Mitochondrial dysfunction and metabolic reprogramming induce macrophage pro-inflammatory phenotype switch and

Aleksandr E Vendrov1, Andrey Lozhkin1, Takayuki Hayami1

  • 1Frankel Cardiovascular Center, Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States.

PubMed
Abstract

Insights

Aging increases NADPH oxidase 4 (NOX4) expression, promoting mitochondrial dysfunction and inflammation in macrophages, which drives atherosclerosis. Inhibiting NOX4 could reduce vascular inflammation and preserve plaque integrity.

Area of Science:

  • Cardiovascular Biology
  • Immunology
  • Aging Research

Background:

  • Aging exacerbates atherosclerotic vascular disease risk, with macrophages playing a key role in vascular aging, inflammation, and atherosclerosis.
  • NADPH oxidase 4 (NOX4) expression rises with age, linked to mitochondrial dysfunction, inflammation, and atherosclerosis.
  • Increased NOX4 is hypothesized to promote aging-associated atherosclerosis via NOX4-dependent mitochondrial oxidative stress, metabolic dysfunction, and macrophage inflammatory phenotype switching.

Purpose of the Study:

  • To investigate the role of NOX4 in aging-associated atherosclerosis.
  • To determine if NOX4-driven mitochondrial oxidative stress in macrophages contributes to metabolic dysfunction and inflammatory phenotype switching.
  • To assess the therapeutic potential of NOX4 inhibition in mitigating aging-related atherosclerosis.

Main Methods:

  • Comparative analysis of atherosclerotic lesion morphology and macrophage phenotype in young and aged Apoe-/- and Nox4-/-/Apoe-/- mice fed a Western diet.
  • Immunofluorescence, flow cytometry, and mitochondrial respiration assessments were used to analyze macrophage populations and function.
  • Pharmacological inhibition of NOX4 using GKT137831 in aged Apoe-/- mice.

Main Results:

  • Aged Nox4-/- mice exhibited significantly reduced atherosclerotic lesion areas, lower oxidative stress, and a shift towards pro-resolving macrophages compared to aged Apoe-/- mice.
  • Macrophages from aged Apoe-/- mice displayed impaired mitochondrial function and a glycolytic metabolic switch, whereas Nox4-/- macrophages maintained aerobic metabolism.
  • NOX4 inhibition in aged Apoe-/- mice attenuated atherosclerosis by reducing macrophage mitochondrial ROS, improving mitochondrial function, and altering macrophage phenotype.

Conclusions:

  • Increased NOX4 in aging drives macrophage mitochondrial dysfunction, metabolic reprogramming towards glycolysis, and a pro-inflammatory phenotype, thereby accelerating atherosclerosis.
  • Targeting NOX4 or mitochondrial dysfunction presents a promising therapeutic strategy to alleviate vascular inflammation and preserve plaque integrity in aging individuals.
  • The study highlights NOX4 as a critical mediator of macrophage dysfunction in vascular aging and atherosclerosis.