Evidence map›Paper›PMID 34343254›Full record

ArticleEuropean heart journal2021

Impact of cholesterol on proinflammatory monocyte production by the bone marrow.

Lotte C A Stiekema, Lisa Willemsen, Yannick Kaiser, Koen H M Prange, Nicholas J Wareham, S Matthijs Boekholdt, Carlijn Kuijk, Menno P J de Winther, Carlijn Voermans, Matthias Nahrendorf and 2 more

Open access · hybridAbstract read
In one paragraph

Article in European heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed
6.6field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 74 citations in OpenAlex.

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  12. Maladaptive trained immunity in viral infections.The Journal of clinical investigation · 2025
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  14. Impaired CAMK4 Activity Limits Atherosclerosis and Reprograms Myelopoiesis.Arteriosclerosis, thrombosis, and vascular biology · 2025
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  15. Review
  16. Microorganisms · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 3 countries.

Lotte C A StiekemaDepartment of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.
Lisa WillemsenDepartment of Medical Biochemistry, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.ORCID 0000-0002-9676-9249
Yannick KaiserDepartment of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.
Koen H M PrangeDepartment of Medical Biochemistry, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.ORCID 0000-0002-9835-1735
Nicholas J WarehamMedical Research Council Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK.ORCID 0000-0003-1422-2993
S Matthijs BoekholdtAmsterdam UMC, University of Amsterdam, Department of Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.ORCID 0000-0002-0861-0765
Carlijn KuijkSanquin Research and Landsteiner Laboratory, Department of Hematopoiesis, University of Amsterdam, Plesmanlaan 125, Amsterdam 1066 CX, The Netherlands.
Menno P J de WintherDepartment of Medical Biochemistry, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.ORCID 0000-0002-4038-6636
Carlijn VoermansSanquin Research and Landsteiner Laboratory, Department of Hematopoiesis, University of Amsterdam, Plesmanlaan 125, Amsterdam 1066 CX, The Netherlands.
Matthias NahrendorfCenter for Systems Biology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, Boston, MA 02114, USA.ORCID 0000-0002-4021-1887
Erik S G StroesDepartment of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.ORCID 0000-0001-9555-6260
Jeffrey KroonDepartment of Experimental Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.ORCID 0000-0001-9983-6614
Amsterdam University Medical Centers · NLSanquin · NLHarvard University · USUniversity of Cambridge · GB

Funding

Cancer Research UK 14136Medical Research Council G0401527Medical Research Council G1000143Medical Research Council MC_UU_00006/1Medical Research Council MR/N003284/1
6 · The paper itself

Abstract

aimPreclinical work indicates that low-density lipoprotein cholesterol (LDL-C) not only drives atherosclerosis by directing the innate immune response at plaque level but also augments proinflammatory monocyte production in the bone marrow (BM) compartment. In this study, we aim to unravel the impact of LDL-C on monocyte production in the BM compartment in human subjects. METHODS AND

resultsA multivariable linear regression analysis in 12 304 individuals of the EPIC-Norfolk prospective population study showed that LDL-C is associated with monocyte percentage (β = 0.131 [95% CI: 0.036-0.225]; P = 0.007), at the expense of granulocytes (β = -0.876 [95% CI: -1.046 to -0.705]; P < 0.001). Next, we investigated whether altered haematopoiesis could explain this monocytic skewing by characterizing CD34+ BM haematopoietic stem and progenitor cells (HSPCs) of patients with familial hypercholesterolaemia (FH) and healthy normocholesterolaemic controls. The HSPC transcriptomic profile of untreated FH patients showed increased gene expression in pathways involved in HSPC migration and, in agreement with our epidemiological findings, myelomonocytic skewing. Twelve weeks of cholesterol-lowering treatment reverted the myelomonocytic skewing, but transcriptomic enrichment of monocyte-associated inflammatory and migratory pathways persisted in HSPCs post-treatment. Lastly, we link hypercholesterolaemia to perturbed lipid homeostasis in HSPCs, characterized by lipid droplet formation and transcriptomic changes compatible with increased intracellular cholesterol availability.

conclusionsCollectively, these data highlight that LDL-C impacts haematopoiesis, promoting both the number and the proinflammatory activation of circulating monocytes. Furthermore, this study reveals a potential contributory role of HSPC transcriptomic reprogramming to residual inflammatory risk in FH patients despite cholesterol-lowering therapy.

Indexed as

Bone MarrowMonocytesCholesterolHematopoiesisHumansProspective StudiesCholesterolAtherosclerosisHaematopoiesisHypercholesterolaemiaMonocytesTrained immunityTranscriptomics

Identifiers

PMID34343254
PMCPMC8572558
OpenAlexW3190466779

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.