1
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Durrington P, Soran H. Paraoxonase 1: evolution of the enzyme and of its role in protecting against atherosclerosis. Curr Opin Lipidol 2024; 35:171-178. [PMID: 38887979 PMCID: PMC11224571 DOI: 10.1097/mol.0000000000000936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
PURPOSE OF REVIEW To review the discoveries which led to the concept that serum paraoxonase 1 (PON1) is inversely related to atherosclerotic cardiovascular disease (ASCVD) incidence, how this association came to be regarded as causal and how such a role might have evolved. RECENT FINDINGS Animal models suggest a causal link between PON1 present on HDL and atherosclerosis. Serum PON1 activity predicts ASCVD with a similar reliability to HDL cholesterol, but at the extremes of high and low HDL cholesterol, there is discordance with PON1 being potentially more accurate. The paraoxonase gene family has its origins in the earliest life forms. Its greatest hydrolytic activity is towards lactones and organophosphates, both of which can be generated in the natural environment. It is active towards a wide range of substrates and thus its conservation may have resulted from improved survival of species facing a variety of evolutionary challenges. SUMMARY Protection against ASCVD is likely to be the consequence of some promiscuous activity of PON1, but nonetheless has the potential for exploitation to improve risk prediction and prevention of ASCVD.
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Affiliation(s)
- Paul Durrington
- Faculty of Biology, Medicine and Health, Cardiovascular Research Group, University of Manchester
| | - Handrean Soran
- NIHR/Wellcome Trust Clinical Research Facility & Department of Diabetes, Metabolism and Endocrinology, Manchester University NHS Foundation Trust, Manchester, UK
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2
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Luciani L, Pedrelli M, Parini P. Modification of lipoprotein metabolism and function driving atherogenesis in diabetes. Atherosclerosis 2024; 394:117545. [PMID: 38688749 DOI: 10.1016/j.atherosclerosis.2024.117545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/18/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease, characterized by raised blood glucose levels and impaired lipid metabolism resulting from insulin resistance and relative insulin deficiency. In diabetes, the peculiar plasma lipoprotein phenotype, consisting in higher levels of apolipoprotein B-containing lipoproteins, hypertriglyceridemia, low levels of HDL cholesterol, elevated number of small, dense LDL, and increased non-HDL cholesterol, results from an increased synthesis and impaired clearance of triglyceride rich lipoproteins. This condition accelerates the development of the atherosclerotic cardiovascular disease (ASCVD), the most common cause of death in T2DM patients. Here, we review the alteration of structure, functions, and distribution of circulating lipoproteins and the pathophysiological mechanisms that induce these modifications in T2DM. The review analyzes the influence of diabetes-associated metabolic imbalances throughout the entire process of the atherosclerotic plaque formation, from lipoprotein synthesis to potential plaque destabilization. Addressing the different pathophysiological mechanisms, we suggest improved approaches for assessing the risk of adverse cardiovascular events and clinical strategies to reduce cardiovascular risk in T2DM and cardiometabolic diseases.
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Affiliation(s)
- Lorenzo Luciani
- Cardio Metabolic Unit, Department of Laboratory Medicine, and Department of Medicine at Huddinge, Karolinska Institutet, Stockholm, Sweden; Interdisciplinary Center for Health Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Matteo Pedrelli
- Cardio Metabolic Unit, Department of Laboratory Medicine, and Department of Medicine at Huddinge, Karolinska Institutet, Stockholm, Sweden; Medicine Unit of Endocrinology, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Paolo Parini
- Cardio Metabolic Unit, Department of Laboratory Medicine, and Department of Medicine at Huddinge, Karolinska Institutet, Stockholm, Sweden; Medicine Unit of Endocrinology, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden.
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3
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Sidgwick GP, Weston R, Mahmoud AM, Schiro A, Serracino-Inglott F, Tandel SM, Skeoch S, Bruce IN, Jones AM, Alexander MY, Wilkinson FL. Novel Glycomimetics Protect against Glycated Low-Density Lipoprotein-Induced Vascular Calcification In Vitro via Attenuation of the RAGE/ERK/CREB Pathway. Cells 2024; 13:312. [PMID: 38391925 PMCID: PMC10887290 DOI: 10.3390/cells13040312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
Heparan sulphate (HS) can act as a co-receptor on the cell surface and alterations in this process underpin many pathological conditions. We have previously described the usefulness of mimics of HS (glycomimetics) in protection against β-glycerophosphate-induced vascular calcification and in the restoration of the functional capacity of diabetic endothelial colony-forming cells in vitro. This study aims to investigate whether our novel glycomimetic compounds can attenuate glycated low-density lipoprotein (g-LDL)-induced calcification by inhibiting RAGE signalling within the context of critical limb ischemia (CLI). We used an established osteogenic in vitro vascular smooth muscle cell (VSMC) model. Osteoprotegerin (OPG), sclerostin and glycation levels were all significantly increased in CLI serum compared to healthy controls, while the vascular calcification marker osteocalcin (OCN) was down-regulated in CLI patients vs. controls. Incubation with both CLI serum and g-LDL (10 µg/mL) significantly increased VSMC calcification vs. controls after 21 days, with CLI serum-induced calcification apparent after only 10 days. Glycomimetics (C2 and C3) significantly inhibited g-LDL and CLI serum-induced mineralisation, as shown by a reduction in alizarin red (AR) staining and alkaline phosphatase (ALP) activity. Furthermore, secretion of the osteogenic marker OCN was significantly reduced in VSMCs incubated with CLI serum in the presence of glycomimetics. Phosphorylation of cyclic AMP response element-binding protein (CREB) was significantly increased in g-LDL-treated cells vs. untreated controls, which was attenuated with glycomimetics. Blocking CREB activation with a pharmacological inhibitor 666-15 replicated the protective effects of glycomimetics, evidenced by elevated AR staining. In silico molecular docking simulations revealed the binding affinity of the glycomimetics C2 and C3 with the V domain of RAGE. In conclusion, these findings demonstrate that novel glycomimetics, C2 and C3 have potent anti-calcification properties in vitro, inhibiting both g-LDL and CLI serum-induced VSMC mineralisation via the inhibition of LDLR, RAGE, CREB and subsequent expression of the downstream osteogenic markers, ALP and OCN.
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Affiliation(s)
- Gary P. Sidgwick
- Department of Life Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK (R.W.); (A.M.M.); (F.S.-I.); (S.M.T.); (A.M.J.); (M.Y.A.)
| | - Ria Weston
- Department of Life Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK (R.W.); (A.M.M.); (F.S.-I.); (S.M.T.); (A.M.J.); (M.Y.A.)
| | - Ayman M. Mahmoud
- Department of Life Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK (R.W.); (A.M.M.); (F.S.-I.); (S.M.T.); (A.M.J.); (M.Y.A.)
| | - Andrew Schiro
- Cardiovascular Research Institute, University of Manchester, Manchester M13 9PL, UK;
- Vascular Unit, Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK
| | - Ferdinand Serracino-Inglott
- Department of Life Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK (R.W.); (A.M.M.); (F.S.-I.); (S.M.T.); (A.M.J.); (M.Y.A.)
- Cardiovascular Research Institute, University of Manchester, Manchester M13 9PL, UK;
- Vascular Unit, Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK
| | - Shikha M. Tandel
- Department of Life Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK (R.W.); (A.M.M.); (F.S.-I.); (S.M.T.); (A.M.J.); (M.Y.A.)
| | - Sarah Skeoch
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester M13 9PL, UK; (S.S.); (I.N.B.)
- National Institute for Health Research Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
- Royal National Hospital for Rheumatic Diseases, Bath BA1 1RL, UK
| | - Ian N. Bruce
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester M13 9PL, UK; (S.S.); (I.N.B.)
- National Institute for Health Research Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - Alan M. Jones
- Department of Life Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK (R.W.); (A.M.M.); (F.S.-I.); (S.M.T.); (A.M.J.); (M.Y.A.)
- School of Pharmacy, University of Birmingham, Birmingham B15 2TT, UK
| | - M. Yvonne Alexander
- Department of Life Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK (R.W.); (A.M.M.); (F.S.-I.); (S.M.T.); (A.M.J.); (M.Y.A.)
| | - Fiona L. Wilkinson
- Department of Life Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK (R.W.); (A.M.M.); (F.S.-I.); (S.M.T.); (A.M.J.); (M.Y.A.)
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4
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Bashir B, Adam S, Ho JH, Linn Z, Durrington PN, Soran H. Established and potential cardiovascular risk factors in metabolic syndrome: Effect of bariatric surgery. Curr Opin Lipidol 2023; 34:221-233. [PMID: 37560987 DOI: 10.1097/mol.0000000000000889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
PURPOSE OF REVIEW The aim of this review was to provide an overview of the role of novel biomarkers in metabolic syndrome, their association with cardiovascular risk and the impact of bariatric surgery on these biomarkers. RECENT FINDINGS Metabolic syndrome encompasses an intricate network of health problems, and its constituents extend beyond the components of its operational definition. Obesity-related dyslipidaemia not only leads to quantitative changes in lipoprotein concentration but also alteration in qualitative composition of various lipoprotein subfractions, including HDL particles, rendering them proatherogenic. This is compounded by the concurrent existence of obstructive sleep apnoea (OSA) and nonalcoholic fatty liver disease (NAFLD), which pave the common pathway to inflammation and oxidative stress culminating in heightened atherosclerotic cardiovascular disease (ASCVD) risk. Bariatric surgery is an exceptional modality to reverse both conventional and less recognised aspects of metabolic syndrome. It reduces the burden of atherosclerosis by ameliorating the impact of obesity and its related complications (OSA, NAFLD) on quantitative and qualitative composition of lipoproteins, ultimately improving endothelial function and cardiovascular morbidity and mortality. SUMMARY Several novel biomarkers, which are not traditionally considered as components of metabolic syndrome play a crucial role in determining ASCVD risk in metabolic syndrome. Due to their independent association with ASCVD, it is imperative that these are addressed. Bariatric surgery is a widely recognized intervention to improve the conventional risk factors associated with metabolic syndrome; however, it also serves as an effective treatment to optimize novel biomarkers.
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Affiliation(s)
- Bilal Bashir
- Faculty of Biology, Medicine and Health, University of Manchester
- Centre for Endocrinology, Diabetes and Metabolism, Peter Mount Building, Manchester University NHS Foundation Trust
| | - Safwaan Adam
- The Christie NHS Foundation Trust, Manchester, UK
| | - Jan H Ho
- The Christie NHS Foundation Trust, Manchester, UK
| | - Zara Linn
- Faculty of Biology, Medicine and Health, University of Manchester
| | | | - Handrean Soran
- Faculty of Biology, Medicine and Health, University of Manchester
- Centre for Endocrinology, Diabetes and Metabolism, Peter Mount Building, Manchester University NHS Foundation Trust
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5
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The Role of Advanced Glycation End Products on Dyslipidemia. Metabolites 2023; 13:metabo13010077. [PMID: 36677002 PMCID: PMC9862879 DOI: 10.3390/metabo13010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023] Open
Abstract
Disorders of lipoprotein metabolism and glucose homeostasis are common consequences of insulin resistance and usually co-segregate in patients with metabolic syndrome and type 2 diabetes mellitus (DM). Insulin-resistant subjects are characterized by atherogenic dyslipidemia, a specific lipid pattern which includes hypertriglyceridemia, reduced high-density lipoprotein cholesterol level, and increased proportion of small, dense low-density lipoprotein (LDL). Chronic hyperglycemia favors the processes of non-enzymatic glycation, leading to the increased production of advanced glycation end products (AGEs). Apart from direct harmful effects, AGEs are also potent inducers of oxidative stress and inflammation. In addition, increased AGEs' production may induce further qualitative modifications of small, dense LDL particles, converting them to glycated LDLs. These particles are even more atherogenic and may confer an increased cardiovascular risk. In this narrative review, we summarize the available evidence of the pathophysiological role and clinical importance of circulating AGEs and glycated LDLs in patients with dyslipidemia, particularly those with DM and related complications. In addition, we discuss recent advances and the issues that should be improved regarding laboratory assessment of AGEs and glycated LDLs, as well as the possibilities for their therapeutic modulation.
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6
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Durrington PN, Bashir B, Soran H. Paraoxonase 1 and atherosclerosis. Front Cardiovasc Med 2023; 10:1065967. [PMID: 36873390 PMCID: PMC9977831 DOI: 10.3389/fcvm.2023.1065967] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Paraoxonase 1 (PON1), residing almost exclusively on HDL, was discovered because of its hydrolytic activity towards organophosphates. Subsequently, it was also found to hydrolyse a wide range of substrates, including lactones and lipid hydroperoxides. PON1 is critical for the capacity of HDL to protect LDL and outer cell membranes against harmful oxidative modification, but this activity depends on its location within the hydrophobic lipid domains of HDL. It does not prevent conjugated diene formation, but directs lipid peroxidation products derived from these to become harmless carboxylic acids rather than aldehydes which might adduct to apolipoprotein B. Serum PON1 is inversely related to the incidence of new atherosclerotic cardiovascular disease (ASCVD) events, particularly in diabetes and established ASCVD. Its serum activity is frequently discordant with that of HDL cholesterol. PON1 activity is diminished in dyslipidaemia, diabetes, and inflammatory disease. Polymorphisms, most notably Q192R, can affect activity towards some substrates, but not towards phenyl acetate. Gene ablation or over-expression of human PON1 in rodent models is associated with increased and decreased atherosclerosis susceptibility respectively. PON1 antioxidant activity is enhanced by apolipoprotein AI and lecithin:cholesterol acyl transferase and diminished by apolipoprotein AII, serum amyloid A, and myeloperoxidase. PON1 loses this activity when separated from its lipid environment. Information about its structure has been obtained from water soluble mutants created by directed evolution. Such recombinant PON1 may, however, lose the capacity to hydrolyse non-polar substrates. Whilst nutrition and pre-existing lipid modifying drugs can influence PON1 activity there is a cogent need for more specific PON1-raising medication to be developed.
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Affiliation(s)
- Paul N Durrington
- Cardiovascular Research Group, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Bilal Bashir
- Cardiovascular Research Group, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Department of Diabetes, Endocrinology and Metabolism, Peter Mount Building, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Handrean Soran
- Cardiovascular Research Group, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Department of Diabetes, Endocrinology and Metabolism, Peter Mount Building, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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7
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Glycated apolipoprotein B decreases after bariatric surgery in people with and without diabetes: A potential contribution to reduction in cardiovascular risk. Atherosclerosis 2022; 346:10-17. [DOI: 10.1016/j.atherosclerosis.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/19/2021] [Accepted: 01/13/2022] [Indexed: 11/17/2022]
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8
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Sourris KC, Watson A, Jandeleit-Dahm K. Inhibitors of Advanced Glycation End Product (AGE) Formation and Accumulation. Handb Exp Pharmacol 2020; 264:395-423. [PMID: 32809100 DOI: 10.1007/164_2020_391] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A range of chemically different compounds are known to inhibit the formation and accumulation of advanced glycation end products (AGEs) or disrupt associated signalling pathways. There is evidence that some of these agents can provide end-organ protection in chronic diseases including diabetes. Whilst this group of therapeutics are structurally and functionally different and have a range of mechanisms of action, they ultimately reduce the deleterious actions and the tissue burden of advanced glycation end products. To date it remains unclear if this is due to the reduction in tissue AGE levels per se or the modulation of downstream signal pathways. Some of these agents either stimulate antioxidant defence or reduce the formation of reactive oxygen species (ROS), modify lipid profiles and inhibit inflammation. A number of existing treatments for glucose lowering, hypertension and hyperlipidaemia are also known to reduce AGE formation as a by-product of their action. Targeted AGE formation inhibitors or AGE cross-link breakers have been developed and have shown beneficial effects in animal models of diabetic complications as well as other chronic conditions. However, only a few of these agents have progressed to clinical development. The failure of clinical translation highlights the importance of further investigation of the advanced glycation pathway, the diverse actions of agents which interfere with AGE formation, cross-linking or AGE receptor activation and their effect on the development and progression of chronic diseases including diabetic complications. Advanced glycation end products (AGEs) are (1) proteins or lipids that become glycated as a result of exposure to sugars or (2) non-proteinaceous oxidised lipids. They are implicated in ageing and the development, or worsening, of many degenerative diseases, such as diabetes, atherosclerosis, chronic kidney and Alzheimer's disease. Several antihypertensive and antidiabetic agents and statins also indirectly lower AGEs. Direct AGE inhibitors currently investigated include pyridoxamine and epalrestat, the inhibition of the formation of reactive dicarbonyls such as methylglyoxal as an important precursor of AGEs via increased activation of the detoxifying enzyme Glo-1 and inhibitors of NOX-derived ROS to reduce the AGE/RAGE signalling.
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Affiliation(s)
- Karly C Sourris
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Anna Watson
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Karin Jandeleit-Dahm
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia.
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9
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Soran H, Ho JH, Adam S, Durrington PN. Non-HDL cholesterol should not generally replace LDL cholesterol in the management of hyperlipidaemia. Curr Opin Lipidol 2019; 30:263-272. [PMID: 31219837 DOI: 10.1097/mol.0000000000000614] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Non-HDL cholesterol was originally conceived as a therapeutic target for statin treatment in hypertriglyceridaemia when apolipoprotein B100 assays were not widely available. Recently non-HDL cholesterol has been recommended to replace LDL cholesterol in the clinical management of dyslipidaemia routinely in general medical practice. This is misguided. RECENT FINDINGS Non-HDL cholesterol is heterogeneous, constituting a mixture of triglyceride-rich VLDL, intermediate density lipoprotein and LDL in which small dense LDL is poorly represented and to which VLDL cholesterol contributes increasingly as triglyceride levels rise. This makes it unsuitable as a goal of lipid-lowering treatment or as an arbiter of who should receive such treatment. Results of trials designed to lower LDL cholesterol are not easily translated to non-HDL cholesterol. Fasting is no longer thought essential for screening the general population for raised LDL cholesterol. ApoB100 measurement also does not require fasting even in rarer more extreme lipoprotein disorders encountered in the Lipid Clinic, provides greater precision and specificity and overcomes the problems posed by LDL and non-HDL cholesterol. It is more easily interpreted both in diagnosis and as a therapeutic goal and it includes SD-LDL. SUMMARY If we are to discourage use of LDL cholesterol, it should be in favour of apoB100 not non-HDL cholesterol.
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Affiliation(s)
- Handrean Soran
- Department of Medicine, Central Manchester University Hospitals NHS Foundation Trust
- Lipoprotein Research Group, Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Core Technology Facility, Manchester, UK
| | - Jan H Ho
- Department of Medicine, Central Manchester University Hospitals NHS Foundation Trust
- Lipoprotein Research Group, Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Core Technology Facility, Manchester, UK
| | - Safwaan Adam
- Department of Medicine, Central Manchester University Hospitals NHS Foundation Trust
- Lipoprotein Research Group, Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Core Technology Facility, Manchester, UK
| | - Paul N Durrington
- Department of Medicine, Central Manchester University Hospitals NHS Foundation Trust
- Lipoprotein Research Group, Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Core Technology Facility, Manchester, UK
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10
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Itabe H, Kato R, Sawada N, Obama T, Yamamoto M. The Significance of Oxidized Low-Density Lipoprotein in Body Fluids as a Marker Related to Diseased Conditions. Curr Med Chem 2019. [PMID: 29521196 DOI: 10.2174/0929867325666180307114855] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Oxidatively modified low-density lipoprotein (oxLDL) is known to be involved in various diseases, including cardiovascular diseases. The presence of oxLDL in the human circulatory system and in atherosclerotic lesions has been demonstrated using monoclonal antibodies. Studies have shown the significance of circulating oxLDL in various systemic diseases, including acute myocardial infarction and diabetic mellitus. Several different enzyme-linked immunosorbent assay (ELISA) procedures to measure oxLDL were utilized. Evidence has been accumulating that reveals changes in oxLDL levels under certain pathological conditions. Since oxLDL concentration tends to correlate with low-density lipoprotein (LDL)-cholesterol, the ratio of ox-LDL and LDL rather than oxLDL concentration alone has also been focused. In addition to circulating plasma, LDL and oxLDL are found in gingival crevicular fluid (GCF), where the ratio of oxLDL to LDL in GCF is much higher than in plasma. LDL and oxLDL levels in GCF show an increase in diabetic patients and periodontal patients, suggesting that GCF might be useful in examining systemic conditions. GCF oxLDL increased when the teeth were affected by periodontitis. It is likely that oxLDL levels in plasma and GCF could reflect oxidative stress and transfer efficacy in the circulatory system.
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Affiliation(s)
- Hiroyuki Itabe
- Division of Biological Chemistry, Department of Molecular Biology, Showa University School of Pharmacy, Tokyo, Japan
| | - Rina Kato
- Division of Biological Chemistry, Department of Molecular Biology, Showa University School of Pharmacy, Tokyo, Japan
| | - Naoko Sawada
- Division of Biological Chemistry, Department of Molecular Biology, Showa University School of Pharmacy, Tokyo, Japan
| | - Takashi Obama
- Division of Biological Chemistry, Department of Molecular Biology, Showa University School of Pharmacy, Tokyo, Japan
| | - Matsuo Yamamoto
- Department of Periodontology, Showa University School of Dentistry, Tokyo, Japan
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11
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Adam S, Liu Y, Siahmansur T, Ho JH, Dhage SS, Yadav R, New JP, Donn R, Ammori BJ, Syed AA, Malik RA, Soran H, Durrington PN. Bariatric surgery as a model to explore the basis and consequences of the Reaven hypothesis: Small, dense low-density lipoprotein and interleukin-6. Diab Vasc Dis Res 2019; 16:144-152. [PMID: 31014098 DOI: 10.1177/1479164119826479] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Reaven originally described the clustering of insulin resistance/hyperinsulinaemia, obesity (particularly visceral), altered cytokine levels, glucose intolerance, hypertriglyceridaemia and low high-density lipoprotein cholesterol. Subsequently, a potentially highly atherogenic small, dense low-density lipoprotein was also reported. We have studied the effect of bariatric surgery on this and other risk factors for atherosclerosis. METHODS Forty patients (20 with type 2 diabetes mellitus) undergoing bariatric surgery were studied before and 1 year after bariatric surgery. RESULTS Twelve months after bariatric surgery, median body mass index had decreased from 49.5 to 36.5 kg/m2, fasting insulin from 21.3 to 7.8 mU/L and insulin resistance (homeostatic model assessment of insulin resistance) from 5.9 to 1.8 (all p < 0.001). Thirteen out of 20 patients had remission from type 2 diabetes mellitus. Highly sensitive C-reactive protein, interleukin-6, fasting triglycerides ( p < 0.001) and small, dense low-density lipoprotein ( p < 0.001) decreased, while high-density lipoprotein cholesterol increased ( p < 0.001) significantly, irrespective of having type 2 diabetes mellitus and/or being treated with statin therapy before surgery. CONCLUSION The association between marked weight loss and change in insulin resistance and hyperinsulinaemia with the change in small, dense low-density lipoprotein and interleukin-6 warrants further investigation. Bariatric surgery provides a model for investigating the mechanisms linking insulin resistance/hyperinsulinaemia to atherosclerosis.
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Affiliation(s)
- Safwaan Adam
- 1 Cardiovascular Research Group, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- 2 Cardiovascular Trials Unit, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Tarza Siahmansur
- 1 Cardiovascular Research Group, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jan H Ho
- 1 Cardiovascular Research Group, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- 2 Cardiovascular Trials Unit, Manchester University NHS Foundation Trust, Manchester, UK
| | - Shaishav S Dhage
- 1 Cardiovascular Research Group, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- 2 Cardiovascular Trials Unit, Manchester University NHS Foundation Trust, Manchester, UK
| | - Rahul Yadav
- 3 Department of Diabetes and Endocrinology, Warrington and Halton Hospitals NHS Foundation Trust, Warrington, UK
| | - John P New
- 1 Cardiovascular Research Group, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- 4 Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust, Salford, UK
| | - Rachelle Donn
- 1 Cardiovascular Research Group, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Basil J Ammori
- 1 Cardiovascular Research Group, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- 5 Department of Surgery, Salford Royal NHS Foundation Trust, Salford, UK
| | - Akheel A Syed
- 1 Cardiovascular Research Group, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- 4 Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust, Salford, UK
| | - Rayaz A Malik
- 1 Cardiovascular Research Group, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- 6 Weill-Cornell Medicine-Qatar, Doha, Qatar
| | - Handrean Soran
- 1 Cardiovascular Research Group, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- 2 Cardiovascular Trials Unit, Manchester University NHS Foundation Trust, Manchester, UK
| | - Paul N Durrington
- 1 Cardiovascular Research Group, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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12
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Yadav R, Hama S, Liu Y, Siahmansur T, Schofield J, Syed AA, France M, Pemberton P, Adam S, Ho JH, Aghamohammadzadeh R, Dhage S, Donn R, Malik RA, New JP, Jeziorska M, Durrington P, Ammori BA, Soran H. Effect of Roux-en-Y Bariatric Surgery on Lipoproteins, Insulin Resistance, and Systemic and Vascular Inflammation in Obesity and Diabetes. Front Immunol 2017; 8:1512. [PMID: 29187850 PMCID: PMC5694757 DOI: 10.3389/fimmu.2017.01512] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/25/2017] [Indexed: 01/29/2023] Open
Abstract
Purpose Obesity is a major modifiable risk factor for cardiovascular disease. Bariatric surgery is considered to be the most effective treatment option for weight reduction in obese patients with and without type 2 diabetes (T2DM). Objective To evaluate changes in lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction following Roux-en-Y bariatric surgery in obese patients with and without diabetes. Materials and methods Lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction were measured in 37 obese patients with (n = 17) and without (n = 20) T2DM, before and 6 and 12 months after Roux-en-Y bariatric surgery. Two way between subject ANOVA was carried out to study the interaction between independent variables (time since surgery and presence of diabetes) and all dependent variables. Results There was a significant effect of time since surgery on (large effect size) weight, body mass index (BMI), waist circumference, triglycerides (TG), small-dense LDL apolipoprotein B (sdLDL ApoB), HOMA-IR, CRP, MCP-1, ICAM-1, E-selectin, P-selectin, leptin, and adiponectin. BMI and waist circumference had the largest impact of time since surgery. The effect of time since surgery was noticed mostly in the first 6 months. Absence of diabetes led to a significantly greater reduction in total cholesterol, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol although the effect size was small to medium. There was a greater reduction in TG and HOMA-IR in patients with diabetes with a small effect size. No patients were lost to follow up. Conclusion Lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction improve mostly 6 months after bariatric surgery in obese patients with and without diabetes. Clinical Trial Registration www.ClinicalTrials.gov, identifier: NCT02169518. https://clinicaltrials.gov/ct2/show/NCT02169518?term=paraoxonase&cntry1=EU%3AGB&rank=1.
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Affiliation(s)
- Rahul Yadav
- Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom
| | - Salam Hama
- Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom
| | - Yifen Liu
- Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom
| | - Tarza Siahmansur
- Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom
| | - Jonathan Schofield
- Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom.,Department of Metabolism, Endocrinology and Diabetes, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Akheel A Syed
- Department of Endocrinology and Diabetes, Salford Royal NHS Foundation Trust, Salford, United Kingdom.,Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Michael France
- Department of Biochemistry, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Philip Pemberton
- Department of Biochemistry, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Safwaan Adam
- Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom
| | - Jan Hoong Ho
- Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom
| | - Reza Aghamohammadzadeh
- Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom
| | - Shaishav Dhage
- Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom
| | - Rachelle Donn
- The Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester, United Kingdom
| | - Rayaz A Malik
- Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom.,Weill Cornell Medicine-Qatar, Doha, Qatar
| | - John P New
- Department of Endocrinology and Diabetes, Salford Royal NHS Foundation Trust, Salford, United Kingdom.,Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Maria Jeziorska
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Paul Durrington
- Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom
| | - Basil A Ammori
- Department of Surgery, Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - Handrean Soran
- Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom.,Department of Metabolism, Endocrinology and Diabetes, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
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Soran H, Liu Y, Adam S, Siahmansur T, Ho JH, Schofield JD, Kwok S, Gittins M, France M, Younis N, Gibson JM, Durrington PN, Rutter MK. A comparison of the effects of low- and high-dose atorvastatin on lipoprotein metabolism and inflammatory cytokines in type 2 diabetes: Results from the Protection Against Nephropathy in Diabetes with Atorvastatin (PANDA) randomized trial. J Clin Lipidol 2017; 12:44-55. [PMID: 29246729 DOI: 10.1016/j.jacl.2017.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/24/2017] [Accepted: 10/17/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Statin therapy is recommended in type 2 diabetes (T2DM) although views on treatment intensity and therapeutic targets remain divided. OBJECTIVES Our objectives were to compare the effects of high-intensity and moderate-intensity atorvastatin treatment on lipoprotein metabolism and inflammatory markers and how frequently treatment goals are met in high-risk T2DM patients. METHODS Patients with T2DM and albuminuria (urinary albumin:creatinine ratio >5 mg/mmol, total cholesterol <7 mmol/L, proteinuria <2 g/d, creatinine <200 μmol/L) were randomized to receive atorvastatin 10 mg (n = 59) or 80 mg (n = 60) daily. Baseline and 1-year follow-up data are reported. RESULTS Patients were at high cardiovascular disease risk (observed combined mortality and nonfatal cardiovascular disease annual event rate 4.8%). The non-high-density lipoprotein cholesterol (HDL-C) goal of <2.6 mmol/L was achieved in 72% of participants receiving high-dose atorvastatin, but only in 40% on low-dose atorvastatin (P < .005). The proportion achieving apolipoprotein B (apoB) <0.8 g/L on high-dose and low-dose atorvastatin was 82% and 70%, respectively (NS). Total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol, non-HDL-C, oxidized LDL, apoB, glyc-apoB, apolipoprotein E, and lipoprotein-associated phospholipase A2 decreased significantly, more so in participants on high-dose atorvastatin. Adiponectin increased and serum amyloid A decreased without dose dependency. Neither dose produced significant changes in HDL-C, cholesterol efflux, high-sensitivity C-reactive protein, glycated hemoglobin, serum paraoxonase-1, lecithin:cholesterol acyltransferase, or cholesteryl ester transfer protein. CONCLUSIONS High-dose atorvastatin is more effective in achieving non-HDL-C therapeutic goals and in modifying LDL-related parameters. Recommended apoB treatment targets may require revision. Despite the increase in adiponectin and the decrease in serum amyloid A, HDL showed no change in functionality.
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Affiliation(s)
- Handrean Soran
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom.
| | - Yifen Liu
- Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Safwaan Adam
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Tarza Siahmansur
- Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Jan H Ho
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Jonathan D Schofield
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - See Kwok
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Matthew Gittins
- Department of Diabetes, Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Michael France
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Department of Clinical Biochemistry, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Naveed Younis
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Department of Diabetes and Endocrinology, University Hospital South Manchester NHS Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom
| | - J Martin Gibson
- Department of Diabetes and Endocrinology, Salford Royal NHS Foundation Trust, University of Manchester, Manchester, United Kingdom
| | - Paul N Durrington
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Martin K Rutter
- Department of Diabetes, Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
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Abstract
PURPOSE OF REVIEW The purpose is to discuss recent developments in the understanding of lipoprotein metabolism in diabetes, the cardiovascular risk associated with both type 1 and type 2 diabetes, recently published guidelines on the management of this risk, concerns over the use of statin treatment in diabetes, and other therapeutic options. RECENT FINDINGS Diabetic dyslipidaemia can be gross with massive hypertriglyceridemia, or subtle with a lipid profile which would be regarded as normal in a nondiabetic patient, but which hides underlying increases in atherogenic subfractions of LDL (e.g., small dense LDL, glycated LDL) and remnant lipoproteins. Statins can decrease these without the clinician being aware from routine biochemistry. In type 2 diabetes, HDL cholesterol levels are often reduced, whereas in type 1, insulin can raise HDL, but its antiatherogenic properties are compromised. Dyslipidaemia and hypertension predate the onset of glycaemia of diabetic proportions (metabolic syndrome). Obese people can thus die of diabetes before they develop it. Obesity should be prevented and treated. Statins decrease the risk of cardiovascular disease in diabetes or metabolic syndrome regardless of whether glycaemia worsens. SUMMARY One unassailable truth is that statin therapy is beneficial and should rarely, if ever, be withheld.
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Affiliation(s)
- Handrean Soran
- aCardiovascular Research Group, School of Biomedicine, University of Manchester bUniversity Department of Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
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15
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Duan P, Tu P, Si L, Hu W, Liu M, Liu J, Xue Y. Gene Polymorphisms in the RANKL/RANK/OPG Pathway Are Associated with Type 2 Diabetes Mellitus in Southern Han Chinese Women. Genet Test Mol Biomarkers 2016; 20:285-90. [PMID: 27171030 DOI: 10.1089/gtmb.2015.0306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Peng Duan
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, China
| | - Ping Tu
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, China
| | - Lian Si
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, China
| | - Wan Hu
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, China
| | - Meng Liu
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, China
| | - Jia Liu
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, China
| | - Yaoming Xue
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
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16
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Soran H, Schofield JD, Durrington PN. Antioxidant properties of HDL. Front Pharmacol 2015; 6:222. [PMID: 26528181 PMCID: PMC4607861 DOI: 10.3389/fphar.2015.00222] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/17/2015] [Indexed: 12/11/2022] Open
Abstract
High-density lipoprotein (HDL) provides a pathway for the passage of lipid peroxides and lysophospholipids to the liver via hepatic scavenger receptors. Perhaps more importantly, HDL actually metabolizes lipid hydroperoxides preventing their accumulation on low-density lipoprotein (LDL), thus impeding its atherogenic structural modification. A number of candidates have been suggested to be responsible for HDL's antioxidant function, with paraoxonase-1 (PON1) perhaps the most prominent. Here we review the evidence for HDL anti-oxidative function and the potential contributions of apolipoproteins, lipid transfer proteins, paraoxonases and other enzymes associated with HDL.
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Affiliation(s)
- Handrean Soran
- Cardiovascular Research Group, Core Technology Facility, University of Manchester Manchester, UK ; Cardiovascular Trials Unit, Central Manchester University Hospitals NHS Foundation Trust Manchester, UK
| | - Jonathan D Schofield
- Cardiovascular Research Group, Core Technology Facility, University of Manchester Manchester, UK ; Cardiovascular Trials Unit, Central Manchester University Hospitals NHS Foundation Trust Manchester, UK
| | - Paul N Durrington
- Cardiovascular Research Group, Core Technology Facility, University of Manchester Manchester, UK
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17
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Yadav R, Liu Y, Kwok S, Hama S, France M, Eatough R, Pemberton P, Schofield J, Siahmansur TJ, Malik R, Ammori BA, Issa B, Younis N, Donn R, Stevens A, Durrington P, Soran H. Effect of Extended-Release Niacin on High-Density Lipoprotein (HDL) Functionality, Lipoprotein Metabolism, and Mediators of Vascular Inflammation in Statin-Treated Patients. J Am Heart Assoc 2015; 4:e001508. [PMID: 26374297 PMCID: PMC4599486 DOI: 10.1161/jaha.114.001508] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background The aim of this study was to explore the influence of extended-release niacin/laropiprant (ERN/LRP) versus placebo on high-density lipoprotein (HDL) antioxidant function, cholesterol efflux, apolipoprotein B100 (apoB)-containing lipoproteins, and mediators of vascular inflammation associated with 15% increase in high-density lipoprotein cholesterol (HDL-C). Study patients had persistent dyslipidemia despite receiving high-dose statin treatment. Methods and Results In a randomized double-blind, placebo-controlled, crossover trial, we compared the effect of ERN/LRP with placebo in 27 statin-treated dyslipidemic patients who had not achieved National Cholesterol Education Program-ATP III targets for low-density lipoprotein cholesterol (LDL-C). We measured fasting lipid profile, apolipoproteins, cholesteryl ester transfer protein (CETP) activity, paraoxonase 1 (PON1) activity, small dense LDL apoB (sdLDL-apoB), oxidized LDL (oxLDL), glycated apoB (glyc-apoB), lipoprotein phospholipase A2 (Lp-PLA2), lysophosphatidyl choline (lyso-PC), macrophage chemoattractant protein (MCP1), serum amyloid A (SAA) and myeloperoxidase (MPO). We also examined the capacity of HDL to protect LDL from in vitro oxidation and the percentage cholesterol efflux mediated by apoB depleted serum. ERN/LRP was associated with an 18% increase in HDL-C levels compared to placebo (1.55 versus 1.31 mmol/L, P<0.0001). There were significant reductions in total cholesterol, triglycerides, LDL cholesterol, total serum apoB, lipoprotein (a), CETP activity, oxLDL, Lp-PLA2, lyso-PC, MCP1, and SAA, but no significant changes in glyc-apoB or sdLDL-apoB concentration. There was a modest increase in cholesterol efflux function of HDL (19.5%, P=0.045), but no change in the antioxidant capacity of HDL in vitro or PON1 activity. Conclusions ERN/LRP reduces LDL-associated mediators of vascular inflammation, but has varied effects on HDL functionality and LDL quality, which may counter its HDL-C-raising effect. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01054508.
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Affiliation(s)
- Rahul Yadav
- Cardiovascular Research Group, Core Technologies Facility, University of Manchester, United Kingdom (R.Y., Y.L., S.H., M.F., J.S., T.J.S., R.M., P.D., H.S.) Cardiovascular Trials Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom (R.Y., S.K., M.F., R.E., J.S., H.S.)
| | - Yifen Liu
- Cardiovascular Research Group, Core Technologies Facility, University of Manchester, United Kingdom (R.Y., Y.L., S.H., M.F., J.S., T.J.S., R.M., P.D., H.S.)
| | - See Kwok
- Cardiovascular Trials Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom (R.Y., S.K., M.F., R.E., J.S., H.S.)
| | - Salam Hama
- Cardiovascular Research Group, Core Technologies Facility, University of Manchester, United Kingdom (R.Y., Y.L., S.H., M.F., J.S., T.J.S., R.M., P.D., H.S.)
| | - Michael France
- Cardiovascular Research Group, Core Technologies Facility, University of Manchester, United Kingdom (R.Y., Y.L., S.H., M.F., J.S., T.J.S., R.M., P.D., H.S.) Cardiovascular Trials Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom (R.Y., S.K., M.F., R.E., J.S., H.S.) The Institute of Inflammation & Repair at the University of Manchester, United Kingdom (M.F.)
| | - Ruth Eatough
- Cardiovascular Trials Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom (R.Y., S.K., M.F., R.E., J.S., H.S.)
| | - Phil Pemberton
- Department of Biochemistry, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom (P.P.)
| | - Jonathan Schofield
- Cardiovascular Research Group, Core Technologies Facility, University of Manchester, United Kingdom (R.Y., Y.L., S.H., M.F., J.S., T.J.S., R.M., P.D., H.S.) Cardiovascular Trials Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom (R.Y., S.K., M.F., R.E., J.S., H.S.)
| | - Tarza J Siahmansur
- Cardiovascular Research Group, Core Technologies Facility, University of Manchester, United Kingdom (R.Y., Y.L., S.H., M.F., J.S., T.J.S., R.M., P.D., H.S.)
| | - Rayaz Malik
- Cardiovascular Research Group, Core Technologies Facility, University of Manchester, United Kingdom (R.Y., Y.L., S.H., M.F., J.S., T.J.S., R.M., P.D., H.S.)
| | - Basil A Ammori
- Department of Surgery, Salford Royal NHS Foundation Trust, Salford, United Kingdom (B.A.A.)
| | - Basil Issa
- Department of Diabetes and Endocrinology, University Hospital of South Manchester, United Kingdom (B.I., N.Y.)
| | - Naveed Younis
- Department of Diabetes and Endocrinology, University Hospital of South Manchester, United Kingdom (B.I., N.Y.)
| | - Rachelle Donn
- Complex Disease Genetics, Centre for Musculoskeletal Research, University of Manchester, United Kingdom (R.D.)
| | - Adam Stevens
- Royal Manchester Children's Hospital, Manchester, United Kingdom (A.S.)
| | - Paul Durrington
- Cardiovascular Research Group, Core Technologies Facility, University of Manchester, United Kingdom (R.Y., Y.L., S.H., M.F., J.S., T.J.S., R.M., P.D., H.S.)
| | - Handrean Soran
- Cardiovascular Research Group, Core Technologies Facility, University of Manchester, United Kingdom (R.Y., Y.L., S.H., M.F., J.S., T.J.S., R.M., P.D., H.S.) Cardiovascular Trials Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom (R.Y., S.K., M.F., R.E., J.S., H.S.)
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Soran H, Schofield JD, Liu Y, Durrington PN. How HDL protects LDL against atherogenic modification: paraoxonase 1 and other dramatis personae. Curr Opin Lipidol 2015; 26:247-56. [PMID: 26103614 DOI: 10.1097/mol.0000000000000194] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW To summarize the current evidence about how HDL impedes the oxidative and glycative atherogenic modification of LDL. RECENT FINDINGS Paraoxonase 1 (PON1) is located on HDL. Meta-analysis of clinical epidemiological investigations reveals a substantial association of low serum PON1 activity with coronary heart disease incidence independent of other risk factors including HDL cholesterol and apolipoprotein AI (apoAI). Transgenic animal models also indicate an antiatherosclerotic role for PON1. However, highly purified and recombinant PON1 do not retain their antioxidant properties. SUMMARY The therapeutic potential of PON1 should be recognized in preventing atherosclerosis and combating infection and organophosphate toxicity. In unleashing this potential, it is important to consider that both highly purified and recombinant PON1 are dissociated from the lipid phase and other components of HDL, such as apoAI and apoM, all of which may be required for HDL (through its PON1 component) to hydrolyze more lipophilic substrates.
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Affiliation(s)
- Handrean Soran
- aCardiovascular Research Group, School of Medicine, Core Technology Facility, University of Manchester bCardiovascular Trials Unit, Central Manchester and Manchester Children University Hospital NHS Foundation Trust, Manchester, UK
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Lu M, Gursky O. Aggregation and fusion of low-density lipoproteins in vivo and in vitro. Biomol Concepts 2015; 4:501-18. [PMID: 25197325 DOI: 10.1515/bmc-2013-0016] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Low-density lipoproteins (LDLs, also known as 'bad cholesterol') are the major carriers of circulating cholesterol and the main causative risk factor of atherosclerosis. Plasma LDLs are 20- to 25-nm nanoparticles containing a core of cholesterol esters surrounded by a phospholipid monolayer and a single copy of apolipoprotein B (550 kDa). An early sign of atherosclerosis is the accumulation of LDL-derived lipid droplets in the arterial wall. According to the widely accepted 'response-to-retention hypothesis', LDL binding to the extracellular matrix proteoglycans in the arterial intima induces hydrolytic and oxidative modifications that promote LDL aggregation and fusion. This enhances LDL uptake by the arterial macrophages and triggers a cascade of pathogenic responses that culminate in the development of atherosclerotic lesions. Hence, LDL aggregation, fusion, and lipid droplet formation are important early steps in atherogenesis. In vitro, a variety of enzymatic and nonenzymatic modifications of LDL can induce these reactions and thereby provide useful models for their detailed analysis. Here, we summarize current knowledge of the in vivo and in vitro modifications of LDLs leading to their aggregation, fusion, and lipid droplet formation; outline the techniques used to study these reactions; and propose a molecular mechanism that underlies these pro-atherogenic processes. Such knowledge is essential in identifying endogenous and exogenous factors that can promote or prevent LDL aggregation and fusion in vivo and to help establish new potential therapeutic targets to decelerate or even block these pathogenic reactions.
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Affiliation(s)
- Mengxiao Lu
- Department of Physiology and Biophysics, Boston University School of Medicine, W321, 700 Albany Street, Boston, MA 02118, USA.
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Chakraborti S, Alam MN, Chaudhury A, Sarkar J, Pramanik A, Asrafuzzaman S, Das SK, Ghosh SN, Chakraborti T. Pathophysiological Aspects of Lipoprotein-Associated Phospholipase A2: A Brief Overview. PHOSPHOLIPASES IN HEALTH AND DISEASE 2014:115-133. [DOI: 10.1007/978-1-4939-0464-8_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
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Elseweidy MM, Abdallah FR, Younis NN, Aldohmy S, Kassem HM. 10-Dehydrogingerdione raises HDL-cholesterol through a CETP inhibition and wards off oxidation and inflammation in dyslipidemic rabbits. Atherosclerosis 2013; 231:334-40. [PMID: 24267247 DOI: 10.1016/j.atherosclerosis.2013.09.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 09/23/2013] [Indexed: 02/08/2023]
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Sánchez-Quesada JL, Vinagre I, De Juan-Franco E, Sánchez-Hernández J, Bonet-Marques R, Blanco-Vaca F, Ordóñez-Llanos J, Pérez A. Impact of the LDL subfraction phenotype on Lp-PLA2 distribution, LDL modification and HDL composition in type 2 diabetes. Cardiovasc Diabetol 2013; 12:112. [PMID: 23915379 PMCID: PMC3750253 DOI: 10.1186/1475-2840-12-112] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 08/03/2013] [Indexed: 01/18/2023] Open
Abstract
Background Qualitative alterations of lipoproteins underlie the high incidence of atherosclerosis in diabetes. The objective of this study was to assess the impact of low-density lipoprotein (LDL) subfraction phenotype on the qualitative characteristics of LDL and high-density lipoprotein (HDL) in patients with type 2 diabetes. Methods One hundred twenty two patients with type 2 diabetes in poor glycemic control and 54 healthy subjects were included in the study. Patients were classified according to their LDL subfraction phenotype. Seventy-seven patients presented phenotype A whereas 45 had phenotype B. All control subjects showed phenotype A. Several forms of modified LDL, HDL composition and the activity and distribution of lipoprotein-associated phospholipase A2 (Lp-PLA2) were analyzed. Results Oxidized LDL, glycated LDL and electronegative LDL were increased in both groups of patients compared with the control group. Patients with phenotype B had increased oxidized LDL and glycated LDL concentration than patients with phenotype A. HDL composition was abnormal in patients with diabetes, being these abnormalities more marked in patients with phenotype B. Total Lp-PLA2 activity was higher in phenotype B than in phenotype A or in control subjects. The distribution of Lp-PLA2 between HDL and apoB-containing lipoproteins differed in patients with phenotype A and phenotype B, with higher activity associated to apoB-containing lipoproteins in the latter. Conclusions The presence of LDL subfraction phenotype B is associated with increased oxidized LDL, glycated LDL and Lp-PLA2 activity associated to apoB-containing lipoproteins, as well as with abnormal HDL composition.
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Affiliation(s)
- Jose Luis Sánchez-Quesada
- Biomedical Research Institute IIB Sant Pau, Cardiovascular Biochemistry Group, C/ Antoni Maria Claret, 167, 08025 Barcelona, Spain.
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Younis NN, Soran H, Charlton-Menys V, Sharma R, Hama S, Pemberton P, Elseweidy MM, Durrington PN. High-density lipoprotein impedes glycation of low-density lipoprotein. Diab Vasc Dis Res 2013; 10:152-60. [PMID: 22890407 DOI: 10.1177/1479164112454309] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Glycation of low-density lipoprotein (LDL) increases its atherogenicity, but whether high-density lipoprotein (HDL) can protect LDL against glycation is not known. LDL and HDL were isolated from 32 volunteers with serum HDL cholesterol concentrations ranging from 0.76 to 2.01 (mean = 1.36) mmol/L. Glycation of LDL was induced by incubation with 0-80 mmol/L glucose for 7 days at 37°C under nitrogen in the presence of and absence of human HDL. Glycation of LDL apolipoprotein B (apoB) doubled at glucose 50 and 80 mmol/L (both p < 0.001), and this increase was ameliorated by HDL. In the absence of glucose, 0.11 (0.01) [mean (standard error, SE)] mg apoB/mg LDL protein was glycated increasing to 0.22 (0.02) mg/mg at glucose 80 mmol/L in the absence of HDL, but remaining at 0.13 (0.01) mg/mg when autologous HDL was present. Heterologous HDL from a further study of 12 healthy participants was similarly effective in impeding LDL apoB glycation. HDL impeded not only glycation but also the lipid peroxidation, free amino group consumption and increased electrophoretic mobility of LDL which accompanied glycation. HDL from participants with higher serum paraoxonase1 (PON1) was more effective in impeding glycation and the related processes. In conclusion, HDL can impede the glucose-induced glycoxidation of LDL. PON1 may be important for this function of HDL.
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Affiliation(s)
- Nahla N Younis
- Cardiovascular Research Group, School of Biomedicine, University of Manchester, UK
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Hirayama S, Miida T. Small dense LDL: An emerging risk factor for cardiovascular disease. Clin Chim Acta 2012; 414:215-24. [DOI: 10.1016/j.cca.2012.09.010] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 08/24/2012] [Accepted: 09/07/2012] [Indexed: 10/27/2022]
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Small dense LDL is more susceptible to glycation than more buoyant LDL in Type 2 diabetes. Clin Sci (Lond) 2012; 124:343-9. [PMID: 22985435 DOI: 10.1042/cs20120304] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Glycation of apoB (apolipoprotein B) of LDL (low-density lipoprotein) increases its atherogenicity. Concentrations of both serum glyc-apoB (glycated apoB) and SD-LDL (small dense LDL) (syn LDL3; D=1.044–1.063 g/ml) are increased in diabetes and are closely correlated. We studied whether SD-LDL is more susceptible to glycation in vitro than more buoyant LDL in statin- and non-statin-treated Type 2 diabetes mellitus. Serum SD-LDL apoB and glyc-apoB on statins was 20±2 (means±S.D.) and 3.6±0.41 compared with 47±3 and 5.89±0.68 mg/dl in those not receiving statins (P<0.001 and <0.01, respectively). There was a dose-dependent increase in glycation on incubation of LDL subfractions with glucose, which was accompanied by an increase in LPO (lipid peroxide) and electrophoretic mobility and a decrease in free amino groups. SD-LDL was more susceptible to these changes than more buoyant LDL. Both SD-LDL and more buoyant LDL from statin-treated patients were less susceptible to glycation. There were fewer free amino groups on LDL subfractions from statin-treated patients, which may contribute to this resistance. In conclusion, greater susceptibility of SD-LDL to glycation is likely to contribute to the raised levels of circulating glyc-apoB in diabetes. Statins are associated with lower levels of both SD-LDL and glyc-apoB.
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de Nigris F, Rienzo M, Sessa M, Infante T, Cesario E, Ignarro LJ, Al-Omran M, Giordano A, Palinski W, Napoli C. Glycoxydation promotes vascular damage via MAPK-ERK/JNK pathways. J Cell Physiol 2012; 227:3639-47. [PMID: 22331607 DOI: 10.1002/jcp.24070] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Oxidation and glycation enhance foam cell formation via MAPK/JNK in euglycemic and diabetic subjects. Here, we investigated the effects of glycated and oxidized LDL (glc-oxLDL) on MAPK-ERK and JNK signaling pathways using human coronary smooth muscle cells. Glc-oxLDL induced a broad cascade of MAPK/JNK-dependent signaling transduction pathways and the AP-1 complex. In glc-oxLDL treated coronary arterioles, tumor necrosis factor (TNF) α increased JNK phosphorylation, whereas protein kinase inhibitor dimethylaminopurine (DMAP) prevented the TNF-induced increase in JNK phosphorylation. The role of MKK4 and JNK were then investigated in vivo, using apolipoprotein E knockout (ApoE(-/-)) mice. Peritoneal macrophages, isolated from spontaneously hyperlipidemic but euglycemic mice showed increases in both proteins and phosphorylated proteins. Compared to streptozotocin-treated diabetic C57BL6 and nondiabetic C57BL6 Wt mice, in streptozotocin-diabetic ApoE(-/-) mice, the increment of foam cell formation corresponded to an increment of phosphorylation of JNK1, JNK2, and MMK4. Thus, we provide a first line of evidence that MAPK-ERK/JNK pathways are involved in vascular damage induced by glycoxidation.
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Affiliation(s)
- Filomena de Nigris
- Department of General Pathology, U.O.C. Immunohematology, and Excellence Research Centre on Cardiovascular Disease, 1st School of Medicine, Second University of Naples, Naples, Italy
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Younis NN, Durrington PN. HDL functionality in diabetes mellitus: potential importance of glycation. ACTA ACUST UNITED AC 2012. [DOI: 10.2217/clp.12.60] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Yadav R, France M, Younis N, Hama S, Ammori BJ, Kwok S, Soran H. Extended-release niacin with laropiprant: a review on efficacy, clinical effectiveness and safety. Expert Opin Pharmacother 2012; 13:1345-62. [DOI: 10.1517/14656566.2012.690395] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Chumakova GA, Gritsenko OV, Veselovskaya NG, Vakhromeeva EV, Kozarenko AA. Clinical role of apolipoproteins A and B. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2011. [DOI: 10.15829/1728-8800-2011-6-105-111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The assessment and correction of the traditional parameters of atherogenic dyslipidemia are important, but not exclusive methods in the management of atherosclerosis, including coronary artery atherosclerosis. More accurate diagnostic and therapeutic assessment requires the measurement of apolipoprotein (Apo) A, ApoB, and their ratio.Lower ApoB/ApoAI ratio values denote lower levels of cardiovascular risk.
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Affiliation(s)
- G. A. Chumakova
- Altay State Medical University, Barnaul; Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo
| | | | - N. G. Veselovskaya
- Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo; Altay Region Cardiology Dispanser, Barnaul
| | | | - A. A. Kozarenko
- Altay State Medical University, Barnaul; Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo
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Soran H, France MW, Kwok S, Dissanayake S, Charlton-Menys V, Younis NN, Durrington PN. Apolipoprotein B100 is a better treatment target than calculated LDL and non-HDL cholesterol in statin-treated patients. Ann Clin Biochem 2011; 48:566-71. [DOI: 10.1258/acb.2011.010277] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction Clinical trials have shown that apolipoprotein B100 (apoB) is better than calculated low-density lipoprotein cholesterol (c-LDL-C) or non-high-density lipoprotein cholesterol (non-HDL-C) as a target for statin treatment. However, there are no published reports of how well these targets are reached in patients with more severe hyperlipidaemias than represented in trials, as seen in lipid clinics. Methods We audited 195 patients attending a tertiary centre lipid clinic, who had been treated with a statin for more than one year. We measured total cholesterol, HDL-cholesterol (HDL-C) and triglyceride and from these calculated LDL-cholesterol (LDL-C) and non-HDL-C. We determined the average measured apoB values, at critical target values of LDL-C and non-HDL-C, by linear regression and compared them with values of apoB considered equivalent to these cholesterol indexes by expert groups. We also assessed the number of patients, both before and after treatment, in whom c-LDL-C and non-HDL-C could not be calculated due to hypertriglyceridaemia. Results At the LDL-C target of 2.6 mmol L−1 and the non-HDL-C target of 3.4 mmol L−1, the measured apoB values were significantly higher than consensus apoB target values. The difference was most marked for c-LDL-C in hypertriglyceridaemic subjects and for non-HDL-C in patients without hypertriglyceridaemia. A similar pattern was seen using centile-derived consensus values but the differences were accentuated because this approach generates lower equivalent consensus apoB values. Conclusion ApoB offers a more consistent treatment target independent of hypertriglyceridaemia and would obviate technical problems related to high triglycerides.
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Affiliation(s)
- Handrean Soran
- Cardiovascular Research Group, School of Biomedicine, Core Technology Facility, 3rd Floor, University of Manchester, 46 Grafton Street, Manchester M13 9NT
- University Department of Medicine, Central Manchester University Hospital NHS Foundation Trust
| | - Michael W France
- Department of Clinical Biochemistry, Central Manchester and Manchester Children's Foundation Trust, Oxford Road, Manchester M13 9WL, UK
| | - See Kwok
- Cardiovascular Research Group, School of Biomedicine, Core Technology Facility, 3rd Floor, University of Manchester, 46 Grafton Street, Manchester M13 9NT
| | - Sanjaya Dissanayake
- University Department of Medicine, Central Manchester University Hospital NHS Foundation Trust
| | - Valentine Charlton-Menys
- Cardiovascular Research Group, School of Biomedicine, Core Technology Facility, 3rd Floor, University of Manchester, 46 Grafton Street, Manchester M13 9NT
| | - Nahla N Younis
- Cardiovascular Research Group, School of Biomedicine, Core Technology Facility, 3rd Floor, University of Manchester, 46 Grafton Street, Manchester M13 9NT
| | - Paul N Durrington
- Cardiovascular Research Group, School of Biomedicine, Core Technology Facility, 3rd Floor, University of Manchester, 46 Grafton Street, Manchester M13 9NT
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Abstract
PURPOSE OF REVIEW To highlight the potential importance of glycation as an atherogenic modification of LDL, factors determining glycated apolipoprotein B in vivo and susceptibility of LDL to glycation in vitro. We also discuss the distribution of glycated apolipoprotein B across different LDL subfractions in healthy controls, patients with type 2 diabetes and metabolic syndrome. RECENT FINDINGS Small, dense LDL, which is known to be most closely associated with atherogenesis, is more preferentially glycated in vivo and more susceptible to glycation in vitro than more buoyant LDL. Glycation and oxidation of LDL appear to be intimately linked. In patients with type 2 diabetes, plasma glycated apolipoprotein B correlated with small, dense LDL apolipoprotein B, but not with HbA1c. Glycated apolipoprotein B is significantly lower in statin-treated type 2 diabetes compared with those not on statins. SUMMARY Glycation of LDL occurs chiefly because of the nonenzymatic reaction of glucose and its metabolites with the free amino groups of lysine of which apolipoprotein B is rich. Higher concentrations of glycated LDL are present in diabetes than in nondiabetic individuals and metabolic syndrome. Even in nondiabetic individuals, however, there is generally more circulating glycated LDL than oxidatively modified LDL. Probably, oxidation and glycation of LDL are partially interdependent and indisputably coexist, and both prevent LDL receptor-mediated uptake and promote macrophage scavenger receptor-mediated LDL uptake. The recognition that LDL glycation is at least as important as oxidation in atherogenesis may lead to improvements in our understanding of its mechanism and how to prevent it.
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Affiliation(s)
- Handrean Soran
- Cardiovascular Research Group, School of Biomedicine, Core Technology Facility, University of Manchester, Manchester, UK
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