We previously reported an altered hyaluronan (HA) metabolism in idiopathic pulmonary arterial hypertension (IPAH) lung tissue and cultured smooth muscle cells. Hyaluronan was present in the smooth muscle cell layer surrounding the pulmonary vasculature and in plexigenic lesions. Additionally, cultured pulmonary artery smooth muscle cells produced spontaneous HA "cable" structures, without additional stimuli, that were leukocyte-adhesive. We now present evidence that the HA that accumulates in IPAH plexigenic lesions is a pathological form of HA in which heavy chains (HCs) from the serum-derived proteoglycan inter-α-inhibitor are covalently attached to the HA backbone to form a pathological HC-HA complex. CD45-positive leukocytes were identified within these HC-HA matrices. Elevated mRNA levels of the enzyme that transfers HCs to HA, known as tumor necrosis factor-stimulated gene 6, were detected in IPAH lung tissue.

During inflammation and developmental processes, heavy chains (HCs) from inter-α-inhibitor (IαI) are covalently transferred to hyaluronan (HA) via the enzyme tumor-necrosis-factor-stimulated-gene 6 (TSG- 6) to form a HC-HA complex. In this manuscript, we describe a gel-based assay to detect HC-HA and TSG-6 activity in tissues.

Monocytes are rapidly recruited to sites of diabetic complications and differentiate into macrophages. Previously, we showed that rat kidney mesangial cells dividing during hyperglycemic stress abnormally synthesize hyaluronan (HA) in intracellular compartments. This initiates a stress response, resulting in an extracellular HA matrix after division that recruits inflammatory cells. Cell–cell communication among macrophages that are recruited into the glomeruli and the damaged rat mesangial cells leads to diabetic nephropathy, fibrosis, and proteinurea, which are inhibited in heparin-treated diabetic rats. In this study, we found that murine bone marrow–derived macrophages (BMDMs) and a human leukemic cell line, U937 cells, dividing in hyperglycemia also accumulate intracellular HA and that heparin inhibits the HA accumulation. Both cell types expressed increased levels of proinflammatory markers: inducible nitric-oxide synthase and tumor necrosis factor-α, when cultured under hyperglycemic stress, which was inhibited by heparin. Furthermore, the abnormal intracellular HA was also observed in peripheral blood monocytes derived from three different hyperglycemic diabetic mouse models: streptozotocin-treated, high-fat fed, and Ins2Akita. Moreover, peripheral blood monocytes in humans with type 2 diabetes and poorly controlled blood glucose levels (hemoglobin A1c (HbA1c) levels of >7) also had intracellular HA, whereas those with HbA1c of <7, did not. Of note, heparin increased the anti-inflammatory markers arginase 1 and interleukin-10 in murine BMDMs. We conclude that heparin treatment of high glucose–exposed dividing BMDMs promotes an anti-inflammatory tissue-repair phenotype in these cells.

In specialized capillary beds such as the kidney glomerulus, the sheet-like structure of the basement membrane in conjunction with opposing monolayers of endothelium and epithelium form the functioning filtration unit of the kidney. Using a novel cross-linking method on a collagen substrate, we have created a novel hydrogel scaffold to substitute for the basement membrane. Using a simple casting method to create thin films of the hydrogel scaffold (1–5μm), the scaffolds were suitable for long-term static culture, and supported cell attachment and long term cell viability similar to a standard type I collagen substrate. Bulk diffusion and protein permeability of the hydrogel scaffold were evaluated, in addition to its use in a perfusion chamber where it withstood hydraulic pressures typical for glomerular capillaries. This system thus provided a suitable cell substrate for the co-culture of renal epithelial podocytes and endothelial cells in a device that replicates the geometry of the in vivo juxtaposition of the two cell types in relation to their basement membrane.

Graphical abstract