Oleoylethanolamide alleviates hyperlipidaemia-mediated vascular calcification via attenuating mitochondrial DNA stress triggered autophagy-dependent ferroptosis by activating PPARα

Biochem Pharmacol. 2023 Feb;208:115379. doi: 10.1016/j.bcp.2022.115379. Epub 2022 Dec 13.


Vascular calcification, a prevalent pathological alteration in metabolic syndromes, is tightly related with cardiometabolic risk events. Ferroptosis, a newly iron-dependent programmed cell death, induced by palmitic acid (PA), the major saturated free fatty acid in hyperlipidemia, is a vital mechanism of vascular calcification. Recent studies reported that ferroptosis is a distinctive type of cell death dependent on autophagy, with the lipotoxicity of PA on cell viability being closely linked with autophagy. Oleoylethanolamide (OEA), an endogenous bioactive mediator of lipid homeostasis, exerts vascular protection against intimal calcification, atherosclerosis; however, its beneficial effect on vascular smooth muscle cell (VSMC)-associated medial calcification has not been investigated. Our aim was to characterize the effect of OEA on vascular calcification and ferroptosis of VSMCs under hyperlipidaemia/PA exposure. In vivo, vascular calcification model was induced in rats by high-fat diet and vitamin D3 plus nicotine; in vitro, VSMCs ferroptosis was induced by PA or plus β-glycerophosphate mimicking vascular calcification. The calcium deposition in hyperlipidaemia-mediated rat thoracic aortas, the PA-induced ferroptosis and subsequent calcium deposition in VSMCs, were suppressed by OEA treatment. Additionally, CGAS-STING1-induced ferritinophagy, the main molecular mechanism of PA-triggered ferroptosis of VSMCs, was activated by mitochondrial DNA damage; however, early administration of OEA alleviated these phenomena. Intriguingly, overexpression of peroxisome proliferator activated receptor alpha (PPARα) contributed to a decrease in PA-induced ferroptosis, whereas PPARɑ knockdown inhibited the OEA-mediated anti-ferroptotic effects. Collectively, our study demonstrated that OEA serves as a prospective candidate for the prevention and treatment of vascular calcification in metabolic abnormality syndromes.

Keywords: Autophagy; Ferroptosis; Oleoylethanolamide; PPARɑ; Vascular calcification; mtDNA damage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Autophagy
  • Calcium / metabolism
  • DNA, Mitochondrial / metabolism
  • Fatty Acids / metabolism
  • Ferroptosis*
  • Hyperlipidemias* / drug therapy
  • Hyperlipidemias* / metabolism
  • Hyperlipidemias* / pathology
  • Myocytes, Smooth Muscle
  • PPAR alpha / genetics
  • PPAR alpha / metabolism
  • Palmitic Acid / pharmacology
  • Rats
  • Vascular Calcification* / drug therapy
  • Vascular Calcification* / genetics
  • Vascular Calcification* / prevention & control


  • oleoylethanolamide
  • PPAR alpha
  • DNA, Mitochondrial
  • Calcium
  • oleoyl ethanolamine
  • Fatty Acids
  • Palmitic Acid