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Endoglin in Health and Disease

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A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Biochemistry".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 47305

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Dr. Lukas J.A.C. Hawinkels

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Department of Gastroenterology-Hepatology, Leiden University Medical Center (LUMC), 2333 ZC, Leiden, The Netherlands
Interests: cancer-asssociated fibroblast; fibroblasts; gastrointestinal cancer; inflammatory bowel disease
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Prof. Marie-José Goumans

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Laboratory for Cardiovascular Cell Biology, Department of Cell and Chemical Biology, Leiden University Medical Center - LUMC, Leiden, The Netherlands
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Dear Colleagues,

Endoglin is a co-receptor for members of the transforming growth factor (TGF)-β family, and is known for its crucial role during developmental- and tumor angiogenesis. Extensive work has shown the important roles endoglin plays in modulating the TGF-β signaling pathway, thereby regulating endothelial cell proliferation, migration, and differentiation. Mutations in the endoglin gene (ENG) have been linked to the autosomal vascular disorder hereditary hemorrhagic telangiectasia type 1 (HHT1), a disease characterized by vessel abnormalities. In cancer, endoglin is extensively studied in relation to tumor angiogenesis. High endoglin levels have been related to poorer prognoses for patients with solid tumors. Consequently, therapies that interfere with the function of endoglin, like soluble endoglin ligand traps and neutralizing antibodies to endoglin, have been developed and (clinically) evaluated. Besides the important role for endoglin in regulating angiogenesis, recent work also shows a more widespread role for endoglin beyond the endothelium. Endoglin expression is also reported on epithelial (cancer) cells, cancer-associated fibroblasts, smooth muscle cells in pathological conditions, and cells of the innate- and adaptive immune system. This Special Issue will bring together the most recent work on endoglin in regulating angiogenesis, but also on its role in non-endothelial cells and the potential of endoglin targeting as a new treatment option in various diseases.

Dr. Lukas J.A.C. Hawinkels
Prof. Marie-José Goumans
Guest Editors

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Keywords

endoglin
HHT
TRC105
angiogenesis
bone morphogenetic protein

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Published Papers (11 papers)

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Research

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20 pages, 11734 KiB

Open AccessArticle

Thresholds of Endoglin Expression in Endothelial Cells Explains Vascular Etiology in Hereditary Hemorrhagic Telangiectasia Type 1

by Georgios Galaris, Kévin Montagne, Jérémy H. Thalgott, Geoffroy J. P. E. Goujon, Sander van den Driesche, Sabrina Martin, Hans-Jurgen J. Mager, Christine L. Mummery, Ton J. Rabelink and Franck Lebrin

Int. J. Mol. Sci. 2021, 22(16), 8948; https://doi.org/10.3390/ijms22168948 - 19 Aug 2021

Cited by 7 | Viewed by 2750

Abstract

Hereditary Hemorrhagic Telangiectasia type 1 (HHT1) is an autosomal dominant inherited disease characterized by arteriovenous malformations and hemorrhage. HHT1 is caused by mutations in ENDOGLIN, which encodes an ancillary receptor for Transforming Growth Factor-β/Bone Morphogenetic Protein-9 expressed in all vascular endothelial cells. Haploinsufficiency is widely accepted as the underlying mechanism for HHT1. However, it remains intriguing that only some, but not all, vascular beds are affected, as these causal gene mutations are present in vasculature throughout the body. Here, we have examined the endoglin expression levels in the blood vessels of multiple organs in mice and in humans. We found a positive correlation between low basal levels of endoglin and the general prevalence of clinical manifestations in selected organs. Endoglin was found to be particularly low in the skin, the earliest site of vascular lesions in HHT1, and even undetectable in the arteries and capillaries of heterozygous endoglin mice. Endoglin levels did not appear to be associated with organ-specific vascular functions. Instead, our data revealed a critical endoglin threshold compatible with the haploinsufficiency model, below which endothelial cells independent of their tissue of origin exhibited abnormal responses to Vascular Endothelial Growth Factor. Our results support the development of drugs promoting endoglin expression as potentially protective. Full article

(This article belongs to the Special Issue Endoglin in Health and Disease)

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16 pages, 2705 KiB

Open AccessArticle

Endoglin Is an Endothelial Housekeeper against Inflammation: Insight in ECFC-Related Permeability through LIMK/Cofilin Pathway

by Elisa Rossi, Alexandre Kauskot, François Saller, Elisa Frezza, Sonia Poirault-Chassac, Anna Lokajczyk, Pierre Bourdoncle, Bruno Saubaméa, Pascale Gaussem, Miguel Pericacho, Regis Bobe, Christilla Bachelot-Loza, Samuela Pasquali, Carmelo Bernabeu and David M. Smadja

Int. J. Mol. Sci. 2021, 22(16), 8837; https://doi.org/10.3390/ijms22168837 - 17 Aug 2021

Cited by 4 | Viewed by 3204

Abstract

Endoglin (Eng) is an endothelial cell (EC) transmembrane glycoprotein involved in adhesion and angiogenesis. Eng mutations result in vessel abnormalities as observed in hereditary hemorrhagic telangiectasia of type 1. The role of Eng was investigated in endothelial functions and permeability under inflammatory conditions, focusing on the actin dynamic signaling pathway. Endothelial Colony-Forming Cells (ECFC) from human cord blood and mouse lung/aortic EC (MLEC, MAEC) from Eng^+/+ and Eng^+/− mice were used. ECFC silenced for Eng with Eng-siRNA and ctr-siRNA were used to test tubulogenesis and permeability +/− TNFα and +/− LIM kinase inhibitors (LIMKi). In silico modeling of TNFα–Eng interactions was carried out from PDB IDs 5HZW and 5HZV. Calcium ions (Ca²⁺) flux was studied by Oregon Green 488 in epifluorescence microscopy. Levels of cofilin phosphorylation and tubulin post-translational modifications were evaluated by Western blot. F-actin and actin–tubulin distribution/co-localization were evaluated in cells by confocal microscopy. Eng silencing in ECFCs resulted in a decrease of cell sprouting by 50 ± 15% (p < 0.05) and an increase in pseudo-tube width (41 ± 4.5%; p < 0.001) compared to control. Upon TNFα stimulation, ECFC Eng–siRNA displayed a significant higher permeability compared to ctr-siRNA (p < 0.01), which is associated to a higher Ca²⁺ mobilization (p < 0.01). Computational analysis suggested that Eng mitigated TNFα activity. F-actin polymerization was significantly increased in ECFC Eng-siRNA, MAEC^+/−, and MLEC^+/− compared to controls (p < 0.001, p < 0.01, and p < 0.01, respectively) as well as actin/tubulin distribution (p < 0.01). Furthermore, the inactive form of cofilin (P-cofilin at Ser3) was significantly decreased by 36.7 ± 4.8% in ECFC Eng-siRNA compared to ctr-siRNA (p < 0.001). Interestingly, LIMKi reproduced the absence of Eng on TNFα-induced ECFC-increased permeability. Our data suggest that Eng plays a critical role in the homeostasis regulation of endothelial cells under inflammatory conditions (TNFα), and loss of Eng influences ECFC-related permeability through the LIMK/cofilin/actin rearrangement-signaling pathway. Full article

(This article belongs to the Special Issue Endoglin in Health and Disease)

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18 pages, 4844 KiB

Open AccessArticle

Evaluation of a Novel Plasmid for Simultaneous Gene Electrotransfer-Mediated Silencing of CD105 and CD146 in Combination with Irradiation

by Monika Savarin, Urska Kamensek, Katarina Znidar, Vesna Todorovic, Gregor Sersa and Maja Cemazar

Int. J. Mol. Sci. 2021, 22(6), 3069; https://doi.org/10.3390/ijms22063069 - 17 Mar 2021

Cited by 4 | Viewed by 2867

Abstract

Targeting tumor vasculature through specific endothelial cell markers represents a promising approach for cancer treatment. Here our aim was to construct an antibiotic resistance gene-free plasmid encoding shRNAs to simultaneously target two endothelial cell markers, CD105 and CD146, and to test its functionality and therapeutic potential in vitro when delivered by gene electrotransfer (GET) and combined with irradiation (IR). Functionality of the plasmid was evaluated by determining the silencing of the targeted genes using qRT-PCR. Antiproliferative and antiangiogenic effects were determined by the cytotoxicity assay tube formation assay and wound healing assay in murine endothelial cells 2H-11. The functionality of the plasmid construct was also evaluated in malignant melanoma tumor cell line B16F10. Additionally, potential activation of immune response was measured by induction of DNA sensor STING and proinflammatory cytokines by qRT-PCR in endothelial cells 2H-11. We demonstrated that the plasmid construction was successful and can efficiently silence the expression of the two targeted genes. As a consequence of silencing, reduced migration rate and angiogenic potential was confirmed in 2H-11 endothelial cells. Furthermore, induction of DNA sensor STING and proinflammatory cytokines were determined, which could add to the therapeutic effectiveness when used in vivo. To conclude, we successfully constructed a novel plasmid DNA with two shRNAs, which holds a great promise for further in vivo testing. Full article

(This article belongs to the Special Issue Endoglin in Health and Disease)

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20 pages, 4594 KiB

Open AccessArticle

Pregnancy-Induced High Plasma Levels of Soluble Endoglin in Mice Lead to Preeclampsia Symptoms and Placental Abnormalities

by Lucía Pérez-Roque, Elena Núñez-Gómez, Alicia Rodríguez-Barbero, Carmelo Bernabéu, José M. López-Novoa and Miguel Pericacho

Int. J. Mol. Sci. 2021, 22(1), 165; https://doi.org/10.3390/ijms22010165 - 26 Dec 2020

Cited by 21 | Viewed by 4539

Abstract

Preeclampsia is a pregnancy-specific disease of high prevalence characterized by the onset of hypertension, among other maternal or fetal signs. Its etiopathogenesis remains elusive, but it is widely accepted that abnormal placentation results in the release of soluble factors that cause the clinical manifestations of the disease. An increased level of soluble endoglin (sEng) in plasma has been proposed to be an early diagnostic and prognostic biomarker of this disease. A pathogenic function of sEng involving hypertension has also been reported in several animal models with high levels of plasma sEng not directly dependent on pregnancy. The aim of this work was to study the functional effect of high plasma levels of sEng in the pathophysiology of preeclampsia in a model of pregnant mice, in which the levels of sEng in the maternal blood during pregnancy replicate the conditions of human preeclampsia. Our results show that wild type pregnant mice carrying human sEng-expressing transgenic fetuses (fWT(hsEng⁺)) present high plasma levels of sEng with a timing profile similar to that of human preeclampsia. High plasma levels of human sEng (hsEng) are associated with hypertension, proteinuria, fetal growth restriction, and the release of soluble factors to maternal plasma. In addition, fWT(hsEng⁺) mice also present placental alterations comparable to those caused by the poor remodeling of the spiral arteries characteristic of preeclampsia. In vitro and ex vivo experiments, performed in a human trophoblast cell line and human placental explants, show that sEng interferes with trophoblast invasion and the associated pseudovasculogenesis, a process by which cytotrophoblasts switch from an epithelial to an endothelial phenotype, both events being related to remodeling of the spiral arteries. Our findings provide a novel and useful animal model for future research in preeclampsia and reveal a much more relevant role of sEng in preeclampsia than initially proposed. Full article

(This article belongs to the Special Issue Endoglin in Health and Disease)

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17 pages, 3382 KiB

Open AccessArticle

Endoglin Promotes Myofibroblast Differentiation and Extracellular Matrix Production in Diabetic Nephropathy

by Tessa Gerrits, Malu Zandbergen, Ron Wolterbeek, Jan A. Bruijn, Hans J. Baelde and Marion Scharpfenecker

Int. J. Mol. Sci. 2020, 21(20), 7713; https://doi.org/10.3390/ijms21207713 - 18 Oct 2020

Cited by 21 | Viewed by 3203

Abstract

Diabetic nephropathy (DN) is a complication of diabetes mellitus that can lead to proteinuria and a progressive decline in renal function. Endoglin, a co-receptor of TGF-β, is known primarily for regulating endothelial cell function; however, endoglin is also associated with hepatic, cardiac, and intestinal fibrosis. This study investigates whether endoglin contributes to the development of interstitial fibrosis in DN. Kidney autopsy material from 80 diabetic patients was stained for endoglin and Sirius Red and scored semi-quantitatively. Interstitial endoglin expression was increased in samples with DN and was correlated with Sirius Red staining (p < 0.001). Endoglin expression was also correlated with reduced eGFR (p = 0.001), increased creatinine (p < 0.01), increased systolic blood pressure (p < 0.05), hypertension (p < 0.05), and higher IFTA scores (p < 0.001). Biopsy samples from DN patients were also co-immunostained for endoglin together with CD31, CD68, vimentin, or α-SMA Endoglin co-localized with both the endothelial marker CD31 and the myofibroblast marker α-SMA. Finally, we used shRNA to knockdown endoglin expression in a human kidney fibroblast cell line. We found that TGF-β1 stimulation upregulated SERPINE1, CTGF, and ACTA2 mRNA and α-SMA protein, and that these effects were significantly reduced in fibroblasts after endoglin knockdown. Taken together, these data suggest that endoglin plays a role in the pathogenesis of interstitial fibrosis in DN. Full article

(This article belongs to the Special Issue Endoglin in Health and Disease)

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Review

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27 pages, 1559 KiB

Open AccessReview

Endoglin/CD105-Based Imaging of Cancer and Cardiovascular Diseases: A Systematic Review

by Vincent Q. Sier, Joost R. van der Vorst, Paul H. A. Quax, Margreet R. de Vries, Elham Zonoobi, Alexander L. Vahrmeijer, Ilona A. Dekkers, Lioe-Fee de Geus-Oei, Anke M. Smits, Weibo Cai, Cornelis F. M. Sier, Marie José T. H. Goumans and Lukas J. A. C. Hawinkels

Int. J. Mol. Sci. 2021, 22(9), 4804; https://doi.org/10.3390/ijms22094804 - 30 Apr 2021

Cited by 12 | Viewed by 5803

Abstract

Molecular imaging of pathologic lesions can improve efficient detection of cancer and cardiovascular diseases. A shared pathophysiological feature is angiogenesis, the formation of new blood vessels. Endoglin (CD105) is a coreceptor for ligands of the Transforming Growth Factor-β (TGF-β) family and is highly expressed on angiogenic endothelial cells. Therefore, endoglin-based imaging has been explored to visualize lesions of the aforementioned diseases. This systematic review highlights the progress in endoglin-based imaging of cancer, atherosclerosis, myocardial infarction, and aortic aneurysm, focusing on positron emission tomography (PET), single-photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), near-infrared fluorescence (NIRF) imaging, and ultrasound imaging. PubMed was searched combining the following subjects and their respective synonyms or relevant subterms: “Endoglin”, “Imaging/Image-guided surgery”. In total, 59 papers were found eligible to be included: 58 reporting about preclinical animal or in vitro models and one ex vivo study in human organs. In addition to exact data extraction of imaging modality type, tumor or cardiovascular disease model, and tracer (class), outcomes were described via a narrative synthesis. Collectively, the data identify endoglin as a suitable target for intraoperative and diagnostic imaging of the neovasculature in tumors, whereas for cardiovascular diseases, the evidence remains scarce but promising. Full article

(This article belongs to the Special Issue Endoglin in Health and Disease)

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13 pages, 1169 KiB

Open AccessReview

Pulmonary Vascular Complications in Hereditary Hemorrhagic Telangiectasia and the Underlying Pathophysiology

by Sala Bofarid, Anna E. Hosman, Johannes J. Mager, Repke J. Snijder and Marco C. Post

Int. J. Mol. Sci. 2021, 22(7), 3471; https://doi.org/10.3390/ijms22073471 - 27 Mar 2021

Cited by 19 | Viewed by 4038

Abstract

In this review, we discuss the role of transforming growth factor-beta (TGF-β) in the development of pulmonary vascular disease (PVD), both pulmonary arteriovenous malformations (AVM) and pulmonary hypertension (PH), in hereditary hemorrhagic telangiectasia (HHT). HHT or Rendu-Osler-Weber disease is an autosomal dominant genetic disorder with an estimated prevalence of 1 in 5000 persons and characterized by epistaxis, telangiectasia and AVMs in more than 80% of cases, HHT is caused by a mutation in the ENG gene on chromosome 9 encoding for the protein endoglin or activin receptor-like kinase 1 (ACVRL1) gene on chromosome 12 encoding for the protein ALK-1, resulting in HHT type 1 or HHT type 2, respectively. A third disease-causing mutation has been found in the SMAD-4 gene, causing a combination of HHT and juvenile polyposis coli. All three genes play a role in the TGF-β signaling pathway that is essential in angiogenesis where it plays a pivotal role in neoangiogenesis, vessel maturation and stabilization. PH is characterized by elevated mean pulmonary arterial pressure caused by a variety of different underlying pathologies. HHT carries an additional increased risk of PH because of high cardiac output as a result of anemia and shunting through hepatic AVMs, or development of pulmonary arterial hypertension due to interference of the TGF-β pathway. HHT in combination with PH is associated with a worse prognosis due to right-sided cardiac failure. The treatment of PVD in HHT includes medical or interventional therapy. Full article

(This article belongs to the Special Issue Endoglin in Health and Disease)

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12 pages, 1247 KiB

Open AccessReview

The Role of Endoglin in Hepatocellular Carcinoma

by Kuo-Shyang Jeng, I-Shyan Sheen, Shu-Sheng Lin, Chuen-Miin Leu and Chiung-Fang Chang

Int. J. Mol. Sci. 2021, 22(6), 3208; https://doi.org/10.3390/ijms22063208 - 22 Mar 2021

Cited by 15 | Viewed by 4248

Abstract

Endoglin (CD105) is a type-1 integral transmembrane glycoprotein and coreceptor for transforming growth factor-β (TGF-β) ligands. The endoglin/TGF-β signaling pathway regulates hemostasis, cell proliferation/migration, extracellular matrix (ECM) synthesis and angiogenesis. Angiogenesis contributes to early progression, invasion, postoperative recurrence, and metastasis in hepatocellular carcinoma (HCC), one of the most widespread malignancies globally. Endoglin is overexpressed in newly formed HCC microvessels. It increases microvessel density in cirrhotic and regenerative HCC nodules. In addition, circulating endoglin is present in HCC patients, suggesting potential for use as a diagnostic or prognostic factor. HCC angiogenesis is dynamic and endoglin expression varies by stage. TRC105 (carotuximab) is an antibody against endoglin, and three of its clinical trials were related to liver diseases. A partial response was achieved when combining TRC105 with sorafenib. Although antiangiogenic therapy still carries some risks, combination therapy with endoglin inhibitors or other targeted therapies holds promise. Full article

(This article belongs to the Special Issue Endoglin in Health and Disease)

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24 pages, 1340 KiB

Open AccessReview

Endoglin in the Spotlight to Treat Cancer

by Teresa González Muñoz, Ana Teresa Amaral, Pilar Puerto-Camacho, Héctor Peinado and Enrique de Álava

Int. J. Mol. Sci. 2021, 22(6), 3186; https://doi.org/10.3390/ijms22063186 - 20 Mar 2021

Cited by 18 | Viewed by 4934

Abstract

A spotlight has been shone on endoglin in recent years due to that fact of its potential to serve as both a reliable disease biomarker and a therapeutic target. Indeed, endoglin has now been assigned many roles in both physiological and pathological processes. From a molecular point of view, endoglin mainly acts as a co-receptor in the canonical TGFβ pathway, but also it may be shed and released from the membrane, giving rise to the soluble form, which also plays important roles in cell signaling. In cancer, in particular, endoglin may contribute to either an oncogenic or a non-oncogenic phenotype depending on the cell context. The fact that endoglin is expressed by neoplastic and non-neoplastic cells within the tumor microenvironment suggests new possibilities for targeted therapies. Here, we aimed to review and discuss the many roles played by endoglin in different tumor types, as well as the strong evidence provided by pre-clinical and clinical studies that supports the therapeutic targeting of endoglin as a novel clinical strategy. Full article

(This article belongs to the Special Issue Endoglin in Health and Disease)

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15 pages, 1358 KiB

Open AccessReview

Endoglin Targeting: Lessons Learned and Questions That Remain

by Yingmiao Liu, Madelon Paauwe, Andrew B. Nixon and Lukas J.A.C. Hawinkels

Int. J. Mol. Sci. 2021, 22(1), 147; https://doi.org/10.3390/ijms22010147 - 25 Dec 2020

Cited by 25 | Viewed by 5099

Abstract

Approximately 30 years ago, endoglin was identified as a transforming growth factor (TGF)-β coreceptor with a crucial role in developmental biology and tumor angiogenesis. Its selectively high expression on tumor vessels and its correlation with poor survival in cancer patients led to the exploration of endoglin as a therapeutic target for cancer. The endoglin neutralizing antibody TRC105 (Carotuximab^®, Tracon Pharmaceuticals (San Diego, CA, USA) was subsequently tested in a wide variety of preclinical cancer models before being tested in phase I-III clinical studies in cancer patients as both a monotherapy and in combination with other chemotherapeutic and anti-angiogenic therapies. The combined data of these studies have revealed new insights into the role of endoglin in angiogenesis and its expression and functional role on other cells in the tumor microenvironment. In this review, we will summarize the preclinical work, clinical trials and biomarker studies of TRC105 and explore what these studies have enabled us to learn and what questions remain unanswered. Full article

(This article belongs to the Special Issue Endoglin in Health and Disease)

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27 pages, 3601 KiB

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Endoglin: An ‘Accessory’ Receptor Regulating Blood Cell Development and Inflammation

by Steffen K. Meurer and Ralf Weiskirchen

Int. J. Mol. Sci. 2020, 21(23), 9247; https://doi.org/10.3390/ijms21239247 - 3 Dec 2020

Cited by 29 | Viewed by 4840

Abstract

Transforming growth factor-β1 (TGF-β1) is a pleiotropic factor sensed by most cells. It regulates a broad spectrum of cellular responses including hematopoiesis. In order to process TGF-β1-responses in time and space in an appropriate manner, there is a tight regulation of its signaling at diverse steps. The downstream signaling is mediated by type I and type II receptors and modulated by the ‘accessory’ receptor Endoglin also termed cluster of differentiation 105 (CD105). Endoglin was initially identified on pre-B leukemia cells but has received most attention due to its high expression on activated endothelial cells. In turn, Endoglin has been figured out as the causative factor for diseases associated with vascular dysfunction like hereditary hemorrhagic telangiectasia-1 (HHT-1), pre-eclampsia, and intrauterine growth restriction (IUPR). Because HHT patients often show signs of inflammation at vascular lesions, and loss of Endoglin in the myeloid lineage leads to spontaneous inflammation, it is speculated that Endoglin impacts inflammatory processes. In line, Endoglin is expressed on progenitor/precursor cells during hematopoiesis as well as on mature, differentiated cells of the innate and adaptive immune system. However, so far only pro-monocytes and macrophages have been in the focus of research, although Endoglin has been identified in many other immune system cell subsets. These findings imply a functional role of Endoglin in the maturation and function of immune cells. Aside the functional relevance of Endoglin in endothelial cells, CD105 is differentially expressed during hematopoiesis, arguing for a role of this receptor in the development of individual cell lineages. In addition, Endoglin expression is present on mature immune cells of the innate (i.e., macrophages and mast cells) and the adaptive (i.e., T-cells) immune system, further suggesting Endoglin as a factor that shapes immune responses. In this review, we summarize current knowledge on Endoglin expression and function in hematopoietic precursors and mature hematopoietic cells of different lineages. Full article

(This article belongs to the Special Issue Endoglin in Health and Disease)

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