Atherosclerosis is closely associated with disturbed flow characterized by low and oscillatory shear stress, but studies directly linking disturbed flow to atherogenesis is lacking. The major reason for this has been a lack of an animal model in which disturbed flow can be acutely induced and cause atherosclerosis. Here, we characterize partial carotid ligation as a model of disturbed flow with characteristics of low and oscillatory wall shear stress. We also describe a method of isolating intimal RNA in sufficient quantity from mouse carotid arteries. Using this model and method, we found that partial ligation causes upregulation of proatherogenic genes, downregulation of antiatherogenic genes, endothelial dysfunction, and rapid atherosclerosis in 2 wk in a p47(phox)-dependent manner and advanced lesions by 4 wk. We found that partial ligation results in endothelial dysfunction, rapid atherosclerosis, and advanced lesion development in a physiologically relevant model of disturbed flow. It also allows for easy and rapid intimal RNA isolation. This novel model and method could be used for genome-wide studies to determine molecular mechanisms underlying flow-dependent regulation of vascular biology and diseases.

Recently, we showed that disturbed flow caused by a partial ligation of mouse carotid artery rapidly induces atherosclerosis. Here, we identified mechanosensitive genes in vivo through a genome-wide microarray study using mouse endothelial RNAs isolated from the flow-disturbed left and the undisturbed right common carotid artery. We found 62 and 523 genes that changed significantly by 12 hours and 48 hours after ligation, respectively. The results were validated by quantitative polymerase chain reaction for 44 of 46 tested genes. This array study discovered numerous novel mechanosensitive genes, including Lmo4, klk10, and dhh, while confirming well-known ones, such as Klf2, eNOS, and BMP4. IntroductionAtherosclerosis is an inflammatory disease 1,2 preferentially occurring in arterial regions exposed to disturbed flow characterized by low and oscillatory shear stress, whereas straight arterial regions exposed to table flow are protected from atherosclerosis. 3,4 Despite the close association between the 2, in vivo evidence directly linking disturbed flow conditions to atherosclerosis has been scarce.The differential mechanisms by which disturbed and stable flow promotes and inhibits atherogenesis, respectively, have been a subject of intense study, mostly using cultured endothelial cells. [5][6][7][8] To define molecular mechanisms responsible for these changes, investigators have carried out DNA microarray studies using endothelial cells [9][10][11][12][13][14][15][16][17] and have subsequently identified numerous shear-sensitive genes, such as kruppel-like factor 2 and 4 (Klf2, Klf4), endothelial nitric oxide synthase (eNOS), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), bone morphogenic protein 4 (BMP-4), cathepsins, and angiopoietin-2 (Angpt2). 11,14,[18][19][20][21][22][23][24][25][26][27][28][29] Functional studies based on these shear-sensitive genes and their protein products have revealed the critical roles that they play in regulation of inflammation, thrombosis, vascular remodeling, angiogenesis, and arteriogenesis. 11,[19][20][21][22][26][27][28][29][30] Although these in vitro studies have provided critical insights regarding shear-sensitive mechanisms in cultured endothelial cells using modeled flow conditions, it cannot be assumed that identical mechanosensitive genes and pathways are involved in vivo regulating flow-dependent vascular responses and diseases. Therefore, it is critical to study how arterial endothelium responds to different flow conditions in vivo. However, the adequate pathophysiologic animal models enabling acute and reproducible modulation of flow conditions that rapidly lead to atherosclerosis have been lacking.Recently, we have shown that partial ligation of mouse carotid artery causes disturbed flow with characteristic low and oscillatory wall shear stress, which in turn rapidly induces atherosclerosis, directly demonstrating the causal relationship between disturbed flow and atherosclerosis. 31 In this model, disturbed flow induces e...

Despite the well-known close association, direct evidence linking disturbed flow to atherogenesis has been lacking. We have recently used a modified version of carotid partial ligation methods to show that it acutely induces low and oscillatory flow conditions, two key characteristics of disturbed flow, in the mouse common carotid artery. Using this model, we have provided direct evidence that disturbed flow indeed leads to rapid and robust atherosclerosis development in Apolipoprotein E knockout mouse. We also developed a method of endothelial RNA preparation with high purity from the mouse carotid intima. Using this mouse model and method, we found that partial ligation causes endothelial dysfunction in a week, followed by robust and rapid atheroma formation in two weeks in a hyperlipidemic mouse model along with features of complex lesion formation such as intraplaque neovascularization by four weeks. This rapid in vivo model and the endothelial RNA preparation method could be used to determine molecular mechanisms underlying flow-dependent regulation of vascular biology and diseases. Also, it could be used to test various therapeutic interventions targeting endothelial dysfunction and atherosclerosis in considerably reduced study duration.

Studying the role of a particular gene in atherosclerosis typically requires a time-consuming and often difficult process of generating double-knockouts or transgenics on ApoE−/− or LDL receptor−/− background. Recently, it was reported that adeno-associated-virus-8 (AAV8) mediated overexpression of PCSK9 (AAV8-PCSK9) rapidly induced hyperlipidemia. However, using this method in C57BL6 wild-type (C57) mice, it took approximately 3 months to develop atherosclerosis. Our partial carotid ligation model is used to rapidly develop atherosclerosis by inducing disturbed flow in the left common carotid artery within 2 weeks in ApoE−/− or LDLR−/− mice. Here, we combined these two approaches to develop an accelerated model of atherosclerosis in C57 mice. C57 mice were injected with AAV9-PCSK9 or AAV9-Luciferase (control) and high-fat diet was initiated. A week later, partial ligation was performed. Compared to the control, AAV-PCSK9 led to elevated serum PCSK9, hypercholesterolemia, and rapid atherosclerosis development within 3 weeks as determined by gross plaque imaging, and staining with Oil-Red-O, Movat’s pentachrome and CD45 antibody. These plaque lesions were comparable to the atherosclerotic lesions that have been previously observed in ApoE−/− or LDLR−/− mice that were subjected to partial carotid ligation and high-fat diet. Next, we tested whether our method can be utilized to rapidly determine the role of a particular gene in atherosclerosis. Using eNOS−/− and NOX1−/y mice on C57 background, we found that the eNOS−/− mice developed more advanced lesions, while the NOX1−/y mice developed less atherosclerotic lesions as compared to the C57 controls. These results are consistent with the previous findings using double knockouts (eNOS−/−_ApoE−/− and NOX1−/y_ApoE−/−). AAV9-PCSK9 injection followed by partial carotid ligation is an effective and time-saving approach to rapidly induce atherosclerosis. This accelerated model is well-suited to quickly determine the role of gene(s) interest without generating double- or triple-knockouts.