Proteomics-Based Metabolic Modeling Reveals That Fatty Acid Oxidation (FAO) Controls Endothelial Cell (EC) Permeability

Endothelial cells (ECs) play a key role to maintain the functionality of blood vessels. Altered EC permeability causes severe impairment in vessel stability and is a hallmark of pathologies such as cancer and thrombosis. Integrating label-free quantitative proteomics data into genome-wide metabolic modeling, we built up a model that predicts the metabolic fluxes in ECs when cultured on a tridimensional matrix and organize into a vascular-like network. We discovered how fatty acid oxidation increases when ECs are assembled into a fully formed network that can be disrupted by inhibiting CPT1A, the fatty acid oxidation rate-limiting enzyme. Acute CPT1A inhibition reduces cellular ATP levels and oxygen consumption, which are restored by replenishing the tricarboxylic acid cycle. Remarkably, global phosphoproteomic changes measured upon acute CPT1A inhibition pinpointed altered calcium signaling. Indeed, CPT1A inhibition increases intracellular calcium oscillations. Finally, inhibiting CPT1A induces hyperpermeability in vitro and leakage of blood vessel in vivo, which were restored blocking calcium influx or replenishing the tricarboxylic acid cycle. Fatty acid oxidation emerges as central regulator of endothelial functions and blood vessel stability and druggable pathway to control pathological vascular permeability.Endothelial cells (ECs)¹ line the inner layer of the blood vessel wall and constitute a barrier between blood and surrounding tissue. As such, a tight regulation of EC permeability is crucial to maintain vessel functionality and avoid excessive extravasation of fluid and plasma proteins (1). Increased endothelial permeability is typical in inflammatory states and a hallmark of diseases such thrombosis, atherosclerosis, and cancer (2, 3). Because of their unique localization, ECs are constantly exposed to oxygen and nutrients that fuel cell metabolism and whose levels vary in physiological and pathological conditions. Yet, how cell metabolism regulates endothelial permeability remains incompletely understood.Previous studies have reported that EC cultures use glucose as predominant source of energy by producing lactate through glycolysis. However, also fatty acids and glutamine contribute to ATP and metabolic intermediate production (4–7). Recent in vivo studies have shown that glycolysis is necessary for EC proliferation and motility in physiological and pathological angiogenesis (4, 8). Moreover, the peroxisome proliferator-activated receptor gamma coactivator 1-α, which can activate oxidative phosphorylation, blocks EC sprouting in diabetes (9). The intriguing information emerging from these studies is that key metabolic pathways, such as glycolysis and oxidative phosphorylation in the mitochondria, play an important role in ECs and that they are actively involved in the regulation of key cell functions.Mitochondrial fatty acid oxidation (FAO) is the process that converts fatty acids (FAs) into acetyl-CoA, which fuels the tricarboxylic acid cycle (TCAc) and generates reducing factors for producing ATP via oxidative phosphorylation. Cells can incorporate FAs from the culture media or can generate FAs from the hydrolysis of triglycerides or through de novo synthesis. FAs, then, can access the mitochondria according to their length; whereas short and medium-chain FAs (up to 12 carbon atoms) diffuse through the mitochondrial membrane, long-chain FAs (with 13–21 carbon atoms) are actively transported by the carnitine O-palmitoyl transferase (CPT) proteins, which are rate-limiting enzymes for this pathway (10). Previous work suggested that FAO is poorly utilized by EC cultures (4), however, under certain stress conditions such as glucose deprivation, FAO becomes a major source of energy (7). Although it is striking to note how cells can adapt and remodel their metabolism, the role of key FAO enzymes in the control of EC functions is still largely unclear.Because of the complexity of the cell metabolome, global-scale metabolomic studies for in depth and quantitative analysis of metabolic fluxes are still challenging and computational models have provided invaluable help to better understand cell metabolism. Among them, the integrative metabolic analysis tool (iMAT), which integrates gene expression data with genome-scale metabolic network model (GSMM), has been successfully used to predict enzyme metabolic flux in several model systems and diseases (11, 12). Because gene expression and protein levels do not always correlate, and because enzymes levels do not necessarily reflect their enzymatic activity or the flux of the reaction that they are involved in, iMAT uses expression data as cue for the likelihood, but not final determinant, of enzyme activity. Modern MS technology and robust approaches for protein quantification, such as stable-isotope labeling with amino acids in cell culture (SILAC) (13) and advanced label-free algorithms (14), allow global comparative proteomic analysis and accurate measurements of protein and post-translational modification levels (15). We reasoned that the integration of quantitative MS-proteomic data into GSMM could contribute to the study of cell metabolism. Moreover, metabolic changes trigger activation of protein kinases (16, 17) to rapidly remodel the intracellular signaling and enable cells to adapt to these sudden alterations. Protein phosphorylation therefore plays an important role in regulating cell response to metabolic alteration and may hide information on cellular pathways and functions controlled by specific metabolic activities. MS-based proteomic approaches therefore offer an additional opportunity to investigate in an unbiased manner the interplay between cell metabolism and cell function (18).We have previously shown (19) that when human primary ECs are cultured for 1 day on the three-dimensional matrix matrigel and assemble into a complex network, a simplified model that recapitulates some aspects of vascular network assembly in vivo (20), the levels of metabolic enzymes are profoundly regulated. This result suggested an interplay between cell metabolism and EC behavior. Here we investigate further this aspect. Integrating label-free quantitative MS-proteomics, predictive metabolic modeling and metabolomics we discovered increased FAO when ECs are assembled into a fully formed network. Moreover, by inhibiting CPT1 pharmacologically, we elucidated that FAO is a central regulator of EC permeability in vitro and blood vessel stability in vivo. Thus, proteomics significantly contributes to the study of cell metabolism and here we identified FAO as a promising target for therapeutic intervention for the control of pathological vascular permeability.