It is well-documented that hyperglycaemia induces EC dysfunction, which plays a critical role in the manifestation and development of diabetic complications. Here, we demonstrated for the first time, to our knowledge, the temporal effect of glucose on the HAEC transcriptome. Our results revealed both consistent and opposing temporal transcriptional changes in response to normal and high glucose levels that ultimately lead to differential signalling pathway activation and/or inhibition.
Given the dynamic nature of biological processes, gene expression studies using a time-series approach enables the detection of transient transcriptional changes and temporal patterns that are often missed by cross-sectional designs. Thus, we chose this approach to better understand the timing of gene expression changes and whether genes expressed at early, middle, or late time points, activate/inhibit specific pathways within these time frames and differentially under HG. The number of DEGs at each time point followed a similar trend under both NG and HG conditions. From the treatment durations that we selected (0.5, 1, 4, 8 and 24 h), 4 h of either NG or HG conditions resulted in the peak number of DEGs. It is possible that due to the HAECs being exposed to reduced serum conditions overnight, (serum starving cells prior to beginning experiments is well documented 16), the addition of either NG or HG treatment containing full serum at the start of the experiment, resulted in an initial burst of transcription, supported by the observance that the majority of DEGs were upregulated at 0.5 and 1 h time points compared to the baseline. Equally, comparative analysis showed that HG treatment induced specific changes from the earliest time point investigated (i.e. 0.5 h). By 4 h and subsequent time points of either NG or HG treatment, the even ratio of upregulated and downregulated DEGs suggests that by 4 h the cells reach a state of balanced up and downregulation following the initial burst of transcription. This is further supported by the analysis between time points, whereby the majority of DEGs observed between 0.5-1 h are downregulated compensating for the earlier upregulation at 0.5 h.
This study investigated changes in the transcriptome under both NG and HG conditions. Our initial focus was to determine which genes were differentially expressed in HG compared to NG conditions and the timing of their expression. Venn analysis first established groups of DEGs that are either unique or common to NG and HG conditions. Interestingly, it was mainly the later time points (8 and 24 h), where we identified genes that were significantly up or downregulated in HG conditions yet showed the reverse trend in NG conditions. One of the significantly upregulated genes observed following 8 h under HG was the WNT2B gene. Previous studies have shown that Wnt ligands and the subsequent Wnt signalling pathways activated are implicated in the control of various processes that are critical in the development of T2DM and its complications 17. Our data, observing the effect of HG in HAECs, suggest that Wnt2b is also implicated in the cardiovascular health of T2DM and warrants further investigation. Additionally, we observed significant upregulation of the AMIGO2 gene at 24 h under HG, as opposed to a downregulated trend under NG conditions. A gene expression profiling study in mice lungs also showed upregulation of AMIGO2 in the hyperglycaemic lung 18. Moreover, at 24 h under HG, upregulation of COL1A2 a major component of extracellular matrix was observed. Previously, COL1A2 upregulation has been measured in both mice with diabetic nephropathy and HK2 cells treated with HG 19.
Further to identifying DEGs specific to HG conditions, our pathway enrichment analysis revealed differential activation and inhibition of signalling pathways under HG compared to NG conditions, which was also influenced by the duration of glucose treatment. We were able to see the effects of HG conditions at the earlier time points, 0.5 h and 1 h, where significant inhibition of PKA and activation of PDGF signalling was observed respectively. PDGFs are synthesized by platelets and are growth factors that regulate cell growth and division 20. It is known that PDGFs can affect the processes of T2DM and its complications via various signalling pathways (including PKC Ө and PKCε, NF-κB, PI3K, PLCγ, Src/ Smad1/Col4, JAK/STAT, PI3K/Akt/mTOR, p38 MAPKSHP-1 and ERK/Akt pathways). Particularly, through the inflammatory and angiogenic effects of PDGFs, endothelial migration and proliferation is impaired 21–23.
Corresponding with the peak number of DEGs observed at 4 h in both NG and HG conditions, we also observed the greatest effect in terms of signalling pathways activated/inhibited at the 4 h time point. A key pathway that was significantly activated at 4 h HG conditions yet not in NG conditions was the T2DM signalling pathway. As predicted, upregulation of MAPK, PI3K, and NF-κB subunits were detected. Furthermore, at the 4 h under HG time point we detected significant activation of multiple growth factor and cell proliferation signalling pathways (HGF, VEGF, ErbB4, IGF-1, BMP, and p70S6K) in HG but not NG conditions. The growth factor signalling pathways identified here have been shown to have clear implications in the development of T2DM and its complications 24–31. Additionally, we observed significant activation of PAK signalling, which has been shown to be involved in metabolic processes, including glucose homeostasis with a role in regulating cell proliferation and in the progression of vascular disorders 32. The 4 h time point enrichment analysis also highlighted significant activation of the interleukin-6 (IL-6) signalling pathway, specific to HG conditions only. IL-6 has been hypothesized to play a critical role in the pathophysiology of T2DM 33 (33). Activation of the P2Y purinergic receptor signalling pathway at 4 h HG treatment was also observed. Purinergic signalling involves multiple receptors and extracellular enzymes that provides a system of cell-cell communication through the recognition and degradation of extracellular nucleotides and adenosine. An increasing number of studies have placed the purinergic system as a key player in numerous physiopathological conditions, including those involved in the inflammatory response such as T2DM 34. Moreover, our data show significant activation of renin-angiotensin signalling at 4 h post HG treatment, however not in NG conditions. It is well known that the renin-angiotensin system (RAS) is activated and initiates the progression of T2DM and its complications 35.
The analysis showed a reduction in the number of enriched pathways at the later time points of 8 and 24 h in both NG and HG conditions. A marked difference that we observed at the 24 h point was the significant activation of Endothelin-1 signalling in HG but not in NG conditions. Our data are in line with the evidence that hyperglycaemia-induced endothelial dysfunction is partially mediated through increased activation of the endothelin system, which plays an important role in the pathophysiology of diabetes-associated cardiovascular diseases 36. Interestingly, we observed significant activation of HMGB1 signalling in both NG and HG conditions at the 0.5, 1, and 4 h time points. However, at the 24 h time point activation was no longer significant in NG conditions. As a late mediator of inflammation, HMBG1 has been shown to be a critical facilitator in the pathogenesis of a variety of diseases including T2DM 37. Only a longer time course would highlight whether HMGB1 signalling remains activated in HG conditions only.
The time-series analysis of glucose treatment in HAECs aimed to identify sets of DEGs according to their temporal gene expression profile. Therefore, potentially identifying groups of coregulated genes at specific time points to improve the understanding of the biological processes that are activated or inhibited. To this end, K-means clustering classified NG or HG DEGs into four clear temporal profiles based on the timing of peak, or a clear switch to downregulation of gene expression. In the ‘early’, ‘middle’ and ‘late’ gene clusters, all of which grouped upregulated genes, we observed a larger number of DEGs in HG compared to NG conditions. Within each cluster, the majority of DEGs were common to both NG and HG conditions, with few unique DEGs in NG conditions, therefore indicating a significant effect of HG conditions on the transcriptional response at each time point. Indeed, pathway enrichment analysis of the ‘late’ gene cluster identified multiple pathways previously implicated in the cellular response to hyperglycaemic conditions and development of T2D complications. Activation of the IL-8 signalling pathway was observed in HG conditions. Studies in vitro have shown that glucose causes increased endothelial production of IL-8 38 and in vivo, circulating IL-8 levels are increased in patients with T2D, who also displayed a more severe inflammatory and cardiometabolic profile 39. Furthermore, the ‘late’ gene cluster significantly activated several transcription factors. Interestingly, HIF-1α signalling was activated in HG conditions. Other reports have detailed the insufficient activation of HIF-1α signalling due to the lack of HIF-1α stability and function from hyperglycaemic conditions 40. In contradiction, through a carbohydrate response element binding protein-mediated mechanism, HG has also been shown to activate HIF-1α signalling in glomerular mesangial cells 41, therefore meriting further investigation into the dysregulation of HIF-1α signalling in hyperglycaemic conditions. Additionally, the role of NFAT in cardiac hypertrophy signalling was significantly activated in cells treated with HG. An increasing number of studies have reported vital roles for NFAT in the development of diabetes and atherosclerosis through endothelial cell damage, foam cell formation and plaque calcification 42. Moreover, two master transcription factors, STAT3 and NF-κB were activated in HG conditions, both of which are well documented in the development of diabetes and its complications. STAT3 signalling mediates the effects of multiple cytokines, resulting in the transcription of genes that control cell survival, proliferation, and immune response 43. Activation of NF-κB through prolonged hyperglycaemia, induces expression of various cytokines, chemokines and cell adhesion molecules leading to endothelial dysfunction and further vascular complications 44. Equally, short durations of HG treatment have been shown to activate NF-κB in endothelial cells 45. Potential for STAT3 and NF-κB crosstalk could occur under hyperglycaemic conditions, as has been shown in other diseases, with collaboration of the two transcription factors resulting in the development of diabetic complications 46.
In reverse to the other clusters, which grouped upregulated genes, the ‘downregulated’ group of DEGs showed a transcriptional profile demonstrating a switch to downregulation between 1 and 4 h and contained more genes in NG compared to HG conditions. Indeed, the previous pathway enrichment analysis of the DEGs at the 4 h time point compared to baseline resulted in more ‘activation’ pathway hits in HG compared to NG conditions. This is supported by the analysis of the ‘downregulated’ cluster, which uses the 1 h and 4 h time points pairwise comparison for DEGs and highlights the increased number of DEGs that are downregulated in NG compared to HG conditions. The data showed that most significantly enriched pathways in this cluster were inhibited. Interestingly, Chemokine, TGF-β and ERK5 signalling were inhibited in NG conditions only. Previous studies have shown that TGF-β is elevated in hyperglycaemic conditions and has a role in the pathogenesis of obesity and T2D through Smad signalling 47. The downregulation of ERK5 signalling observed in NG conditions is interesting as it has been formerly shown that ERK5 regulates glucose-induced endothelin-1 expression 48.
In summary, pathway enrichment analysis of DEGs in NG and HG conditions identified numerous pathways specific to HG conditions that have previously been implicated in hyperglycaemia and the development of T2DM and its complications. Our results show that HAECs respond quickly to HG conditions and from the time course of HG applied that 1–4 h of HG treatment caused the strongest and most significant alteration of the HAEC transcriptome profile. These results clearly show that up/downregulation of particular genes takes place at earlier time points and suggest that these early events may influence the regulation of genes at the later time points ultimately leading to activation/inhibition of pathways. Contrasting the transcriptional changes that take place only under HG conditions revealed a set of genes and temporal patterns that implicate genes and pathways associated with hyperglycaemic conditions and development of T2D complications. The results shown here warrant the inclusion of earlier time points when studying glucose exposure in both cell-based and animal model studies, including in investigations of biomarkers of early dysfunction-associated transcriptional events. Unlike the prolonged and repeated exposure to HG that endothelial cells experience in vivo under disease conditions, this study is limited in that HAECs were only exposed to a short duration of HG in vitro. However, the observations made here show that endothelial cells can exhibit a fast temporal transcriptional response to glucose with differences that can be attributed only to hyperglycaemic conditions.
Although early transient differences in expression seem to fade with time, their consequences on protein levels and subsequently cell processes through activation and/or inhibition of pathways likely remain as supported by IPA analysis. It might be revealing to investigate if these early transcriptional changes are epigenetically regulated and if they result in rapid changes at the protein and metabolic levels as well, both in vitro and under long-term and repetitive exposure to HG as seen in diabetics. Future study of the effects of HG exposure in endothelial cells could build on the mounting evidence of epigenetic changes that take place following HG exposure and metabolic memory. Moreover, investigations are warranted to elucidate whether HG exposure leaves epigenetic marks that influence the transcriptional response of endothelial cells in both the continued presence or interestingly, the absence of HG (mimicking management of the disease state). This investigation enhances our understanding of the genes and pathways that are transcriptionally responsive in the early stages of endothelial cell dysfunction that might ultimately lead to the progression of diabetic complications.