手術後の冠動脈の治癒困難の理由を解明(Why coronary arteries struggle to heal after surgery)

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2025-11-14 バージニア工科大学(Virginia Tech)

米国で年間60万件行われる冠動脈ステント留置やバイパス手術は、処置時に血管内皮が失われることで治癒不良が起こり、再狭窄につながることが課題となっている。フレリン・バイオメディカル研究所のScott Johnstoneらは、血管損傷後にコネキシン43(Connexin43/Cx43)が内皮細胞で増加し、傷口の修復を促す重要なタンパク質であることを明らかにした。マウスモデルでCx43を機能停止させると治癒が大幅に遅れたことから、Cx43が正常な血管修復に不可欠であることが示された。研究チームは、このタンパク質を治療標的とすることで、手術後の回復促進や合併症の減少につながる可能性を指摘している。

手術後の冠動脈の治癒困難の理由を解明(Why coronary arteries struggle to heal after surgery)
A microscopic image of a blood vessel after the endothelium is damaged. The endothelial cell lining is red; the blood vessels’ walls are green; and the cells’ nuclei are blue. Image courtesy of Scott Johnstone.

<関連情報>

傷害誘発性コネキシン43発現は内皮創傷治癒を制御する Injury-induced connexin 43 expression regulates endothelial wound healing

Meghan W. Sedovy, Mark C. Renton, Kailynn Roberts, Xinyan Leng, Clare L. Dennison, Caroline O. Toler, Melissa R. Leaf, Paul D. Lampe, Angela K. Best, Brant E. Isakson, and Scott R. Johnstone
Heart and Circulatory Physiology  Published:2025 Nov 11
DOI:https://doi.org/10.1152/ajpheart.00153.2025

Abstract

Endothelial cell (EC) injury is a major contributing factor to vascular surgical failure. As such, understanding the mechanisms of endothelial healing is essential to the development of vascular therapeutics and procedures. Gap junctions formed by connexin 43 (Cx43) are implicated in regulating skin wound healing, but their role in endothelial healing is unknown. Secondary analysis of RNA-seq data from in vivo injured mouse aortas (GEO: GSE115618) identified significant Cx43 upregulation in EC postinjury. We developed a novel in vivo model of EC injury using mouse carotid artery ligation to test the role of Cx43. We identified that EC immediately adjacent to the wound edge upregulate Cx43 protein expression, predominantly at cell-cell junctions. We show significantly delayed EC healing in a mouse model of inducible EC-specific Cx43 deletion [EC-Cx43 knockout (KO)] at 24 h post ligation. Single-cell RNA-seq analysis of 10,829 cells from 18 h injured EC-wild type (WT) and EC-Cx43 KO carotids revealed a Cx43-associated reduction in enrichment of EC pathways associated with migration, proliferation, and ERK/MAPK signaling pathways. Finally, the importance of Cx43 phosphorylation on EC healing was tested in mice with single-point alanine mutations (phospho-null) in known phosphorylation sites that alter Cx43 channel assembly and opening. Mice containing alanine mutations at ERK phosphorylated Cx43 serines (Cx43S255/262/279/282A) have reduced healing rates similar to EC-Cx43 KO mice. These data suggest that EC injury-induced Cx43 upregulation and subsequent Cx43 gap junction-mediated cell-to-cell communication are required for normal EC migration during wound healing after vascular injury.

NEW & NOTEWORTHY These findings demonstrate for the first time that mechanical injury to large artery endothelium induces the expression of gap junction protein Cx43. This upregulation improves the migratory and proliferative capacity of endothelial cells at the wound edge, facilitating timely wound closure. This phenomenon is dependent on appropriate gap junction function and turnover.

医療・健康
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