Faculty Bibliography

Movement of free cholesterol between the cellular compartment and acceptor is governed by cholesterol gradients that are determined by several enzymes and reverse cholesterol transport proteins. We have previously demonstrated that adenosine A(2A) receptors inhibit foam cell formation and stimulate production of cholesterol 27-hydroxylase (CYP27A1), an enzyme involved in the conversion of cholesterol to oxysterols. We therefore asked whether the effect of adenosine A(2A) receptors on foam cell formation in vitro is mediated by CYP27A1 or apoE, a carrier for cholesterol in the serum. We found that specific lentiviral siRNA infection markedly reduced apoE or 27-hydroxylase mRNA in THP-1 cells. Despite diminished apoE expression (p < 0.0002, interferon-gamma (IFNgamma) CGS vs. IFNgamma alone, n = 4), CGS-21680, an adenosine A(2A) receptor agonist, inhibits foam cell formation. In contrast, CGS-21680 had no effect on reducing foam cell formation in CYP27A1 KD cells (4 +/- 2%; p < 0.5113, inhibition vs. IFNgamma alone, n = 4). Previously, we reported the A(2A) agonist CGS-21680 increases apoAI-mediated cholesterol efflux nearly twofold in wild-type macrophages. Adenosine receptor activation had no effect on cholesterol efflux in CYP27A1 KD cells but reduced efflux in apoE KD cells. These results demonstrate that adenosine A(2A) receptor occupancy diminishes foam cell formation by increasing expression and function of CYP27A1

Background: Our prior observations showed that the nucleoside adenosine and its receptor mediate collagen production and dermal fibrosis by human dermal fibroblasts in vitro. In addition, we showed that IL-13 expression is upregulated in tissues characterized by high levels of adenosine in the adenosine deaminase-deficient mouse model. This suggests adenosine upregulates the pro-fibrogenic cytokine IL-13. However, the receptor(s) and mechanism involved in this upregulation remained unknown. The aim of this study was to characterize further the contributions of endogenous adenosine and adenosine A2A receptors to skin fibrosis. Methods: In an in vitro study of cultured normal human dermal fibroblasts, the effect of adenosine A2A receptor modulation on IL-13 expression was studied. Using both the A2A receptor agonist (CGS21680, 1muM) and antagonist (ZM241385, 1muM), levels of IL-13 and IL-13 receptors were tested. Measurements of mRNA for IL-13 and three IL-13 receptor proteins, IL-13Ralpha1, IL-13Ralpha2 and IL-4 were assessed using real-time PCR amplification. Results: The A2A agonist induced elevated expression of message for IL-13 and two of three IL-13 receptors: IL-13Ralpha1 and IL-13Ralpha2. A 5- fold increase in expression was found for IL-13Ralpha1 and a more modest 1.8-fold increase in IL-13Ralpha2. These inducible elevations were blocked by coincubation with the A2A receptor antagonist but not by antagonists to other adenosine receptors. Incubation with the A2A receptor antagonist alone did not affect the expression of IL-13 or its receptors. Conclusion: Despite efforts at investigating the mechanisms underlying fibrogenic processes in the skin of patients with scleroderma, no effective antifibrotic therapy exists. The nucleoside adenosine induces expression of pro-fibrotic cytokine IL-13 and particularly its cognate receptor IL-13Ralpha1.These findings suggest that blockade of the A2A receptor may be useful as a novel therapeutic agent to modify dermal fibrosis in scleroderma

Methotrexate is a disease-modifying antirheumatic drug commonly used to treat inflammatory conditions such as rheumatoid arthritis which itself is linked to increased cardiovascular risk. Treatments that target inflammation may also impact the cardiovascular system. While methotrexate improves cardiovascular risk, inhibition of the cyclooxygenase (COX)-2 enzyme promotes atherosclerosis. These opposing cardiovascular influences may arise from differing effects on the expression of proteins involved in cholesterol homeostasis. These proteins, ATP-binding cassette transporter (ABC) A1 and cholesterol 27-hydroxylase, facilitate cellular cholesterol efflux and defend against cholesterol overload. Methotrexate upregulates expression of cholesterol 27-hydroxylase and ABCA1 via adenosine release, while COX-2 inhibition downregulates these proteins. Adenosine, acting through the A(2A) and A(3) receptors, may upregulate proteins involved in reverse cholesterol transport by cAMP-PKA-CREB activation and STAT inhibition, respectively. Elucidating underlying cardiovascular mechanisms of these drugs provides a framework for developing novel cardioprotective anti-inflammatory medications, such as selective A(2A) receptor agonists

Immune and inflammatory cells play a critical role in the pathogenesis of atherosclerotic plaques. We have demonstrated that A2ARs inhibit foam cell formation and stimulate production of ABCA1, the primary transporter of lipoproteins. We asked whether the effects of A2ARs on foam cell formation in vitro are mediated by transporters involved in reverse cholesterol transport, ABCA1 and ABCG1. Foam cells were generated from THP-1 cells by incubation with 100 nM PMA for 2 days and incubated with acLDL (50 mug/mL) plus IFN-gamma (500 U/mL) +/- A2AR agonist CGS-21680 (1 muM). Radiolabeled cholesterol (0.2 muCi/ml) was added to cells, and efflux was measured using a liquid scintillation counter. Lentiviral siRNA infection markedly reduces ABCA1 or ABCG1 mRNA in THP-1 cells. Despite diminished ABCG1 expression (KD), CGS-21680 inhibits foam cell formation (81+5% inhibition; P<0.0001 vs. IFN-gamma alone; n=3) but has no effect on foam cell formation in ABCA1 KD cells (5+3% inhibition; P<0.85 vs. IFN-gamma alone; n=3). The A2A agonist increases apoA-I-mediated cholesterol efflux nearly twofold in THP-1-derived macrophages (from 9.5% to 17.5+2.5% [3H]-cholesterol efflux; P<0.0090 vs. control; n=3) but not in ABCA1 KD cells. Activation of Epac, a signaling molecule downstream of the A2AR, increased ABCA1 (23+5%; P<0.0007 vs. control; n=3) and phospho-ABCA1 (13+5%; P<0.0003 vs. control; n=3) protein. These results demonstrate that A2AR occupancy diminishes foam cell formation by stimulating increased reverse cholesterol transport via ABCA1

Adenosine is an endogenous autocoid that regulates a multitude of bodily functions. Its anti-inflammatory actions are well known to rheumatologists since it mediates many of the anti-inflammatory effects of a number of antirheumatic drugs such as methotrexate. However, inflammatory and tissue regenerative responses are intricately linked, with wound healing being a prime example. It has only recently been appreciated that adenosine has a key role in tissue regenerative and fibrotic processes. An understanding of these processes may shed new light on potential therapeutic options in diseases such as scleroderma where tissue fibrosis features prominently