Atherogenic Lipoprotein(a) Increases Vascular Glycolysis, Thereby Facilitating Inflammation and Leukocyte Extravasation

Johan G. Schnitzler, Renate M. Hoogeveen, Lubna Ali, Koen H. M. Prange, Farahnaz Waissi, Michel van Weeghel, Julian C. Bachmann, Miranda Versloot, Matthew J. Borrelli, Calvin Yeang, Dominique P. V. de Kleijn, Riekelt H. Houtkooper, Marlys L. Koschinsky, Menno P. J. de Winther, Albert K. Groen, Joseph L. Witztum, Sotirios Tsimikas, Erik S. G. Stroes, Jeffrey Kroon

Research output: Contribution to journalArticleAcademicpeer-review

91 Citations (Scopus)

Abstract

Rationale: Patients with elevated levels of lipoprotein(a) [Lp(a)] are hallmarked by increased metabolic activity in the arterial wall on positron emission tomography/computed tomography, indicative of a proinflammatory state. Objective: We hypothesized that Lp(a) induces endothelial cell inflammation by rewiring endothelial metabolism. Methods and Results: We evaluated the impact of Lp(a) on the endothelium and describe that Lp(a), through its oxidized phospholipid content, activates arterial endothelial cells, facilitating increased transendothelial migration of monocytes. Transcriptome analysis of Lp(a)-stimulated human arterial endothelial cells revealed upregulation of inflammatory pathways comprising monocyte adhesion and migration, coinciding with increased 6-phophofructo-2-kinase/fructose-2,6-biphosphatase (PFKFB)-3-mediated glycolysis. ICAM (intercellular adhesion molecule)-1 and PFKFB3 were also found to be upregulated in carotid plaques of patients with elevated levels of Lp(a). Inhibition of PFKFB3 abolished the inflammatory signature with concomitant attenuation of transendothelial migration. Conclusions: Collectively, our findings show that Lp(a) activates the endothelium by enhancing PFKFB3-mediated glycolysis, leading to a proadhesive state, which can be reversed by inhibition of glycolysis. These findings pave the way for therapeutic agents targeting metabolism aimed at reducing inflammation in patients with cardiovascular disease.
Original languageEnglish
Pages (from-to)1346-1359
Number of pages14
JournalCirculation Research
Volume126
Issue number10
Early online date2020
DOIs
Publication statusPublished - 2020

Keywords

  • endothelial cell
  • glycolysis
  • inflammation
  • lipoprotein(a)
  • metabolism

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