AUTHOR=Ji Yongli , Ma Yuankun , Shen Jian , Ni Hui , Lu Yunrui , Zhang Yuhao , Ma Hong , Liu Chang , Zhao Yiming , Ding Siyin , Xiang Meixiang , Xie Yao TITLE=TBX20 Contributes to Balancing the Differentiation of Perivascular Adipose-Derived Stem Cells to Vascular Lineages and Neointimal Hyperplasia JOURNAL=Frontiers in Cell and Developmental Biology VOLUME=Volume 9 - 2021 YEAR=2021 URL=https://www.frontiersin.org/journals/cell-and-developmental-biology/articles/10.3389/fcell.2021.662704 DOI=10.3389/fcell.2021.662704 ISSN=2296-634X ABSTRACT=Background: Perivascular adipose-derived stem cells (PVASCs) can contribute to vascular remodeling, which are also capable of differentiating into multiple cell lineages. Present study aims to investigate the mechanism of PVASCs differentiation towards smooth muscle cells (SMCs) and endothelial cells (ECs) as well as its function in neointimal hyperplasia. Methods: Single-cell and bulk mRNA sequencing were applied for searching key genes in PVASC regarding its role in vascular remodeling. PVASCs were induced to differentiate towards SMCs and ECs in vitro, which was quantitatively evaluated using immunofluorescence, quantitative real-time PCR (QPCR) and Western Blot. Lentivirus transfections were performed in PVASCs to knockdown or overexpress TBX20. In vivo, PVASCs transfected with lentivirus were transplanted around the guidewire injured femoral artery. Hematoxylin-eosin (H&E) staining was performed to examine their effects on neointimal hyperplasia. Results: Bulk mRNA sequencing and single-cell sequencing revealed unique expression of TBX20 in PVASCs. TBX20 expression markedly decreased during smooth muscle differentiation while increased during endothelial differentiation of PVASCs. TBX20 knockdown resulted in the upregulation of SMC-specific marker expression and activated Smad2/3 signaling, whereas inhibiting endothelial differentiation. In contrast, TBX20 overexpression repressed the differentiation of PVASCs toward smooth muscle cells but promoted endothelial differentiation in vitro. Transplantation of PVASCs transfected with TBX20 overexpression lentivirus inhibited neointimal hyperplasia in murine femoral artery guidewire injury model. On the contrary, neointimal hyperplasia significantly increased in TBX20 knockdown group. Conclusion: A subpopulation of PVASCs uniquely expressed TBX20. TBX20 could regulate SMC and EC differentiation of PVASCs in vitro. Transplantation of PVASCs after vascular injury suggested that PVASCs participated in neointimal hyperplasia via TBX20.