title: A transgenic model for conditional induction and rescue of portal hypertension reveals a role of VEGF-mediated regulation of sinusoidal fenestrations.
abstract: Portal hypertension (PH) is a common complication and a leading cause of death in patients with chronic liver diseases. PH is underlined by structural and functional derangement of liver sinusoid vessels and its fenestrated endothelium. Because in most clinical settings PH is accompanied by parenchymal injury, it has been difficult to determine the precise role of microvascular perturbations in causing PH. Reasoning that Vascular Endothelial Growth Factor (VEGF) is required to maintain functional integrity of the hepatic microcirculation, we developed a transgenic mouse system for a liver-specific-, reversible VEGF inhibition. The system is based on conditional induction and de-induction of a VEGF decoy receptor that sequesters VEGF and preclude signaling. VEGF blockade results in sinusoidal endothelial cells (SECs) fenestrations closure and in accumulation and transformation of the normally quiescent hepatic stellate cells, i.e. provoking the two processes underlying sinusoidal capillarization. Importantly, sinusoidal capillarization was sufficient to cause PH and its typical sequela, ascites, splenomegaly and venous collateralization without inflicting parenchymal damage or fibrosis. Remarkably, these dramatic phenotypes were fully reversed within few days from lifting-off VEGF blockade and resultant re-opening of SECs' fenestrations. This study not only uncovered an indispensible role for VEGF in maintaining structure and function of mature SECs, but also highlights the vasculo-centric nature of PH pathogenesis. Unprecedented ability to rescue PH and its secondary manifestations via manipulating a single vascular factor may also be harnessed for examining the potential utility of de-capillarization treatment modalities.
authors.affiliation: Department of Molecular Biology, The Hebrew University-Hadassah University Hospital, Jerusalem, Israel.
authors.forename: Dalit
authors.initials: D
authors.lastname: May
authors.forename: Valentin
authors.initials: V
authors.lastname: Djonov
authors.forename: Gideon
authors.initials: G
authors.lastname: Zamir
authors.forename: Miklosh
authors.initials: M
authors.lastname: Bala
authors.forename: Rifaat
authors.initials: R
authors.lastname: Safadi
authors.forename: Miriam
authors.initials: M
authors.lastname: Sklair-Levy
authors.forename: Eli
authors.initials: E
authors.lastname: Keshet
mesh_terms: D000818:Animals; D015152:Blotting, Northern; D015153:Blotting, Western; D006975:Hypertension, Portal / Q000235:genetics / Q000378:metabolism* / Q000628:therapy*; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D008099:Liver / Q000098:blood supply* / Q000378:metabolism* / Q000648:ultrastructure; D051379:Mice; D008822:Mice, Transgenic; D046529:Microscopy, Electron, Transmission; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics / Q000378:metabolism*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000235:genetics / Q000378:metabolism
chemical_list: D042461:Vascular Endothelial Growth Factor A; D040281:Vascular Endothelial Growth Factor Receptor-1