Lipid crystals mechanically stimulate adjacent extracellular matrix in advanced atherosclerotic plaques

- Atherosclerotic lipids and extracellular matrix (ECM) were visualized by a multimodal nonlinear optical (MNLO) imaging.
- The change of ECM at the peripheral region of lipid crystals was spatially quantified based on MNLO images.
- The mechanical influence of lipid crystals on ECM was investigated by MNLO imaging and finite element analysis.

Objective: Although lipid crystals (LCs) have received attention as a causative factor of plaque rupture, the mechanisms by which they increase plaque vulnerability are unknown. We examined whether solid-state LCs physically affect the adjacent extracellular matrix (ECM) using a combination of multimodal nonlinear optical (MNLO) imaging and finite element analysis (FEA). Methods: The changes of ECMs affected by lipids in atherosclerotic arteries in apolipoprotein E-deficient mice (n = 32) fed a high-fat diet for 20-30 weeks were micro-anatomically visualized by a 3D MNLO imaging platform including CARS for lipids, TPEF for elastin, and SHG for collagen. Results and Conclusion: The TPEF signal of elastin was increased at the peripheral regions of LCs (<10 μm) compared with foam cell regions. In order to confirm the increase of elastin, biochemical assay (western blot) was performed. The protein level of elastin was increased approximately 2.25-fold (p = 0.024) in LC-rich arteries. Under the hypothesis that the increase of elastin resulted from the mechanical stimulus from solid-state LCs, MNLO images were subjected to FEA to simulate the displacement according to the expanding magnitude of the vessel during cardiac cycles. We found that microscale focal stress was increased specifically around the LCs. These FEA results corresponded with the increase of elastin observed by TPEF. These data suggest that LCs mechanically stimulate the adjacent ECM to alter the composition of ECM and cause vessel remodeling. The combination of MNLO imaging and FEA has great potential to verify the mechanical predictions in cardiovascular diseases.