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Fluoxetine disrupts cholesterol metabolism in endothelial cells via SREBP2 activation

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Item Type:Article
Title:Fluoxetine disrupts cholesterol metabolism in endothelial cells via SREBP2 activation
Creators: Oliveira, Fabiana, Papa, Christina, Hagemann, Tobias, Schipper, Ruby, Geier, Florian, Röxe, Tino, Zulfqar, Faiqa, Prönnecke, Christoph, Schmidt, Lisa, Stryhanyuk, Hryhoriy, Hoffmann, Anne ORCID logoORCID: https://orcid.org/0000-0003-3258-3397, Kyselova, Anastasia, Karantanou, Christina, Buckley, Yuli, Farhan, Muhammad Asad, Rodríguez-Aguilera, Jesús Rafael, Ambreen, Saira, Yao, He, Arif, Amna, Martin, Hugo N.G., Ebert, Thomas, Klöting, Nora, Blüher, Matthias ORCID logoORCID: https://orcid.org/0000-0003-0208-2065, Shahzad, Khurrum, Boeckel, Jes-Niels, Hagberg, Carolina E. ORCID logoORCID: https://orcid.org/0000-0002-5497-2855, Chakaroun, Rima, Bibli, Sofia-Iris ORCID logoORCID: https://orcid.org/0000-0001-7153-6628 and Sheikh, Bilal N. ORCID logoORCID: https://orcid.org/0000-0002-1970-6236
Abstract:Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for the treatment of depressive disorders. Recent clinical reports and studies in animal models have suggested that fluoxetine increases the risk of cardiovascular diseases, but the underlying mechanisms remain unknown. Here, we uncover that fluoxetine disrupts lipid and cholesterol metabolism in primary human endothelial cells (ECs). Fluoxetine triggered an upregulation of cholesterol metabolism genes, leading to the accumulation of lipid droplets in ECs. We find higher levels of cholesterol esters, ceramides, sphingolipids and fatty acids in ECs treated with fluoxetine. The disruption of lipid homeostasis was driven by increased cholesterol biosynthesis, as well as low-density lipoprotein (LDL) uptake and transcytosis via the LDL receptor. Fluoxetine accumulated in ECs in the endoplasmic reticulum (ER), caused ER expansion and reduced protein translation, without inducing ER stress markers. Mechanistically, fluoxetine activated the SREBP2 transcription factor in an INSIG-dependent manner. SREBP2 inhibition attenuated the fluoxetine-mediated upregulation of the LDL receptor and lipid accumulation. Our findings reveal that fluoxetine reprograms lipid metabolism and leads to endothelial dysfunction.
Keywords:Cholesterol, Cultured Cells, Endoplasmic Reticulum, Endothelial Cells, Fluoxetine, LDL Receptors, Lipid Metabolism, Selective Serotonin Reuptake Inhibitors, Sterol Regulatory Element Binding Protein 2, Up-Regulation
Source:Translational Psychiatry
ISSN:2158-3188
Publisher:Nature Publishing Group
Volume:16
Number:1
Page Range:218
Date:23 June 2026
Additional Information:Accession "GSE304246" is currently private and is scheduled to be released on Jul 31, 2026.
Official Publication:https://doi.org/10.1038/s41398-026-04197-x
PubMed:View item in PubMed
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