Trem2 Agonist Reprograms Foamy Macrophages to Promote Atherosclerotic Plaque Stability—Brief Report

Author:

Patterson Michael T.12ORCID,Xu Yingzheng12ORCID,Hillman Hannah12ORCID,Osinski Victoria13ORCID,Schrank Patricia R.12ORCID,Kennedy Ainsley E.12,Barrow Fanta12ORCID,Zhu Alisha12,Tollison Samuel12,Shekhar Sia12,Stromnes Ingunn M.14ORCID,Tassi Ilaria56ORCID,Wu Dick5,Revelo Xavier S.12ORCID,Binstadt Bryce A.13ORCID,Williams Jesse W.12ORCID

Affiliation:

1. Center for Immunology (M.T.P., Y.X., H.H., V.O., P.R.S., A.E.K., F.B., A.Z., S.T., S.S., I.M.S., X.S.R., B.A.B., J.W.W.), University of Minnesota, Minneapolis.

2. Department of Integrative Biology and Physiology (M.T.P., Y.X., H.H., P.R.S., A.E.K., F.B., A.Z., S.T., S.S., X.S.R., J.W.W.), University of Minnesota, Minneapolis.

3. Department of Pediatrics (V.O., B.A.B.), University of Minnesota, Minneapolis.

4. Department of Microbiology and Immunology (I.M.S.), University of Minnesota, Minneapolis.

5. Alector, Inc, South San Francisco, CA (I.T., D.W.).

6. Now with Deep Apple Therapeutics, South San Francisco, CA (I.T.).

Abstract

BACKGROUND: Trem2 (triggering receptor on myeloid cells 2), a surface lipid receptor, is expressed on foamy macrophages within atherosclerotic lesions and regulates cell survival, proliferation, and anti-inflammatory responses. Studies examining the role of Trem2 in atherosclerosis have shown that deletion of Trem2 leads to impaired foamy macrophage lipid uptake, proliferation, survival, and cholesterol efflux. Thus, we tested the hypothesis that administration of a Trem2 agonist antibody (AL002a) to atherogenic mice would enhance macrophage survival and decrease necrotic core formation to improve plaque stability. METHODS: To model a therapeutic intervention approach, atherosclerosis-prone mice (Ldlr [low-density lipoprotein receptor] −/− ) were fed a high-fat diet for 8 weeks, then transitioned to treatment with AL002a or isotype control for an additional 8 weeks while continuing on a high-fat diet. RESULTS: AL002a-treated mice had increased lesion size in both the aortic root and whole mount aorta, which correlated with an expansion of plaque macrophage area. This expansion was due to increased macrophage survival and proliferation in plaques. Importantly, plaques from AL002a-treated mice showed improved features of plaque stability, including smaller necrotic cores, increased fibrous caps, and greater collagen deposition. Single-cell RNA sequencing of whole aorta suspensions from isotype- and AL002a-treated atherosclerotic mice revealed that Trem2 agonism dramatically altered foamy macrophage transcriptome. This included upregulation of oxidative phosphorylation and increased expression of collagen genes. In vitro studies validated that Trem2 agonism with AL002a promoted foamy macrophage oxidized low-density lipoprotein uptake, survival, and cholesterol efflux. CONCLUSIONS: Trem2 agonism expands atherosclerotic plaque macrophages by promoting cell survival and proliferation but improves features of plaque stability by rewiring foamy macrophage function to enhance cholesterol efflux and collagen deposition.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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