Candesartan prevents arteriopathy progression in cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy model

J Clin Invest. 2021 Nov 15;131(22):e140555. doi: 10.1172/JCI140555.

Abstract

Cerebral small vessel disease (CSVD) causes dementia and gait disturbance due to arteriopathy. Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is a hereditary form of CSVD caused by loss of high-temperature requirement A1 (HTRA1) serine protease activity. In CARASIL, arteriopathy causes intimal thickening, smooth muscle cell (SMC) degeneration, elastic lamina splitting, and vasodilation. The molecular mechanisms were proposed to involve the accumulation of matrisome proteins as substrates or abnormalities in transforming growth factor β (TGF-β) signaling. Here, we show that HTRA1-/- mice exhibited features of CARASIL-associated arteriopathy: intimal thickening, abnormal elastic lamina, and vasodilation. In addition, the mice exhibited reduced distensibility of the cerebral arteries and blood flow in the cerebral cortex. In the thickened intima, matrisome proteins, including the hub protein fibronectin (FN) and latent TGF-β binding protein 4 (LTBP-4), which are substrates of HTRA1, accumulated. Candesartan treatment alleviated matrisome protein accumulation and normalized the vascular distensibility and cerebral blood flow. Furthermore, candesartan reduced the mRNA expression of Fn1, Ltbp-4, and Adamtsl2, which are involved in forming the extracellular matrix network. Our results indicate that these accumulated matrisome proteins may be potential therapeutic targets for arteriopathy in CARASIL.

Keywords: Dementia; Extracellular matrix; Neurodegeneration; Neuroscience; Vascular Biology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • ADAMTS Proteins / analysis
  • Alopecia / complications
  • Alopecia / drug therapy*
  • Animals
  • Benzimidazoles / therapeutic use*
  • Biphenyl Compounds / therapeutic use*
  • Cerebral Infarction / complications
  • Cerebral Infarction / drug therapy*
  • Cerebrovascular Circulation / drug effects
  • Disease Progression
  • Extracellular Matrix Proteins / analysis
  • High-Temperature Requirement A Serine Peptidase 1 / physiology*
  • Latent TGF-beta Binding Proteins / analysis
  • Leukoencephalopathies / complications
  • Leukoencephalopathies / drug therapy*
  • Mice
  • Mice, Inbred C57BL
  • Recombinant Proteins / analysis
  • Spinal Diseases / complications
  • Spinal Diseases / drug therapy*
  • Tetrazoles / therapeutic use*
  • Transforming Growth Factor beta / physiology

Substances

  • Adamtsl2 protein, mouse
  • Benzimidazoles
  • Biphenyl Compounds
  • Extracellular Matrix Proteins
  • Fbln5 protein, mouse
  • LTBP-4 protein, mouse
  • Latent TGF-beta Binding Proteins
  • Recombinant Proteins
  • Tetrazoles
  • Transforming Growth Factor beta
  • High-Temperature Requirement A Serine Peptidase 1
  • HtrA1 protein, mouse
  • ADAMTS Proteins
  • candesartan

Supplementary concepts

  • Cerebral Autosomal Recessive Arteriopathy with Subcortical Infarcts and Leukoencephalopathy