Endothelial dysfunction plays a key role in the pathogenesis of diabetic vascular disease, which predisposes to ischemic cardiovascular events. These vascular disturbances may increase morbidity and mortality in diabetic patients. Endothelial dysfunction from diabetes is associated with altered metabolism and inactivation of small (SKCa) and intermediate (IKCa) conductance calcium-activated-potassium channels in the animal and human coronary vasculature. However, the precise mechanisms responsible for diabetic inactivation of SKCa/IKCa and coronary endothelial dysfunction are still undefined. Recently, we demonstrated that elevation in intracellular NADH results in a significant decrease in endothelial SKCa/IKCa, and the lack of changes in SKCa/IKCa gene/protein abundances in the setting of diabetes and ischemia/reperfusion (I/R) suggests that the effect is post-translational. The goal of this project is to investigate how metabolic changes during diabetes negatively regulate SKCa/IKCa channels of animal/human endothelial cells and endothelial function in the animal/human coronary microvasculature and to evaluate if SKCa/IKCa activation and/or metabolic modulation protect endothelial cells/vessels against diabetes and ischemic insults. We hypothesize that persistent overproduction of reactive oxygen species (ROS) via NADPH oxidase (Nox), dysfunctional mitochondria and PKC during diabetes will result in 1) inactivation of endothelial SKCa/IKCa, 2) impairment of coronary endothelial function/arteriolar relaxation; and that 3) inhibition of Nox and mROS and/or PKC SKCa/IKCa overexpression may potentiate SKCa/IKCa activator-induced endothelial protection of endothelial cells/coronary arterioles against a simulated cardioplegia I/R injury. Using a type-2 diabetic mice model and heart/vessels/endothelial cell samples from patients, we will test our hypothesis by completing 4 specific aims.
Aim 1 will investigate the molecular mechanisms by which persistent over-expression/activation of NADH/Nox during diabetes results in mROS and PKC overproduction/activation, leading to SKCa/IKCa inactivation, endothelial dysfunction/impaired vasodilatation, Aim 2 will elucidate the mechanisms by which persistent increases in mROS from the mitochondrial complex are required for diabetic inactivation of SKCa/IKCa, and endothelial function and arteriolar vasodilatation.
Aim 3 will define the signaling pathways by which persistent PKC activation during diabetes negatively modifies SKCa/IKCa, and coronary endothelial function and microvascular relaxation. These experiments will also determine if PKC mediates its effects on the SKCa/IKCa channel either by direct action on the channel complex or by causing channel isolation from the sarcolemma.
Aim 4 : To examine if pharmacologic inhibition/gene knockdown of Nox, mROS, PKC and/or SKCa/IKCa overexpression may potentiate SKCa/IKCa activator-induced endothelial protection against a simulated cardioplegic I/R injury. To achieve these goals, multiple approaches will be employed such as patch clamping, molecular and cellular biology, biochemistry, vascular physiology, diabetic mouse model and human heart tissue/vessel/cell samples. The present study should lead to novel therapeutic strategies to preserve coronary endothelial function and microvascular relaxation for diabetic or non-diabetic patients with ischemic heart disease during cardiac surgery.

Public Health Relevance

The goal of the proposed research is to determine how metabolic changes during diabetes mellitus negatively regulate the small (SKCa) and intermediate (IKCa) conductance calcium-activated-potassium channels and coronary endothelial function and to evaluate if inhibition of Nox, mROS and PKC, and/or SKCa /IKCa activation protects the animal and human coronary endothelium and coronary arterioles against ischemia and reperfusion injury. The present study will lead to novel therapeutic strategies for protecting coronary endothelium and microcirculation in diabetic and nondiabetic patients with ischemic heart disease during cardiac surgery.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL136347-04
Application #
9919369
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Fleg, Jerome L
Project Start
2017-04-01
Project End
2021-03-31
Budget Start
2020-04-01
Budget End
2021-03-31
Support Year
4
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Rhode Island Hospital
Department
Type
DUNS #
075710996
City
Providence
State
RI
Country
United States
Zip Code
02903
Sellke, Nicholas; Kuczmarski, Alex; Lawandy, Isabella et al. (2018) Enhanced coronary arteriolar contraction to vasopressin in patients with diabetes after cardiac surgery. J Thorac Cardiovasc Surg 156:2098-2107
Liu, Yuhong; Cole, Victoria; Lawandy, Isabella et al. (2018) Decreased coronary arteriolar response to KCa channel opener after cardioplegic arrest in diabetic patients. Mol Cell Biochem 445:187-194
Sellke, Nicholas; Gordon, Caroline; Lawandy, Isabella et al. (2018) Impaired coronary contraction to phenylephrine after cardioplegic arrest in diabetic patients. J Surg Res 230:80-86
Sabe, Sharif A; Feng, Jun; Liu, Yuhong et al. (2018) Decreased contractile response of peripheral arterioles to serotonin after CPB in patients with diabetes. Surgery 164:288-293
Feng, Jun; Anderson, Kelsey; Singh, Arun K et al. (2017) Diabetes Upregulation of Cyclooxygenase 2 Contributes to Altered Coronary Reactivity After Cardiac Surgery. Ann Thorac Surg 104:568-576
Potz, Brittany A; Scrimgeour, Laura A; Feng, Jun et al. (2017) Diabetes and Cardioplegia. J Nat Sci 3:
Feng, Jun; Anderson, Kelsey; Liu, Yuhong et al. (2017) Cyclooxygenase 2 contributes to bradykinin-induced microvascular responses in peripheral arterioles after cardiopulmonary bypass. J Surg Res 218:246-252