# Remdesivir inhibits endothelial activation and atherosclerosis by coupling TAL1 to TRAF6

## TL;DR

Remdesivir, an antiviral drug, reduces atherosclerosis by restoring a key protein interaction that lowers inflammation in blood vessels.

## Contribution

Remdesivir is shown to inhibit atherosclerosis by coupling TAL1 to TRAF6, a novel mechanism for an existing drug.

## Key findings

- Remdesivir reduced atherosclerotic lesions and VCAM-1 expression in ApoE−/− mice.
- The drug restored the TAL1-TRAF6 interaction and suppressed endothelial activation.
- TAL1 overexpression in mice also reduced aortic plaque formation.

## Abstract

Atherosclerosis is characterized by complex pathological processes, including endothelial dysfunction and inflammation. The underlying pathogenic mechanisms have been well elucidated; however, effective treatments are yet to be validated. Our study explored the novel application of a recognized antiviral agent, remdesivir, focusing on its impact on endothelial activation and atherosclerosis.

Pharmacological treatment with remdesivir significantly reduced atherosclerotic lesions in the total aorta and decreased VCAM-1 expression in aortic roots of ApoE−/− mice. Remdesivir notably attenuated ox-LDL-induced endothelial cell (EC) activation, monocyte adhesion, and ROS production. In HUVECs, TAL1 interference via siRNA significantly increased TRAF6 protein levels, which was reversed by remdesivir. Remdesivir also reduced both total and K63-linked ubiquitination of TRAF6 in HUVECs. Immunoprecipitation assays revealed diminished co-localization of the two proteins under ox-LDL treatment, but this effect was reversed by remdesivir. Importantly, ectopic adeno-associated virus (AAV)-mediated overexpression of TAL1 reduced atherosclerotic lesions and VCAM-1 expression in the aorta of ApoE−/− mice.

In ApoE–/– mice fed with a Western diet, remdesivir greatly attenuated atherosclerosis progression. At the cellular level, remdesivir suppressed oxidative stress, THP-1 adhesion, vascular cell adhesion molecule 1, and intercellular adhesion molecule 1 via oxidized low-density lipoprotein in human umbilical vein endothelial cells. T-cell acute lymphoblastic leukemia 1 (TAL1) functions by interacting with the ubiquitin E3 ligase TNF receptor-associated factor 6 (TRAF6) to ubiquitinate TRAF6, inhibiting nuclear factor kappa B activation. Remdesivir also restored the TAL1-TRAF6 interaction and decreased endothelial activation. Endothelial-specific TAL1 over-expression in ApoE–/– mice significantly reduced aortic plaque formation.

Remdesivir impedes atherosclerosis progression by re-establishing the interaction between TAL1 and TRAF6, diminishing endothelial activation. These findings offer an innovative therapeutic approach for atherosclerosis.

The online version contains supplementary material available at 10.1186/s12967-025-06673-2.