Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) promotes angiogenesis and ischemia-induced neovascularization via NADPH oxidase 4 (NOX4) and nitric oxide-dependent mechanisms

Belinda Ann Di Bartolo, Siân Peta Cartland, Leonel Prado-Lourenco, Thomas Scott Griffith, Carmine Gentile, Jayant Ravindran, Nor Saadah Muhammad Azahri, Thuan Thai, Amanda Wing Shee Yeung, Shane Ross Thomas, Mary Meltem Kavurma

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Background-Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) has the ability to inhibit angiogenesis by inducing endothelial cell death, as well as being able to promote pro-angiogenic activity in vitro. These seemingly opposite effects make its role in ischemic disease unclear. Using Trail-/- and wildtype mice, we sought to determine the role of TRAIL in angiogenesis and neovascularization following hindlimb ischemia. Methods and Results-Reduced vascularization assessed by real-time 3-dimensional Vevo ultrasound imaging and CD31 staining was evident in Trail-/- mice after ischemia, and associated with reduced capillary formation and increased apoptosis. Notably, adenoviral TRAIL administration significantly improved limb perfusion, capillary density, and vascular smooth-muscle cell content in both Trail-/- and wildtype mice. Fibroblast growth factor-2, a potent angiogenic factor, increased TRAIL expression in human microvascular endothelial cell-1, with fibroblast growth factor-2-mediated proliferation, migration, and tubule formation inhibited with TRAIL siRNA. Both fibroblast growth factor-2 and TRAIL significantly increased NADPH oxidase 4 (NOX4) expression. TRAILinducible angiogenic activity in vitro was inhibited with siRNAs targeting NOX4, and consistent with this, NOX4 mRNA was reduced in 3-day ischemic hindlimbs of Trail-/- mice. Furthermore, TRAIL-induced proliferation, migration, and tubule formation was blocked by scavenging H2O2, or by inhibiting nitric oxide synthase activity. Importantly, TRAIL-inducible endothelial nitric oxide synthase phosphorylation at Ser-1177 and intracellular human microvascular endothelial cell-1 cell nitric oxide levels were NOX4 dependent. Conclusions-This is the first report demonstrating that TRAIL can promote angiogenesis following hindlimb ischemia in vivo. The angiogenic effect of TRAIL on human microvascular endothelial cell-1 cells is downstream of fibroblast growth factor-2, involving NOX4 and nitric oxide signaling. These data have significant therapeutic implications, such that TRAIL may improve the angiogenic response to ischemia and increase perfusion recovery in patients with cardiovascular disease and diabetes.

Original languageEnglish (US)
Article numbere002527
JournalJournal of the American Heart Association
Issue number11
StatePublished - Nov 1 2015

Bibliographical note

Funding Information:
Di Bartolo is supported by a National Health and Medical Research Council of Australia Early Career Fellowship; Gentile is supported by a Heart Research Institute Marcus Blackmore Fellowship. Kavurma is supported by a Heart Foundation of Australia Career Development Award. This work was supported by a Heart Foundation of Australia Grant in Aid.

Publisher Copyright:
© 2015 The Authors.


  • Angiogenesis
  • Endothelial cell
  • Gene expression
  • Ischemia


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