Objective-Tyrosine kinase receptor B (TrkB) is a high-affinity receptor for brain-derived neurotrophic factor. In addition to its nervous system functions, TrkB is also expressed in the cardiovascular system. However, the association of TrkB and coronary artery disease (CAD) remains unknown. We investigated the role of TrkB in the development of CAD and its mechanism. Approach and Results-We performed a case-control study in 2 independent cohort of Chinese subjects and found -69C>G polymorphisms of TrkB gene significantly associated with CAD. TrkB -69C homozygotes, which corresponded to decreased TrkB expression by luciferase reporter assay, showed increased risk for CAD. Immunofluorescence analysis revealed that TrkB was expressed in the aortic endothelium in atherosclerotic lesions in humans and ApoE -/-mice. TrkB knockdown in the aortic endothelium resulted in vascular leakage in ApoE -/-mice. Mechanistic studies showed that TrkB regulated vascular endothelial cadherin (VE-cadherin) expression through induction and activation of Ets1 transcriptional factor. Importantly, TrkB activation attenuated proatherosclerotic factors induced-endothelial hyperpermeability in human vascular endothelial cells.Conclusions-Our data demonstrate that TrkB protects endothelial integrity during atherogenesis by promoting Ets1-mediated VE-cadherin expression and plays a previously unknown protective role in the development of CAD. Table). This difference was also observed in the Shanxi group (all P<0.05; Table). Multiple logistic regression analysis revealed homozygous TrkB -69C, rather than TrkB -69G carriers, were associated with an increased risk of CAD in the Shandong group (odds ratio, 2.1; 95% confidence interval, 1.68-2.62; P<0.01) and in the Shanxi group (odds ratio, 2.0; 95% confidence interval, 1.69-2.67; P<0.01), after adjusting sex, age, and body mass index. There was no association between the TrkB IVS13+40G>A polymorphism and CAD (P>0.05; Table). All genotype frequencies showed Hardy-Weinberg equilibrium. Statistical powers are all 100% in Shandong and Shanxi group. The clinical characteristics of the 2 cohorts of patients and controls are shown in Table I in the online-only Data Supplement.Polymorphism -69C>G is located in the promoter region of TrkB. It has been reported that approximately one third of promoter variants may alter gene expression to a functionally relevant extent. 8 We then constructed luciferase reporter vectors with TrkB promoter segments (-3258 to -11 bp) of contrasting genotypes (-69CC versus -69GG; Figure 1A and 1B) and tested the effect of TrkB -69C>G polymorphism on luciferase reporter gene expression. Regardless of genotype, the promoter significantly promoted luciferase expression ( Figure 1C and 1D). Of note, luciferase activity was significantly lower with the -69C construct than with the -69G construct in HeLa cells and human vascular endothelial cells (ECs; Figure 1C and 1D). These data suggested that decreased TrkB expression might be associated with increased risk for CAD.
TrkB is...