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Updated: Oct 10, 2025

Stimulation of Vascular Endothelial Cells Using Neutrophil Extracellular Traps in the Presence of Low-Density Lipoprotein
Published on: August 12, 2025
Reconstituted HDL-apoE3 promotes endothelial cell migration through ID1 and its downstream kinases ERK1/2, AKT and
Eftaxia-Konstantina Valanti1, Katerina Dalakoura-Karagkouni2, Panagiotis Fotakis3
14th Department of Internal Medicine, Clinical Genomics and Pharmacogenomics Unit, 'Attikon' Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Molecular Biology Division, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.
Insights
Reconstituted HDL with apolipoprotein E3 (rHDL-apoE3) enhances endothelial cell migration and vascular permeability. This suggests rHDL-apoE3 could be a novel therapeutic for atherosclerosis by promoting re-endothelialization.
Area of Science:
- Cardiovascular Research
- Biomedical Engineering
- Molecular Biology
Background:
- Atherosclerotic Coronary Artery Disease (ASCAD) is a leading global cause of mortality.
- Novel therapies focus on High Density Lipoprotein (HDL) to improve atheroprotective functions.
- Reconstituted HDL containing apolipoprotein E3 (rHDL-apoE3) presents an unexplored therapeutic avenue.
Purpose of the Study:
- To assess the atheroprotective potential of rHDL-apoE3.
- To investigate its effects on endothelial cell (EC) migration, a key process in atherosclerosis.
- To evaluate its translatability in vivo.
Main Methods:
- Whole genome microarrays and qRT-PCR/Western blot to analyze gene and protein expression in ECs.
- Wound healing and transwell assays to measure EC migration.
- In vivo studies in apoE KO mice to assess vascular permeability and hypercholesterolemia.
Main Results:
- rHDL-apoE3 significantly altered gene expression in ECs, particularly those involved in re-endothelialization and migration pathways (MEK/ERK, PI3K/AKT).
- rHDL-apoE3 stimulated EC migration and increased phosphorylation of key signaling molecules (ERK1/2, AKT, p38 MAPK).
- In vivo, rHDL-apoE3 improved vascular permeability and ameliorated hypercholesterolemia in apoE KO mice.
Conclusions:
- rHDL-apoE3 enhances EC migration via ID1, MEK1/2, PI3K, and downstream signaling pathways.
- It also improves vascular permeability in vivo.
- These findings support rHDL-apoE3 as a potential therapeutic for promoting re-endothelialization and preventing atherosclerosis.
Introduction:
Atherosclerotic Coronary Artery Disease (ASCAD) is the leading cause of mortality worldwide. Novel therapeutic approaches aiming to improve the atheroprotective functions of High Density Lipoprotein (HDL) include the use of reconstituted HDL forms containing human apolipoprotein A-I (rHDL-apoA-I). Given the strong atheroprotective properties of apolipoprotein E3 (apoE3), rHDL-apoE3 may represent an attractive yet largely unexplored therapeutic agent.
Objective:
To evaluate the atheroprotective potential of rHDL-apoE3 starting with the unbiased assessment of global transcriptome effects and focusing on endothelial cell (EC) migration as a critical process in re-endothelialization and atherosclerosis prevention. The cellular, molecular and functional effects of rHDL-apoE3 on EC migration-associated pathways were assessed, as well as the potential translatability of these findings in vivo.
Methods:
Human Aortic ECs (HAEC) were treated with rHDL-apoE3 and total RNA was analyzed by whole genome microarrays. Expression and phosphorylation changes of key EC migration-associated molecules were validated by qRT-PCR and Western blot analysis in primary HAEC, Human Coronary Artery ECs (HCAEC) and the human EA.hy926 EC line. The capacity of rHDL-apoE3 to stimulate EC migration was assessed by wound healing and transwell migration assays. The contribution of MEK1/2, PI3K and the transcription factor ID1 in rHDL-apoE3-induced EC migration and activation of EC migration-related effectors was assessed using specific inhibitors (PD98059: MEK1/2, LY294002: PI3K) and siRNA-mediated gene silencing, respectively. The capacity of rHDL-apoE3 to improve vascular permeability and hypercholesterolemia in vivo was tested in a mouse model of hypercholesterolemia (apoE KO mice) using Evans Blue assays and lipid/lipoprotein analysis in the serum, respectively.
Results:
rHDL-apoE3 induced significant expression changes in 198 genes of HAEC mainly involved in re-endothelialization and atherosclerosis-associated functions. The most pronounced effect was observed for EC migration, with 42/198 genes being involved in the following EC migration-related pathways: 1) MEK/ERK, 2) PI3K/AKT/eNOS-MMP2/9, 3) RHO-GTPases, 4) integrin. rHDL-apoE3 induced changes in 24 representative transcripts of these pathways in HAEC, increasing the expression of their key proteins PIK3CG, EFNB2, ID1 and FLT1 in HCAEC and EA.hy926 cells. In addition, rHDL-apoE3 stimulated migration of HCAEC and EA.hy926 cells, and the migration was markedly attenuated in the presence of PD98059 or LY294002. rHDL-apoE3 also increased the phosphorylation of ERK1/2, AKT, eNOS and p38 MAPK in these cells, while PD98059 and LY294002 inhibited rHDL-apoE3-induced phosphorylation of ERK1/2, AKT and p38 MAPK, respectively. LY had no effect on rHDL-apoE3-mediated eNOS phosphorylation. ID1 siRNA markedly decreased EA.hy926 cell migration by inhibiting rHDL-apoE3-triggered ERK1/2 and AKT phosphorylation. Finally, administration of a single dose of rHDL-apoE3 in apoE KO mice markedly improved vascular permeability as demonstrated by the reduced concentration of Evans Blue dye in tissues such as the stomach, the tongue and the urinary bladder and ameliorated hypercholesterolemia.
Conclusions:
rHDL-apoE3 significantly enhanced EC migration in vitro, predominantly via overexpression of ID1 and subsequent activation of MEK1/2 and PI3K, and their downstream targets ERK1/2, AKT and p38 MAPK, respectively, and improved vascular permeability in vivo. These novel insights into the rHDL-apoE3 functions suggest a potential clinical use to promote re-endothelialization and retard development of atherosclerosis.
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