Cyclooxygenase-2 in Endothelial and Vascular Smooth Muscle Cells Restrains Atherogenesis in Hyperlipidemic Mice
Background—Placebo controlled trials of nonsteroidal antinflammatory drugs (NSAIDs) selective for inhibition of COX-2 reveal an emergent cardiovascular hazard in patients selected for low risk of heart disease. Postnatal global deletion of COX-2 accelerates atherogenesis in hyperlipidemic mice, a process delayed by selective enzyme deletion in macrophages.
Methods and Results—Here, selective depletion of COX-2 in vascular smooth muscle cells (VSMCs) and endothelial cells (ECs) depressed biosynthesis of prostaglandin (PG)I2 and PGE2, elevated blood pressure and accelerated atherogenesis in Ldlr knockout (KO) mice. Deletion of COX-2 in VSMCs and ECs coincided with an increase in COX-2 expression in lesional macrophages and increased biosynthesis of thromboxane. Increased accumulation of less organized intimal collagen, laminin, α-smooth muscle actin and matrix-rich fibrosis was also apparent in lesions of the mutants.
Conclusions—Although atherogenesis is accelerated in global COX-2 KOs, consistent with evidence of risk transformation during chronic NSAID administration, this masks the contrasting effects of enzyme depletion in macrophages versus VSMCs and ECs. Targeting delivery of COX-2 inhibitors to macrophages may conserve their efficacy while limiting cardiovascular risk.
- Received December 3, 2013.
- Revision received January 27, 2014.
- Accepted February 4, 2014.