Department of Pediatrics, University of Chicago, Chicago, United States
Nancy B Schwartz
Department of Pediatrics, University of Chicago, Chicago, United States
Karin Tran-Lundmark
Department of Experimental Medical Science and Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
Martina Veigl
Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, United States; Department of Medicine, Case Western Reserve University, Cleveland, United States
David Sedwick
Department of Medicine, Case Western Reserve University, Cleveland, United States
Elliot H Philipson
Department of Biomedical Engineering, Cleveland Clinic Lerner Research Institute, Cleveland, United States; The Women's Health Institute, Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, United States
The umbilical artery lumen closes rapidly at birth, preventing neonatal blood loss, whereas the umbilical vein remains patent longer. Here, analysis of umbilical cords from humans and other mammals identified differential arterial-venous proteoglycan dynamics as a determinant of these contrasting vascular responses. The umbilical artery, but not the vein, has an inner layer enriched in the hydrated proteoglycan aggrecan, external to which lie contraction-primed smooth muscle cells (SMC). At birth, SMC contraction drives inner layer buckling and centripetal displacement to occlude the arterial lumen, a mechanism revealed by biomechanical observations and confirmed by computational analyses. This vascular dimorphism arises from spatially regulated proteoglycan expression and breakdown. Mice lacking aggrecan or the metalloprotease ADAMTS1, which degrades proteoglycans, demonstrate their opposing roles in umbilical vascular dimorphism, including effects on SMC differentiation. Umbilical vessel dimorphism is conserved in mammals, suggesting that differential proteoglycan dynamics and inner layer buckling were positively selected during evolution.