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Abstract
PURPOSE OF REVIEW Cholesterol metabolism is increasingly recognized in inflammatory diseases including transplantation. This review discusses the mechanistic underpinnings that tie macrophage cholesterol efflux capacity (CEC) of high-density lipoprotein (HDL) to chronic rejection in transplanted patients. RECENT FINDINGS Animal studies suggest that administration of apolipoprotein A-I, the main protein constituent of HDL, can prevent transplant arteriosclerosis. apoA-I administration increases CEC of HDL. In patients with cardiac allograft vasculopathy (CAV), decreased CEC has been associated with poorer survival. In addition, reduced CEC in recipients, pretransplant, has been associated with the development of CAV and renal allograft survival. SUMMARY These recent findings raise the hypothesis that increasing cholesterol efflux may prevent chronic rejection and improve allograft survival after transplant. Reconstituted HDL significantly increases CEC and is currently in clinical development for traditional atherosclerosis. Clinical trials of reconstituted HDL administration in transplantation should be performed.
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Javaheri A, Molina M, Zamani P, Rodrigues A, Novak E, Chambers S, Stutman P, Maslanek W, Williams M, Lilly SM, Heeger P, Sayegh MH, Chandraker A, Briscoe DM, Daly KP, Starling R, Ikle D, Christie J, Rame JE, Goldberg LR, Billheimer J, Rader DJ. Cholesterol efflux capacity of high-density lipoprotein correlates with survival and allograft vasculopathy in cardiac transplant recipients. J Heart Lung Transplant 2016; 35:1295-1302. [PMID: 27498384 DOI: 10.1016/j.healun.2016.06.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 05/26/2016] [Accepted: 06/28/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Cardiac allograft vasculopathy (CAV) is a major cause of mortality after cardiac transplantation. High-density lipoprotein (HDL) cholesterol efflux capacity (CEC) is inversely associated with coronary artery disease. In 2 independent studies, we tested the hypothesis that reduced CEC is associated with mortality and disease progression in CAV. METHODS We tested the relationship between CEC and survival in a cohort of patients with CAV (n = 35). To determine whether reduced CEC is associated with CAV progression, we utilized samples from the Clinical Trials in Organ Transplantation 05 (CTOT05) study to determine the association between CEC and CAV progression and status at 1 year (n = 81), as assessed by average change in maximal intimal thickness (MIT) on intravascular ultrasound. RESULTS Multivariable Cox proportional hazard models demonstrated that higher levels of CEC were associated with improved survival (hazard ratio 0.26, 95% confidence interval 0.11 to 0.63) per standard deviation CEC, p = 0.002). Patients who developed CAV had reduced CEC at baseline and 1-year post-transplant. We observed a significant association between pre-transplant CEC and the average change in MIT, particularly among patients who developed CAV at 1 year (β = -0.59, p = 0.02, R2 = 0.35). CONCLUSION Reduced CEC is associated with disease progression and mortality in CAV patients. These findings suggest the hypothesis that interventions to increase CEC may be useful in cardiac transplant patients for prevention or treatment of CAV.
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Affiliation(s)
- Ali Javaheri
- Division of Cardiology, Washington University School of Medicine, St. Louis, Missouri, USA.
| | - Maria Molina
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Payman Zamani
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amrith Rodrigues
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Eric Novak
- Division of Cardiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Susan Chambers
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Patricia Stutman
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Wilhelmina Maslanek
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mary Williams
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Scott M Lilly
- Division of Cardiology, Ohio State University, Columbus, Ohio, USA
| | - Peter Heeger
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mohamed H Sayegh
- Brigham & Women׳s Hospital, Harvard University, Boston, Massachusetts, USA; Department of Medicine and Immunology, American University of Beirut, Beirut, Lebanon
| | - Anil Chandraker
- Brigham & Women׳s Hospital, Harvard University, Boston, Massachusetts, USA
| | | | - Kevin P Daly
- Children's Hospital Boston, Boston, Massachusetts, USA
| | | | - David Ikle
- Department of Biostatistics, Rho Federal Systems Division, Rho, Inc., Chapel Hill, North Carolina, USA
| | - Jason Christie
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - J Eduardo Rame
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lee R Goldberg
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jeffrey Billheimer
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel J Rader
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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3
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Annema W, von Eckardstein A. Dysfunctional high-density lipoproteins in coronary heart disease: implications for diagnostics and therapy. Transl Res 2016; 173:30-57. [PMID: 26972566 DOI: 10.1016/j.trsl.2016.02.008] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 02/15/2016] [Accepted: 02/17/2016] [Indexed: 12/18/2022]
Abstract
Low plasma levels of high-density lipoprotein (HDL) cholesterol are associated with increased risks of coronary heart disease. HDL mediates cholesterol efflux from macrophages for reverse transport to the liver and elicits many anti-inflammatory and anti-oxidative activities which are potentially anti-atherogenic. Nevertheless, HDL has not been successfully targeted by drugs for prevention or treatment of cardiovascular diseases. One potential reason is the targeting of HDL cholesterol which does not capture the structural and functional complexity of HDL particles. Hundreds of lipid species and dozens of proteins as well as several microRNAs have been identified in HDL. This physiological heterogeneity is further increased in pathologic conditions due to additional quantitative and qualitative molecular changes of HDL components which have been associated with both loss of physiological function and gain of pathologic dysfunction. This structural and functional complexity of HDL has prevented clear assignments of molecules to the functions of normal HDL and dysfunctions of pathologic HDL. Systematic analyses of structure-function relationships of HDL-associated molecules and their modifications are needed to test the different components and functions of HDL for their relative contribution in the pathogenesis of atherosclerosis. The derived biomarkers and targets may eventually help to exploit HDL for treatment and diagnostics of cardiovascular diseases.
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Affiliation(s)
- Wijtske Annema
- Institute of Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
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4
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Low H, Cheng L, Di Yacovo MS, Churchill MJ, Meikle P, Bukrinsky M, Hill AF, Sviridov D. Lipid metabolism in patients infected with Nef-deficient HIV-1 strain. Atherosclerosis 2015; 244:22-8. [PMID: 26581048 DOI: 10.1016/j.atherosclerosis.2015.10.103] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/26/2015] [Accepted: 10/26/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND HIV protein Nef plays a key role in impairing cholesterol metabolism in both HIV infected and bystander cells. The existence of a small cohort of patients infected with Nef-deficient strain of HIV presented a unique opportunity to test the effect of Nef on lipid metabolism in a clinical setting. METHODS Here we report the results of a study comparing six patients infected with Nef-deficient strain of HIV (ΔNefHIV) with six treatment-naïve patients infected with wild-type HIV (WT HIV). Lipoprotein profile, size and functionality of high density lipoprotein (HDL) particles as well as lipidomic and microRNA profiles of patient plasma were analyzed. RESULTS We found that patients infected with ΔNefHIV had lower proportion of subjects with plasma HDL-C levels <1 mmol/l compared to patients infected with WT HIV. Furthermore, compared to a reference group of HIV-negative subjects, there was higher abundance of smaller under-lipidated HDL particles in plasma of patients infected with WT HIV, but not in those infected with ΔNefHIV. Lipidomic analysis of plasma revealed differences in abundance of phosphatidylserine and sphingolipids between patients infected with ΔNefHIV and WT HIV. MicroRNA profiling revealed that plasma abundance of 24 miRNAs, many of those involved in regulation of lipid metabolism, was differentially regulated by WT HIV and ΔNefHIV. CONCLUSION Our findings are consistent with HIV protein Nef playing a significant role in pathogenesis of lipid-related metabolic complications of HIV disease.
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Affiliation(s)
- Hann Low
- Baker IDI Heart and Diabetes Institute, PO Box 6492, Melbourne, VIC, 3004, Australia
| | - Lesley Cheng
- Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Maria-Silvana Di Yacovo
- Baker IDI Heart and Diabetes Institute, PO Box 6492, Melbourne, VIC, 3004, Australia; Institut de Resercha Biomedica Bellvitge, University of Barcelona, Gran Via de l'Hospitalet, 199, 08908 Hospitalet de Llobregat, Barcelona, Spain
| | - Melissa J Churchill
- Macfarlane Burnett Institute for Medical Research and Public Health, 85 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Peter Meikle
- Baker IDI Heart and Diabetes Institute, PO Box 6492, Melbourne, VIC, 3004, Australia; Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Michael Bukrinsky
- Department of Microbiology, Immunology and Tropical Medicine, George Washington University, 2300 I St. NW, Ross Hall, Washington DC, 20037, USA
| | - Andrew F Hill
- Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Dmitri Sviridov
- Baker IDI Heart and Diabetes Institute, PO Box 6492, Melbourne, VIC, 3004, Australia.
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5
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Singh N, Jacobs F, Rader DJ, Vanhaecke J, Van Cleemput J, De Geest B. Impaired cholesterol efflux capacity and vasculoprotective function of high-density lipoprotein in heart transplant recipients. J Heart Lung Transplant 2014; 33:499-506. [PMID: 24630408 DOI: 10.1016/j.healun.2014.01.859] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 12/19/2013] [Accepted: 01/16/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND High-density lipoprotein (HDL) metabolism is significantly altered in heart transplant recipients. We hypothesized that HDL function may be impaired in these patients. METHODS Fifty-two patients undergoing coronary angiography between 5 and 15 years after heart transplantation were recruited in this cross-sectional study. Cholesterol efflux capacity of apolipoprotein B-depleted plasma was analyzed using a validated assay. The vasculoprotective function of HDL was studied by means of an endothelial progenitor cell migration assay. RESULTS HDL cholesterol levels were similar in heart transplant patients compared with healthy controls. However, normalized cholesterol efflux and vasculoprotective function were reduced by 24.1% (p < 0.001) and 27.0% (p < 0.01), respectively, in heart transplant recipients compared with healthy controls. HDL function was similar in patients with and without cardiac allograft vasculopathy (CAV) and was not related to C-reactive protein (CRP) levels. An interaction effect (p = 0.0584) was observed between etiology of heart failure before transplantation and steroid use as factors of HDL cholesterol levels. Lower HDL cholesterol levels occurred in patients with prior ischemic cardiomyopathy who were not taking steroids. However, HDL function was independent of the etiology of heart failure before transplantation and steroid use. The percentage of patients with a CRP level ≥6 mg/liter was 3.92-fold (p < 0.01) higher in patients with CAV than in patients without CAV. CONCLUSIONS HDL function is impaired in heart transplant recipients, but it is unrelated to CAV status. The proportion of patients with a CRP level ≥6 mg/liter is prominently higher in CAV-positive patients.
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Affiliation(s)
- Neha Singh
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Frank Jacobs
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Daniel J Rader
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Johan Vanhaecke
- Division of Cardiology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Johan Van Cleemput
- Division of Cardiology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Bart De Geest
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium.
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Huang J, Lee H, Zivkovic AM, Smilowitz JT, Rivera N, German JB, Lebrilla CB. Glycomic analysis of high density lipoprotein shows a highly sialylated particle. J Proteome Res 2014; 13:681-91. [PMID: 24417605 PMCID: PMC3975653 DOI: 10.1021/pr4012393] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
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Many
of the functional proteins and lipids in high density lipoprotein
(HDL) particles are potentially glycosylated, yet very little is known
about the glycoconjugates of HDL. In this study, HDL was isolated
from plasma by sequential micro-ultracentrifugation, followed by glycoprotein
and glycolipid analysis. N-Glycans, glycopeptides, and gangliosides
were extracted and purified followed by analysis with nano-HPLC Chip
quadrupole time of flight mass spectrometry and MS/MS. HDL particles
were found to be highly sialylated. Most of the N-glycans (∼90%)
from HDL glycoproteins were sialylated with one or two neuraminic
acids (Neu5Ac). The most abundant N-glycan was a biantennary complex
type glycan with two sialic acids (Hexose5HexNAc4Neu5Ac2) and was found in multiple glycoproteins using
site-specific glycosylation analysis. The observed O-glycans were
all sialylated, and most contained a core 1 structure with two Neu5Acs,
including those that were associated with apolipoprotein CIII (ApoC-III)
and fetuin A. GM3 (monosialoganglioside, NeuAc2–3Gal1–4Glc–Cer)
and GD3 (disialoganglioside, NeuAc2–8NeuAc2–3Gal1–4Glc–Cer)
were the major gangliosides in HDL. A 60% GM3 and 40% GD3 distribution
was observed. Both GM3 and GD3 were composed of heterogeneous ceramide
lipid tails, including d18:1/16:0 and d18:1/23:0. This report describes
for the first time a glycomic approach for analyzing HDL, highlighting
that HDL are highly sialylated particles.
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Affiliation(s)
- Jincui Huang
- Department of Chemistry, ‡Department of Food Science and Technology, and §Foods for Health Institute, University of California , Davis, California 95616, United States
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Ditiatkovski M, D’Souza W, Kesani R, Chin-Dusting J, de Haan JB, Remaley A, Sviridov D. An apolipoprotein A-I mimetic peptide designed with a reductionist approach stimulates reverse cholesterol transport and reduces atherosclerosis in mice. PLoS One 2013; 8:e68802. [PMID: 23874769 PMCID: PMC3706315 DOI: 10.1371/journal.pone.0068802] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 06/01/2013] [Indexed: 01/19/2023] Open
Abstract
Apolipoprotein A-I (apoA-I) mimetic peptides are considered a promising novel therapeutic approach to prevent and/or treat atherosclerosis. An apoA-I mimetic peptide ELK-2A2K2E was designed with a reductionist approach and has shown exceptional activity in supporting cholesterol efflux but modest anti-inflammatory and anti-oxidant properties in vitro. In this study we compared these in vitro properties with the capacity of this peptide to modify rates of reverse cholesterol transport and development of atherosclerosis in mouse models. The peptide enhanced the rate of reverse cholesterol transport in C57BL/6 mice and reduced atherosclerosis in Apoe(-/-) mice receiving a high fat diet. The peptide modestly reduced the size of the plaques in aortic arch, but was highly active in reducing vascular inflammation and oxidation. Administration of the peptide to Apoe(-/-) mice on a high fat diet reduced the levels of total, high density lipoprotein and non-high density lipoprotein cholesterol and triglycerides. It increased the proportion of smaller HDL particles in plasma at the expense of larger HDL particles, and increased the capacity of the plasma to support cholesterol efflux. Thus, ELK-2A2K2E peptide reduced atherosclerosis in Apoe(-/-) mice, however, the functional activity profile after chronic in vivo administration was different from that found in acute in vitro studies.
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Affiliation(s)
| | - Wilissa D’Souza
- Baker Heart and Diabetes Institute, Melbourne, Vic., Australia
| | - Rajitha Kesani
- Baker Heart and Diabetes Institute, Melbourne, Vic., Australia
| | | | - Judy B. de Haan
- Baker Heart and Diabetes Institute, Melbourne, Vic., Australia
| | - Alan Remaley
- Lipoprotein Section, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Dmitri Sviridov
- Baker Heart and Diabetes Institute, Melbourne, Vic., Australia
- * E-mail:
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8
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Hoang A, Drew BG, Low H, Remaley AT, Nestel P, Kingwell BA, Sviridov D. Mechanism of cholesterol efflux in humans after infusion of reconstituted high-density lipoprotein. Eur Heart J 2011; 33:657-65. [PMID: 21498847 DOI: 10.1093/eurheartj/ehr103] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Infusion of reconstituted HDL (rHDL) leads to changes in HDL metabolism as well as to an increased capacity of plasma to support cholesterol efflux providing an opportunity to investigate mechanisms linking cholesterol efflux to changes in plasma HDL. METHODS AND RESULTS Patient plasmas after infusion of rHDL were tested ex vivo for their capacity to stimulate cholesterol efflux. Reconstituted HDL enhanced mobilization of cholesterol from tissues in vivo as shown by rising HDL cholesterol concentrations over the infusion period. Infusion of rHDL in vivo led to increased cholesterol efflux ex vivo; surprisingly, removing apoB-containing lipoproteins while preserving all HDL subfractions eliminated this increase. Infusion of rHDL led to the remodelling of plasma HDL; however, the capacity of plasma to support cholesterol efflux did not correlate with changes in the concentrations of any of HDL subfractions. Unmodified rHDL accounted for only a proportion of the increment in cholesterol efflux capacity. Furthermore, studies using HeLa and BHK cells overexpressing ABCA1, ABCG1, and SR-B1 showed that the contribution of these cellular mediators of cholesterol efflux to the enhanced capacity of plasma for the efflux was minimal. CONCLUSION Enhanced cholesterol efflux from tissues requires the presence of apoB-containing lipoproteins and may involve enhanced flow of cholesterol through multiple components of the reverse cholesterol transport pathway rather than being determined by a specific HDL subfraction.
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Affiliation(s)
- Anh Hoang
- Baker Heart and Diabetes Institute, PO Box 6492, St. Kilda Rd Central, Melbourne, VIC 8008, Australia
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Säemann MD, Poglitsch M, Kopecky C, Haidinger M, Hörl WH, Weichhart T. The versatility of HDL: a crucial anti-inflammatory regulator. Eur J Clin Invest 2010; 40:1131-43. [PMID: 20695882 DOI: 10.1111/j.1365-2362.2010.02361.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Low levels of plasma high-density lipoprotein (HDL) represent a major cardiovascular risk factor and therefore raising HDL has been proposed to positively affect patients with atherosclerotic heart disease. However, the current evidence that raising HDL per se will reduce atherosclerosis and thereby cardiovascular events still remains controversial. AIMS In this review, we discuss the diverse anti-atherogenic and anti-inflammatory properties of HDL in the light of recent findings indicating that the quality rather than the mere quantity of HDL determines its beneficial effects against atherosclerosis. More specifically, we will focus on the conspicuous anti-inflammatory properties of HDL as this might contribute to the overall beneficial effects of HDL in diseased patients such as modulation of costimulatory/adhesion molecule expression, cytokine production and inhibition of the prototypical proinflammatory transcription factor NF-κB. RESULTS A range of clinical disorders share permanent inflammation as a characteristic hallmark including coronary artery disease, chronic kidney disease, diabetes mellitus or rheumatoid arthritis and also display distinct qualitative changes in the HDL compartment. Loss of anti-inflammatory functions of HDL is emerging as an important risk factor for disease progression and survival in these clinical entities. CONCLUSIONS It will be important to define the anti-inflammatory effects of HDL at the molecular level and to dissect the manifold functional implications to develop both novel functional assays that enable meaningful outcome studies and foster new therapeutic concepts in patients with altered HDL function.
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Affiliation(s)
- Marcus D Säemann
- Department of Internal Medicine III, Division of Nephrology and Dialysis, Medical University Vienna, Währinger Gürtel, Vienna, Austria.
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10
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Leopold JA, Loscalzo J. Oxidative risk for atherothrombotic cardiovascular disease. Free Radic Biol Med 2009; 47:1673-706. [PMID: 19751821 PMCID: PMC2797369 DOI: 10.1016/j.freeradbiomed.2009.09.009] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Revised: 08/31/2009] [Accepted: 09/06/2009] [Indexed: 02/07/2023]
Abstract
In the vasculature, reactive oxidant species, including reactive oxygen, nitrogen, or halogenating species, and thiyl, tyrosyl, or protein radicals may oxidatively modify lipids and proteins with deleterious consequences for vascular function. These biologically active free radical and nonradical species may be produced by increased activation of oxidant-generating sources and/or decreased cellular antioxidant capacity. Once formed, these species may engage in reactions to yield more potent oxidants that promote transition of the homeostatic vascular phenotype to a pathobiological state that is permissive for atherothrombogenesis. This dysfunctional vasculature is characterized by lipid peroxidation and aberrant lipid deposition, inflammation, immune cell activation, platelet activation, thrombus formation, and disturbed hemodynamic flow. Each of these pathobiological states is associated with an increase in the vascular burden of free radical species-derived oxidation products and, thereby, implicates increased oxidant stress in the pathogenesis of atherothrombotic vascular disease.
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Affiliation(s)
- Jane A Leopold
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Puk CG, Bocchi EA, Lo Prete AC, Ferreira SMA, Stolf NAG, Maranhão RC. Transfer of Cholesterol and Other Lipids From a Lipid Nanoemulsion to High-density Lipoprotein in Heart Transplant Patients. J Heart Lung Transplant 2009; 28:1075-80. [DOI: 10.1016/j.healun.2009.05.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2008] [Revised: 05/15/2009] [Accepted: 05/17/2009] [Indexed: 11/30/2022] Open
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12
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Prospective studies on the relationship between high-density lipoprotein cholesterol and cardiovascular risk: a systematic review. ACTA ACUST UNITED AC 2009; 16:404-23. [DOI: 10.1097/hjr.0b013e32832c8891] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Epidemiological studies have extensively evaluated the association between high-density lipoprotein cholesterol (HDL-C) and cardiovascular disease (CVD) risk. The objective of this systematic review was to enumerate the number of original prospective studies that showed a significant association between HDL-C and CVD risk and provided evidence of the consistency of this association across other lipid risk factors. A systematic MEDLINE literature search identified 53 prospective cohort and five nested case-control studies that provided multivariate assessments of the association between HDL-C and CVD risk. Among these 58 prospective studies, 31 studies found a significant inverse association between HDL-C and CVD risk for all CVD outcomes and subpopulations studied, whereas 17 studies found a significant association for some CVD outcomes and/or subpopulations assessed. The ratio of studies that found a significant association out of the total studies identified was similar across all CVD outcomes, although there was less evidence for stroke and atherosclerotic outcomes. Only seven studies tested for the consistency of this association across other lipid risk factors, of which six studies suggested that the association was consistent across other lipid levels. In conclusion, the association between HDL-C and CVD risk is significant and strong, although further evidence may be needed to establish whether this association is consistent across other lipid risk factors. Furthermore, uncertainties remain regarding the mechanism in which HDL-C exerts its effects, suggesting a need for further research focused on new methods for reliable measurement.
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13
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Le VV, Racine N, Pelletier GB, Carrier M, Cossette M, White M. Impact of ezetimibe on cholesterol subfractions in dyslipidemic cardiac transplant recipients receiving statin therapy. Clin Transplant 2009; 23:249-55. [PMID: 19402219 DOI: 10.1111/j.1399-0012.2008.00920.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Ezetimibe decreases cholesterol in cardiac transplant recipients intolerant to statins therapy. The effects of ezetimibe in addition to statins therapy and its relationship with the magnitude of dyslipidemia and statins utilization have not been studied in cardiac transplant recipients. METHODS The design of this investigation was a retrospective case control study. Twenty-two patients receiving the combination of therapy of statins plus ezetimibe were compared with 43 patients treated with statins only. The endpoints were assessed after three months of follow-up. RESULTS The addition of ezetimibe decreased low density lipoprotein-cholesterol by 25% compared with a 4% increase in patients receiving statins only. The impact of ezetimibe was similar regardless of the magnitude of dyslipidemia or statins dosage. Ezetimibe increase high density lipoprotein (HDL)-cholesterol only in patients with baseline HDL-cholesterol above 1.3 mM/L (p < 0.05). There was an asymptomatic, but significant increase in creatinine kinase level [+31.4 +/- 8.1 (ezetimibe) vs. + 1.5 +/- 5.0 mM/L (placebo); p = 0.005]. CONCLUSION Ezetimibe therapy provides a significant reduction in most cholesterol subfractions regardless of the magnitude of dyslipidemia and statins dosage.
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Affiliation(s)
- Vy-Van Le
- Research Center, Montreal Heart Institute andUniversité de Montré al, Montreal, QC, Canada
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14
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Tohyama J, Billheimer JT, Fuki IV, Rothblat GH, Rader DJ, Millar JS. Effects of nevirapine and efavirenz on HDL cholesterol levels and reverse cholesterol transport in mice. Atherosclerosis 2009; 204:418-23. [PMID: 18990393 PMCID: PMC2755296 DOI: 10.1016/j.atherosclerosis.2008.09.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Revised: 08/15/2008] [Accepted: 09/16/2008] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The mechanism by which non-nucleoside reverse transcriptase inhibitors (NNRTIs) increase HDL cholesterol (HDL-C) in HIV+ patients and the benefits of this with respect to cardiovascular risk are not known. Studies were conducted to test the hypothesis that NNRTIs have a beneficial effect on HDL-C and reverse cholesterol transport (RCT). METHODS LDLr-/- and hA-I transgenic mice were fed a Western diet containing either nevirapine (20mg/kg per day), efavirenz (10mg/kg per day), or diet alone. hA-I transgenic mice underwent a study to measure RCT (measured by excretion of macrophage [(3)H]-cholesterol into HDL and feces) at 8 weeks. RESULTS LDLr-/- and hA-I transgenic mice treated with nevirapine and efavirenz had a significant increase in HDL-C level (up to 23% in hA-I transgenic) at 4 weeks. However, there was no difference in HDL levels beyond 4 weeks of treatment. At 4 weeks, the FPLC profile of hA-I transgenic mice showed an increase in large HDL. hApoA-I transgenic mice treated with efavirenz for 4 weeks had increased expression of human apoA-I in liver and an increased human apoA-I production rate. Incubation of plasma from hA-I transgenic mice treated for 4 weeks with [(3)H]-cholesterol-labeled macrophages revealed increased cholesterol efflux to plasma from mice treated with efavirenz and nevirapine. Following injection of hA-I transgenic mice treated for 8 weeks with [(3)H]-cholesterol-labeled macrophages, RCT was increased in the efavirenz (p=0.01) group and trended towards an increase in the nevirapine (p=0.15) group. CONCLUSION Nevirapine and efavirenz transiently increased HDL-C in LDLr-/- and hA-I transgenic mice fed a Western diet that was associated with increased apoA-I production. An increase in RCT in hA-I transgenic mice at 8 weeks despite no difference in HDL levels indicates that these drugs affect additional factors in the RCT pathway that enhance cholesterol efflux from the macrophage and peripheral tissues to plasma and delivery to liver for excretion. These results suggest that treatment with NNRTIs has a beneficial effect on cholesterol efflux and RCT.
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Affiliation(s)
- Junichiro Tohyama
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
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Bakillah A. Nitrated apolipoprotein A-I, a potential new cardiovascular marker, is markedly increased in low high-density lipoprotein cholesterol subjects. Clin Chem Lab Med 2009; 47:60-9. [DOI: 10.1515/cclm.2009.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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16
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Shaw JA, Bobik A, Murphy A, Kanellakis P, Blombery P, Mukhamedova N, Woollard K, Lyon S, Sviridov D, Dart AM. Infusion of reconstituted high-density lipoprotein leads to acute changes in human atherosclerotic plaque. Circ Res 2008; 103:1084-91. [PMID: 18832751 DOI: 10.1161/circresaha.108.182063] [Citation(s) in RCA: 223] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Studies have shown a reduction in plaque volume and change in plaque ultrasound characteristics after 4 infusions of reconstituted high-density lipoprotein (rHDL). Whether rHDL infusion leads to acute changes in plaque characteristics in humans is not known. Patients with claudication scheduled for percutaneous superficial femoral artery revascularization were randomized to receive 1 intravenous infusion of either placebo or rHDL (80 mg/kg given over 4 hours). Five to 7 days following the infusion, patients returned and revascularization was performed including atherectomy to excise plaque from the superficial femoral artery. Twenty patients (17 males) average age, 68+/-10 years (mean+/-SD) were recruited. Eleven patients had a history of documented coronary artery disease, all patients were on aspirin, and 18 were on statins. Ten of the patients received rHDL and 10 placebo. There was significantly less vascular cell adhesion molecule-1 expression (28+/-3% versus 50+/-3%; P<0.05) and a reduction in lipid content in the plaque of HDL-treated subjects compared to placebo. The level of HDL cholesterol increased by 20% after infusion of rHDL and the capacity of apolipoprotein B-depleted plasma to support cholesterol efflux increased. Intravenous infusion of a single dose of reconstituted HDL led to acute changes in plaque characteristics with a reduction in lipid content, macrophage size, and measures of inflammation. These changes may contribute to the cardioprotective effects of HDL.
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Affiliation(s)
- James A Shaw
- Department of Cardiovascular Medicine, Alfred Hospital/Baker IDI Heart and Diabetes Institute, PO Box 6492, St Kilda Rd Central 8008, Australia.
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17
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Hahn BH, Grossman J, Ansell BJ, Skaggs BJ, McMahon M. Altered lipoprotein metabolism in chronic inflammatory states: proinflammatory high-density lipoprotein and accelerated atherosclerosis in systemic lupus erythematosus and rheumatoid arthritis. Arthritis Res Ther 2008; 10:213. [PMID: 18828865 PMCID: PMC2575639 DOI: 10.1186/ar2471] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In this review, the authors discuss the formation and structure of high-density lipoproteins (HDLs) and how those particles are altered in inflammatory or stress states to lose their capacity for reverse cholesterol transport and for antioxidant activity. In addition, abnormal HDLs can become proinflammatory (piHDLs) and actually contribute to oxidative damage. The assay by which piHDLs are identified involves studying the ability of test HDLs to prevent oxidation of low-density lipoproteins. Finally, the authors discuss the potential role of piHDLs (found in some 45% of patients with systemic lupus erythematosus and 20% of patients with rheumatoid arthritis) in the accelerated atherosclerosis associated with some chronic rheumatic diseases.
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Affiliation(s)
- Bevra H Hahn
- Division of Rheumatology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA 90095, USA.
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18
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Rajinda Kekulawala J, Murphy A, D’Souza W, Wai C, Chin-Dusting J, Kingwell B, Sviridov D, Mukhamedova N. Impact of freezing on high-density lipoprotein functionality. Anal Biochem 2008; 379:213-5. [DOI: 10.1016/j.ab.2008.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Accepted: 05/04/2008] [Indexed: 11/29/2022]
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19
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Sviridov D, Mukhamedova N, T. Remaley A, Chin-Dusting J, Nestel P. Antiatherogenic Functionality of High Density Lipoprotein: How Much versus How Gooden-subtitle=. J Atheroscler Thromb 2008; 15:52-62. [DOI: 10.5551/jat.e571] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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20
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Moerland M, Samyn H, van Gent T, Jauhiainen M, Metso J, van Haperen R, Grosveld F, van Tol A, de Crom R. Atherogenic, enlarged, and dysfunctional HDL in human PLTP/apoA-I double transgenic mice. J Lipid Res 2007; 48:2622-31. [PMID: 17761633 DOI: 10.1194/jlr.m700020-jlr200] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In low density lipoprotein receptor (LDLR)-deficient mice, overexpression of human plasma phospholipid transfer protein (PLTP) results in increased atherosclerosis. PLTP strongly decreases HDL levels and might alter the antiatherogenic properties of HDL particles. To study the potential interaction between human PLTP and apolipoprotein A-I (apoA-I), double transgenic animals (hPLTPtg/hApoAItg) were compared with hApoAItg mice. PLTP activity was increased 4.5-fold. Plasma total cholesterol and phospholipid were decreased. Average HDL size (analyzed by gel filtration) increased strongly, hPLTPtg/hApoAItg mice having very large, LDL-sized, HDL particles. Also, after density gradient ultracentrifugation, a substantial part of the apoA-I-containing lipoproteins in hPLTPtg/hApoAItg mice was found in the LDL density range. In cholesterol efflux studies from macrophages, HDL isolated from hPLTPtg/hApoAItg mice was less efficient than HDL isolated from hApoAItg mice. Furthermore, it was found that the largest subfraction of the HDL particles present in hPLTPtg/hApoAItg mice was markedly inferior as a cholesterol acceptor, as no labeled cholesterol was transferred to this fraction. In an LDLR-deficient background, the human PLTP-expressing mouse line showed a 2.2-fold increased atherosclerotic lesion area. These data demonstrate that the action of human PLTP in the presence of human apoA-I results in the formation of a dysfunctional HDL subfraction, which is less efficient in the uptake of cholesterol from cholesterol-laden macrophages.
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Affiliation(s)
- Matthijs Moerland
- Department of Cell Biology and Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
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21
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Abstract
PURPOSE OF REVIEW This review addresses how, in atherosclerosis or systemic inflammation, HDL can lose its usual atheroprotective characteristics and even paradoxically assume proinflammatory properties. RECENT FINDINGS Specific chemical and structural changes within HDL particles can impede reverse cholesterol transport, enhance oxidation of LDL, and increase vascular inflammation. HDL may be viewed as a shuttle that can be either anti-inflammatory or proinflammatory, depending on its cargo of proteins, enzymes, and lipids. Some therapeutic approaches that reduce coronary risk, such as statins and therapeutic lifestyle changes, can favorably moderate the characteristics of proinflammatory HDL. In addition, apolipoprotein A-I mimetic peptides and other compounds that target functional aspects of HDL may offer novel approaches to reduction in cardiovascular risk. SUMMARY Current data suggest that under some conditions HDL can become dysfunctional and even proinflammatory, but this characterization can change with resolution of systemic inflammation or use of certain treatments.
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Affiliation(s)
- Benjamin J Ansell
- Atherosclerosis Research Unit, Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA.
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22
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Ansell BJ, Fonarow GC, Fogelman AM. High-density lipoprotein: Is it always atheroprotective? Curr Atheroscler Rep 2006; 8:405-11. [PMID: 16901411 DOI: 10.1007/s11883-006-0038-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
High-density lipoproteins (HDLs) are appropriately recognized for their many atheroprotective functions, including reverse cholesterol transport, as well as antioxidant, anti-inflammatory, and antithrombotic effects. Furthermore, the inverse relationship between HDL cholesterol and atherosclerosis is well documented in many populations. However, there is an increasing body of evidence that there are circumstances in which HDL may not be protective, and may in fact paradoxically promote vascular inflammation and oxidation of low-density lipoproteins. Recent studies have provided insight as to specific chemical modifications and structural changes within HDL associated with this phenotype. The presence of proinflammatory HDL coincides with conditions associated with chronic systemic inflammation, including atherosclerosis.
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Affiliation(s)
- Benjamin J Ansell
- Atherosclerosis Research Unit, Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, 100 UCLA Medical Plaza, Suite 525, Los Angeles, CA 90095, USA.
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