Background: A hallmark of atherosclerosis is uncontrolled uptake of atherogenic lipoproteins by artery wall cells that accumulate large amounts of cholesteryl esters (“foam cells”). While smooth muscle cells (SMCs) and macrophages are in close proximity in lesions and contribute to cholesterol accumulation, whether these cells influence each other’s tendency to form foam cells is not clearly established. Hypothesis: Direct and indirect interactions between SMCs and macrophages promote foam cell formation by both cell types. Method: Human vascular SMCs were seeded onto macrophages to mimic direct macrophage-SMC interactions (n=5). Alternatively, conditioned media generated from human macrophages or SMCs with or without lipoprotein exposure was incubated with the alternate cell type (n=3). Aggregated lipoproteins were added in both models to induce cellular cholesterol accumulation. Intracellular cholesterol was quantified to compare lipoprotein uptake in cocultures relative to monocultures. Crosstalk based on CellChat analysis using single-cell RNA sequencing data from human coronary samples was performed to identify potential factors responsible for foam cell development (n=3). One-way ANOVA was used for statistical analysis. Result: SMCs showed a 4-fold (+/-0.3, p=0.002) increase in cell cholesterol accumulation when in direct contact with macrophages and a 3-fold (+/- 0.3, p<0.0001) increase when exposed to the conditioned media from macrophage foam cells. In contrast, macrophages showed a 3-fold reduction (+/- 0.3, p=0.001) in intracellular cholesterol accumulation when in direct contact with SMCs and a 2-fold reduction (+/-0.2, p=0.0005) when exposed to SMC foam cell-conditioned media. CellChat analysis suggested macrophage foam cells but not macrophage non-foam cells promote SMC foam cell formation by secretion of inflammatory cytokines, and that SMCs promote macrophage foam cell formation by secretion of extracellular matrix components. Conclusion: Our study provides novel understanding of how macrophage-SMC interactions influence macrophage and SMC foam cell formation. Further studies will be presented examining the role of SMC extracellular matrix proteins and macrophage-secreted cytokines on foam cell formation.
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