Introduction:
Thrombomodulin (TM), a glycoprotein predominantly expressed in endothelial cells, has been well known for its anti-coagulant and anti-inflammatory properties. Paradoxically, we recently found a promoting role of monocytic membrane-bound TM in experimental sepsis.
Hypothesis:
We assessed the hypothesis that membrane-bound TM may participate in vascular inflammation and the development of abdominal aortic aneurysm (AAA).
Methods and Results:
Characterization of the CaCl
2
-induced AAA in mice revealed that TM expression was mainly localized in vascular smooth muscle cells (VSMCs) and infiltrating macrophages. To investigate the function of membrane-bound TM in vivo, transgenic mice with myeloid- (LysMcre/TM
flox/flox
) and VSMC-specific (SM22-cre
tg
/TM
flox/flox
) TM ablation and their wild type counterparts were generated. In the CaCl
2
-induced AAA model, myeloid TM-deficient mice (n=12) but not VSMC TM-deficient mice (n=8), when compared with their wild-type respective controls (TM
flox/flox
, SM22-cre
tg
/TM
+/+
), showed attenuated accumulation of macrophages, reduced production of proinflammatory cytokines and suppressed levels of matrix metalloproteinase-9, thereby preventing progressive aortic dilatation.
In vitro
TM-deficient macrophages had reduced proinflammatory mediator production, macrophage-endothelial cell adhesion and intracellular oxidative stress (e.g., reactive oxygen species [ROS]) versus TM wild-type macrophages. In addition, deficiency of TM in hyperlipidemic mice (ApoE
-/-
/LysMcre/TM
flox/flox
, n=9) conferred protection against angiotensin II-infused AAA, compatible with dramatically diminished aortic ROS production and matrix metalloproteinase activities. Finally, human AAA samples (n=6) showed that TM signals were predominantly localized to infiltrating macrophages, implicating the potential involvement of monocytic membrane-bound TM in human diseases.
Conclusion:
Membrane-bound TM in macrophages plays a critical role in the development of AAA by enhancing macrophage-endothelial cell adhesion, proinflammatory mediator elaboration and intracellular ROS production.