Low- but not high-dose FK506 treatment confers atheroprotection due to alternative macrophage activation and unaffected cholesterol levels

Thromb Haemost. 2010 Jul;104(1):143-50. doi: 10.1160/TH09-07-0502. Epub 2010 May 10.

Abstract

Previous studies showed both pro- and anti-atherogenic effects of immunosuppressant drug FK506 on atherosclerosis. As these divergent/paradoxical results of FK506 may at least in part be attributable to differences in FK506 dosing, we have, in the current study, assessed dose-dependent effects of FK506 on atherosclerotic lesion formation as well as on inflammatory parameters relevant to atherosclerosis. Unlike low-dose FK506, high-dose FK506 did not protect against atherosclerosis in ApoE-/- mice. The high-dose induced hypercholesterolaemia, whereas the low-dose did not. Both low- and high-dose FK506 treatment significantly reduced systemic CD3+ and CD4+CD25+ T-cell populations, and showed similar suppression of FoxP3 regulatory T-cell populations. Increased IL-4+ CD4+ T-cells and decreased IgG-MDA-LDL antibody titres pointed to a selective, albeit modest Th2 skewing in the high-dose treatment group, despite the advanced stage of atherosclerosis. Low concentrations of FK506, however, skewed bone marrow-derived macrophage polarisation towards a M2 macrophage phenotype, whereas high concentration did not. A low-dose FK506 treatment regime protected against atherosclerosis by suppressing T-cell activation and favouring (M2) macrophage polarisation. Although a high-dose FK506 treatment effected a similar T-cell suppressive effect, with an even more pronounced shift towards Th2 type immune responses, this did not translate in atheroprotection due to the hypercholesterolaemia and absent M2 skewing.

MeSH terms

  • Animals
  • Antibodies / blood
  • Apolipoproteins E / genetics
  • Atherosclerosis / blood
  • Atherosclerosis / drug therapy*
  • Atherosclerosis / physiopathology
  • Carotid Arteries / metabolism
  • Carotid Arteries / pathology
  • Carotid Arteries / surgery
  • Cell Differentiation / drug effects
  • Cell Differentiation / genetics
  • Cells, Cultured
  • Cholesterol / blood
  • Cytokines / metabolism
  • Cytoprotection / drug effects
  • Drug Dosage Calculations
  • Humans
  • Hypercholesterolemia / etiology
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / pharmacology*
  • Lipoproteins, LDL / immunology
  • Lymphocyte Activation / drug effects
  • Lymphocyte Activation / genetics
  • Macrophages / drug effects
  • Macrophages / immunology
  • Macrophages / metabolism*
  • Macrophages / pathology
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Tacrolimus / administration & dosage
  • Tacrolimus / adverse effects
  • Tacrolimus / pharmacology*
  • Th2 Cells / drug effects
  • Th2 Cells / immunology
  • Th2 Cells / metabolism*
  • Th2 Cells / pathology

Substances

  • Antibodies
  • Apolipoproteins E
  • Cytokines
  • Immunosuppressive Agents
  • Lipoproteins, LDL
  • oxidized low density lipoprotein
  • Cholesterol
  • Tacrolimus