Therapeutic siRNA targeting endothelial KDR decreases portosystemic collateralization in portal hypertension

Sci Rep. 2017 Nov 1;7(1):14791. doi: 10.1038/s41598-017-14818-7.


Development of portosystemic collateral vessels and gastroesophageal varices is responsible for the most serious clinical consequences of portal hypertension, but effective clinical therapies are limited. Here we developed and investigated the therapeutic potential of an innovative liposomally-formulated short-interfering RNA (siRNA) technology based on clinical stage components, capable to attenuate production of the endothelial kinase insert domain receptor (KDR), which controls portosystemic collateralization and contributes to disease progression and aggravation. These siRNAs were first validated in vitro, and then, their therapeutic potential on portosystemic collateralization and pathological angiogenesis was tested in vivo in mouse models of portal hypertension (portal vein-ligation). siRNAKDR-lipoplexes efficiently transported siRNAKDR to vascular endothelial cells in mesenteric microvenules and portal vein of portal hypertensive mice, where collaterogenesis and angiogenesis take place. This systemic treatment significantly downregulated pathological KDR overexpression, without causing complete KDR knockout, preserving homeostatic baseline KDR levels and thus limiting adverse effects. siRNAKDR-lipoplex-induced endothelial-specific KDR knockdown drastically reduced by 73% the portosystemic collateralization, and impaired the pathologic angiogenic potential of vascular endothelial cells at different levels (cell proliferation, sprouting and remodeling). Targeting endothelial KDR with therapeutic siRNAKDR-lipoplexes could be a promising and plausible treatment modality for attenuating the formation of portosystemic collaterals in a clinical setting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Endothelium, Vascular* / metabolism
  • Endothelium, Vascular* / pathology
  • Humans
  • Hypertension, Portal* / genetics
  • Hypertension, Portal* / metabolism
  • Hypertension, Portal* / pathology
  • Hypertension, Portal* / therapy
  • Male
  • Mice
  • Mice, Inbred BALB C
  • Neovascularization, Pathologic* / genetics
  • Neovascularization, Pathologic* / metabolism
  • Neovascularization, Pathologic* / pathology
  • Neovascularization, Pathologic* / therapy
  • RNA, Small Interfering* / genetics
  • RNA, Small Interfering* / pharmacology
  • Vascular Endothelial Growth Factor Receptor-2* / antagonists & inhibitors
  • Vascular Endothelial Growth Factor Receptor-2* / biosynthesis
  • Vascular Endothelial Growth Factor Receptor-2* / genetics


  • RNA, Small Interfering
  • KDR protein, human
  • Kdr protein, mouse
  • Vascular Endothelial Growth Factor Receptor-2