Abstract 3010: Inhibition Of Endothelial Cell-Mediated Efferocytosis Promotes Abdominal Aortic Aneurysm Formation

Introduction: Aortic wall inflammation and vascular smooth muscle (VSMC) apoptosis can lead to accumulation of apoptotic cells and debris during abdominal aortic aneurysm (AAA) formation. We hypothesize that dysregulation of MerTK receptor-mediated efferocytosis (clearance of apoptotic cell debris) by endothelial cells (ECs) can significantly contribute to aortic inflammation and vascular remodeling in AAA pathogenesis. Methods: Single-cell RNA sequencing of human AAA tissue from a published dataset (PMID: 33779682) was evaluated for cells of the aortic wall (VSMC/EC) identified via SingleR and cell-specific marker s. Differentially expressed genes (DEGs) were identified via edgeR using the QL F-test and efferocytosis-related genes (ERGs) were recognized using a list of 141 ERGs curated from GeneCards. MerTK expression was assessed in human aortic tissue and ECs via western blot and immunofluorescence. PKH67-labelled apoptotic VSMCs were overlayed on ECs to assess efferocytosis activity and visualized via confocal microscopy. In a murine elastase AAA model, endothelial-specific MerTK knockout ( Cdh5 Cre-ERT2 / MerTK fl/fl ) and littermate male mice were analyzed on postoperative day 14 for aortic diameter. Statistical analyses were performed by Welch’s T-test and p |1|) between aortic wall cells of human AAAs and control. Human AAA tissue displayed a significant increase in MerTK protein compared to controls (1±0.1 vs. 1.51±0.4, n=6/group, p=0.01). The expression of MerTK in aortic ECs was confirmed by western blot and immunofluorescence(n=3). Pharmacologic inhibition of MerTK using UNC5293, a specific MerTK inhibitor, attenuated EC-mediated efferocytosis of apoptotic VSMCs (qualitative data; 10 images/group n=4). Importantly, EC-specific MerTK -/- mice had a significant increase in aortic diameter compared to littermate controls (155±40.4 vs. 103±30.9%, n=5-6/group, p=0.04) on day 14. Conclusion: EC-mediated efferocytosis can be regulated by MerTK to mediate AAA formation. Ongoing studies will delineate mechanisms of EC-MerTK signaling in AAA formation.