寿司的一种低频变体、血管性血友病因子 A 型、EGF 和含有五聚蛋白结构域的蛋白 1 (SVEP1)（一种细胞外基质蛋白）与人类患冠心病的风险相关，与血浆脂质无关。尽管存在强大的统计关联，但 SVEP1 是否以及如何导致动脉粥样硬化仍不清楚。在这里，使用孟德尔随机化和互补小鼠模型，我们提供证据表明 SVEP1 促进人类和小鼠的动脉粥样硬化，并由动脉粥样硬化斑块内的血管平滑肌细胞 (VSMC) 表达。VSMC 还与 SVEP1 相互作用，导致关键分化途径的增殖和失调，包括整合素和 Notch 信号传导。SVEP1变体 p.D2702G。这些影响最终会导致炎症并促进动脉粥样硬化。总之，我们的结果表明 VSMC 衍生的 SVEP1 是一种致动脉粥样硬化因子，并支持 SVEP1 的药理学抑制应防止人类发生动脉粥样硬化的概念。

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A low-frequency variant of sushi, von Willebrand factor type A, EGF, and pentraxin domain-containing protein 1 (SVEP1), an extracellular matrix protein, is associated with risk of coronary disease in humans independent of plasma lipids. Despite a robust statistical association, if and how SVEP1 might contribute to atherosclerosis remained unclear. Here, using Mendelian randomization and complementary mouse models, we provide evidence that SVEP1 promotes atherosclerosis in humans and mice and is expressed by vascular smooth muscle cells (VSMCs) within the atherosclerotic plaque. VSMCs also interact with SVEP1, causing proliferation and dysregulation of key differentiation pathways, including integrin and Notch signaling. Fibroblast growth factor receptor transcription increases in VSMCs interacting with SVEP1 and is further increased by the coronary disease–associated SVEP1 variant p.D2702G. These effects ultimately drive inflammation and promote atherosclerosis. Together, our results suggest that VSMC-derived SVEP1 is a proatherogenic factor and support the concept that pharmacological inhibition of SVEP1 should protect against atherosclerosis in humans.