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Accumulating evidence highlights protein O-GlcNAcylation as a putative pathogenic contributor of diabetic vascular complications. We previously reported that elevated protein O-GlcNAcylation correlates with increased atherosclerotic lesion formation and VSMC proliferation in response to hyperglycemia. However, the role of O-GlcNAc transferase (OGT), regulator of O-GlcNAc signaling, in the evolution of diabetic atherosclerosis remains elusive. The goal of this study was to determine whether smooth muscle OGT (smOGT) plays a direct role in hyperglycemia-induced atherosclerotic lesion formation and SMC de-differentiation. Using tamoxifen-inducible Myh11-CreERT2 and Ogtfl/fl mice, we generated smOGTWT and smOGTKO mice, with and without ApoE-null backgrounds. Following STZ-induced hyperglycemia, smOGTWT and smOGTKO mice were kept on a standard laboratory diet for the study duration. In a parallel study, smOGTWTApoE-/- and smOGTKOApoE-/- were initiated on Western diet at 8-wks-age. Animals harvested at 14–16-wks-age were used for plasma and tissue collection. Loss of smOGT augmented SM contractile marker expression in aortic vessels of STZ-induced hyperglycemic smOGTKO mice. Consistently, smOGT deletion attenuated atherosclerotic lesion lipid burden (Oil red O), plaque area (H&E), leukocyte (CD45) and smooth muscle cell (ACTA2) abundance in Western diet-fed hyperglycemic smOGTKOApoE-/- mice. This was accompanied by increased SM contractile markers and reduced inflammatory and proliferative marker expression. Further, smOGT deletion attenuated YY1 and SRF expression (transcriptional regulators of SM contractile genes) in hyperglycemic smOGTKOApoE-/- and smOGTKO mice. These data uncover an athero-protective outcome of smOGT loss-of-function and suggest a direct regulatory role of OGT-mediated O-GlcNAcylation in VSMC de-differentiation in hyperglycemia.

Accumulating evidence highlights protein O-GlcNAcylation as a putative pathogenic contributor of diabetic vascular complications. We previously reported that elevated protein O-GlcNAcylation correlates with increased atherosclerotic lesion formation and VSMC proliferation in response to hyperglycemia. However, the role of O-GlcNAc transferase (OGT), regulator of O-GlcNAc signaling, in evolution of diabetic atherosclerosis remains elusive. The goal of this study was to determine whether smooth muscle OGT (smOGT) plays a direct role in hyperglycemia-induced atherosclerotic lesion formation and SMC de-differentiation. Using tamoxifen-inducibleMyh11-CreERT2and OGTfl/flmice, we generated smOGTWTand smOGTKOmice, with and without ApoE-null backgrounds. Following STZ-induced hyperglycemia, smOGTWTand smOGTKOmice were kept on standard laboratory diet for study duration. In a parallel study, smOGTWTApoE-/-and smOGTKOApoE-/-were kept on Western diet beginning 8-wks-age. Animals harvested at 14-16-wks-age were used for plasma and tissue collection. Loss of smOGT augmented SM contractile marker expression in aortic vessels of STZ-induced hyperglycemic smOGTKOmice. Consistently, smOGT deletion attenuated atherosclerotic lesion lipid burden (Oil red O), plaque area (H&E), leukocyte (CD45) and smooth muscle cell (ACTA2) abundance in Western diet-induced hyperglycemic smOGTKOApoE-/-mice. This was accompanied with increased SM contractile markers, and reduced inflammatory and proliferative marker expression. Further, smOGT deletion attenuated YY1 and SRF expression (transcriptional regulators of SM contractile genes) in hyperglycemic smOGTKOApoE-/-and smOGTKOmice. These data uncover an atheroprotective outcome of smOGT loss-of-function and suggest a direct regulatory role of OGT-mediated O-GlcNAcylation in VSMC de-differentiation in hyperglycemia.

IntroductionMetabolic syndrome (MetS) amplifies the risks of atherosclerosis. Despite well-known sexual dimorphism in atherosclerosis, underlying mechanisms are poorly understood. Our previous findings highlight a proatherogenic protein, thrombospondin-1 (TSP-1), in hyperglycemia- or hyperleptinemia (mimicking obesity)-induced atherosclerosis. However, the role of TSP-1 in the development of atherosclerosis prompted by co-existing hyperglycemia and obesity, characteristic of MetS, is unknown. The goal of this study was to examine sex-specific differences in lesion progression in a model of combined MetS and atherosclerosis (KKAyApoE) and interrogate how these differences relate to TSP-1 expression.MethodsMale and female KKAy+/−ApoE–/– (with ectopic agouti gene expression) and age-matched non-agouti KKAy–/–ApoE–/– littermates were placed on a standard laboratory diet from 4 to 24 weeks age followed by blood and tissue harvests for biochemical, molecular, and aortic root morphometric studies.ResultsMetabolic profiling confirmed MetS phenotype of KKAy+/−ApoE–/–; however, only male genotypes were glucose intolerant with elevated VLDL-cholesterol and VLDL-triglyceride levels. Aortic root morphometry demonstrated profound lipid-filled lesions, increased plaque area, and augmented inflammatory and SMC abundance in MetS vs non-MetS males. This increase in lesion burden was accompanied with elevated TSP-1 and attenuated LMOD-1 (SM contractile marker) and SRF (transcriptional activator of SM differentiation) expression in male MetS aortic vessels. In contrast, while lipid burden, plaque area, and TSP-1 expression increased in MetS and non-MetS female mice, there was no significant difference between these genotypes. Increased collagen content was noted in MetS and non-MetS genotypes, specific to female mice. Measurement of plasma testosterone revealed a link between the atherogenic phenotype and abnormally high or low testosterone levels. To interrogate whether TSP-1 plays a direct role in SMC de-differentiation in MetS, we generated KKAy+/− mice with and without global TSP-1 deletion. Immunoblotting showed increased SM contractile markers in male KKAy+/−TSP-1–/– aortic vessels vs male KKAy+/−TSP-1+/ +. In contrast, TSP-1 deletion had no effect on SM contractile marker expression in female genotypes.ConclusionTogether, the current study implicates a role of plasma testosterone in sex-specific differences in atherosclerosis and TSP-1 expression in MetS vs non-MetS mice. Our data suggest a sex-dependent differential role of TSP-1 on SMC de-differentiation in MetS. Collectively, these findings underscore a fundamental link between TSP-1 and VSMC phenotypic transformation in MetS.

Metabolic syndrome (MetS) amplifies risks of atherosclerotic complications. MetS induces abnormal vascular smooth muscle cell (VSMC) migration and proliferation, hallmark of SMC de-differentiation, crucial in the pathogenesis of atherosclerosis. Despite multiple studies revealing sexual dimorphism in atherosclerosis, underlying sex-specific mechanisms are poorly understood. We previously reported a protective role of a potent proatherogenic protein, thrombospondin-1 (TSP1), in hyperglycemia- or hyperleptinemia-induced atherosclerosis. The goal of the present study was to interrogate sex-specific differences in the role of TSP1 on MetS-induced atherosclerosis. We generated a mouse model of combined MetS and atherosclerosis (KKAy +/- ApoE -/- ) by crossing obese hyperglycemic agouti KKAy +/- mice with atherosclerotic ApoE -/- . Male and female age-matched MetS KKAy +/- ApoE -/- and non-MetS KKAy -/- ApoE -/- mice were placed on standard lab diet from 4-24 wks age. After overnight fasting, mice were harvested; plasma, aorta and heart were collected for various studies. In male MetS KKAy +/- ApoE -/- , increased aortic root ORO-positive lipid burden, reduced LMOD (SM contractile marker) and SRF (transcriptional activator of SM differentiation) expression in aortic vessels associated with augmented TSP1 expression vs. non-MetS KKAy -/- ApoE -/- mice. In contrast, no significant differences in lesion lipid burden, TSP1, LMOD and SRF expression were detected between the female genotypes. To delineate whether TSP1 plays a direct role in SMC de-differentiation in MetS, we next crossed KKAy +/- with TSP1 -/- to generate MetS mice with and without global TSP1 deletion. Male and female KKAy +/- TSP1 +/+ (with intact TSP1) and KKAy +/- TSP1 -/- (lacking TSP1) on standard lab diet from 4-18 wks age were harvested at endpoint for aortic tissue collection. In male KKAy +/- TSP1 -/- aortic vessels, SM contractile marker expression (LMOD, calponin) was markedly increased vs. KKAy +/- TSP1 +/+ , suggesting reduced SMC de-differentiation. In contrast, TSP1 deletion had no effect on SM contractile marker expression in female MetS KKAy +/- . Together, these data suggest a sex-specific role of TSP1 on SMC de-differentiation and atherosclerotic lesion formation in MetS.

Metabolic syndrome (MetS) amplifies risks of atherosclerotic complications. MetS induces abnormal vascular smooth muscle cell (VSMC) migration and proliferation, hallmark of SMC de-differentiation, crucial in the pathogenesis of atherosclerosis. Despite multiple studies revealing sexual dimorphism in atherosclerosis, underlying sex-specific mechanisms are poorly understood. We previously reported a protective role of a potent proatherogenic protein, thrombospondin-1 (TSP1), in hyperglycemia- or hyperleptinemia-induced atherosclerosis. The goal of the present study was to interrogate sex-specific differences in the role of TSP1 on MetS-induced atherosclerosis. We generated a mouse model of combined MetS and atherosclerosis (KKAy +/- ApoE -/- ) by crossing obese hyperglycemic agouti KKAy +/- mice with atherosclerotic ApoE -/- . Male and female age-matched MetS KKAy +/- ApoE -/- and non-MetS KKAy -/- ApoE -/- mice were placed on standard lab diet from 4-24 wks age. After overnight fasting, mice were harvested; plasma, aorta and heart were collected for various studies. In male MetS KKAy +/- ApoE -/- , increased aortic root ORO-positive lipid burden, reduced LMOD (SM contractile marker) and SRF (transcriptional activator of SM differentiation) expression in aortic vessels associated with augmented TSP1 expression vs. non-MetS KKAy -/- ApoE -/- mice. In contrast, no significant differences in lesion lipid burden, TSP1, LMOD and SRF expression were detected between the female genotypes. To delineate whether TSP1 plays a direct role in SMC de-differentiation in MetS, we next crossed KKAy +/- with TSP1 -/- to generate MetS mice with and without global TSP1 deletion. Male and female KKAy +/- TSP1 +/+ (with intact TSP1) and KKAy +/- TSP1 -/- (lacking TSP1) on standard lab diet from 4-18 wks age were harvested at endpoint for aortic tissue collection. In male KKAy +/- TSP1 -/- aortic vessels, SM contractile marker expression (LMOD, calponin) was markedly increased vs. KKAy +/- TSP1 +/+ , suggesting reduced SMC de-differentiation. In contrast, TSP1 deletion had no effect on SM contractile marker expression in female MetS KKAy +/- . Together, these data suggest a sex-specific role of TSP1 on SMC de-differentiation and atherosclerotic lesion formation in MetS.

Attachment of O-linked N-acetylglucosamine (O-GlcNAc) to nucleocytoplasmic proteins or ‘O-GlcNAcylation’ is a ubiquitous post-translational modification affecting numerous cellular processes. We and others have previously reported that augmented protein O-GlcNAcylation mediates upregulation of numerous genes associated with atherosclerosis. Recent studies suggest the role of O-GlcNAc transferase (OGT), a key regulator of O-GlcNAc signaling, in diabetic vascular calcification and wound healing. However, the role of OGT in the etiology of atherosclerosis is elusive. The goal of the current study was to interrogate whether OGT plays a direct role in the development of atherosclerosis. For this, we crossed tamoxifen-inducible male Myh11-CreERT2;OGT fl/y ;ApoE -/- mice with female OGT fl/+ ;ApoE -/- to generate SMC-specific OGT knockout on ApoE -/- background. To induce Cre recombinase activity, mice genotypes were injected i.p. with 60mg/Kg/day tamoxifen (peanut oil-vehicle control) once daily for 5 consecutive days beginning at 6 wks age. This was followed by a Western diet feeding regimen for additional 6-7 wks. Mice were harvested at 14 wks age after overnight fasting; plasma, aorta, and heart were collected for biochemical, molecular, and lesion studies. Immunoblotting confirmed loss of OGT expression in aortic vessels of tamoxifen-treated Cre tg ;OGT fl/y ;ApoE -/- mice (smOGT KO ;ApoE -/- ) vs. age-matched tamoxifen-treated Cre tg ;OGT +/y ;ApoE -/- littermates (smOGT WT ;ApoE -/- , with intact OGT). Aortic root morphometry revealed a significant reduction (2.5-fold) in lesion lipid burden in smOGT KO ;ApoE -/- mice compared with smOGT WT ;ApoE -/- . This was accompanied by attenuated PCNA (proliferation marker), osteopontin (SM synthetic marker), pERK (SM signaling regulator), YY1 (transcriptional repressor of SM contractile genes), and SRF (transcriptional regulator of SMC proliferation) expression in smOGT KO ;ApoE -/- vs. smOGT WT ;ApoE -/- aortic lysates, shown via immunoblotting. Interestingly, SMC-specific OGT deletion had no effect on plasma total cholesterol and total triglyceride levels. Taken together, these results demonstrate a protective role of SMC-specific loss of OGT on atherosclerotic lesion formation.

Hyperglycemia and obesity, characteristic of metabolic syndrome (MetS), are important risk-factors for atherosclerosis. MetS patients manifest increased vascular smooth muscle cell (VSMC) migration and proliferation, hallmark of VSMC phenotypic transition, critical for evolution of atherosclerosis. We previously reported that high glucose and high leptin independently upregulate a potent proatherogenic matricellular protein, Thrombospondin-1 (TSP-1), expression in VSMC. The goal of the present study was to interrogate the role of TSP-1 in SMC de-differentiation and development of atherosclerosis in MetS. We utilized a mouse model of combined MetS and atherosclerosis (KKAy +/- /ApoE -/- ) generated by crossing obese hyperglycemic agouti KKAy +/- mice with atherosclerotic ApoE -/- . Upon weaning (4 wks age), male yellow KKAy +/- /ApoE -/- and age-matched black KKAy -/- /ApoE -/- littermates on standard lab diet were monitored monthly for body weight and blood glucose. At 24 wks age, mice were harvested after overnight fasting; plasma, aorta and heart were collected for biochemical, molecular and lesion studies. Prior to harvest, mice were subjected to treadmill exercise test at an incline with progressively increasing speed until exhaustion. At 16 wks age, yellow KKAy +/- /ApoE -/- mice showed significant increase in body weight and random blood glucose levels (-/- /ApoE -/- littermates, validating the MetS phenotype. Peak oxygen consumption (VO 2max ), maximum running speed and total run time until exhaustion were significantly reduced in MetS KKAy +/- /ApoE -/- mice (p-/- /ApoE -/- ), suggesting impaired cardiovascular fitness. Aortic root morphometry revealed 4-fold increase in lesion lipid burden in MetS vs non-MetS mice. This was accompanied with reduced LMOD (SM contractile marker) and SRF (transcriptional activator of SM contractile genes) expression in aortic vessels of MetS mice (p

Objective: Hyperleptinemia, hallmark of obesity, is a putative pathophysiologic trigger for atherosclerosis. We previously reported a stimulatory effect of leptin on TSP-1 (thrombospondin-1) expression, a proatherogenic matricellular protein implicated in atherogenesis. However, a causal role of TSP-1 in leptin-driven atherosclerosis remains unknown. Approach and Results: Seventeen-weeks-old ApoE −/− and TSP-1 −/− /ApoE −/− double knockout mice, on normocholesterolemic diet, were treated with or without murine recombinant leptin (5 µg/g bwt, IP) once daily for 3 weeks. Using aortic root morphometry and en face lesion assay, we found that TSP-1 deletion abrogated leptin-stimulated lipid-filled lesion burden, plaque area, and collagen accumulation in aortic roots of ApoE −/− mice, shown via Oil red O, hematoxylin and eosin, and Masson trichrome staining, respectively. Immunofluorescence microscopy of aortic roots showed that TSP-1 deficiency blocked leptin-induced inflammatory and smooth muscle cell abundance as well as cellular proliferation in ApoE −/− mice. Moreover, these effects were concomitant to changes in VLDL (very low-density lipoprotein)-triglyceride and HDL (high-density lipoprotein)-cholesterol levels. Immunoblotting further revealed reduced vimentin and pCREB (phospho-cyclic AMP response element-binding protein) accompanied with augmented smooth muscle-myosin heavy chain expression in aortic vessels of leptin-treated double knockout versus leptin-treated ApoE −/− ; also confirmed in aortic smooth muscle cells from the mice genotypes, incubated ± leptin in vitro. Finally, TSP-1 deletion impeded plaque burden in leptin-treated ApoE −/− on western diet, independent of plasma lipid alterations. Conclusions: The present study provides evidence for a protective effect of TSP-1 deletion on leptin-stimulated atherogenesis. Our findings suggest a regulatory role of TSP-1 on leptin-induced vascular smooth muscle cell phenotypic transition and inflammatory lesion invasion. Collectively, these results underscore TSP-1 as a potential target of leptin-induced vasculopathy.

OBJECTIVE –: Hyperleptinemia, hallmark of obesity, is a putative pathophysiologic trigger for atherosclerosis. We previously reported a stimulatory effect of leptin on thrombospondin-1 (TSP-1) expression, a proatherogenic matricellular protein implicated in atherogenesis. However, a causal role of TSP-1 in leptin-driven atherosclerosis remains unknown. APPROACH AND RESULTS –: 17-wks-old ApoE(−/−) and TSP-1(−/−)/ApoE(−/−) double knockout (dKO) mice, on normocholesterolemic diet, were treated with or without murine recombinant leptin (5µg/g bwt, IP) once daily for three weeks. Using aortic root morphometry and en-face lesion assay, we found that TSP-1 deletion abrogated leptin-stimulated lipid-filled lesion burden, plaque area and collagen accumulation in aortic roots of ApoE(−/−) mice, shown via Oil red O, H & E and Masson’s trichrome staining, respectively. Immunofluorescence microscopy of aortic roots showed that TSP-1 deficiency blocked leptin-induced inflammatory and smooth muscle cell abundance as well as cellular proliferation in ApoE(−/−) mice. Moreover, these effects were concomitant to changes in VLDL-triglyceride and HDL-cholesterol levels. Immunoblotting further revealed reduced vimentin and pCREB accompanied with augmented SM-MHC expression in aortic vessels of leptin-treated dKO vs. leptin-treated ApoE(−/−); also confirmed in aortic SMCs from the mice genotypes, incubated ± leptin in vitro. Finally, TSP-1 deletion impeded plaque burden in leptin-treated ApoE(−/−) on western diet, independent of plasma lipid alterations. CONCLUSIONS –: The present study provides evidence for a protective effect of TSP-1 deletion on leptin-stimulated atherogenesis. Our findings suggest a regulatory role of TSP-1 on leptin-induced VSMC phenotypic transition and inflammatory lesion invasion. Collectively, these results underscore TSP-1 as a potential target of leptin-induced vasculopathy.

Atherosclerosis is the leading cause of increased morbidity and mortality in metabolic syndrome (MetS), a constellation of risk factors that include hyperglycemia and visceral obesity. Individuals with MetS have increased incidence of vascular smooth muscle cell (VSMC) migration and proliferation, a key characteristic of VSMC phenotypic transition. We previously reported that high glucose and high leptin, mimicking hyperglycemia and obesity, independently upregulate a potent proatherogenic matricellular protein, thrombospondin-1 (TSP-1), expression in VSMCs. The goal of the present study was to investigate the role of TSP-1 in development of atherosclerosis in MetS. We generated a mouse model of combined MetS and atherosclerosis ( KKAy +/- /ApoE -/- ) by crossing obese hyperglycemic agouti yellow KKAy +/- mice with atherosclerotic ApoE -/- mice. Upon weaning, yellow KKAy +/- /ApoE -/- mice and age-matched black KKAy -/- /ApoE -/- littermates were maintained on regular chow diet from 4-18 wks of age. Mice were euthanized after an overnight fasting; blood, aortae and heart were collected for lipid profiling, immunoblotting and atherosclerotic lesion studies. Yellow KKAy +/- /ApoE -/- mice showed significant increase in body weight, blood glucose and plasma lipid levels vs. black KKAy -/- /ApoE -/- littermates. Aortic root morphometry demonstrated increased lesion burden (Oil red O) and neointimal thickening (H & E) in MetS KKAy +/- /ApoE -/- vs. non-MetS KKAy -/- /ApoE -/- mice. Immunohistochemistry further revealed co-localization of α-SMA (SMC marker) and PCNA (proliferation marker) expression in aortic roots of KKAy +/- /ApoE -/- vs. KKAy -/- /ApoE -/- mice. Notably, lesion formation was associated with an increase in TSP-1 expression in aortic vessels. Consistently, TSP-1 and PCNA expression were elevated in aortic SMC (aSMC) primary cultures derived from obese diabetic KKAy +/- mice vs. lean non-diabetic KKAy -/- littermates. Finally, incubation of aSMC with a TSP-1 blocking peptide reduced PCNA and vimentin (SMC synthetic marker) expression coupled with attenuated SMC proliferation in obese diabetic KKAy +/- mice. Together, these results suggest a putative role of TSP-1 in accelerated atherosclerosis and VSMC phenotypic transition in MetS.