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Targeting the 5-HT1B-YAP positive feedback loop protects against disturbed flow-induced atherogenesis in mice

Min-chun Jiang1,2, Huan-yu Ding2, Chak Kwong Cheng3, Dong-qin Cai4,5, Hai-xia Guan1, Jian Kuang1, Ronald Ching Wan Ma6, Yin Xia2, Xiao-qiang Yao2, Li Wang3, Yu Huang3,7
1 Department of Endocrinology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
2 School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
3 Department of Biomedical Sciences, College of Biomedicine, City University of Hong Kong, Hong Kong 999077, China
4 School of Medicine, South China University of Technology, Guangzhou 510006, China
5 Department of Cardiovascular, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangzhou 510080, China
6 Department of Medicine and Therapeutics and Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
7 Tung Biomedical Sciences Centre, City University of Hong Kong, Hong Kong 999077, China
Correspondence to: Yu Huang: yu.huang@cityu.edu.hk,
DOI: 10.1038/s41401-025-01672-x
Received: 21 July 2025
Accepted: 7 September 2025
Advance online: 1 November 2025

Abstract

Atherosclerosis preferentially develops at arterial bifurcations where the endothelial cells are constantly exposed to disturbed flow, and sustained oscillatory shear stress (OSS) triggers endothelial inflammation. The mechanosensitive transcriptional coactivator YAP plays a critical role in disturbed flow-induced endothelial inflammation. Our recent studies show that disturbed flow upregulates the expression of the mechanosensor 5-HT1B. In this study, we investigated the molecular mechanisms underlying OSS-induced 5-HT1B upregulation in vivo and in vitro. Disturbed flow was induced in mice by partial carotid ligation. In vitro experiments were conducted in human aortic endothelial cells (HAECs) subjected to oscillatory shear stress using an ibidi flow system. We showed that oscillatory shear stress significantly upregulated the expression of 5-HT1B in HAECs via activation of YAP, while knockout of YAP significantly reduced this upregulation. We demonstrated that YAP directly regulated the expression of HTR1B via binding to its promoter region. Inhibition of 5-HT1B using its antagonist SB-216641 impeded YAP nuclear localization and endothelial activation in HAECs. We verified that a 5-HT1B-YAP loop was also activated in atherosclerotic arteries of ApoE−/− mice. Endothelium-specific overexpression of YAP exacerbated atherosclerosis. Moreover, endothelium-specific knockout of 5-HT1B or YAP inhibited disturbed flow-induced endothelial inflammation and plaque formation in ApoE−/− mice. Taken together, the 5-HT1B-YAP positive feedback loop amplifies the pro-atherogenic effect of disturbed flow. We suggest that targeting 5-HT1B-YAP loop holds promise as a novel therapeutic strategy for atherosclerotic diseases.

Keywords: atherosclerosis; disturbed flow; endothelial cells; inflammation; 5-HT1B-YAP positive feedback loop

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