Relationships of plasma and hepatic variables with rates of plasma low-density lipoprotein apolipoprotein B metabolism in baboons fed low- and high-fat diets

Gene therapy for rhesus monkeys heterozygous for LDL receptor deficiency by balloon catheter hepatic delivery of helper-dependent adenoviral vector

Autosomal dominant familial hypercholesterolemia (FH) is a monogenic life-threatening disease. We tested the efficacy of low-density lipoprotein receptor (LDLR) gene therapy using helper-dependent adenoviral vector (HDAd) in a nonhuman primate model of FH, comparing intravenous injection versus intrahepatic arterial injection in the presence of balloon catheter-based hepatic venous occlusion. Rhesus monkeys heterozygous for mutant LDLR gene (LDLR+/-) developed hypercholesterolemia while on a high-cholesterol diet. We treated them with HDAd-LDLR either by intravenous delivery or by catheter-based intrahepatic artery injection. Intravenous injection of ⩽1.1 × 10(12) viral particles (vp) kg(-1) failed to have any effect on plasma cholesterol. Increasing the dose to 5 × 10(12) vp kg(-1) led to a 59% lowering of the plasma cholesterol that lasted for 30 days before it returned to pre-treatment levels by day 40. A further increase in dose to 8.4 × 10(12) vp kg(-1) resulted in severe lethal toxicity. In contrast, direct hepatic artery injection following catheter-based hepatic venous occlusion enabled the use of a reduced HDAd-LDLR dose of 1 × 10(12) vp kg(-1) that lowered plasma cholesterol within a week, and reached a nadir of 59% pre-treatment level on days 20-48 after injection. Serum alanine aminotransferase remained normal until day 48 when it went up slightly and stayed mildly elevated on day 72 before it returned to normal on day 90. In this monkey, the HDAd-LDLR-induced trough of hypocholesterolemia started trending upward on day 72 and returned to pre-treatment levels on day 120. We measured the LDL apolipoprotein B turnover rate at 10 days before, and again 79 days after, HDAd-LDLR treatment in two monkeys that exhibited a cholesterol-lowering response. HDAd-LDLR therapy increased the LDL fractional catabolic rate by 78 and 50% in the two monkeys, coincident with an increase in hepatic LDLR mRNA expression. In conclusion, HDAd-mediated LDLR gene delivery to the liver using a balloon catheter occlusion procedure is effective in reversing hypercholesterolemia in a nonhuman primate FH model; however, the unsustainability of the hypocholesterolemic response during 3-4 months of follow up and heterogeneous response to the treatment remains a challenge.

Low-density lipoprotein apolipoprotein B production differs between laboratory opossums exhibiting high and low lipemic responses to dietary cholesterol and fat

Two partially inbred strains of laboratory opossums exhibit extremely high or low levels of low-density lipoprotein (LDL) cholesterol concentrations, respectively, when challenged with a high-cholesterol and high-fat (HCHF) diet. The present studies were conducted to determine whether the catabolism or the production of LDL apolipoprotein B (apoB) is responsible for the variability in plasma LDL cholesterol and apoB concentrations. Iodinated LDL prepared from plasma of donor opossums consuming HCHF diet was injected into high- and low-responding recipients maintained on the HCHF diet. Blood was drawn at intervals beginning at 3 minutes and ending at 24 hours. At the end of the study, animals were necropsied, and livers were removed for isolation of RNA. Plasma LDL apoB was separated by sodium dodecyl sulfate-electrophoresis, and the level of radioactivity was determined. Hepatic LDL receptor and apoB mRNA levels were measured by Northern blotting. Radioactivity decay curves were plotted by using the radioactivity at each time point as percentage of the radioactivity recovered at 3 minutes. Fractional catabolic rates (FCRs) were calculated by the curve peeling technique. Steady-state production rates were calculated by multiplying the FCR values with apoB concentrations. LDL apoB FCR was slightly higher (1.63-fold) in low responders than in high responders. On the other hand, LDL apoB production was much higher (5.5-fold) in high responders than in low responders. There was no difference in hepatic mRNA levels for either the LDL receptor or apoB. The differences in LDL apoB FCR may be explained on the basis of differences in pool size between the 2 strains. Therefore, LDL apoB production is the major determinant of diet-induced hyperlipidemia in laboratory opossums. Because LDL apoB production was not associated with hepatic mRNA levels, the production of LDL apoB is regulated posttranscriptionally or posttranslationally.