Alexander Faussner

Peripheral cannabinoid CB1 receptor antagonists that lack central nervous system effects are emerging as promising therapies for metabolic disease, yet the role of endothelial CB1 signaling in atherosclerosis remains unclear. Here, we show that endothelial CB1 is expressed in human atherosclerotic plaques, is induced by oscillatory shear stress in atheroprone flow regions, and promotes vascular inflammation, permeability and lipid uptake. Endothelial-specific Cnr1 deletion or peripheral CB1 antagonism in mice attenuates atherosclerosis, reduces endothelial caveolae–dependent low-density lipoprotein uptake by downregulating caveolin-1 and ALK1 expression, and improves metabolic parameters in brown and white adipose tissue and the liver. The anti-atherogenic and metabolic effects are more pronounced in females, which is possibly linked to estrogen signaling. These findings identify endothelial CB1 as a proatherogenic, sex-biased regulator of vascular lipid transport and plaque development and associated metabolic dysfunction.

Peripherally restricted cannabinoid CB1 receptor antagonists without central side effects hold promise for treating metabolic disorders including diabetes and obesity. In atherosclerosis, the specific effects of peripheral endothelial CB1 signaling remain incompletely understood. Here, we report the expression of the CB1 encoding gene CNR1 in arterial endothelial cells of human plaques. We also show that endothelial CNR1 expression is increased by oscillatory shear stress (OSS) in human aortic endothelial cells (HAoECs) and is higher in atheroprone regions than in atheroresistant regions of murine aortas. Endothelial CB1 deficiency (Cnr1EC-KO) in atheroprone mice resulted in pronounced endothelial phenotypic changes with reduced vascular inflammation and permeability. This led to reduced plaque development with a lower lipid content in female mice, whereas attenuated plaque development, but no changes in plaque lipid content were found in males. Reduced white and brown adipose tissue mass and liver steatosis upon Cnr1EC-KO were observed in both males and females. Ex vivo imaging of female carotid arteries revealed less low density lipoprotein (Dil-LDL) uptake in Cnr1EC-KO. This was accompanied by reduced endothelial caveolin-1 (CAV1) expression, a key structural protein involved in lipid transcytosis, which was only observed in female Cnr1EC-KO mice. In vitro, pharmacological blocking with CB1 antagonist AM281 reproduced the inhibition of CAV1 expression and Dil-LDL uptake in response to atheroprone OSS in HAoECs, which was dependent on cAMP-mediated PKA activation. Conversely, the CB1 agonist ACEA increased Dil-LDL uptake and CAV1 expression in HAoECs. Chronic treatment of atherosclerotic mice with the peripheral CB1 antagonist JD-5037 reduced plaque progression and endothelial CAV1 expression in female mice. Consistent with more pronounced effects in females, HAECs treated with the estrogen receptor ligand estradiol exhibited increased CNR1 and CAV1 expression. These results support a proatherogenic role of endothelial CB1, which appears to be more pronounced in females.

Background: Peripherally restricted cannabinoid CB1 receptor antagonists without central side effects hold promise for treating metabolic disorders including diabetes and obesity. In atherosclerosis, the specific effects of peripheral CB1 signaling in vascular endothelial cells (ECs) remain incompletely understood. Methods and results: Endothelial expression of the CB1 encoding gene CNR1 was detectable in human plaque single-cell RNA sequencing data. In situ hybridization of Cnr1 in murine aortas revealed a significantly increased endothelial expression within atheroprone compared to atheroresistant regions. In vitro , CNR1 was upregulated by oscillatory shear stress (OSS) in human aortic endothelial cells (HAoECs). Endothelial CB1 deficiency ( Cnr1 ^EC-KO ) in female mice on atherogenic background resulted in pronounced endothelial phenotypic changes, with reduced vascular inflammation and permeability. This resulted in attenuated plaque development with reduced lipid content in female mice, while reduced white and brown adipose tissue mass and liver steatosis were observed in both males and females. Ex vivo imaging of carotid arteries via two-photon microscopy revealed less labeled low density lipoprotein (Dil-LDL) uptake in Cnr1 ^EC-KO . This was accompanied by a significant reduction of aortic endothelial caveolin-1 (CAV1) expression, a key structural protein involved in lipid transcytosis, in female Cnr1 ^EC-KO mice. In vitro , pharmacological blocking with CB1 antagonist AM281 reproduced the inhibition of CAV1 expression and Dil-LDL uptake in response to atheroprone OSS in HAoECs, which was dependent on cAMP-mediated PKA activation. Conversely, the CB1 agonist ACEA increased Dil-LDL uptake and CAV1 expression in HAoECs. Finally, treatment of atherosclerotic mice with the peripheral CB1 antagonist JD-5037 reduced plaque progression, CAV1 and endothelial adhesion molecule expression in female mice. Conclusions: These results confirm an essential role of endothelial CB1 to the pathogenesis of atherosclerosis. Peripheral CB1 antagonists may hold promise as an effective therapeutic strategy for treating atherosclerosis and related metabolic disorders. NOVELTY AND SIGNIFICANCE: What is known? Enhanced endocannabinoid-cannabinoid CB1 receptor signaling has been implicated in metabolic disorders, atherosclerosis, and hypertension, but the cell-specific role of endothelial CB1 in atherosclerosis is not well understood. Global CB1 antagonists improve metabolic function and inhibit atherosclerotic plaque development in mouse models, but have failed in the clinic due to centrally mediated psychiatric side effects. What is new? Based on human single-cell RNA sequencing data, CB1 is expressed in human plaque ECs. Using transgenic mouse models and human primary aortic endothelial cells, we provide evidence for a key role of CB1 in endothelial shear stress response, inflammatory gene expression, and LDL uptake. The underlying signaling pathway of CB1-induced endothelial LDL uptake involves a cAMP-PKA-dependent regulation of caveolin 1 (CAV1) expression, a structural protein of the shear stress sensitive signaling domains of the plasma membrane. By limiting endothelial CAV1 and VCAM1 expression, peripherally restricted CB1 antagonists confer atheroprotection in mice. Our findings reveal that endothelial CB1 expression is induced by atheroprone shear stress responses and contributes to impaired vascular barrier function, inflammation, and lipid uptake, thereby promoting atherosclerotic lesion formation and progression. By elucidating the transcriptomic pathways regulated by endothelial CB1 and its broad influence on lipid uptake and metabolism in arteries, liver, and brown and white adipose tissue, our study provides insights into novel pathways and potential interventions for the treatment of atherosclerosis and metabolic disorders. The use of peripherally restricted CB1 antagonists that specifically target vascular inflammation and tissue lipid storage could be a complementary and safe therapeutic avenue to treat cardiovascular and metabolic disease comorbidities without altering CB1 signaling in the brain.

CCL17 is produced by conventional dendritic cells, signals through CCR4 on regulatory T (T_reg) cells and drives atherosclerosis by suppressing T_reg functions through yet undefined mechanisms. Here we show that conventional dendritic cells from CCL17-deficient mice display a pro-tolerogenic phenotype and transcriptome that is not phenocopied in mice lacking its cognate receptor CCR4. In the plasma of CCL17-deficient mice, CCL3 was the only decreased cytokine/chemokine. We found that CCL17 signaled through CCR8 as an alternate high-affinity receptor, which induced CCL3 expression and suppressed T_reg functions in the absence of CCR4. Genetic ablation of CCL3 and CCR8 in CD4⁺ T cells reduced CCL3 secretion, boosted FoxP3⁺ T_reg numbers and limited atherosclerosis. Conversely, CCL3 administration exacerbated atherosclerosis and restrained T_reg differentiation. In symptomatic versus asymptomatic human carotid atheroma, CCL3 expression was increased, whereas FoxP3 expression was reduced. Together, we identified a non-canonical chemokine pathway whereby CCL17 interacts with CCR8 to yield a CCL3-dependent suppression of atheroprotective T_reg cells.

Dissecting the pathways regulating the adaptive immune response in atherosclerosis is of particular therapeutic interest. Here we report that the lipid G-protein-coupled receptor GPR55 is highly expressed by splenic plasma cells (PCs), upregulated in mouse spleens during atherogenesis and human unstable or ruptured compared to stable plaques.Gpr55-deficient mice developed larger atherosclerotic plaques with increased necrotic core size compared to their corresponding controls. Lack of GPR55 hyperactivated B cells, disturbed PC maturation and resulted in IgG overproduction. B-cell-specificGpr55depletion or adoptive transfer ofGpr55-deficient B cells was sufficient to promote plaque development and elevated IgG titers. In vitro, the endogenous GPR55 ligand lysophsophatidylinositol (LPI) enhanced PC proliferation, whereas GPR55 antagonism blocked PC maturation and increased their mitochondrial content. Collectively, these discoveries provide previously undefined evidence for GPR55 in B cells as a key modulator of the adaptive immune response in atherosclerosis.

For most cell culture experiments, it is indispensable that the cells are firmly anchored to culture plates, withstanding rinsing steps that can create shear forces and tolerating temperature changes without detaching. For semi-adherent cells such as the common HEK 293 or PC-12 cells, this could so far be obtained by time-consuming plate pre-coating with cationic polymer solutions. We report here, that i) pre-coating with the cheaper poly-ethylenimine (PEI) works as well as the commonly used poly-D-lysine (PDL), but more importantly and novel ii) that simple direct addition of either PEI (1.5 μg/ml) or PDL (2 μg/ml) to the cell culture medium results in strongly anchored HEK 293 cells, indistinguishable from ones seeded on pre-coated plates. Therefore, the replacement of plate pre-coating by direct addition of either PEI or PDL gives comparable excellent results, but is highly labour-, time-, and cost-efficient. Moreover, we could show that addition of PDL or PEI also works similarly well in animal-free culture using human platelet lysate instead of fetal bovine serum. Interestingly, additional experiments showed that strong cell attachment requires only cationic polymers but not fetal bovine serum or human platelet lysate added to the medium.

Identifying novel pathways regulating the adaptive immune response in chronic inflammatory diseases such as atherosclerosis is of particular interest in view of developing new therapeutic drugs. Here we report that the lipid receptor GPR55 is highly expressed by splenic B cells and inversely correlates with atheroma plaque size in mice. In human carotid endarterectomy specimen, GPR55 transcript levels were significantly lower in unstable compared to stable carotid plaques. To study the impact of GPR55 deficiency in atherosclerosis, we crossed Gpr55 knockout mice with apolipoprotein E (ApoE) knockout mice and subjected the mice to Western diet for 4 to 16 weeks. Compared to ApoE-/- controls, ApoE-/-Gpr55-/- mice developed larger plaques with increased necrotic core size, associated with elevated circulating and aortic leukocyte counts. Flow cytometry, immunofluorescence and RNA-sequencing analysis of splenic B cells in these mice revealed a hyperactivated B cell phenotype with disturbed plasma cell maturation and immunoglobulin (Ig)G antibody overproduction. The specific contribution of B cell GPR55 in atherosclerosis was further studied in mixed Gpr55-/-/µMT bone marrow chimeras on low density receptor deficiency (Ldlr-/-) background, revealing that B-cell specific depletion of Gpr55 was sufficient to promote plaque development. Conversely, adoptive transfer of wildtype B cells into ApoE-/-Gpr55-/- mice blunted the proatherogenic phenotype. In vitro stimulation of splenocytes with the endogenous GPR55 ligand LPI promoted plasma cell proliferation and enhanced B cell activation marker expression, which was inhibited by the GPR55 antagonist CID16020046. Collectively, these discoveries provide new evidence for GPR55 as key modulator of the adaptive immune response in atherosclerosis. Targeting GPR55 could be useful to limit inflammation and plaque progression in patients suffering from atherosclerosis.

For most cell culture experiments, it is indispensable that the cells are firmly anchored to the culture plates, tolerating several rinsing steps, and withstanding shear forces or temperature changes without detaching. For semi-adherent cells such as the very common HEK 293 cells, this could so far be obtained only by time-consuming plate pre-coating with cationic polymer solutions. We report here, that i) pre-coating with the cheaper poly-ethylenimine (PEI) works as well as the commonly used poly-D-lysine (PDL), but more importantly and novel ii) that simple direct addition of either PEI (1.5 μg/ml) or PDL (2 μg/ml) to the cell culture medium results in strongly anchored HEK 293 cells, indistinguishable from ones seeded on pre-coated plates. Therefore, the replacement of plate pre-coating by direct addition of either PEI or PDL gives comparable excellent results, but is highly labour-, time-, and cost-efficient. Interestingly, additional experiments in this context showed that strong cell attachment requires only cationic polymers but not fetal calf serum added to the medium. Fetal calf serum is, however, of course required for further maintenance and growth of the cells.

Candida albicans yeast produces 10 distinct secreted aspartic proteases (Saps), which are some of the most important virulence factors of this pathogenic fungus. One of the suggested roles of Saps is their deregulating effect on various proteolytic cascades that constitute the major homeostatic systems in human hosts, including blood coagulation, fibrinolysis, and kallikrein-kinin systems. This study compared the characteristics of the action of all 10 Saps on human kininogens, which results in generating proinflammatory bradykinin-related peptides (kinins). Recombinant forms of Saps, heterologously overexpressed in Pichia pastoris were applied. Except for Sap7 and Sap10, all Saps effectively cleaved the kininogens, with the highest hydrolytic activity toward the low-molecular-mass form (LK). Sap1–6 and 8 produced a biologically active kinin—Met-Lys-bradykinin—and Sap3 was exceptional in terms of the kinin-releasing yield (>60% LK at pH 5.0 after 24 hours). Des-Arg1-bradykinin was released from LK by Sap9 at a comparably high yield, but this peptide was assumed to be biologically inactive because it was unable to interact with cellular B2-type kinin receptors. However, the collaborative actions of Sap9 and Sap1, −2, −4–6, and −8 on LK rerouted kininogen cleavage toward the high-yield release of the biologically active Met-Lys-bradykinin. Our present results, together with the available data on the expression of individual SAP genes in candidal infection models, suggest a biological potential of Saps to produce kinins at the infection foci. The kinin release during candidiasis can involve predominant and complementary contributions of two different Sap3- and Sap9-dependent mechanisms.