Fig. 2: Plasma LDL levels positively correlate with inflammation and lipid accumulation in the aortic valve.

a–c Flow cytometry analyses of the aortic valves of C57BL/6 J, Apoe−/−, and Ldlr−/− mice fed a chow diet (chow) or western diet (WD) for 10 weeks (n = 5). Representative plot of leukocytes (a), percentage of leukocytes, macrophages, and macrophage subsets (b), and correlations between the percentage of MHC-IIhi CD11c+ CD206- macrophages and blood lipid profiles of WD-fed hyperlipidemic mice (c). d–i Apoe−/− mice were injected with PCSK9-AAV to identify the effect of elevated serum LDL levels. PCSK9-AAV-injected Apoe−/− mice were compared with non-injected Apoe−/− mice (WD for 24 weeks). Representative Oil Red O stain images. Scale bar: 150 μm (top), 50 μm (bottom) (d), quantification of valvular lipid deposition and thickness of aortic valve (n = 5) (e), total cholesterol and LDL levels in blood plasma (n = 5 for Apoe−/−, n = 4 for Apoe−/−+PCSK9-AAV) (f), correlation between valvular lipid deposition and each lipid profile (total cholesterol and LDL) (n = 9 total; 5 from Apoe−/−; 4 from Apoe−/−+PCSK9-AAV) (g), immunostaining of CD68 (red) and Vimentin (white) along with the lipid stain using BODIPY 493/503 (green). Scale bar: 150 μm (top), 50 μm (bottom) (h), and quantification of CD68 + macrophages accumulated in the aortic valve (n = 5) (i). j, k Lipid-lowering effects of ezetimibe on lipid accumulation in the aortic valves of WD-fed (for 10 weeks) Ldlr−/− mice (n = 4). Representative lipid stain images. Scale bar: 150 μm (top), 20μm (bottom) (j) and quantification of valvular lipid deposition with blood lipid profiles (k). l, m Effects of lipid-lowering by ezetimibe on the proportion of immune cells in aortic valves of WD-fed (for 10 weeks) Ldlr−/− mice, through flow cytometry (n = 5). Representative plot of leukocytes (l) and percentages of each cell population in single cells (m). WD: western diet. For (b), (e), (f), (i), (k), and (m), two-sided Mann-Whitney test was used. For (c) and (g), the Spearman correlation test was used. Data are presented as mean ± SD.