1. Introduction
As we age, all of our biological processes and function lose their efficiency. Age is not a direct cause of death, but the decreased function of our bodies, brought on by age, is. It has been long recognized that aging is as a major risk factor for numerous diseases including inflammation, metabolic syndrome, and CVD. Leonard Hayflick [
1] observed that a culture of human tissue, in vitro, stopped dividing once the culture had reached a fixed threshold age via numerous cellular divisions. It was hypothesized that this phenomenon could be used to study human aging at the cellular level [
2].
Endothelial metabolic changes associated with aging have been linked to vascular remodeling in blood vessels [
3] and decline in blood flow and increased fluid shear stress, which become the driving force in activating platelets and inducing thrombosis. Aging-induced reduction in microcirculation plasticity and aging associated telomeric DNA damage contribute to the pathogenesis of range of age-related diseases, including brain [
4], heart [
5], kidney [
6], and eye disease. The general consensus is that aging is driven largely by reactive oxygen species (ROS) produced in mitochondria, which can lead to oxidative damage to mitochondrial protein, membrane and DNA. ROS has been documented to damage telomeric DNA effectively [
7,
8]. ROS also causes lipid peroxidation [
9] and promotes a prothrombotic state in vascular system. Hypertension, a limb of the metabolic syndrome, is associated with diabetes and impaired glucose tolerance. Notably, high glucose concentrations are associated with elevated ROS and reduced NO, highlighting the presence of a bidirectional response [
10]. These studies brought the conclusions that aging endothelial cells undergo metabolic changes that these cells are simply unable to maintain antioxidant-ROS balance. Moreover, the aging of cells could be directly linked to genomic DNA [
11] or environmental factors (such as salt intake and medications) that alter angiotensin II (Ang II, a potent vasoconstrictor) production [
12].
It has been suggested that replicative senescent endothelial cell is a feature of type 2 diabetes mellitus (T2DM) and atherosclerosis. Although endothelial dysfunction is recognized as an initial step in atherosclerotic vascular disease, it is advanced in diabetes. PRCP is expressed in endothelial cells. All arteries, veins, and capillaries of the human circulatory system produce PRCP. Plasma PRCP was elevated in diabetic patients [
13] while its substrate plasma kallikrein (the G allele of KLKB1 rs3733402) activity correlated with reduced history of CVD [
14]. PRCP plays a role in regulating the function of activated cells in restoring and maintaining cellular homeostasis. For instance, PRCP metabolizes Ang II [
15] to angiotensin (1-7) (Ang
1-7, a vasodilator) and angiotensin III (Ang III, a vasoconstrictor) [
16] to angiotensin (2-7) (Ang 2-7) at acidic pH [
17]. A recent evidence indicates that PRCP is capable of protecting the heart from Ang II -induced hypertrophic remodeling via controlling myocardial Ang II levels [
18]. Bradykinin (BK) protects endothelial cells. PRCP also activates the plasma PK to kallikrein in the presence of HK [
19]. Formed kallikrein cleaves HK to liberate BK [
20]. Activation of the BKB2 (B
2) receptors [
21] by BK and the Mas oncogene receptors [
22] by Ang1-7 lead, among others, to vasorelaxation and improving cell metabolism via the generation of nitric oxide (NO), which was found to prevent endothelial senescence [
23]. Strikingly, it is controversial as to whether Ang 1-7 mediates its effect via the proto-oncogene Mas receptors [
24]. Regardless of the binding of the Ang 1-7 to Mas receptors, PRCP is capable of inactivating both Ang II and Ang III, both of which play crucial roles not only in the release of aldosterone from the adrenal glands, but also in the modulation of vascular tone. Thus, PRCP backs the endothelium -dependent relaxation.
PRCP expression has been found to be altered under pathologic conditions of inflammation, hyperlipidemia, diabetes, obesity, and hypertension. The central issue of PRCP involvement in the pathogenesis of experimental hypertension and heart transplant patients was defined as an essential identity for both renal and cardiac Ang1-7 formation [
25]. Wu et al. [
26] observed susceptibility for hypertension in Han Chinese without history of diabetes mellitus (DM) with the G allele of PRCP SNP rs7104980. Another interesting observation suggests that this SNP of PRCP may be a potential cardiovascular risk factor for percutaneous transluminal coronary angioplasty (PTCA) [
14]. A decrease in PRCP level was reported following chronic ethanol regimen in spontaneously hypertensive rats (SHRs) [
27]. Furthermore, their findings also indicated that the downregulation of PRCP in addition to enhanced RAS activity may provoke further deterioration of left ventricular (LV) systolic dysfunctions in SHRs. While PRCP gene variant affects the progression of hypertension [
28], its depletion results in vascular dysfunction and faster arterial thrombosis in mice [
29]. Endothelial dysfunction is induced in hypertensive patients [
9]. Additional studies are required to confirm whether PRCP plays an essential role in endothelial cell regulation.
Here, we aimed to examine (1) whether senescent HPAECs are predisposed to enhanced PK activation due to enhanced HK binding, (2) whether senescent HPAECs express lower levels of PRCP mRNA, protein, and activity and produce less NO compared with early passage cells, and (3) whether the inhibition of PRCP is associated with the disruption of mitochondrial bioenergetics in HPAECs.
3. Discussion
PRCP has emerged as a cardioprotective protease with imperative implications for cardiovascular health. PRCP may have crucial physiological functions in the kidney, heart, brain, and in particular, in endothelial cells, which regulate in coordination with vascular smooth muscle cells to help the blood flow to tissues. Recent research studies provided compelling evidence that PRCP protects against the impairment of both heart [
18] and kidney [
58] and help to dampen elevated blood pressure [
17]. PRCP is associated with a significantly increase risk of preeclampsia [
28], metabolic condition [
13], including IgA nephropathy (IgAN), an autoimmune disease, pathogenesis [
59]; however, several of the underlying mechanisms have yet to be fully elucidated.
The aim of the present study was to examine the effects of aging on PRCP in cultured HPAE cells. Due to its ability to regulate various vasoactive peptides that help to control water and electrolytes, cause smooth muscles in the heart and the blood vessels to relax, and delay thrombus formation through the activation of the plasma kallikrein-kinin system (KKS) and regulation of angiotensin molecules. PRCP-dependent pathways appear to represent a remarkable role in vascular physiology and in the development of cardiovascular disease. The major findings of this study are as follows: (1) this study addressed significant gap in PRCP data related to endothelial injury during the aging process, (2) as the cell ages the expression of PRCP and the activity of PK, a PRCP substrate, are increased in the early stages of senescent cells, (3) the possible molecular mechanisms underlying the PRCP-induced vascular protection is found to be via a progressive elevation of the production of NO during the replicative cell senescence, (4) Increased PRCP expression is associated with progressively reduced hTERT expression in age-related HPAEC dysfunction, suggesting PRCP could be an early predictor of endothelial dysfunction, and (5) UM8190 may also act as an inhibitor of complex I of mitochondrial respiratory chain.
Both plasma KKS and the renin-angiotensin system (RAS) serve a central role in the regulation of renal, cardiac, and vascular physiology. The activation of these two intertwined pathways have significant role in numerous common pathology conditions including inflammation, heart failure, renal disease, and diabetes. While both KKS and RAS are tightly regulated system and recognize different receptors that are expressed on endothelial cells, they keep their effect at just the right level by sharing enzymes (angiotensin converting enzyme, PRCP) that perform more than one function. While kinins (BK, des-Arg
9-bradykinin), metabolites of both plasma KKS and tissue KKS, can increase vascular permeability and vasodilation, angiotensin II and angiotensin III molecules, metabolites of RAS, can cause vasoconstriction
in vivo. The endothelium maintains the delicate balance between these two physiological functions [
60] to give instantaneous power to generate the forward-moving pushing blood wave in order to prevent coagulation, fibrinolysis, and inflammation by producing NO and other regulatory factors [
61], while accepting nutrients from the blood.
The process of vascular disease is complex and is co-regulated by multiple interwoven signaling pathways leading to endothelial dysfunction or damage, whereas increasing evidence suggests that chronic low-grade inflammation in the pathology of numerous age-related chronic conditions (such as insulin resistance, hypertension, vascular aging) is one of the initiating events [
62,
63,
64]. Endothelial senescence is considered to be a hallmarks of aging [
65]. Most importantly, the impairment of endothelium contributes to compromised tissue perfusion and induces functional decline in older individuals [
66].
By investigating the effects of HK and PK complex on senescent endothelium cells, we found a great starting point to investigate whether the PK activation in the presence of cell- bound HK may help to delay cell dysfunction. Evidence has revealed a strong connection between PRCP certain facets of autophagy [
67], and a causal relationship was found among kallikrein activity, angiotensin II and PRCP [
18,
68]. This study showed that the PRCP-mediated kallikrein-kinin pathway delayed endothelial cell senescence by promoting cellular survival through generation of NO, a vasodilative molecule. Taken together, this finding may be explained by the idea that PRCP helps to prevent free radical induced cell injury via not only the production of NO, but it also through a previously described process of autophagy [
67], a complex and diverse homeostatic phenomenon.
Cellular replicative senescence is a slow, biological process of aging that involves the accumulation of various changes to the internal environment of a cell, most notably the buildup of acidic β-gal. These changes, both structural and molecular in nature, disable metabolism of many cellular processes and eventually lead to the induction of apoptosis. As cells divide, the ends of chromosomes, and telomeres, slowly shorten. Once telomere shortening reaches critical levels, those chromosomes may no longer replicate properly, leading to cellular process complication and apoptosis. Telomerase is a reverse transcriptase that is responsible to counteract telomere shortening and prolong cellular life span. To explore whether PRCP possesses a novel function in pro-survival pathway, we compared its expression against the expression pattern of hTERT. PRCP serves as a focal point in response to a variety of extracellular stimuli including Ang II, Ang III, kinin, and the plasma HK-PK complex. One of the crucial findings of this study demonstrated that the expression and function of PRCP was age-dependent. We also found that in comparison with low hTERT expression, PRCP expression was elevated in HPAECs. Since our study found age-dependent increase in PRCP expression that was proportional to decrease in telomerase expression, monitoring PRCP activity may be predictive of biological age.
Prior studies have shown that the endothelial senescence is triggered by numerous senescence stressors including oxidative stress and mitochondrial dysfunction [
36,
69]. In a previous work, we showed that overexpression of PRCP enhanced certain markers of mitochondrial autophagy [
67], the process by which damaged mitochondria are removed under mitochondrial toxicity conditions [
70] or may help to delay cell death. The chronic defects in mitochondrial proton-pumping NADH:ubiquinone oxidoreductase (complex I) [
71] or metformin-induced inhibition of complex I [
72] with an IC
50 value of 20 mM [
73] suppressed basal autophagy [
71] and prevented ROS generation by complex I.
The kallikrein proteomics analysis of the diabetic macular edema [
74] and antibody-array interaction mapping method to detect the activation of the plasma PK [
75], and hydrolysis of PK to kallikrein when bound to HK on cells to liberate BK [
76], have demonstrated their crucial role involved in disease-related signaling networks. Multiple lines of evidence indicate that damage occurs to the vascular endothelium is an early event in cardiovascular disease, switching from anti-thrombotic properties to prothrombotic state, and may therefore play a key pathogenic role in the disease. Ang II display numerous physiological actions, related mainly to the regulation of electrolytes and fluid osmolarity. While chronic elevation of Ang II induces hypertension that is accompanied by enhanced thrombosis in arterioles through the angiotensin type 2 receptor-dependent pathway [
77], treatment with angiotensin-converting enzyme inhibitors and angiotensin II type 1 receptor antagonists appear to affect the balance between the RAS and KKS axis, regulating not only blood pressure but also thrombosis [
78]. In contrast, prekallikrein null mice (
Klkb1-/-) exhibited a delayed artery occlusion times on the rose Bengal and ferric chloride thrombosis models [
79]. Interestingly, ablation of
Klkb1 dampened the progression of atherosclerosis in mice on Apoe-deficient background [
80]. We also showed that B
2 receptor knockout mice were protected from thrombosis by increased NO and prostacyclin [
81]. In brain, a compelling evidence demonstrated that the inhibition of plasma kallikrein reduced matrix metalloproteinase-9 activity [
82] following stroke and tissue plasminogen activator (tPA) therapy. Thus, PK activation is tissue specific. Remarkably, BK has been recognized as an inducer of tPA [
83,
84].
UM8190 inhibits PRCP [
50]. It also appears to inhibit complex I of mitochondrial respiratory chain. Evidence indicates that complex I inhibitors are capable of improving glucose homeostasis [
85]. Thus, while the clinical safety of UM8190 compound is largely unproven, its effect on complex I offers a promising and exciting strategy to control hyperglycemia and help prevent diabetes complications. Together, these data indicated that PRCP-dependent PK activation may serve as cell signaling molecule for a normal biologic process. Moreover, PRCP expression is elevated when endothelial cells are activated and may provide a novel strategy for the prediction of the risk and severity of vascular disease.
4. Materials and Methods
4.1. Materials
The HPAECs, EGM, FBS growth supplement, HEPES, 0.25% Trypsin-EDTA, and trypsin neutralizing solution were used as supplied by Clonetics (San Diego, CA). The HK and PK were purchased from Enzyme Research Laboratory (South Bend, IN). S2302 was purchased from DiaPharma (Franklin, OH). The primary antibody, Goat Anti-Human PRCP and the secondary Anti-Goat IgG: Whole Molecule, Peroxidase Conjugate were purchased from Bioscience (Long Beach, CA). Mouse Anti-Human β-Actin (Santa Cruz, CA). The “Nitrate/Nitrite Fluorometric Assay Kit” was purchased from Cayman Chemicals. The Cellular Senescence Assay Kit was purchased from Chemicon International (Temecula, CA). TRIzol, Super Signal West Femto Maximum Sensitivity Substrate, RiPA Buffer, Super Signal West Femto Maximum Sensitivity Substrate were supplied by ThermoFisher Scientific (Rockford, IL). the Precision Plus Protein standard (Dual Color) was purchased from Bio-Rad (Rockford, IL). Ethidium bromide was from Sigma-Aldrich (St. Louis, MO).
4.2. Endothelial Cell Culture
Human pulmonary artery endothelial cells (HPAECs) were grown and subcultured over time, from Passage 7 to Passage 40 in endothelial growth medium (EGM) according to manufacture recommendations. Cells were allowed three days to proliferate before each subculture procedure using 0.25% Trypsin-EDTA, DPSB, and the trypsin neutralizing solution (TNS). Right before detaching the cells from the flask to be subcultured, condition medium was removed and aliquoted and saved for further study. The cells were grown in fetal bovine serum (FBS) supplemented with EGM at a constant temperature of 37°C, in an environment with a constant carbon dioxide level of 5%.
4.3. HK/PK Activity
After obtaining a cell pellet from the trypsinized flask, 100 µL of the HPAECs were seeded at 30,000 cells / well of the 96 wells plate and incubated at 37°C incubator with 5% CO2. The cells were washed with HEPES-NaHCO3 buffer (137 mM NaCl; 3 mM KCl; 14.7 mM HEPES; 1 mM MgCl2; 2 mM CaCl2; 5.5 mM glucose and 0.1% gelatin, pH 7.1) and blocked with 1% HEPES-gelatin mixture for an additional 1 hr to reduce any non specific binding. At the end of incubation, the cells was washed twice with HEPES and treated with 20 nM HK for one hour. At the end of the incubation, the cells were washed and treated with 20 nM PK and incubated for additional hour. Finally, the cells were treated with 0.5 mM a HD-Pro-Phe-Arg-paranitroaniline substrate (S2302) and incubated for an hour. All incubations took place at a constant temperature of 37°C incubator with 5% CO2. The activity of formed plasma kallikrein was quantified by detecting the amount of free paranitroanilide in vitro, at 405 nm using the ELx800 Plate Reader (Bio-Tek).
4.4. Western Blot
Adherent cell monolayer were washed with DPSB. The protein cell lysates were extracted using the 1x RIPA Buffer (ThermoFisher Scientific) containg protease inhibitors and separated by electrophoresis in a 10% SDS-PAGE. After electrophoresis, the gel was transferred to a nitrocellulose membrane using electro-blot buffer ( 20% methanol, in 1x Tris/glycine) at 4 °C for one hour. Once transferred, the membrane was blocked with 5% non-fat, dry milk in PBS containing 0.1% Tween-20 (PBST) for an hour at room tempeture. Then, the membrane is treated overnight at 4 °C with 1:20 dilution of the primary antibody (Goat Anti-Human PRCP from Bioscience). The next day, the membrane was washed thrice with PBST and then treated with 1:1000 dilution of secondary antibody (Anti-Goat IgG: Whole Molecule, Peroxidase Conjugate from Bioscience). The membrane was washed thrice again with PBST before being treated with the “Super Signal West Femto Maximum Sensitivity Substrate,” courtesy of Thermo Scientific (Rockford, IL), a chemiluminescent substrate to be used for imaging with the ChemiDoc Imager (Bio-Rad).
Following the first set of imaging, the membrane was washed with 1x PBS and stripped with Thermo Scientific’s “Restore Western Blot Stripping Buffer” at room temperature for 15 minutes before being blocked again and re-probed with 1:100 dilution of the primary antibody (Mouse Anti-Human B-Actin from (Santa Cruz, CA), followed by 1:1000 dilution of secondary antibody (Anti-Goat IgG: Whole Molecule, Peroxidase Conjugate from Bioscience). After blocking, antibody treatments, and washing, the membrane was imaged again and a ratio between the two densities was calculated.
4.5. Nitrite/Nitrate Assay
The condition medium which was collected and stored over the course of growing HPAECs passages was used to measure nitric oxide. The “Nitrate/Nitrite Fluorometric Assay Kit” (Cayman Chemicals) was used to quantify the metabolites of endothelial nitric oxide. Samples of condition medium were adjusted to 80 µL with a 50/50 mix of fresh growth medium and assay Buffer. Enzyme Cofactors and Nitrate Reductase was added to each well and the plate was incubated for an hour at room temperature. Afterwards, DAN (2,3-diaminoaphthalene) was added, followed by sodium hydroxide. The plate was read (Ex 360-365 nm, Em 430 nm). By using the standard curve, the concentration of Nitrate + Nitrite of the sample was calculated.
4.6. Cellular Senescence Assay Kit
The “Chemicon International” Cellular Senescence Assay Kit was used on various passages of growing HPAE cells to qualify their percentage of senescent cells. Senescent-associated β-galactosidase (SA-β-gal) is only present in senescent cells, and Chemicon’s kit provides all reagents needed to detect SA-β-gal activity at pH 6.0 in cell cultures. SA-β-gal catalyzes the hydrolysis of X-gal, causing the accumulation of the blue dye in senescent cells.
4.7. Reverse-Transcriptase Polymerase Chain reaction and Agarose Gel
Cell pellets were resuspended using TRIzol (Life Technologies). The mRNA was extracted from subcultured HPAEC using QIAGEN’s “RNase-Free DNase Set.” RNA was put through reverse-transcription via Invitrogen’s “SuperScript III One-Step RT-PCR (with Platinum Taq) Kit.” We bought multiple human DNA primers from Invitrogen, including hTERT (SENSE – 5’ ATG GGG ACA TGG AGA ACA AG 3’ and ANTISENSE – 5’ GTG AAC CTG CGG AAG ACG GT 3’), B-Actin (SENSE – 5’ TGA ATG GAC AGC CAT CAT GGA C 3’ and ANTISENSE – 5’ TCT CAA GTC AGT GTA CAG GAA AGC 3’), FGF-2 (SENSE – 5’ TCA GCT CTT AGC AGA CAT TGG AAG AAA AAG 3’ and ANTISENSE – 5’ GGA GTG TGT GCT AAC CGT TAC CTG GCT ATG 3’), PRCP (SENSE – 5’ GTG GCT GAG GAA CTG AAA GC 3’ and ANTISENSE – 5’ TGT CAC CAA AGG GGA GAG AC 3’) , and eNOS (SENSE – 5’ ATG TTT GTC TGC GGC GAT GTT AC 3’ and ANTISENSE – 5’ ATG CGG CTT GTC ACT TCC TG 3’). The PCR products were visualized using 1-2% agarose gel containg ethidium bromide (agarose powder and ethidium bromide were purchased from Invitrogen and Sigma respectively) depending on the size of the expected PCR product.
4.8. Oxygen Consumption Rate Measurements on HPAE Cells
Mitochondrial respiration is measured using Oxytherm Clarke-type electrode System (Hansatech, Germany, distributed by PP System, MA) to monitor oxygen concentration in non-permeabilized or digitonin permebilized human pulmonary artery endothelial (HPAE) cells.
The confluent HPAE cells were dissociated using trypsin-EDTA solution. Trypsinized cells were centrifuged at 180 x g, for 5 mins at RT and the HPAE cell pellet was washed twice with DPBS and re-centrifuged. The final HPAE cell pellet was re-suspended in 1x PBS to a final cell density of 50 x 104 cells/ mL. 100 μl of cell suspention was used in 900 μl of Sodium Carbonate free DMEM/F/12 medium (Sigma, MO) for each non-permebilize assay ( 50 x 103 cells per run).
HPAECs mitochondrial respiration rate was measured in 1.0 mL of total respiration solution (Sodium Carbonate free DMEM/F/12 medium) at 37°C under continuous stirring. 100 μl of HPAE cells (50x104 cells/mL) was added to euilibrated media in Oxytherm incubation chamber with constant stirring. The mitochodrial respiration was performed in the absence or presence of UM8190.
To check the mechanistic mitochodrial function for each complex, respiration rate was measured either through complex I or complex II in mitochondria buffer (20 mm HEPES, 120 mm KCl, 2 mm KH2PO4, 2 mm MgCl2, 1 mm EGTA, pH = 7.3). We examine complex I function by using digitonin (12 μm) permeabilize HPAE cells in mitochondria buffer and start the respiration through complex I by adding malate (5 mM) and pyruvate (5 mM). The respiration rate of malate/pyruvate was inhibited with 1 μM rotinone ( a complex I inhibitor) and then the respiration was restored by adding succinate (5 mM) to stimulate mitochodrial respiration through complex II and generate ATP via OXPHOS (succinate dehydrogenase). The mitochondrial respiration, after addition of succinate was inhibited by antimycin A (an inhibitor of coenzyme Q–cytochrome C reductase and complex III or cytochrome bc1). Finally, the integrity of mitochondria was checked by adding ascorbate (5 mM) and N,N,N,N-tetramethyl-p-phenylenediamine (TMPD; 0.2 mM; Sigma, MO) to rescue respiration by stimulation of cytochrome C oxidase (complex IV). Respiration rates were measured for at least 15 min in each step or a steady state was reached. Baseline was recorded for normalization, then the test compounds were added alone or in combination. To examine the mitochodrial respiration rate through complex II, we used digitonin (12 μm) permeabilize HPAE cells in mitochondria buffer and add succinate (5mM) to start respiration through complex II. The respiration was inhibited by antimycin A (an inhibitor of coenzyme Q–cytochrome C reductase and complex III or cytochrome bc1). Finally, the integrity of mitochondria was checked by adding ascorbate (5 mM) and N,N,N,N-tetramethyl-p-phenylenediamine (TMPD; 0.2 mM) to rescue respiration by stimulation of cytochrome C oxidase (complex IV).