Objective-Based on the observation that Fxr Ϫ/Ϫ mice exhibit a proatherogenic lipoprotein profile, we investigated the role of FXR in the development of atherosclerosis.
Methods and Results-Administration of a western diet to FxrϪ/Ϫ mice or wild-type mice does not result in the development of significant atherosclerotic lesions. Consequently we generated Fxr Ϫ/Ϫ Ldlr Ϫ/Ϫ (DKO) mice and compared lesion development with Ldlr Ϫ/Ϫ mice. After 16 weeks on a Western diet, en face analysis of the aorta indicated that the male DKO mice had reduced atherosclerotic lesions as compared with Ldlr Ϫ/Ϫ mice. Plasma low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels were reduced by 40% to 50%, whereas triglyceride levels increased 4-fold in the male DKO mice. Finally, peritoneal macrophages freshly isolated from male DKO mice had reduced expression of CD36 mRNA and decreased neutral lipid accumulation, as compared with Ldlr Ϫ/Ϫ mice. Conclusions-FXR deficiency in male, but not female, Ldlr Ϫ/Ϫ mice results in a reduction in the size of atherosclerotic lesions in the aorta. The reduction in atherosclerosis may result from a decrease in plasma low-density lipoprotein cholesterol, coupled with reduced expression of CD36 in macrophages of DKO mice. Key Words: atherosclerosis Ⅲ cholesterol Ⅲ FXR Ⅲ LDLR Ⅲ nuclear receptor A therosclerosis is a chronic inflammatory disease, characterized by accumulation of lipids and fibrous elements in the walls of large arteries. 1 It is well-established that high-plasma low-density lipoprotein cholesterol (LDL-C) level is an independent risk factor for the development of atherosclerosis. High levels of LDL-C are thought to result in the generation of oxidized (ox) and aggregated LDL in the subendothelial areas of the arterial wall. Ox-LDL contains bioactive lipids that promote the entry of monocytes into the subendothelial space, where they differentiate into macrophages. These macrophages then take up ox-LDL and/or aggregated LDL via scavenger receptors (CD36 or SR-A) or phagocytosis. The result is the generation of lipid-engorged macrophages (also called foam cells) that are found in the early fatty streak as well as more complex advanced lesions. [1][2][3] The role of CD36 in atherosclerotic lesion development has become controversial. Original studies showed that a null mutation of CD36 in mice impaired the conversion of peritoneal macrophages to foam cells. 4 Farnesoid X receptor (FXR) is a member of the nuclear receptor superfamily that is highly expressed in liver, intestine, kidney, and adrenal gland, 7 with very low levels (Ϸ10%) being detected in white adipose tissue. 8 FXR is activated by specific bile acids that include chenodeoxycholic acid (CDCA) and cholic acid, 9 -11 and also structurally unrelated synthetic compounds, such as GW4064 12 and fexaramine. 13 FXR plays an important role in maintaining bile acid, cholesterol, triglyceride, and glucose homeostasis. 12,14 -18 Importantly, plasma cholesterol and triglyceride levels are increased in Fxr Ϫ/Ϫ ...