High levels of the inflammatory
cytokine tumor necrosis factor-alpha (
TNF-alpha) are present in atherosclerotic lesions.
TNF-alpha regulates expression of multiple genes involved in various stages of
atherosclerosis, and it exhibits proatherosclerotic and antiatherosclerotic properties. ACAT catalyzes the formation of
cholesteryl esters (CE) in monocytes/macrophages, and it promotes the foam cell formation at the early stage of
atherosclerosis. We hypothesize that
TNF-alpha may be involved in regulating the ACAT gene expression in monocytes/macrophages. In this article, we show that in cultured, differentiating human monocytes,
TNF-alpha enhances the expression of the ACAT1 but not ACAT2 gene, increases the
cholesteryl ester accumulation, and promotes the
lipid-laden cell formation. Several other proinflammatory
cytokines tested do not affect the ACAT1 gene expression. The stimulation effect is consistent with a receptor-dependent process, and is blocked by using
nuclear factor-kappa B (
NF-kappa B) inhibitors. A functional and unique
NF-kappa B element located within the human ACAT1 gene proximal promoter is required to mediate the action of
TNF-alpha. Our data demonstrate that
TNF-alpha, through the
NF-kappa B pathway, specifically enhances the expression of human ACAT1 gene to promote the CE-laden cell formation from the differentiating monocytes, and our data support the hypothesis that
TNF-alpha is proatherosclerotic during early phase of lesion development.