Project Summary/Abstract:
Atherosclerosis is a disease of the mid- and large-sized arteries that promotes plaque formation. Plaque
development can lead to restricted blood flow, vessel rigidity, and in some cases thrombosis. Atherosclerosis is
a major underlying condition that promotes the morbidity and mortality associated with cardiovascular disease,
such as heart disease and stroke. Atherosclerosis is mediated by chronic exposure to elevated serum cholesterol
which leads to deposition and accumulation of inflammatory cells in the intima-region of the vessel wall.
Monocyte infiltration is a hallmark of disease progression where cells differentiate into lipid-laden macrophages,
termed “foamy cells”. We interrogated single cell RNA-seq (scRNA-seq) gene expression data from
atherosclerotic plaques which identified genes uniquely associated with foamy macrophages, including the
myeloid lipid sensor Trem2. Additionally, an unbiased genome-wide Crispr-screen of in vitro derived foamy
macrophages found Trem2 was required for oxidized LDL uptake. However, paradoxically, Trem2 was also
required for efflux of cholesterol in foamy macrophages. Since Trem2 has been associated with enhanced lipid
uptake in adipose macrophages and efflux in microglia, we sought to test its role in atherosclerosis. Using Trem2-
knockout and conditional Trem2-deletion approaches, we found Trem2 mediates lipid accumulation in plaque
macrophages and loss of Trem2 resulted in a dramatic reduction in atherosclerotic plaque size. Thus, based on
our preliminary data, we hypothesize that Trem2 regulates foamy macrophage lipid uptake and survival in
atherosclerosis. We have extensive experience studying myeloid cells in atherosclerosis and include newly
developed monocyte fate-mapping model to track monocyte differentiation in plaque, and a viral atherosclerosis
regression model, which places our lab in unique position to address the questions outlined in this application.
In addition, we incorporate a Trem2 agonistic antibody as an approach to complement deletion experiments to
determine the mechanisms of Trem2 in atherosclerotic disease. Together, we will address the role of Trem2 in
atherosclerosis progression, examine in depth signaling mechanisms in foamy cells that are regulated by Trem2,
and determine whether Trem2 is a therapeutic target for intervention. Findings from this study represent
potentially highly impactful knowledge for translation of a novel candidate to drive plaque regression in
atherosclerosis patients.