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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Physiol.</journal-id>
<journal-title>Frontiers in Physiology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Physiol.</abbrev-journal-title>
<issn pub-type="epub">1664-042X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fphys.2021.756450</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Physiology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Leukotriene D<sub>4</sub> Upregulates Oxidized Low-Density Lipoprotein Receptor 1 and CD36 to Enhance Oxidized LDL Uptake and Phagocytosis in Macrophages Through Cysteinyl Leukotriene Receptor 1</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Pokhrel</surname> <given-names>Sabita</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1517905/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Gudneppanavar</surname> <given-names>Ravindra</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1488210/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Teegala</surname> <given-names>Lakshminarayan Reddy</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1437897/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Duah</surname> <given-names>Ernest</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Thodeti</surname> <given-names>Charles K.</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/376614/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Paruchuri</surname> <given-names>Sailaja</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1113934/overview"/>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup><institution>Department of Chemistry, University of Akron</institution>, <addr-line>Akron, OH</addr-line>, <country>United States</country></aff>
<aff id="aff2"><sup>2</sup><institution>Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences</institution>, <addr-line>Toledo, OH</addr-line>, <country>United States</country></aff>
<aff id="aff3"><sup>3</sup><institution>Department of Integrative Medical Sciences, Northeast Ohio Medical University</institution>, <addr-line>Rootstown, OH</addr-line>, <country>United States</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: Anna Maria Giudetti, University of Salento, Italy</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: Gang Shu, South China Agricultural University, China; Kameswara Rao Badri, Morehouse School of Medicine, United States; Mathumai Kanapathipillai, University of Michigan-Dearborn, United States</p></fn>
<corresp id="c001">&#x002A;Correspondence: Sailaja Paruchuri, <email>sailaja.paruchuri@UToledo.edu</email></corresp>
<fn fn-type="other" id="fn004"><p>This article was submitted to Lipid and Fatty Acid Research, a section of the journal Frontiers in Physiology</p></fn>
</author-notes>
<pub-date pub-type="epub">
<day>18</day>
<month>11</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="collection">
<year>2021</year>
</pub-date>
<volume>12</volume>
<elocation-id>756450</elocation-id>
<history>
<date date-type="received">
<day>10</day>
<month>08</month>
<year>2021</year>
</date>
<date date-type="accepted">
<day>14</day>
<month>10</month>
<year>2021</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2021 Pokhrel, Gudneppanavar, Teegala, Duah, Thodeti and Paruchuri.</copyright-statement>
<copyright-year>2021</copyright-year>
<copyright-holder>Pokhrel, Gudneppanavar, Teegala, Duah, Thodeti and Paruchuri</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license>
</permissions>
<abstract>
<p>Endothelial permeability, leukocyte attachment, and unregulated oxidized LDL (oxLDL) uptake by macrophages leading to the formation of foam cells are all vital in the initiation and progression of atherosclerosis. During inflammation, several inflammatory mediators regulate this process through the expression of distinct oxLDL binding cell surface receptors on macrophages. We have previously shown that Leukotriene D<sub>4</sub> (LTD<sub>4</sub>) promotes endothelial dysfunction, increasing endothelial permeability and enhancing TNF&#x03B1;-mediated attachment of monocytes to endothelium, which hints at its possible role in atherosclerosis. Here we analyzed the effect of LTD<sub>4</sub> on macrophage function. Macrophages mainly express CysLT<sub>1</sub>R and flux calcium in response to LTD<sub>4</sub>. Further, LTD<sub>4</sub> potentiates phagocytosis in macrophages as revealed by the uptake of zymosan particles. Notably, LTD<sub>4</sub> augmented macrophage phagocytosis and oxLDL uptake which is sensitive to MK-571 [Montelukast (MK)], a CysLT<sub>1</sub>R-specific antagonist. Mechanistically, LTD<sub>4</sub> upregulated two receptors central to foam cell formation, oxidized low-density lipoprotein receptor-1 (OLR1/LOX-1), and CD36 in a time and dose-dependent manner. Finally, LTD<sub>4</sub> enhanced the secretion of chemokines MCP-1 and MIP1&#x03B2;. Our results suggest that LTD<sub>4</sub> contributes to atherosclerosis either through driving foam cell formation or recruitment of immune cells or both. CysLT<sub>1</sub>R antagonists are safely being used in the treatment of asthma, and the findings from the current study suggest that these can be re-purposed for the treatment of atherosclerosis.</p>
</abstract>
<kwd-group>
<kwd>LTD<sub>4</sub></kwd>
<kwd>CysLT<sub>1</sub>R</kwd>
<kwd>phagocytosis</kwd>
<kwd>oxLDL</kwd>
<kwd>CD36</kwd>
<kwd>OLR1</kwd>
<kwd>MCP-1</kwd>
<kwd>atherosclerosis</kwd>
</kwd-group>
<contract-sponsor id="cn001">National Institutes of Health <named-content content-type="fundref-id">10.13039/100000002</named-content></contract-sponsor>
<contract-sponsor id="cn002">National Institutes of Health <named-content content-type="fundref-id">10.13039/100000002</named-content></contract-sponsor>
<counts>
<fig-count count="7"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="52"/>
<page-count count="11"/>
<word-count count="7001"/>
</counts>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="S1">
<title>Introduction</title>
<p>Macrophages are innate immune cells present ubiquitously in the body, and they are involved in the phagocytosis of foreign materials and pathogens (<xref ref-type="bibr" rid="B19">Han et al., 2016</xref>). The role of macrophages is not only limited to engulfing foreign allergens, but also extends to ingesting self-antigens like extracellular debris and modified lipids (<xref ref-type="bibr" rid="B41">Patten and Shetty, 2018</xref>). Macrophages encounter diverse antigens, and they need distinct receptors to recognize them and initiate phagocytosis (<xref ref-type="bibr" rid="B25">Kelley et al., 2014</xref>). Phagocytosis is mediated through scavenger receptors classified into different groups ranging from A&#x2013;J (<xref ref-type="bibr" rid="B1">Aderem and Underhill, 1999</xref>). Scavenger receptors not only function in scavenging self-antigens expressing damage associated molecular patterns (DAMPS) (<xref ref-type="bibr" rid="B41">Patten and Shetty, 2018</xref>), they also facilitate phagocytosis of particles like oxLDL that are the products of oxidative stress (<xref ref-type="bibr" rid="B48">Woo et al., 2016</xref>). Receptors like class B scavenger receptor CD36, Scavenger Receptor A (SR-A), CD204, and lectin like oxidized low density lipoprotein receptor (OLR1) in macrophages facilitate the internalization and degradation of modified lipids (<xref ref-type="bibr" rid="B48">Woo et al., 2016</xref>; <xref ref-type="bibr" rid="B2">Arslan et al., 2017</xref>), which initiates the buildup of foam cells, an event that is crucial in the initiation and progression of atherosclerosis. Atherosclerosis is an inflammatory disease involving endothelial dysfunction and the dysregulated uptake of lipid molecules into the blood vessels (<xref ref-type="bibr" rid="B20">Hansson and Hermansson, 2011</xref>). The accumulation of foam cells results in the formation of atherosclerotic plaques that further release their lipid contents into the vasculature. Plaque instability and its ultimate rupture results in the formation of a pro-thrombotic necrotic core during atherogenesis (<xref ref-type="bibr" rid="B47">Tabas and Bornfeldt, 2016</xref>). Macrophages are the key effector cells, and they have been extensively studied with respect to the disease (<xref ref-type="bibr" rid="B35">Moore et al., 2013</xref>). Attenuation of atherosclerotic complications in mice was observed when macrophages were egressed from the lesion microenvironment or when their phenotype was switched to resolution (M2) subset from their inflammatory (M1) counterparts (<xref ref-type="bibr" rid="B15">Feig et al., 2011a</xref>, <xref ref-type="bibr" rid="B16">b</xref>). Therefore, it is important to understand how soluble factors secreted during inflammation affect macrophage behavior, impacting atherosclerosis progression. From the time a link between inflammation and atherosclerosis was proposed, a range of inflammatory mediators were investigated for their possible role in this disorder (<xref ref-type="bibr" rid="B36">Nguyen et al., 2019</xref>). Increased expression of 5-lipoxygenase (5-LO) products, including leukotrienes and their receptors, were reported in atherosclerotic lesions, identifying these molecules as potential therapeutic targets for the disease (<xref ref-type="bibr" rid="B3">Back, 2009</xref>). Cysteinyl leukotrienes (cys-LTs) comprising of LTC<sub>4</sub>, LTD<sub>4</sub>, and LTE<sub>4</sub> are derivatives of arachidonic acid generated by mast cells, macrophages, eosinophils, and basophils (<xref ref-type="bibr" rid="B23">Kanaoka and Boyce, 2004</xref>). Cys-LTs are the most potent bronchoconstrictors (<xref ref-type="bibr" rid="B8">Davidson et al., 1987</xref>; <xref ref-type="bibr" rid="B9">Drazen and Austen, 1987</xref>), and they are involved in the pathophysiology of various inflammatory diseases like asthma, rheumatoid arthritis, and cardiovascular diseases (<xref ref-type="bibr" rid="B7">Chung, 1995</xref>; <xref ref-type="bibr" rid="B6">Busse, 1996</xref>; <xref ref-type="bibr" rid="B29">Liu and Yokomizo, 2015</xref>). Cys-LTs mediate their biologic functions mainly through two known G protein-coupled receptors (GPCRs), CysLT<sub>1</sub>R, and CysLT<sub>2</sub>R (<xref ref-type="bibr" rid="B31">Lynch et al., 1999</xref>; <xref ref-type="bibr" rid="B21">Heise et al., 2000</xref>). Apart from these two main receptors, GPR17 is activated by LTD<sub>4</sub> and acts as a negative regulator for CysLT<sub>1</sub>R (<xref ref-type="bibr" rid="B32">Maekawa et al., 2009</xref>). Further, LTE<sub>4</sub>, the most abundant and stable of the cys-LTs, is a weak, partial agonist for the CysLT<sub>1</sub>R and CysLT<sub>2</sub>R (<xref ref-type="bibr" rid="B12">Evans, 2002</xref>). In contrast to LTD<sub>4</sub>, LTE<sub>4</sub> relays signals through both peroxisome proliferator activating receptor (PPAR)-&#x03B3;, a ligand-activated transcription factor (<xref ref-type="bibr" rid="B39">Paruchuri et al., 2008</xref>), and P2Y<sub>12</sub> receptor (P2Y<sub>1</sub><sub>2</sub>R), a GPCR that recognizes adenosine diphosphate (ADP) (<xref ref-type="bibr" rid="B40">Paruchuri et al., 2009</xref>). Recently, GPR99 was identified as another CysLTR with a preference for LTE<sub>4</sub> (<xref ref-type="bibr" rid="B24">Kanaoka et al., 2013</xref>). Pro-inflammatory mediators generated during inflammation activate endothelial cells (EC) and leukocyte extravasation. Injection of each of the three cys-LTs has been shown to enhance dermal vascular permeability in mice and humans (<xref ref-type="bibr" rid="B44">Soter et al., 1983</xref>; <xref ref-type="bibr" rid="B33">Maekawa et al., 2008</xref>; <xref ref-type="bibr" rid="B27">Kondeti et al., 2013</xref>). We recently demonstrated that EC CysLT<sub>2</sub>R mediates calcium influx, EC contraction <italic>in vitro</italic>, permeability of blood vessels, as well as angiogenesis <italic>in vivo</italic> (<xref ref-type="bibr" rid="B10">Duah et al., 2013</xref>, <xref ref-type="bibr" rid="B11">2019</xref>). In addition, we also demonstrated that cys-LTs enhance TNF&#x03B1;-mediated up-regulation of vascular cell adhesion molecule (VCAM-1) and also enhance the attachment of monocytes to the endothelium (<xref ref-type="bibr" rid="B10">Duah et al., 2013</xref>). Since CysLTR signaling causes endothelial dysfunction, leading to enhanced vessel contraction and permeability facilitating monocyte attachment to endothelium, we explored their role in regulating macrophage function in the current study. While there have been many studies on macrophages, foam cell formation, and atherosclerosis, the involvement of cys-LTs or associated molecular mechanisms in macrophage function impacting atherosclerosis progression is elusive. Therefore in this study, we analyzed the role of cys-LTs in the uptake of oxidized LDL by macrophages, an initial step in the formation of foam cells, and the mechanism involved.</p>
</sec>
<sec id="S2" sec-type="materials|methods">
<title>Materials and Methods</title>
<sec id="S2.SS1">
<title>Animals</title>
<p>Bone marrow-derived macrophages (BMDM) were cultured from wild type C57BL/6 (WT) mice (6&#x2013;8-weeks old), purchased from the Jackson Laboratory and maintained at the University of Akron Research vivarium (UARV). Animals were euthanized in accordance with standard guidelines, as approved by the Animal Care and Use Committee of UA.</p>
</sec>
<sec id="S2.SS2">
<title>Materials</title>
<p>Murine recombinant colony stimulating factor (m-CSF) was purchased from Peprotech (Cranbury, NJ). LTD<sub>4</sub> and MK571 (MK) were from Cayman Chemicals (Ann Arbor, MI). Fura-2 AM was purchased from Molecular Probes (Eugene, OR). Texas-red conjugated zymosan bioparticles and DiI conjugated oxLDL were purchased from fisher scientific (Waltham, MA).</p>
</sec>
<sec id="S2.SS3">
<title>Cell Culture</title>
<p>Raw 264.7 (raw) cells were cultured in Dulbecco&#x2019;s Modified Eagle&#x2019;s high glucose medium (DMEM; Corning, NY) supplemented with 10% FBS and 1% pen-strep. THP-1 monocytes were cultured in RPMI-1640 medium supplemented with 10% FBS and 1% pen-strep. These cells were differentiated into macrophages for 48 h in the presence of 50 ng/ml phorbol-12-myristate-13-acetate (PMA). For BMDM, bones (tibia and femur) were collected from 6 to 8 weeks old WT, <italic>Cysltr1<sup>&#x2013;/&#x2013;</sup></italic>, and <italic>Cysltr2<sup>&#x2013;/&#x2013;</sup></italic> mice on C57BL/6 background, and bone marrow cells (BMCs) were isolated by flushing bones. Cells were suspended in R10 media (RPMI-1640 supplemented with 10% FBS, 5% non-essential amino acids, 1% pen-strep, and 50 &#x03BC;M &#x03B2;-mercaptoethanol) and maintained at 37&#x00B0;C. BMCs were differentiated into BMDMs using 10 ng/ml macrophage colony stimulating factor (M-CSF). On third day, the culture plate was replenished with fresh R10 medium containing 10 ng/ml M-CSF, and incubated for 3 more days. We confirmed the purity of the culture by F4/80 staining.</p>
</sec>
<sec id="S2.SS4">
<title>Immunofluorescence</title>
<p>Raw macrophages were fixed with 4% paraformaldehyde solution, and permeabilised with 0.25% Triton X-100 for 15 min. Cells were washed twice with PBS, blocked with 10% FBS containing medium for 30 min and were stained with CysLT<sub>1</sub>R antibody for 1 h. Thereafter, the cells were washed twice in PBS and incubated with Alexa Fluor 488 goat anti-rabbit secondary antibody for 45 min. Images were obtained using EVOS fluorescence microscope.</p>
</sec>
<sec id="S2.SS5">
<title>Ca<sup>2+</sup> Flux Assay</title>
<p>Raw cells, THP-1-derived macrophages, and BMDMs were loaded with Fura-2 AM for 30 min and washed in calcium buffer. Cells were stimulated with LTD<sub>4</sub> (0.5 &#x03BC;M) in the presence or absence of CysLT<sub>1</sub>R antagonist MK (1 &#x03BC;M, 30 min pre-incubation). Changes in the intracellular calcium levels were measured using the ratio of excitation wavelengths (340/380 nm) in a fluorescence spectrophotometer (Hitachi F-4500).</p>
<p>The relative ratios of fluorescence emitted at 510 nm were recorded and displayed as a reflection of intracellular calcium concentration (<xref ref-type="bibr" rid="B39">Paruchuri et al., 2008</xref>).</p>
</sec>
<sec id="S2.SS6">
<title>Zymosan Phagocytosis Assay</title>
<p>Macrophages were cultured as mentioned earlier, and 50,000 cells were plated in each well of an 8-well chamber slide in 200 &#x03BC;l DMEM high glucose, supplemented with 10% FBS, and stimulated with LTD<sub>4</sub> (0.5 &#x03BC;M) for 24 h. Texas-red conjugated zymosan bioparticles were reconstituted to obtain uniform suspension according to the manufacturer&#x2019;s protocol, and 500,000 zymosan bioparticles (1:10) were added to each well and incubated for 1 h. Excess zymosan particles were removed and washed with PBS, and imaged using a fluorescence microscope. The images were quantified by ImageJ and the percentage phagocytosis was calculated based on the percentage of number of cells with zymosan particles compared to total number of cells (DAPI staining).</p>
</sec>
<sec id="S2.SS7">
<title>Oxidized LDL Uptake Assay</title>
<p>Macrophages were stimulated with 0.5 &#x03BC;M LTD<sub>4</sub> for 24 h in the presence or absence of CysLT<sub>1</sub>R antagonist MK (1 &#x03BC;M) pre-incubated for 30 min. After 24 h, macrophages were incubated with oxLDL (10 &#x03BC;g/ml) for 1 h at 37&#x00B0;C in a humidified incubator with 5% CO<sub>2</sub> environment and stained with oil red O (only stains the lipid particles). Excess stain was washed with PBS, and the slides were observed under the microscope. Quantification of phagocytosis was done using ImageJ (NIH) as described above.</p>
</sec>
<sec id="S2.SS8">
<title>Real-Time Quantitative PCR</title>
<p>The expressions of mOLR1, mCD36, and mMCP-1 were determined with qPCR performed on Light cycler 480 (Roche) (<xref ref-type="bibr" rid="B26">Kondeti et al., 2016</xref>). Total RNA was isolated from Raw cells, THP-1-derived macrophages, and BMDMs after respective treatments with an E.Z.N.A. Total RNA kit 1 (Omega Bio-Tek, Norcross, Georgia). DNAse contamination was removed using a DNA-free DNA Removal Kit (Invitrogen, Waltham, MA) based on the manufacturer&#x2019;s instructions. cDNA was synthesized using a cDNA synthesis kit (Roche, Indianapolis, IN). qPCR was performed using the primers mentioned below. The levels of respective genes relative to the GAPDH were analyzed, and the &#x0394;&#x0394;CT values were calculated and expressed as relative expression or fold change compared to control (no template). The quality of the RNA, primers, and qPCR reaction was validated using proper controls, like no RT control or no template control. Real time PCR for each sample was performed in at least triplicates and then repeated in three different experiments.</p>
<sec id="S2.SS8.SSS1">
<title>Primers</title>
<list list-type="simple">
<list-item><p><bold><italic>mOLR1</italic></bold></p></list-item>
<list-item><p>F: 5&#x2032;-ACAATACCAAGCGAACCTTACT-3&#x2032;; R: 5&#x2032;-TGGGT GAGGGTGTCTATCTT-3&#x2032;</p></list-item>
<list-item><p><bold><italic>mCD36</italic></bold></p></list-item>
<list-item><p>F: 5&#x2032;-CCAGTCGGAGACATGCTTATT-3&#x2032;; R: 5&#x2032;-GTACAC AGTGGTGCCTGTT-3&#x2032;</p></list-item>
<list-item><p><bold><italic>mMCP-1</italic></bold></p></list-item>
<list-item><p>F: 5&#x2032;-AGTAGGCTGGAGAGCTACAA-3; R: 5&#x2032;-GTATGT CTGGACCCATTCCTTC-3&#x2032;</p></list-item>
<list-item><p><bold><italic>mGAPDH</italic></bold></p></list-item>
<list-item><p>F: 5&#x2032;-CTCCCACTCTTCCACCTTCG-3&#x2032;; R: 5&#x2032;-CCACCA CCCTGTTGCTGTAG-3&#x2032;</p></list-item>
</list>
</sec>
</sec>
<sec id="S2.SS9">
<title>ELISA</title>
<p>The concentrations of MCP-1 and MIP1&#x03B2; secreted into the medium by macrophages after respective treatments were analyzed by MCP-1 ELISA kit (Invitrogen, Waltham, MA) and MIP1&#x03B2; ELISA kit (R &#x0026; D Systems, Minneapolis, MN), respectively, according to the manufacturer&#x2019;s protocol (<xref ref-type="bibr" rid="B26">Kondeti et al., 2016</xref>).</p>
</sec>
<sec id="S2.SS10">
<title>Statistical Analysis</title>
<p>Data are expressed as means &#x00B1; SEM from at least three experiments except where otherwise indicated. Data were converted to a percentage of control for each experiment where indicated. Significance was determined using one-way ANOVA, and comparisons between the groups were determined by Tukey&#x2019;s multiple comparisons test (GraphPad Prism 7.01; GraphPad Software, La Jolla, CA, United States). &#x002A;<italic>P</italic> &#x003C; 0.05, &#x002A;&#x002A;<italic>P</italic> &#x003C; 0.01, &#x002A;&#x002A;&#x002A;<italic>P</italic> &#x003C; 0.001.</p>
</sec>
</sec>
<sec sec-type="results" id="S3">
<title>Results</title>
<sec id="S3.SS1">
<title>Leukotriene D<sub>4</sub> Mediated Calcium Flux in Macrophages</title>
<p>To understand the role of CysLTR signaling in regulating macrophage function, first we studied the expression of CysLT<sub>1</sub>R and CysLT<sub>2</sub>R in three different macrophage cell types- raw macrophages, THP-1-derived macrophages, and BMDMs by qPCR. Our results revealed that all macrophages mainly express CysLT<sub>1</sub>R compared to CysLT<sub>2</sub>R (<xref ref-type="fig" rid="F1">Figures 1A&#x2013;C</xref>). We observed a modest expression of CysLT<sub>2</sub>R in BMDMs. None of the macrophages revealed expression of GPR99 transcript (not shown). Immune-staining of raw macrophages revealed significant CysLT<sub>1</sub>R expression at protein level (<xref ref-type="fig" rid="F1">Figure 1D</xref>). Further, in Fura-2 loaded macrophages, LTD<sub>4</sub> induced robust calcium flux, which is completely blocked by pretreatment of the cells with MK (<xref ref-type="fig" rid="F1">Figures 1E&#x2013;J</xref>), which competitively antagonizes CysLT<sub>1</sub>R, but not CysLT<sub>2</sub>R (<xref ref-type="bibr" rid="B39">Paruchuri et al., 2008</xref>; <xref ref-type="bibr" rid="B11">Duah et al., 2019</xref>). Thus, macrophages flux calcium mainly <italic>via</italic> CysLT<sub>1</sub>R.</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption><p>Cys-LTs induce calcium flux in macrophages through CysLT<sub>1</sub>R. The expression of CysLT<sub>1</sub>R and CysLT<sub>2</sub>R transcript was analyzed in <bold>(A)</bold> raw macrophages, <bold>(B)</bold> THP-1-derived macrophages, and <bold>(C)</bold> BMDMs by qPCR. <bold>(D)</bold> Immune-staining of raw macrophages for CysLT<sub>1</sub>R expression. Macrophages were loaded with Fura-2-AM, stimulated with LTD<sub>4</sub> (0.5 &#x03BC;M), and then calcium flux was measured in <bold>(E)</bold> raw macrophages, <bold>(F)</bold> THP-1-derived macrophages, and <bold>(G)</bold> BMDM in the presence or absence of CysLT<sub>1</sub>R antagonist MK. Panels <bold>(H&#x2013;J)</bold> represent quantification of data from panels <bold>(E&#x2013;G)</bold>, respectively. The results shown are mean &#x00B1; SEM from three independent experiments (Student&#x2019;s <italic>t</italic>-test, &#x002A;<italic>p</italic> &#x2264; 0.05 and &#x002A;&#x002A;&#x002A;<italic>p</italic> &#x2264; 0.001).</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fphys-12-756450-g001.tif"/>
</fig>
</sec>
<sec id="S3.SS2">
<title>Phagocytosis in Response to Leukotriene D<sub>4</sub> in Macrophages</title>
<p>To explore the phagocytic ability of macrophages in response to LTD<sub>4</sub>, we treated raw macrophages and BMDMs with 0.5 &#x03BC;M LTD<sub>4</sub> for 24 h, and then performed phagocytosis assay using Texas red conjugated zymosan particles. LTD<sub>4</sub> increased the phagocytosis of zymosan particles in raw macrophages (<xref ref-type="fig" rid="F2">Figures 2A,B</xref>). Although BMDM exhibited higher basal phagocytosis compared to raw macrophages, LTD<sub>4</sub> significantly potentiated phagocytosis in these macrophages (<xref ref-type="fig" rid="F2">Figures 2C,D</xref>).</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption><p>Cys-LTs enhance phagocytosis in macrophages. Fluorescence micrographs showing zymosan particle phagocytosis in <bold>(A)</bold> raw macrophages and <bold>(C)</bold> BMDMs. Macrophages were treated with 0.5 &#x03BC;M LTD<sub>4</sub> for 24 h and incubated with zymosan particles (1:10) for 1 h. Images were quantified using ImageJ. Panels <bold>(B,D)</bold> represent the quantification of raw macrophages and BMDMs, respectively. The results shown are mean &#x00B1; SEM from three experiments performed (Student&#x2019;s <italic>t</italic>-test, &#x002A;&#x002A;<italic>p</italic> &#x2264; 0.01 &#x002A;&#x002A;&#x002A;<italic>p</italic> &#x2264; 0.001).</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fphys-12-756450-g002.tif"/>
</fig>
</sec>
<sec id="S3.SS3">
<title>Effect of Leukotriene D<sub>4</sub> on Oxidized LDL Uptake in Macrophages</title>
<p>To determine whether LTD<sub>4</sub> can modulate the uptake of oxLDL, macrophages were subjected to LTD<sub>4</sub> for 24 h followed by incubation with oxLDL for another hour. The uptake of oxLDL was determined by staining with oil red O. We observed enhanced uptake of oxLDL when macrophages were treated with LTD<sub>4</sub>, as visualized by oil red O staining (<xref ref-type="fig" rid="F3">Figures 3A,B</xref>). Notably, CysLT<sub>1</sub>R antagonist MK abrogated this response, suggesting that LTD<sub>4</sub> potentiates oxLDL uptake <italic>via</italic> CysLT<sub>1</sub>R. In agreement, BMDM lacking CysLT<sub>1</sub>R exhibited an attenuated oxLDL uptake compared to WT and CysLT<sub>2</sub>R-deficient BMDMs (<xref ref-type="fig" rid="F3">Figure 3C</xref>).</p>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption><p>Cys-LTs induce oxLDL uptake in macrophages. Representative images showing oxLDL uptake in macrophages. Cells were treated with 0.5 &#x03BC;M LTD<sub>4</sub> for 24 h in the presence or absence of CysLT<sub>1</sub>R antagonist MK (1 &#x03BC;M) and then incubated with oxLDL for 1 h. Thereafter, cells were stained with oil red-O (ORO), imaged and quantified using ImageJ. <bold>(A)</bold> Images of control and LTD<sub>4</sub>-treated cells depicting positive ORO staining, <bold>(B)</bold> quantification of ORO staining in macrophages pre-treated with or without MK and treated with or without LTD<sub>4</sub>. <bold>(C)</bold> Bone marrow cells were isolated from WT, <italic>Cysltr1<sup>&#x2013; /&#x2013;</sup> </italic>, and <italic>Cysltr2<sup>&#x2013; /&#x2013;</sup> </italic> mice and then cultured for 6 days with M-CSF to differentiate them into macrophages. BMDMs were incubated with fluorescently labeled oxLDL for 1 h and the oxLDL uptake was measured by analyzing the fluorescence incorporated into the cells using BioTek microplate reader. Results shown are mean &#x00B1; SEM from three separate experiments (one-way ANOVA followed by <italic>post hoc</italic> Tukey multiple comparison test, &#x002A;<italic>p</italic> &#x2264; 0.05, &#x002A;&#x002A;<italic>p</italic> &#x2264; 0.01, ns = not significant).</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fphys-12-756450-g003.tif"/>
</fig>
</sec>
<sec id="S3.SS4">
<title>Leukotriene D<sub>4</sub>-Induced Changes in Oxidized LDL Receptors</title>
<p>Macrophages are known for their receptor-mediated phagocytosis to ingest extracellular particles (<xref ref-type="bibr" rid="B18">Guest et al., 2007</xref>). Because LTD<sub>4</sub> enhances phagocytosis and oxLDL uptake, we examined if LTD<sub>4</sub> promotes the expression of scavenger receptors. We treated macrophages with LTD<sub>4</sub> and analyzed the mRNA expression of receptors known to be involved in phagocytosis by qPCR. <italic>OLR1</italic> transcript was upregulated with LTD<sub>4</sub> in a dose-dependent manner (<xref ref-type="fig" rid="F4">Figure 4A</xref>). Similarly, LTD<sub>4</sub> caused up-regulation of CD36 transcript (<xref ref-type="fig" rid="F5">Figure 5A</xref>), starting from 0.1 &#x03BC;M and sustained with increasing doses. Temporally, <italic>OLR1</italic> mRNA upregulation by LTD<sub>4</sub> was relatively early, peaking at 6 h and declined later (<xref ref-type="fig" rid="F4">Figure 4B</xref>). In contrast, CD36 transcript was enhanced starting 6 h and sustained till 24 h (<xref ref-type="fig" rid="F5">Figure 5B</xref>). Reflecting our transcript data, we observed increase in OLR1 protein at 6 and 12 h of LTD<sub>4</sub> treatment and declined by 24 h (<xref ref-type="fig" rid="F4">Figures 4C,D</xref>). Similarly, CD36 protein expression is augmented by LTD<sub>4</sub> treatment starting at 6 h with a significant increase at 12 and 24 h (<xref ref-type="fig" rid="F5">Figures 5C,D</xref>).</p>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption><p>Cys-LTs induce upregulation of OLR1 transcript and protein. Raw macrophages were treated with increasing concentrations of LTD<sub>4</sub> for 6, 12, and 24 h, and the expressions of <italic>OLR1</italic> transcript <bold>(A,B)</bold> was analyzed using qPCR and protein expression was analyzed by Western blotting <bold>(C,D)</bold>. The results shown are mean &#x00B1; SEM from three separate experiments (one-way ANOVA followed by <italic>post hoc</italic> Tukey multiple comparison test, &#x002A;&#x002A;<italic>p</italic> &#x2264; 0.01, &#x002A;&#x002A;&#x002A;<italic>p</italic> &#x2264; 0.001, ns = not significant).</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fphys-12-756450-g004.tif"/>
</fig>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption><p>Cys-LTs induce upregulation of CD36 transcript and protein. Raw macrophages were treated with increasing concentrations of LTD<sub>4</sub> for 6, 12, and 24 h, and the expressions of CD36 transcript <bold>(A,B)</bold> was analyzed using qPCR and protein expression was analyzed by Western blotting <bold>(C,D)</bold>. The results shown are mean &#x00B1; SEM from three separate experiments (one-way ANOVA followed by <italic>post hoc</italic> Tukey multiple comparison test, &#x002A;<italic>p</italic> &#x2264; 0.05, &#x002A;&#x002A;<italic>p</italic> &#x2264; 0.01, &#x002A;&#x002A;&#x002A;<italic>p</italic> &#x2264; 0.001, ns = not significant).</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fphys-12-756450-g005.tif"/>
</fig>
</sec>
<sec id="S3.SS5">
<title>Induction of Monocyte Chemoattractant Protein-1 by Leukotriene D<sub>4</sub></title>
<p>MCP-1 (CCL-2) has been associated with atherosclerosis <italic>via</italic> increasing foam cell load in the intima of the blood vessels (<xref ref-type="bibr" rid="B28">Lin et al., 2014</xref>). We asked whether LTD<sub>4</sub> induces MCP-1 expression by macrophages. Real-time PCR analysis showed that LTD<sub>4</sub> stimulation of raw macrophages induced the expression of MCP-1 transcripts at all doses tested (<xref ref-type="fig" rid="F6">Figure 6A</xref>). Further. LTD<sub>4</sub>-potentiated MCP-1 transcript peaked at 12 h and sustained till 24 h (<xref ref-type="fig" rid="F6">Figure 6B</xref>). Consistent with mRNA data, LTD<sub>4</sub> induced MCP-1 expression at the protein level as determined by ELISA, sensitive to MK571 (<xref ref-type="fig" rid="F6">Figure 6C</xref>). Notably, we found similar potentiation of MCP-1 and MIP1&#x03B2; in BMDMs (<xref ref-type="fig" rid="F6">Figures 6D,E</xref>).</p>
<fig id="F6" position="float">
<label>FIGURE 6</label>
<caption><p>CysLTs enhance MCP-1 production in macrophages. Raw macrophages were treated with increasing concentrations of LTD<sub>4</sub> <bold>(A)</bold>, for 6, 12, and 24 h <bold>(B)</bold>, and <italic>MCP-1</italic> transcript was analyzed using qPCR. In panel <bold>(C)</bold>, raw macrophages were pre-incubated for 30 min in the presence or absence of MK571, treated with 0.5 &#x03BC;M LTD<sub>4</sub> for 6 h and supernatants were collected and analyzed for MCP-1. BMDMs <bold>(D,E)</bold> were treated with 0.5 &#x03BC;M LTD<sub>4</sub> for 6 h, supernatants were collected and <bold>(D)</bold> MCP-1 protein and <bold>(E)</bold> MIP1&#x03B2; protein in the supernatants were analyzed by ELISA according to the manufacturer&#x2019;s instructions. The results shown are mean &#x00B1; SEM from three experiments (one-way ANOVA followed by <italic>post hoc</italic> Tukey multiple comparison test, &#x002A;<italic>p</italic> &#x2264; 0.05, &#x002A;&#x002A;<italic>p</italic> &#x2264; 0.01 &#x002A;&#x002A;&#x002A;<italic>p</italic> &#x2264; 0.001, ns = not significant).</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fphys-12-756450-g006.tif"/>
</fig>
</sec>
</sec>
<sec sec-type="discussion" id="S4">
<title>Discussion</title>
<p>5-Lipoxygenase metabolites have been implicated to play an important role in phagocytosis of macrophages (<xref ref-type="bibr" rid="B43">Serezani et al., 2011</xref>), and they are associated with inflammatory diseases like atherosclerosis (<xref ref-type="bibr" rid="B4">Back and Hansson, 2006</xref>). The 5-LO pathway has been demonstrated to be abundantly expressed in the arterial walls of patients suffering from various lesion stages of atherosclerosis of the aorta, with an increased number of 5-LO expressing cells (macrophages, dendritic cells, foam cells, mast cells, and neutrophilic granulocytes) in advanced lesions (<xref ref-type="bibr" rid="B45">Spanbroek et al., 2003</xref>). Notably, mice deficient in 5-LO were reported to exhibit reduced lesions in <italic>LDLR<sup>&#x2013;/&#x2013;</sup></italic> background, suggesting that leukotrienes may play a dominant role in atherogenesis (<xref ref-type="bibr" rid="B34">Mehrabian et al., 2002</xref>). LTB<sub>4</sub>, also a 5-LO metabolite, was shown to play vital roles during atherogenesis <italic>via</italic> its receptors, BLT-1 and BLT-2 (<xref ref-type="bibr" rid="B46">Subbarao et al., 2004</xref>). Although the involvement of the 5-LO pathway in mediating atherosclerosis is convincing, the role of CysLTR and associated signaling in modulating macrophage function and atherosclerosis still remains elusive. Macrophages are not only equipped with all the essential enzymes to synthesize cys-LTs in response to various agonists, but also possess the relevant receptors to facilitate autocrine signaling. Therefore, it is vital to understand how cys-LTs modulate macrophage function. Previous studies from our lab suggest that CysLTR signaling causes endothelial dysfunction and potentiates the attachment of monocytes to EC in response to TNF&#x03B1; (<xref ref-type="bibr" rid="B10">Duah et al., 2013</xref>). Based on these findings, we speculated that cys-LTs generated at the site of inflammation may also trigger macrophage dysfunction and contribute to atherosclerosis. To address this, we first confirmed the CysLTR expression in three different macrophage populations. We found that macrophages mainly express CysLT<sub>1</sub>R compared to CysLT<sub>2</sub>R, in agreement with the literature (<xref ref-type="bibr" rid="B30">Lotzer et al., 2003</xref>). Since CysLT<sub>1</sub>R couples to G&#x03B1;q in many systems, generating calcium flux upon activation (<xref ref-type="bibr" rid="B31">Lynch et al., 1999</xref>), we measured intracellular calcium in macrophages in response to LTD<sub>4</sub> and confirmed that macrophages mainly flux calcium in response to LTD<sub>4</sub> <italic>via</italic> CysLT<sub>1</sub>R, employing CysLT<sub>1</sub>R antagonist MK. We next asked what effect this receptor has in modulating macrophage phagocytosis. Macrophages play a vital role in the phagocytosis of infectious agents, pathogens, and debris during inflammation, which is crucial for maintaining cellular homeostasis (<xref ref-type="bibr" rid="B19">Han et al., 2016</xref>). We observed that LTD<sub>4</sub> significantly promoted phagocytosis of zymosan bioparticles in both raw macrophages and BMDMs, although BMDMs exhibited enhanced basal phagocytosis compared to raw macrophages. Endothelial dysfunction leading to lipid modification is perceived as a danger signal by the macrophages, and they function by engulfing these cholesterol-rich lipid molecules, leading to the formation of lipid-laden foam cells (<xref ref-type="bibr" rid="B47">Tabas and Bornfeldt, 2016</xref>). Our previous study demonstrated that cys-LTs cause endothelial cell (EC) dysfunction such as EC contraction, gap formation, and attachment of monocytes to the endothelium (<xref ref-type="bibr" rid="B10">Duah et al., 2013</xref>). Notably, LTB<sub>4</sub> (<xref ref-type="bibr" rid="B52">Zhang et al., 2017</xref>) and cys-LTs (<xref ref-type="bibr" rid="B51">Yu et al., 2014</xref>) have been shown to be involved in the recruitment of immune cells to the site of inflammation, enhancing phagocytosis. Further, the enhanced expression of 5-LO and cys-LTs have been shown in atherosclerotic lesions, suggesting their potential role in plaque instability and atherosclerosis progression (<xref ref-type="bibr" rid="B42">Qiu et al., 2006</xref>). Based on these studies, we wondered about the role of the LTD<sub>4</sub>/CysLT<sub>1</sub>R axis on oxLDL uptake in macrophages. Our results demonstrate that LTD<sub>4</sub> <italic>via</italic> CysLT<sub>1</sub>R enhanced the uptake of oxLDL in macrophages. BMDMs lacking CysLT<sub>1</sub>R exhibited an attenuated uptake compared to WT and CysLT<sub>2</sub>R null BMDMs, further suggesting an important role of cys-LTs in engulfing oxidized lipids. We further explored the mechanism and relevant cell surface oxLDL receptors activated by LTD<sub>4</sub>, which are responsible for lipid accumulation and foam cells in macrophages. OxLDL acts <italic>via</italic> binding to several receptors, including CD36, and OLR1, Peroxisome proliferator-activated receptor-gamma coactivator 1 &#x03B1; (PGC-1&#x03B1;), and SRA mediating lipid accumulation (<xref ref-type="bibr" rid="B14">Febbraio et al., 2000</xref>; <xref ref-type="bibr" rid="B18">Guest et al., 2007</xref>; <xref ref-type="bibr" rid="B41">Patten and Shetty, 2018</xref>). We observed the upregulation of <italic>OLR1</italic> and <italic>CD36</italic> in response to LTD<sub>4</sub>. Notably, we could not detect the upregulation of other scavenger receptors like <italic>PGC1</italic>&#x03B1; and <italic>SRA1</italic> by LTD<sub>4</sub> (not shown), suggesting that LTD<sub>4</sub> signaling is relayed mainly <italic>via</italic> CD36 and OLR1, contributing to enhanced uptake of lipid molecules. OLR1 is a membrane glycoprotein that can selectively bind and internalize oxLDL (<xref ref-type="bibr" rid="B37">Ogura et al., 2009</xref>). Several inflammatory and atherosclerosis-related stimuli have been shown to induce OLR1 expression, including lipopolysaccharide (LPS), TNF&#x03B1;, interleukin-1 (IL-1), interferon gamma (IFN&#x03B3;), oxLDL, and angiotensin II (<xref ref-type="bibr" rid="B49">Xu et al., 2013</xref>). CD36 belongs to the class B scavenger receptor family, and it is expressed on various cell types, including macrophages, platelets, and microvascular EC (<xref ref-type="bibr" rid="B38">Park, 2014</xref>). CD36-null mice were shown to exhibit increased cholesterol, triacylglycerol, and fatty acids in the plasma level, suggesting a major role of CD36 in fatty acid uptake and lipid metabolism <italic>in vivo</italic> (<xref ref-type="bibr" rid="B13">Febbraio et al., 1999</xref>).</p>
<p>Apart from the above mentioned receptors, chemokine CCL2/MCP-1 is a critical mediator of atherosclerosis, and the absence of MCP-1 has been shown to reduce atherosclerosis in low-density lipoprotein receptor-deficient mice (<xref ref-type="bibr" rid="B17">Gu et al., 1998</xref>). In support, MCP-1 expression was observed in human and rabbit atherosclerotic plaques (<xref ref-type="bibr" rid="B50">Yla-Herttuala et al., 1991</xref>), and a reduction in arterial lipid deposition was observed in CCL2 deficient mice (<xref ref-type="bibr" rid="B5">Boring et al., 1998</xref>). MCP-1 null mice were shown to have severe defects in monocyte recruitment to inflammatory sites (<xref ref-type="bibr" rid="B17">Gu et al., 1998</xref>), suggesting that MCP-1 plays an essential role in monocyte/macrophage populations. Interestingly, LTD<sub>4</sub> was shown to up-regulate MCP-1 in human monocytes and macrophages (<xref ref-type="bibr" rid="B22">Ichiyama et al., 2005</xref>). This prompted us to analyze if LTD<sub>4</sub> signaling to lipid uptake required MCP-1. We observed an enhanced <italic>MCP-1</italic> expression in response to LTD<sub>4</sub>, both at the transcript and protein level.</p>
</sec>
<sec sec-type="conclusion" id="S5">
<title>Conclusion</title>
<p>In conclusion, our study demonstrated a role for cys-LT/CysLT<sub>1</sub>R in upregulating CD36 and OLR1 receptors and MCP-1, and subsequent uptake of oxidized lipid molecules (<xref ref-type="fig" rid="F7">Figure 7</xref>). All these events are crucial for foam cell formation during atherosclerosis. CysLT<sub>1</sub>R antagonists are FDA-approved and have been widely used in the therapy of asthma for the past few decades, with minimal side effects. Our study further suggests that these drugs may be repurposed for the treatment of atherosclerosis.</p>
<fig id="F7" position="float">
<label>FIGURE 7</label>
<caption><p>Schematic, suggests the role for CysLT<sub>1</sub>R in macrophage activation and atherosclerosis. LTD<sub>4</sub> stimulation induces the upregulation of oxLDL receptors, OLR1, and CD36 <italic>via</italic> CysLT<sub>1</sub>R, which in turn facilitates oxLDL uptake in macrophages, resulting in foam cell formation. LTD<sub>4</sub> also induces the secretion of MCP-1 and MIP1&#x03B2; in macrophages, which further recruits immune cells, amplifying inflammation. These events can lead to atherosclerosis, and our study suggests that CysLT<sub>1</sub>R antagonist, MK (Montelukast) can be used as a novel therapeutic target for the treatment of atherosclerosis.</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fphys-12-756450-g007.tif"/>
</fig>
</sec>
<sec sec-type="data-availability" id="S6">
<title>Data Availability Statement</title>
<p>The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.</p>
</sec>
<sec id="S7">
<title>Ethics Statement</title>
<p>The animal study was reviewed and approved by the Animal Care and Use Committee of University of Akron.</p>
</sec>
<sec id="S8">
<title>Author Contributions</title>
<p>SPo, RG, LT, and ED performed the experiments, analyzed the data, and edited the manuscript. CT designed the experiments and edited the manuscript. SPa designed the experiments, performed the research, analyzed and interpreted the data, and wrote the manuscript. All authors contributed to the article and approved the submitted version.</p>
</sec>
<sec sec-type="COI-statement" id="conf1">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="pudiscl1">
<title>Publisher&#x2019;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
</body>
<back>
<sec sec-type="funding-information" id="S9">
<title>Funding</title>
<p>This work was supported by James Foght Professor support (University of Akron), NIH R01AI144115 (SPa), and NIH R01HL148585 (CT).</p>
</sec>
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</ref-list>
<glossary>
<title>Abbreviations</title>
<def-list id="DL1">
<def-item><term>CysLT<sub>1</sub>R</term><def><p>Cysteinyl Leukotriene 1 Receptor</p></def></def-item>
<def-item><term>CysLT<sub>2</sub>R</term><def><p>Cysteinyl Leukotriene 2 Receptor</p></def></def-item>
<def-item><term>BMDM</term><def><p>Bone marrow-derived macrophages</p></def></def-item>
<def-item><term>LTD<sub>4</sub></term><def><p>Leukotriene D<sub>4</sub></p></def></def-item>
<def-item><term>OLR1</term><def><p>Oxidized low-density lipoprotein receptor 1</p></def></def-item>
<def-item><term>LDL</term><def><p>Low density lipoprotein</p></def></def-item>
<def-item><term>MCP-1</term><def><p>Monocyte chemoattractant protein-1</p></def></def-item>
<def-item><term>MIP1 &#x03B2; </term><def><p>Macrophage Inflammatory protein-1 &#x03B2;.</p></def></def-item>
</def-list>
</glossary>
</back>
</article>