Cigarette smoking upregulates vascular expression of the novel atherosclerosis risk factor ADAMTS-7

BackgroundCigarette smoking is an established risk factor for coronary artery disease (CAD) and myocardial infarction. Genetic variants in the extracellular matrix protease ADAMTS-7 were also identified to increase CAD risk. Notably, ADAMTS7 represents the only genomic locus that revealed a gene-environment interaction with smoking. The underlying mechanisms of this interaction remain unclear. Methods and ResultsIn a murine model, cigarette smoke exposure (CSE) led to an upregulation of vascular ADAMTS7 expression in wild type (WT) C57BL/6J mice. ADAMTS7 upregulation was also found in carotid plaques from ever-smokers undergoing carotid endarterectomy in humans. Bulk RNA sequencing of lung tissues from WT mice exposed to CS revealed a downregulation of 20 and an upregulation of 173 transcripts. Among upregulated transcripts in smoking-exposed lungs, we found C-C motif chemokine ligand 17 (CCL17), which was likewise upregulated in plasma from smoking mice and humans. In vitro, recombinant CCL17 upregulated ADAMTS7 expression in primary vascular smooth muscle cells (VSMC), which was inhibited secondary to silencing of CCL17s bona fide receptor C-C Motif Chemokine Receptor 4 (CCR4). Conditioned media from CCL17-stimulated VSMC lacking ADAMTS-7 showed reduced release of inflammatory cytokines by endothelial cells (EC), reduced EC activation, and monocyte-to-EC adhesion. In proatherogenic Apoe-/- mice exposed to CS, more numerous neutrophils, inflammatory monocytes, and macrophages were found in atherosclerotic plaques as compared to room air exposition. This effect was blunted in Apoe-/-Adamts7-/- mice. ConclusionsFor the first time, our findings link CSE to vascular inflammation via CCL17-mediated upregulation of the CAD risk factor ADAMTS7 and provide a mechanistic explanation for the gene-environment interaction between CS and ADAMTS7 in CAD. Targeting ADAMTS-7 might be a promising therapeutic strategy irrespective of smoking status. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=85 SRC="FIGDIR/small/685237v1_ufig1.gif" ALT="Figure 1"> View larger version (16K): org.highwire.dtl.DTLVardef@1d8366eorg.highwire.dtl.DTLVardef@1dda3feorg.highwire.dtl.DTLVardef@39a4bcorg.highwire.dtl.DTLVardef@6e58b6_HPS_FORMAT_FIGEXP M_FIG C_FIG