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Anti-GRP78 autoantibodies induce endothelial cell activation and accelerate the development of atherosclerotic lesions
Elizabeth D. Crane, Ali A. Al-Hashimi, Jack Chen, Edward G. Lynn, Kevin Doyoon Won, Šárka Lhoták, Magda Naeim, Khrystyna Platko, Paul Lebeau, Jae Hyun Byun, Bobby Shayegan, Joan C. Krepinsky, Katey J. Rayner, Serena Marchiò, Renata Pasqualini, Wadih Arap, Richard C. Austin
Elizabeth D. Crane, Ali A. Al-Hashimi, Jack Chen, Edward G. Lynn, Kevin Doyoon Won, Šárka Lhoták, Magda Naeim, Khrystyna Platko, Paul Lebeau, Jae Hyun Byun, Bobby Shayegan, Joan C. Krepinsky, Katey J. Rayner, Serena Marchiò, Renata Pasqualini, Wadih Arap, Richard C. Austin
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Research Article

Anti-GRP78 autoantibodies induce endothelial cell activation and accelerate the development of atherosclerotic lesions

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Abstract

The 78-kDa glucose-regulated protein (GRP78) is an ER molecular chaperone that aids in protein folding and secretion. However, pathological conditions that cause ER stress can promote the relocalization of GRP78 to the cell surface (csGRP78), where it acts as a signaling receptor to promote cancer progression. csGRP78 also possesses antigenic properties, leading to the production of anti-GRP78 autoantibodies, which contribute to tumor growth. In contrast, the presence and role of anti-GRP78 autoantibodies in atherosclerosis is unknown. Here, we show that atherosclerotic-prone ApoE–/– mice develop circulating anti-GRP78 autoantibodies that bind to csGRP78 on lesion-resident endothelial cells. Moreover, GRP78-immunized ApoE–/– mice exhibit a marked increase in circulating anti-GRP78 autoantibody titers that correlated with accelerated lesion growth. Mechanistically, engagement of anti-GRP78 autoantibodies with csGRP78 on human endothelial cells activated NF-κB, thereby inducing the expression of ICAM-1 and VCAM-1, a process blocked by NF-κB inhibitors. Disrupting the autoantibody/csGRP78 complex with enoxaparin, a low-molecular-weight heparin, reduced the expression of adhesion molecules and attenuated lesion growth. In conclusion, anti-GRP78 autoantibodies play a crucial role in atherosclerosis development, and disruption of the interaction between anti-GRP78 autoantibodies and csGRP78 represents a therapeutic strategy.

Authors

Elizabeth D. Crane, Ali A. Al-Hashimi, Jack Chen, Edward G. Lynn, Kevin Doyoon Won, Šárka Lhoták, Magda Naeim, Khrystyna Platko, Paul Lebeau, Jae Hyun Byun, Bobby Shayegan, Joan C. Krepinsky, Katey J. Rayner, Serena Marchiò, Renata Pasqualini, Wadih Arap, Richard C. Austin

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Figure 2

Atherosclerotic lesion growth is accelerated in ApoE–/– mice with elevated anti-GRP78 autoantibody titers.

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Atherosclerotic lesion growth is accelerated in ApoE–/– mice with elevat...
(A) Serum levels of anti-GRP78 autoantibodies were measured by ELISA in female ApoE–/– mice fed a chow diet and injected 3 times at 10-day intervals with 50 μg/ml OVA or rGRP78 beginning at 6 weeks of age. Data are presented as a ratio of absorbance units (AU) relative to a standard sample (n = 6 per group). *P < 0.05 versus OVA at each time point, 2-tailed t test. (B) Quantification of atherosclerotic lesion size at the aortic root from 15-week-old immunized mice. Lesion size was measured in 5–6 sections at 80-μm intervals (n = 6 per group). *P < 0.01 versus OVA immunized mice, 2-tailed t test. (C) Representative cross-section images of the aortic root stained with H&E for each treatment group. Arrows indicate atherosclerotic lesions. Original magnification, ×10. Scale bar: 100 μm. (D) Quantification of necrotic area in lesions at the aortic root. Data are expressed as percentage of total lesion area (n = 6 per group). *P < 0.01 versus OVA treated mice, 2-tailed t test. (E) Classification of atherosclerotic lesions in ApoE–/– mice immunized with OVA or rGRP78. Plasma levels of (F) triglycerides and (G) total cholesterol were measured in immunized ApoE–/– mice at 15 weeks of age by colorimetric assays (n = 6–8 per group).

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