Thromboxane A2 Receptor Activates a Rho-associated Kinase/LKB1/PTEN Pathway to Attenuate Endothelium Insulin Signaling*

This study was conducted to elucidate the molecular mechanisms of thromboxane A2 receptor (TP)-induced insulin resistance in endothelial cells. Exposure of human umbilical vein endothelial cells (HUVECs) or mouse aortic endothelial cells to either IBOP or U46619, two structurally related thromboxane A2 mimetics, significantly reduced insulin-stimulated phosphorylation of endothelial nitric-oxide synthase (eNOS) at Ser1177 and Akt at Ser473. These effects were abolished by pharmacological or genetic inhibitors of TP. TP-induced suppression of both eNOS and Akt phosphorylation was accompanied by up-regulation of PTEN (phosphatase and tension homolog deleted on chromosome 10), Ser380/Thr382/383 PTEN phosphorylation, and PTEN lipid phosphatase activity. PTEN-specific small interference RNA restored insulin signaling in the face of TP activation. The small GTPase, Rho, was also activated by TP stimulation, and pretreatment of HUVECs with Y27632, a Rho-associated kinase inhibitor, rescued TP-impaired insulin signaling. Consistent with this result, pertussis toxin abrogated IBOP-induced dephosphorylation of both Akt and eNOS, implicating the Gi family of G proteins in the suppressive effects of TP. In mice, high fat diet-induced diabetes was associated with aortic PTEN up-regulation, PTEN-Ser380/Thr382/383 phosphorylation, and dephosphorylation of both Akt (at Ser473) and eNOS (at Ser1177). Importantly, administration of TP antagonist blocked these changes. We conclude that TP stimulation impairs insulin signaling in vascular endothelial cells by selectively activating the Rho/Rho-associated kinase/LKB1/PTEN pathway.

Insulin exerts multiple biological actions relating to not only metabolism but also to endothelial functions (1,2). Insulin has beneficial effects on the vasculature, primarily because of its ability to enhance endothelial nitric-oxide synthase (eNOS) 2 activation and expression. These effects, in turn, enhance the bioavailability of nitric oxide (3), which engenders a wide array of antiatherogenic effects. Global insulin resistance is a key feature of the metabolic syndrome leading to cardiovascular disease. In an insulin-resistant state, a systemic deregulation of the insulin signal leads to a combined deregulation of insulin-regulated metabolism and endothelial functions (4), resulting in glucose intolerance and cardiovascular disease. Insulin resistance is associated with endothelial dysfunction (5), a hallmark of atherosclerosis, and predicts adverse cardiovascular events (6). Therefore, endothelium-specific insulin resistance (impaired insulin-stimulated phosphorylation of Akt and eNOS) may play an important role in the development of cardiovascular diseases.
Prostanoids have critical roles in the development of endothelial dysfunction (7). Thromboxane A 2 (TXA 2 ) is believed to be a prime mediator of a variety of cardiovascular and pulmonary diseases such as atherosclerosis, myocardial infarction, and primary pulmonary hypertension. TXA 2 perturbs the normal quiescent phenotype of endothelial cells (ECs). This results in leukocyte adhesion to the vessel wall as well as increased vascular permeability and expression of adhesion molecules on ECs, all important components of the inflammatory response. In smooth muscle cells, TXA 2 promotes proliferation (8) and migration, contributing to neointima formation (9). TXA 2 binds to the thromboxane A 2 receptor (TP), which has two isoforms TP␣ and TP␤ in human (10 -12), activation of which is implicated in atherosclerosis and inflammation (13)(14)(15)(16). Atherosclerosis is accelerated by diabetes and is associated with increased levels of TXA 2 and other eicosanoids that stimulate TP (14). TP expression and plasma levels of TP ligands are elevated, both locally and systemically, in several vascular and thrombotic diseases (17). Importantly, TP activation induces EC apoptosis (15,18) and prevents tube formation (19) by inhibiting Akt phosphorylation (18). TP activation also inhibits vascular endothelial growth factor-induced EC migration and angiogenesis by decreasing Akt and eNOS phosphorylation (20). However, the regulatory mechanisms underlying Akt inhi-* This work was supported, in whole or in part, by National Institutes of Health Grants HL079584, HL074399, HL080499, HL089920, and HL096032. This work was also supported by a research award from the American Diabetes Association, a research award from the Juvenile Diabetes Research Foundation, a grant from Oklahoma Center for Advancement of Science and Technology, and funds from the Travis Endowed Chair in Endocrinology, University of Oklahoma Health Sciences Center. 1  This article has been withdrawn by the authors. The Journal raised questions that the Akt immunoblot in Fig. 2A  bition by TP stimulation remain largely undefined. Moreover, whether TP activation impairs endothelial insulin signaling is also unclear.
Here, we investigated whether TP ligands interfere with insulin signaling. Our results reveal that activation of TP using a potent and stable ligand (IBOP) abrogates insulin signaling in ECs. We also show that Rho/ROCK/LKB1-mediated PTEN (phosphatase and tensin homolog deleted on chromosome ten) up-regulation is required for TP-induced inhibition of insulin signaling in ECs.

EXPERIMENTAL PROCEDURES
Materials-Human umbilical vein endothelial cells (HUVECs) were purchased from Invitrogen. HUVECs were maintained in endothelial cell basal medium (EBM) supplemented with EGM TM SingleQuots from LONZA (Walkersville, MD). Culture media were supplemented with penicillin (100 units/ml) and streptomycin (100 g/ml). Mouse aortic endothelial cells (MAECs) were isolated and maintained in cultured, as described previously (21). Recombinant  Cell Treatment-HUVECs cultured in 0.5% serum medium were preincubated for 30 min with the indicated concentration of SQ29548 (TP blocker) or Y27632 (ROCK inhibitor). They were then treated with IBOP or U46619 overnight.
siRNA-mediated Gene Silencing-A series of 21-nucleotide siRNAs were chemically synthesized, desalted, deprotected, and PAGE-purified by Applied Biosystems (Austin, TX). TP synthesis was inhibited using the following oligoribonucleotides (TP siRNA): 5Ј-GGAGCUGCUCAUCUACUUG UU-3Ј and 5Ј-CAAGUAGAUGAGCAGCUCCUU-3Ј. PTEN siRNA as well as a nonsilencing control siRNA were obtained from Cell Signaling Technology. The siRNA duplexes were applied at a concentration of 100 nM. HUVECs were transfected with gene target-specific siRNA or nonspecific control siRNA for 48 h using Lipofectamine TM 2000 (Invitrogen) according to the manufacturer's instructions. Transfected cells were cultured in 0.5% serum medium and exposed to the indicated agents overnight.
In Vitro Kinase Assays-To determine the effect of ROCK on Akt activation, we incubated glycogen synthase kinase-3␤ fusion protein with recombinant Akt1 in the presence or absence of recombinant ROCK1 or ROCK2 for 20 min at 37°C. The reaction mixture consisted of kinase buffer (25 mM Tris, pH 7.5, 5 mM ␤-glycerophosphate, 2 mM dithiothreitol, 0.1 mM Na 3 VO 4 , 10 mM MgCl 2 ) supplemented with 0.2 mM ATP. The A, TP activation impairs basal eNOS phosphorylation. Confluent HUVECs cultured in 0.5% FBS were pretreated with TP antagonist (SQ29548, 4 mol/liter) for 20 min and exposed to TP agonist (IBOP or U46619, 0.4 mol/liter) overnight. The cells were then harvested for detection of eNOS phosphorylation (n ϭ 5; *, p Ͻ 0.05 versus control (Ctrl); †, p Ͻ 0.05 versus IBOP or U46619). B, TP activation impairs insulin-stimulated eNOS phosphorylation. HUVECs were treated as described above and then stimulated with insulin for 10 min. The cells were then harvested for analysis of eNOS-Ser 1177 phosphorylation (n ϭ 5; *, p Ͻ 0.05 versus insulin; †, p Ͻ 0.05 versus IBOP ϩ insulin or U46619 ϩ insulin). C, TP is required for the IBOP action. HUVECs were transfected with either control siRNA or TP siRNA (100 nmol/liter) for 48 h and treated with IBOP (0.4 mol/liter, overnight). TP siRNA significantly knocked down both TP␣ and TP␤ isoforms in HUVECs as immunoblotted with antibody from Cayman Chemical. The blot is representative of three blots obtained from three separate experiments (n ϭ 3; *, p Ͻ 0.05 versus control; †, p Ͻ 0.05 versus control siRNA ϩ IBOP). D, TP is required for the inhibition of insulin signaling by IBOP. The siRNA-transfected HUVECs were treated with IBOP (0.4 mol/liter, overnight) and then stimulated with insulin (n ϭ 3; *, p Ͻ 0.05 versus control siRNA ϩ insulin; †, p Ͻ 0.05 versus control siRNA ϩ IBOP ϩ insulin).
effects of the ROCK proteins on LKB1 phosphorylation were investigated by incubating LKB1 with recombinant active either ROCK1 or ROCK2. To define the influence of the ROCK proteins on LKB1-mediated PTEN phosphorylation, we incubated recombinant LKB1 and PTEN in the presence or absence of recombinant ROCKs. In both cases, the reaction conditions were the same as described above. The reactions were terminated by adding SDS sample buffer and were heated for 5 min at 95°C. The samples were then subjected to SDS-PAGE and Western blotting using phospho-specific antibodies.
Western Blot Analysis-HUVECs were washed once with cold phosphate-buffered saline and lysed with ice-cold buffer from Cell Signaling Technology (Beverly, MA) containing 20 mM Tris-HCl, pH 7.5, 150 mM NaCl, 1 mM Na 2 EDTA, 1 mM EGTA, 1% Triton, 2.5 mM sodium pyrophosphate, 1 mM ␤-glycerophosphate, 1 mM phenylmethylsulfonyl fluoride, 10 g/ml leupeptin, 10 g/ml aprotinin, 1 mM Na 3 VO 4 , and 10 mM NaF. The lysates were clarified by centrifugation at 4°C for 18 min. Protein concentrations were measured using the BCA protein assay (Pierce). Samples containing 20 -50 g of protein were separated on a polyacrylamide gel with Tris-glycine-SDS running buffer (Bio-Rad) and transferred onto nitrocellulose membranes (Bio-Rad) for 2 h. The membranes were blocked in 5% milk in Tris-buffered saline with Tween 20 for 1 h and incu-bated overnight with the primary antibody. The membranes were washed and incubated with a peroxidase-linked secondary antibody. The reactive bands were detected using ECL TM Western blotting detection reagents (Amersham Biosciences).
Rhotekin Pulldown Assay for Rho Activation-HUVECs were plated in 0.5% serum medium in 10-cm culture dishes and treated with 0.4 mol/liter IBOP, with or without pretreatment of SQ29548. After 1 h of culture, the cells were rapidly lysed on ice and processed for assay of the levels of GTP-bound Rho. The assays were performed according to the manufacturer's instructions (Thermo Fisher Scientific, Inc.).
PTEN Activity Assay-Anti-PTEN antibody (10 l) was incubated with 500 g of cell lysate for 2 h. The mixture was then incubated with protein A-Sepharose CL-4B beads overnight at 4°C. The immunoprecipitates were washed with lysis buffer, and PTEN phosphatase activity was measured with a malachite greenbased assay (Upstate) using phosphatidylinositol 3,4,5-triphosphate as substrate. An affinity-purified, constitutively active form of PTEN supplied with the kit served as a positive control.
Animals and Feeding Protocol-Male C57BL/6J mice were obtained from Jackson Laboratory (Bar Harbor, ME) and maintained on a regular diet. The mice were housed in temperaturecontrolled cages (20 -22°C), fed ad libitum, and maintained on a 12-h/12-h light/dark cycle. All of the animal experiments were approved by the Institutional Animal Care and Use Committee at University of Oklahoma Health Sciences Center. Age-matched groups (6 -8 weeks of age, n ϭ 10/group) were fed equicaloric diets containing a normal or high amount of fat (60% saturated fat) (Research Diets, New Brunswick, NJ). The animals received a normal or high fat diet (HFD) for 13 weeks. One-half of the animals in each group received either vehicle or SQ29548 (5 mg/kg/day) in drinking water for 5 weeks, with the water being changed twice daily. At the end of this time (18 weeks), the mice were subjected to an intraperitoneal glucose tolerance test and then sacrificed. For the glucose tolerance test, the mice were fasted overnight, and blood was collected from the tail vein at 0, 5, 15, 30, 60, 120, and 240 min after intraperitoneal injection of D-glucose (2 g/kg of body weight). Blood glucose levels were assayed using a blood glucose meter (LifeScan, Inc.). The trapezoid rule was used to determine the area under the curve for glucose concentrations in each animal. After the mice were sacrificed, the thoracic aortas were immediately collected and snap frozen in liquid nitrogen. The

ROCK/LKB1-mediated PTEN Up-regulation
mouse aortas were subsequently homogenized for analysis of eNOS, Akt, and PTEN.
Western Blot Quantification-The integrated intensity (area ϫ density) of individual bands was quantified by densitometry (AlphaEaseFC, Alpha Innotech). The background was subtracted from the calculated area.
Statistical Analysis-All of the quantitative variables are presented as the means Ϯ S.D. Differences between individual groups were analyzed using a one-way, repeated measures analysis of variance with Student's t tests. p Ͻ 0.05 was considered significant.  1A). Short term (less than 8 h) treatment with TP agonists did not significantly block eNOS phosphorylation (data not shown). Similar results were obtained with another TP agonist, U46619 (25) (Fig. 1A).

TP Activation Abrogates Basal and
To determine whether IBOP-or U46619-induced inhibition of eNOS phosphorylation is mediated by TP receptors, we pretreated HUVECs with SQ29548 (4 mol/liter), a TXA 2 receptor antagonist that has higher affinity to TPs than IBOP (26). As shown in Fig. 1A, SQ29548 pretreatment selectively blocked the dephosphorylation of eNOS elicited by either IBOP or U46619. We also investigated the effect of TP activation on insulinstimulated phosphorylation of eNOS. HUVECs preincubated with either IBOP or U46619 were cultured in medium (0.5% serum) overnight before being challenged with insulin. Insulin stimulated eNOS-Ser 1177 phosphorylation, and this effect was blocked by either IBOP or U46619 (Fig. 1B). These results demonstrate that TP stimulation effectively antagonizes insulin-induced eNOS phosphorylation. Interestingly, the inhibitory effects of either IBOP or U46619 were completely reversed by SQ29548 pretreatment (Fig. 1B). The ability of this TP antagonist to block either IBOP-or U46619-induced inhibition of both basal and insulin-stimulated eNOS phosphorylation suggests that these TXA 2 mimetics attenuate eNOS activation through TP. To confirm that TP participates in IBOP-induced inhibition of insulin signaling, we transfected HUVECs with TP-specific siRNA to knockdown TP. As shown in Fig. 1C, TP siRNA clearly blocked IBOP-induced inhibition of eNOS-Ser 1177 phosphorylation, whereas control siRNA did not. Interestingly, TP siRNA also abrogated IBOP-mediated inhibition of insulinstimulated eNOS phosphorylation. However, TP siRNA alone did not further enhanced insulin-stimulated eNOS phosphorylation compared with control siRNA with insulin (data not shown). These data strongly suggest that TP activation suppresses insulin signaling in ECs.
TP Activation Blocks Both Basal and Insulin-stimulated Akt Phosphorylation-Because insulin activates eNOS through Akt (27), we investigated whether TP activation affects both basal and insulin-enhanced Akt activation, as assessed by Ser 473 phosphorylation. We found that TP activation blocked both

. TP activation impairs both basal and insulin-stimulated eNOS-Ser 1177 and Akt-Ser 473 phosphorylation in MAECs.
A and B, TP activation impairs basal eNOS and Akt phosphorylation. Confluent MAECs cultured in 0.5% FBS were pretreated with TP antagonist (SQ29548, 4 mol/liter) for 20 min and exposed to TP agonist (IBOP or U46619, 0.4 mol/liter) overnight. The cells were then harvested for detection of (A) eNOS and (B) Akt phosphorylation (n ϭ 3; *, p Ͻ 0.05 versus control; †, p Ͻ 0.05 versus IBOP or U46619). C and D, TP activation impairs insulin-stimulated eNOS and Akt phosphorylation. MAECs were treated as described above and then stimulated with insulin for 10 min. The cells were then harvested for the analysis of eNOS and Akt phosphorylation (n ϭ 3; *, p Ͻ 0.05 versus insulin; †, p Ͻ 0.05 versus IBOP ϩ insulin or U46619 ϩ insulin). E and F, TP activation impairs both basal and insulin-stimulated phosphorylation of Akt-Ser 473 in human aortic endothelial cells. Confluent human aortic endothelial cells cultured in 0.5% FBS were pretreated with TP antagonist (SQ29548, 4 mol/liter) for 20 min and exposed to TP agonists (IBOP or U46619, 0.4 mol/liter) overnight (E) or then treated with insulin (F). The cells were then harvested for the detection of Akt phosphorylation. The blot is a representative of two blots obtained from two independent experiments. basal and insulin-stimulated Akt phosphorylation at Ser 473 (Fig. 2, A  and B). Pretreatment with the TP antagonist SQ29548 abolished the inhibitory effects of either IBOP or U46619 on both basal and insulinstimulated Akt phosphorylation (Fig. 2, A and B). TP-specific siRNA blocked IBOP suppression of both basal and insulin-stimulated Akt phosphorylation (Fig. 2, C and D), whereas TP siRNA alone did not further stimulate insulin-induced Akt phosphorylation (data not shown). These results confirm that TP activation impairs endothelial insulin signaling.
TP Activation Inhibits the Phosphorylation of Akt and eNOS in Freshly Isolated MAECs-To test whether TP activation contributes to the development of atherosclerosis, freshly isolated MAECs were treated with either IBOP or U46619 in the presence or absence of insulin. As shown in Fig. 3 (A and B), both IBOP and U46619 significantly attenuated the phosphorylation of both eNOS and Akt. SQ29548 also blocked the inhibition of TP agonists (IBOP or U46619) on both basal and insulin-stimulated eNOS phosphorylation in mouse primary aortic endothelial cells (Fig. 3, A and  C). SQ29548 also reversed the inhibition of TP agonists (IBOP or U46619) on both basal and insulinstimulated Akt phosphorylation in MAECs (Fig. 3, B and D). Similar results were also obtained with IBOP and U46619 in cultured human aortic endothelial cells (Fig.  3, E and F).

TP-induced Inhibition of Insulin Signaling Requires PTEN-To begin
to understand what molecules TP may target to block insulin signaling, we investigated IBOP-induced changes in PTEN, a lipid phosphatase that participates in insulin resistance (28,29). As shown in Fig.  4A, IBOP induced PTEN phosphorylation at Ser 380 /Thr 382/383 , a modification that is essential for PTEN stability (30 -32). IBOP also up-regulated PTEN protein levels (Fig.  4A). Exposure of HUVECs to IBOP increased the specific lipid phos-  phatase activity of PTEN by 50%, and SQ29548 preincubation abrogated IBOP-stimulated PTEN activity (Fig. 4B).
To determine whether PTEN is required for TP-induced inhibition of Akt phosphorylation and insulin signaling, HUVECs were transfected with control siRNA or PTEN-specific siRNA. Transfection of PTEN siRNA, but not control siRNA, markedly reduced endogenous PTEN in HUVECs (Fig.  4C). However, PTEN-specific siRNA did not alter either Akt-Ser 473 or eNOS-Ser 1177 phosphorylation (Fig. 4C). Importantly, IBOP-induced inhibition of both basal (Fig. 4C) and insulinstimulated (Fig. 4D) Akt and eNOS phosphorylation was blocked by transfection of PTEN-specific siRNA but not control siRNA. Taken together, these results imply that TP-induced impairment of endothelial insulin signaling requires PTEN.
LKB1 Participates in TP-induced Inhibition of Insulin Signaling-LKB1 is thought to function as a tumor suppressor through its ability to negatively regulate the Akt signaling pathway (33). Our group and others have found that LKB1 may impair insulin signaling (32,34). In addition, our earlier work indicates that IBOP significantly elevates Ser 428 phosphorylation of LKB1 in vascular smooth muscle cells (8). Thus, we investigated whether LKB1 is required for TP-induced Akt inhibition. As shown in Fig. 5A, IBOP (0.4 mol/liter) significantly increased LKB1-Ser 428 phosphorylation, whereas SQ29548 pretreatment clearly blocked the induction of LKB1-Ser 428 phosphorylation by IBOP, suggesting that LKB1 is required for TP-induced inhibition of Akt.
To determine whether LKB1 is required for the inhibitory effects of TP activation, HUVECs were transiently transfected with LKB1 siRNA. Transfection of LKB1-specific siRNA, but not control siRNA, reduced LKB1 protein levels by 80% (Fig. 5B). LKB1 siRNA abrogated IBOP-induced inhibition of insulinstimulated eNOS and Akt phosphorylation, whereas control siRNA had no effect (Fig. 5B). LKB1 siRNA also blocked IBOP-induced increases in PTEN levels and PTEN phosphorylation at Ser 380 /Thr 382/383 (Fig. 5C). As before, control siRNA had no effect on these IBOP-induced changes (Fig. 5C).

Rho/ROCK Participates in TP-induced Inhibition of Insulin
Signaling-In human ECs, Rho/ ROCK negatively regulates eNOS phosphorylation by inhibiting Akt (35). However, whether the Rho kinase pathway participates in TP-induced inhibition of insulin signaling is unknown. To investigate whether Rho participates in TXA 2 signaling, we determined whether stimulation of TP activates Rho. Rhotekin pulldown assays revealed that IBOP did stimulate Rho activation (Fig. 6A), consistent with the ability of U46619 to activate Rho in prostate carcinoma PC-3 cells (36). This activation was attenuated by pretreatment of cells with SQ29548 (Fig. 6A). These data suggest that IBOP activates Rho through TXA 2 receptor stimulation.
To investigate the requirement for Rho/Rho-associated kinase (ROCK) in TP-induced inhibition of insulin signaling, we evaluated the effects of Y27632, a specific inhibitor of ROCK (37). As shown in Fig. 6B, Y27632 (10 mol/liter) pretreatment blocked IBOP-induced inhibition of basal Akt and eNOS phosphorylation in HUVECs. Y27632 also considerably disrupted IBOP-induced increases in PTEN, PTEN-Ser 380 /Thr 382/383 phosphorylation, and PTEN lipid phosphatase activity (Fig. 6, C and D). Y27632 pretreatment dramatically ablated the inhibitory effect of IBOP on insulin-stimulated both Akt and eNOS phosphorylation (Fig. 6E). Taken together, these data show that Rho activation is required for TP-induced inhibition of insulin signaling and that Rho/ROCK may serve as intermediate component of the TXA 2 -TP signaling pathway regulating the insulin response.
ROCK Functions as an Upstream Kinase for LKB1, Which Phosphorylates PTEN-Next, we determined whether ROCK directly inhibits Akt. Incubation of recombinant Akt1 with recombinant ROCK1 or ROCK2 did not inhibit Akt-Ser 473 or Akt-Thr 308 phosphorylation. Indeed, phosphorylation of Akt-Ser 473 was increased to some extent. Both ROCK1 and ROCK2 dramatically inhibited the ability of Akt to phosphorylate its substrate, glycogen synthase kinase-3␤ (Fig. 7A). These results indicate that ROCK needs a partner to inhibit Akt activation in response to TP stimulation.

G i Contributes to TP-induced
Inhibition of Insulin Signaling-The major signaling pathways initiated by TXA 2 -receptor binding may be mediated by G proteins (40 -42). RhoA is activated by G protein-coupled receptors including the G q/11 heterotrimeric G proteins, which are activated by IBOP. We determined whether a pertussis toxin (PTx)-sensitive G protein (43) mediates IBOP-induced Akt dephosphorylation. Preincubation of HUVECs with 50 ng/ml PTx for 30 min completely inhibited TP-induced dephosphorylation of both Akt and eNOS under basal conditions (Fig. 8A) and in the presence of insulin (Fig. 8B). These results are consistent with the concept that TP effect in HUVECs was mediated by G i signaling (15).
A HFD Inhibits Both Akt and eNOS Signaling in a TP-and PTENdependent Manner-We further investigated the up-regulation of PTEN and inhibition of both Akt and eNOS in an in vivo model of type 2 diabetes mellitus. Consistent with a previous report (44), body weight, fat mass, and fasting insulin levels were greater in animals fed a HFD for 18 weeks than in those fed a normal diet (data not shown). The HFD also significantly decreased eNOS-Ser 1177 phosphorylation and eNOS levels in thoracic aortas (Fig. 9A). A 5-week administration of SQ29548 in the drinking water reversed this repression of both eNOS-Ser 1177 phosphorylation and eNOS expression (Fig. 9A), although it did not block glucose intolerance and body weight gain (data not shown). The HFD also notably decreased Akt-Ser 473 phosphorylation in the thoracic aorta, with SQ29548 treatment abolishing this effect (Fig. 9B). HFD-induced dephosphorylation of Akt was accompanied by enhanced PTEN-Ser 380 /Thr 382/383 phosphorylation and a 2-fold increase in PTEN levels. SQ29548 normalized PTEN phosphorylation and PTEN levels in HFD-fed animals (Fig. 9C).

DISCUSSION
In the present study, we provide evidence that TP activation, through the G i G protein family, stimulates the Rho/ROCK 3 LKB1 3 PTEN signaling axis, which suppresses both basal and insulin-stimulated Akt and eNOS phosphorylation, effects that cause insulin resistance (Fig. 9D). These data may have important implications in clinical settings. TP activation is thought to contribute to the development of diabetic (types 1 and 2) complications (14,45,46), and diabetic mice have elevated PTEN levels (32,47). In a diabetic state, increased PTEN levels impair insulin signaling, acting to hamper EC responses to insulin, inhibit NO release, and increase the risk of smooth muscle cell hypertrophy and neointima formation. Our results have uncovered a novel mechanism whereby TP activation induces impairments in endothelial insulin signaling, which may cause vascular endothelium dysfunction contributing to cardiovascular disease.
We show here, for the first time, that TP activation up-regulates PTEN. Several lines of evidence are consistent with the hypothesis that TP activation enhances PTEN stability and leads to an accumulation of lipid phosphatase activity, which represses basal and insulin-stimulated phosphorylation of both Akt and eNOS. First, the TXA 2 mimetic IBOP markedly increased PTEN Ser 380 / Thr 382/383 phosphorylation, which increases PTEN stability (30,31), and a TP antagonist attenuated this effect. Second, a TP antagonist as well as TP-specific siRNA blocked IBOP-induced suppression of insulin signaling. Third, siRNA-mediated knock down of PTEN restored insulin responsiveness in the presence of TP activation. Fourth, a HFD dramatically increased aortic PTEN phosphorylation and PTEN levels in a TP antagonist-reversible manner. Taken together, these findings demonstrate that TP stimulation up-regulates PTEN, which potently modulates insulin signaling and function. This suggests that PTEN is a viable target for diabetes therapies aimed at improving EC function, including antiatherogenic responses to insulin and angiogenesis.
The Rho GTPase family, which includes RhoA, Cdc42, and Rac, is critical for dynamic changes in cell shape and adhesion that govern polarity and drive migration (48 -50). Recent studies reveal that Rho/ROCK pathways play a critical role in diabetic retinal microvasculopathy (51). Here, we show that the Rho/ROCK pathway participates in TP-induced impairment of endothelial insulin signaling. TP stimulation appreciably activated Rho in HUVECs. In addition, the ROCK-specific inhibitor, Y27632, removed TP-induced suppression of insulin signaling and blocked TP-induced elevation of PTEN and its lipid phosphatase activity. Our results revealed that ROCK functioned as an upstream kinase for LKB1 and in this way up-regulated phosphorylation of PTEN at sites known to regulate PTEN stability. These findings suggest that Rho kinase inhibition could ameliorate endothelial insulin signaling, which contributes to endothelial function (52) in human subjects with TP activation.
In conclusion, Rho/ROCK-mediated, LKB1-dependent upregulation of PTEN in response to TP activation attenuates FIGURE 8. G i contributes to TP-induced inhibition of insulin signaling. A, effect of PTx on IBOP-induced dephosphorylation of Akt and eNOS in HUVECs. The cells were pretreated with PTx (50 ng/ml, 30 min) and exposed to IBOP overnight (n ϭ 3; *, p Ͻ 0.05 versus control; †, p Ͻ 0.05 versus IBOP). B, effect of PTx on IBOP-induced suppression of insulin-stimulated both Akt and eNOS phosphorylation. HUVECs were treated with PTx, exposed to IBOP overnight, and stimulated with insulin (n ϭ 3; *, p Ͻ 0.05 versus insulin; †, p Ͻ 0.05 versus IBOP ϩ insulin). insulin signaling in ECs. This results in EC dysfunction, which contributes to atherosclerosis and impaired angiogenesis. These findings suggest that inhibition of TP stimulation could enhance EC insulin sensitivity in patients with types 1 and 2 diabetes.