Key result
Smoke extract plus TNFα induces ~50% endothelial detachment under high flow, implicating plaque erosion mechanisms.
Why the study?
Endothelial erosion of plaques causes approximately 30% of ACS, with smoking as a risk factor and lesions most often occurring under elevated shear stress. The pathological mechanisms linking smoking and elevated shear stress to plaque erosion needed to be identified.
Does cigarette smoke combined with inflammation under elevated shear stress induce coronary endothelial cell detachment via the Nrf2-OSGIN1&2-HSP70 axis, and are GDF15 and HSP70 elevated in STEMI patients with plaque erosion?
Does cigarette smoke combined with inflammation under elevated shear stress induce coronary endothelial cell detachment via the Nrf2-OSGIN1&2-HSP70 axis, and are GDF15 and HSP70 elevated in STEMI patients with plaque erosion?
Identifies a novel smoking-activated Nrf2-OSGIN1&2-HSP70 pathway driving coronary endothelial detachment under elevated shear stress and highlights GDF15 and HSP70 as potential biomarkers and therapeutic targets for ACS caused by plaque erosion.
Answers are grounded in this paper and cite their sources.
Does not support GDF15 testing or Nrf2 modulation in smoking-related ACS; leaves open mechanistic targeting of endothelial detachment pending human validation.
AIMS: Endothelial erosion of plaques is responsible for ∼30% of acute coronary syndromes (ACS). Smoking is a risk factor for plaque erosion, which most frequently occurs on the upstream surface of plaques where the endothelium experiences elevated shear stress. We sought to recreate these conditions in vitro to identify potential pathological mechanisms that might be of relevance to plaque erosion. METHODS AND RESULTS: Culturing human coronary artery endothelial cells (HCAECs) under elevated flow (shear stress of 7.5 Pa) and chronically exposing them to cigarette smoke extract (CSE) and tumour necrosis factor-alpha (TNFα) recapitulated a defect in HCAEC adhesion, which corresponded with augmented Nrf2-regulated gene expression. Pharmacological activation or adenoviral overexpression of Nrf2 triggered endothelial detachment, identifying Nrf2 as a mediator of endothelial detachment. Growth/Differentiation Factor-15 (GDF15) expression was elevated in this model, with protein expression elevated in the plasma of patients experiencing plaque erosion compared with plaque rupture. The expression of two Nrf2-regulated genes, OSGIN1 and OSGIN2, was increased by CSE and TNFα under elevated flow and was also elevated in the aortas of mice exposed to cigarette smoke in vivo. Knockdown of OSGIN1&2 inhibited Nrf2-induced cell detachment. Overexpression of OSGIN1&2 induced endothelial detachment and resulted in cell cycle arrest, induction of senescence, loss of focal adhesions and actin stress fibres, and disturbed proteostasis mediated in part by HSP70, restoration of which reduced HCAEC detachment. In ACS patients who smoked, blood concentrations of HSP70 were elevated in plaque erosion compared with plaque rupture. CONCLUSION: We identified a novel Nrf2-OSGIN1&2-HSP70 axis that regulates endothelial adhesion, elevated GDF15 and HSP70 as biomarkers for plaque erosion in patients who smoke, and two therapeutic targets that offer the potential for reducing the risk of plaque erosion.
No takes yet. Share an insight, caveat, or question.
Satta et al. (2023) studied ST-segment elevation myocardial infarction (plaque erosion vs. plaque rupture) and in vitro human coronary artery endothelial cells (n=80). Cigarette smoke extract (CSE) and TNF-alpha under elevated laminar shear stress (in vitro) / Plaque erosion in smokers (clinical) vs. Elevated shear stress control (in vitro) / OCT-defined plaque rupture (clinical) was evaluated on Endothelial cell detachment (in vitro) and circulating GDF15 levels in STEMI patients with plaque erosion vs. plaque rupture (pg/mL) (p=0.024). Cigarette smoke extract and TNFα under elevated flow caused ~50% endothelial detachment via Nrf2-OSGIN1&2-HSP70, with elevated plasma GDF15 in plaque erosion vs. rupture.
Synapse has enriched 10 related papers. Consider them for comparative context: