High-mobility group box-1 protein induces osteogenic phenotype changes in aortic valve interstitial cells Bo Wang, PhD, Fei Li, MD, Chao Zhang, PhD,

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Date of download: 5/28/2016 Copyright © The American College of Cardiology. All rights reserved. From: Pro-Osteogenic Phenotype of Human Aortic Valve Interstitial.

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High-mobility group box-1 protein induces osteogenic phenotype changes in aortic valve interstitial cells Bo Wang, PhD, Fei Li, MD, Chao Zhang, PhD, Guangxia Wei, MD, Pingping Liao, PhD, Nianguo Dong, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 151, Issue 1, Pages 255-262 (January 2016) DOI: 10.1016/j.jtcvs.2015.09.077 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 The expression of HMGB1 and TLR4 is increased in human calcific AVs. A-D, Representative images of immunohistochemical staining of HMGB1 and TLR4 in human calcific AVs and normal AVs. E and F, Immunoblotting showed that HMGB1 and TLR4 were significantly increased in human calcific AVs (healthy AVs, n = 10; calcific AVs, n = 15; AV, Aortic valve; HMGB1, high-mobility group box-1 protein; TLR4, Toll-like receptor 4. **P < .01. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 255-262DOI: (10.1016/j.jtcvs.2015.09.077) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 The HMGB1 protein induced osteoblastic differentiation of aortic valve interstitial cells, via TLR4. A-C, The HMGB1 treatment increased the expression of TLR4, BMP2, and osteocalcin in a dose-dependent manner. D-F, The TLR4 siRNA significantly (D) reduced the expression of TLR4; and (E and F) suppressed the up-regulation of BMP2 and osteocalcin induced by HMGB1. Data are presented as the mean ± SE (error bars) of independent experiments in cells from 3 different aortic valve tissues. TLR4, Toll-like receptor 4; BMP2, bone morphogenetic protein 2; HMGB1, high-mobility group box-1 protein; Scr siRNA, scrambled small interfering ribonucleic acid. **P < .01 versus control subjects. ##P < .01 versus HMGB1 + Scr siRNA. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 255-262DOI: (10.1016/j.jtcvs.2015.09.077) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Quantitative polymerase chain reaction analysis of inflammatory cytokine mRNA expression in valvular interstitial cells. The HMGB1 markedly augmented mRNA expression of (A) MCP-1, (B) TNF-α, and (C) IL-6, which was attenuated by TLR4 siRNA. Data are presented as the mean ± SE (error bars) of independent experiments in cells from 3 different aortic valve tissues. MCP, Monocyte chemoattractant protein; mRNA, messenger RNA; TNF, tumor necrosis factor; IL, interleukin; HMGB1, high-mobility group box; Scr siRNA, scrambled small interfering ribonucleic acid; TLR4, Toll-like receptor 4. **P < .01 versus control. ##P < .01 versus HMGB1 + Scr siRNA. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 255-262DOI: (10.1016/j.jtcvs.2015.09.077) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 The HMGB1-induced osteoblastic differentiation of valve interstitial cells, which is TLR4 dependent, and mediated by NF-κB and JNK MAPK. A and B, The HMGB1 protein induced the phosphorylation of NF-κB and JNK MAPK, which was suppressed by TLR4 silencing. C, In the presence of NF-κB and JNK MAPK inhibitors, the HMGB1–up-regulated expression of both BMP2 and osteocalcin were decreased significantly. Data are presented as the mean ± SE (error bars) of independent experiments in cells from 3 different aortic valve tissues. NF-κB, Nuclear factor kappa-B; JNK, c-Jun N-terminal kinase; BMP, bone morphogenetic protein; HMGB1, high-mobility group box; Scr siRNA, scrambled small interfering ribonucleic acid; TLR4 siRNA, Toll-like receptor 4 small interfering ribonucleic acid; DMSO, dimethyl sulfoxide. **P < .01 versus control. ##P < .01 versus HMGB1 + Scr siRNA or HMGB1. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 255-262DOI: (10.1016/j.jtcvs.2015.09.077) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Analysis of calcium deposition of VICs induced by different treatment. A, Representative alizarin red staining of VICs. Scale bar = 200 μm. B, Quantitative analysis showed that HMGB1 increased calcium deposition in VICs; TLR4 siRNA, NF-κB, and JNK MAPK inhibitors attenuated this effect. Data are presented as the mean ± SE (error bars) of independent experiments in cells from 3 different aortic valve tissues. HMGB1, High-mobility group box; siRNA, small interfering ribonucleic acid; TLR4, Toll-like receptor 4; JNK, c-Jun N-terminal kinase; NF-κB, nuclear factor kappa-B. **P < .01 versus control. ##P < .01 versus HMGB1 + Scr siRNA or HMGB1. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 255-262DOI: (10.1016/j.jtcvs.2015.09.077) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Schematic illustration of the role of (HMGB1 and TLR4 in the development of osteoblastic phenotype change in human aortic valve interstitial cells. HMGB1, High-mobility group box 1; TLR4, Toll-like receptor 4; p, phosphorylated; NF-κB, nuclear factor kappa-B; JNK, c-Jun N-terminal kinase; BMP, bone morphogenetic protein; MCP, monocyte chemoattractant protein; TNF, tumor necrosis factor; IL, interleukin. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 255-262DOI: (10.1016/j.jtcvs.2015.09.077) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

The HMGB1 protein may promote the osteoblastic differentiation of VICs, through the TLR4 pathway. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 255-262DOI: (10.1016/j.jtcvs.2015.09.077) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions