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Anti-GRP78 autoantibodies induce endothelial cell activation and accelerate the development of atherosclerotic lesions
Elizabeth D. Crane, … , Wadih Arap, Richard C. Austin
Elizabeth D. Crane, … , Wadih Arap, Richard C. Austin
Published December 20, 2018
Citation Information: JCI Insight. 2018;3(24):e99363. https://doi.org/10.1172/jci.insight.99363.
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Research Article

Anti-GRP78 autoantibodies induce endothelial cell activation and accelerate the development of atherosclerotic lesions

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Abstract

The 78-kDa glucose-regulated protein (GRP78) is an ER molecular chaperone that aids in protein folding and secretion. However, pathological conditions that cause ER stress can promote the relocalization of GRP78 to the cell surface (csGRP78), where it acts as a signaling receptor to promote cancer progression. csGRP78 also possesses antigenic properties, leading to the production of anti-GRP78 autoantibodies, which contribute to tumor growth. In contrast, the presence and role of anti-GRP78 autoantibodies in atherosclerosis is unknown. Here, we show that atherosclerotic-prone ApoE–/– mice develop circulating anti-GRP78 autoantibodies that bind to csGRP78 on lesion-resident endothelial cells. Moreover, GRP78-immunized ApoE–/– mice exhibit a marked increase in circulating anti-GRP78 autoantibody titers that correlated with accelerated lesion growth. Mechanistically, engagement of anti-GRP78 autoantibodies with csGRP78 on human endothelial cells activated NF-κB, thereby inducing the expression of ICAM-1 and VCAM-1, a process blocked by NF-κB inhibitors. Disrupting the autoantibody/csGRP78 complex with enoxaparin, a low-molecular-weight heparin, reduced the expression of adhesion molecules and attenuated lesion growth. In conclusion, anti-GRP78 autoantibodies play a crucial role in atherosclerosis development, and disruption of the interaction between anti-GRP78 autoantibodies and csGRP78 represents a therapeutic strategy.

Authors

Elizabeth D. Crane, Ali A. Al-Hashimi, Jack Chen, Edward G. Lynn, Kevin Doyoon Won, Šárka Lhoták, Magda Naeim, Khrystyna Platko, Paul Lebeau, Jae Hyun Byun, Bobby Shayegan, Joan C. Krepinsky, Katey J. Rayner, Serena Marchiò, Renata Pasqualini, Wadih Arap, Richard C. Austin

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Figure 8

Schematic diagram illustrating the mechanism by which the binding of anti-GRP78 autoantibodies to csGRP78 on lesion-resident ECs accelerates atherosclerotic lesion growth via NF-κB activation.

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Schematic diagram illustrating the mechanism by which the binding of ant...
Conditions of ER stress in the early stages of atherosclerosis lead to the translocation of GRP78 from the ER to the cell surface. The presentation of csGRP78 induces an immunological response that drives the production of anti-GRP78 autoantibodies. Binding of anti-GRP78 autoantibodies to ECs activates the NF-κB pathway, leading to increased expression of adhesion molecules and the progression of atherosclerotic plaque.

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