Platelet-enhanced apolipoprotein E production by human macrophages: a possible role in atherosclerosis

Attenuation of Atherosclerosis with PAR4 Deficiency: Differential Platelet Outcomes in apoE -/- vs. Ldlr -/- Mice

Objective

Cardiovascular disease (CVD) is a significant burden globally and, despite current therapeutics, remains the leading cause of death. Platelet inhibitors are of interest in CVD treatment to reduce thrombus formation post-plaque rupture as well their contribution to inflammation throughout the progression of atherosclerosis. Protease activated receptor 4 (PAR4) is a receptor highly expressed by platelets, strongly activated by thrombin, and plays a vital role in platelet activation and aggregation. However, the role of PAR4.

Approach and Results

Mice on a low-density lipoprotein receptor-deficient ( Ldlr -/- ) background were bred with Par4 deficient ( Par4 -/- ) mice to create Ldlr -/- /Par4 +/+ and Ldlr -/- /Par4 -/- cousin lines. Mice were fed high fat (42%) and cholesterol (0.2%) 'Western' diet for 12 weeks for all studies. Bone marrow transplant (BMT) studies were conducted by irradiating Ldlr -/- /Par4 +/+ and Ldlr -/- /Par4 -/- mice with 550 rads (2x, 4 hours apart) and then repopulated with Par4 +/+ or Par4 -/- bone marrow. To determine if the effects of thrombin were mediated solely by PAR4, the thrombin inhibitor dabigatran was added to the 'Western' diet. Ldlr -/- /Par4 -/- given dabigatran did not further decrease their atherosclerotic burden. Differences between apolipoprotein E deficient ( apoE -/- ) and Ldlr -/- platelets were assessed for changes in reactivity. We observed higher PAR4 abundance in arteries with atherosclerosis in human and mice versus healthy controls. PAR4 deficiency attenuated atherosclerosis in the aortic sinus and root versus proficient controls. BMT studies demonstrated this effect was due to hematopoietic cells, most likely platelets. PAR4 appeared to be acting independent of PAR1, as there werer no changes with addition of dabigatran to PAR4 deficient mice. apoE -/- platelets are hyperreactive compared to Ldlr -/- platelets.

Conclusions

Hematopoietic-derived PAR4, most likely platelets, plays a vital role in the development and progression of atherosclerosis. Specific targeting of PAR4 may be a potential therapeutic target for CVD.

Highlights

Deficiency of protease-activated receptor 4 attenuates the development of diet-induced atherosclerosis in a Ldlr -/- mouse model. PAR4 deficiency in hematopoietic cells is atheroprotective. PAR4 deficiency accounts for the majority of thrombin-induced atherosclerosis in a Ldlr -/- mouse model. The examination of platelet-specific proteins and platelet activation should be carefully considered before using the apoE -/- or Ldlr -/- mouse models of atherosclerosis.

Update on solid-phase extraction for the analysis of lipid classes and related compounds

This article provides information on the different procedures and methodologies developed when solid-phase extraction (SPE) is used for lipid component separation. The analytical systematics, established by different authors and designed to separate groups of compounds and also specific components by using a combination of chromatographic supports and solvents are presented. The review has been divided into three parts, which we consider well defined: edible fats and oils, fatty foods and biological samples. Separations of non-polar and polar lipids is the most extensive systematic, although many other published methods have been established to isolate specific components or a reduced number of components from edible fats and oils, fatty foods or biological samples susceptible to further analysis by other quantitative techniques.

Influence of macrophage-derived apolipoprotein E on plasma lipoprotein distribution of apolipoprotein A-I in apolipoprotein E-deficient mice

High density lipoprotein (HDL) cholesterol in apolipoprotein (apo) E-deficient mice is decreased. It has been suggested that apoA-I is lost from HDL in these mice because it must substitute for apoE as a structural protein for the abnormal cholesterol-rich lipoproteins. Therefore, we examined in vivo the influence of selective apoE expression on plasma HDL cholesterol in apoE-deficient mice. Bone marrow transplantation was used to establish macrophage-specific expression of apoE. Bone marrow transplantation normalized plasma triglycerides and significantly reduced total plasma cholesterol, but it did not increase hepatic apoA-I mRNA levels or total plasma apoA-I. Although total plasma apoA-I was not increased, HDL cholesterol measured following chromatographic separation was elevated twofold. Furthermore, plasma apoA-I was recovered from this HDL in animals expressing macrophage apoE. Compared to HDL of wildtype mice, this HDL had a similar chromatographic size distribution, but it lacked apoE and was more negatively charged. These studies indicated that plasma apoA-I distribution and HDL composition are influenced by apoE and that the abnormal apoA-I lipoprotein distribution of apoE-deficient mice can be altered in vivo by macrophage-derived apoE.

Non-ischemic hypoxia of the arterial wall is a primary cause of atherosclerosis

The response-to-injury hypothesis has been the dominant model of atherosclerosis for 20 years. However, it does not explain the experimental role of oxygen in atherogenesis, does not explain many of the clinical features of atherosclerosis, and has failed to provide useful countermeasures. I propose that arterial wall hypoxia results from risk factors for atherosclerosis. The primary mechanism is decreased oxygen delivery by a microcirculatory derangement resulting from impaired erythrocyte deformability. As in a healing wound, hypoxia causes growth factor release within the arterial media. Diffusion of these factors causes intimal proliferation and atheroma formation. This hypothesis implies that simple inexpensive oxygenation regimens might prevent the morbidity and mortality of atherosclerosis. Despite demonstrated effectiveness in experimental models, such treatments have not been extensively studied in clinical atherosclerosis because they conflict with the dominant model. This dogma needs to be re-examined.

Human apolipoprotein E mediates processive buoyant lipoprotein formation in insect larvae

The expression of human apolipoprotein E in tobacco hornworm larvae causes a dramatic change in the buoyant density of the insect's endogenous lipoproteins. Larvae without apoE have lipoproteins that are found exclusively in the high-density range. Baculovirus-mediated apoE expression results in the conversion of approximately one-fourth of the endogenous lipoproteins to low-density species. This density conversion is progressive and parallels a similar change in apoE density distribution. ApoE is secreted from the lipoprotein producing fat body tissue in a lipid-poor form, but readily associates with circulating insect lipoproteins in the hemolymph where the density conversion takes place. Analysis of the buoyant lipoprotein particles indicates that they contain apoE and insect apolipophorins I and II with few or no other proteins present. Immunoprecipitation of apolipophorins I and II results in coprecipitation of apoE. This association is disrupted by detergent, consistent with the three proteins sharing the same lipoprotein particles. The ability of apoE to influence buoyant lipoprotein formation in an invertebrate system leads us to suggest that small apolipoproteins such as apoE may play a role in buoyant lipoprotein production in mammals.

Abundant expression of apoprotein E by macrophages in human and rabbit atherosclerotic lesions

Previous studies have demonstrated the presence of apoprotein (apo) E protein and message in arterial lesions. To determine the source of the synthesized apoE, we performed simultaneous in situ hybridization and immunocytochemistry on human and rabbit atherosclerotic tissue. Studies of serial sections of aortic atherosclerotic lesions from humans and hypercholesterolemic New Zealand White rabbits and Watanabe heritable hyperlipidemic rabbits revealed a similar pattern of macrophage-specific apoE expression in the rabbit and human lesions. In early lesions of rabbit atherosclerotic tissue, in which many macrophages were present, there was abundant expression of apoE mRNA. Northern blot analyses of total mRNA obtained from arterial macrophage-derived foam cells, freshly isolated from ballooned, cholesterol-fed New Zealand White rabbits, demonstrated positive hybridization with an apoE-specific riboprobe. Western blot analyses of conditioned media from the isolated foam cells placed in culture for up to 24 hours demonstrated the presence of secreted apoE. These studies demonstrated that in atherosclerotic lesions, arterial wall macrophages synthesize and secrete apoE and probably account for most of the apoE synthesized in the atherosclerotic artery.

Cytokine regulation of macrophage apo E secretion: opposing effects of GM-CSF and TGF-beta

Biosynthesis of apolipoprotein (apo) E has been previously demonstrated to be regulated in macrophages by intracellular free cholesterol levels as well as by macrophage activating factors. In this report, the regulation of apo E secretion by cytokines detected within atherosclerotic lesions has been investigated. Granulocyte macrophage-colony stimulating factor (GM-CSF) stimulated macrophages had a 3-5-fold reduction in apo E secretion, comparable to that observed for gamma interferon (IFN gamma), while tumor necrosis factor alpha (TNF alpha) and interleukin 1 beta (IL-1 beta) resulted in a 2-fold decrease. In contrast to the reduction in apo E secretion by these cytokines, transforming growth factor beta (TGF-beta) stimulated macrophages secreted 3-fold greater amounts of apo E than controls. The reduced secretion of apo E by GM-CSF was reversible, heat labile, dose dependent, maximal 48 h after cytokine exposure and was coincident with an increase in fibronectin secretion. The opposing effects of GM-CSF and TGF-beta on apo E secretion were consistent with similar changes detected in apo E mRNA levels. Cytokine effects on apo E secretion in cholesterol loaded macrophages were also investigated and found to be similar to the non-loaded cells with GM-CSF decreasing and TGF-beta increasing apo E secretion. The observed differences in apo E secretion did not correlate with any significant changes in either cellular cholesterol distribution in the non-cholesterol loaded macrophages or in basal ACAT activity. In addition to changes in apo E secretion, cytokine treated macrophages pulsed with [14C]oleate and acetylated LDL for 2-6 h had a 2-fold increase (GM-CSF) or decrease (TGF-beta) in cholesterol esterification. Therefore, GM-CSF and TGF-beta mediated changes in apo E secretion may occur through a mechanism independent of changes in cellular free cholesterol levels. These results suggest that cytokines expressed within an atheroma may play an important role in the modulation of macrophage mediated reverse cholesterol transport.

Apolipoprotein E expression by human-monocyte-derived macrophages. Modulation by opsonised zymosan and cholesterol

The effects of opsonised zymosan and of acetylated low-density lipoprotein (AcLDL) on the synthesis and secretion of apolipoprotein E (apoE), and of apoE mRNA abundance, have been studied in human-monocyte-derived macrophages (MDM). Stimulation by opsonised zymosan led to a concentration-dependent increase in apoE secretion; non-opsonised zymosan was without effect. Incubation with AcLDL led to a concentration-dependent elevation in apoE synthesis which paralleled the increase in cellular cholesterol content. The opsonised-zymosan-induced stimulation of apoE production was additive to that resulting from cholesterol loading with AcLDL. Opsonised zymosan alone did not affect the cholesterol content of MDM. Cholesterol-loaded MDM remained responsive to opsonised zymosan stimulation, displaying a 3.5-fold elevation in apoE secretion as compared to their non-stimulated counterparts. Cell-associated apoE remained at trace levels under all conditions of cell treatment. Studies involving [35S]methionine incorporation showed de novo synthesis of apoE to be enhanced in both cholesterol-loaded and opsonised-zymosan-stimulated macrophages. Estimation of apoE mRNA in opsonised-zymosan-stimulated and control MDM by dot-blot analysis revealed similar message abundance; by contrast, elevation in cellular cholesterol content following incubation with modified LDL led to a significant increase in apoE mRNA levels. We conclude that the opsonised-zymosan-induced stimulation of apoE synthesis and secretion in human MDM may occur by a mechanism(s) independent of cellular cholesterol content.