title: Ephrin type-B receptor 4 activation reduces neointimal hyperplasia in human saphenous vein in vitro.
abstract: BACKGROUND
  Vein bypass is an essential therapy for patients with advanced peripheral and coronary artery disease despite development of neointimal hyperplasia. We have shown that stimulation of the receptor tyrosine kinase ephrin type-B receptor 4 (Eph-B4) with its ligand ephrin-B2 prevents neointimal hyperplasia in murine vein grafts. This study determines whether Eph-B4 in adult human veins is capable of phosphorylation and activation of downstream signaling pathways, as well as functional to release nitric oxide (NO) and prevent neointimal hyperplasia in vitro.
  
  
  METHODS
  Discarded human saphenous veins were taken from the operating room and placed in organ culture without or with ephrin-B2/Fc (2 μg/mL) for 14 days, and the neointima/media ratio was measured in matched veins. Primary human umbilical vein endothelial cells were treated with ephrin-B2/Fc (2 μg/mL) and examined with quantitative polymerase chain reaction, Western blot, immunoassays, and for release of NO. Ephrin-B2/Fc (2 μg/mL) was placed on the adventitia of saphenous veins treated with arterial shear stress for 24 hours in a bioreactor and activated Eph-B4 examined with immunofluorescence.
  
  
  RESULTS
  The baseline intima/media ratio in saphenous vein rings was 0.456 ± 0.097, which increased to 0.726 ± 0.142 in untreated veins after 14 days in organ culture but only to 0.630 ± 0.132 in veins treated with ephrin-B2/Fc (n = 19, P = .017). Ephrin-B2/Fc stimulated Akt, endothelial NO synthase and caveolin-1 phosphorylation, and NO release (P = .007) from human umbilical vein endothelial cells (n = 6). Ephrin-B2/Fc delivered to the adventitia stimulated endothelial Eph-B4 phosphorylation after 24 hours of arterial stress in a bioreactor (n = 3).
  
  
  CONCLUSIONS
  Eph-B4 is present and functional in adult human saphenous veins, with intact downstream signaling pathways capable of NO release and prevention of neointimal hyperplasia in vitro. Adventitial delivery of ephrin-B2/Fc activates endothelial Eph-B4 in saphenous veins treated with arterial shear stress in vitro. These results suggest that stimulation of Eph-B4 function may be a candidate strategy for translation to human clinical trials designed to inhibit venous neointimal hyperplasia.
authors.affiliation: Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Wong
authors.affiliation: Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: Daniel Y
authors.initials: DY
authors.lastname: Lu
authors.affiliation: Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: Clinton D
authors.initials: CD
authors.lastname: Protack
authors.affiliation: Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: Go
authors.initials: G
authors.lastname: Kuwahara
authors.affiliation: Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: Hualong
authors.initials: H
authors.lastname: Bai
authors.affiliation: Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: Nirvana
authors.initials: N
authors.lastname: Sadaghianloo
authors.affiliation: Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn; Department of Surgery, VA Connecticut Healthcare System, West Haven, Conn.
authors.forename: George
authors.initials: G
authors.lastname: Tellides
authors.affiliation: Vascular Biology and Therapeutics (VBT) Program and the Department of Surgery, Yale University School of Medicine, New Haven, Conn; Department of Surgery, VA Connecticut Healthcare System, West Haven, Conn. Electronic address: alan.dardik@yale.edu.
authors.forename: Alan
authors.initials: A
authors.lastname: Dardik
mesh_terms: D019149:Bioreactors; D051242:Caveolin 1 / Q000378:metabolism; D049109:Cell Proliferation / Q000187:drug effects; D002478:Cells, Cultured; D004789:Enzyme Activation; D036388:Ephrin-B2 / Q000494:pharmacology*; D061307:Human Umbilical Vein Endothelial Cells / Q000187:drug effects / Q000473:pathology; D006801:Humans; D006965:Hyperplasia; D007141:Immunoglobulin Fc Fragments / Q000494:pharmacology*; D040542:Mechanotransduction, Cellular / Q000187:drug effects; D058426:Neointima; D009569:Nitric Oxide / Q000378:metabolism; D052250:Nitric Oxide Synthase Type III / Q000378:metabolism; D010766:Phosphorylation; D061251:Primary Cell Culture; D051057:Proto-Oncogene Proteins c-akt / Q000378:metabolism; D036224:Receptor, EphB4 / Q000819:agonists* / Q000235:genetics / Q000378:metabolism; D012501:Saphenous Vein / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D013314:Stress, Mechanical; D046509:Tissue Culture Techniques / Q000295:instrumentation
chemical_list: C495540:CAV1 protein, human; D051242:Caveolin 1; D036388:Ephrin-B2; D007141:Immunoglobulin Fc Fragments; D009569:Nitric Oxide; C496314:NOS3 protein, human; D052250:Nitric Oxide Synthase Type III; D036224:Receptor, EphB4; D051057:Proto-Oncogene Proteins c-akt