Thromb Haemost 2024; 124(06): 568-580
DOI: 10.1055/a-2173-3602
Atherosclerosis and Ischaemic Disease

Macrophage Ferroptosis Promotes MMP2/9 Overexpression Induced by Hemin in Hemorrhagic Plaque

Bicheng Li*
1   Department of Cardiology, The First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P. R. China
,
Minqiao Lu*
2   Department of Pathophysiology and Key Laboratory of Cardiovascular Pathophysiology, Harbin Medical University, Key Laboratory of Cardiovascular Medicine Research (Harbin Medical University), Ministry of Education, Harbin, P. R. China
,
Hui Wang
1   Department of Cardiology, The First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P. R. China
,
Siqi Sheng
1   Department of Cardiology, The First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P. R. China
,
Shuyuan Guo
1   Department of Cardiology, The First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P. R. China
,
Jia Li
1   Department of Cardiology, The First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P. R. China
,
Ye Tian
1   Department of Cardiology, The First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, P. R. China
2   Department of Pathophysiology and Key Laboratory of Cardiovascular Pathophysiology, Harbin Medical University, Key Laboratory of Cardiovascular Medicine Research (Harbin Medical University), Ministry of Education, Harbin, P. R. China
› Author Affiliations

Funding This work was supported by the National Key Scientific Instrument and Equipment Development Projects of China (81727809), the Young Scientist Fund of the National Natural Science Foundation of China (82200485), the Scientific Research Fund of the First Affiliated Hospital of Harbin Medical University (Doctoral Fund) (20201306), the Scientific Research Project of Heilongjiang Provincial Health Commission (2020-136), and the Support Project for Outstanding Young Talents of the First Affiliated Hospital of Harbin Medical University (2021Y07).


Preview

Abstract

Background Intra-plaque hemorrhage (IPH) leads to rapid plaque progression and instability through upregulation of matrix metalloproteinases (MMPs) and collagen degradation. Hemoglobin-derived hemin during IPH promotes plaque instability. We investigated whether hemin affects MMP overexpression in macrophages and explored the underlying mechanisms.

Material and Methods In vivo, hemorrhagic plaque models were established in rabbits and ApoE−/− mice. Ferrostatin-1 was used to inhibit ferroptosis. Plaque size, collagen, and MMP2/9 levels were evaluated using immunohistochemistry, H&E, Sirius Red, and Masson staining. In vitro, mouse peritoneal macrophages were extracted. Western blot and ELISA were used to measure MMP2/9 levels. Bioinformatics analysis investigated the association between MMPs and ferroptosis pathway genes. Macrophage ferroptosis was assessed by evaluating cell viability, lipid reactive oxygen species, mitochondrial ultrastructure, iron content, and COX2 levels after pretreatment with cell death inhibitors. Hemin's impact on ferroptosis and MMP expression was studied using Ferrostatin-1 and SB202190.

Results In the rabbit hemorrhagic plaques, hemin deposition and overexpression of MMP2/9 were observed, particularly in macrophage-enriched regions. In vitro, hemin induced ferroptosis and MMP2/9 expression in macrophages. Ferrostatin-1 and SB202190 inhibited hemin-induced MMP2/9 overexpression. Ferrostatin-1 inhibited p38 phosphorylation in macrophages. Ferostatin-1 inhibits macrophage ferroptosis, reduces MMP2/9 levels in plaques, and stabilizes the hemorrhagic plaques.

Conclusion Our results suggested that hemin-induced macrophage ferroptosis promotes p38 pathway activation and MMP2/9 overexpression, which may play a crucial role in increasing hemorrhagic plaque vulnerability. These findings provide insights into the pathogenesis of hemorrhagic plaques and suggest that targeting macrophage ferroptosis may be a promising strategy for stabilizing vulnerable plaque.

Authors' Contribution

Y.T. and B.L. contributed to the conception of the study; B.L., M.L., H.W. and S.S. performed the experiment; S.G. and H.W. contributed significantly to analysis and manuscript preparation; Y.T., B.L. and J.L. performed the data analyses and wrote the manuscript.


* These authors contributed equally to this work.


Supplementary Material



Publication History

Received: 01 March 2023

Accepted: 06 September 2023

Accepted Manuscript online:
11 September 2023

Article published online:
09 October 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany