Fatty acid composition of low-density lipoprotein influences its susceptibility to autoxidation

Effect of infusion of a triacylglycerol emulsion on low-density lipoprotein composition and oxidizability

Six, healthy, male volunteers aged 19-48 years received a 4-h infusion of a triacylgycerol emulsion (Intralipid 10%) after an overnight fast. Plasma triacylglycerol (TAG) and low-density lipoprotein (LDL) -TAG, -protein and -phospholipid concentrations all rose significantly during the course of the infusion and remained elevated 90 min after its end. The weight/weight ratio of LDL-TAG to -protein also increased significantly (from 0.43+/-0.14 to 0.79+/-0.30 at 4 h and 0.63+/-0.31 90 min later), indicating TAG-enrichment of LDL particles. There were no significant changes in LDL particle density. Susceptibility of LDL to copper-induced oxidation, as measured by the lag time for conjugated diene formation, was less at the end of and 90 min after the end of the infusion than in the fasting state (59.3+/-16.5, 47.4+/-17.4 and 34.8+/-19.6 min, respectively). Lag time was positively correlated with LDL TAG in the fasting state (rS=0.900, P < 0.0001) and the correlation continued with the post-infusion TAG-enriched LDL (rs=0.886, P < 0.05). Acute hypertriglyceridaemia induced by infusion of Intralipid therefore causes TAG-enrichment and a decrease in the susceptibility to oxidation of LDL. TAG-enrichment of LDL may lead to subsequent potentially atherogenic changes in LDL following TAG hydrolysis.

Evidence for a paraoxonase-independent inhibition of low-density lipoprotein oxidation by high-density lipoprotein

One mechanism by which plasma high-density lipoprotein (HDL) may protect against atherogenesis is by inhibiting the oxidation of low-density lipoprotein (LDL). Recent evidence suggests that paraoxonase, an HDL-associated, calcium-dependent enzyme, may be responsible for the antioxidant action of HDL (Mackness et al., Atherosclerosis 1993;104:129; Mackness et al., FEBS Lett 1991;286:152; Watson et al., J Clin Invest 1995;96:2882; Navab et al., Arterio Thromb Vasc Biol 1996;16:831); in particular, paraoxonase activity inhibits the formation of 'minimally oxidized' LDL by hydrolyzing biologically active oxidized phospholipids (Watson et al., J Clin Invest 1995;96:2882; Navab et al., Arterio Thromb Vasc Biol 1996;16:831). However, antioxidant effects of HDL have also been demonstrated under calcium-free conditions, arguing that this enzyme may not be the only mechanism by which HDL inhibits LDL oxidation (Tribble et al., J Lipid Res 1995;36:2580). Here we have evaluated the role of paraoxonase in prevention of LDL oxidation by using HDL subfractions, isolated from human serum or EDTA-plasma, which display markedly different levels of paraoxonase activity; the abilities of modified forms of HDL to prevent LDL oxidation by cultured human (THP-1) macrophages were also assessed. Paraoxonase activity was substantially lower in HDL prepared from plasma compared to serum HDL; moreover, virtually all of the lipoprotein-associated paraoxonase activity was located in the HDL3 fraction, with HDL2 retaining only 1-5% of the total activity. Despite possessing 5-fold differences in paraoxonase activity, HDL3 isolated from plasma or serum was equally effective in inhibiting LDL oxidation by THP-1 macrophages; furthermore, although plasma HDL3 was more protective than plasma HDL2, the latter did significantly inhibit LDL oxidation. Non-paraoxonase antioxidant constituents of plasma HDL3 were investigated further. ApoHDL3, the totally delipidated form of HDL3, was much less effective than native HDL3; when examined individually, purified apolipoprotein A-II gave greater protection than apo A-I, although this effect was not evident in apo A-II-enriched HDL3. Partial delipidation of HDL3, which removes both neutral lipids and alpha-tocopherol, did not significantly diminish its ability to inhibit LDL oxidation by THP-1 macrophages; phospholipid vesicles prepared from partially delipidated HDL3 also inhibited LDL oxidation effectively. We conclude that, in this model of cellular LDL oxidation, the phospholipid fraction of HDL exerts inhibitory effects which are independent of HDL paraoxonase activity.

Peroxidation of LDL from combined-hyperlipidemic male smokers supplied with omega-3 fatty acids and antioxidants

The effects of marine omega-3 polyunsaturated fatty acids (FAs) and antioxidants on the oxidative modification of LDL were studied in a randomized, double-blind, placebo-controlled trial. Male smokers (n = 41) with combined hyperlipidemia were allocated to one of four groups receiving supplementation with omega-3 FAs (5 g eicosapentaenoic acid and docosahexaenoic acid per day), antioxidants (75 mg vitamin E, 150 mg vitamin C, 15 mg beta-carotene, and 30 mg coenzyme Q10 per day), both omega-3 FAs and antioxidants, or control oils. LDL and human mononuclear cells were isolated from the patients at baseline and after 6 weeks of supplementation. LDL was subjected to cell-mediated oxidation by the patients' own mononuclear cells, as well as to Cu(2+)-catalyzed and 2,2'-azobis-(2-amidinopropane hydrochloride) (AAPH)-initiated oxidation. Extent of LDL modification was measured as lag time, the formation rate of conjugated dienes (CDs), the maximum amount of CDs formed, formation of lipid peroxides, and the relative electrophoretic mobility of LDL on agarose gels. Dietary supplementation with omega-3 FAs increased the concentration of total omega-3 FAs in LDL and reduced the concentration of vitamin E in serum. The omega-3 FA-enriched LDL particles were not more susceptible to Cu(2+)-catalyzed, AAPH-initiated, or autologous cell-mediated oxidation than control LDL. In fact, enrichment with omega-3 FAs significantly reduced the formation rate of CDs when LDL was subjected to AAPH-induced oxidation. Supplementation with moderate amounts of antioxidants significantly increased the concentration of vitamin E in serum and increased the resistance of LDL to undergo Cu(2+)-catalyzed oxidation, measured as increased lag time, reduced formation of lipid peroxides, and reduced relative electrophoretic mobility compared with control LDL. Supplementation with omega-3 FAs/antioxidants showed oxidizability of LDL similar to that of control LDL and omega-3 FA-enriched LDL. In conclusion, omega-3 FAs neither rendered the LDL particles more susceptible to undergo in vitro oxidation nor influenced mononuclear cells' ability to oxidize autologous LDL, whereas moderate amounts of antioxidants protected LDL against oxidative modification.

Omega-3 and omega-6 fatty acids in the insulin resistance syndrome. Lipid and lipoprotein metabolism and atherosclerosis

Dietary fatty acids appear to be of significant importance for several of the most-common diseases in modern societies. To obtain more knowledge about the health consequences of dietary fatty acids, we depend upon a better understanding of the mechanisms of action of these fatty acids in vivo. With regard to the IRS, omega-3 PUFA may exert beneficial effects upon many of the associated pathophysiological metabolic changes. Omega-3 PUFA reduce fasting and postprandial TG, may improve insulin sensitivity (as shown in animal experiments), decrease platelet and leukocyte reactivity, alter immunological functions, and may slightly decrease blood pressure. Omega-3 PUFA may also beneficially influence vessel wall characteristics and blood rheology. Furthermore, both types of PUFA (omega-3 and omega-6) have been shown to inhibit cardiac arrhythmias in animals. The role of omega-3 PUFA in blood clotting and fibrinolysis still remains controversial, whereas omega-6 fatty acids may lead to increased oxidation of lipoproteins. Regardless of the effects on LDL oxidizability, both types of PUFA have shown beneficial effects on the development of atherosclerosis. As yet, little is known about the effect of specific omega-6 fatty acids with respect to the IRS. Potential adverse effects of dietary PUFA must not be neglected, but should be viewed in light of the beneficial effects of these agents.

Vitamin E supplementation in elderly lowers the oxidation rate of linoleic acid in LDL

Oxidation of LDL-linoleic acid (LDL-LA), a major substrate for lipid peroxidation, may be counteracted by the antioxidant vitamin E. In a 3-month randomized double-blind placebo-controlled trial in 83 apparently healthy Dutch elderly, aged 67-85 years, the direct protective effect of 100 IU vitamin E on the rate of oxidized LDL-LA was studied. The oxidation of LDL-LA was measured by its disappearance after a 5-h in vitro Cu-oxidation of LDL isolated from 1 ml plasma. In the vitamin E group, the decrease in oxidized LDL LA of 10.4, (p < 0.05) was significantly different (p < 0.05) from the smaller 4.6% p< 0.01) decrease in the control group. Moreover, within the vitamin E group the decrease was even more marked over tertiles of alpha-tocopherol to LDL-LA ratio with a significant difference in decrease (p < 0.05) from the lowest compared to the highest tertile of, respectively, 18.4% [-24; -2%] (median and range) and 2.0% [-16: 34%]. In conclusion, supplementation with 100 IU vitamin E in elderly is beneficial in lowering the rate of oxidation of LDL LA. The protective effect of vitamin E might best be monitored by using the ratio of alpha-tocopherol to LDL-LA as this reflects the degree of alpha-tocopherol available to protect the amount of LDL-LA present.

Resistance of lipoproteins from continuous ambulatory peritoneal dialysis patients to in vitro oxidation

Patients with end-stage renal failure on continuous ambulatory peritoneal dialysis (CAPD) develop abnormalities in plasma lipoproteins that may contribute to their increased risk for atherosclerosis. The oxidative modification of lipoproteins is considered to play a central role in atherogenesis. This study examines the susceptibility to oxidation in vitro of low- and high-density lipoprotein (LDL and HDL, respectively) obtained from long-term CAPD patients. CAPD LDL was less susceptible to copper-mediated protein derivatization (fluorescence) compared with control LDL CAPD LDL and HDL displayed less copper-promoted conjugated-diene production and lipid peroxide generation, suggesting a greater resistance of CAPD lipoprotein lipids to oxidation. Autooxidation during long-term storage was also much lower in CAPD LDL and HDL. However, when 2,2'-azobis(2-amidinopropane) dihydrochloride (ABAP) was used to initiate oxidation, there was no difference in conjugated-diene generation between CAPD and the control. CAPD LDL contained slightly less oxidizable, polyunsaturated fatty acid, but the vitamin E content of CAPD and control LDL was equivalent. Our findings indicate that lipoproteins from uremic patients undergoing long-term CAPD are more resistant to in vitro oxidation than control lipoproteins.

Hepatic origin of cholesteryl oleate in coronary artery atherosclerosis in African green monkeys. Enrichment by dietary monounsaturated fat

Relationships among plasma lipoprotein cholesterol, cholesterol secretion by the isolated, perfused liver, and coronary artery atherosclerosis were examined in African green monkeys fed diets containing cholesterol and 35% of calories as fat enriched in polyunsaturated, monounsaturated, or saturated fatty acids. The livers of animals fed monounsaturated fat had significantly higher cholesteryl ester concentrations (8.5 mg/g wet wt) than the livers of the other diet groups (3.65 and 3.37 mg/g wet wt for saturated and polyunsaturated fat groups, respectively) and this concentration was highly correlated with plasma cholesterol and apoB concentrations in each diet group. Cholesteryl oleate was 58 and 74. 5% of the liver cholesteryl ester in the saturated and monounsaturated fat groups. In each diet group, perfusate cholesteryl ester accumulation rate was highly correlated to liver and plasma cholesterol concentrations, and to plasma LDL cholesteryl ester content. Cholesteryl oleate was 48 and 67% of the cholesteryl esters that accumulated in perfusate in the saturated and monounsaturated fat animals, and this percentage was very highly correlated (r = -0.9) with plasma apoB concentration. Finally, in these two diet groups, liver perfusate cholesteryl ester accumulation rate was well correlated (r >/= 0.8) to coronary artery cholesteryl ester concentration, a measure of the extent of coronary artery atherosclerosis that occurred over the five years of diet induction in these animals. These data define an important role for the liver in the cholesteryl oleate enrichment of the plasma lipoproteins in the saturated and monounsaturated fat groups, and demonstrate strong relationships among hepatic cholesteryl ester concentration, cholesteryl ester secretion, and LDL particle cholesteryl ester content. The high correlation between liver cholesteryl ester secretion and coronary artery atherosclerosis provides the first direct demonstration of the high degree of importance of hepatic cholesteryl ester secretion in the development of this disease process. The remarkable degree of enrichment of cholesteryl oleate in plasma cholesteryl esters of the monounsaturated fat group may account for the relatively high amount of coronary artery atherosclerosis in this group.

Endothelial cell monolayer dysfunction caused by oxidized low density lipoprotein: attenuation by oleic acid

Oleic acid (18:1) may exert beneficial effects on the pathogenesis of vascular disease by a variety of mechanisms. To determine if 18:1 exerts direct protective effects on vascular endothelial cells, porcine pulmonary artery endothelial cells (PAEC) were supplemented with 0.1 mM 18:1, gamma-linolenic acid (18:3), or ethanol vehicle (ETOH) prior to treatment with low density lipoprotein (LDL), or CU(2+)-oxidized LDL (OXLDL). Treatment with neither LDL nor OXLDL (100 micrograms protein/ml) for 24-48 h caused PAEC cytotoxicity, whereas OXLDL, but not LDL, caused derangements in PAEC actin microfilament architecture and monolayer barrier dysfunction. Supplementation with 18:1, but not 18:3, attenuated derangements caused by OXLDL and lysophosphatidylcholine, a component of OXLDL. These results demonstrate that monounsaturated fatty acids directly alter the response of vascular endothelial cells to OXLDL and may retard the atherosclerotic process by decreasing the efflux of macromolecules (e.g. LDL) into the vessel wall.

Plasma LDL and HDL subspecies are heterogenous in particle content of tocopherols and oxygenated and hydrocarbon carotenoids. Relevance to oxidative resistance and atherogenesis

Epidemiological data indicate that dietary tocopherols and carotenoids can exert cardioprotective effects, which may be mediated by their antioxidant actions. The oxidative modification of LDL underlies the atherogenicity of these cholesterol-rich particles. The resistance of LDL to oxidation is influenced by several endogenous factors, among which the content of tocopherols and carotenoids is prominent. Of the exogenous factors, HDL inhibits oxidation of LDL via several mechanisms. In view of the paucity of data on the distribution of diverse tocopherol and carotenoid components among the apoB- and apoA-I-containing lipoproteins of human plasma, we evaluated the quantitative and qualitative features of the LDL and HDL particle subspecies in normolipidemic subjects. The bulk of tocopherols and hydrocarbon carotenoids (lycopene, alpha- and beta-carotene) was transported in LDL (45% and 76%, respectively), in contrast to the oxygenated carotenoids (lutein/zeaxanthin, canthaxanthin, and beta-cryptoxanthin), which were equally distributed between LDL and HDL. alpha-Tocopherol content was independently associated with lipid core size (cholesteryl ester and triglyceride) in VLDL, LDL, and HDL (P < .005); by contrast, the particle content of the oxygenated carotenoids lutein/zeaxanthin and canthaxanthin was strongly related to that of phospholipids. A significant and progressive decrease in the molar content of alpha- and gamma-tocopherols was found with increase in density from light to dense LDL subspecies (LDL1 to LDL5); a similar trend was observed in HDL subspecies. Furthermore, particle contents of lutein/zeaxanthin, beta-cryptoxanthin, beta-carotene, and lycopene were markedly reduced in small, dense LDL (LDL5, d = 1.050 to 1.065 g/mL). We conclude that diminished contents in such carotenoids as well as in tocopherols could underlie not only the diminished oxidative resistance of small, dense LDL but also reduced tissue targeting of antioxidants in subjects with a dense LDL phenotype.

The pH dependence of lipid peroxidation using water-soluble azo initiators

We report here the pH dependence of the rate of lipid peroxidation of methyl linoleate/Triton mixed micelles using a series of water-soluble azo initiators. The cationic initiators 2,2'-azobis(2-amidinopropane) (ABAP) and 2,2'-azobis[2-(2-imidazolin-2-yl)propane] (ABIP) exhibit similar behavior, in which increased pH results in dramatically enhanced rates of peroxidation. Rate data for ABAP and ABIP were fitted to a single proton equilibrium, which yielded apparent kinetic pKa values for the rate of approximately 7 and 6, respectively. The azo initiator 4,4'-azobis(4-cyanopentanoic acid) (ABCPA), which yields a negatively charged radical upon thermolysis at neutral pH, was also studied. In contrast to the effects observed with ABAP and ABIP, peroxidation rates with ABCPA exhibit an inverse pH dependence, in which the rates of peroxidation increase with decreasing pH, with an apparent pKa of approximately 5. By comparison, methyl linoleate oxidation rates with 2,2'-azobis (2-cyanopropane) (ABCP) display minimal changes over the pH range 5 to 7.5. Two alternatives can be advanced to account for this behavior, including either a buffer effect which is specific to the cationic initiators or an altered amidinium pKa (approximately 6 to 7) in either the initial carbon-centered radical or the subsequent peroxyl radical generated upon thermolysis of ABAP or ABIP. In the latter case, the kinetic pH dependence could thus reflect an enhanced competence of neutral radicals over charged radicals to partition into the micelles and initiate peroxidation.

A comparison of the kinetics of low-density lipoprotein oxidation initiated by copper or by azobis (2-amidinopropane)

This article describes the kinetics of low density lipoprotein (LDL) oxidation catalyzed by azobis (2-amidinopropane) dihydrochloride, ABAP, or by copper. The LDLs were isolated from nonhuman primates fed diets enriched in one of three types of fatty acids: saturated fatty acids, monounsaturated fatty acids, predominantly, oleic acid, or polyunsaturated fatty acids, predominantly linoleic acid. Oxidation was followed by monitoring the formation of conjugated diene hydroperoxides from polyunsaturated fatty acids (PUFA). For both copper and ABAP-initiated oxidation, the rate of LDL oxidation depended on the concentrations of initiator, PUFA, and LDL. Except for the dependence on PUFA concentration the rate of LDL oxidation was not directly influenced by the fatty acid composition of the LDL particle. The two initiators had very different dependence on initiator concentration. Because LDL particles are essentially small, lipid-rich droplets, the kinetic descriptions of LDL oxidation assumed: (1), that there was only one chain per particle, and (2) that the radical chain was terminated when a second radical either entered or was formed in the particle. When two LDL samples having very different lag times were mixed, the oxidation profile was bimodal. This finding demonstrated that the oxidation of native LDL particles was independent of the oxidation state of the other native LDL particles in solution, i.e., LDL particles do not rapidly exchange radicals, for example, hydroperoxyl radicals. Oxidation initiated by ABAP was proportional to [ABAP]0.5, suggesting that hydroperoxyl radical recombination between the lipid hydroperoxyl radical and the ABAP-hydroperoxyl radical was the chain-terminating step. The reciprocal of the rate of copper oxidation was linearly related to the reciprocal copper concentration, demonstrating that the binding of copper to LDL was necessary to initiate oxidation. This binding constant showed considerable variability among LDL samples. The kinetic descriptions of LDL oxidation reflect the differences in the mechanisms of initiation and termination.

[Malnutrition and HIV infection]

The wasting syndrome is well known in HIV infected patients. Predominant free fatty mass deletion is achieved. The weight loss results from decrease of food intake, from gut disorders due to HIV or opportunistic infections. Metabolic disorders are reported too. Breakdown of carbohydrates and proteins presents energy source. Raised free fatty acid turn over and hypertriglyceridemia are reported. Polyunsatured fatty acid level is raised inducing free radicals increase. Free radicals delete immune functions (apoptosis). Vitamin and trace element decrease worsen negative effects of free radicals.

Oxidative susceptibility of low-density lipoproteins--influence of regular alcohol use

In population studies, a low-to-moderate intake of alcohol has been consistently linked to a lower risk of coronary artery disease. The recent suggestion that alcoholic beverages may be conferring this decrease in risk because they contain antioxidant phenolic compounds that reduce the oxidizability of low-density lipoprotein (LDL) has to be reconciled with the possible counteracting influence of a pro-oxidant effect of alcohol. In a controlled crossover study, we have now measured the oxidizability of LDL in 27 regular beer drinkers during consecutive 4-week periods, wherein they consumed a high versus low alcohol beer (4.9 vs. 0.9% alcohol v/v, respectively), with the two beers being similar in phenolic content. This resulted in a decrease in alcohol consumption by approximately 80% (408 +/- 25 ml/week vs. 75 +/- 11 ml/week). During the low alcohol period, there was no change in LDL vitamin E or its cholesterol or protein content. Analysis of LDL oxidation kinetics revealed an increase in oxidizability during the high alcohol phase. This was despite a decrease in arachidonic acid content of LDL and a corresponding increase in palmitic acid during high alcohol intake--a change in fatty acid composition that has the potential to favor a decrease in oxidizability. Our results suggest that alcohol ingestion increases LDL oxidation, despite reducing the polyunsaturated fatty acid composition. The overall effect of alcoholic beverages on LDL oxidation may be a balance between the pro-oxidant and antioxidant activity of its various constituents. The predominant pro-oxidant effect demonstrated in these beer drinkers, although not relevant to any potential decrease in coronary artery disease, may be important in the pathogenesis of alcohol-related disease in other organ systems.

Factors affecting resistance of low density lipoproteins to oxidation

Oxidation resistance (OR) of low density lipoproteins (LDL) is frequently determined by the conjugated diene (CD) assay, in which isolated LDL is exposed to CU2+ as prooxidant in the range of 1-10 microM. A brief review on major findings obtained with this assay will be given. A consistent observation is that vitamin E supplements or oleic acid-rich diets increase OR. Oxidation indices measured by the CD assay and effects of antioxidants very significantly depended on the Cu2+ concentration used for LDL oxidation. For medium and high Cu2+ concentrations, the relationship between lag time and propagation rate can be described by a simple hyperbolic saturation function, which has the same mathematical form as the Michaelis-Menten equation. At medium and high Cu2+ concentrations (0.5 to 5 microM), vitamin E increases lag time in a dose-dependent manner. The increase is higher for 0.5 microM Cu2+ as compared to 5 microM. At low Cu2+ concentrations (0.5 microM or less), the mechanism of LDL oxidation changes. Significant oxidation occurs in a preoxidation phase, which commences shortly after addition of Cu2+. Preoxidation is not inhibited by vitamin E. It is concluded that much additional work is needed to validate the importance of oxidation indices derived from CD and similar assays.

How different constituents of low density lipoprotein determine its oxidizability by copper: a correlational approach

Although low density lipoprotein (LDL) susceptibility to oxidation is expected to be primarily related to its composition, the individual contributions of different constituents to its oxidizability remain unclear. The present study was undertaken to elucidate how different constituents of isolated LDL determine its susceptibility to oxidation induced by Cu2+ under conditions close to those of well-known Cu2(+)-oxidation assay (H. Esterbauer, G. Striegl, H. Puhl and M. Rotheneder (1989) Free Radical Research Communications, 6, 67-75). We characterized antioxidant, fatty acid and total lipid composition of human LDL from healthy donors (n = 22) and compared each with LDL oxidizability by Cu2+. LDL oxidizability was evaluated as oxidizability of antioxidant-containing LDL (rate of lipid peroxidation measured before total consumption of alpha-tocopherol, the major LDL antioxidant), oxidizability of antioxidant-depleted LDL (maximal rate of lipid peroxidation and maximal production of conjugated dienes within the propagation, antioxidant-depleted phase of oxidation) and overall LDL resistance to oxidation (duration of the lag-phase before the onset of the propagation phase). We found that the oxidizability of antioxidant-containing LDL correlated negatively with LDL content of ubiquinol-10 and free cholesterol, and positively with that of n-3 polyunsaturated fatty acids (PUFAs). LDL n-3 PUFAs, ubiquinol-10 and free cholesterol were the most important determinants of the oxidizability of antioxidant-containing LDL, contributing to about 35%, 25% and 25% of its total variability, respectively. Oxidizability of antioxidant-depleted LDL was largely determined by LDL PUFA content. The overall LDL resistance to oxidation correlated weakly with LDL chemical composition. alpha-Tocopherol was found to be only a minor contributor to the oxidizability of isolated LDL under oxidative conditions used (7.5 or 14 mol Cu2+ / mol LDL). It appears that the oxidizability of antioxidant-containing LDL represents a parameter highly sensitive to changing LDL composition, whereas the overall LDL resistance to oxidation combines contributions from different LDL constituents more uniformly, being weaker sensitive to individual factors. It is suggested that PUFAs, ubiquinol-10 and free cholesterol are the most important determinants of LDL oxidizability of Cu2+.

Compared with dietary monounsaturated and saturated fat, polyunsaturated fat protects African green monkeys from coronary artery atherosclerosis

Atherogenic diets enriched in saturated, n-6 polyunsaturated, and monounsaturated fatty acids were fed to African green monkeys for 5 years to define effects on plasma lipoproteins and coronary artery atherosclerosis. The monkeys fed polyunsaturated and monounsaturated fat had similar plasma concentrations of LDL cholesterol, and these values were significantly lower than for LDL in the animals fed saturated fat. Plasma HDL cholesterol concentrations were comparable in animals fed saturated and monounsaturated fat and were significantly higher than in animals fed polyunsaturated fat. Thus, the monounsaturated fat group had the lowest LDL/HDL ratio. LDL particle size was largest in the saturated and monounsaturated fat groups, significantly larger than in the polyunsaturated fat group. LDL particle enrichment with cholesteryl oleate was the greatest in the animals fed monounsaturated fat, next greatest in the saturated fat-fed animals, and was least in the polyunsaturated fat-fed animals. Coronary artery atherosclerosis as measured by intimal area was less in the polyunsaturated fat compared with the saturated fat groups, was less in the animals fed polyunsaturated fat compared with the monounsaturated fat-fed animals, but did not differ between the monounsaturated and saturated fat groups. Cholesteryl ester, particularly cholesteryl oleate, accumulation in the coronary arteries was also similar between groups fed monounsaturated and saturated fat but was minimal in the animals fed polyunsaturated fat. In sum, the monkeys fed monounsaturated fat developed equivalent amounts of coronary artery atherosclerosis as those fed saturated fat, but monkeys fed polyunsaturated fat developed less. The beneficial effects of the lower LDL and higher HDL in the animals fed monounsaturated fat apparently were offset by the atherogenic shifts in LDL particle composition. Dietary polyunsaturated fat appears to result in the least amount of coronary artery atherosclerosis because it prevents cholesteryl oleate accumulation in LDL and the coronary arteries in these primates.

Beta-carotene inhibits atherosclerosis in hypercholesterolemic rabbits

Oxidatively damaged LDL may be of central importance in atherogenesis. Epidemiological evidence suggests that high dietary intakes of beta-carotene and vitamin E decreases the risk for atherosclerotic vascular disease, raising the possibility that lipid-soluble antioxidants slow vascular disease by protecting LDL from oxidation. To test this hypothesis, we fed male New Zealand White rabbits a high-cholesterol diet or the same diet supplemented with either 1% probucol, 0.01% vitamin E, 0.01% all-trans beta-carotene, or 0.01% 9-cis beta-carotene; then we assessed both the susceptibility of LDL to oxidation ex vivo and the extent of aortic atherosclerosis. As in earlier studies, probucol protected LDL from oxidation and inhibited lesion formation. In contrast, vitamin E modestly inhibited LDL oxidation but did not prevent atherosclerosis. While beta-carotene had no effect on LDL oxidation ex vivo, the all-trans isomer inhibited lesion formation to the same degree as probucol. Moreover, all-trans beta-carotene was undetectable in LDL isolated from rabbits fed the compound, although tissue levels of retinyl palmitate were increased. The effect of all-trans beta-carotene on atherogenesis can thus be separated from the resistance of LDL to oxidation, indicating that other mechanisms may account for the ability of this compound to prevent vascular disease. Our results suggest that metabolites derived from all-trans beta-carotene inhibit atherosclerosis in hypercholesterolemic rabbits, possibly via stereospecific interactions with retinoic acid receptors in the artery wall.

Contribution of vitamin A to the oxidation resistance of human low density lipoproteins

This study investigated the antioxidant contribution of vitamin A in protecting human low density lipoprotein (LDL) against copper-stimulated oxidation. The presence of small amounts of retinol (0.033 +/- 0.012 nmol/mol LDL) and retinyl palmitate (0.036 +/- 0.021 nmol/mol LDL) was routinely ascertained in the LDL. A single oral supplementation with 20,000 IU vitamin A caused a two- to three-fold increase of retinol and retinyl palmitate in the LDL isolated 8 h after the supplementation. In comparison to autologous-control LDL, vitamin A-enriched LDL were more resistant to oxidation, as expressed both by a clear delay in the onset of lipid peroxidation and by a reduction of the rate of conjugated diene hydroperoxide production during the propagation phase. The calculated incremental increase in the lag phase produced by 1 mol retinol per mol LDL is about 1000 min, suggesting that retinol is more potent than alpha-tocopherol in LDL. Oxidation experiments carried out with LDL isolated from plasma incubated in vitro with either retinol or retinyl palmitate indicated that retinol does lengthen the lag phase, whereas retinyl palmitate can slow the rate of peroxyl chain propagation, without affecting the duration of the lag phase. Temporal disappearance of retinol and retinyl palmitate, followed in comparison with that of alpha-tocopherol and beta-carotene, indicated that the reactivity of the antioxidants with lipoperoxyl radicals was in the sequence alpha-tocopherol, retinol, beta-carotene, and retinyl esters. Although the detailed antioxidant mechanism remains to be elucidated, these results suggest that LDL-associated vitamin A can play a role in maintaining the antioxidant status of LDL during oxidative stress in vivo.

Oxidation of low-density lipoproteins: effect of antioxidant content, fatty acid composition and intrinsic phospholipase activity on susceptibility to metal ion-induced oxidation

The oxidative modification of low-density lipoprotein (LDL) may play an important role in atherogenesis. Our understanding of the mechanism of LDL oxidation and the factors that determine its susceptibility to oxidation is still incomplete. We have isolated LDL from 45 healthy individuals and studied the relationship between LDL fatty acid, vitamin E and beta-carotene composition, intrinsic phospholipase A2-like activity and parameters of LDL oxidation. LDL was exposed to a copper ion-dependent oxidising system and the kinetics of oxidation studied by monitoring formation of fatty acid conjugated dienes. The length of the lag phase of inhibited lipid peroxidation was measured as well as the rate of lipid peroxidation during the propagation phase. There was no significant correlation between LDL antioxidant vitamin or fatty acid composition and lag time to LDL oxidation. Oleic acid was negatively correlated with the rate of LDL oxidation (r = -0.41, P < 0.01) whilst linoleic acid was significantly correlated with the extent of LDL oxidation measured by the production of total dienes (r = 0.34, P < 0.05). Interestingly, LDL vitamin E content was positively correlated with both the rate (r = 0.28, P < 0.05) and extent of LDL oxidation (r = 0.43, P < 0.01). LDL isolated from this group of subjects showed significant intrinsic phospholipase-like activity. The phospholipase activity, whilst not correlated with lag time, was significantly correlated with both rate (r = 0.43, P < 0.01) and total diene production (r = 0.44, P < 0.01) of LDL oxidation. We conclude that antioxidant content, fatty acid composition and intrinsic phospholipase activity have little influence on the lag time of Cu-induced LDL oxidation. These components do however, significantly influence both the rate and extent of LDL oxidation, with increased vitamin E, linoleic acid content and phospholipase activity associated with faster and more extensive oxidation. The possible pro-oxidant effect of vitamin E has interesting implications for the postulated 'protective' effects of vitamin E on atherogenesis.

Human plasma phospholipid transfer protein accelerates exchange/transfer of alpha-tocopherol between lipoproteins and cells

alpha-Tocopherol (alpha-T), an important anti-oxidant of plasma lipoproteins and cell membranes, is secreted from liver together with very-low-density lipoproteins into the blood stream. Other serum lipoprotein classes gain alpha-T by exchange and transfer processes. We show here that the lipoprotein-free d > 1.22 g/ml fraction of human or pig serum increases the exchange rate of alpha-T by a factor of 2-4 as compared with spontaneous exchange/transfer. The alpha-T exchange/transfer (alpha-TET) activity was purified by multiple-step column chromatography. It gave a single band in PAGE with an apparent molecular mass of 75 kDa, and was found to be identical with the phospholipid transfer protein (PLTP). PLTP catalysed alpha-T exchange between different lipoprotein classes, as well as the transfer of alpha-T from artificial liposomes to high-density lipoproteins. The alpha-TET activity measured with a newly developed assay in ten healthy people was 2.45 +/- 0.88 nmol.ml-1.h-1.alpha-TET activity was negatively correlated with plasma low-density lipoprotein-cholesterol (r = -0.75; P < 0.01). It is concluded that human PLTP catalyses exchange/transfer processes of alpha-T between lipid compartments. This factor may be of relevance in atherogenesis and tumour initiation and growth.