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Inhibition of EphA2 protects against atherosclerosis by synergizing with statins to mitigate macrophage inflammation - 04/12/23

Doi : 10.1016/j.biopha.2023.115885 
Jie Zeng a, 1, Qiao Wu b, 1, Shiqiang Xiong c, 1, Cong Lu a, Zheng Zhang c, Hui Huang a, Yan Xiong a, Tiantian Luo a,
a Department of Cardiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610014, China 
b Department of Cardiology, Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510080, China 
c Department of Cardiology, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan 610031, China 

Corresponding author.

Abstract

Statins are highly prevalent in patients with coronary artery disease. Statins exert their anti-inflammatory effects on the vascular wall and circulating levels of pro-inflammatory cytokines. However, increasing attention revealed the exacerbation of macrophage inflammation induced by statins, and a clear mechanistic explanation of whether the detrimental effects of statins on macrophage inflammatory phenotypes outweigh the beneficial effects is has not yet been established. Here, RNA-sequencing and RT-qPCR analyses demonstrated that statins significantly upregulated EphA2, Nlrp3, IL-1β and TNF-α expression in macrophages. Mechanistically, we found that atorvastatin reduced KLF4 binding to the EphA2 promoter using KLF4-chromatin immunoprecipitation, suppressed HDAC11-mediated deacetylation and subsequently led to enhanced EphA2 transcription. The 4D-label-free proteomics analysis further confirmed the upregulated EphA2 and inflammatory signals. Furthermore, the proinflammatory effect of atorvastatin was neutralized by an addition of recombinant Fc-ephrinA1, a selective Eph receptor tyrosine kinase inhibitor (ALW-II-41–27) or EphA2-silencing adenovirus (siEphA2). In vivo, EphA2 was identified a proatherogenic factor and apoE-/- mice placed on a high-fat diet following gastric gavage with atorvastatin exhibited a consistent elevation in EphA2 expression. We further observed that the transfection with siEphA2 in atorvastatin-treated mice significantly attenuated atherosclerotic plaque formation and abrogated statin-orchestrated macrophages proinflammatory genes expression as compared to that in atorvastatin alone. Increased plaque stability index was also observed following the addition of siEphA2, as evidenced by increased collagen and smooth muscle content and diminished lipid accumulation and macrophage infiltration. The data suggest that blockage of EphA2 provides an additional therapeutic benefit for further improving the anti-atherogenic effects of statins.

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Graphical Abstract




 : 

Summary schematic showing that EphA2 inhibition may attenuate macrophage inflammation and further improve the antiatherogenic effect of atorvastatin. Statins treatment attenuates atherosclerosis development and progression mainly due to the reduction in hepatic LDL-C production and inflammatory markers represented by CRP. However, statins also reduce the binding of KLF4 at the EphA2 promoter via HDAC11-mediated chromatin modification, thereby leading an upregulated EphA2 expression in macrophages. The combination of statins and EphA2 inhibition directly inactivates NF-κB and Nlrp3 inflammasome signals, further suppresses the pro-inflammatory macrophage phenotypes, eventually leading to a significant atheroprotective effect.


Summary schematic showing that EphA2 inhibition may attenuate macrophage inflammation and further improve the antiatherogenic effect of atorvastatin. Statins treatment attenuates atherosclerosis development and progression mainly due to the reduction in hepatic LDL-C production and inflammatory markers represented by CRP. However, statins also reduce the binding of KLF4 at the EphA2 promoter via HDAC11-mediated chromatin modification, thereby leading an upregulated EphA2 expression in macrophages. The combination of statins and EphA2 inhibition directly inactivates NF-κB and Nlrp3 inflammasome signals, further suppresses the pro-inflammatory macrophage phenotypes, eventually leading to a significant atheroprotective effect.ga1

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Highlights

Statins induces the expression of inflammatory genes and proteins in macrophages.
Atorvastatin reduces the binding of KLF4 at the EphA2 promoter.
Atorvastatin upregulates EphA2 expression in vitro and in vivo.
Inhibition of EphA2 synergizes with statin to mitigate macrophage inflammation.
EphA2 silencing further alleviates atherosclerotic plaque formation.

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Keywords : Atherosclerosis, Statins, Ephrin type-A receptor 2, Macrophage inflammation


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© 2023  The Authors. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 169

Article 115885- décembre 2023 Retour au numéro
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