Imidazole propionate is an early biomarker and therapeutic target for atherosclerosis [bulk RNA-seq]

Atherosclerosis is the main underlying cause of cardiovascular diseases (CVDs). Its prevention is based on traditional cardiovascular risk factor-based scores but often fails to identify individuals at early stages of the disease. Here, we identified microbially produced imidazole propionate (ImP) as an early biomarker of atherosclerosis in mice and in two independent human cohorts. Furthermore, ImP administration induced atherosclerosis without altering lipid metabolism and it was associated with activation of both systemic and local innate and adaptive immunity and inflammation. Notably, ImP caused atherosclerosis through the Imidazoline-1 receptor (I1R), and the blockade of the ImP/I1R axis inhibited the development of atherosclerosis induced by ImP as well as by high cholesterol diet in mice. Here, we profiled three cell lines which represent cell types typically found in aortas (bone marrow-derived macrophages, mouse embryonic fibroblasts and mouse aortic endothelial cells) upon in vitro stimulation with ImP at different time points to better understand the transcriptional regulation of the ImP/I1R axis and its role in the development of the disease. Identification of ImP as an early biomarker for atherosclerosis and uncovering the contribution of the ImP/I1R axis in disease progression open new avenues to improve atherosclerosis early diagnosis and therapy.