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Circulation. 1999;99:3125-3131

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(Circulation. 1999;99:3125-3131.)
© 1999 American Heart Association, Inc.


Clinical Investigation and Reports

PPAR{alpha} Activators Inhibit Cytokine-Induced Vascular Cell Adhesion Molecule-1 Expression in Human Endothelial Cells

Nikolaus Marx, MD; Galina K. Sukhova, PhD; Tucker Collins, MD, PhD; Peter Libby, MD; Jorge Plutzky, MD

From the Vascular Medicine and Atherosclerosis Unit, Cardiovascular Division (N.M., G.K.S., P.L., J.P.) and the Vascular Research Division, Department of Pathology (T.C.), Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

Correspondence to Jorge Plutzky, MD, Vascular Medicine and Atherosclerosis Unit, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA 02115. E-mail jplutzky{at}rics.bwh.harvard.edu


*    Abstract
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Background—Adhesion molecule expression on the endothelial cell (EC) surface is critical for leukocyte recruitment to atherosclerotic lesions. Better understanding of transcriptional regulation of adhesion molecules in ECs may provide important insight into plaque formation. Peroxisome proliferator–activated receptor-{alpha} (PPAR{alpha}), a member of the nuclear receptor family, regulates gene expression in response to certain fatty acids and fibric acid derivatives. The present study investigated PPAR{alpha} expression in human ECs and their regulation of vascular cell adhesion molecule-1 (VCAM-1).

Methods and Results—Immunohistochemistry revealed that human carotid artery ECs express PPAR{alpha}. Pretreatment of cultured human ECs with the PPAR{alpha} activators fenofibrate or WY14643 inhibited TNF-{alpha}–induced VCAM-1 in a time- and concentration-dependent manner, an effect not seen with PPAR{gamma} activators. Both PPAR{alpha} activators decreased cytokine-induced VCAM-1 mRNA expression without altering its mRNA half-life. Transient transfection of deletional VCAM-1 promoter constructs and electrophoretic mobility shift assays suggest that fenofibrate inhibits VCAM-1 transcription in part by inhibiting NF-{kappa}B. Finally, PPAR{alpha} activators significantly reduced adhesion of U937 cells to cultured human ECs.

Conclusions—Human ECs express PPAR{alpha}, a potentially important regulator of atherogenesis through its transcriptional control of VCAM-1 gene expression. Such findings also have implications regarding the clinical use of lipid-lowering agents, like fibric acids, which can activate PPAR{alpha}.


Key Words: atherosclerosis • endothelium • leukocytes


*    Introduction
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Adhesion of circulating leukocytes to the endothelium is a critical early step in atherogenesis.1 2 3 4 5 This process depends on the interaction between adhesion molecules on the endothelial cell (EC) surface and their cognate ligands on leukocytes. These EC adhesion molecules include vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), E-selectin, and P-selectin.6 7 Increased adhesion molecule expression by ECs in human atherosclerotic lesions may contribute to further leukocyte recruitment to sites of atherosclerosis.6 8 9 Although inducers of EC adhesion molecule expression, such as the inflammatory mediators tumor necrosis factor (TNF)-{alpha} and interleukin (IL)-1,10 have received much attention, less is known about the negative regulation of adhesion molecule transcription. Such understanding may provide important insight into plaque formation.

Certain polyunsaturated fatty acids, for example, docosahexaenoic acid (DHA), can inhibit cytokine-induced VCAM-1 expression in ECs, although the underlying mechanism remains unclear.11 Interestingly, some polyunsaturated fatty acids can activate the peroxisome proliferator–activated receptor-{alpha} (PPAR{alpha}), a nuclear receptor involved with transcriptional responses to fatty acids. Fibric acid derivatives, such as fenofibrate, are also thought to act as specific activators for PPAR{alpha}.12 13 14 In addition to PPAR{alpha}, the PPAR family also includes PPAR{gamma} and PPAR{delta}. PPARs, activated by binding of specific agonists, form heterodimers with the retinoid X receptor and associate with PPAR response elements in the promoter region of target genes whose expression they regulate.15 We have demonstrated expression of PPAR{gamma} in human ECs and identified plasminogen activator inhibitor-1 as a potential PPAR{gamma} target gene in these cells.16 Although PPAR{alpha} mRNA expression in human ECs has been reported,17 its role in EC biology, including candidate target genes, remains essentially unexplored.

We hypothesized that PPAR{alpha} might regulate VCAM-1 expression in human ECs, thus potentially modulating leukocyte adhesion. To this end, we investigated the presence of PPAR{alpha} in human ECs, studying the effect of well-established PPAR{alpha} and PPAR{gamma} activators on adhesion molecule expression in these cells.


*    Methods
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Immunohistochemistry of Human Carotid Artery Specimens
Staining for PPAR{alpha} was performed on acetone-fixed serial cryostat sections of human carotid arteries (protocols approved by Brigham and Women's Institutional Review Board) with a polyclonal goat anti-human PPAR{alpha} antibody (Santa Cruz). ECs were identified by staining with anti-CD31 antibodies (Dako). Sections were blocked with PBS/5% serum, and incubated with appropriate biotinylated secondary antibody (Vector Laboratories), then avidin-biotin-peroxidase complex (Vectastain ABC kit). Antibody binding was visualized with True Blue peroxidase substrate (Kirkegaard & Perry Laboratories) and counterstained with Gill's hematoxylin or contrast red (Kirkegaard & Perry Laboratories).

Cell Culture
Human saphenous vein ECs were isolated from explants from unused portions of saphenous veins harvested at coronary artery bypass surgery. Cells, cultured as described before,11 were >99% von Willebrand factor–positive by flow cytometry, exhibited typical EC cobblestone growth pattern, and were of low passage number (p2–5). Bovine aortic ECs (BAECs) and human fibroblasts were cultured in DMEM (Biowhittaker) containing 1% glutamine, 1% penicillin-streptomycin, and 10% FCS. The hematopoietic cell line U937 was cultured in RPMI medium (Biowhittaker) containing 1% glutamine, 1% penicillin-streptomycin, and 10% FCS.

Preparation of Nuclear and Cytosolic Extracts and Western Blot Analysis
For Western blotting, nuclear and cytosolic extracts of 107 cells were prepared as previously described.18 Processed samples were applied to 10% SDS-PAGE and transferred to nitrocellulose membranes (Millipore) by use of semidry blotting.18 Membranes were treated overnight with TBS-Tween/5% dry milk and incubated with goat anti-human PPAR{alpha} antibodies (Santa Cruz) for 1 hour. After washing, membranes were incubated with horseradish peroxidase–conjugated rabbit anti-goat monoclonal antibodies. Antigen detection was performed via chemiluminescence (NEN); Nuclear extracts from human fibroblasts transfected with a PPAR{alpha} expression construct (provided by Dr Bruce Spiegelman, Dana Farber Cancer Institute, Boston, Mass) served as a positive control.

Cell-Surface Enzyme Immunoassays
For determination of cell-surface expression of adhesion molecules, ECs were pretreated with PPAR activators [PPAR{alpha} activators: fenofibrate (Sigma) and WY14643 (Biomol); PPAR{gamma} activators: 15-deoxy-{Delta}12,14-prostaglandin J2 (15d-PGJ2) (Calbiochem), troglitazone (Parke-Davis), and BRL 49653 (SmithKline Beecham)] at the times and concentrations indicated and then stimulated with the specified cytokines (8 hours). Enzyme immunoassay (EIA) was performed by incubating EC monolayers first with specific monoclonal antibodies against VCAM-1 (E1/6), ICAM-1 (HU5/3), or E-selectin (H18/7), then with biotinylated goat anti-mouse IgG (Vector Laboratories), and finally with streptavidin–alkaline phosphatase (Zymed Laboratories). (All monoclonal antibodies were a generous gift from Dr Michael Gimbrone, Brigham and Women's Hospital, Boston, Mass). Cells were washed in PBS/1% BSA after each incubation step, and the integrity of the cellular monolayer was ensured by phase-contrast microscopy. Surface expression of each adhesion molecule was measured spectrophotometrically at 410 nm 15 to 30 minutes after addition of the chromogenic substrate (para-nitrophenylphosphate, Sigma). Experiments were performed in triplicate for each condition.

Adhesion Assay
ECs were grown to confluence in 96-well plates, pretreated with PPAR{alpha} activators for 24 hours, and stimulated with TNF-{alpha} for 8 hours, then adhesion assays were performed.19 Briefly, U937 cells were labeled with 2',7'-bis(2-carboxy)-fluorescein acetoxymethyl ester (Molecular Probes) and then added, under rolling conditions (63 rpm, 23°C, 15 minutes), to a rinsed EC monolayer (2x106 cells/mL) in RPMI medium/10% FCS/1 mmol/L CaCl2. Nonadherent cells were removed by inverting the plate under rotation (20 minutes). After solubilization of well contents, fluorescence intensity was measured in a microtiter plate fluorimeter (Pandex, FCA). A standard curve using dilutions of labeled U937 cells was determined, and results were expressed as cells/cm2.

RNA Extraction and Northern Blot Analysis
For Northern blot experiments, human ECs were pretreated with PPAR{alpha} activators for 24 hours and then stimulated with the specified cytokines for 3 hours. Total RNA (107 cells) was isolated by the guanidinium thiocyanate–phenol-chloroform method (RNAzol, Tel-Test) and 5 µg of RNA used in standard Northern blot analysis with a VCAM-1 probe.

VCAM-1 mRNA half-life was determined by stimulating ECs with TNF-{alpha} for 3 hours before blocking transcription by treatment with actinomycin D 5 µg/L. Cells then received fenofibrate for the times indicated; mRNA levels were compared with those of untreated cells.

Transient Transfections
To investigate the effect of PPAR{alpha} activators on VCAM-1 promoter activity, we transiently transfected BAECs with a series of deletional VCAM-1 promoter constructs, all containing the chloramphenicol acetyltransferase (CAT) reporter.20 [-755]F0.CAT is the putative full-length human VCAM-1 promoter containing AP-1, GATA, and NF-{kappa}B binding sites. [-98]F3.CAT lacks the AP-1 and GATA sites but retains NF-{kappa}B binding sites. [-44]F4.CAT lacks NF-{kappa}B binding sites (Figure 5ADown). BAECs, which are more easily transfectable than human ECs, were cotransfected via calcium phosphate precipitation21 with each reporter construct (5 µg) and a pCMV.ß-GAL (4 µg) as an internal control. Cells were stimulated (48 hours after transfection) with TNF-{alpha} 10 µg/L with or without fenofibrate 100 µmol/L. BAECs were then harvested after 36 hours, and lysates were subjected to CAT and ß-galactosidase assay (Tropix) as described.22 Normalized CAT activity was calculated as the ratio of CAT activity to ß-galactosidase activity. Results for each reporter construct were expressed as multiples of induction compared with transfected, unstimulated cells.



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Figure 5. Fenofibrate inhibits TNF-{alpha}–induced activation of human VCAM-1 promoter and activation of NF-{kappa}B. A, Deletional series of VCAM-1 promoter constructs used in transfection experiments. B, Bovine ECs were cotransfected with VCAM-1 promoter deletion constructs indicated and a ß-galactosidase expression construct (pCMV.ß-GAL). Transfected cells were stimulated with agents indicated for 36 hours, and assays were performed for CAT- and ß-galactosidase activity. Results for each construct were normalized to ß-galactosidase activity and expressed as multiples of induction compared with unstimulated cells. Bars represent mean±SEM (n=3); *P<0.05 vs TNF-{alpha}–stimulated cells. C, EMSA of human ECs pretreated with fenofibrate 100 µmol/L for 24 hours before TNF-{alpha} stimulation for 2 hours. Specificity was determined by addition of 40 ng unlabeled NF-{kappa}B oligonucleotide (cold probe). Supershift analysis was performed with anti-p50 and anti-p65 antibodies. As a control, nuclear extracts were incubated with nonspecific IgG. Similar results were seen in 3 independent experiments.

Electrophoretic Mobility Shift Assay
For electrophoretic mobility shift assays (EMSAs), human ECs were preincubated for 24 hours with fenofibrate 100 µmol/L and then stimulated for 2 hours with TNF-{alpha} 10 µg/L before nuclear extracts were prepared. The NF-{kappa}B oligonucleotide (CCTGGGTTTCCCCTTGAAGGGATTTCCCTCC) (Genosys Biotechnologies) spanning the 2 tandem NF-{kappa}B sites (as underlined above) in the human VCAM-1 promoter was end-labeled with [{gamma}-32P]ATP (3000 Ci/mmol) by T4 polynucleotide kinase (New England Biolabs) and purified (Sephadex G-25 columns, Pharmacia LKB Biotechnology). Nuclear extracts (5 µg) were incubated with the labeled NF-{kappa}B oligonucleotide under standard conditions.11 In the indicated experiments, nuclear extracts were incubated with anti-p50 [polyclonal rabbit anti-p50 (NLS)X, Santa Cruz] or anti-p65 (polyclonal rabbit anti-p65 AX, Santa Cruz) or nonspecific IgG before the addition of radiolabeled NF-{kappa}B probes. DNA-protein complexes were electrophoretically separated (5% nondenaturing polyacrylamide gel). Specificity was determined by addition of an excess of unlabeled (cold) NF-{kappa}B oligonucleotide to the nuclear extracts before formation of DNA-protein complexes.

Assessment of Total Protein Synthesis
Total protein synthesis was assessed as 35S-methionine incorporation as described previously.11

Statistical Analysis
Results of the experimental studies are reported as mean±SEM. Differences were analyzed by 1-way ANOVA followed by Fisher's protected least significant difference test. A value of P<0.05 was regarded as significant.


*    Results
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*Results
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Human ECs Express PPAR{alpha} In Vivo and In Vitro
Immunohistochemistry of human carotid artery specimens (n=6) revealed PPAR{alpha} staining in the EC nuclei (Figure 1ADown; blue staining, arrowheads). Parallel sections stained with goat IgG showed no immunostaining (Figure 1BDown). ECs were identified by immunoreactive CD31 (platelet and endothelial cell adhesion molecule-1) in parallel sections (Figure 1CDown; red staining).



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Figure 1. ECs express PPAR{alpha} in vivo and in vitro. A, PPAR{alpha} expression in nuclei of ECs of human carotid arteries (positive nuclei stained blue, arrowheads). B, Parallel sections stained with goat IgG show no signal, which suggests that staining for PPAR{alpha} is specific. C, Immunostaining of parallel sections with CD31 identifies endothelial cell layer at luminal surface of artery (stained red). Magnification x400 in all. Analysis of 6 separate carotid sections revealed similar results. D, Western blot analysis of cultured human saphenous vein ECs reveals PPAR{alpha} protein expression in nuclear extracts (Nucl). Identity of detected band was confirmed by comigration with a band from fibroblasts transfected with a PPAR{alpha} expression construct (Co). PPAR{alpha} is not seen in cytosolic fraction of ECs (Cyto). Three independent experiments showed similar results.

To demonstrate PPAR{alpha} expression in vitro in a homogeneous population of human ECs, Western blot analysis of cultured human saphenous vein ECs was performed. Consistent with the in situ findings, PPAR{alpha} protein was detected in nuclear but not cytosolic fractions. The identity of the detected band was confirmed by comigration with a band from fibroblasts transfected with a PPAR{alpha} expression construct (Figure 1DUp); untransfected fibroblasts reveal no such band (data not shown).

PPAR{alpha} but Not PPAR{gamma} Activators Reduce EC Surface Expression of VCAM-1
As expected, cell surface EIAs of human ECs revealed a marked increase of VCAM-1 expression in response to stimulation with TNF-{alpha} 10 µg/L. Pretreatment of ECs with the PPAR{alpha} activator fenofibrate 100 µmol/L or WY14643 250 µmol/L reduced VCAM-1 expression levels significantly, to 33±9% (P<0.01) or 52±2% (P<0.01) of TNF-{alpha}–stimulated cells, respectively (Figure 2ADown). Similar results were obtained by flow cytometry (data not shown). None of 3 different PPAR{gamma} activators (troglitazone, 10 µmol/L; 15d-PGJ2, 10 µmol/L; or BRL49653, 10 µmol/L); significantly affected TNF-{alpha}–induced VCAM-1 expression (Figure 2ADown). Treatment of unstimulated human ECs with PPAR{alpha} or PPAR{gamma} activators did not alter VCAM-1 expression (data not shown). Fenofibrate did not affect EC viability (>95% excluded trypan blue) or total protein synthesis (263±5x103 cpm/cm2 well in TNF-{alpha}–treated cells versus 283±22x103 cpm/cm2 well in TNF-{alpha}– and fenofibrate-treated cells; P=NS).



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Figure 2. PPAR{alpha} but not PPAR{gamma} activators inhibit cytokine-induced cell surface expression of VCAM-1 in human ECs. A and B, Cells were pretreated with PPAR{alpha} [100 µmol/L fenofibrate (feno), 250 µmol/L WY14643 (WY)] or PPAR{gamma} [10 µmol/L troglitazone (trogl), 10 µmol/L 15d-PGJ2 (PGJ2), 10 µmol/L BRL49653 (BRL)] activators for 24 hours and then stimulated with TNF-{alpha} 10 µg/L for 8 hours before cell surface EIAs were performed for VCAM-1 (A), ICAM-1, and E-selectin (B). Results are expressed as percent of TNF-{alpha}–stimulated cells (% control). Bars represent mean±SEM (VCAM-1, n=8; ICAM-1/E-selectin, n=4); *P<0.05, **P<0.01 vs control. C and D, PPAR{alpha} activators inhibit surface expression of VCAM-1 in human ECs in a time- and concentration-dependent manner. Cells were pretreated with fenofibrate 100 µmol/L for duration shown before stimulation with TNF-{alpha} 10 µg/L for 8 hours (C). ECs were pretreated with fenofibrate at concentrations shown for 24 hours, before stimulation with TNF-{alpha} 10 µg/L (D, solid bars), or IL-1{alpha} 10 µg/L (D, open bars). Results are expressed as percent of cytokine-stimulated cells (% control) as determined by cell surface EIA. Circles/bars represent mean±SEM (n=3); *P<0.05, **P<0.01 vs control.

Neither PPAR{alpha} nor PPAR{gamma} activators significantly reduced the TNF-{alpha}–induced cell surface expression of ICAM-1 (Figure 2BUp, solid bars) or E-selectin (Figure 2BUp, open bars) in ECs.

Fenofibrate Reduces Cytokine-Induced VCAM-1 Expression in a Time- and Concentration-Dependent Manner
To investigate the time- and concentration-dependence of PPAR{alpha} activator treatment on VCAM-1 expression, human ECs were pretreated with fenofibrate for different times or concentrations before stimulation with TNF-{alpha} and subsequent EIA determination of VCAM-1 expression. Inhibition of TNF-{alpha}–induced VCAM-1 expression depended on the time of fenofibrate exposure, with a maximal reduction after 24 hours of fenofibrate pretreatment (Figure 2CUp). In addition, fenofibrate inhibited VCAM-1 expression in human ECs induced by TNF-{alpha} (Figure 2DUp, solid bars) or IL-1{alpha} (Figure 2DUp, open bars) in a concentration-dependent manner with a maximal reduction at 100 µmol/L fenofibrate.

PPAR{alpha} Activators Inhibit the Adhesion of Monocyte-Like Cells on Human ECs
To investigate the potential functional relevance of PPAR{alpha} activator–reduced VCAM-1 expression in human ECs, we performed an in vitro adhesion assay using fluorescently labeled U937 cells and monolayers of human ECs. Stimulation of the EC monolayer with TNF-{alpha} increased the number of adherent cells from 9.1±1.5x103 cells/cm2 to 73.2±2.4x103 cells/cm2 (P<0.01) (Figure 3BDown). Pretreatment of ECs with fenofibrate or WY14643 before TNF-{alpha} stimulation reduced U937 cell adhesion significantly, to 36.7±2.2x103 cells/cm2 (P<0.01) or 37.3±4.3x103 cells/cm2 (P<0.01), respectively (Figure 3ADown and 3BDown). Preincubation of TNF-{alpha}–stimulated ECs with blocking anti-VCAM monoclonal antibody inhibited U937 cell adhesion almost completely (data not shown).



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Figure 3. PPAR{alpha} activators inhibit adhesion of U937 monocytoid cells to human ECs. A, Fluorescein-labeled U937 cells were added to TNF-{alpha} 10 µg/L–stimulated human EC monolayers with or without fenofibrate pretreatment. Fluorescence microscopy shows adherent U937 cells (green) on ECs. B, Quantification of U937 adherence on EC monolayers after EC pretreatment with fenofibrate (feno) 100 µmol/L or WY14643 (WY) 250 µmol/L as determined by fluorescence assay. Results are expressed as cells/cm2. Bars represent mean±SEM (n=3); **P<0.01 vs TNF-{alpha} stimulated cells.

PPAR{alpha} Activators Reduce Cytokine-Induced VCAM-1 mRNA Levels in Human ECs
Northern blot analysis revealed increased VCAM-1 mRNA levels after 3 hours of stimulation of human ECs with TNF-{alpha} 10 µg/L, which could be inhibited in a concentration-dependent manner by pretreatment with the PPAR{alpha} activators fenofibrate or WY14643 (Figure 4ADown). Similar results were seen when ECs were stimulated with IL-1{alpha} instead of TNF-{alpha} (data not shown). In the presence of actinomycin D, fenofibrate did not significantly reduce VCAM-1 mRNA half-life compared with control cells (6.4±0.6 hours in control cells versus 6.4±1.1 hours in fenofibrate-stimulated cells, P=NS), indicating that the inhibitory effect of PPAR{alpha} activators on VCAM-1 does not result from altered mRNA stability (Figure 4BDown).



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Figure 4. PPAR{alpha} activators inhibit VCAM-1 mRNA expression but not mRNA half-life in human ECs. A, Northern blot analysis of ECs pretreated with fenofibrate or WY14643 at concentrations shown for 24 hours before stimulation with TNF-{alpha} 10 µg/L for 3 hours (top). Ethidium bromide staining (bottom) demonstrates equal loading of intact RNA. Three independent experiments yielded similar results. B, Densitometry analysis of TNF-{alpha}–induced VCAM-1 mRNA levels in absence or presence of fenofibrate 100 µmol/L as measured by Northern blot analysis of actinomycin D-treated ECs. Actinomycin D and fenofibrate were added to ECs 3 hours after TNF-{alpha} stimulation (0 hours); cells were harvested at times indicated. Amount of mRNA at each time point was compared with mRNA levels after 3 hours of TNF-{alpha} stimulation at time 0 hours (ordinate labeled as relative mRNA level). Results are shown as mean±SEM of 3 independent experiments.

Fenofibrate Inhibits TNF-{alpha}–Induced VCAM-1 Promoter Activity
To determine potential sites of interaction of PPAR{alpha} activators with the VCAM-1 promoter, we performed transient transfections of various deletional VCAM-1 promoter reporter CAT constructs in bovine ECs (Figure 5AUp). After stimulation for 36 hours, CAT activity, as well as the activity of a cotransfected ß-galactosidase construct, was measured (Figure 5BUp). TNF-{alpha} stimulation of cells transfected with the full-length promoter construct (F0) led to a 5.9±1.6-fold increase in normalized promoter activity (CAT/ß-galactosidase activity). Treatment with fenofibrate significantly reduced this response to 2.4±0.4-fold (P<0.05 compared with TNF-{alpha}–stimulated cells). Transfection studies with a VCAM-1 promoter deletion construct (F3) containing the 2 tandem NF-{kappa}B sites, but lacking the AP-1 and GATA sites, revealed similar PPAR{alpha} agonist responsiveness. Stimulation of transfected cells with TNF-{alpha} enhanced relative CAT activity 3.4±0.6-fold; treatment with fenofibrate significantly inhibited this increase to 1.4±0.2 (P<0.05 compared with TNF-{alpha}–stimulated cells). Transfection studies with the VCAM-1 deletion construct (F4), lacking the 2 NF-{kappa}B sites, revealed no change in relative CAT activity after treatment with TNF-{alpha} or fenofibrate. In the case of all constructs, treatment with fenofibrate alone had no effect on relative CAT activity compared with control, consistent with the absence of consensus PPAR response elements in the VCAM promoter.

Fenofibrate Inhibits TNF-{alpha}–Induced NF-{kappa}B Activation
EMSAs that used radiolabeled oligonucleotides corresponding to the 2 tandem NF-{kappa}B sites in the VCAM-1 promoter were performed to investigate whether PPAR{alpha} activators inhibit NF-{kappa}B activation. Fenofibrate decreased the amount of shifted complexes induced by TNF-{alpha}, which suggests that PPAR{alpha} activators directly inhibit NF-{kappa}B activation (Figure 5CUp).

To further investigate these findings, supershift analysis was performed to define fenofibrate effects on the NF-{kappa}B transcriptional complex (Figure 5CUp). As described by others, TNF-{alpha}–induced NF-{kappa}B activation involves the p50 and p65 subunits. Fenofibrate treatment of similarly stimulated ECs resulted in a parallel decrease in the amount of supershifted p50 and p65 complexes.


*    Discussion
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*Discussion
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The present study reports expression of PPAR{alpha} in ECs of human arteries and reduction of cytokine-induced VCAM-1 expression by PPAR{alpha} agonists through inhibition of NF-{kappa}B. This inhibition of VCAM-1 expression by PPAR{alpha} activators decreased adhesion of monocyte-like cells to stimulated ECs. PPAR{gamma} activators exhibited no such effects.

Initially, PPAR{alpha} was thought to be limited to tissues such as liver and fat, in which it participates in the regulation of lipid, and in particular fatty acid, metabolism.23 24 A recent study demonstrated PPAR{alpha} expression in human vascular smooth muscle cells with inhibition of IL-6, cyclooxygenase-2, and prostaglandin gene expression by the same PPAR{alpha} activators used here (WY14643, fenofibrate).25 Human ECs, like vascular smooth muscle cells, express both PPAR{alpha} and PPAR{gamma},16 with each PPAR probably having unique effects relevant to vascular biology in these cellular settings. We have previously shown PPAR{gamma} expression in ECs and suggested a role of PPAR{gamma} in the regulation of plasminogen activator inhibitor-1 gene expression.16 We report here that PPAR{gamma} activation does not appear to be involved in the regulation of adhesion molecule expression (Figure 2Up).

In contrast, 2 different established PPAR{alpha} activators, fenofibrate and WY14643, inhibit cytokine-induced VCAM-1 expression in ECs. These agents probably act in ECs by activating PPAR{alpha}. Both of these agonists have high binding affinities to PPAR{alpha} while selectively interacting with PPAR{alpha}, with little to no activity on other PPAR isoforms.12 26 The fibrates used here produced inhibitory effects at concentrations similar to those that induced established PPAR{alpha} response genes, eg, apolipoprotein A-II.27 In contrast, various PPAR{gamma} activators, among them the highly specific PPAR{gamma} agonist BRL49653,12 26 added either before or after (data not shown) cytokine treatment, had no effect on VCAM-1 levels. Therefore, PPAR{gamma} activation by PPAR{alpha} agonists seems an unlikely explanation for our results.

The reduction of VCAM-1 expression by PPAR{alpha} activators appears at a transcriptional level because fenofibrate did not alter VCAM-1 mRNA half-life but did inhibit TNF-{alpha}–induced VCAM-1 promoter activity. This effect appears to stem from inhibition of NF-{kappa}B activation, as suggested by the reduction of CAT activity of the promoter construct lacking NF-{kappa}B binding sites ([-44]F4) and gel shift assays. The inhibition of NF-{kappa}B activation by PPAR{alpha} could result from direct interference with NF-{kappa}B binding to the VCAM-1 promoter, as postulated for the interaction of NF-{kappa}B with the estrogen receptor.28 Alternatively, the inhibitory effects might occur through competitive binding of transcriptional coactivators by PPAR{alpha} or by PPAR{alpha}-induced transcription factors. Such "negative crosstalk" has been suggested between other nuclear receptors and the transcription factor AP-1.29 In fact, one such coactivator, p300, involved in VCAM-1 expression30 reportedly interacts with PPAR{alpha}.31 Our data also do not exclude a PPAR{alpha} effect on I{kappa}B or an effect on the transcription of NF-{kappa}B subunits p50 and p65.

The genes encoding ICAM-1 and E-selectin have NF-{kappa}B sites in their promoter; nonetheless, PPAR{alpha} activators did not alter ICAM-1 or E-selectin expression. This result may be explained in several ways. It could derive from the distinct nature of the VCAM-1 promoter, either its NF-{kappa}B sites or another undefined VCAM-1 transcriptional element,32 ie, the interferon regulatory factor-1 site. We saw no effect of fenofibrate on the known TNF-{alpha} induction of interferon regulatory factor-1 expression in ECs (data not shown).22 Other mechanisms might include competition for transcriptional coactivators as described above. Interestingly, retinoic acid, acting through the retinoic acid receptor, another nuclear receptor family member, also appears to inhibit activation of the NF-{kappa}B site of the VCAM-1 promoter, but not NF-{kappa}B activation of either the ICAM-1 or E-selectin promoters.33

Inhibition of VCAM-1 expression in human ECs by PPAR{alpha} activators, with a consequent decrease in monocyte adherence to ECs, has important implications regarding atherogenic mechanisms as well as the treatment of atherosclerosis, especially given the similarity of fenofibrate concentrations used here and those achieved in patients.34 Human angiographic studies have reported that fenofibrate treatment reduces coronary artery stenoses.35 Epidemiological36 as well as experimental work37 38 suggests that the intake of polyunsaturated fatty acids, some of them also known PPAR{alpha} agonists,12 reduces the incidence of cardiovascular events. Given the likely involvement of VCAM-1 in monocyte recruitment to early atherosclerotic lesions,6 our findings suggest PPAR{alpha} as a potential mediator of critical inflammatory processes in the vessel wall.


*    Acknowledgments
 
This work was supported by grants from the Deutsche Forschungsgemeinschaft to Dr Marx (MA 2047/1-1) and from the NIH/NHLBI to Dr Libby (HL-48743) and to Dr Plutzky (HL-03107). We thank Eugenia Shvartz, Dr Maria Muszynski, Irina Chulsky, Dr Todd Bourcier, Dr Mitch Lazar, and Dr Francis W. Luscinskas for their assistance.


*    Footnotes
 
Drs Libby and Plutzky are speakers/consultants for Abbott Laboratories, Groupe Fournier, and Parke-Davis, Warner-Lambert Company.

Received December 31, 1998; revision received April 6, 1999; accepted April 6, 1999.


*    References
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up arrowAbstract
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*References
 
1. Poole JCF, Florey HW. Changes in the endothelium of the aorta and the behavior of macrophages in experimental atheroma of rabbits. J Pathol Bacteriol. 1958;75:245–253.[Medline] [Order article via Infotrieve]

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