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Smooth Muscle Cell-Mineralocorticoid Receptor as a Mediator of Cardiovascular Stiffness With Aging.

Abstract
Stiffening of the vasculature with aging is a strong predictor of adverse cardiovascular events, independent of all other risk factors including blood pressure, yet no therapies target this process. MRs (mineralocorticoid receptors) in smooth muscle cells (SMCs) have been implicated in the regulation of vascular fibrosis but have not been explored in vascular aging. Comparing SMC-MR-deleted male mice to MR-intact littermates at 3, 12, and 18 months of age, we demonstrated that aging-associated vascular stiffening and fibrosis are mitigated by MR deletion in SMCs. Progression of cardiac stiffness and fibrosis and the decline in exercise capacity with aging were also mitigated by MR deletion in SMC. Vascular gene expression profiling analysis revealed that MR deletion in SMC is associated with recruitment of a distinct antifibrotic vascular gene expression program with aging. Moreover, long-term pharmacological inhibition of MR in aged mice prevented the progression of vascular fibrosis and stiffness and induced a similar antifibrotic vascular gene program. Finally, in a small trial in elderly male humans, short-term MR antagonism produced an antifibrotic signature of circulating biomarkers similar to that observed in the vasculature of SMC-MR-deleted mice. These findings suggest that SMC-MR contributes to vascular stiffening with aging and is a potential therapeutic target to prevent the progression of aging-associated vascular fibrosis and stiffness.
AuthorsSeung Kyum Kim, Amy T McCurley, Jennifer J DuPont, Mark Aronovitz, M Elizabeth Moss, Isaac E Stillman, S Ananth Karumanchi, Demetra D Christou, Iris Z Jaffe
JournalHypertension (Dallas, Tex. : 1979) (Hypertension) Vol. 71 Issue 4 Pg. 609-621 (04 2018) ISSN: 1524-4563 [Electronic] United States
PMID29463624 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Copyright© 2018 American Heart Association, Inc.
Chemical References
  • Mineralocorticoid Receptor Antagonists
  • Receptors, Mineralocorticoid
  • Spironolactone
Topics
  • Aged
  • Animals
  • Cellular Senescence (drug effects, physiology)
  • Disease Progression
  • Exercise Tolerance (physiology)
  • Fibrosis (metabolism, pathology, prevention & control)
  • Gene Expression (drug effects)
  • Gene Expression Profiling
  • Humans
  • Male
  • Mice
  • Mineralocorticoid Receptor Antagonists (metabolism, pharmacology)
  • Muscle, Smooth, Vascular (drug effects, metabolism, pathology)
  • Myocytes, Smooth Muscle (drug effects, metabolism)
  • Receptors, Mineralocorticoid (genetics, metabolism)
  • Spironolactone (metabolism, pharmacology)
  • Treatment Outcome
  • Vascular Stiffness (drug effects, physiology)

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