Transcriptome profiling of 3D co-cultured cardiomyocytes and endothelial cells under oxidative stress using a photocrosslinkable hydrogel system
Open accessAbstract
Myocardial infarction (MI) is one of the most common among cardiovascular diseases. Endothelial cells (ECs) are considered to have protective effects on cardiomyocytes (CMs) under stress conditions such as MI; however, the paracrine CM-EC crosstalk and the resulting endogenous cellular responses that could contribute to this protective effect are not thoroughly investigated. Here we created biomimetic synthetic tissues containing CMs and human induced pluripotent stem cell (hiPSC)-derived ECs (iECs), which showed improved cell survival compared to single cultures under conditions mimicking the aftermath of MI, and performed high-throughput RNA-sequencing to identify target pathways that could govern CM-iEC crosstalk and the resulting improvement in cell viability. Our results showed that single cultured CMs had different gene expression profiles compared to CMs co-cultured with iECs. More importantly, this gene expression profile was preserved in response to oxidative stress in co-cultured CMs while single cultured CMs showed a significantly different gene expression pattern under stress, suggesting a stabilizing effect of iECs on CMs under oxidative stress conditions. Furthermore, we have validated the in vivo relevance of our engineered model tissues by comparing the changes in the expression levels of several key genes of the encapsulated CMs and iECs with in vivo rat MI model data and clinical data, respectively. We conclude that iECs have protective effects on CMs under oxidative stress through stabilizing mitochondrial complexes, suppressing oxidative phosphorylation pathway and activating pathways such as the drug metabolism-cytochrome P450 pathway, Rap1 signaling pathway, and adrenergic signaling in cardiomyocytes pathway. Statement of significance Heart diseases are the leading cause of death worldwide. Oxidative stress is a common unwanted outcome that especially occurs due to the reperfusion following heart attack or heart surgery. Standard methods of in vivo analysis do not allow dissecting various intermingled parameters, while regular 2D cell culture approaches often fail to provide a biomimetic environment for the physiologically relevant cellular phenotypes. In this research, a systematic genome-wide transcriptome profiling was performed on myocardial cells in a biomimetic 3D hydrogel-based synthetic model tissue, for identifying possible target genes and pathways as protecting regulators against oxidative stress. Identification of such pathways would be very valuable for new strategies during heart disease treatment by reducing the cellular damage due to reperfusion injury.
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hCMEC supports efficient metabolic and electrical function by increasing oxygenation and electrophysiological properties through the release of vascular endothelial growth factor (VEGF) and nitric oxide.
“Moreover hCMEC supports efficient metabolic and electrical function by increasing oxygenation and electrophysiological properties through the release of vascular endothelial growth factor (VEGF) and nitric oxide.[ 55 , 56 ]”
From Engineered in vitro multi-cell type ventricle model generates long-term pulsatile flow and modulates cardiac output in response to cardioactive drugs (2025) · cites this paper as [55]
The Introduction (page not provided) describes nitric oxide as an endothelial-cell modulator and says endothelial–cardiomyocyte interactions affect cardiac function and metabolism. The Results and Discussion report that endothelial co-culture stabilizes cardiomyocyte gene expression and metabolism under oxidative stress. The paper does not establish increased oxygenation or electrophysiological properties through these factors; its Introduction identifies cardiomyocytes, not endothelial cells, as releasing VEGF. (LLM, conf=0.86)
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Endothelial cell oxidative stress and signal transduction
FONCEA, R., CARVAJAL, C., ALMARZA, C., & LEIGHTON, F. (2000) · Biological Research · doi:10.4067/s0716-97602000000200008 · Cited by 89 · see citing works
Pessler, D., Rudich, A., & Bashan, N. (2001) · Diabetologia · doi:10.1007/s001250100024 · Cited by 82 · cited 1× · see citing works
“Glut4 is associated with diabetes and its mRNA expression decreases after 4 h of exposure to H2O2 in 3T3-L1 adipocytes [52].”
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Research works printed but not linked: 69
- [1]Liehn EA Postea O Curaj A Marx N Repair after myocardial infarction, between fantasy and reality: The role of chemokines J Am Coll Cardiol 58 2011 2357 2362 22115639
- [2]Abrial M Da Silva CC Pillot B Augeul L Ivanes F Teixeira G Cartier R Angoulvant D Ovize M Ferrera R Cardiac fibroblasts protect cardiomyocytes against lethal ischemia-reperfusion injury J Mol Cell Cardiol 68 2014 56 65 24440456
- [3]Ongstad E Kohl P Fibroblast-myocyte coupling in the heart: potential relevance for therapeutic interventions J Mol Cell Cardiol 91 2016 238 246 26774702 PMC5022561
- [4]Leucker TM Bienengraeber M Muravyeva M Baotic I Weihrauch D Brzezinska AK Warltier DC Kersten JR Jr Pratt PF Endothelial-cardiomyocyte crosstalk enhances pharmacological cardioprotection J Mol Cell Cardiol 51 2011 803 811 21791217 PMC3342532
- [5]Furchgott RF Zawadzki JV The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine Nature 288 1980 373 376 6253831
- [6]Noireaud J Andriantsitohaina R Recent insights in the paracrine modulation of cardiomyocyte contractility by cardiac endothelial cells BioMed Res Int 2014 2014 923805 24745027 PMC3972907
- [7]Arita Y Nakaoka Y Matsunaga T Kidoya H Yamamizu K Arima Y Kataoka-Hashimoto T Ikeoka K Yasui T Masaki T Yamamoto K Higuchi K Park JS Shirai M Nishiyama K Yamagishi H Otsu K Kurihara H Minami T Yamauchi-Takihara K Koh GY Mochizuki N Takakura N Sakata Y Yamashita JK Komuro I Myocardium-derived angiopoietin-1 is essential for coronary vein formation in the developing heart Nat Commun 5 2014 4552 25072663 PMC4124867
- [8]Tian Y Morrisey EE Importance of myocyte-nonmyocyte interactions in cardiac development and disease Circ Res 110 2012 1023 1034 22461366 PMC3366271
- [9]Cleaver O Melton DA Endothelial signaling during development Nat Med 9 2003 661 668 12778164
- [10]Drawnel FM Archer CR Roderick HL The role of the paracrine/autocrine mediator endothelin-1 in regulation of cardiac contractility and growth Br J Pharmacol 168 2013 296 317 22946456 PMC3572557
- [11]Wu B Zhang Z Lui W Chen X Wang Y Chamberlain A Moreno-Rodriquez RA Markwald RR O’Rourke BP Sharp DJ Zheng D Lenz J Baldwin HS Chang CP Zhou B Endocardial cells form the coronary arteries by angiogenesis through myocardial-endocardial VEGF signaling Cell 151 2012 1083 1096 23178125 PMC3508471
- [12]Park KH Park WJ Endothelial dysfunction: clinical implications in cardiovascular disease and therapeutic approaches J Korean Med Sci 30 2015 1213 1225 26339159 PMC4553666
- [13]Favero G Paganelli C Buffoli B Rodella LF Rezzani R Endothelium and its alterations in cardiovascular diseases: life style intervention BioMed, Res Int 2014 2014 801896 24719887 PMC3955677
- [14]Leucker TM Ge ZD Procknow J Liu Y Shi Y Bienengraeber M Warltier DC Kersten JR Impairment of endothelial-myocardial interaction increases the susceptibility of cardiomyocytes to ischemia/reperfusion injury PLoS One 8 2013 e70088 23894596 PMC3718730
- [15]Dowling P Clynes M Conditioned media from cell lines: a complementary model to clinical specimens for the discovery of disease-specific biomarkers Proteomics 11 2011 794 804 21229588
- [16]Hakim TS Sugimori K Camporesi EM Anderson G Half-life of nitric oxide in aqueous solutions with and without haemoglobin Physiol Meas 17 1996 267 277 8953625
- [17]Rodríguez-Pascual F Busnadiego O González-Santamaría J The profibrotic role of endothelin-1: is the door still open for the treatment of fibrotic diseases? Life Sci 118 2014 156 164 24378671
- [18]Liu X Gu X Li Z Li X Li H Chang J Chen P Jin J Xi B Chen D Lai D Graham RM Zhou M Neuregulin-1/erbB-activation improves cardiac function and survival in models of ischemic, dilated, and viral cardiomyopathy J Am Coll Cardiol 48 2006 1438 1447 17010808
- [19]Lu HF Leong M Lim T Chua YP Lim JK Du C Wan AC Engineering a functional three-dimensional human cardiac tissue model for drug toxicity screening Biofabrication 2017 10.1088/1758-5090/aa6c3a ahead of print 28393762 · DOI
- [20]Wang G McCain ML Yang L He A Pasqualini FS Agarwal A Yuan H Jiang D Zhang D Zangi L Roberts JGAE Ma Q Ding J Chen J Wang D Wang KLJ Wanders RJA Kulik W Vaz FM Laflamme MA Murry CE Chien KR Kelley RI Church GM Parker KK Pu WT Modeling the mitochondrial cardiomyopathy of Barth syndrome with induced pluripotent stem cell and heart-on-chip technologies Nature Medicine 20 2014 616 623 PMC4172922 24813252
- [21]Bayzigitov DR Medvedev SP Dementyeva EV Bayramova SA Pokushalov EA Karaskov AM Zakian SM Human induced pluripotent stem cell-derived cardiomyocytes afford new opportunities in inherited cardiovascular disease modeling Cardiol Res Pract 2016 3582380 27110425 PMC4826691
- [22]Ellis BW Acun A Can UI Zorlutuna P Human iPSC-derived myocardium-on-chip with capillary-like flow for personalized medicine Biomicrofluidics 11 2017 024105 28396709 PMC5367145
- [23]Sheehy SP Pasqualini F Grosberg A Park SJ Aratyn-Schaus Y Parker KK Quality metrics for stem cell-derived cardiac myocytes Stem Cell Reports 2 2014 282 294 24672752 PMC3964283
- [24]Wang GJ Guo LY Wang HX Yao YS IP3R and RyR calcium channels are involved in neonatal rat cardiac myocyte hypertrophy induced by tumor necrosis factor-α Am J Transl Res 9 2017 343 354 28337264 PMC5340671
- [25]Rat Genome Sequencing Project Consortium Genome sequence of the Brown Norway rat yields insights into mammalian evolution Nature 428 2004 493 521 15057822
- [26]Tanaka M Ito H Adachi S Akimoto H Nishikawa T Kasajima T Marumo F Hiroe M Hypoxia induces apoptosis with enhanced expression of Fas antigen messenger RNA in cultured neonatal rat cardiomyocytes Circ Res 75 1994 426 433 7520371
- [27]Patsch C Challet-Meylan L Thoma EC Urich E Heckel T O’Sullivan JF Grainger SJ Kapp FG Sun L Christensen K Xia Y Florido MH He W Pan W Prummer M Warren CR Jakob-Roetne R Certa U Jagasia R Freskgård PO Adatto I Kling D Huang P Zon LI Chaikof EL Gerszten RE Graf M Iacone R Cowan CA Generation of vascular endothelial and smooth muscle cells from human pluripotent stem cells Nat Cell Biol 17 2015 994 1003 26214132 PMC4566857
- [28]Merwald H Klosner G Kokesch C Der-Petrossian M Honigsmann H Trautinger F UVA-induced oxidative damage and cytotoxicity depend on the mode of exposure J Photochem Photobiol B 79 2005 197 207 15896646
- [29]Shorrocks J Paul ND McMillan TJ The dose rate of UVA treatment influences the cellular response of HaCaT keratinocytes J Invest Dermatol 128 2008 685 693 17762856
- [30]Yu G Wang L Han Y He Q clusterProfiler: an R package for comparing biological themes among gene clusters OMICS 16 2012 284 287 22455463 PMC3339379
- [31]Franceschini A Szklarczyk D Frankild S Kuhn M Simonovic M Roth A Lin J Minguez P Bork P von Mering C Jensen LJ STRING v9.1: protein-protein interaction networks, with increased coverage and integration Nucleic Acids Res 41 Database issue 2013 D808 D815 23203871 PMC3531103
- [32]Engler AJ Carag-Krieger C Johnson CP Raab M Tang HY Speicher DW Sanger JW Sanger JM Discher DE Embryonic cardiomyocytes beat best on a matrix with heart-like elasticity: scar-like rigidity inhibits beating J Cell Sci 121 2008 3794 3802 18957515 PMC2740334
- [33]Acun A Zorlutuna P Engineered myocardium model to study the roles of HIF-1α and HIF1A-AS1 in paracrine-only signaling under pathological level oxidative stress Acta Biomater 10.1016/j.actbio.2017.06.023 PMC5563471 28629892 · DOI
- [34]Hoppe S Bierhoff H Cado I Weber A Tiebe M Grummt I Voit R AMP-activated protein kinase adapts rRNA synthesis to cellular energy supply Proc Natl Acad Sci U S A 106 2009 17781 17786 19815529 PMC2764937
- [35]Owens DM Keyse SM Differential regulation of MAP kinase signalling by dual-specificity protein phosphatases Oncogene 26 2007 3203 3213 17496916
- [36]Kashida S Sugino N Takiguchi S Karube A Takayama H Yamagata Y Nakamura Y Kato H Regulation and role of vascular endothelial growth factor in the corpus luteum during mid-pregnancy in rats Biol Reprod 64 2001 317 323 11133689
- [37]Sun LN Li LL Li ZB Wang L Wang XL Protective effects of TREK-1 against oxidative injury induced by SNP and H2O2 Acta Pharmacol Sin 29 2008 1150 1156 18817618
- [38]Kim YH Lim DS Lee JH Shim WJ Ro YM Park GH Becker KG Cho-Chung YS Kim MK Gene expression profiling of oxidative stress on atrial fibrillation in humans Exp Mol Med 35 2003 336 349 14646586
- [39]Siwik DA Pagano PJ Colucci WS Oxidative stress regulates collagen synthesis and matrix metalloproteinase activity in cardiac fibroblasts Am J Physiol Cell Physiol 280 2001 C53 60 11121376
- [40]Vasiliou V Nebert DW Analysis and update of the human aldehyde dehydrogenase (ALDH) gene family Hum Genomics 2 2005 138 143 16004729 PMC3525259
- [41]Cao SS Kaufman RJ Endoplasmic reticulum stress and oxidative stress in cell fate decision and human disease Antioxid Redox Signal 21 2014 396 413 24702237 PMC4076992
- [42]Dominguez-Rodriguez A Abreu-Gonzalez P Avanzas P Relation of growth-differentiation factor 15 to left ventricular remodeling in ST-segment elevation myocardial infarction Am J Cardiol 108 2011 955 958 21784389
- [43]Bhasin M Yuan L Keskin DB Otu HH Libermann TA Oettgen P Bioinformatic identification and characterization of human endothelial cell-restricted genes BMC Genomics 11 2010 342 20509943 PMC2887814
- [44]Rani R Li J Pang Q Differential p53 engagement in response to oxidative and oncogenic stresses in Fanconi anemia mice Cancer Res 68 2008 9693 9702 19047147 PMC2597211
- [45]Cheng C Haasdijk R Tempel D van de Kamp EH Herpers R Bos F Den Dekker WK Blonden LA de Jong R Bürgisser PE Chrifi I Biessen EA Dimmeler S Schulte-Merker S Duckers HJ Endothelial cell-specific FGD5 involvement in vascular pruning defines neovessel fate in mice Circulation 125 2012 3142 3158 22661514
- [46]Ye F Yuan F Li X Cooper N Tinney JP Keller BB Gene expression profiles in engineered cardiac tissues respond to mechanical loading and inhibition of tyrosine kinases Physiol Rep 1 2013 e00078 24303162 PMC3841024
- [47]Mirotsou M Zhang Z Deb A Zhang L Gnecchi M Noiseux N Mu H Pachori A Dzau V Secreted frizzled related protein 2 (Sfrp2) is the key Akt-mesenchymal stem cell-released paracrine factor mediating myocardial survival and repair Proc Natl Acad Sci U S A 104 2007 1643 1648 17251350 PMC1785280
- [48]Lage SL Longo C Branco LM da Costa TB de Buzzo CL Bortoluci KR Emerging concepts about NAIP/NLRC4 inflammasomes Front Immunol 5 2014 309 25071770 PMC4078251
- [49]Götz R Karch C Digby MR Troppmair J Rapp UR Sendtner M The neuronal apoptosis inhibitory protein suppresses neuronal differentiation and apoptosis in PC12 cells Hum Mol Genet 9 2000 2479 2489 11030753
- [50]Lin L Knowlton AA Innate immunity and cardiomyocytes in ischemic heart disease Life Sci 100 2014 1 8 24486305 PMC3970925
- [51]Clerk A Kemp TJ Zoumpoulidou G Sugden PH Cardiac myocyte gene expression profiling during H2O2-induced apoptosis Physiol Genomics 29 2007 118 127 17148688
- [53]Lu H Buchan RJ Cook SA MicroRNA-223 regulates Glut4 expression and cardiomyocyte glucose metabolism Cardiovasc Res 86 2010 410 420 20080987
- [54]Montessuit C Lerch R Regulation and dysregulation of glucose transport in cardiomyocytes Biochim Biophys Acta 1833 2013 848 856 22967513
- [55]Horie T Ono K Nagao K Nishi H Kinoshita M Kawamura T Wada H Shimatsu A Kita T Hasegawa K Oxidative stress induces GLUT4 translocation by activation of PI3-K/Akt and dual AMPK kinase in cardiac myocytes J Cell Physiol 215 2008 733 742 18163380
- [56]Selvaraj N Budka JA Ferris MW Plotnik JP Hollenhorst PC Extracellular signal-regulated kinase signaling regulates the opposing roles of JUN family transcription factors at ETS/AP-1 sites and in cell migration Mol Cell Biol 35 2015 88 100 25332240 PMC4295391
- [57]Catani MV Savini I Duranti G Caporossi D Ceci R Sabatini S Avigliano L Nuclear factor kappaB and activating protein 1 are involved in differentiation-related resistance to oxidative stress in skeletal muscle cells Free Radic Biol Med 37 2004 1024 1036 15336319
- [58]Bergman MR Cheng S Honbo N Piacentini L Karliner JS Lovett DH A functional activating protein 1 (AP-1) site regulates matrix metalloproteinase 2 (MMP-2) transcription by cardiac cells through interactions with JunB-Fra1 and JunB-FosB heterodimers Biochem J 369 2003 485 496 12371906 PMC1223099
- [59]Venugopal R Jaiswal AK Nrf1 and Nrf2 positively and c-Fos and Fra1 negatively regulate the human antioxidant response element-mediated expression of NAD(P)H:quinone oxidoreductase1 gene Proc Natl Acad Sci U S A 93 1996 14960 14965 8962164 PMC26245
- [60]Beutner G Eliseev RA Porter GA Initiation of electron transport chain activity in the embryonic heart coincides with the activation of mitochondrial complex 1 and the formation of supercomplexes PLoS ONE 9 2014 e113330 25427064 PMC4245138
- [61]Ide T Tsutsui H Kinugawa S Utsumi H Kang D Hattori N Uchida K Arimura Ki Egashira K Takeshita A Mitochondrial electron transport complex I is a potential source of oxygen free radicals in the failingmyocardium Circ Res 85 1999 357 363 10455064
- [62]Wagner BK Kitami T Gilbert TJ Peck D Ramanathan A Schreiber SL Golub TR Mootha VK Large-scale chemical dissection of mitochondrial function Nat Biotechnol 26 2008 343 351 18297058 PMC2715872
- [63]Singhal SS Singh SP Singhal P Horne D Singhal J Awasthi S Antioxidant role of Glutathione S-Transferases: 4-Hydroxynonenal, a key molecule in stress-mediated signaling Toxicol Appl Pharmacol 289 2015 361 370 26476300 PMC4852854
- [64]Klaus A Zorman S Berthier A Polge C Ramirez S Michelland S Sève M Vertommen D Rider M Lentze N Auerbach D Schlattner U Glutathione S-Transferases interact with AMP-activated protein kinase: evidence for S-Glutathionylation and activation in vitro PLoS ONE 8 2013 e62497 23741294 PMC3669356
- [65]Röth E Marczin N Balatonyi B Ghosh S Kovács V Alotti N Borsiczky B Gasz B Effect of a glutathione S-transferase inhibitor on oxidative stress and ischemia-reperfusion-induced apoptotic signaling of cultured cardiomyocytes Exp Clin Cardiol 16 2011 92 96 22065940 PMC3209546
- [66]Krueger SK Williams DE Mammalian flavin-containing monooxygenases: structure/function, genetic polymorphisms and role in drug metabolism Pharmacol Ther 106 2005 357 387 15922018 PMC1828602
- [67]Ebrahimian TG Heymes C You D Blanc-Brude O Mees B Waeckel L Duriez M Vilar J Brandes RP Levy BI Shah AM Silvestre JS NADPH oxidase-derived overproduction of reactive oxygen species impairs postischemic neovascularization in mice with type 1 diabetes Am J Pathol 169 2006 719 728 16877369 PMC1698801
- [68]Cai H Hydrogen peroxide regulation of endothelial function: origins, mechanisms, and consequences Cardiovasc Res 68 2005 26 36 16009356
- [69]Liu L Gu L Ma Q Zhu D Huang X Resveratrol attenuates hydrogen peroxide-induced apoptosis in human umbilical vein endothelial cells Eur Rev Med Pharmacol Sci 17 2013 88 94 23329528
- [71]Abe M Sato Y cDNA microarray analysis of the gene expression profile of VEGF-activated human umbilical vein endothelial cells Angiogenesis 4 2001 289 298 12197474
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Sorted by citations
Kuckelkorn, C., Aksoy, E., Stojanovic, N., Oulahyane, L., Ritter, M., Pfannkuche, K., & Fischer, H. (2025) · Advanced Healthcare Materials · doi:10.1002/adhm.202403897 · Cited by 3 · see citing works
- Authors
- Yue, X., Acun, A., & Zorlutuna, P.
- Affiliations
- University of Notre Dame (US)
- Venue
- Acta Biomaterialia
- Publisher
- Elsevier BV
- Published
- 2017-08
- Volume
- 58
- Pages
- 337-348
- ISSN
- 1742-7061 (ISSN-L)
- PMC
- PMC5563470
- OpenAlex
- W2686400070
- Cited by
- 16
- References
- 2
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2019: 4 · 2018: 2 · 2017: 4
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Acta Biomaterialia (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR001108)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Surgery › Tissue Engineering and Regenerative Medicine
- Health Sciences › Medicine › Pathology and Forensic Medicine › Cardiac Ischemia and Reperfusion
- Physical Sciences › Engineering › Biomedical Engineering › 3D Printing in Biomedical Research
- Keywords
- cardiomyocytes, endothelial cells, oxidative stress, myocardial infarction, ischemia-reperfusion injury, 3D co-culture, photocrosslinkable hydrogels, biomimetic tissue engineering, gene expression profiling, oxidative phosphorylation, cytochrome P450 pathway, Rap1 signaling, adrenergic signaling, cell viability
- MeSH terms
- Animals, Gene Expression Regulation, Rats, Sprague-Dawley, Oxidative Stress, Coculture Techniques, Hydrogels, Gene Expression Profiling, Myocytes, Cardiac, Endothelial Cells, Rats
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