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Background: Chronic activation of the innate immune system drives inflammation and contributes to atherosclerosis. Pro-inflammatory agents (oxidised LDL, IL-1β) drive lesional inflammation and development, whereas anti-inflammatory agents (IL-10, HDL, Apolipoprotein-AI), promote an anti-inflammatory milieu and resolution. RIPK1 (Receptor interacting protein kinase 1) is a master regulatory gene that decides whether a cell undergoes inflammation, apoptosis and/or necroptosis, depending on its phosphorylation or ubiquitination status. We have previously observed that RIPK1 gene expression is increased in both endothelial cells and macrophages in early atherosclerotic lesions (Karunakaran et al, Circulation 2022). Here, we seek to determine whether macrophage-specific RIPK1 contributes to atherosclerosis. Methods: Given that Ripk1 -/- mice are lethal, we performed bone marrow (BM) transplants of Ripk1 +/- and wild-type (wt) littermate BM into female and male Ldlr -/- mice (n=8-12/grp) and mice were fed a western diet for 12-16 wks. In vitro experiments were performed in BM derived macrophages from wt and Ripk1 +/- mice. Results: Ldlr -/- mice recipient of Ripk1 +/- BM and western diet feeding for 12 or 16 wk had a marked reduction in aortic sinus lesion area (68.9% and 49.7% respectively, p<0.05) compared to their wt controls. Preliminary analysis show that there is a reduction in lesional macrophage area in Ripk1 +/- BM recipient Ldlr -/- mice relative to control (0.02±0.01 vs 0.01±0.006mm, p<0.01), suggesting that macrophage infiltration was reduced. Interestingly, anti-inflammatory agents, including recombinant IL10, IL13 (both 100ng/ml), Apolipoprotein-AI and discoidal HDL (both 500ug/mL) markedly reduced macrophage Ripk1 expression in vitro (by ~50%, p<0.05), likely reducing Ripk1-dependent inflammation and promoting an anti-inflammatory milieu. Current mechanistic studies are investigating the transcriptional regulator, STAT3, as a key regulator of Ripk1 expression. Conclusion: We identified macrophage-RIPK1 as a central driver of atherosclerosis. These timely studies highlight the therapeutic potential of dampening Ripk1 overexpression, as opposed to the detrimental abolishment of Ripk1, in treating atherosclerosis.
Han et al. (Wed,) studied this question.