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Defective autophagy in vascular smooth muscle cells accelerates senescence and promotes neointima formation and atherogenesis
Open accessAbstract
Autophagy is triggered in vascular smooth muscle cells (VSMCs) of diseased arterial vessels. However, the role of VSMC autophagy in cardiovascular disease is poorly understood. Therefore, we investigated the effect of defective autophagy on VSMC survival and phenotype and its significance in the development of postinjury neointima formation and atherosclerosis. Tissue-specific deletion of the essential autophagy gene Atg7 in murine VSMCs (atg7−/− VSMCs) caused accumulation of SQSTM1/p62 and accelerated the development of stress-induced premature senescence as shown by cellular and nuclear hypertrophy, CDKN2A-RB-mediated G1 proliferative arrest and senescence-associated GLB1 activity. Transfection of SQSTM1-encoding plasmid DNA in Atg7+/+ VSMCs induced similar features, suggesting that accumulation of SQSTM1 promotes VSMC senescence. Interestingly, atg7−/− VSMCs were resistant to oxidative stress-induced cell death as compared to controls. This effect was attributed to nuclear translocation of the transcription factor NFE2L2 resulting in upregulation of several antioxidative enzymes. In vivo, defective VSMC autophagy led to upregulation of MMP9, TGFB and CXCL12 and promoted postinjury neointima formation and diet-induced atherogenesis. Lesions of VSMC-specific atg7 knockout mice were characterized by increased total collagen deposition, nuclear hypertrophy, CDKN2A upregulation, RB hypophosphorylation, and GLB1 activity, all features typical of cellular senescence. To conclude, autophagy is crucial for VSMC function, phenotype, and survival. Defective autophagy in VSMCs accelerates senescence and promotes ligation-induced neointima formation and diet-induced atherogenesis, implying that autophagy inhibition as therapeutic strategy in the treatment of neointimal stenosis and atherosclerosis would be unfavorable. Conversely, stimulation of autophagy could be a valuable new strategy in the treatment of arterial disease.
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“Loss of autophagy can also drive VSMC senescence 75 .”
From Vascular smooth muscle cells in atherosclerosis (2019) · cites this paper as [75]
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Self-citationLncRNA-modulated autophagy in plaque cells: a new paradigm of gene regulation in atherosclerosis?
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Li, J., Wang, Y., Shrestha, S., Gewirtz, A. T., Ding, Y., & Zou, J. (2025) · Nutrients · doi:10.3390/nu17172887 · Cited by 12
Zheng, X., Yu, Q., Shang, D., Yin, C., Xie, D., Huang, T., Du, X., Wang, W., Yan, X., Zhang, C., et al. (2022) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2022.01.009 · Cited by 12
Gao, W., Yang, T., Wang, B., Liu, Q., Li, Q., Zhou, X., Zheng, C., & Chen, P. (2024) · Clinical and Experimental Pharmacology and Physiology · doi:10.1111/1440-1681.13845 · Cited by 12
“12 Conversely, the stimulation of autophagy has been shown to diminish the formation of VSMC-derived foam cells, 9,10 thereby positioning the autophagy pathway as a viable target for ameliorating lipid accumulation and treating AS.”
BackgroundMochida, A., Mita, T., Azuma, K., Osonoi, Y., Masuyama, A., Nakajima, K., Goto, H., Nishida, Y., Miyatsuka, T., Mitsumata, M., et al. (2021) · Physiological Reports · doi:10.14814/phy2.15000 · Cited by 12
“Both Grootaert et al. and our group demonstrated that SMC- specific Atg7 deficiency increased the medial thickness and resulted in the development of advanced plaques with increased collagen content (Grootaert et al., 2015; Osonoi et al., 2018).”
BackgroundCellular senescence and abdominal aortic aneurysm: From pathogenesis to therapeutics
Wang, D., Hao, X., Jia, L., Jing, Y., Jiang, B., & Xin, S. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.999465 · Cited by 14
“It was reported that a large amount of SQSTM1/p62 was accumulated in the VSMCs of ATG7 knockout mice, which accelerated the occurrence of SIPS, such as cell enlargement, nuclear hyperplasia, cell cycle arrest and increased SA-β-Gal activity (143).”
BackgroundProtoporphyrin IX-mediated sonodynamic therapy promotes autophagy in vascular smooth muscle cells
Li, Q., Kang, J., Xiong, X., Liu, Y., Cao, W., Liu, Y., & Li, Y. (2017) · Oncology Letters · doi:10.3892/ol.2017.6394 · Cited by 12
A potential role of autophagy-mediated vascular senescence in the pathophysiology of HFpEF
Sanhueza‐Olivares, F., Troncoso, M. F., la Fuente, F. P.-D., Martinez-Bilbao, J., Riquelme, J. A., Norambuena‐Soto, I., Villa, M., Lavandero, S., Castro, P., & Chiong, M. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.1057349 · Cited by 13
Kang, S., Park, J.-W., Cho, E., Kim, D., Ye, S., Jeong, E. T., Jun, S., & Kang, N. G. (2025) · Biomedicines · doi:10.3390/biomedicines13102395 · Cited by 13
“Previous studies observed that a deficient autophagy accelerates senescence [49,50] and promotes the development of not only aging-related phenotypes but also diverse pathologic conditions such as Alzheimer’s disease, diabetes and obesity [50,51].”
Fuerlinger, A., Stockner, A., Sedej, S., & Abdellatif, M. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-024-02566-8 · Cited by 12
The multifaceted role of autophagy and mitophagy in cardiovascular health and disease
Nàger, M., Calvoli, M., Larsen, K. B., & Birgisdottir, Å. B. (2025) · Autophagy Reports · doi:10.1080/27694127.2025.2572511 · Cited by 11
“Specific deletion of Atg7 in VSMCs leads to accelerated senescence, neointima formation, and diet-induced atherogenesis in atheroprone ( apoe −/− ) mice [148] .”
Shen, X., Zou, J., Li, F., Zhang, T., & Guo, T. (2018) · Molecular Medicine Reports · doi:10.3892/mmr.2018.8937 · Cited by 11
Metformin protects against abdominal aortic aneurysm by Atg7-induced autophagy
Guo, J., Wang, Z., Xue, M., Mi, L., Zhao, M., Ma, C., Wu, J., & Han, X. (2021) · Advances in Clinical and Experimental Medicine · doi:10.17219/acem/142026 · Cited by 11
Defective Protein Catabolism in Atherosclerotic Vascular Inflammation
Miyazaki, T., & Miyazaki, A. (2017) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2017.00079 · Cited by 11
“Interestingly, VSMC-specific deficiency of autophagy exacerbated high fat diet-induced atherosclerosis in Apoe−/− mice, which was accompanied by a thickening of the fibrous cap (64).”
BackgroundWang, B., Dong, G., Zhang, Q., Yan, F., Li, Z.-H., Li, C., Zhang, H., Ma, Q., Dai, J., Si, C., et al. (2019) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2019.8317 · Cited by 12
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Circadian misalignment promotes vascular smooth muscle cell apoptosis via defective autophagy
Guo, Z., Yu, B., Li, X., Yang, X., Wang, C., & Fan, L. (2021) · Journal of Molecular Histology · doi:10.1007/s10735-021-10000-6 · Cited by 10
Circular RNAs Involved in the Regulation of the Age-Related Pathways
Wang, S., Xiao, F., Li, J., Fan, X., He, Z., Yan, T., Yang, M., & Yang, D. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms231810443 · Cited by 10
The Potential Role of Connexins in the Pathogenesis of Atherosclerosis
Kiełbowski, K., Bakinowska, E., & Pawlik, A. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24032600 · Cited by 10
Zhang, W., Cheng, Y., Xiao, Y., Sun, Y., Lin, Y., Li, Q., & Cai, W. (2023) · Frontiers in Bioengineering and Biotechnology · doi:10.3389/fbioe.2023.1199785 · Cited by 10
Chen, Y., Zhang, H., Liu, H., Li, K., Jia, M., & Su, X. (2018) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2018.02.028 · Cited by 10
Munck, D. G. D., Moudt, S. D., Roth, L., Meyer, G. R. Y. D., Martinet, W., & Fransen, P. F. (2020) · Frontiers in Physiology · doi:10.3389/fphys.2020.548943 · Cited by 10
“Indeed, changes in peripheral vascular resistance due to structural and functional alterations in large elastic arteries and small resistance arteries are typical features of hypertension development (Harvey et al., 2015; Brown et al., 2018).”
BackgroundSelf-citationp62/SQSTM1: A potential molecular target for treatment of atherosclerosis
Liang, X., & Guan, X. (2017) · Frontiers in Laboratory Medicine · doi:10.1016/j.flm.2017.06.007 · Cited by 10
Hewedy, W. A., Abdulmalek, S. A., Ghareeb, D. A., & Habiba, E. S. (2023) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-023-02627-x · Cited by 9
“Medial calcification occurs within elastic lamellae of affected arteries where the vascular smooth muscle cells (VSMCs) undergo a phenotypic transition from contractile cells into osteogenic cells that express key osteogenic markers and become capable of hydroxyapatite formation (Johnson et al. 2006) (Wu et al. 2013).”
BackgroundInfluentialThe Role of Hydrogen Sulfide in Plaque Stability
Lin, Q., & Geng, B. (2022) · Antioxidants · doi:10.3390/antiox11122356 · Cited by 9
“VSMC specific deletion human antigen R (HuR) or autophagy related 7 (ATG7) [85,86] caused autophagy defective, which promoted VSMC senescence and death, resulting in plaque instability.”
BackgroundUnbalanced Redox With Autophagy in Cardiovascular Disease
Jeong, S.-J., & Oh, G. (2023) · Journal of Lipid and Atherosclerosis · doi:10.12997/jla.2023.12.2.132 · Cited by 10
Chen, Y., Bao, M., Liu, J.-T., Bao, H., Zhang, S., Lou, Y., & Qi, Y. (2022) · Journal of Molecular and Cellular Cardiology · doi:10.1016/j.yjmcc.2022.10.001 · Cited by 10
Zuo, J., Guo, S., & Qin, X. (2023) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-023-02558-7 · Cited by 9
“In animal models of AS, defects in autophagy have been shown to result in apoptosis, increased inflammation, and disrupted cholesterol metabolism (Grootaert et al. 2015).”
BackgroundResult
Metadata
- Authors
- Grootaert, M. O., da Costa Martins, P. A., Bitsch, N., Pintelon, I., De Meyer, G. R., Martinet, W., & Schrijvers, D. M.
- Affiliations
- University of Antwerp (BE)
- Department of Cardiology; Cardiovascular Research Institute Maastricht; Maastricht, The Netherlands
- Maastricht University (NL)
- Laboratory of Physiopharmacology; University of Antwerp; Antwerp, Belgium
- Corresponding author
- Schrijvers, Dorien M
- Venue
- Autophagy
- Publisher
- Informa UK Limited
- Published
- 2015-11-02
- Volume
- 11
- Issue
- 11
- Pages
- 2014-2032
- ISSN
- 1554-8627 (ISSN-L)
- 1554-8635
- PMC
- PMC4824610
- OpenAlex
- W2200751652
- Cited by
- 267
- References
- 73
- Citations by year
- 2026: 8 · 2025: 20 · 2024: 22 · 2023: 28 · 2022: 28 · 2021: 35 · 2020: 30 · 2019: 31 · 2018: 33 · 2017: 19 · 2016: 13
- FWCI
- 17.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Autophagy (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Digital Access to Libraries (submittedVersion, other-oa)
- Funders
- Fonds Wetenschappelijk Onderzoek (G044312N)
- Vlaamse regering
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Autophagy in Disease and Therapy
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Telomeres, Telomerase, and Senescence
- Keywords
- vascular smooth muscle cells, cellular senescence, neointima formation, atherosclerosis, ATG7, p62, stress-induced premature senescence, Nrf2, oxidative stress resistance, GLB1, MMP-9, CXCL12, collagen deposition
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