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CD163+ macrophages restrain vascular calcification, promoting the development of high-risk plaque
Atsushi Sakamoto, … , Renu Virmani, Aloke V. Finn
Atsushi Sakamoto, … , Renu Virmani, Aloke V. Finn
Published January 31, 2023
Citation Information: JCI Insight. 2023;8(5):e154922. https://doi.org/10.1172/jci.insight.154922.
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Research Article Cell biology Vascular biology

CD163+ macrophages restrain vascular calcification, promoting the development of high-risk plaque

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Abstract

Vascular calcification (VC) is concomitant with atherosclerosis, yet it remains uncertain why rupture-prone high-risk plaques do not typically show extensive calcification. Intraplaque hemorrhage (IPH) deposits erythrocyte-derived cholesterol, enlarging the necrotic core and promoting high-risk plaque development. Pro-atherogenic CD163+ alternative macrophages engulf hemoglobin:haptoglobin (HH) complexes at IPH sites. However, their role in VC has never been examined to our knowledge. Here we show, in human arteries, the distribution of CD163+ macrophages correlated inversely with VC. In vitro experiments using vascular smooth muscle cells (VSMCs) cultured with HH-exposed human macrophage — M(Hb) — supernatant reduced calcification, while arteries from ApoE–/– CD163–/– mice showed greater VC. M(Hb) supernatant–exposed VSMCs showed activated NF-κB, while blocking NF-κB attenuated the anticalcific effect of M(Hb) on VSMCs. CD163+ macrophages altered VC through NF-κB–induced transcription of hyaluronan synthase (HAS), an enzyme that catalyzes the formation of the extracellular matrix glycosaminoglycan, hyaluronan, within VSMCs. M(Hb) supernatants enhanced HAS production in VSMCs, while knocking down HAS attenuated its anticalcific effect. NF-κB blockade in ApoE–/– mice reduced hyaluronan and increased VC. In human arteries, hyaluronan and HAS were increased in areas of CD163+ macrophage presence. Our findings highlight an important mechanism by which CD163+ macrophages inhibit VC through NF-κB–induced HAS augmentation and thus promote the high-risk plaque development.

Authors

Atsushi Sakamoto, Rika Kawakami, Masayuki Mori, Liang Guo, Ka Hyun Paek, Jose Verdezoto Mosquera, Anne Cornelissen, Saikat Kumar B. Ghosh, Kenji Kawai, Takao Konishi, Raquel Fernandez, Daniela T. Fuller, Weili Xu, Aimee E. Vozenilek, Yu Sato, Hiroyuki Jinnouchi, Sho Torii, Adam W. Turner, Hirokuni Akahori, Salome Kuntz, Craig C. Weinkauf, Parker J. Lee, Robert Kutys, Kathryn Harris, Alfred Lawrence Killey, Christina M. Mayhew, Matthew Ellis, Leah M. Weinstein, Neel V. Gadhoke, Roma Dhingra, Jeremy Ullman, Armella Dikongue, Maria E. Romero, Frank D. Kolodgie, Clint L. Miller, Renu Virmani, Aloke V. Finn

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Figure 10

scRNA-Seq data analysis for human coronary artery samples.

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scRNA-Seq data analysis for human coronary artery samples.
(A) UMAP embe...
(A) UMAP embeddings of human coronary artery (HCA) lesion scRNA-Seq data (26) integration into HCA snATAC-Seq data of samples with varying clinical presentations of CAD (41 individuals, ~30,000 cells) (27). scRNA-Seq cell type labels and expression profiles were transferred to snATAC-Seq clusters using the ArchR implementation (29) of canonical correlation analysis (28) to maximize the number of cells available for gene expression statistical analyses. The UMAP plot shows 8 identified major cell types including macrophages, contractile/modulated SMCs, endothelial cells, fibroblasts, B cells, pericytes, and a mixed population of T/NK cells. (B) Box plot depicting stratification of individual patients based on the CD163 mean expression level of their corresponding macrophages. Individuals below the CD163 mean macrophage expression distribution 25% quartile were denoted as low CD163 (n = 11, norm expression < 3.87), whereas individuals above the distribution 75% quartile were denoted as high CD163 (n = 11, norm expression > 5.33). Box plots show the median and interquartile range with upper (75%) and lower (25%) quartiles shown. The difference in CD163 mean expression between low and high CD163 patients was statistically significant (P < 0.001) as calculated by an unpaired Student’s t test. (C and D) Bar plots depicting enrichment of TF in gene sets from a transcriptome-wide differential expression analysis of SMCs from high versus low CD163 patients. Genes were ranked based on the mean expression difference between the 2 conditions, and the top 100 genes upregulated in CD163hi SMCs (C) as well as top 100 genes upregulated in CD163lo groups (D) were used for TF target overrepresentation analyses using ChEA3 (30). The x axis of the plot denotes the negative log10 of the calculated Fisher Exact Test (FET) P value. Metadata for each patient within high and low CD163 groups can be found in Supplemental Table 5.

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