NADPH oxidase (NOX) 1 but not NOX4-dependent oxidative stress plays a role in diabetic vascular disease, including atherosclerosis. Endothelin (ET)-1 has been implicated in diabetes-induced vascular complications. We showed that crossing mice overexpressing human ET-1 selectively in endothelium (eET-1) with apolipoprotein E knockout (Apoe-/-) mice enhanced high-fat diet-induced atherosclerosis in part by increasing oxidative stress. We tested the hypothesis that ET-1 overexpression in the endothelium would worsen atherosclerosis in type-1 diabetes through a mechanism involving NOX1 but not NOX4.
Six-week-old male Apoe-/- and eET-1/Apoe-/- mice with or without Nox1 (Nox1-/y) or Nox4 knockout (Nox4-/-) were injected intraperitoneally with either vehicle or streptozotocin (55 mg/kg/day) for 5 days to induce type-1 diabetes and were studied 14 weeks later. ET-1 overexpression increased 2.5-fold and 5-fold the atherosclerotic lesion area in the aortic sinus and arch of diabetic Apoe-/- mice, respectively. Deletion of Nox1 reduced aortic arch plaque size by 60%; by contrast, Nox4 knockout increased lesion size by 1.5-fold. ET-1 overexpression decreased aortic sinus and arch plaque alpha smooth muscle cell content by ∼35% and ∼50%, respectively, which was blunted by Nox1 but not Nox4 knockout. Reactive oxygen species production was increased 2-fold in aortic arch perivascular fat of diabetic eET-1/Apoe-/- and eET-1/Apoe-/- / Nox4-/- mice but not eET-1/Apoe-/- / Nox1y/- mice. ET-1 overexpression enhanced monocyte/macrophage and CD3+ T cell infiltration ∼2.7-fold in the aortic arch perivascular fat of diabetic Apoe-/- mice. Both Nox1 and Nox4 knockout blunted CD3+ T cell infiltration whereas only Nox1 knockout prevented the monocyte/macrophage infiltration in diabetic eET-1/Apoe-/- mice.
Endothelium ET-1 overexpression enhances the progression of atherosclerosis in type-1 diabetes, perivascular oxidative stress and inflammation through NOX1.
We demonstrate that endothelial cell-restricted human ET-1 overexpression worsens atherosclerosis in diabetes and causes perivascular oxidative stress and inflammation, extending our previous findings to a model of type-1 diabetes mellitus. We also show that these effects are mediated through NOX1 and that atherosclerosis is worsened by loss of NOX4, providing evidence that NADPH oxidase isoforms play differential roles in plaque progression. These results offer new approaches to prevent the progression of atherosclerosis in diabetes, which is associated with significantly increased risk of cardiovascular events.

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