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Increased soluble urokinase plasminogen activator levels modulate monocyte function to promote atherosclerosis.


ABSTRACT: People with kidney disease are disproportionately affected by atherosclerosis for unclear reasons. Soluble urokinase plasminogen activator receptor (suPAR) is an immune-derived mediator of kidney disease, levels of which are strongly associated with cardiovascular outcomes. We assessed suPAR's pathogenic involvement in atherosclerosis using epidemiologic, genetic, and experimental approaches. We found serum suPAR levels to be predictive of coronary artery calcification and cardiovascular events in 5,406 participants without known coronary disease. In a genome-wide association meta-analysis including over 25,000 individuals, we identified a missense variant in the plasminogen activator, urokinase receptor (PLAUR) gene (rs4760), confirmed experimentally to lead to higher suPAR levels. Mendelian randomization analysis in the UK Biobank using rs4760 indicated a causal association between genetically predicted suPAR levels and atherosclerotic phenotypes. In an experimental model of atherosclerosis, proprotein convertase subtilisin/kexin-9 (Pcsk9) transfection in mice overexpressing suPAR (suPARTg) led to substantially increased atherosclerotic plaques with necrotic cores and macrophage infiltration compared with those in WT mice, despite similar cholesterol levels. Prior to induction of atherosclerosis, aortas of suPARTg mice excreted higher levels of CCL2 and had higher monocyte counts compared with WT aortas. Aortic and circulating suPARTg monocytes exhibited a proinflammatory profile and enhanced chemotaxis. These findings characterize suPAR as a pathogenic factor for atherosclerosis acting at least partially through modulation of monocyte function.

SUBMITTER: Hindy G 

PROVIDER: S-EPMC9754000 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Increased soluble urokinase plasminogen activator levels modulate monocyte function to promote atherosclerosis.

Hindy George G   Tyrrell Daniel J DJ   Vasbinder Alexi A   Wei Changli C   Presswalla Feriel F   Wang Hui H   Blakely Pennelope P   Ozel Ayse Bilge AB   Graham Sarah S   Holton Grace H GH   Dowsett Joseph J   Fahed Akl C AC   Amadi Kingsley-Michael KM   Erne Grace K GK   Tekmulla Annika A   Ismail Anis A   Launius Christopher C   Sotoodehnia Nona N   Pankow James S JS   Thørner Lise Wegner LW   Erikstrup Christian C   Pedersen Ole Birger OB   Banasik Karina K   Brunak Søren S   Ullum Henrik H   Eugen-Olsen Jesper J   Ostrowski Sisse Rye SR   Haas Mary E ME   Nielsen Jonas B JB   Lotta Luca A LA   Engström Gunnar G   Melander Olle O   Orho-Melander Marju M   Zhao Lili L   Murthy Venkatesh L VL   Pinsky David J DJ   Willer Cristen J CJ   Heckbert Susan R SR   Reiser Jochen J   Goldstein Daniel R DR   Desch Karl C KC   Hayek Salim S SS  

The Journal of clinical investigation 20221215 24


People with kidney disease are disproportionately affected by atherosclerosis for unclear reasons. Soluble urokinase plasminogen activator receptor (suPAR) is an immune-derived mediator of kidney disease, levels of which are strongly associated with cardiovascular outcomes. We assessed suPAR's pathogenic involvement in atherosclerosis using epidemiologic, genetic, and experimental approaches. We found serum suPAR levels to be predictive of coronary artery calcification and cardiovascular events  ...[more]

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