Objective
Abdominal aortic aneurysm (AAA) formation is characterized by inflammation, smooth muscle activation and matrix degradation. This study tests the hypothesis that macrophage-produced high mobility group box1 (HMGB1) production is dependent on NADPH oxidase (Nox2) which leads to increase in IL-17 production resulting in AAA formation and that treatment with human mesenchymal stem cells (MSCs) can attenuate this process thereby inhibiting AAA formation.
Approach and Results
Human aortic tissue demonstrated a significant increase in HMGB1 expression in AAA patients compared to controls. An elastase-perfusion model of AAA demonstrated a significant increase in HMGB1 production in C57BL/6 (wild type; WT) mice, which was attenuated by MSC treatment. Furthermore, anti-HMGB1 antibody treatment of WT mice attenuated AAA formation, IL-17 production and immune cell infiltration compared to elastase-perfused WT mice on day 14. Elastase-perfused Nox2−/y mice demonstrated a significant attenuation of HMGB1 and IL-17 production, cellular infiltration, matrix metalloproteinase activity and AAA formation compared to WT mice on day 14. In vitro studies showed that elastase-treated macrophages from WT mice, but not Nox2−/y mice, produced HMGB1, which was attenuated by MSC treatment. The production of macrophage-dependent HMGB1 involved Nox2 activation and superoxide anion production, which was mitigated by MSC treatment.
Conclusions
These results demonstrate that macrophage-produced HMGB1 leads to aortic inflammation and acts as a trigger for CD4+ T cell produced IL-17 during AAA formation. HMGB1 release is dependent on Nox2 activation, which can be inhibited by MSCs leading to attenuation of proinflammatory cytokines, especially IL-17, and protection against AAA formation.