Histone Lactylation–Mediated Metabolic Remodeling in Vascular Smooth Muscle Cells Aggravates Aortic Aneurysm and Dissection by Promoting Lactate Accumulation

Vascular smooth muscle cells (VSMCs) undergo phenotypic changes during the development of aortic aneurysm and dissection (AAD). Metabolism shifts from oxidative phosphorylation to glycolysis. Recent studies suggest that epigenetics plays a crucial role in AAD.

The epigenetic regulation of histone lactylation was analyzed in the aorta of patients with aortic aneurysm and in a murine model of AAD. Histone lactylation was also studied in VSMCs treated with angiotensin II. The epigenetic pathway involving H4K16 lactylation (H4K16la) was explored in vitro and in vivo. To examine the role of H4K16la in AAD formation, mice lacking Pdk1 or Kat7 in VSMCs were created. Mice were treated with pharmacological inhibitors of Pdk1 or Kat7. The levels of blood lactate, aortic lactate, and aortic H4K16la were compared between patients with aortic aneurysm and controls.