PROJECT SUMMARY:
Endothelial-to-mesenchymal transition (EndMT) has been detected in atherosclerosis, and the extent of EndMT
observed in the human plaques strongly correlates with the severity of the disease, implying clinical relevance
of EndMT in the pathogenesis of atherosclerosis. Both disturbed blood flow (d-flow) and interleukin-1 signaling
(IL-1) have been implicated in EndMT formation. The signaling pathway that links d-flow and EndMT is still
unclear. Moreover, IL-1 as a therapeutic target has already been tested and the Canakinumab Anti-inflammatory
Thrombosis Outcome Study (CANTOS) assessed the therapeutic effect of the anti-IL-1β antibody in patients
after myocardial infarction and showed 31% reduction of cardiovascular and all-cause mortality. However, some
of those patients developed immunosuppressive off-target effects. In addition, there is no clear principal cell type
in human severe atherosclerosis responsible for IL-1 signaling. Our recently published work has demonstrated
that d-flow induces activation of interleukin-1 receptor signaling kinase (IRAK1) within endothelial cells (ECs),
with an increase in p-IRAK1 levels in human and mouse atherosclerosis. IRAK1 is co-expressed with EndMT in
severe atherosclerosis, and deletion of IRAK1 decreases EndMT in vitro, identifying a novel role for IRAK1 as a
downstream effector in d-flow-induced EndMT. Our central hypothesis is that IRAK1 activation mediates d-
flow-induced EndMT and selective inhibition of IRAK1 will allow efficient inhibition of atherosclerosis without
promoting significant immunosuppression. Aim 1 Determine the mechanistic role of IRAK1 activation in
oscillatory flow-induced EndMT. Our preliminary data supports IRAK1 activation by d-flow and that mediates
EndMT formation. Aim 1.1, utilizing CRISPR Cas-9 KO selective deletion and re-expressing vectors, we will test
the role of IRAK1 in oscillatory flow-induced EndMT. In Aim 1.2, we will evaluate the activating roles of IRAK1
domains by transiently transfecting IRAK1 truncated mutants into IRAK1-depleted and overexpressed ECs and
we will measure Phospho-IRAK1 and EndMT after oscillatory flow. In Aim 1.3, we will assess the functional role
of IRAK1 endogenous interactions by utilizing immunoprecipitations, gene silencing, and mass spectrometry.
Aim 2 will determine if selective inhibition of IRAK1 in d-flow-induced EndMT prevents atherosclerosis
progression. We will use Cre-lox endothelial-specific lineage tracing and novel endothelial-specific IRAK1
knockout mice and IRAK1 selective inhibitor to provide the first assessment of IRAK1 inhibition on EndMT
formation in vivo. Fibrous cap thickness, plaque lesion size, composition, and EndMT will be assessed in both
partial carotid ligation model of d-flow (Aim2.1) and diet-induced atherosclerosis (Aim2.2). FACS analysis of
blood and plaques will be done to assess total and differential leukocytes and proinflammatory cytokines. These
studies will determine the dynamic interplay between disturbed flow and IL-1 signaling in EndMT and will define
a novel role for IRAK1 as a novel therapeutic target in d-flow-induced EndMT and atherosclerosis.