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Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224
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ABSTRACT |
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The endothelial cell (EC) lining of the pulmonary vasculature forms a semipermeable barrier between the blood and the interstitium of the lung. Disruption of this barrier occurs during inflammatory disease states such as acute lung injury and acute respiratory distress syndrome and results in the movement of fluid and macromolecules into the interstitium and pulmonary air spaces. These processes significantly contribute to the high morbidity and mortality of patients afflicted with acute lung injury. The critical importance of pulmonary vascular barrier function is shown by the balance between competing EC contractile forces, which generate centripetal tension, and adhesive cell-cell and cell-matrix tethering forces, which regulate cell shape. Both competing forces in this model are intimately linked through the endothelial cytoskeleton, a complex network of actin microfilaments, microtubules, and intermediate filaments, which combine to regulate shape change and transduce signals within and between EC. A key EC contractile event in several models of agonist-induced barrier dysfunction is the phosphorylation of regulatory myosin light chains catalyzed by Ca2+/calmodulin-dependent myosin light chain kinase and/or through the activity of the Rho/Rho kinase pathway. Intercellular contacts along the endothelial monolayer consist primarily of two types of complexes (adherens junctions and tight junctions), which link to the actin cytoskeleton to provide both mechanical stability and transduction of extracellular signals into the cell. Focal adhesions provide additional adhesive forces in barrier regulation by forming a critical bridge for bidirectional signal transduction between the actin cytoskeleton and the cell-matrix interface. Increasingly, the effects of mechanical forces such as shear stress and ventilator-induced stretch on EC barrier function are being recognized. The critical role of the endothelial cytoskeleton in integrating these multiple aspects of pulmonary vascular permeability provides a fertile area for the development of clinically important barrier-modulating therapies.
cytoskeleton; endothelium; actomyosin contraction; actin-binding proteins; acute lung injury
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PULMONARY VASCULAR BARRIER REGULATION: OVERVIEW |
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Despite recent therapeutic advances, inflammatory pulmonary conditions such as acute lung injury, acute respiratory distress syndrome, and sepsis continue to result in high rates of patient morbidity and mortality (3). Centrally involved in the pathogenesis of these processes and now recognized as a cardinal feature of inflammation, increased vascular permeability contributes to the profound pathophysiological derangements observed in these disorders. Because of the enormous surface area of the pulmonary vasculature, the pulmonary endothelium, which functions as a semipermeable cellular barrier between the vascular compartment and the interstitium, is particularly sensitive to the dynamic features of barrier regulation. Endothelial barrier properties are not uniform throughout the pulmonary vasculature, with greater macromolecule diffusion in postcapillary venules compared with pulmonary arterioles in whole lung models (91, 96, 118), whereas cultured microvascular endothelial cells (ECs) exhibit tenfold higher barrier properties than macrovascular EC as measured by electrical resistance across monolayers (13). Although the precise mechanisms that regulate this variability in segmental barrier function are unknown, barrier regulatory components such as Ca2+ signaling pathways and differences in content and regulation of barrier protective cAMP are likely involved (21, 80, 135).
The integrity of the pulmonary EC monolayer is a critical requirement
for preservation of pulmonary function, with two general pathways
described for the movement of fluid, macromolecules, and leukocytes
into the interstitium and subsequently the alveolar air spaces. The
transcellular pathway utilizes a tyrosine kinase-dependent, gp60-mediated transcytotic albumin route, whose regulation and function
are unclear but which may serve to uncouple protein and fluid
permeability (103, 127, 143). However, there is general consensus that the primary mode of fluid and transendothelial leukocyte
trafficking occurs by the paracellular pathway (Fig. 1), whose essential role in endothelial
permeability has been well supported by an impressive body of research,
including electron microscopy studies (69, 102), which
demonstrate the formation of paracellular gaps at sites of active
inflammation within the vasculature.
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Mechanistic approaches designed to understand EC paracellular gap
formation and barrier function have revealed the complexity of these
processes; however, several valuable paradigms have been developed. One
useful model describes paracellular gap formation as regulated by the
balance of competing contractile forces, which generate centripetal
tension, and adhesive cell-cell and cell-matrix tethering forces, which
together regulate cell shape changes (53). As outlined in
Fig. 2, both competing forces in this
model are intimately linked to the actin-based endothelial cytoskeleton by a variety of actin-binding proteins that are critical to both tensile force generation as well as to linkage of the actin
cytoskeleton to adhesive membrane components. In this review, we will
highlight the essential role of the EC cytoskeleton in linking these
elements to the modulation of vascular permeability within the
pulmonary circulation.
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EC CYTOSKELETON |
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The cytoskeleton is composed of three primary elements: actin microfilaments, intermediate filaments, and microtubules. Actin filaments are of critical importance to EC permeability, as demonstrated by the findings that cytochalasin D, a well-described disrupter of the actin cytoskeleton, increases EC permeability in cultured cells (129), whereas phallacidin, an actin stabilizer, prevents agonist-mediated barrier dysfunction (117). The actin microfilament system is focally linked to multiple membrane adhesive proteins such as cadherin molecules, glycocalyx components, functional intercellular proteins of the zona occludens (ZO) and zona adherens, and focal adhesion complex proteins (Fig. 2). Actin structures are also intimately involved in EC tensile force generation. ECs contain an abundance of the molecular machinery necessary to generate tension via an actomyosin motor, actin and myosin represent ~16% of total endothelial protein (159), and focally distributed changes in tension and relaxation can be accomplished by regulation of the level of myosin light chain (MLC) phosphorylation and actin stress fiber formation. There is excellent association between the development of transcellular actin cables, stress fibers, increased MLC phosphorylation, and enhanced tension development, with a key regulator of the EC contractile apparatus being the Ca2+/calmodulin (CaM)-dependent MLC kinase (EC MLCK) (an enzyme discussed in detail below).
The actin cytoskeleton is a dynamic structure that undergoes
rearrangement under the control of various actin binding, capping, nucleating, and severing proteins, which are intimately involved in
regulating the contractile status of cells (Table
1). For example, the
actin-depolymerizing activity of cofilin is inhibited by Rho-GTPase
pathway activation during stress fiber formation (101). In
addition, reduction in either expression or activity of the abundant
actin-severing protein gelsolin significantly decreases stress
fiber-dependent contraction in cultured cells (4). Another
actin-binding protein involved in cellular contraction is the 27-kDa
heat shock protein (HSP27), whose actin-binding properties are altered
by phosphorylation through a p38 mitogen-activated protein kinase
(MAPK)-driven pathway. Reduction of HSP27-induced inhibition of actin
polymerization alone can produce stress fiber formation (121,
126). Undoubtedly, important roles for additional F-actin
binding proteins in regulating cell contraction, potentially in a
splice-variant-specific manner (12), will continue to be elucidated.
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The roles of microtubules and intermediate filaments in EC barrier
regulation are much less defined. Microtubules are polymers of
- and
-tubulins that form a lattice network of rigid hollow rods spanning
the cell in a polarized fashion from the nucleus to the periphery while
undergoing frequent assembly and disassembly (153).
Historically viewed as separate and distinct cytoskeletal systems,
microtubules and actin filaments are now known to interact functionally
during dynamic cellular processes (64, 87). Microtubule disruption with agents such as nocodazole or vinblastine induces rapid
assembly of actin filaments and focal adhesions (9, 28, 149), isometric cellular contraction (28), which
correlates with the level of MLC phosphorylation (88),
increased permeability across EC monolayers (149, 155),
and increased transendothelial leukocyte migration
(85), whereas microtubule stabilization with
paclitaxel attenuates these effects. The mechanisms involved in these
effects are poorly understood but are likely to be mediated through
interaction with actin filaments, suggesting significant microfilament-microtubule cross talk and an intriguing role for the
microtubule cytoskeleton in EC barrier regulation.
Intermediate filaments represent the third major element involved in EC
cytoskeletal structure. Although they exhibit much greater diversity
than the highly conserved components of either actin microfilaments or
microtubules, intermediate filament proteins share a common dimer
structure containing two parallel
-helices, which combine to form
apolar fibrils that associate with an array of intermediate
filament-binding proteins while connecting to the nuclear envelope,
peripheral cell junctions, and other cytoskeletal components (23,
46). Intermediate filament proteins are expressed in a highly
cell-specific manner, with vimentin representing the primary protein
found in EC and other cells of mesenchymal origin (39).
Vimentin phosphorylation occurs rapidly in thrombin- or phorbol-stimulated endothelium (134); however, the role of
vimentin in EC structure and resultant barrier function remains
unclear. Early work utilizing an ethchlorvynol-induced model of EC
permeability failed to demonstrate any effects on intermediate filament
structure (160). Although a more recent report describes
dramatic alteration of actin and microtubule filaments in cultured
cells after peptide-induced vimentin disassembly (63),
fibroblasts derived from vimentin knockout mice displayed normal actin
and microtubule architecture, whereas the animals themselves developed
normally without any obvious phenotypic abnormalities
(24). These data suggest that potential roles for
intermediate filaments in EC cytoskeletal structure, and more
specifically barrier function, are likely to be subtle and subject to
compensation by biologic redundancy.
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REGULATION OF VASCULAR PERMEABILITY BY THE EC CONTRACTILE APPARATUS |
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Multiple studies have demonstrated a critical role for activation
of the contractile apparatus in specific models of agonist-induced EC
barrier dysfunction. A well-studied model is that evoked by thrombin, a
central regulatory molecule in the coagulation cascade. The dual
finding of microthrombi in the pulmonary microvasculature of
patients expiring from acute lung injury and recent success of
anticoagulant strategies at microcirculatory sites of inflammation (8) illustrates the relevance of this model to the study
of acute lung injury and barrier regulation. Thrombin increases
pulmonary lymph flow in awake sheep and also increases lung weight gain and reduces the sigma reflective coefficient in the isolated perfused lung, consistent with enhanced permeability (71, 98, 99). In vitro, thrombin induces a profound increase in EC albumin
permeability and a reduction in electrical resistance reflective of a
loss of barrier integrity through rapid actin cytoskeletal
rearrangement and force generation dependent on actomyosin interaction,
effects confirmed by fluorescent microscopy and biophysical
measurements (49, 50, 89, 125). A key EC contractile event
in several models of agonist-induced barrier dysfunction is the
phosphorylation of regulatory MLCs catalyzed by
Ca2+/CaM-dependent MLCK, which is sufficient to produce EC
contraction and barrier dysfunction (141, 161). The
inflammatory agonists thrombin and histamine both produce rapid
increases in MLC phosphorylation, actomyosin interaction, and EC
permeability, which can be significantly attenuated by treatment with
MLCK inhibitors (50, 148). In addition, MLCK inhibition
prevents transforming growth factor-
1-stimulated EC
permeability (75) and abolishes barrier dysfunction in
both rat lung models of ischemia-reperfusion injury
(84) and ventilator-induced lung permeability
(108). The EC contractile apparatus is activated by
polymorphonuclear neutrophil (PMN) adherence and diapedesis with
increased MLC phosphorylation, whereas reduction in EC MLCK activity
significantly attenuates leukocyte migration (55, 70, 122).
The regulation of the MLCK isoform in the endothelium is complex and
differs significantly from smooth muscle MLCK regulation. The only MLCK
isoform expressed in ECs is a 1,914-amino acid high-molecular-mass (214 kDa) protein derived from a single gene on chromosome 3 in humans,
which also encodes the smaller (130-150 kDa) smooth muscle MLCK
isoform (51, 94, 151). EC MLCK shares essentially
identical catalytic and CaM regulatory motifs with smooth muscle MLCK
(Fig. 3) but in addition includes a
unique 922-amino acid NH2 terminus containing multiple
sites for protein-protein interactions as well as sites for
p60src-catalyzed tyrosine phosphorylation, which regulate
enzyme activity (12, 51). Protein tyrosine phosphorylation
status appears to play an important role in regulation of EC
permeability, as demonstrated by the modest enhancement of barrier
function with the nonspecific tyrosine kinase inhibitor genistein
(17). More specifically, p60src-induced
tyrosine phosphorylation is critical for diperoxovanadate-induced EC
barrier dysfunction through increased contraction and altered focal
contacts (54, 131). EC MLCK may provide the link between tyrosine phosphorylation events and permeability changes because tyrosine phosphorylation of EC MLCK evokes significant increases in
MLCK activity, EC contraction, and subsequent EC barrier dysfunction while promoting the development of a contractile complex
containing EC MLCK, actin, myosin, CaM, p60src, and
the actin-binding protein cortactin (56, 58, 150).
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Recently, the critical importance of the small GTPase Rho in
regulation of the contractile apparatus has been demonstrated in
several models of agonist-induced EC barrier dysfunction. The Rho
family of small GTPases is involved in signal transduction linking
extracellular stimuli to dynamic actin cytoskeletal rearrangement (137), and activation of Rho specifically produces stress
fiber formation in cultured cells (119). Through its
downstream effector, Rho kinase, Rho activation leads to
phosphorylation of the myosin binding subunit of MLC phosphatase (PP1),
thereby inhibiting its phosphatase activity and resulting in increased
MLC phosphorylation, actomyosin interaction, stress fiber formation,
and subsequent EC barrier dysfunction (Fig.
4) (2, 38, 86).
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The relative contributions of the EC MLCK and Rho pathways in regulating EC permeability are not well understood: inhibition of either MLCK activity (50) or Rho activation (16, 18) attenuates thrombin-induced EC barrier dysfunction. A recent report suggests that Rho/Rho kinase and MLCK may differentially regulate MLC phosphorylation according to spatial localization within cultured cells (144). Additional complexity in the system is provided by the contribution of the p21-activated kinase (PAK) family, downstream effectors of the small GTPases Rac and Cdc42. Isoforms PAK1 and PAK2 have both been shown to phosphorylate smooth muscle MLCK and decrease MLCK activity in cultured cells (61, 123), but whether PAK regulates the high-molecular-mass MLCK present in endothelium in this fashion is not clear. Conversely, PAK2 can directly phosphorylate MLC to produce EC contraction (163). A complex interplay exists among these processes in regulating MLC phosphorylation status, cell tension, and subsequent EC permeability. Continued exploration of these pathways should provide additional important insights into the regulation of EC barrier function.
Despite the clear contribution of MLCK/Rho kinase-driven increases in
MLC phosphorylation to tension development and increased vascular
permeability, MLCK-independent pathways are also involved in the
regulation of cellular contraction (Fig. 4). Protein kinase C
(PKC)-mediated pathways exert a prominent effect on barrier regulation
in a time- and species-specific manner. For example, phorbol myristate
acetate induces a PKC-dependent increase in bovine pulmonary EC
permeability without significantly increasing MLC phosphorylation
and without inducing formation of actin stress fibers, whereas PKC
activation in human umbilical vein ECs does not have this
barrier-disrupting effect (19, 50, 134), likely reflecting
differences in PKC isotype-specific expression in the two species.
PKC-mediated increases in bovine EC permeability may occur through
phosphorylation of caldesmon, an actin-, myosin-, and CaM-binding
protein present in smooth muscle actomyosin cross bridges as a 145-kDa
protein and in EC as a 77-kDa protein (134). The
phosphorylation of caldesmon is known to alter smooth muscle cross-bridge activity (93). Caldesmon distributes along
stress fibers and is phosphorylated in EC after thrombin and phorbol myristate acetate challenge (134). Caldesmon-mediated
regulation of actomyosin ATPase in smooth muscle is also modified by
the actin cross-linking protein filamin and gelsolin (Table 1)
(66). Although filamin participates directly in barrier
regulation via CaM kinase II activation (14), its effects
on actin cytoskeletal rearrangement are regulated through Rho family
GTPases (6, 106), thereby providing another link with a
known modulator of EC barrier function. Tumor necrosis factor-
(TNF-
) slowly induces barrier disruption in cultured EC, which is
independent of MLCK activity (115). Finally, p38 kinase
activation has also been linked to contractile regulation in smooth
muscle (90), EC migration (97, 121), and
lipopolysaccharide-induced EC permeability (164). The
mechanism through which p38 exerts these effects is unclear but may
involve the actin binding protein HSP27 (162), a known p38
MAPK target whose actin polymerization-inhibiting activity dramatically
decreases after phosphorylation (7, 45) in association with stress fiber development (121, 126).
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ADHESIVE PROTEIN-CYTOSKELETON LINKAGES |
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Cell-cell and cell-matrix adhesions are essential for barrier maintenance and restoration and exist in dynamic equilibrium with EC contractile forces. Intercellular contacts along the endothelial monolayer consist primarily of two types of complexes, adherens junctions and tight junctions, which link to the actin cytoskeleton to provide both mechanical stability and transduction of extracellular signals into the cell (152). Adherens junctions are composed of cadherins bound together in a homotypic and Ca2+-dependent fashion to link adjacent EC (81). Cadherins interact through their cytoplasmic tail with the catenin family of intracellular proteins, which in turn provide anchorage to the actin cytoskeleton (1). The primary adhesive protein present in human endothelial adherens junctions, vascular endothelial (VE) cadherin (29), is critical to maintenance of EC barrier integrity as demonstrated by increased vascular permeability induced in mice after infusion of VE-cadherin-blocking antibody (25). Similarly in cultured EC, VE-cadherin-blocking antibody increased permeability (124) and enhanced neutrophil transendothelial migration while producing reorganization of the actin cytoskeleton (72). The observation that VE-cadherin-blocking antibodies produce barrier disruption primarily in the alveolar capillary bed (25) suggests that differential adherens junction functioning exists within segments of the pulmonary vasculature. The MAPK pathway may be involved in regulating adherens junction/VE-cadherin function because MAPK inhibitors attenuate vascular endothelial growth factor (VEGF)-mediated VE-cadherin rearrangement and subsequent EC monolayer permeability (83).
Tyrosine phosphorylation may provide an additional regulatory link between actin cytoskeletal rearrangement and adherens junction function. Pervanadate treatment of cultured cells resulted in tyrosine hyperphosphorylation of catenins, partial dissociation of the catenin-cadherin complex, and subsequent decreased cell-cell adhesion (107). Similarly, the anti-adhesive protein thrombospondin-1-induced tyrosine phosphorylation of adherens junction proteins, actin rearrangement, and increased albumin flux across EC monolayers, whereas tyrosine kinase inhibition attenuated these effects (62). Recent work suggests that, in addition to increasing contractile forces, thrombin also alters EC permeability through dissociation of the tyrosine phosphatase, SHP2, from VE-cadherin complexes to produce increased tyrosine phosphorylation of catenins and subsequent destabilization of adherens junction linkage to the cytoskeleton (145). However, a certain level of basal tyrosine phosphorylation is likely necessary for maintenance of cell-cell contacts since selective inhibition of specific tyrosine kinases can disrupt these attachments (41).
A critical function of the EC barrier is the regulation of neutrophil
(PMN) margination and migration into sites of acute inflammation, a
complex process involving cytokine/chemokine signaling and interaction
of specific recognition molecules (e.g., platelet endothelial cell
adhesion molecule-1) on PMNs and ECs (154). As evidence
for an integral role for the EC cytoskeleton and its connections in PMN
diapedesis, disruption of either the EC actin cytoskeleton with
cytochalasin B or stabilization of microtubules with paclitaxel
decreases leukocyte transendothelial movement, whereas disassembly of
microtubules increases PMN migration (85). The ability of
activated PMNs to increase EC permeability suggests that cross-cellular
signaling pathways are employed during the cytoskeletal rearrangements
of PMN transendothelial migration (57, 120). Binding of
PMN to EC causes disruption of adherens junctions, as evidenced by the
disappearance of VE cadherin and catenins from cell-cell contacts
(30). Adherens junctions appear integral to this process
because VE-cadherin-blocking antibodies increase PMN diapedesis
(72), whereas conversely tight junctions remain intact
during this migration (15). The signaling pathways involved in PMN diapedesis are not completely understood; however, elevation of intracellular Ca2+ likely plays a role
(73). Tyrosine phosphorylation pathways also appear
important because activated PMNs increase the phosphotyrosine content
of VE cadherin and
-catenin in association with adherens junctions
disruption and hyperpermeability (142).
Tight junctions consist of transmembrane proteins such as occludin, the claudins, and junctional adhesion molecules coupled to cytoplasmic proteins, including the ZO family (104). Tight junction-associated cytoskeletal proteins such as ZO-1 appear to participate in signal transduction and to provide a link between occludin and the actin cytoskeleton (40). The functional significance of confocal microscopy-observed colocalization of F actin and ZO-1 is supported by the finding that cytochalasin D inhibits cytokine-induced fragmentation of ZO-1 interendothelial staining (13). Alterations in tight junctions may be signaled through the MAPK pathway, as both VEGF and H2O2-induced occludin dissociation from cell junctions and EC barrier dysfunction were partially blocked by MAPK inhibitors (82, 83).
Focal adhesions comprise extracellular matrix (ECM) proteins (collagen,
fibronectin, laminin, vitronectin, proteoglycans), transmembrane
integrin receptors, and cytoplasmic focal adhesion plaques (containing
-actinin, vinculin, paxillin, and talin), which combine to provide
additional adhesive forces in barrier regulation and form a critical
bridge for bidirectional signal transduction between the actin
cytoskeleton and the cell-matrix interface (78, 128). ECM
protein composition modulates basal EC permeability as well as
TNF-induced barrier dysfunction (113, 158), whereas
antibodies to
1-integrin alter EC attachment, cell
spreading, and permeability (92). Extracellular stimuli can be transmitted to the cytoskeleton through focal adhesion rearrangement linked to integrin ligation. Unliganded integrins are not
associated with the cytoskeleton; however, ECM binding induces the
attachment of integrins to intracellular actin fibers (42), a process in EC that stimulates tyrosine
phosphorylation of multiple proteins [including paxillin, cortactin,
and focal adhesion kinase (FAK)] as well as tyrosine
phosphorylation-dependent Ca2+ influx (10,
11). Integrin binding also targets activated extracellular
signal-regulated kinase to newly formed focal adhesion sites
(44). Reciprocally, intracellular signaling pathways that regulate cytoskeletal rearrangement can also modulate cell-matrix contacts. Rho inhibition dissociates stress fibers from focal adhesions, decreases phosphotyrosine content of paxillin and FAK, and
enhances EC barrier function (18). Similarly,
v-Src-induced tyrosine phosphorylation of focal adhesion proteins is a
well-established stimulus for disassembly of these adhesive structures
(43); however, some basal level of tyrosine
phosphorylation appears necessary to maintain focal adhesions because
selective tyrosine kinase inhibition will disrupt these contacts
(41). In support of a barrier maintenance function for
tyrosine phosphorylation of focal adhesions is a recent report
describing the association of diperoxovanadate-induced transient EC
barrier enhancement with phosphotyrosine incorporation into FAK
(54). Further studies to clarify the role of
barrier-protective and barrier-disruptive tyrosine kinases in both
focal adhesion and adherens junction complexes will increase our
understanding of EC barrier regulation by tethering forces.
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PULMONARY VASCULAR CYTOSKELETAL AND BARRIER REGULATION BY MECHANICAL FORCES |
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The study of EC in static culture provides the opportunity to mechanistically evaluate the role of cytoskeletal components in physiological functions. However, it has been increasingly appreciated that this approach may have major limitations given that the pulmonary endothelium in its native state is continuously exposed to mechanical forces that greatly influence cellular structure and function. Shear stress activates signaling pathways (e.g., MAPK), leading to upregulation of transcription factors and subsequent gene expression of various vasoactive substances, growth factors, and adhesion molecules (22, 60). Active cytoskeletal rearrangement begins rapidly and continues to occur over several hours as ECs orient themselves to reduce both peak shear stresses and shear stress gradients (5, 47). The cellular mechanisms for sensing flow and transducing its signal are still unclear, but recent reports suggest that both apical actin stress fibers linked to cell-cell contact sites and integrin-mediated signal transduction are involved (20, 79).
When EC in static culture are exposed to shear stress, multiple signaling pathways implicated in cytoskeletal rearrangement are stimulated, including Ca2+ mobilization, G-protein activation, increased tyrosine phosphorylation, and MLCK and MAPK activation (65, 77, 130). These pathways interact downstream to produce the complex cellular effects of flow. For example, during shear stress, the GTPases Rho and Cdc42 combine to activate MAPKs; however, individually, Rho is necessary for flow-induced stress fiber formation and cell alignment and Cdc42 activates transcription factors (95). The integrated effects of these shear-induced signals on EC barrier function are variable depending on the magnitude, duration, and gradient of flow. Shear stress maximally increases protein expression of integrins after 12 h of exposure and significantly enhances cell-matrix attachment, suggesting that flow helps maintain the EC monolayer through augmentation of focal adhesions (146). However, ECs exposed to high shear gradients, or turbulent flow, develop increased permeability relative to areas of either constant laminar flow or no flow (116). The majority of these studies have been performed using systemic circulation EC, and pulmonary EC-specific responses to flow are not well understood. One mechanism by which shear stress may alter barrier function is by inhibition of EC apoptosis (31); however, our recent work using a TNF model under static conditions suggests distinct signaling and cytoskeletal involvement in cytokine-induced apoptosis and permeability (115).
Ventilator-induced lung injury, a topic recently reviewed in this journal (32), is a highly morbid clinical entity believed to be caused by excessive mechanical stretch of pulmonary airways and vasculature, producing fluid flux across capillaries primarily through an active endothelial response (33, 109, 110). Similarly, the contribution of capillary rupture in this process has recently been reviewed in this journal (157). Intracellular Ca2+ and tyrosine phosphorylation-dependent pathways appear to mediate the response to cell stretch (111, 112). In addition, reduction in endothelial tensile forces by MLCK inhibition significantly attenuates capillary leak in this model, illustrating the importance of the EC contractile apparatus in stretch-induced pulmonary edema (108).
The mechanism by which mechanical signals are transduced to the EC cytoskeleton is unclear but may involve the complex array of proteins that constitute the EC glycocalyx. The glycocalyx is a meshwork of glycoproteins and glycolipids that combine to form a cell-surface layer of anionic polymers that is variable across the vasculature (67). The components of the glycocalyx have been implicated in cytoskeletal organization as both syndecan, the primary heparin sulfate proteoglycan, and podocalyxin, the primary sialoprotein, modulating cell-cell and cell-matrix adhesion through their cytoplasmic domains (27, 35, 136). NMR techniques have demonstrated that cell-surface proteoglycans behave as viscoelastic anionic polymers, undergoing shear-dependent conformational changes, which may function as blood-flow sensors to transduce signals into the EC (132, 133).
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FUTURE DIRECTIONS |
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Although significant progress has been made in understanding the cellular and molecular events that regulate permeability, the goal of modulating the EC barrier in a clinically advantageous way remains elusive. Mechanistic investigation of known barrier-enhancing agents is essential to the development of novel therapeutic approaches, as evidenced by the failure of various clinical trials attempting to reduce the effects of individual cytokines or other mediators during sepsis or acute respiratory distress syndrome. One exciting exception is the recent report of significant mortality reduction in septic patients treated with recombinant activated protein C (8), although the exact mechanism by which activated protein C reduces microvascular injury is poorly understood. An alternative strategy to protect barrier integrity might instead focus on the downstream EC cytoskeletal rearrangements critical to the development of leakiness or barrier restoration. For example, agents designed to prevent the EC cellular contraction via reductions in hyperphosphorylation known to be essential for several models of agonist-induced pulmonary edema and ventilator-induced lung injury might facilitate restoration after barrier dysfunction occurs. It is therefore important to identify key regulatory events and effectors responsible for cytoskeletal modulation of pulmonary vascular permeability to hopefully provide a basis for the development of effective therapeutic interventions targeted toward the cytoskeleton. Further understanding of barrier restorative or barrier preserving mechanisms likely involved after short-acting edemagenic agents may provide valuable clues as to which therapies may shorten the edemagenic phase.
The study of angiogenesis may provide encouraging insights into mechanisms regulating EC permeability, a key event in angiogenic processes. For example, transgenic mice overexpressing angiopoietin-1 develop blood vessels resistant to the barrier-disruptive effects of inflammatory agents (140), whereas acute adenoviral vector delivery of angiopoietin-1 blocked VEGF-induced EC permeability (139). Recent in vitro work suggests angiopoietin-1 exerts its barrier protective effects by strengthening cell-cell contacts (48). Long recognized as critical to the integrity of the microvasculature (59), the barrier maintenance properties of platelets and platelet-derived phospholipids such as lysophosphatidic acid (37) and sphingosine 1-phosphate (J. G. N. Garcia, F. Liu, A. D. Verin, A. Birukova, M. A. Dechert, W. T. Gerthoffer, and D. English, unpublished observations), a distinct angiogenic factor, provide additional targets for exploration of pathways that enhance vascular integrity.
Finally, a viable area of interest concerns the physiological diversity of ECs along pulmonary segments, and, although at present the role of the cytoskeleton in the differential barrier properties of macrovascular vs. microvascular EC is unknown, exploration of this question may provide valuable insights into the regulation of pulmonary EC barrier function. The burgeoning field of DNA microarray technology provides an extremely powerful tool for this type of phenotypic analysis. With the Human Genome Project producing a wealth of sequence data, expression profiles of thousands of genes can now be assayed quickly and simultaneously (34, 68). Identification and analysis of single nucleotide polymorphisms in candidate cytoskeletal genes with defined barrier regulatory properties may also take us closer to understanding issues of individual variability in disease severity and therapy responses in edemagenic states. These exciting techniques provide an opportunity to determine critical regulatory genes responsible for complex processes such as barrier regulation and may reveal multiple novel targets for therapeutic intervention.
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ACKNOWLEDGEMENTS |
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This work was supported by National Heart, Lung, and Blood Institute (NHLBI) Grants P01 HL-58064 and R01 HL-50533 and the American Heart Association. S. M. Dudek received support from the Four Schools Physician-Scientist Program and NHBLI Grant HL-10403.
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FOOTNOTES |
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Address for reprint requests and other correspondence: J. G. N. Garcia, Division of Pulmonary & Critical Care Medicine, Johns Hopkins Asthma and Allergy Center, 5,501 Hopkins Bayview Circle, Baltimore, MD 21224 (E-mail: drgarcia{at}jhmi.edu).
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H. R. Ranaivo, N. Carusio, R. Wangensteen, P. Ohlmann, C. Loichot, A. Tesse, K. Chalupsky, I. Lobysheva, J. Haiech, D. M. Watterson, et al. Protection Against Endotoxic Shock as a Consequence of Reduced Nitrosative Stress in MLCK210-Null Mice Am. J. Pathol., February 1, 2007; 170(2): 439 - 446. [Abstract] [Full Text] [PDF] |
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C. D'hondt, R. Ponsaerts, S. P. Srinivas, J. Vereecke, and B. Himpens Thrombin Inhibits Intercellular Calcium Wave Propagation in Corneal Endothelial Cells by Modulation of Hemichannels and Gap Junctions Invest. Ophthalmol. Vis. Sci., January 1, 2007; 48(1): 120 - 133. [Abstract] [Full Text] [PDF] |
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N. J. Meyer and J. G. N. Garcia Wading into the Genomic Pool to Unravel Acute Lung Injury Genetics Proceedings of the ATS, January 1, 2007; 4(1): 69 - 76. [Abstract] [Full Text] [PDF] |
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G. L. Bentz, M. Jarquin-Pardo, G. Chan, M. S. Smith, C. Sinzger, and A. D. Yurochko Human Cytomegalovirus (HCMV) Infection of Endothelial Cells Promotes Naive Monocyte Extravasation and Transfer of Productive Virus To Enhance Hematogenous Dissemination of HCMV J. Virol., December 1, 2006; 80(23): 11539 - 11555. [Abstract] [Full Text] [PDF] |
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D. J. Angelini, S.-W. Hyun, D. N. Grigoryev, P. Garg, P. Gong, I. S. Singh, A. Passaniti, J. D. Hasday, and S. E. Goldblum TNF-{alpha} increases tyrosine phosphorylation of vascular endothelial cadherin and opens the paracellular pathway through fyn activation in human lung endothelia Am J Physiol Lung Cell Mol Physiol, December 1, 2006; 291(6): L1232 - L1245. [Abstract] [Full Text] [PDF] |
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P. V. Usatyuk, N. L. Parinandi, and V. Natarajan Redox Regulation of 4-Hydroxy-2-nonenal-mediated Endothelial Barrier Dysfunction by Focal Adhesion, Adherens, and Tight Junction Proteins J. Biol. Chem., November 17, 2006; 281(46): 35554 - 35566. [Abstract] [Full Text] [PDF] |
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P. A. Singleton, S. M. Dudek, S.-F. Ma, and J. G. N. Garcia Transactivation of Sphingosine 1-Phosphate Receptors Is Essential for Vascular Barrier Regulation: NOVEL ROLE FOR HYALURONAN AND CD44 RECEPTOR FAMILY J. Biol. Chem., November 10, 2006; 281(45): 34381 - 34393. [Abstract] [Full Text] [PDF] |
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T. Mirzapoiazova, I. Kolosova, P. V. Usatyuk, V. Natarajan, and A. D. Verin Diverse effects of vascular endothelial growth factor on human pulmonary endothelial barrier and migration Am J Physiol Lung Cell Mol Physiol, October 1, 2006; 291(4): L718 - L724. [Abstract] [Full Text] [PDF] |
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A. Maeda, Y.-i. Ozaki, S. Sivakumaran, T. Akiyama, H. Urakubo, A. Usami, M. Sato, K. Kaibuchi, and S. Kuroda Ca-independent phospholipase A2-dependent sustained Rho-kinase activation exhibits all-or-none response. Genes Cells, September 1, 2006; 11(9): 1071 - 1083. [Abstract] [Full Text] [PDF] |
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Q. Lu, E. O. Harrington, H. Jackson, N. Morin, C. Shannon, and S. Rounds Transforming growth factor-beta1-induced endothelial barrier dysfunction involves Smad2-dependent p38 activation and subsequent RhoA activation J Appl Physiol, August 1, 2006; 101(2): 375 - 384. [Abstract] [Full Text] [PDF] |
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N. Gavara, R. Sunyer, P. Roca-Cusachs, R. Farre, M. Rotger, and D. Navajas Thrombin-induced contraction in alveolar epithelial cells probed by traction microscopy J Appl Physiol, August 1, 2006; 101(2): 512 - 520. [Abstract] [Full Text] [PDF] |
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B. C. Paria, A. M. Bair, J. Xue, Y. Yu, A. B. Malik, and C. Tiruppathi Ca2+ Influx Induced by Protease-activated Receptor-1 Activates a Feed-forward Mechanism of TRPC1 Expression via Nuclear Factor-{kappa}B Activation in Endothelial Cells J. Biol. Chem., July 28, 2006; 281(30): 20715 - 20727. [Abstract] [Full Text] [PDF] |
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Y. Su, Z. Cui, Z. Li, and E. R. Block Calpain-2 regulation of VEGF-mediated angiogenesis FASEB J, July 1, 2006; 20(9): 1443 - 1451. [Abstract] [Full Text] [PDF] |
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X. Trepat, F. Puig, N. Gavara, J. J. Fredberg, R. Farre, and D. Navajas Effect of stretch on structural integrity and micromechanics of human alveolar epithelial cell monolayers exposed to thrombin Am J Physiol Lung Cell Mol Physiol, June 1, 2006; 290(6): L1104 - L1110. [Abstract] [Full Text] [PDF] |
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E. P. van de Visse, M. van der Heijden, J. Verheij, G. P. van Nieuw Amerongen, V. W. M. van Hinsbergh, A. R. J. Girbes, and A. B. J. Groeneveld Effect of prior statin therapy on capillary permeability in the lungs after cardiac or vascular surgery. Eur. Respir. J., May 1, 2006; 27(5): 1026 - 1032. [Abstract] [Full Text] [PDF] |
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A. A. Birukova, S. Chatchavalvanich, A. Rios, K. Kawkitinarong, J. G.N. Garcia, and K. G. Birukov Differential Regulation of Pulmonary Endothelial Monolayer Integrity by Varying Degrees of Cyclic Stretch Am. J. Pathol., May 1, 2006; 168(5): 1749 - 1761. [Abstract] [Full Text] [PDF] |
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L. Gao, A. Grant, I. Halder, R. Brower, J. Sevransky, J. P. Maloney, M. Moss, C. Shanholtz, C. R. Yates, G. U. Meduri, et al. Novel Polymorphisms in the Myosin Light Chain Kinase Gene Confer Risk for Acute Lung Injury Am. J. Respir. Cell Mol. Biol., April 1, 2006; 34(4): 487 - 495. [Abstract] [Full Text] [PDF] |
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L. H. Romer, K. G. Birukov, and J. G.N. Garcia Focal Adhesions: Paradigm for a Signaling Nexus Circ. Res., March 17, 2006; 98(5): 606 - 616. [Abstract] [Full Text] [PDF] |
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A. A. Birukova, D. Adyshev, B. Gorshkov, G. M. Bokoch, K. G. Birukov, and A. D. Verin GEF-H1 is involved in agonist-induced human pulmonary endothelial barrier dysfunction Am J Physiol Lung Cell Mol Physiol, March 1, 2006; 290(3): L540 - L548. [Abstract] [Full Text] [PDF] |
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E. Tzima Role of Small GTPases in Endothelial Cytoskeletal Dynamics and the Shear Stress Response Circ. Res., February 3, 2006; 98(2): 176 - 185. [Abstract] [Full Text] [PDF] |
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J. W. Breslin, H. Sun, W. Xu, C. Rodarte, A. B. Moy, M. H. Wu, and S. Y. Yuan Involvement of ROCK-mediated endothelial tension development in neutrophil-stimulated microvascular leakage Am J Physiol Heart Circ Physiol, February 1, 2006; 290(2): H741 - H750. [Abstract] [Full Text] [PDF] |
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M. Holinstat, N. Knezevic, M. Broman, A. M. Samarel, A. B. Malik, and D. Mehta Suppression of RhoA Activity by Focal Adhesion Kinase-induced Activation of p190RhoGAP: ROLE IN REGULATION OF ENDOTHELIAL PERMEABILITY J. Biol. Chem., January 27, 2006; 281(4): 2296 - 2305. [Abstract] [Full Text] [PDF] |
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D. Mehta and A. B. Malik Signaling Mechanisms Regulating Endothelial Permeability Physiol Rev, January 1, 2006; 86(1): 279 - 367. [Abstract] [Full Text] [PDF] |
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D. Kondrikov, H.-R. Han, E. R. Block, and Y. Su Growth and density-dependent regulation of NO synthase by the actin cytoskeleton in pulmonary artery endothelial cells Am J Physiol Lung Cell Mol Physiol, January 1, 2006; 290(1): L41 - L50. [Abstract] [Full Text] [PDF] |
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P. V. Usatyuk and V. Natarajan Regulation of reactive oxygen species-induced endothelial cell-cell and cell-matrix contacts by focal adhesion kinase and adherens junction proteins Am J Physiol Lung Cell Mol Physiol, December 1, 2005; 289(6): L999 - L1010. [Abstract] [Full Text] [PDF] |
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B. Han, M. Lodyga, and M. Liu Ventilator-induced Lung Injury: Role of Protein-Protein Interaction in Mechanosensation Proceedings of the ATS, October 1, 2005; 2(3): 181 - 187. [Abstract] [Full Text] [PDF] |
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P. A. Singleton, S. M. Dudek, E. T. Chiang, and J. G. N. Garcia Regulation of sphingosine 1-phosphate-induced endothelial cytoskeletal rearrangement and barrier enhancement by S1P1 receptor, PI3 kinase, Tiam1/Rac1, and {alpha}-actinin FASEB J, October 1, 2005; 19(12): 1646 - 1656. [Abstract] [Full Text] [PDF] |
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H. Cai Hydrogen peroxide regulation of endothelial function: Origins, mechanisms, and consequences Cardiovasc Res, October 1, 2005; 68(1): 26 - 36. [Abstract] [Full Text] [PDF] |
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S. S. An, C. M. Pennella, A. Gonnabathula, J. Chen, N. Wang, M. Gaestel, P. M. Hassoun, J. J. Fredberg, and U. S. Kayyali Hypoxia alters biophysical properties of endothelial cells via p38 MAPK- and Rho kinase-dependent pathways Am J Physiol Cell Physiol, September 1, 2005; 289(3): C521 - C530. [Abstract] [Full Text] [PDF] |
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C. M. Nelson, R. P. Jean, J. L. Tan, W. F. Liu, N. J. Sniadecki, A. A. Spector, and C. S. Chen From the Cover: Emergent patterns of growth controlled by multicellular form and mechanics PNAS, August 16, 2005; 102(33): 11594 - 11599. [Abstract] [Full Text] [PDF] |
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D. Mehta Lysophosphatidylcholine: an enigmatic lysolipid Am J Physiol Lung Cell Mol Physiol, August 1, 2005; 289(2): L174 - L175. [Full Text] [PDF] |
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P. Caironi, F. Ichinose, R. Liu, R. C. Jones, K. D. Bloch, and W. M. Zapol 5-Lipoxygenase Deficiency Prevents Respiratory Failure during Ventilator-induced Lung Injury Am. J. Respir. Crit. Care Med., August 1, 2005; 172(3): 334 - 343. [Abstract] [Full Text] [PDF] |
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I. A. Kolosova, T. Mirzapoiazova, D. Adyshev, P. Usatyuk, L. H. Romer, J. R. Jacobson, V. Natarajan, D. B. Pearse, J. G.N. Garcia, and A. D. Verin Signaling Pathways Involved in Adenosine Triphosphate-Induced Endothelial Cell Barrier Enhancement Circ. Res., July 22, 2005; 97(2): 115 - 124. [Abstract] [Full Text] [PDF] |
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M. Gorovoy, J. Niu, O. Bernard, J. Profirovic, R. Minshall, R. Neamu, and T. Voyno-Yasenetskaya LIM Kinase 1 Coordinates Microtubule Stability and Actin Polymerization in Human Endothelial Cells J. Biol. Chem., July 15, 2005; 280(28): 26533 - 26542. [Abstract] [Full Text] [PDF] |
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A. A. Birukova, K. G. Birukov, B. Gorshkov, F. Liu, J. G. N. Garcia, and A. D. Verin MAP kinases in lung endothelial permeability induced by microtubule disassembly Am J Physiol Lung Cell Mol Physiol, July 1, 2005; 289(1): L75 - L84. [Abstract] [Full Text] [PDF] |
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N. E. Vlahakis and R. D. Hubmayr Cellular Stress Failure in Ventilator-injured Lungs Am. J. Respir. Crit. Care Med., June 15, 2005; 171(12): 1328 - 1342. [Abstract] [Full Text] [PDF] |
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J. M. Warfel, A. D. Steele, and F. D'Agnillo Anthrax Lethal Toxin Induces Endothelial Barrier Dysfunction Am. J. Pathol., June 1, 2005; 166(6): 1871 - 1881. [Abstract] [Full Text] [PDF] |
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J. R. Jacobson, J. W. Barnard, D. N. Grigoryev, S.-F. Ma, R. M. Tuder, and J. G. N. Garcia Simvastatin attenuates vascular leak and inflammation in murine inflammatory lung injury Am J Physiol Lung Cell Mol Physiol, June 1, 2005; 288(6): L1026 - L1032. [Abstract] [Full Text] [PDF] |
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R. Goggel and S. Uhlig The inositol trisphosphate pathway mediates platelet-activating-factor-induced pulmonary oedema Eur. Respir. J., May 1, 2005; 25(5): 849 - 857. [Abstract] [Full Text] [PDF] |
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J. H. Finigan, S. M. Dudek, P. A. Singleton, E. T. Chiang, J. R. Jacobson, S. M. Camp, S. Q. Ye, and J. G. N. Garcia Activated Protein C Mediates Novel Lung Endothelial Barrier Enhancement: ROLE OF SPHINGOSINE 1-PHOSPHATE RECEPTOR TRANSACTIVATION J. Biol. Chem., April 29, 2005; 280(17): 17286 - 17293. [Abstract] [Full Text] [PDF] |
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D. Mehta, M. Konstantoulaki, G. U. Ahmmed, and A. B. Malik Sphingosine 1-Phosphate-induced Mobilization of Intracellular Ca2+ Mediates Rac Activation and Adherens Junction Assembly in Endothelial Cells J. Biol. Chem., April 29, 2005; 280(17): 17320 - 17328. [Abstract] [Full Text] [PDF] |
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X. Trepat, M. Grabulosa, L. Buscemi, F. Rico, R. Farre, and D. Navajas Thrombin and histamine induce stiffening of alveolar epithelial cells J Appl Physiol, April 1, 2005; 98(4): 1567 - 1574. [Abstract] [Full Text] [PDF] |
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A. D. Verin Tyrosine Phosphorylation and Endothelial Cell Barrier Regulation Am. J. Pathol., April 1, 2005; 166(4): 955 - 957. [Full Text] [PDF] |
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X. F. Sui, T. D. Kiser, S. W. Hyun, D. J. Angelini, R. L. Del Vecchio, B. A. Young, J. D. Hasday, L. H. Romer, A. Passaniti, N. K. Tonks, et al. Receptor Protein Tyrosine Phosphatase {micro} Regulates the Paracellular Pathway in Human Lung Microvascular Endothelia Am. J. Pathol., April 1, 2005; 166(4): 1247 - 1258. [Abstract] [Full Text] [PDF] |
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S. Fukuhara, A. Sakurai, H. Sano, A. Yamagishi, S. Somekawa, N. Takakura, Y. Saito, K. Kangawa, and N. Mochizuki Cyclic AMP Potentiates Vascular Endothelial Cadherin-Mediated Cell-Cell Contact To Enhance Endothelial Barrier Function through an Epac-Rap1 Signaling Pathway Mol. Cell. Biol., January 1, 2005; 25(1): 136 - 146. [Abstract] [Full Text] [PDF] |
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D. Mehta, J. Bhattacharya, M. A. Matthay, and A. B. Malik Integrated control of lung fluid balance Am J Physiol Lung Cell Mol Physiol, December 1, 2004; 287(6): L1081 - L1090. [Abstract] [Full Text] [PDF] |
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E. O. Harrington, J. Newton, N. Morin, and S. Rounds Barrier dysfunction and RhoA activation are blunted by homocysteine and adenosine in pulmonary endothelium Am J Physiol Lung Cell Mol Physiol, December 1, 2004; 287(6): L1091 - L1097. [Abstract] [Full Text] [PDF] |
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B. C. Paria, S. M. Vogel, G. U. Ahmmed, S. Alamgir, J. Shroff, A. B. Malik, and C. Tiruppathi Tumor necrosis factor-{alpha}-induced TRPC1 expression amplifies store-operated Ca2+ influx and endothelial permeability Am J Physiol Lung Cell Mol Physiol, December 1, 2004; 287(6): L1303 - L1313. [Abstract] [Full Text] [PDF] |
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R. A. Stockton, E. Schaefer, and M. A. Schwartz p21-activated Kinase Regulates Endothelial Permeability through Modulation of Contractility J. Biol. Chem., November 5, 2004; 279(45): 46621 - 46630. [Abstract] [Full Text] [PDF] |
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R. O. Dull, B. J. DeWitt, R. Dinavahi, L. Schwartz, C. Hubert, N. Pace, and C. Fronticelli Quantitative assessment of hemoglobin-induced endothelial barrier dysfunction J Appl Physiol, November 1, 2004; 97(5): 1930 - 1937. [Abstract] [Full Text] [PDF] |
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T. Borbiev, A. Birukova, F. Liu, S. Nurmukhambetova, W. T. Gerthoffer, J. G. N. Garcia, and A. D. Verin p38 MAP kinase-dependent regulation of endothelial cell permeability Am J Physiol Lung Cell Mol Physiol, November 1, 2004; 287(5): L911 - L918. [Abstract] [Full Text] [PDF] |
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K. Kawkitinarong, L. Linz-McGillem, K. G. Birukov, and J. G. N. Garcia Differential Regulation of Human Lung Epithelial and Endothelial Barrier Function by Thrombin Am. J. Respir. Cell Mol. Biol., November 1, 2004; 31(5): 517 - 527. [Abstract] [Full Text] [PDF] |
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X. Trepat, M. Grabulosa, F. Puig, G. N. Maksym, D. Navajas, and R. Farre Viscoelasticity of human alveolar epithelial cells subjected to stretch Am J Physiol Lung Cell Mol Physiol, November 1, 2004; 287(5): L1025 - L1034. [Abstract] [Full Text] [PDF] |
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K. G. Birukov, V. N. Bochkov, A. A. Birukova, K. Kawkitinarong, A. Rios, A. Leitner, A. D. Verin, G. M. Bokoch, N. Leitinger, and Joe. G.N. Garcia Epoxycyclopentenone-Containing Oxidized Phospholipids Restore Endothelial Barrier Function via Cdc42 and Rac Circ. Res., October 29, 2004; 95(9): 892 - 901. [Abstract] [Full Text] [PDF] |
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S. Boitano, Z. Safdar, D. G. Welsh, J. Bhattacharya, and M. Koval Cell-cell interactions in regulating lung function Am J Physiol Lung Cell Mol Physiol, September 1, 2004; 287(3): L455 - L459. [Abstract] [Full Text] [PDF] |
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G. Bazzoni and E. Dejana Endothelial Cell-to-Cell Junctions: Molecular Organization and Role in Vascular Homeostasis Physiol Rev, July 1, 2004; 84(3): 869 - 901. [Abstract] [Full Text] [PDF] |
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A. A. Birukova, F. Liu, J. G. N. Garcia, and A. D. Verin Protein kinase A attenuates endothelial cell barrier dysfunction induced by microtubule disassembly Am J Physiol Lung Cell Mol Physiol, July 1, 2004; 287(1): L86 - L93. [Abstract] [Full Text] [PDF] |
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N. Kurimoto, Y.-S. Nan, Z.-Y. Chen, G.-G. Feng, T. Komatsu, N. Kandatsu, J. Ko, N. Kawai, and N. Ishikawa Effects of specific signal transduction inhibitors on increased permeability across rat endothelial monolayers induced by neuropeptide Y or VEGF Am J Physiol Heart Circ Physiol, July 1, 2004; 287(1): H100 - H106. [Abstract] [Full Text] [PDF] |
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S. M. Dudek, J. R. Jacobson, E. T. Chiang, K. G. Birukov, P. Wang, X. Zhan, and J. G. N. Garcia Pulmonary Endothelial Cell Barrier Enhancement by Sphingosine 1-Phosphate: ROLES FOR CORTACTIN AND MYOSIN LIGHT CHAIN KINASE J. Biol. Chem., June 4, 2004; 279(23): 24692 - 24700. [Abstract] [Full Text] [PDF] |
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