In this study, we observed that ILK is an important regulator of intimal thickening. We have shown for the first time increased ILK expression in the intima and media in two models of intimal thickening. Furthermore, the significant inhibition of intimal thickening by 50% with a dominant negative ILK directly indicates its involvement in intimal thickening. Following balloon injury of the rat carotid artery, VSMCs in the media undergo an early, reversible de-differentiation, followed by proliferation and migration [
1]. We observed that ILK is up-regulated as early as 2 days after injury and therefore participates in the induction of VSMC proliferation and migration. Although a previous study has demonstrated the ability of ILK to regulate VSMC proliferation and migration [
8] this is the first demonstration that ILK is elevated during intimal thickening and inhibition of ILK effectively retards intimal thickening. We confirmed the ability of ILK to modulate VSMC proliferation and migration in cultured cells and suggest that this is mediated at least in part by modulation of cell–matrix contacts and cross-talk between cell–matrix and cell–cell contact proteins and
β-catenin signaling.
To investigate the mechanism by which ILK is upregulated during intimal thickening we utilised cultured VSMCs. We observed that ILK protein expression was high both in the presence and absence of FCS when VSMCs were grown on plastic tissue culture wells, indicating that expression was not regulated by growth factors. Since low levels of ILK were observed in vivo in the presence of extracellular matrix we attempted to modulate ILK levels by growing VSMCs on laminin a basement membrane component that normally surrounds VSMCs and maintains the contractile phenotype [
13]. ILK was significantly, albeit partially, reduced by culture on laminin, which illustrates the ability of the extracellular matrix to modulate ILK expression as observed previously with collagen type I in fibroblasts [
22]. In support of this we also observed that ILK expression was elevated by culture on fibronectin, an extracellular matrix protein associated with the synthetic phenotype and intimal thickening and atherosclerosis [
5,
33].
We examined the role of ILK by increasing ILK levels using over-expression of WT-ILK and by inhibiting ILK using siRNA and over-expression of DN-ILK. Over-expression of WT-ILK significantly increased both proliferation and migration of VSMC grown on laminin in vitro, corroborating previous findings [
8]. Interestingly, enhanced migration was not observed by over-expression of WT-ILK when VSMC were grown on uncoated or fibronectin-coated membranes. We suggest that in these conditions where ILK activity is elevated over-expression of ILK is unable to further enhance migration, since the ILK-dependent pathway is maximally stimulated. The inhibitory experiments confirmed the ability of ILK to stimulate proliferation and migration on all matrices. Importantly no significant induction of VSMC death was observed with over-expression of ILK, after ILK silencing or in DN-ILK expressing cells at the time of the migration and proliferation assays (24 h) so enhanced cell death cannot be responsible for the reduced proliferation and migration. Interestingly, however, sustained inhibition of ILK with DN-ILK for 72 h significantly increased VSMC apoptosis. We suggest that extended culture of VSMCs that have reduced levels of FAK,
N-cadherin, and pAkt which provide vital survival signals for VSMCs [
14,
18] render the VSMC more susceptible to apoptosis.
A key function of ILK is to provide a molecular scaffold in focal adhesions and therefore a potential mechanism for these effects on VSMC behaviour is the modulation of focal adhesion complexes. Indeed, studies in ILK-null systems in
Drosophila melanogaster and
Caenorhabditis elegans questioned the role of ILK kinase activity in cellular regulation and suggested a more dominant role for ILK as a molecular scaffold [
20,
42]. This is supported by the observation that ILK mutants which retain kinase activity act as a dominant negative by blocking paxillin binding and ILK localization to focal adhesions [
23,
40]. In this study we observed decreased localization of paxillin in focal adhesions despite no effect on total levels of this protein in VSMCs subjected to ILK silencing or expressing DN-ILK. This is consistent with previous findings with this DN-ILK and with siRNA inhibition of ILK in other cell types [
12,
17,
24,
36]. In addition, we observed reduced vinculin localization in focal adhesions and attenuated levels of FAK, indicative of decreased numbers of focal adhesions. Although we were unable to detect cleavage of FAK at 24 h after the infection period after extended culture for 72 h a 60 kDa fragment was detected, indicating that FAK cleavage may be responsible for the reduction in FAK expression (data not shown). It is likely that reduced FAK is the result of attenuated levels of paxillin in focal adhesions since Yano et al. [
41] demonstrated that paxillin is essential for the recruitment of FAK to focal adhesions. FAK is a cytoplasmic tyrosine kinase, which functions as an integrin-activated scaffold in focal adhesions for assembly of signaling and structural proteins involved in cell migration (see for review [
39]). Activation of FAK is also necessary for optimal growth factor-mediated VSMC proliferation [
32]. Furthermore, we observed that ILK inhibition led to disorganization of the actin cytoskeleton, this may be the result of reduced Rac- and Cdc-42 activity as observed previously in epithelial cells [
7]. Therefore our findings suggest that via acting as a molecular scaffold for paxillin binding and organization of focal adhesions and the actin cytoskeleton, ILK regulates VSMC proliferation and migration and thereby intimal thickening.
Although it is fair to say that controversy exists as to whether ILK is a
bona fide kinase, many studies have shown that activation of ILK phosphorylates downstream effectors, including Akt and GSK-3
β [
4]. Consequently, ILK is an important modulator of several signaling pathways including the canonical Wnt/
β-catenin pathway [
25-
27], which regulates expression of cell cycle genes including cyclin D1, p21 and c-myc and migratory genes including MMP-7. Indeed in this study, silencing of ILK caused a dramatic reduction in the phosphorylation of GSK-3
β and Akt and therefore this may contribute to the observed effects on intimal thickening by modulation of signaling pathways including the Wnt/
β-catenin pathway. In support of this we observed that silencing of ILK significantly reduced
β-catenin signalling. Additionally, culture on laminin which decreased ILK expression reduced
β-catenin signaling, while the contrary was observed with fibronectin. We and others have shown that
β-catenin is increased during intimal thickening and is a key regulator of VSMC proliferation [
29,
31,
35,
37]. However, the mechanism responsible for up-regulation of
β-catenin during intimal thickening has not been fully elucidated. We suggest therefore that increased ILK activity contributes to increased
β-catenin signaling during intimal thickening and thereby alters the expression of
β-catenin responsive genes including two cell cycle regulators, cyclin D1 and p21. Oloumi et al. have also highlighted that ILK may regulate
β-catenin stability in a GSK-3
β independent manner [
26] and therefore we cannot rule out that this also contributes to
β-catenin stability and signaling.
Previous studies have demonstrated cross-talk between cell–matrix and cell–cell contacts, which may result from a physical response to integrin-mediated adhesion, complex cell differentiation processes or direct signaling pathways that link the two adhesion systems (see for review [
3]). We and others have previously demonstrated that
N-cadherin-mediated cell–cell contacts modulate VSMC proliferation and migration [
15,
29,
35]. Consequently, it is pertinent to determine the mechanisms by which cell–cell adhesion proteins are regulated. To determine therefore whether ILK activity affects cell–cell adhesion proteins, we investigated the levels of
N-cadherin, which is important for cell–cell contacts in VSMCs [
35]. We observed decreased levels of
N-cadherin in VSMCs subjected to ILK siRNA knockdown and expressing DN-ILK compared to controls. We observed no effect on mRNA levels (data not shown) and therefore we suggest that this is a post-translational effect, for example shedding by MMPs as we previously observed [
35]. Therefore we propose that reduced focal adhesions lead to a concomitant loss of
N-cadherin and thereby cell–cell contacts. In agreement with our results Yano et al. [
41] have previously demonstrated that siRNA-mediated knockdown of FAK and paxillin resulted in impaired assembly of
N-cadherin-mediated cell–cell contacts due to impaired FAK and Rac1 activity. It is logical that reduced levels of
N-cadherin may inhibit VSMC migration since
N-cadherin is required for VSMC migration [
15]. From our previous studies, one would predict that reduced
N-cadherin levels would promote VSMC proliferation [
31,
35,
37]. However, we have shown that this requires
β-catenin signaling [
29] and therefore since
β-catenin stability and signaling is reduced by ILK inhibition [
26], loss of
N-cadherin may be unable to promote proliferation due to attenuated levels of
β-catenin. Consequently, we suggest that inhibition of ILK regulates intimal thickening via attenuation of VSMC migration and proliferation is mediated at least in part by loss of
N-cadherin and down-regulation of
β-catenin signaling.
In summary, ILK plays an important role in intimal thickening via regulation of VSMC proliferation and migration. We observed that ILK is a key intermediate regulator of several pathways which control VSMC proliferation and migration and therefore small molecule inhibitors of ILK such as QLT-0267 may be useful for attenuating intimal thickening.