Genetic and pharmacological targeting of Snail prevents atherosclerosis
by relieving intraplaque endothelium dysfunction and associated
inflammation
Abstract
Background and Purpose The molecular mechanisms responsible for
atherogenesis have not been fully elucidated. The intraplaque
endothelium dysfunction and associated inflammation are believed to
contribute to the progression of atherosclerosis. This study aims to
uncover molecular drivers of atherosclerotic cardiovascular disease and
then develop therapeutic strategies for the disease. Methods The
expression of zinc-finger transcription factor Snail in human and mouse
atherosclerotic plaques was assessed using immunostaining, LacZ reporter
mouse line and single-cell RNA-sequencing. The functional role and
underlying mechanisms of endothelium-derived Snail in driving
atherosclerosis was determined using the canonical and accelerated
models of atherosclerosis developed in the endothelial cell
(EC)-specific Snail-inducible deleted mice with the ApoE-/- background.
An orally bioavailable small-molecule inhibitor of Snail was developed
using the docking algorithm analysis and chemical structural
optimization, and the anti-atherosclerotic effects of the compound were
evaluated in mice. Results Snail is activated in ECs in both human and
mouse atherosclerotic plaques, and its expression is positively
correlated with disease severity. EC-specific Snail deletion in ApoE-/-
mice reduces intraplaque endothelium dysfunction, inflammation and lipid
uptake in tandem with enhanced plaque stability. Mechanistically, Snail
deletion decreases histone acetylation on Ccl5 and Cxcl10 promoters,
thereby decreases CCL5/CXCL10-driven vascular damage and inflammation.
Administration with recombinant CXCL10 protein could efficiently restore
atherogenesis in Snail-deleted mice. The orally bioavailable
small-molecule inhibitor of Snail exhibits a potent anti-atherosclerotic
effect in ApoE-/- mice. Conclusions These results reveal that Snail
plays an essential role in atherogenesis and pharmacological targeting
of Snail may provide therapeutic benefits against atherosclerotic
cardiovascular disease.