Background: Scavenger Receptor Class B, Type I (SR-BI), encoded by Scarb1, mediates LDL cholesterol transcytosis in endothelial cells (EC) to deliver circulating LDL into the subendothelial space to drive atherogenesis. Research Questions: It is unknown whether EC SR-BI expression is altered in atherosclerosis, and how EC SR-BI expression is regulated. Approach: Single cell RNAseq was performed on coronary arteries from 5 ischemic heart disease patients, in segments both with and without a grossly apparent atheroma. Transcription factor (TF) network analysis was done to reveal possible regulatory relationships between differentially-expressed genes (DEGs). The modulation of EC SR-BI was studied in primary human aortic EC (HAEC) and in vivo in mouse aortic EC. ChIP-seq, ChIP-qPCR and CRISPR-based mutagenesis were used to interrogate TF binding to the human Scarb1 gene. EC SR-BI expression was determined by immunoblotting and qPCR, and EC LDL transcytosis was studied in transwells using DiI-labeled LDL. Results: SR-BI expression was greater in EC in coronary segments with atheroma versus those without atheroma (p=0.003). TF networks for DEGs in atheroma versus non-atheroma EC, and for DEGs in EC with low versus high SR-BI revealed multiple TF with possible regulatory relationships with Scarb1. One TF in common was HIF-1α. In HAEC, an increase in HIF-1α with the HIF prolyl hydroxylase inhibitor dimethyloxalylglycine (DMOG) caused upregulation of SR-BI mRNA and protein, and a parallel increase in LDL transcytosis that was entirely SR-BI-dependent. Expression of a constitutively-active HIF-1α variant also increased SR-BI and LDL transcytosis. ChIP-seq revealed a HIF-1α binding site in Scarb1 intron 1, and HIF-1α binding there increased 4-fold with DMOG. CRISPR deletion of the binding site fully prevented SR-BI upregulation by DMOG without affecting known HIF-1α target genes. In mice, 3d treatment with DMOG increased SR-BI in aortic EC. Conclusions: EC expression of SR-BI is upregulated with increasing atherosclerosis severity in human coronary artery. HIF-1α is upregulated in parallel, and HIF-1α causes the direct transcriptional upregulation of EC SR-BI leading to enhanced EC LDL transport. HIF-1α control of SR-BI in EC may be critical to atherogenesis.
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