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Rykaczewska U, Zhao Q, Saliba-Gustafsson P, Lengquist M, Kronqvist M, Bergman O, Huang Z, Lund K, Waden K, Pons Vila Z, Caidahl K, Skogsberg J, Vukojevic V, Lindeman JHN, Roy J, Hansson GK, Treuter E, Leeper NJ, Eriksson P, Ehrenborg E, Razuvaev A, Hedin U, Matic L. Plaque Evaluation by Ultrasound and Transcriptomics Reveals BCLAF1 as a Regulator of Smooth Muscle Cell Lipid Transdifferentiation in Atherosclerosis. Arterioscler Thromb Vasc Biol 2022; 42:659-676. [PMID: 35321563 DOI: 10.1161/atvbaha.121.317018] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Understanding the processes behind carotid plaque instability is necessary to develop methods for identification of patients and lesions with stroke risk. Here, we investigated molecular signatures in human plaques stratified by echogenicity as assessed by duplex ultrasound. METHODS Lesion echogenicity was correlated to microarray gene expression profiles from carotid endarterectomies (n=96). The findings were extended into studies of human and mouse atherosclerotic lesions in situ, followed by functional investigations in vitro in human carotid smooth muscle cells (SMCs). RESULTS Pathway analyses highlighted muscle differentiation, iron homeostasis, calcification, matrix organization, cell survival balance, and BCLAF1 (BCL2 [B-cell lymphoma 2]-associated transcription factor 1) as the most significant signatures. BCLAF1 was downregulated in echolucent plaques, positively correlated to proliferation and negatively to apoptosis. By immunohistochemistry, BCLAF1 was found in normal medial SMCs. It was repressed early during atherogenesis but reappeared in CD68+ cells in advanced plaques and interacted with BCL2 by proximity ligation assay. In cultured SMCs, BCLAF1 was induced by differentiation factors and mitogens and suppressed by macrophage-conditioned medium. BCLAF1 silencing led to downregulation of BCL2 and SMC markers, reduced proliferation, and increased apoptosis. Transdifferentiation of SMCs by oxLDL (oxidized low-denisty lipoprotein) was accompanied by upregulation of BCLAF1, CD36, and CD68, while oxLDL exposure with BCLAF1 silencing preserved MYH (myosin heavy chain) 11 expression and prevented transdifferentiation. BCLAF1 was associated with expression of cell differentiation, contractility, viability, and inflammatory genes, as well as the scavenger receptors CD36 and CD68. BCLAF1 expression in CD68+/BCL2+ cells of SMC origin was verified in plaques from MYH11 lineage-tracing atherosclerotic mice. Moreover, BCLAF1 downregulation associated with vulnerability parameters and cardiovascular risk in patients with carotid atherosclerosis. CONCLUSIONS Plaque echogenicity correlated with enrichment of distinct molecular pathways and identified BCLAF1, previously not described in atherosclerosis, as the most significant gene. Functionally, BCLAF1 seems necessary for survival and transdifferentiation of SMCs into a macrophage-like phenotype. The role of BCLAF1 in plaque vulnerability should be further evaluated.
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Affiliation(s)
- Urszula Rykaczewska
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery (U.R., M.L., M.K., K.L., K.W., K.C., J.R., A.R., U.H., L.M.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Quanyi Zhao
- Division of Cardiovascular Medicine, Cardiovascular Institute (Q.Z., P.S.-G.), Stanford University School of Medicine, CA
| | - Peter Saliba-Gustafsson
- Cardiovascular Medicine Unit, Department of Medicine, Center for Molecular Medicine (P.S.-G., O.B., G.K.H., P.E., E.E.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.,Division of Cardiovascular Medicine, Cardiovascular Institute (Q.Z., P.S.-G.), Stanford University School of Medicine, CA
| | - Mariette Lengquist
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery (U.R., M.L., M.K., K.L., K.W., K.C., J.R., A.R., U.H., L.M.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Malin Kronqvist
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery (U.R., M.L., M.K., K.L., K.W., K.C., J.R., A.R., U.H., L.M.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Otto Bergman
- Cardiovascular Medicine Unit, Department of Medicine, Center for Molecular Medicine (P.S.-G., O.B., G.K.H., P.E., E.E.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Zhiqiang Huang
- Department of Biosciences and Nutrition (Z.H., E.T.), Karolinska Institutet, Stockholm, Sweden
| | - Kent Lund
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery (U.R., M.L., M.K., K.L., K.W., K.C., J.R., A.R., U.H., L.M.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Katarina Waden
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery (U.R., M.L., M.K., K.L., K.W., K.C., J.R., A.R., U.H., L.M.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Zara Pons Vila
- Clinical Chemistry and Blood Coagulation, Department of Molecular Medicine and Surgery (Z.P.V.), Karolinska Institutet, Stockholm, Sweden
| | - Kenneth Caidahl
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery (U.R., M.L., M.K., K.L., K.W., K.C., J.R., A.R., U.H., L.M.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Physiology, Sahlgrenska University Hospital and Molecular and Clinical Medicine, University of Gothenburg, Sweden (K.C.)
| | - Josefin Skogsberg
- Department of Medical Biochemistry and Biophysics (J.S.), Karolinska Institutet, Stockholm, Sweden
| | - Vladana Vukojevic
- Department of Clinical Neuroscience, Center for Molecular Medicine (V.V.), Karolinska Institutet, Stockholm, Sweden
| | - Jan H N Lindeman
- Department of Vascular Surgery, Leiden University Medical Center, the Netherlands (J.H.N.L.)
| | - Joy Roy
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery (U.R., M.L., M.K., K.L., K.W., K.C., J.R., A.R., U.H., L.M.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Göran K Hansson
- Cardiovascular Medicine Unit, Department of Medicine, Center for Molecular Medicine (P.S.-G., O.B., G.K.H., P.E., E.E.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Eckardt Treuter
- Department of Biosciences and Nutrition (Z.H., E.T.), Karolinska Institutet, Stockholm, Sweden
| | - Nicholas J Leeper
- Department of Surgery (N.J.L.), Stanford University School of Medicine, CA.,Department of Medicine (N.J.L.), Stanford University School of Medicine, CA
| | - Per Eriksson
- Cardiovascular Medicine Unit, Department of Medicine, Center for Molecular Medicine (P.S.-G., O.B., G.K.H., P.E., E.E.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Ewa Ehrenborg
- Cardiovascular Medicine Unit, Department of Medicine, Center for Molecular Medicine (P.S.-G., O.B., G.K.H., P.E., E.E.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Anton Razuvaev
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery (U.R., M.L., M.K., K.L., K.W., K.C., J.R., A.R., U.H., L.M.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Ulf Hedin
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery (U.R., M.L., M.K., K.L., K.W., K.C., J.R., A.R., U.H., L.M.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Ljubica Matic
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery (U.R., M.L., M.K., K.L., K.W., K.C., J.R., A.R., U.H., L.M.), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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