Effect of core composition and particle size of lipid emulsions on apolipoprotein transfer of plasma lipoproteins in vivo

Apolipoprotein A-V N-terminal domain lipid interaction properties in vitro explain the hypertriglyceridemic phenotype associated with natural truncation mutants

The N-terminal 146 residues of apolipoprotein (apo) A-V adopt a helix bundle conformation in the absence of lipid. Because similarly sized truncation mutants in human subjects correlate with severe hypertriglyceridemia, the lipid binding properties of apoA-V(1-146) were studied. Upon incubation with phospholipid in vitro, apoA-V(1-146) forms reconstituted high density lipoproteins 15-17 nm in diameter. Far UV circular dichroism spectroscopy analyses of lipid-bound apoA-V(1-146) yielded an alpha-helix secondary structure content of 60%. Fourier transformed infrared spectroscopy analysis revealed that apoA-V(1-146) alpha-helix segments align perpendicular with respect to particle phospholipid fatty acyl chains. Fluorescence spectroscopy of single Trp variant apoA-V(1-146) indicates that lipid interaction is accompanied by a conformational change. The data are consistent with a model wherein apoA-V(1-146) alpha-helices circumscribe the perimeter of a disk-shaped bilayer. The ability of apoA-V(1-146) to solubilize dimyristoylphosphatidylcholine vesicles at a rate faster than full-length apoA-V suggests that N- and C-terminal interactions in the full-length protein modulate its lipid binding properties. Preferential association of apoA-V(1-146) with murine plasma HDL, but not with VLDL, suggests that particle size is a determinant of its lipoprotein binding specificity. It may be concluded that defective lipoprotein binding of truncated apoA-V contributes to the hypertriglyceridemia phenotype associated with truncation mutations in human subjects.

Triglyceride-rich lipoprotein-associated apolipoprotein C-III production is stimulated by plasma free fatty acids in humans

OBJECTIVE

Insulin resistant states are associated with increased fatty acid flux to liver and intestine, which stimulates the production of triglyceride-rich lipoproteins (TRL). ApoC-III production and plasma and TRL concentrations are increased in insulin resistance and may contribute to the hypertriglyceridemia of these conditions. The mechanism underlying that increase is not known, but because apoC-III and VLDL production are closely linked we hypothesized that FFAs may stimulate TRL apoC-III production.

METHODS AND RESULTS

We used Intralipid/heparin (IH) to raise plasma FFA in 12 healthy men in the fed state, and stable isotopes to examine apoC-III metabolism. TRL apoC-III concentration was significantly higher in the IH study, and this increase was associated with higher production (PR) and fractional catabolic rate (FCR). The increase in production was greater than in FCR (90% versus 30%, respectively), accounting for the elevated concentration. Glycerol infusion had no effect on apoC-III concentration, PR, or FCR compared to saline, indicating that the effect was not attributable to glycerol released from intralipid.

CONCLUSIONS

These findings confirm that TRL apoC-III production is stimulated by an acute elevation of plasma FFAs, suggesting a novel regulatory pathway that may play a role in the overproduction of TRL apoC-III in insulin resistant states.

Oil-in-water lipid emulsions: implications for parenteral and ocular delivering systems

Lipid emulsions (LEs) are heterogenous dispersions of two immiscible liquids (oil-in-water or water-in-oil) and they are subjected to various instability processes like aggregation, flocculation, coalescence and hence eventual phase separation according to the second law of thermodynamics. However, the physical stability of the LE can substantially be improved with help of suitable emulsifiers that are capable of forming a mono- or multi-layer coating film around the dispersed liquid droplets in such a way to reduce interfacial tension or to increase droplet-droplet repulsion. Depending on the concentrations of these three components (oil-water-emulsifier) and the efficiency of the emulsification equipments used to reduce droplet size, the final LE may be in the form of oil-in-water (o/w), water-in-oil (w/o), micron, submicron and double or multiple emulsions (o/w/o and w/o/w). The o/w type LEs (LE) are colloidal drug carriers, which have various therapeutic applications. As an intravenous delivery system it incorporates lipophilic water non-soluble drugs, stabilize drugs that tend to undergo hydrolysis and reduce side effects of various potent drugs. When the LE is used as an ocular delivery systems they increase local bioavailability, sustain the pharmacological effect of drugs and decrease systemic side effects of the drugs. Thus, the rationale of using LE as an integral part of effective treatment is clear. Following administration of LE through these routes, the biofate of LE associated bioactive molecules are somehow related to the vehicles disposition kinetics inside blood or eyeball. However, the LE is not devoid from undergoing various bio-process while exerting their efficacious actions. The purpose of this review is therefore to give an implication of LE for parenteral and ocular delivering systems.

LDL binding to lipid emulsion particles: effects of incubation duration, temperature, and addition of plasma subfractions

Lipid emulsions used in parenteral nutrition interact with lipoproteins leading to exchanges of lipids and acquisition of several apolipoproteins (apo). It has been previously observed that, during in vitro incubation of emulsions with purified LDL, a variable fraction of LDL binds to TG-rich emulsion particles. The purpose of this study was to better characterize such an interaction. Two emulsions containing 20% soybean oil (Endolipid, B. Braun AG, Melsungen, Germany) or fish oil were incubated with LDL, either alone or in the presence of various plasma subfractions, for different durations and at different temperatures. The fraction named M-LE (containing TG-rich particles modified after incubation) was separated by ultracentrifugation or gel filtration chromatography, and the apoB content was measured as an index of LDL binding to TG-rich emulsion particles. The formation of such complexes was visualized by freeze-fracture electron microscopy. LDL binding was not influenced by the method used for M-LE isolation. Binding occurred quickly, did not increase with prolonged incubation, was inversely related to increasing incubation or ultracentrifugation temperature, and withstood 40 h of ultracentrifugation at 163,000 x g. The presence of glycerol or excess phospholipids in the emulsion did not markedly affect the formation of the complexes. In contrast, adding very small amounts of lipoprotein-poor plasma (d > 1.210 g/mL) or HDL markedly reduced the process, and albumin had no effect. The TG composition of the emulsion influenced the binding of LDL to TG-rich particles, since more apoB was found in M-LE from fish oil than from soybean oil emulsion.

Intralipid 10%: physicochemical characterization

OBJECTIVES

Parenteral fat emulsions contain two populations of particles: artificial chylomicrons rich in triacylglycerols (TAG), and liposomes (bilayer of phospholipids [PL] enveloping an aqueous phase). Centrifugation permits isolating the liposomes in the infranatant called mesophase. The aim of the present work was to better characterize this mesophase chemically and to view the particles it contains by electron microscopy.

METHODS

Electron microscopy (Philips 410) was performed after cryofracture on native 10% Intralipid, mesophase (centrifugation for 1 h at 27 000 g), and a liposome-enriched fraction (ring of density 1.010-1.030 g/l obtained after centrifuging mesophase in a KBr density gradient at 100 000 g for 24 h). The TAG and protein content of the mesophase was analyzed and the proteins partially characterized by immunodetection (Western-blot).

RESULTS

This electron microscope study of 10% Intralipid gives evidence for the coexistence of artificial chylomicrons (mean diameter, 260 nm) and liposomes (43 nm), the latter being smaller than expected and containing 8% w/w TAG after purification. The solubilization of TAG in PL bilayers (reported to be < or = 3.1% w/w) might have been increased in parenteral emulsions by the manufacturing process or/and the high TAG/PL ratio. Minute amounts of proteins have also been detected and partially characterized using a specific antibody raised against the human 7 kDa Anionic Polypeptide Factor (APF), known to strongly interact with PL in bile.

CONCLUSIONS

This work has shown that the size (mean diameter, 43 nm) of the liposomes present in 10% Intralipid is smaller than that usually assumed. Traces of hydrophobic proteins in the emulsion may account for certain allergic reactions sometimes observed in infused patients.

Disposition characteristics of emulsions and incorporated drugs after systemic or local injection

Lipid emulsions are useful tools for controlling the in vivo disposition of drugs and plasmid DNA. The dispositions of lipid emulsions are determined by their tissue interaction depending on the anatomical and physiological characteristics of each tissue and the physicochemical and biological properties of lipid emulsions. In addition, the retention of drugs is another issue, as too rapid a release of the drug would lead to failure of exerting its therapeutic potency. This review presents an overview about the disposition profiles and various physicochemical properties of lipid emulsions and incorporated drugs after systemic or local injection. Controlled biodistribution of lipid emulsions and incorporated drugs are also discussed.

Receptor-mediated mechanisms of lipoprotein remnant catabolism

Chylomicron and VLDL are triglyceride-rich lipoprotein particles assembled by the intestine and liver respectively. These particles are not metabolized by the liver in their native form. However, upon entry into the plasma, their triglyceride component is rapidly hydrolyzed by lipoprotein lipase and they are converted to cholesterol-rich remnant particles. The remnant particles are recognized by the liver and rapidly cleared from the plasma. This process is believed to occur in two steps. (i) An initial sequestration of remnant particles on hepatic cell surface proteoglycans, and (ii) receptor-mediated endocytosis of remnants by hepatic parenchymal cells. The initial binding to proteoglycans may be facilitated by lipoprotein lipase and hepatic lipase which possess both lipid- and heparin-binding domains. The subsequent endocytic process may be mediated by LDL receptors and/or LRP. Both receptors have a high affinity for apoE, a major apolipoprotein component of remnant particles. The lipases may also serve as ligands for these receptors. An impairment of any component of this complex process may result in an accumulation of remnant particles in the plasma leading to atherosclerosis and coronary heart disease.

'In vitro' cholesteryl ester bidirectional flow between high-density lipoproteins and triglyceride-rich emulsions: effects of particle concentration and composition, cholesteryl ester transfer activity and oleic acid

The cholesteryl ester flow between high-density lipoproteins (HDL) and triglyceride-rich lipoproteins was investigated utilizing HDL fractions and synthetic lipid emulsion particles (EM). HDL was labeled in vitro with [1,2-3H(n)]cholesteryl ester or with [1,2,6,7-3H(n)]cholesteryl oleate, whereas EM were made with [4-14C]cholesteryl oleate (CO) or [carboxyl-14C]triolein (TO). The cholesteryl ester (CE) transfer rate between HDL and EM was spontaneous to some extent (because it occurred in saline medium), saturable, enhanced in a dose-dependent manner by the plasma fraction at D > 1.21 g/ml ascribed to its CETP activity, and greater for HDL3 than for HDL2. Unesterified fatty acids in the medium elicited two opposing effects: (1) enhanced the spontaneous cholesteryl oleate shift to EM and inhibited the reverse flow from EM to HDL3 but not to HDL2; (2) partially impaired the plasma D > 1.21 g/ml-induced bidirectional cholesteryl oleate flow. Approx. 2 mol TO from EM exchange for 1 mol CO from HDL3. Net cholesteryl ester balance was dependent on the concentration of HDL-cholesteryl ester, and independent from EM-cholesteryl oleate, possibly due to the much smaller concentration of the latter. These in vitro experiments shed light on the complex physical chemistry of transport of cholesteryl ester and triolein between HDL and TG-rich lipoproteins which occurs during the metabolism of chylomicrons in plasma.

Effects of particle size on cell uptake of model triglyceride-rich particles with and without apoprotein E

The effect of apoprotein E on cellular uptake of "VLDL-size" and "IDL-size" triacylglycerol-phospholipid emulsion particles was studied in J-774 macrophages and fibroblasts. In the absence of apoprotein E (apo E), uptake of the smaller IDL-size particles was up to 2-fold higher by mass and 100-fold higher as calculated by particle number. Apo E enhanced the uptake of both VLDL-size and IDL-size emulsion particles, but the effect was greater on the uptake of larger particles (4-5-fold) as compared to up to a 2-fold increase in the uptake of IDL-size particles. In fibroblasts, particle uptake was less than in macrophages (30-50%), but preferential uptake of smaller particles was similarly observed. Particle internalization was demonstrated by 125I-apo E degradation and resistance to particle release by heparin-suramin. In the absence of apo E, cholesteryl ester of emulsion particles (prepared with trace amounts of [3H]cholesteryl ester) was hydrolyzed to free cholesterol, proving internalization and intracellular metabolism. Double-label experiments using DiI-labeled emulsion particles, in the absence and presence of apo E, showed that emulsion particles are rapidly targeted to perinuclear lysosomes. Thus, at physiological concentrations of triglyceride-rich particles, non-receptor-mediated uptake is a mechanism for the uptake of VLDL-size and IDL-size particles into cells.

Effects of intravenous infusions of commercial fat emulsions (Intralipid 10 or 20%) on rat plasma lipoproteins: phospholipids in excess are the main precursors of lipoprotein-X-like particles

Like most commercial parenteral emulsions, Intralipid contains the same amount of phospholipids (12 mg/ml) to stabilize 100 or 200 mg of soybean oil (10 or 20% formula, respectively). By centrifugation, 10 or 20% Intralipid was separated into a supernatant, fat particles containing the bulk of triacylglycerols stabilized by a fraction of phospholipids and an infranatant--called mesophase--consisting mainly of phospholipids used in excess as emulsifier. We observed that the initial triacylglycerol/phospholipid ratio of the emulsion (100/12 and 200/12, respectively) determines the size of the triacylglycerol-rich particles (260 and 350 nm) as well as the phospholipid content of the mesophase (6.02 and 4.67 mg/ml). To understand the mechanism of the lipoprotein-X (LPX) accumulation generally reported after intravenous fat infusions, plasma lipid levels and lipoprotein profiles were first compared in the rats after infusion (at a constant rate of 0.5 or 1 ml/h for 43 h) of Intralipid 10 or 20%. For the same intravenous triacylglycerol load (100 mg/h), rats infused with Intralipid 10% at 1 ml/h displayed higher triacylglycerol levels than rats infused with the 20% emulsion at 0.5 ml/h, suggesting that the size of exogenous fat particles modulated the catabolic rate of their triacylglycerols. The plasma levels of LPX varied according to the infusion rate of phospholipids not associated with triacylglycerol-rich particles of the emulsion. Moreover, an apo E and apo B enrichment of plasma and an elevation of the apo B48/apo B100 ratio was always observed after Intralipid infusions. In order to confirm that phospholipids of the mesophase are the main LPX precursors, lipoprotein profiles were then compared in the rats after intravenous infusion, at a constant rate of 1 ml/h, of either the mesophase or a suspension of triacylglycerol-rich particles isolated from Intralipid 20%. As expected, significant LPX amounts were only detected in rats infused with the pure mesophase of the emulsion. It was concluded that products of the lipolysis of exogenous fat particles play only a minor role in the formation of LPX. In fact these abnormal lipoproteins are generated by phospholipids of the mesophase which, like infused liposomes, actively mobilize endogenous free cholesterol. Consequently, in order to be considered as true chylomicron models for safe fat delivery in parenteral nutrition and in order to prevent some detrimental effects on cholesterol metabolism, commercial emulsions should be cleared of phospholipid excess.

Transfer of apolipoproteins between plasma lipoproteins and exogenous lipid particles after repeated bolus injections or during a continuous infusion of fat emulsion

Recent studies on the metabolism of artificial lipid particles in a fat emulsion (exo TG) revealed that exo TG acquired apolipoproteins in vivo and in vitro. In particular, apolipoproteins C-II and C-III (apo C-II and apo C-III) are rapidly transferred from high-density lipoprotein (HDL) to exo TG, and return to HDL after the hydrolysis of exo TG. The present study was undertaken to examine whether the movement of apo C-II and apo C-III between HDL and exo TG is influenced by a prior injection of fat emulsion. Two experiments were undertaken. In experiment 1, six male volunteers received three bolus injections of a fat emulsion at a dose of 0.1 g of TG/kg with intervals of 90 min between injections. In experiment 2, the plasma concentrations of triglycerides were maintained at approximately 500 mg/dl for 160 min by the continuous infusion of exo TG. Levels of apo C-II and apo C-III, and the elimination rate of exo TG were followed in each test. In experiment 1, the movement of apolipoproteins between exo TG and HDL was unchanged between the first, second, and third bolus. The elimination rate of exo TG after the third bolus was higher than that after the first bolus. In experiment 2, after the administration of exo TG, the levels of C apolipoproteins in the fraction of HDL began to decrease, and those in the fraction of very-low-density lipoprotein that contained exo TG began to increase. When the concentrations of triglycerides in plasma reached a plateau, the distribution of C apolipoproteins in the lipoprotein fraction also stabilized.(ABSTRACT TRUNCATED AT 250 WORDS)

Thrombogenicity of total parenteral nutrition solutions: I. Effect on induction of monocyte/macrophage procoagulant activity

Although thrombosis is a frequent complication of total parenteral nutrition (TPN), its pathogenesis has received little scientific attention. We have studied, in vitro, the effects of the component solutions of TPN on the induction and modulation of human monocyte procoagulant activity, an initiator of coagulation. Human peripheral blood mononuclear cells were cultured with (a) 200 microliters of dextrose solution (10%, 15%, 20%, 25%, and 50%), (b) 200 microliters of amino acid solution (full, one-half, and one-quarter strength), and (c) 200 microliters of isosmolar 10% lipid emulsion (LE). Cocultures of LE and 20% dextrose, LE and full-strength amino acid solution, and LE and bacterial lipopolysaccharide were also studied. Cells cultured with lipopolysaccharide or medium alone constituted positive and negative controls, respectively. In addition, cocultures of LE and 20% dextrose, LE and full-strength amino acid solution, and LE and lipopolysaccharide were also studied. Cells were incubated for intervals of 12-72 h, washed, frozen, and assayed for monocyte procoagulant activity (MPCA). Milliunits of MPCA were derived from a standard thromboplastin curve. In addition, spontaneous MPCA levels were measured in healthy volunteers (n = 4) and "home" total parenteral nutrition patients (n = 4) before and after a 2-h infusion of 500 ml of LE. Our results show that, in vitro, hypertonic dextrose and full-strength amino acid solutions induce significant levels of MPCA. Induction of MPCA by dextrose was lymphocyte-independent. Although a significant increase in MPCA by full-strength amino acid solution was seen in cultures of isolated monocytes, a lymphocyte requirement was demonstrated for full MPCA. In contrast, LE significantly inhibited the induction of MPCA by 20% dextrose and full-strength amino acid solution. This inhibitory activity was at the monocyte level. Subfractionation of the LE into triglyceride and phospholipid phases showed the inhibitory capacity to reside in the former. In vivo, patients on home total parenteral nutrition expressed higher spontaneous MPCA levels than normal controls. Ten percent lipid emulsion infusion abolished MPCA expression in both groups. These corroborative in vitro and in vivo data suggest a mechanism for the thrombogenicity of total parenteral nutrition solutions and that the inhibitory properties of LE may be of practical advantage in preventing thrombosis.

A comparison of the surface activities of human apolipoproteins A-I and A-II at the air/water interface

Surface pressure (pi) and adsorption isotherms for human apolipoproteins A-I and A-II at the air/water interface have been determined and used to deduce the probable molecular structures of the monomolecular films. The surface concentrations were measured using the surface radioactivity method to monitor the adsorption of reductively [14C]methylated apoproteins. Apolipoprotein A-I and apolipoprotein A-II are extremely surface-active proteins and adsorb to exert maximal pi values of 22 and 24 mN.m-1 respectively, at a steady-state subphase concentration of about 3.10(-5) g/100 ml (equivalent to 11 and 17 nM for apolipoprotein A-I and apolipoprotein A-II, respectively). At saturation monolayer coverage, the average molecular areas for apolipoprotein A-I and apolipoprotein A-II are 15 and 13 A2/residue, respectively. These packing densities are consistent with monolayers consisting largely of alpha-helical protein molecules lying with the long axes of the helical segments in the plane of the interface. Comparison of the molecular packings of spread and adsorbed monolayers of these proteins indicates that at low pi values, the adsorbed films are more expanded, but at high pi values, the molecular packing in both types of film is the same.

Elimination and metabolism of a fat emulsion containing medium chain triglycerides (lipofundin MCT 10%)

Medium chain triglycerides (MCT) are supposed to be advantageous on account of rapid energy supply in parental nutrition. However, data on the elimination rate of MCT-containing emulsions during an intravenous fat-tolerance test (IVFTT) are scarce. We performed this test (0.1 g lipid/kg body weight) in 18 young healthy volunteers (nine females and nine males) using Lipofundin MCT 10% (50% MCT; egg phospholipids as emulsifier). Our results indicate that both elimination and metabolization of the emulsion are fast: a prompt decrease of light-scattering index and of triglyceride concentrations in serum, an immediate appearance of post-load fatty acids and of beta-hydroxybutyrate were observed. This was in good agreement with the findings obtained during 6-hr infusions in the same probands. Fractional elimination rates k2 obtained from light-scattering indices are 7.29 +/- 2.73%/min in males and 11.59 +/- 3.38%/min in females, indicating a higher removal capacity in women. In the same subjects, the corresponding k2 values for Lipofundin S 10% (containing only long chain triglycerides) were higher, reflecting an elimination rate that is faster due to the use of soya bean phospholipids as emulsifier. In comparison, k2 values based on the course of the triglyceride concentrations are generally lower.

Uptake of endogenous cholesterol by a synthetic lipoprotein

The addition of cholesterol-poor phospholipid liposomes to canine plasma in vivo and in vitro substantially alters the distribution of phospholipids, apoproteins, and, especially, cholesterol. In vivo, intravenously injected phospholipid liposomes remain discrete particles, which are readily distinguished from the normally occurring lipoproteins by their buoyant density and electrophoretic mobility. They acquire unesterified cholesterol from endogenous sources, thereby producing an acute rise in the concentration of this sterol in plasma. The liposomes also accumulate endogenous proteins, one of which is identified as apolipoprotein A-I. In vitro, phospholipid liposomes incubated with plasma acquire unesterified cholesterol and apolipoprotein A-I at the expense of high-density lipoproteins (HDL), the major carrier of cholesterol in normal canine plasma. In exchange, the HDL particles are enriched in phospholipids and become larger. At sufficiently high concentrations, the liposomes nearly completely deplete HDL of its unesterified cholesterol. Thus, there are generated two types of particles, both rich in apolipoprotein A-I and phospholipid, but one (modified HDL) containing mainly esterified cholesterol in its core and the other (modified liposomes) containing mainly unesterified cholesterol at its surface. It is concluded that phospholipid liposomes produce important changes in the distribution of lipids and protein in canine plasma, particularly at the expense of HDL. These changes appear to favor the mobilization of tissue cholesterol into the plasma, and may have application to atherosclerosis.

Elimination of lipofundin S during the intravenous fat tolerance test in patients with low, medium, and high fasting triglyceride concentrations

The intravenous fat tolerance test with Lipofundin S (0.5 ml of 20% emulsion/kg body weight) was performed in 22 male nondiabetic patients. According to their fasting triglycerides (TG), the patients were arranged into three groups: low (less than 2.8 mmol/liter), medium (2.8-5.7 mmol/liter), and high (greater than 5.7 mmol/liter) concentrations. Fractional elimination rates of injected Lipofundin S decreased from 11.08 in low TG to 4.57%/min in high TG; they were positively correlated with fasting levels of high-density lipoprotein cholesterol but negatively with those of TG. The same pattern of correlations was observed with fractional catabolic rates of endogenous TG as measured after injection of tritium-labeled glycerol. The intravenous Lipofundin S load effected transient TG and free fatty acid elevations which were delayed in high TG. The elimination mechanisms of injected Lipofundin S and of endogenous TG are compared.

Differential transfer of C and E apolipoproteins from very-low-density lipoprotein to lysophosphatidylcholine-phosphatidylcholine micelles

Rat plasma VLDL was incubated with lysoPC/PC micelles consisting of 45-90 mol% lysoPC at micelle/VLDL phospholipid ratios of 0.33-6. Following incubation, the VLDL and micellar particles were reisolated by ultracentrifugation and the lipid and apolipoprotein composition determined by high-temperature gas chromatography and polyacrylamide gel electrophoresis, respectively. Lysophosphatidylcholine was found to equilibrate between the very-low-density lipoproteins and micellar fraction without transfer of phosphatidylcholine or sphingomyelin between these fractions. This produced reisolated VLDL and micellar particles with nearly identical lysoPC/PC ratios. Only apolipoprotein E transferred to reisolated micellar fractions with less than 35 mol% lysoPC. The C apolipoproteins were also transferred to the micellar fraction when the reisolated micelles contained more than 35 mol% lysoPC. It is concluded that apolipoproteins E and C can bind to HDL-size micellar particles of appropriate composition. The differential transfer of apolipoproteins E and C indicates that fundamental differences exist between these apolipoproteins in their interaction with lipid interfaces.