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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:1150.)
© 2006 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Mechanisms of Dysregulation of Low-Density Lipoprotein Receptor Expression in Vascular Smooth Muscle Cells by Inflammatory Cytokines

Xiong Z. Ruan; John F. Moorhead; Jian L. Tao; Kun L. Ma; David C. Wheeler; Stephen H. Powis; Zac Varghese

From the Centre for Nephrology, Royal Free and University College Medical School, Royal Free Campus, London, UK.

Correspondence to Dr Xiong Z. Ruan, Centre for Nephrology, Royal Free and University College Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK. E-mail x.ruan{at}medsch.ucl.ac.uk

Objective— Although inflammation is a recognized feature of atherosclerosis, the impact of inflammation on cellular cholesterol homeostasis is unclear. This study focuses on the molecular mechanisms by which inflammatory cytokines disrupt low-density lipoprotein (LDL) receptor regulation.

Methods and Results— IL-1ß enhanced transformation of vascular smooth muscle cells into foam cells by increasing uptake of unmodified LDL via LDL receptors and by enhancing cholesterol esterification as demonstrated by Oil Red O staining and direct assay of intracellular cholesterol concentrations. In the absence of IL-1ß, a high concentration of LDL decreased LDL receptor promoter activity, mRNA synthesis and protein expression. However, IL-1ß enhanced LDL receptor expression, overriding the suppression usually induced by a high concentration of LDL and inappropriately increasing LDL uptake. Exposure to IL-1ß also caused overexpression of the sterol regulatory element binding protein (SREBP) cleavage-activating protein (SCAP), and enhanced its translocation from the endoplasmic reticulum to the Golgi, where it is known to cleave SREBP, thereby enhancing LDL receptor gene expression.

Conclusions— These observations demonstrate that IL-1ß disrupts cholesterol-mediated LDL receptor feedback regulation, permitting intracellular accumulation of unmodified LDL and causing foam cell formation. The implication of these findings is that inflammatory cytokines may contribute to intracellular LDL accumulation without previous modification of the lipoprotein.

Inflammation is associated with atherosclerosis. We demonstrated that the inflammatory mediator IL-1ß disrupts cholesterol-mediated LDL receptor feedback regulation, permitting unregulated intracellular accumulation of unmodified LDL and causing foam cell formation. This mechanism may contribute to the development of atherosclerosis in patients with chronic inflammation.

Key Words: atherosclerosis • cytokine • LDL receptor • SREBP cleavage-activating protein • vascular smooth muscle cells

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