In vivo kinetics of oxidatively modified HDL

Structure and Dynamics of Oxidized Lipoproteins In Vivo: Roles of High-Density Lipoprotein

Oxidative modification of lipoproteins is implicated in the occurrence and development of atherosclerotic lesions. Earlier studies have elucidated on the mechanisms of foam cell formation and lipid accumulation in these lesions, which is mediated by scavenger receptor-mediated endocytosis of oxidized low-density lipoprotein (oxLDL). Mounting clinical evidence has supported the involvement of oxLDL in cardiovascular diseases. High-density lipoprotein (HDL) is known as anti-atherogenic; however, recent studies have shown circulating oxidized HDL (oxHDL) is related to cardiovascular diseases. A modified structure of oxLDL, which was increased in the plasma of patients with acute myocardial infarction, was characterized. It had two unique features: (1) a fraction of oxLDL accompanied oxHDL, and (2) apoA1 was heavily modified, while modification of apoB, and the accumulation of oxidized phosphatidylcholine (oxPC) and lysophosphatidylcholine (lysoPC) was less pronounced. When LDL and HDL were present at the same time, oxidized lipoproteins actively interacted with each other, and oxPC and lysoPC were transferred to another lipoprotein particle and enzymatically metabolized rapidly. This brief review provides a novel view on the dynamics of oxLDL and oxHDL in circulation.

Oxidized plasma high-density lipoprotein is decreased in Alzheimer's disease

Oxidative stress is implicated in the pathogenesis of Alzheimer's disease (AD), and the enzyme myeloperoxidase (MPO) has been identified as one source of reactive oxidants. MPO-mediated oxidation of high-density lipoprotein (HDL) plays an important role in the pathogenesis of atherosclerosis and although several links between cardiovascular disease and AD have been reported, surprisingly little is known about the role of HDL oxidation in AD. We show that MPO binding to isolated HDL depends on the lipidation state of apolipoprotein A-I (apo A-I), the major protein constituent of HDL. When quantifying apo A-I and oxidized HDL in plasma of AD patients and cognitive healthy, age- and gender matched controls, we observed similar apo A-I levels in AD patients (263 +/- 70 mg/dl) and controls (268 +/- 70 mg/dl, p = 0.83). In striking contrast, oxidized HDL was significantly reduced in AD patients (4.72 +/- 1.91 U/dl) compared to controls (6.98 +/- 3.32 U/dl, p = 0.012). The marked decrease of oxidized HDL in AD patients is surprising considering the current oxidation hypothesis. We suggest that additional mechanisms, including increased antioxidant production and/or altered lipoprotein metabolism, might be involved in AD pathology.

Plasma very-low-density lipoprotein, low-density lipoprotein, and high-density lipoprotein oxidative modification induces procoagulant profiles in endogenous hypertriglyceridemia

This study was to investigate whether oxidatively modified lipoproteins were associated with changes of pro- and anticoagulant profiles in hypertriglyceridemic subjects. Plasma VLDL, LDL, and HDL were isolated with the one-step density gradient ultracentrifugation method. The oxidation of the lipoproteins was identified. Prothrombin time (PT) and activated partial thrombplastin time (APTT), tissue plasminogen activator and plasminogen activator inhibitor-1, and platelet aggregation rate were determined with a reaction system consisting of mixed fresh normal plasma, in endogenous hypertriglyceridemic (HTG) patients, in in vitro modified lipoproteins from a normolipidemic donor, and in experimental rats. The results indicated that oxVLDL, oxLDL, and oxHDL occurred in the plasma of HTG patients. Compared with the control group, PT and APTT, incubated with plasma VLDL, LDL, or HDL from HTG patients, respectively, were significantly reduced, while platelet maximal aggregation rates were significantly higher (P < 0.05-0.01). Similar procoagulant profiles were observed in in vitro modified lipoprotein components and in rats with intrinsic hypertriglyceridemia as well. These results support our previous finding that LDL, VLDL, and HDL were all oxidatively modified in vivo in the subjects with HTG, and suggest that procoagulation state may result from the abnormal plasma lipoprotein oxidative modification in vivo.

Effect of simvastatin on the oxidation of native and modified lipoproteins

Modified (oxidized) low-density lipoprotein (LDL) plays a significant role in atherosclerosis by accumulation in arteries. Also, glycated LDL, such as in diabetics, are increasing the risk for atherosclerosis, due to an increased oxidizability as compared to native LDL. For these reasons, the potential inhibition of such modifications is of clinical importance. We investigated the influence of simvastatin on oxidation of native and modified LDL as well as high-density lipoprotein (HDL), which plays a protective role in atherosclerosis. Quantitative assessment of the oxidation end-product malondialdehyde (MDA) revealed the highest inhibitory rate for HDL at concentrations of 1.6 microg/ml and 0.8 microg/ml by 30.3% and 20.4%, at 6 h and 4 h, respectively. At 24 h, the inhibition was still persisting amounting to 27.9% and 20.3%, respectively. For native LDL, we found less inhibition of oxidation at a concentration of 1.6 microg/ml amounting to 19.2% and 11.5%, for 4 h and 6 h, respectively. Similar effects were found at a concentration of 0.8 microg/ml. For modified, glycated LDL, the most pronounced effect was found at a concentration of 1.6 microg/ml amounting to 22.4% for the period of 2-24 h of oxidation. For glycoxidated LDL, the inhibition of oxidation was less expressed amounting to 10.1% for the period of 2-6 h at the same concentration. The influence of simvastatin on lag time (protection from oxidation) by diene conjugation was also investigated. At the highest concentration of simvastatin (1.6 microg/ml), we found a prolongation of lag time from 73 min to 99 min for native LDL, for glycoxidated LDL 60 min to 89 min and for HDL 54 min to 64 min. For glycated LDL, only a small decrease of lag time (66 min versus 71 min) at same concentration was observed. For glycated and glycoxidated LDL, we found a moderate increase in relative electrophoretic mobility (REM) by 2.0 and 2.3, respectively, but no changes in the presence of simvastatin were observed. These data show that simvastatin besides its lipid-lowering action has also significant antioxidative properties.

Detection of oxidized high-density lipoprotein

This paper reviews working procedures for the separation and detection of oxidized high-density lipoproteins (ox-HDL) and their constituents. It begins with an introductory overview of structural alterations of the HDL particle and its constituents generated during oxidation. The main body of the review delineates various procedures for the isolation and detection of ox-HDL as well as the purification and separation of phosphatidylcholine metabolites and denatured apolipoproteins in the particle. The useful methods published more recently are picked up and the utility of the separation techniques is described. The last section covers a clinical evaluation of changes in these factors in ox-HDL as well as future directions of ox-HDL research.

Effects of a high polyunsaturated fat diet and vitamin E supplementation on high-density lipoprotein oxidation in humans

Oxidative modification of high-density lipoproteins (HDL) impairs several biologic functions critical to its role in reverse cholesterol transport. We therefore investigated the effect of dietary polyunsaturated fat and vitamin E on the kinetics of HDL oxidation. Ten subjects were fed sequentially: a baseline diet in which the major fat source was olive oil; a high polyunsaturated fat diet in which the major fat source was safflower oil; and the safflower oil diet plus 800 I.U. vitamin E per day. Plasma lipoprotein levels, vitamin E content, fatty acid composition, and oxidation lag time and rate were determined after 3 weeks on each diet. The polyunsaturated fat diet increased the mean HDL(2) lag time from 45.8+/-12.5 to 83.3+/-11.6 min with no change in oxidation rate. Addition of vitamin E further increased the HDL(2) lag time to 115.6+/-4.4 min and decreased the HDL(2) oxidation rate 10-fold. Neither the polyunsaturated diet alone nor the diet with vitamin E supplementation had any effect on HDL(3) oxidation. We conclude that under conditions of controlled dietary fat intake, a high polyunsaturated fat intake does not increase the oxidation susceptibility of HDL subfractions, and that in this setting, vitamin E supplementation reduces the oxidation susceptibility of HDL(2). These data suggest that antioxidants could influence HDL function in vivo.

Oxidative modification of lipoproteins in hypertriglyceridemic patients and hypercholesterolemic rabbits in vivo

Many lines of evidence suggest that LDL is oxidized in vivo and that Ox-LDL is present in the artery wall. But the oxidation of VLDL and HDL in vivo has not yet been reported. In this study, the oxidative modification of serum LDL, VLDL, and HDL in patients with endogenous hypertriglyceridemia (HTG) and in serum of rabbits fed on high cholesterol diet were made. The serum LDL, VLDL and HDL were isolated by the density gradient ultracentrifugation. The oxidative modification of LDL, VLDL and HDL were identified by agarose eletrophoresis, absorbance at 234 nm and fluorescence of TBARS. The results showed that serum TC, TG and TBARS in the HTG group (n = 25) and in rabbits fed with a high fat diet (for 12 weeks, n = 8) were significantly higher than those of the corresponding control groups (normal subjects, n = 25; rabbits fed with a normal diet, n = 8; p < 0.01). The electrophoretic mobilities of LDL, VLDL and HDL were increased when compared with the controls, and absorbance at 234 nm and TBARS of LDL, VLDL and HDL in the HTG group and in the high fat diet rabbits were significantly higher than those of the controls (p < 0.01). These results suggest that not only LDL but also VLDL and HDL were oxidatively modified in vivo in the patients with HTG and in the rabbits fed with a high cholesterol diet.

Susceptibility of low- and high-density lipoproteins from diabetic subjects to in vitro oxidative modification

AIMS

To investigate the hypothesis that lipid peroxidation of both low-density lipoproteins (LDL) and high-density lipoproteins (HDL) is important in the development of atherosclerosis.

METHODS

We have investigated whether LDL and HDL from patients with Type 1 diabetes mellitus (DM, n = 16) and Type 2 DM (n = 15) is more susceptible to Cu2+ -induced lipid peroxidation than LDL and HDL from a similar number of nondiabetic controls matched for age, gender and serum cholesterol.

RESULTS

The vitamin E content of LDL and HDL from both groups of diabetic patients was not significantly different from controls. The LDL from Type 2 diabetic patients and HDL from both diabetic groups were significantly richer in triglyceride than controls. Phospholipid was decreased in LDL from Type 2 diabetic patients and protein was decreased in HDL in Type 1 DM, but otherwise the composition of LDL and HDL in diabetic subjects was similar to controls. No significant differences were observed in the generation of conjugated dienes or lipid peroxides in either LDL or HDL when the two groups were compared with each other or with their respective controls.

CONCLUSIONS

Increased lipid peroxidation occurring in vivo in diabetes is unlikely to be the result of increased susceptibility of lipoproteins to lipid peroxidation, but rather to increased generation of free radicals, to oxidation of lipids other than those present in serum lipoproteins or to decreases in antioxidant systems other than the fat-soluble antioxidants present in lipoproteins.

Possible role of high susceptibility of high-density lipoprotein to lipid peroxidative modification and oxidized high-density lipoprotein in genesis of coronary artery spasm

Recent study demonstrated high susceptibility of plasma LDL to lipid peroxidative modification in patients with variant angina. Oxidized stress state, especially oxidized LDL, may induce coronary artery spasm by its impairing effect of endothelium-dependent arterial relaxation, but precise mechanisms remain unclear. Study subjects included 93 patients who underwent coronary angiographic examination: 12 patients with coronary artery spasm provoked by ergonovine without organic stenosis (group I), 11 patients who did not demonstrate coronary artery spasm or organic stenosis (group II) and 70 patients with organic coronary artery stenosis (group III). Levels of plasma HDL-cholesterol and apoA-I in group I were similar to those in III but were significantly lower than those in II, although the other plasma lipid parameters were not different among the three groups. The levels of TBARS in plasma and HDL were significantly higher in group I than in II or III (2.94+/-1.56 vs. 1.91+/-0.35 or 2.23+/-0.89 nmol MDA/ml and 1.23+/-1.00 vs. 0.54+/-0.37 or 0.70+/-0.63 nmol MDA/mg protein; P < 0.05), although the levels of TBARS in LDL were not significantly different. In the monitoring curve of diene production during copper-induced lipid peroxidation of HDL, its propagation slope was steeper and levels of maximum diene absorbance was higher in group I as compared with that in II or III, but not found in those of LDL. These results suggested that high susceptibility of HDL to lipid peroxidative modification in group I may contribute to the genesis of coronary artery spasm, and oxidized HDL rather than oxidized LDL is more likely to be related to coronary artery spasm.