Endothelial insulin signaling regulates perfusion, leukocyte adhesion, and angiogenesis, and its impairment may contribute to the development of vascular complications in diabetes. Hypoxia-inducible factors (HIF) are known modulators of insulin signaling and we have recently shown that a negative regulator of HIF activity, CBP/p300 interacting transactivator-2 (CITED2), is increased in the vasculature of people with type 2 diabetes. Therefore, we examined the role of CITED2 in endothelial insulin signaling by generating a mouse model with endothelial-specific loss of Cited2. We found that in the aorta and isolated endothelial cells, loss of Cited2 markedly enhanced insulin-stimulated Akt phosphorylation at Ser473 without altering ERK1/2 phosphorylation. Consistent with this observation, Cited2 deletion in endothelial cells increased insulin-stimulated Vegfa expression, endothelial nitric oxide synthase phosphorylation, and cell proliferation. Endothelial cells lacking CITED2 exhibited a 3.6-fold increase in insulin receptor substrate (IRS)-2 protein, a key mediator of the insulin signaling cascade, and 66% increase in Irs2 mRNA expression while IRS-1 was unchanged. Similarly, overexpression of CITED2 in endothelial cells decreased IRS-2 levels by 55% without altering IRS-1. Expression of HIF-2α significantly increased transcription of the Irs2 promoter and co-expression of CITED2 abolished this increase. Moreover, ChIP showed that loss of CITED2 increases occupancy of p300, a key component of the HIF transcriptional complex, on the Irs2 promoter. Together, these results suggest that loss of CITED2 enhances endothelial insulin signaling through de-repression of HIF-dependent Irs2 expression. The CITED2-p300 interaction can likely be interrupted by a small-molecule drug, and is thus a potential target to improve insulin action on endothelial cells in order to prevent vascular complications of diabetes.
B. Kunkemoeller: None. K. Chen: None. X. Wang: None. C. Rask-Madsen: None.
National Institutes of Health (5T32DK007260)