H yperlipidemia and type 2 diabetes mellitus (T2DM) are major risk factors for the development of cardiovascular diseases.1 Hyperlipidemia and T2DM severely impair adaptive angiogenesis and arteriogenesis in response to myocardial and peripheral hindlimb ischemia, attributed to dysregulated gene expression as shown in animal models.
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In This Issue, see p 221Epigenetic regulation of gene expression involves modifications of chromatin, such as DNA methylation and histone modifications, without alterations in DNA sequence. ) mouse models of hindlimb ischemia.
Methods and Results:Unilateral hindlimb ischemia was induced by ligating femoral artery. Perfusion was assessed using ultrasound, and capillary and arteriole parameters were assessed using immunohistochemistry. Genomewide methylated DNA sequencing was performed with DNA isolated from ischemic muscle, tissue macrophages (Mϕs), and endothelial cells. Compared with the controls, hyperlipidemia and T2DM mice showed impaired perfusion recovery, which was associated with impaired angiogenesis and arteriogenesis. Genome-wide proximal promoter DNA methylation analysis suggested differential patterns of methylation in Mϕ genes in ischemic muscles. Classically activated M1-Mϕ gene promoters, including Cfb, Serping1, and Tnfsf15, were significantly hypomethylated, whereas alternatively activated M2-Mϕ gene promoters, including Nrp1, Cxcr4, Plxnd1, Arg1, Cdk18, and Fes, were significantly hypermethylated in Mϕs isolated from hyperlipidemia and T2DM ischemic muscles compared with controls. These results combined with mRNA expression and immunohistochemistry showed the predominance of proinflammatory M1-Mϕs, compared with anti-inflammatory and proangiogenic M2-Mϕs in hyperlipidemia and T2DM ischemic muscles. The DNA methylation sequencing data have been submitted to the NCBI Gene Expression Omnibus (http://www.ncbi.nlm.nih.gov/geo/) under the accession number GSE65803.
Conclusions:The online-only Data Supplement is available with this article at http://circres.ahajournals.org/lookup/suppl