Systemic Inflammation in Microphysiological Models of Muscle and Vascular Disease

摘要 动脉粥样硬化的发生和发展受全身炎症和个体的影响 患有自身免疫性疾病，如类风湿性关节炎， 心血管疾病同样，类风湿性关节炎中的慢性和全身性炎症诱导肌肉 浪费和功能丧失。减少炎症的疗法有效地治疗类风湿性关节炎， 有可能降低心血管疾病的严重程度。克服动物的局限性 我们建立的模型复制了一些关键的疾病表型，但不是潜在的机制， 健康人体骨骼肌和心肌的功能性人体微生理系统（hMPS）， 内皮化组织工程血管（eTBEV）使用原代和iPS衍生的细胞，并评估 对药物和促炎细胞因子的反应。这些模型复制了结构和关键功能 并保持其结构和功能至少4周。这些体外组织 系统准确地模拟了对药物的反应。我们在这个项目中的目标是开发临床相关的 hMPS疾病模型用于检查类风湿性关节炎（RA）肌肉功能障碍和动脉粥样硬化的风险 以及运动在减轻疾病相关炎症中的作用。为了实现这一目标，我们将扩大 开发和验证早期动脉粥样硬化模型的初步结果， 内皮功能障碍、巨噬细胞积聚、泡沫细胞形成和改变的血管活性。我们将 通过加入巨噬细胞和细胞因子在骨骼肌和心肌中复制RA表型 存在于RA中，并证明肌肉上的模拟运动条件产生肌因子， 在这个RA模型中。然后，我们将开发一个集成的灌注系统，用于eTEBV，骨骼 和心肌，并表明RA模型可以增加eTEBV中巨噬细胞的积聚， 心脏束，并评估对运动和药物治疗动脉粥样硬化和炎症的反应。 我们将使用CRISPR基因编辑技术产生突变，以前蛋白转化酶枯草杆菌蛋白酶/kexin 9型（PCSK 9）和影响IL-6脱落的基因，以评估其对内皮功能障碍的影响， eTEBV中的泡沫细胞形成以及骨骼肌和心肌束中的炎症。我们会侧写 细胞因子和代谢产物的研究，并证明疾病进展和 生物标志物在常见的抗炎治疗干预的存在下减少， 动脉粥样硬化，并评估运动的影响。同样，在RA肌肉模型中，我们将检查是否 基因变异产生细胞因子谱的改变，影响肌肉功能和对运动的反应; 这些可能指向新的疾病相关生物标志物和治疗靶点。本项目的成果 将为动脉粥样硬化和自身免疫性疾病的体外建模提供一般框架， 基因变异在疾病严重程度和药物开发中的作用。

ABSTRACT The initiation and progression of atherosclerosis is influenced by systemic inflammation and individuals suffering from autoimmune diseases, such as rheumatoid arthritis, have increased risk of developing cardiovascular diseases. Likewise, chronic and systemic inflammation in rheumatoid arthritis induces muscle wasting and loss of function. Therapies that reduce inflammation effectively treat rheumatoid arthritis and have the potential to reduce the severity of cardiovascular disease. To overcome limitations of animal models replicating some key disease phenotypes, but not the underlying mechanisms, we established functional human microphysiological systems (hMPS) for healthy human skeletal and cardiac muscle and endothelialized tissue-engineered blood vessels (eTBEVs) using primary and iPS-derived cells and assessed the response to drugs and pro-inflammatory cytokines. These models replicate the structure and key functions of the native tissue and maintain their structure and function for at least 4 weeks. These in vitro tissue systems accurately model the response to drugs. Our goal in this project is to develop clinically relevant hMPS disease models to examine rheumatoid arthritis (RA) risk for muscle dysfunction and atherosclerosis and the role of exercise in attenuating disease-associated inflammation. To meet this goal, we will expand our preliminary results to develop and validate an early atherosclerosis model that uses flow conditions promoting endothelial dysfunction, macrophage accumulation, foam cell formation, and altered vasoactivity. We will reproduce the RA phenotype in skeletal and cardiac muscle through addition of macrophages and cytokines present in RA, and demonstrate that simulated exercise conditions on muscle produce myokines that reduce inflammation in this RA model. Then, we will develop an integrated perfusion system for eTEBVs, skeletal and cardiac muscle and show that the RA model can increase macrophage accumulation in eTEBVs and cardiac bundles, and assess the response to exercise and drugs to treat atherosclerosis and inflammation. We will use CRISPR gene editing technology to generate mutations to proprotein convertase subtilisin/kexin type 9 (PCSK9) and genes that affect IL-6 shedding to assess their impact on endothelial dysfunction and foam cell formation in eTEBVs, and inflammation in skeletal and cardiac muscle bundles. We will profile cytokines and metabolites in the models with and without RA, and demonstrate that disease progression and biomarkers are reduced in the presence of common anti-inflammatory therapeutic interventions for atherosclerosis, and assess the effect of exercise. Likewise, in the RA muscle model, we will examine whether gene variants produce alterations in cytokine profiles impacting muscle function and response to exercise; these may point toward new disease-associated biomarkers and therapeutic targets. Results of this project will provide a general framework for in vitro modeling of atherosclerosis and autoimmune diseases and the role of gene variants in disease severity and drug development.