Vascular SMCs are specialized cells that express a contractile, quiescent phenotype, but are capable of undergoing significant phenotypic and functional alterations. As a result, mature SMCs are major contributors to pathological vascular remodeling. Using a highly specific SMC lineage-mapping approach, remarkably, we detected SMC-derived cells in the arterial adventitia, suggesting that mature SMCs contribute to both intimal and adventitial remodeling. The recent discovery that the normal adventitia is home to a resident population of vascular stem/progenitor cells with multiple fate potentials raised new and important questions about roles these cells play in growth, remodeling, repair, and disease of the artery wall. We described a population of adventitial vascular progenitor cells that express the progenitor cell markers Sca1 and CD34 (AdvSca1 cells) and cluster in an adventitial domain of hedgehog signaling. Our published work demonstrated two distinct subpopulations of AdvSca1 cells, one that derives from mature SMCs that undergo reprogramming in situ and is dependent on induction of the transcription factor, Klf4. Other groups have shown that induction of Klf4 in SMCs promotes SMC cell transitions in the setting in atherosclerosis and cancer progression, however the mechanism underlying Klf4 induction remains unknown. We also demonstrated that SMC-derived AdvSca1 cells (AdvSca1-SM) exhibit a multipotent phenotype capable of differentiating into multiple cell types. Further, we demonstrated that AdvSca1- SM cells expand rapidly in response to vascular injury suggesting that these cells are the dominant source of injury-induced adventitial remodeling. The full functional capacity of AdvSca1-SM cells in the setting of vascular disease remains unknown largely due to the lack of a reliable and specific lineage-mapping system. Our new data support the concept that the adventitial microenvironment is critical to the reprogramming process and promotes reprogramming through induction of constitutive Gli1 activity, which induces the long non-coding RNA (lncRNA) H19, and downstream activation of Wnt/?-catenin signaling. Wnt/?-catenin activity drives expression of the pluripotency genes, Myc and Klf4, resulting in SMC reprogramming and AdvSca1-SM cell maintenance and quiescence. In response to injury, AdvSca1-SM cells downregulate Gli1/H19/Wnt/?-catenin/Klf4 signaling, acquire a pro-fibrotic myofibroblast phenotype, and are the major contributors to vascular fibrosis. In contrast, mature SMCs downregulate SMC markers and acquire a progenitor cell phenotype. For this project, we propose that the unique adventitial microenvironment promotes SMC reprogramming by autonomous and constitutive activation of Gli1/H19/Wnt/?-catenin signaling (Aim One), that loss of Gli1/H19/Wnt/?-catenin activity promotes AdvSca1-SM-to-myofibroblast differentiation and adventitial fibrosis in the setting of injury or vasa vasorum expansion and plaque neovascularization in the setting of atherogenesis (Aim Two), and that the atherosclerotic plaque microenvironment promotes SMC reprogramming through a similar pathway to contribute to intimal SMC and macrophage accumulation (Aim Three).

Public Health Relevance

This project addresses several issues of central importance to our understanding of vascular disease. These include defining the mechanisms governing cell composition of the vessel wall, which is essential to understand normal maintenance of blood vessels, and the contribution of specific cell types to vascular disease progression. These studies will show how normal vascular muscle cells contribute to the stem cell populations that reside in the vessel wall, how these muscle-derived stem cells promote changes in vessel stiffness and hypertension or atherosclerotic plaque formation, how vascular muscle cells directly contribute to pathological disease progression, and will identify clinically relevant and targetable mechanisms pertinent to human disease that will facilitate the potential to manipulate muscle-derived stem cells to improve therapeutic applications.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Study Section
Atherosclerosis and Inflammation of the Cardiovascular System Study Section (AICS)
Program Officer
Olive, Michelle
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University of Colorado Denver
Internal Medicine/Medicine
Schools of Medicine
United States
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Bentzon, Jacob F; Majesky, Mark W (2018) Lineage tracking of origin and fate of smooth muscle cells in atherosclerosis. Cardiovasc Res 114:492-500
Brewer, Chris M; Majesky, Mark W (2018) Branch Point Smooth Muscle Cells Highlighted by Novel Lineage Tracking Approach. Circ Res 122:194-196
Majesky, Mark W (2018) Vascular Development. Arterioscler Thromb Vasc Biol 38:e17-e24
Berthiaume, Andrée-Anne; Hartmann, David A; Majesky, Mark W et al. (2018) Pericyte Structural Remodeling in Cerebrovascular Health and Homeostasis. Front Aging Neurosci 10:210
Majesky, Mark W; Horita, Henrick; Ostriker, Allison et al. (2017) Differentiated Smooth Muscle Cells Generate a Subpopulation of Resident Vascular Progenitor Cells in the Adventitia Regulated by Klf4. Circ Res 120:296-311
Weiser-Evans, Mary C M (2017) Smooth Muscle Differentiation Control Comes Full Circle: The Circular Noncoding RNA, circActa2, Functions as a miRNA Sponge to Fine-Tune ?-SMA Expression. Circ Res 121:591-593
Wu, Jing; Montaniel, Kim Ramil C; Saleh, Mohamed A et al. (2016) Origin of Matrix-Producing Cells That Contribute to Aortic Fibrosis in Hypertension. Hypertension 67:461-8
Majesky, Mark W (2016) Vascular Smooth Muscle Cells. Arterioscler Thromb Vasc Biol 36:e82-6
Majesky, Mark W (2015) Adventitia and perivascular cells. Arterioscler Thromb Vasc Biol 35:e31-5