Background
Homeostasis of the vessel wall is cooperatively maintained by endothelial cells (ECs), smooth muscle cells, and adventitial fibroblasts. The genetic deletion of fibulin‐4 (
Fbln4
) in smooth muscle cells (
SMKO
) leads to the formation of thoracic aortic aneurysms with the disruption of elastic fibers. Although
Fbln4
is expressed in the entire vessel wall, its function in ECs and relevance to the maintenance of valvulo‐arterial integrity are not fully understood.
Methods and Results
Gene silencing of
FBLN4
was conducted on human aortic ECs to evaluate morphological changes and gene expression profile.
Fbln4
double knockout (
DKO
) mice in ECs and smooth muscle cells were generated and subjected to histological analysis, echocardiography, Western blotting, RNA sequencing, and immunostaining. An evaluation of the thoracic aortic aneurysm phenotype and screening of altered signaling pathways were performed. Knockdown of
FBLN4
in human aortic ECs induced mesenchymal cell–like changes with the upregulation of mesenchymal genes, including
TAGLN
and
MYL9
.
DKO
mice showed the exacerbation of thoracic aortic aneurysms when compared with those of
SMKO
and upregulated Thbs1, a mechanical stress–responsive molecule, throughout the aorta.
DKO
mice also showed progressive aortic valve thickening with collagen deposition from postnatal day 14, as well as turbulent flow in the ascending aorta. Furthermore, RNA sequencing and immunostaining of the aortic valve revealed the upregulation of genes involved in endothelial‐to‐mesenchymal transition, inflammatory response, and tissue fibrosis in
DKO
valves and the presence of activated valve interstitial cells.
Conclusions
The current study uncovers the pivotal role of endothelial fibulin‐4 in the maintenance of valvulo‐arterial integrity, which influences thoracic aortic aneurysm progression.