Type I interferon regulates angiogenesis in Down Syndrome Supplement - SUMMARY:
Trisomy 21 (T21) is the most prevalent chromosomal abnormality worldwide, resulting in Down Syndrome (DS)
[1, 2], a multisystem syndrome associated with cardiopulmonary disorders. Pulmonary disorders include
pulmonary hypertension, pulmonary hypoplasia, pulmonary hemosiderosis and pulmonary capillaritis, all of
which can result from a dysregulated lung endothelium. In addition, T21 lungs are characterized by the
persistence of an immature double capillary network system surrounding the alveoli and representative of the
saccular stage of development [3]. This suggests that endothelial defects in individuals with DS are likely initiated
in utero. Single cell transcriptomics data demonstrated the presence of diverse endothelial cell populations in
the human adult lung [4, 5]. While others and we have reported impaired endothelial networks in the developing
T21 lung characterized by congested capillaries, lymphatic dilatation, and muscularized arteries [6], the nature
of these defects and the different endothelial cell populations contributing to such defects are yet to be
understood. Moreover, developing T21 human lungs display increased expression of anti-angiogenic factors [3,
6-8]. A decrease in endothelial progenitor cells is found in T21 peripheral blood [9]. Furthermore, T21 iPSC-
derived endothelial cells exhibit decreased cell proliferation, impaired sprouting and tube formation compared to
euploid cells [10]. One of the major pathways consistently activated in DS is the type I interferon (IFN) pathway
[6]. Elevated type I IFN causes a decrease of endothelial progenitor cells [9] and inhibits VEGF induced
development of capillary like structures [11, 12], thus playing an anti-angiogenic role. Additionally, type I
interferonopathies are linked to pulmonary hypertension and pulmonary vasculopathy [13]. Sc-RNAseq data of
T21 and euploid lung cells demonstrated the presence of several endothelial cell populations displaying
increased expression of type I IFN signaling pathway genes in T21. Therefore, we hypothesize that defective
lung angiogenesis occurs in T21 during development and is a result of type I IFN-dependent changes in
endothelial cell proliferation, differentiation and migration. To test this hypothesis, we will 1) determine endothelial
cell defects in T21 vs euploid human developing lungs by defining the different endothelial cell populations and
their spatiotemporal distribution using combinatorial in situ hyridization with IF stainings and assessing defects
in endothelial cell proliferation and sprouting of each group via IF and 3D image quantifications and 2) define the
role of type I IFN signaling in the endothelial defects in T21 by determining the effect of gain and loss of type I
IFN signaling on proliferation, migration, permeability and tube formation in primary and iPSC-derived endothelial
cell cultures of T21 and euploid cells. Improved strategies to prevent, ameliorate or reverse endothelial related
lung disease in DS will be contingent upon a detailed understanding of the defects and pathways driving these
defects that may identify novel therapeutic targets for intervention.