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Circulation. 2001;104:3103-3108
doi: 10.1161/hc5001.100631
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(Circulation. 2001;104:3103.)
© 2001 American Heart Association, Inc.


Basic Science Reports

Toll-Like Receptor-4 Is Expressed by Macrophages in Murine and Human Lipid-Rich Atherosclerotic Plaques and Upregulated by Oxidized LDL

Xiaoou Helen Xu, MD; Prediman K. Shah, MD; Emmanuelle Faure, PhD; Ozlem Equils, MD; Lisa Thomas, BS; Michael C. Fishbein, MD; Daniel Luthringer, MD; Xiao-Ping Xu, MD; Tripathi B. Rajavashisth, PhD; Juliana Yano, BS; Sanjay Kaul, MD; Moshe Arditi, MD

From the Atherosclerosis Research Center, Burns and Allen Research Institute, Division of Cardiology (X.H.X., P.K.S., X.-P.X., T.B.R., J.Y., S.K.), the Division of Pediatric Infectious Diseases, Steven Spielberg Pediatric Research Center (E.F., O.E., L.T., M.A.), the Department of Pathology, UCLA School of Medicine (M.C.F.), and the Department of Pathology, Cedars-Sinai Medical Center (D.L.), Los Angeles, Calif.

Correspondence to Moshe Arditi, MD, Cedars-Sinai Medical Center, Division of Pediatric Infectious Diseases, 8700 Beverly Blvd, Room 4220, Los Angeles, CA 90048. E-mail moshe.arditi{at}cshs.org

Background Inflammation is implicated in atherogenesis and plaque disruption. Toll-like receptor 2 (TLR-2) and TLR-4, a human homologue of drosophila Toll, play an important role in the innate and inflammatory signaling responses to microbial agents. To investigate a potential role of these receptors in atherosclerosis, we assessed the expression of TLR-2 and TLR-4 in murine and human atherosclerotic plaques.

Methods and Results Aortic root lesions of high-fat diet-fed apoE-deficient mice (n=5) and human coronary atherosclerotic plaques (n=9) obtained at autopsy were examined for TLR-4 and TLR-2 expression by immunohistochemistry. Aortic atherosclerotic lesions in all apoE-deficient mice expressed TLR-4, whereas aortic tissue obtained from control C57BL/6J mice showed no TLR-4 expression. All 5 lipid-rich human plaques expressed TRL-4, whereas the 4 fibrous plaques and 4 normal human arteries showed no or minimal expression. Serial sections and double immunostaining showed TLR-4 colocalizing with macrophages both in murine atherosclerotic lesions and at the shoulder region of human coronary artery plaques. In contrast to TLR-4, none of the plaques expressed TLR-2. Furthermore, basal TLR-4 mRNA expression by human monocyte-derived macrophages was upregulated by ox-LDL in vitro.

Conclusions Our study demonstrates that TLR-4 is preferentially expressed by macrophages in murine and human lipid-rich atherosclerotic lesions, where it may play a role to enhance and sustain the innate immune and inflammatory responses. Moreover, upregulation of TLR-4 in macrophages by oxidized LDL suggests that TLR-4 may provide a potential pathophysiological link between lipids and infection/inflammation and atherosclerosis.


Key Words: receptors • inflammation • cells • atherosclerosis • lipoproteins




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Cardiovasc ResHome page
D. de Kleijn and G. Pasterkamp
Toll-like receptors in cardiovascular diseases
Cardiovasc Res, October 15, 2003; 60(1): 58 - 67.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
J. B. Rice, L. L. Stoll, W.-G. Li, G. M. Denning, J. Weydert, E. Charipar, W. E. Richenbacher, F. J. Miller Jr, and N. L. Weintraub
Low-Level Endotoxin Induces Potent Inflammatory Activation of Human Blood Vessels: Inhibition by Statins
Arterioscler Thromb Vasc Biol, September 1, 2003; 23(9): 1576 - 1582.
[Abstract] [Full Text] [PDF]


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CirculationHome page
S. M. Boekholdt, W. R.P. Agema, R. J.G. Peters, A. H. Zwinderman, E. E. van der Wall, P. H. Reitsma, J. J.P. Kastelein, and J. W. Jukema
Variants of Toll-Like Receptor 4 Modify the Efficacy of Statin Therapy and the Risk of Cardiovascular Events
Circulation, May 20, 2003; 107(19): 2416 - 2421.
[Abstract] [Full Text] [PDF]


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J. Biol. Chem.Home page
Y. I. Miller, S. Viriyakosol, C. J. Binder, J. R. Feramisco, T. N. Kirkland, and J. L. Witztum
Minimally Modified LDL Binds to CD14, Induces Macrophage Spreading via TLR4/MD-2, and Inhibits Phagocytosis of Apoptotic Cells
J. Biol. Chem., January 10, 2003; 278(3): 1561 - 1568.
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CirculationHome page
A. Vink, A. H. Schoneveld, J. J. van der Meer, B. J. van Middelaar, J. P.G. Sluijter, M. B. Smeets, P. H.A. Quax, S. K. Lim, C. Borst, G. Pasterkamp, et al.
In Vivo Evidence for a Role of Toll-Like Receptor 4 in the Development of Intimal Lesions
Circulation, October 8, 2002; 106(15): 1985 - 1990.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
Q. Xu
Role of Heat Shock Proteins in Atherosclerosis
Arterioscler Thromb Vasc Biol, October 1, 2002; 22(10): 1547 - 1559.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
G. K. Hansson, P. Libby, U. Schonbeck, and Z.-Q. Yan
Innate and Adaptive Immunity in the Pathogenesis of Atherosclerosis
Circ. Res., August 23, 2002; 91(4): 281 - 291.
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NEJMHome page
S. Kiechl, E. Lorenz, M. Reindl, C. J. Wiedermann, F. Oberhollenzer, E. Bonora, J. Willeit, and D. A. Schwartz
Toll-like Receptor 4 Polymorphisms and Atherogenesis
N. Engl. J. Med., July 18, 2002; 347(3): 185 - 192.
[Abstract] [Full Text] [PDF]


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CirculationHome page
J. A. Vita and J. Loscalzo
Shouldering the Risk Factor Burden: Infection, Atherosclerosis, and the Vascular Endothelium
Circulation, July 9, 2002; 106(2): 164 - 166.
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J. Lipid Res.Home page
M. G. Netea, B. J. Kullberg, P. N. M. Demacker, L. E. H. Jacobs, T. J. G. Verver-Jansen, A. Hijmans, L. H. J. van Tits, J. G. J. Hoenderop, P. H. G. M. Willems, J. W. M. Van der Meer, et al.
Native LDL potentiate TNF{alpha} and IL-8 production by human mononuclear cells
J. Lipid Res., July 1, 2002; 43(7): 1065 - 1071.
[Abstract] [Full Text] [PDF]


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CirculationHome page
K. Edfeldt, J. Swedenborg, G. K. Hansson, and Z.-q. Yan
Expression of Toll-Like Receptors in Human Atherosclerotic Lesions: A Possible Pathway for Plaque Activation
Circulation, March 12, 2002; 105(10): 1158 - 1161.
[Abstract] [Full Text] [PDF]


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J. Immunol.Home page
Y. Bulut, E. Faure, L. Thomas, H. Karahashi, K. S. Michelsen, O. Equils, S. G. Morrison, R. P. Morrison, and M. Arditi
Chlamydial Heat Shock Protein 60 Activates Macrophages and Endothelial Cells Through Toll-Like Receptor 4 and MD2 in a MyD88-Dependent Pathway
J. Immunol., February 1, 2002; 168(3): 1435 - 1440.
[Abstract] [Full Text] [PDF]