Food and Behaviour Research

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Sweetener aspartame aggravates atherosclerosis through insulin-triggered inflammation

Wu W, Sui W, Chen S, Guo Z, Jing X, Wang X, Wang Q, Yu X, Xiong W, Ji J, Yang L, Zhang Y, Jiang W, Yu G, Liu S, Tao W, Zhao C, Zhang Y, Chen Y, Zhang C, Cao Y (2025) Cell Metabolism  Feb 19:S1550-4131(25)00006-3 doi: 10.1016/j.cmet.2025.01.006 

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Abstract:

Consumption of artificial sweeteners (ASWs) in various foods and beverages has been linked to an increased risk of cardiovascular diseases (CVDs). However, molecular mechanisms underlying ASW-associated CVD remain unknown. Here, we show that consumption of 0.15% aspartame (APM) markedly increased insulin secretion in mice and monkeys. Bilateral subdiaphragmatic vagotomy (SDV) obliterated APM-elevated blood insulin levels, demonstrating crucial roles of parasympathetic activation in regulation of insulin secretion. Incessant APM feeding of ApoE-/- mice aggravated atherosclerotic plaque formation and growth via an insulin-dependent mechanism. Implantation of an insulin-slow-release pump in ApoE-/- mice exacerbated atherosclerosis. Whole-genome expression profiling discovered that CX3CL1 chemokine was the most upregulated gene in the insulin-stimulated arterial endothelial cells. Specific deletion of a CX3CL1 receptor, Cx3cr1 gene, in monocytes/macrophages completely abrogated the APM-exacerbated atherosclerosis. Our findings uncover a novel mechanism of APM-associated atherosclerosis and therapeutic targeting of the endothelial CX3CL1-macrophage CX3CR1 signaling axis provides an approach for treating atherosclerotic CVD.

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