Cited by 121Endoplasmic Reticulum Stress and DiseaseAtherosclerosis and Cardiovascular DiseasesIon Channels and Receptors

The UPR in atherosclerosis

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Zhou, Alex X., Tabas, Ira·2013·Seminars in Immunopathology

Abstract

Multiple systemic factors and local stressors in the arterial wall can disturb the functions of endoplasmic reticulum (ER), causing ER stress in endothelial cells (ECs), smooth muscle cells (SMCs), and macrophages during the initiation and progression of atherosclerosis. As a protective response to restore ER homeostasis, the unfolded protein response (UPR) is initiated by three major ER sensors: protein kinase RNA-like ER kinase (PERK), inositol-requiring protein 1α (IRE1α), and activating transcription factor 6 (ATF6). The activation of the various UPR signaling pathways displays a temporal pattern of activation at different stages of the disease. The ATF6 and IRE1α pathways that promote the expression of protein chaperones in ER are activated in ECs in athero-susceptible regions of pre-lesional arteries and before the appearance of foam cells. The PERK pathway that reduces ER protein client load by blocking protein translation is activated in SMCs and macrophages in early lesions. The activation of these UPR signaling pathways aims to cope with the ER stress and plays a pro-survival role in the early stage of atherosclerosis. However, with the progression of atherosclerosis, the extended duration and increased intensity of ER stress in lesions lead to prolonged and enhanced UPR signaling. Under this circumstance, the PERK pathway induces expression of death effectors, and possibly IRE1α activates apoptosis signaling pathways, leading to apoptosis of macrophages and SMCs in advanced lesions. Importantly, UPR-mediated cell death is associated with plaque instability and the clinical progression of atherosclerosis. Moreover, UPR signaling is linked to inflammation and possibly to macrophage differentiation in lesions. Therapeutic approaches targeting the UPR may have promise in the prevention and/or regression of atherosclerosis. However, more progress is needed to fully understand all of the roles of the UPR in atherosclerosis and to harness this information for therapeutic advances.

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Authors
Zhou, A. X., & Tabas, I.
Affiliations
  • Columbia University Irving Medical Center (US)
  • Columbia University (US)
Corresponding author
Zhou, Alex X.
Venue
Seminars in Immunopathology
Published
2013-04-04
Volume
35
Issue
3
Pages
321-332
ISSN
  • 1863-2297 (ISSN-L)
  • 1863-2300
OpenAlex
W2023441054
Cited by
121
References
91
Citations by year
2026: 5 · 2025: 5 · 2024: 7 · 2023: 8 · 2022: 9 · 2021: 7 · 2020: 6 · 2019: 11 · 2018: 11 · 2017: 12 · 2016: 12 · 2015: 11 · 2014: 14 · 2013: 3
FWCI
1.53
Type
journal article
Language
en
Open access
Locations
  • Seminars in Immunopathology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute (R01HL106019, P01HL087123, R01HL075662, R01HL107497)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Endoplasmic Reticulum Stress and Disease
  • Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
  • Life Sciences › Neuroscience › Sensory Systems › Ion Channels and Receptors
Keywords
unfolded protein response, atherosclerosis, endoplasmic reticulum stress, PERK pathway, ATF6 pathway, endothelial cells, vascular smooth muscle cells, macrophages, apoptosis, plaque vulnerability, inflammation, macrophage differentiation
MeSH terms
Animals, Cell Differentiation, Humans, Inflammation, Macrophages, Apoptosis, Atherosclerosis, Unfolded Protein Response, Endoplasmic Reticulum Stress

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