Lipid class and molecular species interrelationships among plasma lipoproteins of type III and type IV hyperlipemic subjects

Sphingomyelin in high-density lipoproteins: structural role and biological function

High-density lipoprotein (HDL) levels are an inverse risk factor for cardiovascular diseases, and sphingomyelin (SM) is the second most abundant phospholipid component and the major sphingolipid in HDL. Considering the marked presence of SM, the present review has focused on the current knowledge about this phospholipid by addressing its variable distribution among HDL lipoparticles, how they acquire this phospholipid, and the important role that SM plays in regulating their fluidity and cholesterol efflux from different cells. In addition, plasma enzymes involved in HDL metabolism such as lecithin-cholesterol acyltransferase or phospholipid transfer protein are inhibited by HDL SM content. Likewise, HDL SM levels are influenced by dietary maneuvers (source of protein or fat), drugs (statins or diuretics) and modified in diseases such as diabetes, renal failure or Niemann-Pick disease. Furthermore, increased levels of HDL SM have been shown to be an inverse risk factor for coronary heart disease. The complexity of SM species, described using new lipidomic methodologies, and their distribution in different HDL particles under many experimental conditions are promising avenues for further research in the future.

Absorption and lipoprotein transport of sphingomyelin

Dietary sphingomyelin (SM) is hydrolyzed by intestinal alkaline sphingomyelinase and neutral ceramidase to sphingosine, which is absorbed and converted to palmitic acid and acylated into chylomicron triglycerides (TGs). SM digestion is slow and is affected by luminal factors such as bile salt, cholesterol, and other lipids. In the gut, SM and its metabolites may influence TG hydrolysis, cholesterol absorption, lipoprotein formation, and mucosal growth. SM accounts for approximately 20% of the phospholipids in human plasma lipoproteins, of which two-thirds are in LDL and VLDL. It is secreted in chylomicrons and VLDL and transferred into HDL via the ABCA1 transporter. Plasma SM increases after periods of large lipid loads, during suckling, and in type II hypercholesterolemia, cholesterol-fed animals, and apolipoprotein E-deficient mice. SM is thus an important amphiphilic component when plasma lipoprotein pools expand in response to large lipid loads or metabolic abnormalities. It inhibits lipoprotein lipase and LCAT as well as the interaction of lipoproteins with receptors and counteracts LDL oxidation. The turnover of plasma SM is greater than can be accounted for by the turnover of LDL and HDL particles. Some SM must be degraded via receptor-mediated catabolism of chylomicron and VLDL remnants and by scavenger receptor class B type I receptor-mediated transfer into cells.

Gas-liquid chromatographic profiling of plasma lipids using high-temperature-polarizable capillary columns

We have examined the potential usefulness in plasma lipid profiling of capillary columns coated with a high-temperature-polarizable phenylmethyl silicone liquid phase, previously employed for gas-liquid chromatography (GLC) of natural triacylglycerols. The column yielded an excellent resolution for plasma triacylglycerols, cholesteryl esters and the trimethylsilyl (TMS) and tert-butyldimethylsilyl (t-BDMS) ethers of free cholesterol, as well as of the TMS and t-BDMS ethers of the diacylglycerols and ceramides released from plasma phospholipids by phospholipase C digestion. The various lipid classes were resolved into molecular species according to chain length and number of double bonds. The different molecular species were recovered in variable proportions as indicated by comparisons of peak area percentages obtained on the polar columns with those recorded on non-polar columns, which have been previously shown to give correct quantitative proportions. The cholesteryl esters are thermally degraded at high temperatures and must be eluted at as low a temperature as possible. Under the selected experimental conditions, the cholesteryl esters were found to partly interdigitate with the triacylglycerol species of carbon numbers 46-48. The TMS and t-BDMS ethers of diacylglycerols and ceramides emerged clearly ahead of the leading triacylglycerol of the 42 acyl carbon series. However, the diacylglycerol and ceramide species overlapped and interdigitated extensively with each other. Due to low polarity below 280 degrees C, the polarizable-liquid phase was not suitable for the resolution of the molecular species of monoacylglycerols and free fatty acids, which were separated on the basis of carbon number only. Nevertheless, capillary GLC on the polarizable liquid phases provides a novel and informative profiling of plasma lipids, the application of which to the assay of plasma lipid abnormalities deserves further examination.

A comparison of fatty acid composition of cholesteryl esters in subjects at various concentrations of serum lipid

We have evaluated the fatty acid composition of high density lipoprotein (HDL) cholesteryl esters in serum specimens of 83 male subjects, divided into 2 groups: one with a mean HDL cholesterol of 0.75 mmol/L and the other with 1.25 mmol/L. The specimens with low HDL cholesterol concentrations had an increase in the proportion of palmitic acid (6%) and stearic acid (67%) compared with specimens and high HDL cholesterol concentration. When the fatty acid composition of the same specimens was evaluated in groups corresponding to the four major phenotypes (normolipidemic, hypercholesterolemic, hypertriglyceridemic and hyperlipidemic), we found statistically no significant differences between these groups in the HDL cholesteryl ester fraction. There were, however, statistically significant differences between the hyperlipidemic group and the other three groups in the proportions of palmitoleic, oleic and stearic acids, and in the ratio of oleic/linoleic acids of total cholesteryl esters.

Usefulness of gas chromatographic profiles of plasma total lipids in diagnosis of phytosterolemia

A Cambodian male (aged 5 years and 9 months) presented with subcutaneous and tendon xanthomas in association with hypercholesterolemia. He was erroneously diagnosed as having familial hypercholesterolemia and treated with a low cholesterol diet (+/- cholestyramine) to which he did not respond. A determination of plasma total lipid profile by high-temperature gas chromatography revealed elevated plasma levels of free and esterified plant sterols along with the hypercholesterolemia. Introduction and maintenance of a diet low in cholesterol and plant sterols resulted in significant reduction in the blood concentration of these sterols, which returned to pretreatment level upon discontinuation of the low sterol regimen. The rapid identification and quantitation of the plant sterols by high-temperature gas chromatography provides a sensitive means of distinguishing phytosterolemia, which might be more common than previously suspected, from other forms of dyslipidemia, and for following the course of any treatment.

Lipids and their constituents

Many tissues, cells and body fluids possess characteristic lipid composition that can be readily recognized without full resolution and quantitation of individual molecular species. Various chromatographic methods have been adopted for this purpose and are extensively employed in biomedical research. Although lipid profiles are known to change with disease and lipid profiling holds considerable potential for clinical diagnosis, few routines have been established for this purpose. This is partly due to the laborious nature of the simpler methods and the high cost of automated systems. A combination of thin-layer or liquid chromatography with universal detection systems promises to provide more attractive analytical routines for clinical application in the future. At present thin-layer chromatography is the simplest and most rapid qualitative assay for both neutral and polar lipids. Low-temperature gas chromatography is still the method of choice for fatty acid analyses, while high-temperature gas chromatography is eminently suited for quantitative analysis of intact neutral lipids. The availability of the flame ionization and mass detectors now makes high-performance liquid chromatography more useful for profiling both neutral and polar lipids. Combinations of gas or liquid chromatography with mass spectrometry must remain of specialized interest only because of the prohibitive costs of operation.

Apolipoprotein B-48 and B-100 very low density lipoproteins. Comparison in dysbetalipoproteinemia (type III) and familial hypertriglyceridemia (type IV)

A protein band having the same migration as apolipoprotein (apo) B-48 was observed by SDS electrophoresis in the plasma very low density lipoprotein (VLDL) from 14 Type IV and three Type III hyperlipoproteinemic subjects and from six normal fasting subjects. The VLDL from five Type IV, three Type III, and one normal subject were separated into two subfractions, retained and nonretained, by immunoaffinity chromatography on monoclonal anti-apo B-100 Sepharose. Based on results of electrophoresis and radioimmunoassay, we have concluded that these two fractions represent apo B-48 and apo B-100 lipoproteins that we have named apo B-48 and apo B-100 VLDL. When compared to their respective apo B-100 VLDL, the apo B-48 VLDL from either Type III or Type IV was principally enriched in total lipids, in apo E, and had an electrophoretic migration similar to chylomicrons. This suggests that apo B-48 VLDL has the same origin (i.e., intestinal) in the two disorders. Both apo B-48 and apo B-100 VLDL were enriched in cholesteryl ester (CE) and depleted in triglyceride (TG) in Type III; however, both fractions were rich in TG and poor in CE in Type IV and in normal subjects. In addition, compared to their respective apo B-100 VLDL, the apo B-48 fraction was enriched in CE in Type III and in TG in Type IV. We conclude that, despite a possible similar origin for apo B-48 VLDL in Type III and in Type IV subjects, the composition of apo B-48 VLDL is variable and the CE/TG ratio is more characteristic of the type of hyperlipidemia than of the particular VLDL subfractions.

Distribution of the molecular species of phospholipids in human umbilical cord blood

The composition of phosphatidylcholine (PC) and sphingomyelin (SM) was studied in cord blood lipoproteins to determine whether equilibration of the molecular species of phospholipids among lipoproteins was comparable with that reported for adults. The molecular species distributions of PC in low density lipoprotein (LDL) differed from that of high density lipoprotein (HDL). Whereas LDL PC was richer in combinations of fatty acids with 16 and 18 carbon atoms than HDL, the HDL was markedly enriched in combinations of fatty acids with 18 and 20 carbon atoms. Sphingomyelins in LDL were richer in palmitic acid than HDL while HDL had a greater proportion of long chain sphingomyelin than LDL. The molecular species of PC and SM do not equilibrate in cord blood. The results for the SM distributions were similar to other reports for adult human lipoprotein. However, the marked differential distribution of PC among lipoproteins appears unique to cord blood. The mechanisms responsible for equilibrating PC among lipoproteins are less well developed in the neonate when compared with the adult.

Isolation and characterization of apolipoprotein B-48 and B-100 very low density lipoproteins from type III hyperlipoproteinemic subjects

Two major species of human apolipoprotein (apo) B have been identified, apo B-48 and apo B-100, which are the predominant forms in chylomicrons and very low density lipoproteins (VLDL), respectively. Due to defective hepatic clearance, apo B-48 containing lipoproteins accumulate in the plasma of subjects with type III hyperlipoproteinemia. In the present study, we have used immunoaffinity chromatography to separate type III VLDL into a nonretained (apo B-48 VLDL) and a retained (apo B-100 VLDL) fraction. To achieve complete separation, as determined by electrophoresis and radioimmunoassay, it was necessary to employ two different insolubilized anti-apo B-100 monoclonal antibodies because of immunochemical heterogeneity within the apo B-100 VLDL fraction. The ability to separate apo B-100 VLDL from apo B-48 VLDL shows that the two apo B species are found on different particles. The apo B-48 VLDL had an electrophoretic mobility similar to chylomicrons, whereas the apo B-100 VLDL migrated similarly to total type III VLDL. Both fractions showed a concentration of particles with diameters approximately 100 nm, with apo B-48 VLDL being somewhat more heterogeneous in particle size. The two fractions were qualitatively similar in apolipoprotein composition but apo B-48 VLDL was enriched in apo E, relative to apo B-100 VLDL. Apo B-48 VLDL was enriched in cholesterol esters and deficient in triglycerides and phospholipids when compared with apo B-100 VLDL. The existence of immunochemical heterogeneity in the apo B-100 VLDL may reflect different functional subpopulations of particles within this fraction.

Decreased plasma phosphatidylcholine/free cholesterol ratio as an indicator of risk for ischemic vascular disease

As part of a population survey and a follow-up study of plasma lipid profiles by high temperature gas-liquid chromatography, we have determined the quantities and relative proportions of all major chemical classes and molecular species of lipids of plasma from 1200 subjects at Visit 2 of the Toronto-McMaster Lipid Research Clinic Prevalence Study. We have compared these values between our 24 subjects with ischemic vascular disease and 73 control subjects matched for age, sex, and plasma total cholesterol and triacylglycerols. The phosphatidylcholine/free cholesterol ratio showed the highest association with ischemic vascular disease of any of over 10 other lipid parameters and all the common risk indicators except high density lipoprotein cholesterol. The phosphatidylcholine/free cholesterol ratio had a relative risk ratio of 20/4 (95% confidence limits, 15/9, 23/1) and high density lipoprotein cholesterol, a risk ratio of 23/1 (95% confidence limits, 24/0, 19/5) for ischemic vascular disease. The average ratio of phosphatidylcholine/free cholesterol for the ischemic vascular disease group was 1.36 and for the controls 1.51, the population average being 1.50. Plasma high density lipoprotein cholesterol had a significant correlation (R = 0.15) with the phosphatidylcholine/free cholesterol ratio in the total population sample. The increased risk for ischemic vascular disease from a lower phosphatidylcholine/free cholesterol ratio may possibly be explained on the basis of decreased fluidity and stability of the lipoproteins due to a relative oversaturation with free cholesterol.