Bone morphogenetic protein-4 system expression in human coronary artery endothelial and smooth muscle cells under dynamic flow: effect of medicated bioresorbable vascular scaffolds at low and normal shear stress.

Endothelial and smooth muscle cell dysfunction is an early event at the onset of atherosclerosis, a heterogeneous and multifactorial pathology of the vascular wall. Bone morphogenetic protein (BMP)-4, a mechanosensitive autocrine cytokine, and BMPR-1a, BMPR-1b, BMPR2 specific receptors play a key role in atherosclerotic plaque formation and vascular calcification, and BMP4 is regarded as a biomarker of endothelial cell activation. The study aimed to examine the BMP4 system expression by Real-Time PCR in Human Coronary Artery Endothelial (HCAECs) and Smooth Muscle Cells (HCASMCs) under different flow rates determining low or physiological shear stress in the presence/absence of medicated Bioresorbable Vascular Scaffold (BVS). The HCAEC and HCASMC were subjected to 1-10-20 dyne/cm2 shear stress in a laminar-flow bioreactor system, with/without BVS+Everolimus (600 nM). In HCAECs without BVS, the BMP4 expression was similar at 1,20 dyne/cm2, decreasing at 10 dyne/cm2, while adding BVS+Everolimus, it decreased both at 1,10 compared to 20 dyne/cm2. In HCASMCs without BVS+Everolimus, the BMP4 system mRNA expression was significantly reduced at 1,10 dyne/cm2 compared to 20 dyne/cm2, while in the presence of BVS+Everolimus, higher BMP4 mRNA levels were observed at 10 compared to 1,20 dyne/cm2. In HCAECs and HCASMCs, BMPRs were expressed in all experimental conditions except for BMPR-1a at 1 dyne/cm2 in HCAEC. Significant correlations were found between BMP4 and BMPRs. The more negligible effect on BMP4 expression due to low shear stress in HCAEC compared to HCASMC and its reduction in the presence of BVS+Everolimus at low shear stress highlighted the protection BMP4-mediated against endothelial dysfunction and neo-atherogenesis.