Abstract:Objective To explore the role of angiotensin Ⅱ type 1 receptor (AT1R) in the promotion of atherosclerosis by trimethylamine N-oxide (TMAO).Methods Molecular docking was used to predict the possible interaction between TMAO and AT1R. Twenty-one 6-week-old ApoE-/- mice were randomly divided into control group, TMAO group, and TMAO + telmisartan group, with 7 mice in each group. The TMAO group was fed with 1% choline in the diet to replicate the high TMAO blood model. The TMAO + telmisartan group was treated with telmisartan 10 mg/(kg·d) by gavage. After 12 weeks, blood was collected, and plasma TMAO levels were determined by high-performance liquid chromatography-tandem mass spectrometry. Oil Red O staining was used to determine the plaque area at the aortic root. Immunohistochemistry was used to detect the infiltration of inflammatory factors monocyte chemoattractant protein-1 (MCP-1) and interleukin-6 (IL-6) in the plaque. AT1R expression plasmids were constructed, transfected into 293T cells, and treated with TMAO (200 μmol/L) or TMAO (200 μmol/L) + telmisartan (1 μmol/L) for 0, 5, 10, 15, 30, and 60 min. The activation of the downstream signaling pathways ERK and PKC was detected.Results Molecular docking predicted a direct binding site between TMAO and AT1R. The proportion of plaque area at the aortic root, expression of MCP-1, and IL-6 in the plaque were statistically different among the three groups (P < 0.05). The TMAO group showed an increase in the proportion of plaque area at the aortic root and an elevation of MCP-1 and IL-6 expression compared to the control group (P < 0.05), while the telmisartan group showed a decrease compared to the TMAO group (P < 0.05). The expression of AT1R, p-ERK1/2, and p-PKC in aortic tissues differed significantly among the three groups (P < 0.05). The TMAO group increased significantly compared to the control group (P < 0.05), while the telmisartan group decreased compared to the TMAO group (P < 0.05). In 293T cells transfected with AT1R plasmids, the relative expression of p-ERK1/2 and p-PKC protein at different time points in the TMAO group (200 μmol/L) was statistically different (P < 0.05). Compared with 0 min, the relative expression of p-ERK1/2 increased at 15 and 30 min (P < 0.05), and the relative expression of p-PKC increased at 10 and 15 min (P < 0.05). After treatment with telmisartan (1 μmol/L), there was no statistically significant difference in the relative expression of p-ERK1/2 and p-PKC at each time point (P > 0.05).Conclusion The mechanism by which TMAO exacerbates atherosclerosis in ApoE-/- mice may involve its action on AT1R.