T he pentraxin (PTX) family includes 2 subgroups of proteins that are structurally divided into short and long forms, are encoded by different genes, and are produced by different cells. [1][2][3] PTX3 is the prototype of the long PTX group, which differs from short PTXs by the presence of an unrelated long N-terminal domain giving it a different ligand recognition capacity. 4 PTX3 is highly conserved from mouse to humans (82% identical and 92% conserved amino acids) and is induced by primary inflammatory stimuli in a variety of cell types, 5,6 including mononuclear phagocytes, fibroblasts, adipocytes, dendritic, and endothelial and smooth muscle cells. 5,7 Marked as an innate immunity protein, PTX3 not only regulates inflammatory responses but also is involved in a range of important biological mechanisms, including vascular pathology. In fact, blood vessels produce large amounts of PTX3 during inflammation, and the level of circulating PTX3 increases in several pathological conditions affecting the cardiovascular system. 8,9 Moreover, in advanced atherosclerotic lesions and in patients with vasculitis, the protein is abundantly present in endothelial cells. 10,11 Thus, PTX3 seems to be a rapid marker of primary local innate immunity and inflammation activation and a novel diagnostic tool for vascular disorders.
Clinical Perspective on p 1505In addition, high plasma PTX3 has been linked to vascular endothelial dysfunction in several human diseases, including Background-Pentraxin 3 (PTX3), the prototype of long pentraxins, has been described to be associated with endothelial dysfunction in different cardiovascular disorders. No study has yet evaluated the possible direct effect of PTX3 on vascular function. Methods and Results-Through in vitro experiments of vascular reactivity and ultrastructural analyses, we demonstrate that PTX3 induces dysfunction and morphological changes in the endothelial layer through a P-selectin/matrix metalloproteinase-1 pathway. The latter hampered the detachment of endothelial nitric oxide synthase from caveolin-1, leading to an impairment of nitric oxide signaling. In vivo studies showed that administering PTX3 to wild-type mice induced endothelial dysfunction and increased blood pressure, an effect absent in P-selectin-deficient mice. In isolated human umbilical vein endothelial cells, PTX3 significantly blunted nitric oxide production through the matrix metalloproteinase-1 pathway. Finally, using ELISA, we found that hypertensive patients (n=31) have higher plasma levels of PTX3 and its mediators P-selectin and matrix metalloproteinase-1 than normotensive subjects (n=21). Conclusions-Our data show for the first time a direct role of PTX3 on vascular function and blood pressure homeostasis, identifying the molecular mechanisms involved. The findings in humans suggest that PTX3, P-selectin, and matrix metalloproteinase-1 may be novel biomarkers that predict the onset of vascular dysfunction in hypertensive patients. Here, we demonstrate that (1) PTX3 induces vascular dysfuncti...