Characterization of the vascular phenotype in dHet mice has correlated hypertension, decreased vessel diameter, increased vessel length, and vessel tortuosity with elastin haploinsufficiency, and fibrillin-1 deficiency with aortic dilation and significantly less, with increased vessel length. Together with estimates of mutant ECM composition, the analyses also indicate that perturbations of some material properties are mostly accounted for by reduction in the total amount of both proteins, which operate in either additive (aortic stiffness) or partially overlapping (carotid artery compliance) manners. Lastly, preliminary evidence suggests that fibrillin-1 participates in the developmental adaptation of Eln+/− arteries (number of elastic lamellae) to hypertension.
Combined reduction of elastin and fibrillin-1 levels leads to changes in the pressure-diameter relationship of the arterial wall, which restricts vessel expansion at extreme pressures and promotes expansion at intermediate physiological values. Reduced expansion of
Eln+/− aortae at high pressures may reflect an increase in the relative ratio between collagen and elastin, which causes stiff collagen fibers to become the load-bearing elements at lower pressures. On the other hand, increased vessel expansion at intermediate physiological pressures in
Fbn1+/− aortae conceivably reflects the mechanical role of microfibrils in opposing pressure-induced dilation.
1,22 Consistent with evolutionary considerations,
22 the fact that
dHet aortae display abnormalities in both pressure ranges supports the notion that the two proteins have distinct functions in vessel compliance, with elastin providing elastic recoil and fibrillin-1 providing tensile strength. In accordance with previous work,
10,11 our data also indicate that normalization of aortic diameter and blood flow occurs at physiological pressures in
WT or
Eln+/− but not in
Fbn1+/− or
dHet aortae. This last finding strongly suggests that vascular compensation requires optimal fibrillin-1 levels.
Further analyses of our data indicate that elastin levels are critical for the mechanical behavior of both the ascending aorta and carotid artery, whereas fibrillin-1 levels mostly affect the ascending aorta. These findings are in agreement with the restricted vascular manifestations in MFS patients and mouse models of the disease, and imply spatially defined role(s) of fibrillin-1 microfibrils in the circulatory system.
2 Circumferential stress and stretch ratio of
Eln+/− and
Fbn1+/− aortae show similar increases at intermediate pressure values suggesting that elastin and fibrillin-1 cooperate in endowing the aortic wall with discrete material properties that influence the mechanical behavior. This conclusion is also supported by the observation that the stretch ratio of
dHet aortae differs significantly from that of
Eln+/− or
Fbn1+/− in the same pressure range. A similar argument applies to the incremental stiffness of dHet aortae. Previous studies have highlighted the associations between increased arterial stiffness and decreased compliance with both systemic hypertension and left ventricular hypertrophy.
23,24 They have also shown that aortic stiffness is abnormally high in either elastin or fibrillin-1 deficiency.
9–11,25,26Although increased stiffness characterizes both
Eln+/− and
Fbn1+/− aortae, only the former mice are hypertensive probably because reduced fibrillin-1 levels do not decrease the unloaded aortic diameter thus maintaining normal blood flow. This observation supports our contention that hypertension is primarily caused by elastin deficiency, which restricts vessel size and causes hypertension in both
Eln+/− and
dHet mice. Association of elastin haploinsufficiency and hypertension with a greater number of lamellar units is also consistent with the notion that increased hemodynamic force induces wall remodeling to maintain a constant tension per lamellar unit.
6,10–13 Lamellar unit number is established during arterial development in coordination with blood pressure increases, SMC differentiation, and elastin accumulation.
1,27 Elastin deficiency causes perinatal hypertension leading to more lamellar units and lamellar tension normalization in
Eln+/− mice.
10,11,14 The fact that
dHet mice are hypertensive and have fewer lamellar units than
Eln+/− mice indicates that a threshold level of fibrillin-1 is required to normalize the tension/lamellar unit ratio and thus aortic mechanics. This line of reasoning is consistent with our earlier report that the organization and maturation of lamellar units are grossly impaired in
Fbn1-null mice.
15 Collectively, these findings advance substantially our understanding of the structural determinants of vascular physiology and the pathological mechanisms that underlay disease progression in SVAS and MFS, and in age-related processes of vascular tissue degradation.