Vascular
spasm is a poorly understood but critical biomedical process because it can acutely reduce blood supply and tissue oxygenation.
Cardiomyopathy in mice lacking
gamma-sarcoglycan or
delta-sarcoglycan is characterized by focal damage. In the heart,
sarcoglycan gene mutations produce regional defects in membrane permeability and focal degeneration, and it was hypothesized that vascular
spasm was responsible for this focal
necrosis. Supporting this notion, vascular
spasm was noted in coronary arteries, and disruption of the
sarcoglycan complex was observed in vascular smooth muscle providing a molecular mechanism for
spasm. Using a transgene rescue strategy in the background of
sarcoglycan-null mice, we replaced cardiomyocyte
sarcoglycan expression. Cardiomyocyte-specific
sarcoglycan expression was sufficient to correct cardiac focal degeneration. Intriguingly, successful restoration of the cardiomyocyte
sarcoglycan complex also eliminated coronary artery vascular
spasm, while restoration of smooth muscle
sarcoglycan in the background of
sarcoglycan-null alleles did not. This mechanism, whereby tissue damage leads to vascular
spasm, can be partially corrected by
NO synthase inhibitors. Therefore, we propose that
cytokine release from damaged cardiomyocytes can feed back to produce vascular
spasm. Moreover, vascular
spasm feeds forward to produce additional cardiac damage.