Association of serum MMP-9 with autoantibodies against oxidized LDL

Metabolic syndrome, inflammation and atherothrombosis

Extensive research of the past decades altered our traditional concept about the genesis of atherosclerosis fundamentally. Today, the crucial role of inflammation in the formation and progression of atherosclerotic plaques is indisputable. Patients at high risk for developing cardiovascular disease, owing to poor diet, obesity and low physical activity have been shown to exhibit a particular inflammatory pattern.

Therefore, the present review highlights the crosslink between the metabolic syndrome (MetS), adipose tissue, adipokines and selected inflammatory cytokines in the context of atherothrombosis and cardiovascular disease.

Plaque oxysterols induce unbalanced up-regulation of matrix metalloproteinase-9 in macrophagic cells through redox-sensitive signaling pathways: Implications regarding the vulnerability of atherosclerotic lesions

An imbalance in the matrix metalloproteinases/tissue inhibitors of metalloproteinases (MMPs/TIMPs) contributes to atherosclerotic plaque destabilization and rupture. Here we determined whether oxysterols accumulating in advanced atherosclerotic lesions play a role in plaque destabilization. In human promonocytic U937 cells, we investigated the effects of an oxysterol mixture of composition similar to that in advanced human carotid plaques on the expression and synthesis of MMP-9 and its endogenous inhibitors TIMP-1 and TIMP-2. A marked increment of MMP-9 gene expression, but not of its inhibitors, was observed by real-time RT-PCR; MMP-9 gelatinolytic activity was also found increased by gel zymography. Consistently, a net increment of MMP-9 protein level was also observed by immunoblotting. Using antioxidants or specific inhibitors or siRNAs, we demonstrated that the oxysterol mixture induces MMP-9 expression through: (i) overproduction of reactive oxygen species, probably by NADPH-oxidase and mitochondria; (ii) up-regulation of mitogen-activated protein kinase signaling pathways via protein kinase C; and (iii) up-regulation of activator protein-1- and nuclear factor-κB-DNA binding. These results suggest, for the first time, that oxysterols accumulating in advanced atherosclerotic lesions significantly contribute to plaque vulnerability by promoting MMP-9/TIMP-1/2 imbalance in phagocytic cells.

Once-weekly 22microg subcutaneous IFN-beta-1a in secondary progressive MS: a 3-year follow-up study on brain MRI measurements and serum MMP-9 levels

OBJECTIVE

To study the effect of weekly injected subcutaneous interferon (IFN)-beta-1a 22 microg on the extent of brain lesions on magnetic resonance imaging (MRI) and the level of serum matrix metalloproteinase (MMP)-9 in patients with secondary progressive multiple sclerosis (SPMS).

SUBJECTS AND METHODS

All the 28 Finnish patients participating in the Nordic multicentre trial on the clinical efficacy of weekly IFN-beta-1a (Rebif) 22 microg in SPMS were studied neurologically and by volumetric MRI during a 3-year follow-up. The levels of MMP-9 in serum were measured over the 3-year study.

RESULTS

There was no obvious effect on the number of contrast medium-enhancing lesions, the volume of T1 or T2 lesions or level of serum MMP-9, nor was any effect detected on the relapse rate and the Expanded Disability Status Scale (EDSS). Brain atrophy progression was not affected by the treatment.

CONCLUSION

The lack of effect on MRI, clinical outcomes or the levels of MMP-9 indicates that subcutaneous administration of low-dose low-frequency IFN-beta-1a is insufficient in controlling either the inflammatory constitutes or the neurodegenerative changes of advanced SPMS.

Gelatinolytic Activity in Atherosclerotic Plaques Is Highly Localized and Is Associated With Both Macrophages and Smooth Muscle Cells In Vivo

Background— Atherosclerosis is considered an inflammatory disease. Recent studies provided evidence for a predominant upstream location of plaque inflammation. The present study introduces a novel technique that evaluates the underlying mechanism of this spatial organization.

Methods and Results— In hypercholesterolemic rabbits, atherosclerosis of the infrarenal aorta was induced by a combination of endothelial denudation and a high-cholesterol diet (2% cholesterol for 2 months). At the time of death, aortic vessel segments were dissected and reconstructed with a new technique that preserved the original intravascular ultrasound–derived lumen geometry. This enabled us to study the spatial relation of histological markers like macrophages, smooth muscle cells, lipids, gelatinolytic activity, and oxidized low-density lipoprotein. Results showed a predominant upstream localization of macrophages and gelatinase activity. Colocalization studies indicated that gelatinase activity was associated with macrophages and smooth muscle cells. Further analysis revealed that this was caused by subsets of smooth muscle cells and macrophages, which were associated with oxidized low-density lipoprotein accumulation.

Conclusions— Upstream localization of a vulnerable plaque phenotype is probably due to an accumulation of oxidized low-density lipoprotein, which activates/induces subsets of smooth muscle cells and macrophages to gelatinase production.

Serum matrix metalloproteinase-9 and venous bypass graft occlusion

OBJECTIVE

The primary results after coronary artery bypass grafting are good, but early clinical events as a result of graft occlusion are still a problem. Early occlusions are thought to be due to thrombosis or fibrointimal hyperplasia superimposed by thrombosis, but the etiology of these phenomena is not fully understood. Matrix metalloproteinase-9 has been suggested to have a role in graft occlusion ex vivo.

MATERIAL AND METHODS

We investigated whether the level of serum matrix metalloproteinase-9 reflects its proposed role in occlusion of vein grafts. The study population consisted of 30 men with a history of myocardial infarction and 31 men without myocardial infarction who had undergone coronary artery bypass grafting. All the men were asymptomatic.

RESULTS

Among the patients with no previous myocardial infarction, serum matrix metalloproteinase-9 level was significantly higher in those with graft occlusion than in those without occlusion (54.0+/-11.0 microg/L and 41.7+/-10.4 microg/L, respectively, p = 0.006), and it correlated positively with the number of occluded grafts (R = 0.55, p = 0.001). In the patients with myocardial infarction, this effect was not detected.

CONCLUSIONS

Serum matrix metalloproteinase-9 reflected the occurrence of vein graft occlusion in subjects with no previous history of myocardial infarction.

Autoantibodies against oxidized LDL correlate with serum concentrations of ceruloplasmin in patients with cardiovascular disease

BACKGROUND

Ceruloplasmin (CP) has been suggested to play a role in the oxidative modification of LDL. The correlation between autoantibodies against oxidized LDL (anti-oxLDL), markers of oxidative stress, and the concentration of CP has not been previously investigated. We examined the status of these parameters in patients with myocardial infarction (MI) and stable angina.

METHODS

Blood samples were collected from patients with MI (n=56), stable angina (n=96) and from healthy controls (n=109). Levels of CP and copper were determined using turbidimetry and atomic absorption spectrophotometry, respectively. Levels of anti-oxLDL were obtained by ELISA.

RESULTS

Serum concentrations of CP, copper and anti-oxLDL were significantly higher in both groups of patients than those in controls. Among patient groups, concentrations of CP and copper were not significantly different, however, the concentrations of anti-oxLDL were higher in MI patients than that in angina (P=0.001), and were greatly influenced by underlying conditions such as diabetes mellitus, hypertension and smoking. Significant positive correlation was observed between serum concentrations of both CP and copper and the concentrations of anti-oxLDL in both patient groups but not in controls.

CONCLUSIONS

High concentrations of anti-oxLDL suggest an increase in oxidative stress that would contribute to disease severity. The observed correlation of CP with anti-oxLDL may suggest a possible pro-oxidative activity of CP in patients with cardiovascular disease.

Modulation of angiogenic processes in cultured endothelial cells by low density lipoproteins subfractions from patients with familial hypercholesterolemia

OBJECTIVE

Electronegative low density lipoprotein (LDL) subfractions are cytotoxic to endothelial cells. To continue our study of homozygotic familial hypercholesterolemic (FH)-LDL, we report the effects of FH-LDL subfractions (FH-L1 to FH-L5) on the angiogenic processes in cultured endothelial cells.

METHODS AND RESULTS

Subconfluent bovine aortic endothelial cells (BAEC) were treated with LDL subfractions (20 microg/ml), and the effects on angiogenic functions, including cell proliferation, migration, apoptosis, tube formation, secretion of matrix metalloproteinases (MMPs), and vascular endothelial growth factor (VEGF) were determined. The electronegative FH-L4 and FH-L5 inhibited cell proliferation while the other FH-LDL subfractions and LDL from normocholesterolemic subjects (N-LDL) had negligible effects. Like Cu2+ ox-LDL, FH-L5 strongly inhibited endothelial cell viability and FH-L4 had a milder effects. Similarly, FH-L4 and FH-L5 but not the other subfractions retarded cell migration, induced cell apoptosis, and perturbed tube formation by BAEC in matrigel. FH-L5 inhibited secretion of MMP-2 and MMP-9 by BAEC without affecting their endogenous levels. In contrast, FH-L5 increased the VEGF expression in endothelial cells.

CONCLUSIONS

Our results show for the first time that FH-L5, a circulating LDL subfraction from hypercholesterolemic patients, modulates various angiogenic processes, thereby dysregulating endothelial function in a way that may be atherogenic.