Cardiovascular disease is a devastating disorder that has a major impact on length and quality of life. According to the CDC, approximately 27 million Americans carry the diagnosis of heart disease. The number of heart and vascular procedures (balloon angioplasties and vascular grafts) that will be performed in 2030 is ex- pected to be nearly twice the number performed in 2010. Similar increases will occur in the veteran population When a blood vessel is treated with angioplasty, the endothelial cells (EC) are removed. The cells must migrate from the edge of the injury into the area of injury to heal it. If healing is delayed, the chance of restenosis is increased. Lipid oxidation products accumulate in atherosclerotic arteries and at regions of injury, cause cellular dysfunction, and inhibit EC migration in vitro and in vivo. Limited re-endothelialization contributes to thrombogenicity, smooth muscle cell proliferation, and restenosis. Oxidized lipids cause an inappropriate increase in intracellular free calcium ion concentration ([Ca2+]i) through canonical transient receptor potential (TRPC) channels, specifically TRPC6. Activation of TRPC6 by causes an increase in [Ca2+]i that results in activation of TRPC5 and a prolonged increase in [Ca2+]i. The increased [Ca2+]i activates calpains that break down cytoskeletal proteins inhibiting EC migration. Studies in TRPC6-/- mice provide compelling evidence of the importance of this cascade in vivo. Re-endothelialization of injured carotid arteries is dramatically reduced in wild-type (WT) mice on a high fat diet compared with chow- fed mice, but in TRPC6-/- mice, hypercholesterolemia does not inhibit re-endothelialization of the injury. Considerable effort has been directed at identifying a TRPC6 inhibitor without success. Lipid oxidation products induce TRPC6 externalization by activating phosphatidylinositol 3-kinase (PI3K), which generates PIP3 (phosphatidylinositol (3,4,5)-trisphosphate). PIP3 is anchored in the cell membrane and binds to TRPC6, which promotes TRPC6 translocation to the cell membrane and leads to increased [Ca2+]i. We hypothesize that inhibition of PI3K can block the activation of TRPC6 channels by lipid oxidation products and restore EC migra- tion in vitro and promote EC healing of arterial injuries in vivo. To test this, we will 1) identify the PI3K iso- form(s) essential for TRPC6 activation, 2) investigate the effectiveness of isoform-specific PI3K inhibitors to re- store EC healing of arterial injuries in hypercholesterolemic animals, and 3) investigate the mechanism through which PIP3 interacts with TRPC6 to promote TRPC6 translocation to the membrane and activation to identify a more specific method of TRPC6 inhibition. The long-term scientific goal is to improve the outcome of ther- apeutic vascular interventions promoting endothelial surfacing of angioplasty sites, stents, and vascular grafts. In terms of a research career development, my short-term research goal is to develop a foundation in a focused research area that I can expand over the course of my career and which will serve as a complement to my clinical practice. My knowledge of vascular wall biology will increase through seminars and I will expand my experience in cellular molecular biology laboratory techniques over the course of the award, including protein extraction and analysis, small-inhibitory RNA transfection, and site directed mutagenesis. Over the course of the award, I will gain additional experience in biostatistics, scientific and grant writing, laboratory management and leadership, and mentoring. I will also continue to develop the critical thinking skills necessary for successful research plans. My primary long-term career goal is to transition to an independent investigator and compete for VA Merit Review and NIH funding. My long-term research goal is to more clearly define the mechanisms by which reactive oxygen species and the activation of TRPC channels inhibit endothelial cell healing. With progress in this area, mechanism-based treatment regimens can be developed, transitioned into clinical trials, and ultimately be carried into clinical practice to improve the long-term outcomes following vascular intervention.

Public Health Relevance

Cardiovascular disease is a devastating disorder that has a major impact on length and quality of life. The population is aging and between the years 2010 and 2030, the number of people over the age of 65 is expected to increase by 73% in the United States. The number of heart and vascular procedures (balloon angioplasties and vascular grafts) that will be performed in 2030 is expected to be nearly twice the number per- formed in 2010. Similar increases will occur in the Veteran population. Regardless of whether the veterans undergo endovascular management or open surgical intervention, the long-term results are limited by throm- bosis or restenosis. If endothelial cells migrate across the injured area and create an intact endothelial surface that prevents clotting and scar formation inside the blood vessels, the outcome for veterans undergoing procedures to treat heart and vascular disease will improve significantly. Improving outcomes will decrease the need for reintervention and improve veterans' quality of life, leading to a very high reward for the project.

Agency
National Institute of Health (NIH)
Institute
Veterans Affairs (VA)
Type
Veterans Administration (IK2)
Project #
5IK2BX003628-03
Application #
9635700
Study Section
Cardiovascular Studies B (CARB)
Project Start
2017-01-01
Project End
2021-12-31
Budget Start
2019-01-01
Budget End
2019-12-31
Support Year
3
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Louis Stokes Cleveland VA Medical Center
Department
Type
DUNS #
093016124
City
Cleveland
State
OH
Country
United States
Zip Code
44141
Chaudhuri, Pinaki; Rosenbaum, Michael A; Birnbaumer, Lutz et al. (2017) Integration of TRPC6 and NADPH oxidase activation in lysophosphatidylcholine-induced TRPC5 externalization. Am J Physiol Cell Physiol 313:C541-C555
Chaudhuri, Pinaki; Rosenbaum, Michael A; Sinharoy, Pritam et al. (2016) Membrane translocation of TRPC6 channels and endothelial migration are regulated by calmodulin and PI3 kinase activation. Proc Natl Acad Sci U S A 113:2110-5