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Integrated human carotid plaque transcriptomics and macrophage perturbation link BCAP31 to endoplasmic reticulum stress, inflammation, and apoptosis

Year: 2026
Type: article
Abstract: Background: Atherosclerotic plaque progression couples chronic inflammation to dysregulated cell survival, but the cellular context and regulatory role of endoplasmic reticulum (ER)-associated death responses in human carotid disease remain incompletely resolved. Methods: We integrated paired bulk transcriptomes from 32 carotid plaque and macroscopically intact tissue pairs, laser-captured macrophages from five ruptured and six stable plaques, whole-plaque transcriptomes from 27 intraplaque-hemorrhage and 16 non-hemorrhage lesions, and single-cell RNA sequencing from three patients with matched atherosclerotic core and proximal adjacent tissue. BCAP31 was evaluated by siRNA-mediated depletion in oxidized low-density lipoprotein (oxLDL)-exposed THP-1-derived macrophages, with PCR, immunofluorescence, ELISA, apoptosis assays, and 4-phenylbutyrate treatment. Results: Paired bulk analysis showed coordinated increases in apoptosis, ferroptosis, pyroptosis, necroptosis, inflammasome, inflammatory-response, and TNF/NF-κB programs. Ruptured plaque macrophages showed increases in ferroptosis, pyroptosis, and necroptosis scores, whereas intraplaque-hemorrhage plaques showed broader activation across all prespecified programs. Patient-level single-cell pseudobulk analysis localized a directionally consistent increase in BCAP31 to macrophages, although the estimate did not remain significant after transcriptome-wide correction in the three-patient dataset. Cross-sectional state ordering placed higher BCAP31 expression toward plaque-enriched HLA-C1QC, APOC1-SPP1-remodeling, and SPP1-lipid-loaded macrophage states, while predicted macrophage-to-vascular-wall SPP1 signaling increased in all three patient pairs. BCAP31 was also increased in paired plaque, rupture-macrophage, and intraplaque-hemorrhage cohorts and belonged to a plaque-associated coexpression module. In macrophages derived from THP-1 cells and treated with oxLDL, BCAP31 knockdown increased ER-stress transcripts, nuclear DDIT3, inflammatory cytokine expression and release, and Annexin V-positive apoptosis. The chemical chaperone 4-phenylbutyrate attenuated these effects. Conclusion: Human plaque transcriptomics and macrophage perturbation support a stress-adaptive role for BCAP31 in ER-stress-associated inflammation and apoptosis. Increased tissue expression and the adverse effects of depletion indicate that plaque-associated upregulation may reflect a compensatory response.
Language: English
Subfield: Immunology
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223377274
FWCI:
Cites: 45
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Related to: 10