Objective-A functional polymorphism in the chemokine receptor CX 3 CR1 is associated with protection from vascular diseases including coronary artery disease and internal carotid artery occlusive disease. We investigated the mechanisms by which CX 3 CR1 may be involved by evaluating the inflammatory response to arterial injury in CX 3 CR1-deficient animals.
Methods and Results-Femoral arteries of CX 3 CR1Ϫ/Ϫ and wild-type (WT) mice were injured with an angioplasty guide wire. After 1, 5, 14, and 28 days, arteries were harvested and evaluated by histology, morphometry, and immunohistochemistry. Arterial injury upregulated the CX 3 CR1 ligand CX 3 CL1. In CX 3 CR1Ϫ/Ϫ compared with WT animals, the incidence of neointima formation was 58% lower (Pϭ0.0017), accompanied by no difference in the area of platelet accumulation at day 1 (Pϭ0.48) but a significant decrease in intimal monocyte infiltration at day 5 (Pϭ0.006), vascular smooth muscle cell (VSMC) proliferation at days 5 and 14, and intimal area at day 28 (Pϭ0.009). Both animal models and human genetic association studies have implicated an important role for the chemokine receptor CX 3 CR1 and its ligand fractalkine (CX 3 CL1) in vascular disease. Mice that lack both CX 3 CR1 and apolipoprotein E (apoE) exhibit a reduction in atherosclerotic lesion formation in the aorta and aortic root compared with apoE-deficient mice. 4,5 CX 3 CL1-deficient mice have a reduction in atherosclerotic plaque burden in the innominate artery. 6 In humans, the V249I/T280M variant of CX 3 CR1 is associated with protection from coronary artery disease 7-9 and internal carotid artery occlusive disease. 10 While CX 3 CR1 and CX 3 CL1 are emerging as important mediators of vascular disease, the specific mechanisms regulating their involvement remain unclear. CX 3 CL1 is a transmembrane chemokine on activated endothelium that also exists in a soluble form. 11-13 Soluble CX 3 CL1 is a potent chemoattractant, and membrane-tethered CX 3 CL1 promotes cell adhesion by supporting the capture and firm adhesion of circulating CX 3 CR1-expressing cells. 14,15 CX 3 CR1 is expressed on monocytes, 16 VSMCs, 17,18 and platelets. 19 Thus, each of these cell types is a candidate to mediate the effects of CX 3 CR1 on vascular inflammatory responses.
Conclusions-InThe prevailing hypothesis is that the mechanism for CX 3 CR1 in the development of vascular diseases such as atherosclerosis is the adherence of CX 3 CR1-expressing monocytes to inflamed endothelium. 5,14 However, recent evidence that smooth muscle cells (SMCs) found in human atherosclerotic plaques also express CX 3 CR1 suggests an alternative mechanism. 18 Stimulation of aortic smooth muscle cells with soluble CX 3 CL1 leads to an increase in cell survival and proliferation. 20 Monocyte adhesion and arrest on neointimal SMC is dependent on CX 3 CL1, 21 and VSMCs undergo chemotaxis toward CX 3 CL1. 17 Thus, CX 3 CL1 may act not only on monocytes, but also may function to stimulate SMC proliferation and recruitment into the neointima.In the pre...