Abstract

A growing body of evidence demonstrates that autophagy, an evolutionarily conserved intracellular degradation process, is involved in the pathogenesis of atherosclerosis and has become a potential therapeutic target. Here we tested the effect of two inhibitors of phosphatidylinositol 3-kinase, 3-methyladenine (3-MA) and 2-(4-morpholinyl)-8-phenyl-chromone (LY294002), commonly used as inhibitors of autophagy, in atherosclerosis in apolipoprotein E−/− mice. Systemic application of 3-MA but not LY294002 markedly reduced the size of atherosclerotic plaque and increased the stability of lesions in high-fat diet-fed mice as compared with controls. Furthermore, 3-MA had multiple atheroprotective effects, including modulating macrophage autophagy and foam cell formation and altering the immune microenvironment. Long-term treatment with 3-MA promoted oxidized low-density lipoprotein (oxLDL)-induced macrophage autophagy and suppressed foam cell formation and cell viability in vitro. Furthermore, systemic application of 3-MA promoted lipid droplet breakdown and decreased apoptosis, most likely associated with autophagy. 3-MA treatment strikingly enhanced the expression of immune-negative molecules such as interleukin 10 (IL-10), transforming growth factor β and IL-35, as well as forkhead box P3 (Foxp3), the specific transcriptional factor for regulatory T cells, but did not affect the level of proinflammatory cytokines in the arterial wall. We provide strong evidence for the potential therapeutic benefit of 3-MA in inhibiting atherosclerosis development and improving plaque stability.

Highlights

  • Atherosclerosis is a chronic inflammatory and metabolic disease in the wall of large- and medium-sized arteries

  • The uptake of modified lipoproteins by macrophages accompanied by defective cholesterol efflux results in foam cell formation, which has an important role in the growth of atherosclerotic plaque and vulnerable plaque.[2–4]

  • Recent studies demonstrate that autophagy is involved in the pathogenesis of atherosclerosis and has become a potential therapeutic target for treating atherosclerosis

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Summary

Results

3-MA markedly inhibited the development of atherosclerotic lesion in ApoE− / − mice fed an HFD. Hematoxylin and eosin (H&E) staining and Oil Red O staining of aortic roots showed significantly decreased atherosclerotic plaques and lipid content in 3-MA-treated mice (Figures 1b and c). Right panels of LC3 staining (white arrows; scale bar, 25 μm) are the enlargements of boxed areas in left panels (scale bar, 25 μm) autophagy.21,22 3-MA-treated macrophages did not show the classical morphology of foam cells and recovery tendency after oxLDL stimulation in vitro (Figure 4b), so we wondered whether 3-MA could eliminate autophagy-induced macrophages by promoting autophagy, similar to everolimus. As IL-10, TGF-β and IL-35 are effector molecules of regulatory T cells (Tregs), we further analyzed the expression of Foxp[3], a specific transcription factor for Tregs, and found that 3-MA treatment significantly upregulated Foxp[3] expression (Figure 5i)

Discussion
Materials and Methods
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