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May 15, 2026European Heart Journal167 citationsOpen Access

Fibroblast activation protein is induced by inflammation and degrades type I collagen in thin-cap fibroatheromata

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CBChad E. BrokoppRSRoman SchoenauerPRPeter J. Richards

Key Result

Fibroblast activation protein expression was significantly increased in thin-cap versus thick-cap human coronary fibroatheromata (P<0.01) and contributed to type I collagen breakdown.

Key Points

  • This research aims to investigate the role of fibroblast activation protein (FAP) in collagen degradation within thin-cap fibroatheromata associated with atherosclerosis.
  • Evaluated FAP expression in human aortic atheromata using immunostaining and western blot analyses (n=12 for type IV-V and n=9 for type II-III).
  • Conducted zymography to assess collagen enzyme activity related to FAP in cultured smooth muscle cells (n=6).
  • Analyzed correlations between macrophage burden and FAP expression in aortic plaques (n=12).
  • FAP levels significantly increased in type IV-V lesions compared to type II-III lesions and healthy aortae (P<0.01).
  • A significant association between macrophage burden and FAP expression was found (R(2)=0.763; P<0.05).
  • FAP demonstrated collagenase activity by degrading type I collagen in vitro (P<0.01).

Study Design

Type

Observational

Structured PICO

P
Population
Human aortic atheromata (type IV-V n=12, type II-III n=9), healthy aortae (n=8), human coronary fibroatheromata (thin-cap n=12, thick-cap n=12), and cultured human aortic smooth muscle cells (HASMC).
I
Intervention
In vitro stimulation with human tumour necrosis factor α (TNFα) and neutralization with an antibody directed against the FAP catalytic domain.
C
Comparator
Healthy aortae, thick-cap fibroatheromata, and untreated control cells.
O
Outcome
Fibroblast activation protein (FAP) expression and FAP-mediated type I collagenase activity.surrogate

FAP is upregulated by macrophage-derived TNFα in human aortic smooth muscle cells and contributes to collagen breakdown in thin-cap fibroatheromata, suggesting a mechanistic role in plaque vulnerability and rupture.

Main Result

p-value: p=<0.01

Abstract

AIMS: Collagen degradation in atherosclerotic plaques with thin fibrous caps renders them more prone to rupture. Fibroblast activation protein (FAP) plays a role in arthritis and tumour formation through its collagenase activity. However, the significance of FAP in thin-cap human fibroatheromata remains unknown. METHODS AND RESULTS: We detected enhanced FAP expression in type IV-V human aortic atheromata (n = 12), compared with type II-III lesions (n = 9; P < 0.01) and healthy aortae (n = 8; P < 0.01) by immunostaining and western blot analyses. Fibroblast activation protein was also increased in thin-cap (<65 µm) vs. thick-cap (≥ 65 µm) human coronary fibroatheromata (n = 12; P < 0.01). Fibroblast activation protein was expressed by human aortic smooth muscle cells (HASMC) as shown by colocalization on immunofluorescent aortic plaque stainings (n = 10; P < 0.01) and by flow cytometry in cell culture. Although macrophages did not express FAP, macrophage burden in human aortic plaques correlated with FAP expression (n = 12; R(2)= 0.763; P < 0.05). Enzyme-linked immunosorbent assays showed a time- and dose-dependent up-regulation of FAP in response to human tumour necrosis factor α (TNFα) in HASMC (n = 6; P < 0.01). Moreover, supernatants from peripheral blood-derived macrophages induced FAP expression in cultured HASMC (n = 6; P < 0.01), an effect abolished by blocking TNFα (n = 6; P < 0.01). Fibroblast activation protein associated with collagen-poor regions in human coronary fibrous caps and digested type I collagen and gelatin in vitro (n = 6; P < 0.01). Zymography revealed that FAP-mediated collagenase activity was neutralized by an antibody directed against the FAP catalytic domain both in HASMC (n = 6; P < 0.01) and in fibrous caps of atherosclerotic plaques (n = 10; P < 0.01). CONCLUSION: Fibroblast activation protein expression in HASMC is induced by macrophage-derived TNFα. Fibroblast activation protein associates with thin-cap human coronary fibroatheromata and contributes to type I collagen breakdown in fibrous caps.

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Cite This Study

Brokopp et al. (2011) conducted an observational in Atherosclerosis / Thin-cap fibroatheromata. Fibroblast activation protein expression was significantly increased in thin-cap versus thick-cap human coronary fibroatheromata (P<0.01) and contributed to type I collagen breakdown.

synapsesocial.com/papers/6a078dcbd9ec3070f22dd5ffhttps://doi.org/10.1093/eurheartj/ehq519
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