- Zhu, Xiaolong;
- Wang, Yunyun;
- Soaita, Ioana;
- Lee, Heon-Woo;
- Bae, Hosung;
- Boutagy, Nabil;
- Bostwick, Anna;
- Zhang, Rong-Mo;
- Bowman, Caitlyn;
- Xu, Yanying;
- Trefely, Sophie;
- Chen, Yu;
- Qin, Lingfeng;
- Sessa, William;
- Tellides, George;
- Jang, Cholsoon;
- Snyder, Nathaniel;
- Yu, Luyang;
- Arany, Zoltan;
- Simons, Michael
Endothelial-to-mesenchymal transition (EndMT), a process initiated by activation of endothelial TGF-β signaling, underlies numerous chronic vascular diseases and fibrotic states. Once induced, EndMT leads to a further increase in TGF-β signaling, thus establishing a positive-feedback loop with EndMT leading to more EndMT. Although EndMT is understood at the cellular level, the molecular basis of TGF-β-driven EndMT induction and persistence remains largely unknown. Here, we show that metabolic modulation of the endothelium, triggered by atypical production of acetate from glucose, underlies TGF-β-driven EndMT. Induction of EndMT suppresses the expression of the enzyme PDK4, which leads to an increase in ACSS2-dependent Ac-CoA synthesis from pyruvate-derived acetate. This increased Ac-CoA production results in acetylation of the TGF-β receptor ALK5 and SMADs 2 and 4 leading to activation and long-term stabilization of TGF-β signaling. Our results establish the metabolic basis of EndMT persistence and unveil novel targets, such as ACSS2, for the potential treatment of chronic vascular diseases.