we investigated the role of the endothe- treatment for myocarditis are still poor. Elucidating the lial glycocalyx in regulating inflammation in viral underlying mechanisms of enhanced or sustained myocarditis in this study with a specific focus on cardiac inflammation can facilitate the development ECM protein Secreted Protein Acidic and Rich in of new specific therapies for viral myocarditis. Cysteine (SPARC). The cardiac extracellular matrix (ECM), comprised SPARC has been shown to regulate fibroblast of proteoglycans, glycoproteins and glycosamino- function in connective tissue [16–19] as well as glycans [8], plays an important role in intercellular tumour development and progression [20,21], bone communication during cardiac disease [9,10]. Since homeostasis and repair [22], angiogenesis [23] and inflammation and heart failure reciprocally trigger cardiac ageing [18,24,25]. Moreover, both in vitro one another [11], we speculated that ECM proteins studies and in vivo murine oncology studies have may trigger heart failure development by potentiating recognized the increased vascular permeability in the immune response [12,13]. When addressing the the absence of SPARC [26,27], however the mech- interaction of the immune system and the ECM in anisms by which SPARC may influence vascular cardiac disease however, the prominent vascular permeability are still unclear. Where SPARC has gatekeeper known as the endothelial glycocalyx is been recognized for its fundamental roles as an often overlooked. This while the endothelial glycoca- adhesive component of the ECM, no attention has lyx is comprised of similar proteoglycans, glycopro- been given to the extracellular lining of the endothe- teins and glycosaminoglycans to the cardiac ECM lium as a possible immune-regulating structure and is known to regulate inflammation, vascular housing SPARC [14]. As the expression of SPARC permeability, coagulation and mechanotransduction is low during normal post-natal life but dramatically A B C D CD45 Viral myocarditis m R N A ).u WT 20 4 %) 100 %) *** ( a . ( KO a ( 15 3 i v a l H 5 s i o n D V a r e C D 4 AP 10 2 v 50 r s S u e G /3 e x p r o f L 5 1 VB C 0 0 0 WT KO WT KO 0 20 40 60 80 Time (days) E F Sham Viral myocarditis ) ) 300000 ) 300000 600000 o c a r d i u m 600000 d WT n=6 WT n=5 WT n=5 i u m WT n=5 ) o o o d KO n=5 KO n=5 lb KO n=3 0.08 KO n=4 r d olb s ( 400000 c a 200000 200000 400000 0.08 s ( t y o * m y n e n t e m 200000 ( 100000 v 100000 200000 ( # e n t s # e v s n t * v e 0 v e 0 0 0 slle B - c e l l s e s sll e s s e sll T - c e l l s s u l o c y t e s t e s sl sl s - c e l l s e s sll s s # e s e s s l l T - c e l l t e - c e l l l e ty c e l # t e c y t t e + c e t c y t D 4 5 + c e c y t c e e e c y y c y -T y c- y n o c c n o c B- u l o c o n o c o n o c o T lu B o M o n o B o + + C D 4 5 l n C D 4 5 5 o o G r a n u m o n D 4 r a n n m a M a M M r ih r ih C C G G G C C 6 L y 6 y L Fig.