While the role of lipids in atherosclerotic cardiovascular disease (ASCVD) is well studied, the contribution of amino acids is becoming increasingly recognized. We and others reported that the ratio of glycine to serine is reduced in association with ASCVD severity. Primarily expressed in the liver, serine hydroxymethyltransferase 2 (SHMT2) is thought to be responsible for the bulk of glycine biosynthesis from serine. We recently reported that reversed SHMT2 activity in fatty livers drives glycine depletion ( Ghrayeb et al. Cell Metab 2024 ). Nevertheless, whether the regulation of glycine/serine metabolism by hepatic SHMT2 affects atherosclerosis remains unknown. Utilizing novel hepatocyte-specific Shmt2 knockout mice ( Shmt2 HKO ) crossed with apolipoprotein E-deficient ( Apoe -/- ) mice, metabolomics, and transcriptomics, we studied the role of hepatocyte SHMT2 in atherosclerosis. We found a significant increase in glycine and the glycine:serine ratio in plasma from Shmt2 HKO / Apoe -/- mice compered to Shmt2 flox / Apoe -/- mice fed a Western diet. In livers from Shmt2 HKO / Apoe -/- mice, decreased S-adenosylmethionine (SAM) and increased adenosylhomocysteine (SAH) resulted in reduced SAM:SAH ratio. While hepatic steatosis was unaltered, Shmt2 HKO / Apoe -/- mice had lower phosphatidylcholine (PC) and PC:phosphatidylethanolamine (PE) ratio, key regulators of hepatic VLDL assembly and secretion. Accordingly, FPLC demonstrated reduced triglyceride and cholesterol contents in VLDL from Shmt2 HKO / Apoe -/- mice. Moreover, RNA-seq and qPCR analyses revealed a downregulation of proinflammatory mediators ( Tnf, Ir1b, Ccr5 ) and an upregulation of fatty acid β-oxidation regulators ( Acadm , Acadl ) in livers from Shmt2 HKO / Apoe -/- mice. Finally, histological analysis of aortic sinuses revealed lower plaque size in female Shmt2 HKO / Apoe -/- mice. These studies uncover hepatic SHMT2 as a regulator of one-carbon and VLDL metabolism in atherosclerosis.
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