Abstract
The vasculature system is composed of a multiplicity of juxtaposed cells to generate a functional biological barrier between the blood and tissues. On the luminal surface of blood vessels, endothelial cells (ECs) are in close contact with circulating cells while supporting basal lamina and pericytes wrap the abluminal surface. Thus, the reciprocal interaction of pericytes with ECs is a vital element in the physiological activity of the vascular system. Several reports have indicated that the occurrence of pericyte dysfunction under ischemic and degenerative conditions results in varied micro and macro-vascular complications. Emerging evidence points to the fact that autophagy, a conserved self-digestive cell machinery, can regulate the activity of several cells like pericytes in response to various stresses and pathological conditions. Here, we aim to highlight the role of autophagic response in pericyte activity and angiogenesis potential following different pathological conditions.
1 Introduction
Brain and other tissue pericytes are one of the main cellular components involved in vascular integrity and the regulation of blood flow (). Pericytes are located at the abluminal surface of vascular tissue and enwrap the endothelial layer via juxtacrine interaction, namely, myoendothelial gap junction (Vicario and Parenti, 2022). The occurrence of varied pathological conditions such as ischemic stroke, infarction, and degenerative conditions can increase pericyte atresia and detach them from the endothelial layer (Uemura et al., 2020). Under pathological conditions, the release of degrading enzymes with severe vascular injury contributes to the development of hemorrhagia, and the recruitment of immune cells (). Besides, the loss of vascular integrity and cell-to-cell junction leads to local hematoma inside the cranial cavity. It is evident the increase in intracranial pressure promotes brain tissue injury (Wang, 2010; Yang et al., 2022). Along with these descriptions, reciprocal cross-talk between different vascular cells such as pericytes, endothelial cells (ECs), and other cells is critical in the homeostasis and physiology of blood vessels (). It has been shown that the loss of homotypic pericyte‒to‒pericyte junction, and the heterotypic interaction of pericytes with ECs, and other cells contributes to the disruption of vascular integrity (). As a common belief, pericytes can regulate the permeability of the blood-brain-barrier (BBB) interface via the production of various signaling molecules. These factors support the maintenance of tight junctions between the ECs and guide the astrocyte polarization endfeet ().
Emerging data have revealed the fundamental role of several signaling pathways, especially autophagy, in the function of pericytes under physiological and pathological conditions (). Autophagy, a self-digestive and catabolic system, has a crucial role in the maintenance of cell homeostasis (). The autophagy machinery is a scavenging system to exclude injured organelles and misfolded proteins. This system can recycle the digested substrates to compensate for the fatal energy crisis. These features make the cells resistant to several insulting conditions (; ). The activation of adaptive (normal) autophagic response is associated with pericyte functional characteristics and vascular homeostasis (). It has been thought that both impaired autophagic response and excessive autophagy response not only cannot protect the host cells like pericytes after being exposed to pathological conditions but also it can accelerate cell death mechanisms (). Here, in this review article, the role of autophagy was highlighted in angiogenic activity and function of pericyte in several pathologies. How and by which mechanisms adaptive autophagy can regulate pericyte function, increase their resistance to insulting conditions, i.e., metabolic disorders and inflammatory response, and restore the cellular homeostasis is at the center of debate. Besides, the detrimental effects of excessive and impaired autophagy were also discussed in vascular pericytes. It seems that this review article can help us in the understanding of protective/detrimental role of autophagy in pericytes functional characterises under different biological situations.
2 Pericytes function and activity
Pericytes exhibit heterogeneous sources and originate from the mesoderm and neural crest. The cell can support the vascular integrity by wrapping the vascular endothelial layer. A fraction of pericytes within the central nervous system and lymphoid organs such as the thymus are from the neural crest origin while in the heart, lungs, liver, and gut mesothelium is the source of pericytes (; ). From the morphological aspect, pericytes constitute three sub-types as follows; mesh pericytes, ensheathing pericytes, and thin-strand pericytes (). Although all pericyte types can share a protruding soma the existence of varied cellular processes with distinct morphologies helps them to function in different tissues (; ). It is suggested that ensheathing pericytes are juxtaposed to the arteriole-capillary junction via projections wrapping the vascular structure. The mid-capillaries are the source of thin-strand pericytes with long, thin processes tracing the external vascular surface. The last cell type is mesh pericytes longitudinal short processes are located on the abluminal surface of post-capillary venules and the capillaries (; ).
Along with morphological features, the molecular identity and genomic profile have revealed different pericyte types. Importantly, the molecular profile is not exclusive to pericytes, and the type, function, and location of these cells can affect the molecular signature (). Intracellular proteins like desmin, alpha-smooth muscle actin (α-SMA), regulator of G protein signaling 5 (RGS-5), cell surface proteins like neuron-glial antigen 2 (NG2), and platelet-derived growth factor receptor beta (PDGFR-β) are the main target molecules used commonly for pericyte identification (van Splunder et al., 2023). Unfortunately, desmin belonging to type III contractile filaments can be found in different muscle cell types (). Likewise, α-SMA is a cytoskeletal protein and presents in smooth-muscle cells and fibroblasts (Zheng et al., 2023). RGS-5 is a protein that activates GTPase proteins and disrupts sphingosine-1-phosphate, endothelin-1, angiotensin II, and PDGF-induced signaling in cultured cells (; ). RGS-5 is an angiogenesis marker and its expression promotes neovascularization rate (). Of Note, NG2 is a chondroitin sulfate proteoglycan expressed on the surface of pericytes during vasculogenesis and angiogenesis (). This factor is not detectable in mature vascular, indicating the role of this factor in the induction and progression of angiogenesis (). PDGFR-β with a tyrosine-kinase activity is crucial for the commitment of stem cells toward pericytes. Besides, the activity of this receptor in the angiogenesis process has been proved (; ; ). It is thought that differences in origin, molecular profile, and morphology lead to unique pericyte activity (). For instance, the production of α-SMA, myosin, and tropomyosin especially in ensheathing pericytes increases the cell contractibility, resulting in the regulation of blood flow rate (; ).
The central nervous system is exposed to several compounds in blood. To prevent the uncontrolled entry of these compounds into the brain parenchyma, pericytes constitute a selective BBB interface with the collaboration of ECs and astrocytes. It is suggested that the integrity and function of BBB are extremely associated with the normal function of pericytes (Figure 1) (; ). Of note, histological and molecular works have provided evidence that the pericyte/EC ratio is higher in the brain microvascular system compared to other vessel types, indicating an important role of pericytes in the BBB integrity (Uemura et al., 2020). In newly generated blood vessels, the recruitment of pericytes results in the functional integrity of the vascular barrier (Uemura et al., 2020).
FIGURE 1
The production of several signaling molecules by pericytes supports the maintenance of tight conjunction between the ECs and the attachment of astrocyte end-feet (
3 Autophagy mechanisms and molecular machinery
Autophagy is a cellular process to exclude defective organelles and misfolded proteins under normal and pathological conditions (
FIGURE 2

Autophagy activation steps. In the initiation step, the ULK1 complex is stimulated due to the existence of several stimuli, leading to the reduction of ATP/AMP ratio, activation of AMPK, and inhibition of mTORC1. Along with the activation of the ULK1 complex, ATG13, ATG101, and FIP200/RB1CC1 were also engaged and are localized to pre-autosomal structures. The procedure is continued with the nucleation step, leading to the generation of phagophores. In this step, namely, elongation, BCLIN1 activates other complexes like ATGL14, VPS34, and VPS15. In the elongation step, ATGs and lipids are added to the phagophores. Finally, phagophores generate autophagosomes and fuse with the lysosomes to form autophagolysosomes.
4 Role of autophagy in pericyte activity
Whether and how autophagy mechanisms can regulate the dynamic activity of pericytes within the vascular structure has been at the center of the debate. Emerging data have indicated that autophagy is closely associated with the function of pericytes in several vessel types (
4.1 Diabetic conditions
Previous data have confirmed the inevitable role of autophagy on bovine retinal pericyte migration in in vitro conditions (
Given the intricate and complex association of metabolic disorders with the vascular unit, it is postulated that a diabetic condition is likely to alter the function of cells in the BBB interface integrity (
FIGURE 3

The relationship between autophagic response and retinal pericyte death in a dog with diabetes mellitus (A–H). Ultrastructural images revealed dilated capillaries in the retina with normal ECs and a lack of enwrapping pericytes. Along with basal membrane thickening, numerous vesicles containing electron-dense substrates are accumulated inside the pericyte cytoplasm (E,F). Vacuoles with heterogeneous materials are seen in the pericyte projections, indicating autophagy stimulation [red arrows; (F)]. Dense and dark vacuoles (red arrow) are autophagosomes. The green arrow indicates a clathrin-coated pit at the inner surface of the basal membrane. Scale bar: 1.0 µm; Pericyte process: PP; Red blood cells: RBC; Vessel lumen: L; Glial processes: G; Basal membrane: BM; Pericyte ghost: PG; and Endothelial cell nucleus: N. Reproduced with permission (
Recent works have established that the diabetic milieu contributes to lysosomal malfunction which in turn increases the possibility of autophagic stress and stagnation instead of adaptive autophagy (Zheng et al., 2020). It is thought that in diabetic cells the maturation of lysosomal Cathepsin D and thus the enzymatic activity of lysosomes are reduced. Concurrently, the hyperactivity of mTORC1 per se affects lysosomal maturation and activity via the promotion of phosphorylated ULK1 and reduction of TFEB nuclear translocation following interaction with Smad3 (
4.2 Autophagy and inflammation
The occurrence of ischemic stroke is associated with, inflammation, pericyte loss and BBB disintegrity (Zhang et al., 2020). Despite the direct effect of pathological conditions on BBB multi-cellular components, it is postulated that the secretome of glial cells can also affect the function of pericytes under hypoxic conditions (
In an experiment conducted by Zhang and co-workers, they found that sigma-1 (σ-1R) receptor activity can reduce pericyte dysfunction under ischemic stroke in the brain parenchyma (Zhang et al., 2020). The induction of experimental stroke in σ-1R knock-out mice led to massive pericyte apoptosis compared to the wild-type group (Zhang et al., 2020). Besides, it is postulated that the suppression of these receptors can exacerbate the protein levels of tight junction proteins like occludin, claudin 5, and ZO-1 in BBB ECs (Zhang et al., 2020). σ-1R is an endoplasmic membrane receptor and participates in intracellular calcium homeostasis via the regulation of voltage-gated and non-voltage-gated ion channels (
FIGURE 4

Effect of σ-1R agonist, YZ001, on the autophagic activity of pericyte in σ-1R knock-out mice subjected to photothrombotic middle cerebral artery occlusion (A–E). TEM images revealed the existence of autolysosomes and autophagosomes (yellow arrows) in pericytes 24 h after induction of ischemic conditions (n = 4; Scale bar = 0.2 μm). The suppression of σ-1R leads to stress autophagy in the ischemic group [(B,C); n = 3]. ***p < 0.001 versus the wild-type sham group and ###p < 0.001 versus the wild-type ischemic group. LC3-II/LC3-I ratio and total LC3 content were increased in σ-1R knock-out mice compared to the control group. Application of σ-1R agonist, YZ001, alleviated ipsilaterally the overactivity of autophagy in ischemic mice [(D,E); n = 3]. ***p < 0.001 versus the sham group, ###p < 0.001 versus the ischemic-treated control group. One-way ANOVA followed by the Holm–Sidak test. Photothrombotic middle cerebral artery occlusion; pMCAO. Reproduced with permission (Zhang et al., 2020). Copyright 2020, Translational Stroke Research.
During several degenerative diseases, the accumulation of inclusion bodies in vascular cells increases the possibility of microvessel-associated injuries (
4.3 Autophagy and juxtacrine (physical) activity
It has been shown that the exchange of intracellular organelles and small-sized vesicles occurs via juxtacrine activity and intercellular bridges between the multiplicity of cells within the BBB (
FIGURE 5

Monitoring inter pericyte-astrocyte mitochondrial trafficking in vitro(A–G). Pericytes and astrocytes were stained with MitoTracker Deep Red (MT) and CellMask Orange (CM) and co-cultured in vitro. Pericytes extended projections toward the astrocytes in the co-culture system (A). Epi-fluorescence imaging of TNT (200 μm in length; yellow arrow) formed between the red-colored pericyte and blue-colored astrocyte. Mitochondria are present inside the TNT (white arrows) (B). Monitoring the formation of TNT between pericytes after 24 h using confocal images (C). F-actin was stained with fluorescent phalloidin (green). Numerous mitochondria are visible inside the TNT (length >200 μm). Imaging of inter pericyte-astrocyte TNT formation (D). TNT F-actin was stained with green fluorescent phalloidin extended from pericytes toward astrocytes with numerous mitochondria (red particles). Inside the astrocyte cytoplasm, donated mitochondria are visible (n = 3; (D). Measuring homotypic, heterotypic TNT formation between pericytes (P-P), astrocytes (A-A), and pericytes with astrocytes (A-P) after 24 h in vitro (TNT number/field of 50 cells) [n = 3; (E)]. Homotypic and heterotypic-TNT length after 24 h of co-culture [n = 3; (F)]. Pericyte mitochondria are inside the GFAP-positive astrocytes [n = 3; (G)]. *p < 0.05; **p < 0.005 with Kruskal–Wallis/Dunn’s tests. Reproduced with permission (
Based on astrocyte activity in response to pathological conditions, excessive oxidative stress can contribute to the promotion of several proteases in the mitochondrial matrix and mitophagy response (Weidling and Swerdlow, 2019). It is postulated that the mitochondrial donation by pericytes to juxtaposed acceptor cells like astrocytes occurs under pathological conditions to regulate redox homeostasis, compensate for the lack of sufficient ATP, and reduce injuries related to deficient mitochondria (
Under diabetic conditions, the generation of TNTs is a compensatory mechanism to alleviate impaired autophagic response due to AGE-induced lysosomal dysfunction (
4.4 Autophagy and paracrine activity
The interplay between autophagy and other secretory pathways is another approach that can improve cell function and activity. Data indicated shared molecular effectors ATG5, ATG16L1, and Alix between the autophagic system and endosomal system [exosome abscission] (
FIGURE 6

Studying the phagocytic properties of lamp2a knock-out pericytes (KO PC) in comparison with wild-type pericytes (WT PC) after incubation with glioblastoma cells. Pericytes were stained with green phalloidin (Phall-PC). These cells can phagocyte pyknotic nuclei (DAPI, white; arrows) and cytoplasmic inclusions (arrowheads) of apoptotic glioblastoma cells [APO-GB stained with DiI and phalloidin (yellow)] in comparison with control wild-type PC without apoptotic glioblastoma cells (vehicle). This assay was done in pentaplicate in U373 and U87 cells. Scale bars: 50 μm. Reproduced with permission (
FIGURE 7

The promotion of CMA in pericytes leads to the development of U87 or U373 glioblastoma cells 4–11 weeks after transplantation. CD4+ lymphocytes were isolated from lymph nodes of mice xenografted with wild-type pericytes (WT PC), lamp2a knock-out pericytes (KO PC), and RFP + glioblastoma cells (GB), and proliferation capacity (A), IL-2 levels (B) and cytotoxicity (C) were evaluated and compared to mice xenografted with glioblastoma cells (GB) or PBS (vehicle). Cells were exposed to anti-CD3 and -CD28 antibodies for 72 h ex vivo (n = 3; *p < 0.05). Flow cytometry analysis of inhibitory factors in isolated CD4+ lymphocytes (*p < 0.05; **p < 0.01) (C). Immunofluorescence images of PD-1 in T lymphocytes isolated from cerebrospinal fluid in mice with xenograft glioblastoma cells and wild-type pericytes (Scale bar: 10 μm) (D). Growth of glioblastoma mass in mice xenografted with glioblastoma cells and wild-type pericytes and compared to the group that received glioblastoma cells with lamp2a knock-out pericytes [(E); left panel; Scale bars: 250 μm]. In the right panel (E), numerous red RFP+ glioblastoma cells proliferate prominently (Ki-67+ cells) in the presence of wild-type pericytes compared to the group juxtaposed to lamp2a knock-out pericytes (Scale bar: 50 μm). Measuring LAMP-2A in GFP+ pericytes and glioblastoma cells (F). The upper row indicates a strong elevation of LAMP-2A juxtaposed to the perivascular niche (arrows; Scale bar, 100 μm). In the below row, GFP+ pericytes are present in the ventral pole of the tumor mass (arrows; Scale bar: 250 μm). Staining of nuclei with DAPI indicates a higher cellularity rate in the ventral pole (arrows). Along with these changes, the number of red LAMP-2A+ pericytes at the periphery of tumor mass (arrowheads: LAMP-2A + punctate pattern; blood vessels: V; Scale bar = 45 μm). Immunohistochemistry analysis of LAMP-2A levels (arrows) around the vascular structures (V) in brain samples obtained from the glioblastoma patients (G) (Scale bar: 50 μm). (Valdor et al., 2019). Copyright 2019, Proceedings of the National Academy of Sciences of the United States of America.
5 Conclusion
In this review article, the critical role of autophagy was highlighted in vascular cell function, especially pericytes, under physiological and pathological conditions. As expected, autophagy is an early-stage cell resistance mechanism against several insulting conditions such as metabolic disorders. Molecular investigations and histological examination in laboratory scale and animal models uncovered the stimulation of autophagic response in pericytes at early steps following exposure to the insulting conditions. The activation of adaptive autophagy can influence several biological aspects of pericytes within the vessel structure. Autophagy helps the injured pericytes restore their physical connection with the ECs. Under pathological conditions, autophagy can help pericytes generate homotypic and heterotypic TNTs and release exosomes, resulting in the interchange of intracellular organelles and other subcellular components. In contrast to these features, the over-activity of autophagy molecular machinery for a prolonged time can contribute to scavenging system exhaust and provoke the cross-talked cell death pathway like apoptosis in pericytes. Taken together, autophagy can exert its protective effects on pericytes in a time- and intensity-dependent manner. Besides, the crucial role of different autophagy forms should be revisited in the dynamic activity of pericytes and other vascular cells.
Statements
Author contributions
SM: Software, Writing–original draft. AR: Writing–review and editing. MK: Writing–review and editing. LS: Writing–original draft. NM: Writing–original draft. MN: Writing–original draft. FS: Writing–original draft. FV: Writing–original draft. RR: Conceptualization, Funding acquisition, Supervision, Writing–original draft.
Funding
The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by a grant (72983) with an ethical code of IR.TBZMED.VCR.REC.1402.216 from Tabriz University of Medical Sciences.
Acknowledgments
Authors wish to thank the personnel of the Faculty of Advanced Medical Sciences for their help and guidance.
Conflict of interest
Author FV was employed by Technology Development Zones Management CO.
The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.
Publisher’s note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
Abbreviations
Advanced glycation end products, AGEs; Alpha-smooth muscle actin, α-SMA; AMP-activated protein kinase, AMPK; Autophagy-related proteins, ATG; Blood-brain-barrier, BBB; Chaperone-mediated autophagy, CMA; c-Jun N-terminal Kinase, JNK; Cytotoxic T lymphocyte-associated protein-4, CTLA-4; Endothelial cells, ECs; Focal adhesion kinase, FAK; G protein signaling 5, RGS-5; Glucose transporter 1, GLUT1; Interleukin-1 beta, IL-1β; Low-density lipoprotein, LDL; Mechanistic target of rapamycin kinase complex 1, mTORC1; Metalloproteinase-2, MMP-2; Microtubule-associated protein 1 light chain 3 alpha, LC3; Multivesicular bodies, MVBs; Neuron-glial antigen 2, NG2; Phosphatase and Tensin homolog, PTEN; Phosphatidylethanolamine, PE; PI3-phosphate, PI3P; Platelet-derived growth factor receptor beta, PDGFR-β; Pre-autophagosomal structures, PAS; Programmed cell death protein 1, PD-1; Reactive oxygen species, ROS; Sigma-1 receptor, σ-1R; Tumor necrosis factor-alpha, TNF-α; Tunneling nanotubes, TNTs; and Vascular endothelial growth factor, VEGF.
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Summary
Keywords
pericytes, vascular function, autophagy, protective/detrimental activity, pathological conditions
Citation
Milani SZ, Rezabakhsh A, Karimipour M, Salimi L, Mardi N, Narmi MT, Sadeghsoltani F, Valioglu F and Rahbarghazi R (2024) Role of autophagy in angiogenic potential of vascular pericytes. Front. Cell Dev. Biol. 12:1347857. doi: 10.3389/fcell.2024.1347857
Received
01 December 2023
Accepted
24 January 2024
Published
06 February 2024
Volume
12 - 2024
Edited by
Chunsik Lee, Sun Yat-Sen University, China
Reviewed by
Albert L. Gonzales, University of Nevada, Reno, United States
Nahid Arghiani, Stockholm University, Sweden
Linda Alex, University of Texas Southwestern Medical Center, United States
Yunpei Zhang, Oregon Health and Science University, United States
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© 2024 Milani, Rezabakhsh, Karimipour, Salimi, Mardi, Narmi, Sadeghsoltani, Valioglu and Rahbarghazi.
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*Correspondence: Reza Rahbarghazi, rezarahbardvm@gmail.com, rahbarghazir@tbzmed.ac.ir
† These authors share first authorship
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