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The Department of Diabetes, Endocrinology and Metabolism (R.N., S.S., J.N.), City of Hope Medical Center, Duarte, California 91010; Research Service Detroit VA Medical Center and Department of Medicine (P.R.S., M.F.W., J.R.S.), Wayne State University, 48202; Research Service (M.L.G., J.W.L., K.C., B.D.), Denver VA Medical Center and Department of Medicine University of Colorado Health Sciences Center, Denver, Colorado 80220
Address all correspondence and requests for reprints to: Boris Draznin, M.D., Ph.D., VA Hospital (151), 1055 Clermont Street, Denver, Colorado 80220. E-mail: bdraznin{at}sembilan.uchsc.edu
| Abstract |
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In this study, we demonstrate that insulin increases the amount of farnesylated p21Ras in vascular smooth muscle cells (VSMC), thereby augmenting the pool of cellular Ras available for activation by platelet-derived growth factor (PDGF). In VSMC incubated with insulin for 24 h, PDGFs influence on GTP-loading of Ras was significantly increased. Furthermore, in cells preincubated with insulin, PDGF increased thymidine incorporation by 96% as compared with a 44% increase in control cells (a 2-fold increment). Similarly, preincubation of VSMC with insulin increased the ability of PDGF to stimulate gene expression of vascular endothelial growth factor 5- to 8-fold. The potentiating influence of insulin on PDGF action was abrogated in the presence of a farnesyltransferase inhibitor. Thus, the detrimental influence of hyperinsulinemia on the arterial wall may be related to the ability of insulin to augment farnesyltransferase activity and provide greater amounts of farnesylated p21Ras for stimulation by various growth promoting agents.
| Introduction |
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On the other hand, patients with diabetes mellitus have a substantially increased risk of developing and dying of cardiovascular disease. Eight prospective studies with patient numbers ranging from 121 in the Whitehall Study to over 5,000 in the Multiple Risk Factor Intervention Trial (MRFIT), have concluded that patients with diabetes exhibit greatly increased cardiovascular morbidity and mortality (5, 15, 16, 17, 18, 19). High levels of insulin have also been found to be associated with large vessel disease in both diabetic and nondiabetic individuals (20, 21, 22, 23).
In most instances, endogenous hyperinsulinemia occurs in states of insulin resistance (24, 25). In fact, hyperinsulinemia is a hallmark of the insulin resistance, manifested otherwise by normal or high levels of glucose in the face of hyperinsulinemia. Insulin resistance has also been linked to cardiovascular disease, although it has been extremely difficult to decipher whether hyperinsulinemia or insulin resistance plays the most important role in the pathogenesis of atherosclerosis and CAD (1, 24, 26). The question of whether or not insulin has a direct effect on the vascular wall lies at the center of this controversy.
We have recently shown that insulin, a mild mitogen on its own, potentiates the influence of other growth factors on the Ras pathway in 3T3 L1 fibroblasts and adipocytes (27, 28, 29). The mechanism of this potentiating influence of insulin appears to involve an activation of farnesyltransferase (FTase), an enzyme responsible for isoprenylation (farnesylation) of Ras proteins (30). Farnesylation is a posttranslational modification of Ras, required for its association with the plasma membrane (31). Because only farnesylated p21Ras is activated by GTP loading, regulation of farnesylation of Ras by insulin becomes critical for subsequent activation of the Ras pathway. Thus, via its stimulatory effect on FTase, insulin significantly augments the amounts of farnesylated and plasma membrane-associated p21Ras, thereby increasing the pool of cellular Ras available for activation by various growth factors. In the present study, we demonstrate that in porcine and rat vascular smooth muscle cells (VSMC), hyperinsulinemia significantly potentiates the mitogenic properties of platelet-derived growth factor (PDGF). In cells preincubated with insulin, PDGF caused greater activation of p21Ras, thymidine incorporation, and vascular endothelial growth factor (VEGF) gene expression. The influence of hyperinsulinemia was abrogated in the presence of a farnesyltransferase inhibitor, supporting our hypothesis that insulins effect is mediated by an increased activity of FTase and resultant increases in the size of the cellular pool of farnesylated p21Ras (28).
| Materials and Methods |
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-hydroxyfarnesylphosphonic acid (
-HFPA) was from Biomol (Plymouth
Meeting, PA), all supplies and reagents for SDS-PAGE were from Bio-Rad
(Hercules, CA), and the enhanced chemiluminescence kit (ECL) was from
Amersham (Arlington Heights, IL).
Culture of rat and porcine VSMC
Freshly disassociated VSMC were isolated from rat aorta and tail
arteries Wistar, Charles River Laboratories (Wilmington, MA) using
techniques previously described (32). Porcine VSMC were cultured from
porcine smooth muscle explants and used from passages 26 as described
earlier (33). Cells were cultured in DMEM containing 100 mg/dl glucose
and 10% FCS.
Separation of farnesylated and unfarnesylated p21Ras
VSMC were serum-starved overnight and incubated with or without
insulin (10 nM) for the indicated times. Equal volumes of
cell lystate and 4% Triton X-114 were combined in a borosilicate glass
tube, vortexed and incubated at 37 C for three minutes. Solutions were
kept at room temperature until phases had separated. Equal samples from
each phase were placed in separate 1.5 ml Eppendorf tubes, and p21Ras
was immunoprecipitated using a monoclonal antibody (Y13259). Relative
amounts of p21Ras were determined by Western blotting followed by
densitometry (27, 28).
Insulin-mediated p21 Ras·GTP formation
Confluent VSMC were serum and phosphate starved for 24 h
and labeled with 32P-orthophosphate (250 µCi) overnight.
Cells were then incubated with or without insulin (10 nM)
for 24 or 48 h as indicated. In some experiments, cells were also
incubated with the farnesyltransferase inhibitor
HFPA (1
µM). Cells were then challenged with PDGF for 10 min
after preincubations with insulin. Precleared cell lysates were
immunoprecipitated with anti-Ras antibody (Y13259), and the
nucleotides were separated by thin layer chromatography. GTP and GDP
were visualized by autoradiography and using acid molybdate reagent,
cut, and quantified by liquid scintillation counting (28).
Thymidine incorporation
Rat aortic VSMC (passages 68) were plated onto 6-well plates
and allowed to reach 80% confluence. At that time, the medium was
aspirated and replaced with serum-free D-MEM/F-12 (Gibco BRL,
Gaithersburg, MD) with and without the FTase inhibitor (1
µM). After 36 h, insulin (10 nM) was
added to half the wells and incubation continued before addition of
PDGF-BB (human recombinant PDGF from Gibco BRL). Cells were incubated
for a further 6 h before 3H-thymidine (1 µCi/dish)
incorporation for 1 h at 37 C. After washing with cold PBS the
cells were precipitated with 10% TCA and solubilized with 0.4
N NaOH. Samples were dissolved in Opti-Fluor before
scintillation counting (Tri Carb 2500 TR) Packard (Downers Grove, IL).
Aliquots of each sample were reserved for protein determination Bio-Rad
Laboratories (Hercules, CA) and thymidine incorporation corrected for
protein content.
Northern blotting to detect VEGF messenger RNA (mRNA)
Nearly confluent porcine VSMC in 100-mm dishes were made
quiescent by placing in medium containing 0.4% FCS and 0.2% BSA for
24 h. Cells were then rinsed with PBS and placed in fresh medium
containing 0.2% BSA alone. Insulin (10 nM) was added
24 h later to indicated dishes. After a further 24 h period,
PDGF-BB was added to some dishes and the cells incubated for another
3.5 h. At the end of this period, the plates were cooled on ice
and RNA was extracted using RNA-STAT 60 (Teltest, Friendswood, TX).
Total RNA (20 µg) from each of the samples was size fractionated on
1.2% agarose gels containing 0.5% formaldehyde. The denatured RNA was
then transferred to positively charged nylon membranes and hybridized
to the specific 32P-labeled VEGF complementary DNA (cDNA)
probe. The plasmid containing a 930-bp fragment of the human VEGF cDNA
was a gift from Genentech (San Francisco, CA). The cDNA probe was
radiolabeled with
-32P-dCTP using a random primer
labeling system. Hybridization was performed in 50% formamide
containing 4 x SSPE, 5 x Denhardts solution, 3% SDS and
0.5 mg/ml salmon sperm DNA at 42 C overnight. Washing conditions were
2 x SSPE/0.1% SDS at room temperature for 15 min, 1 x
SSPE/0.1% SDS at 37 C for 15 min, and 0.5 x SSPE/0.1% SDS at 53
C for 15 min. Blots were exposed to KODAK film for 24 h. Control
for RNA quantity and loading efficiency was determined from ethidium
bromide stains of 18S and 28S RNA as well as by the measurements of the
levels of mRNA of glyceraldehyde 3-phosphate dehydrogenase (GAPDH), a
housekeeping gene. The autoradiograms and gels were analyzed by
densitometry to quantitate the ratio of VEGF to 18S and 28S or to GAPDH
mRNA.
| Results |
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-HFPA (1 µM), completely inhibited the potentiating
influence of insulin. The effect of
-HFPA was apparent within 30 min
of incubation, and had no detrimental influence on cell viability, as
assayed by DNA synthesis.
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-HFPA.
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| Discussion |
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Although insulin is a relatively weak mitogen, the detrimental
influence of hyperinsulinemia on the arterial wall may be related to
its ability to potentiate the mitogenic action of other growth factors.
We now demonstrate that hyperinsulinemia augments the magnitude of the
nuclear action of PDGF in the VSMC, presumably via its effect on FTase
and the size of the cellular pool of farnesylated p21Ras (Fig. 1
).
These observations provide additional strong experimental evidence that
hyperinsulinemia may directly affect the vascular wall by enhancing
cellular responses to growth factors and other substances working via
the Ras pathway. Among these substances are adrenergic agonists,
cytokines, and advanced glycosylation end-products (37, 38). The latter
have been recently shown to activate the Ras pathway in VSMC (38).
Insulin increases mitogenic signaling pathways and increases thymidine incorporation into DNA in vascular endothelial and smooth muscle cells (26). Many of the effects of insulin on vascular growth and remodeling are likely to be mediated through an insulin-like growth factor (IGF-1) receptor in endothelial and VSMC (39, 40, 41) or indirectly by stimulating IGF-1 synthesis by VSMC (41). Insulin and IGF-1 are structurally related, share receptors, and have similar postreceptor actions. Unlike insulin, which must traverse the endothelium before acting on VSMCs in vivo, IGF-1 is synthesized by VSMCs and is more likely to act in autocrine and paracrine processes. In addition to stimulating vascular cell mitogenesis and growth, IGF-1 enhances proteoglycan synthesis by microvascular and macrovascular endothelial cells (41). However, activation of FTase, with resultant increases in the amount of farnesylated p21Ras, appears to be specific for insulin but not IGF-1 (unpublished observations). At the same time, we have demonstrated that hyperinsulinemia potentiates activation of p21Ras by IGF-1 at least in 3T3-L1 fibroblasts (28). Whether similar potentiation of IGF-1 action exists in VSMC remains to be examined.
PDGF is secreted by platelets and vascular cells and appears to play a
key autocrine/paracrine role in the development of diabetic vascular
complications and atherosclerosis (42, 43, 44, 45). In the present study, we
assessed two nuclear actions of PDGF: thymidine incorporation and VEGF
expression. Both effects were significantly potentiated by
hyperinsulinemia (Figs. 3
and 4
). VEGF is a potent angiogenic and
vascular permeability factor and can induce monocyte migration through
the endothelium (46, 47, 48). These events are essential early steps in the
atherosclerotic process that, in turn, are mediated by the actions of
multiple growth factors, lipids and cytokines (49). Growth factors such
as angiotensin II and PDGF induce VEGF in VSMC (35, 36, 50). Thus, VEGF
is an attractive candidate for the pathological neovascularization and
endothelial permeability observed in atherosclerosis (51). The present
results show that hyperinsulinemia can augment PDGF-induced VEGF
expression, and provide new evidence for the role of insulin on the
development of atherosclerotic complications.
Although this study does not directly address the possible influence of hyperinsulinemia on the development of atherosclerosis, it provides strong evidence that it can influence this process. Hyperinsulinemia may create a new background in the signal transduction machinery, on which the development of atherosclerosis is significantly accelerated. In our previous studies, we demonstrated that insulin augments the ability of other growth factors to activate p21Ras (28). The novel aspect of the present investigation extends beyond this step and points out that insulin also augments nuclear responses to growth factors, in this case to PDGF. This study offers new evidence that hyperinsulinemia per se, without insulin resistance, may engender an atherogenic milieu in the cells of the vascular wall. Additional studies are needed to determine whether insulins effect on the amounts of farnesylated p21Ras directly promotes the development of atherosclerosis. If this is the case, inhibitors of FTase can play an extremely important role as potential therapeutic agents to retard the progression of atherosclerosis in hyperinsulinemic, insulin-resistant individuals.
| Acknowledgments |
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| Footnotes |
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Received March 23, 1998.
| References |
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