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Bonilha I, Zimetti F, Zanotti I, Papotti B, Sposito AC. Dysfunctional High-Density Lipoproteins in Type 2 Diabetes Mellitus: Molecular Mechanisms and Therapeutic Implications. J Clin Med 2021; 10:2233. [PMID: 34063950 PMCID: PMC8196572 DOI: 10.3390/jcm10112233] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 12/29/2022] Open
Abstract
High density lipoproteins (HDLs) are commonly known for their anti-atherogenic properties that include functions such as the promotion of cholesterol efflux and reverse cholesterol transport, as well as antioxidant and anti-inflammatory activities. However, because of some chronic inflammatory diseases, such as type 2 diabetes mellitus (T2DM), significant changes occur in HDLs in terms of both structure and composition. These alterations lead to the loss of HDLs' physiological functions, to transformation into dysfunctional lipoproteins, and to increased risk of cardiovascular disease (CVD). In this review, we describe the main HDL structural/functional alterations observed in T2DM and the molecular mechanisms involved in these T2DM-derived modifications. Finally, the main available therapeutic interventions targeting HDL in diabetes are discussed.
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Affiliation(s)
- Isabella Bonilha
- Atherosclerosis and Vascular Biology Laboratory (AtheroLab), Cardiology Department, State University of Campinas (Unicamp), Campinas 13084-971, Brazil;
| | - Francesca Zimetti
- Department of Food and Drug, University of Parma, 43124 Parma, Italy; (I.Z.); (B.P.)
| | - Ilaria Zanotti
- Department of Food and Drug, University of Parma, 43124 Parma, Italy; (I.Z.); (B.P.)
| | - Bianca Papotti
- Department of Food and Drug, University of Parma, 43124 Parma, Italy; (I.Z.); (B.P.)
| | - Andrei C. Sposito
- Atherosclerosis and Vascular Biology Laboratory (AtheroLab), Cardiology Department, State University of Campinas (Unicamp), Campinas 13084-971, Brazil;
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The Beneficial Effects of Alpha Lipoic Acid Supplementation on Lp-PLA2 Mass and Its Distribution between HDL and apoB-Containing Lipoproteins in Type 2 Diabetic Patients: A Randomized, Double-Blind, Placebo-Controlled Trial. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:5850865. [PMID: 32256955 PMCID: PMC7085885 DOI: 10.1155/2020/5850865] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/11/2020] [Indexed: 02/06/2023]
Abstract
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a new specific vascular inflammation biomarker that is carried by the lipoproteins in the blood and plays a prominent role in the pathogenesis of atherosclerosis. Increased Lp-PLA2 levels and impaired Lp-PLA2 distribution across high-density lipoprotein (HDL) and non-HDL lipoproteins have been reported in diabetic patients, which is associated with the increase in cardiovascular disease (CVD) risk. This study is aimed at investigating the effect of alpha lipoic acid (ALA), as an antioxidant with potential cardioprotective properties, on the Lp-PLA2 mass and its distribution in diabetic patients. In a double-blind, randomized, placebo-controlled clinical trial, seventy diabetic patients were randomly allocated to ALA (1200 mg ALA as two 600 mg capsules/day) and placebo (two maltodextrin capsules/day) groups. The serum levels of total Lp-PLA2 mass, HDL-Lp-PLA2, oxidized low-density lipoproteins (ox-LDL), apolipoprotein A1 (apo A1), lipid profiles, fasting blood sugar (FBS), and insulin were measured, and apolipoprotein B- (apoB-) associated Lp-PLA2 and homeostasis model of assessment index (HOMA-IR) were calculated at the baseline and after 8 weeks of intervention. ALA significantly decreased the ox-LDL, total Lp-PLA2 mass, apoB-associated Lp-PLA2, and percent of apoB-associated Lp-PLA2 and triglyceride and increased the percent of HDL-Lp-PLA2 compared with the placebo group but had no significant effect on HDL-Lp-PLA2 mass, apo A1, lipid profiles, and glycemic indices. There was a positive correlation between the reduction in the ox-LDL level and total Lp-PLA2 mass in the ALA group. In conclusion, ALA may decrease the CVD risk by reducing the ox-LDL and Lp-PLA2 mass and improving the Lp-PLA2 distribution among lipoproteins in type 2 diabetic patients.
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Seyfarth J, Herebian D, Reinauer C, Baechle C, Roden M, Holl RW, Reinehr T, Mayatepek E, Meissner T, Rosenbauer J. Evaluation of lipoprotein-associated phospholipase A2 as a marker for renal microvasculopathy in adolescents with Type 1 diabetes. Diabet Med 2020; 37:75-83. [PMID: 31335994 DOI: 10.1111/dme.14086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2019] [Indexed: 11/26/2022]
Abstract
AIM To assess the relevance of lipoprotein-associated phospholipase A2 activity as a diagnostic and prognostic marker for renal microvascular diseases. METHODS We analysed lipoprotein-associated phospholipase A2 activity and lysophosphatidylcholine levels (as a surrogate marker of oxidative stress) in 165 adolescents (aged 17.0 ± 2.3 years) with a history of Type 1 diabetes greater than 10 years. Clinical data were obtained from the German/Austrian nationwide Diabetes-Patients Follow-up (DPV) registry at blood collection and on average 2.4 ± 1.3 years later at follow-up. Relationships between lipoprotein-associated phospholipase A2 activity and clinical, demographic and laboratory variables, lysophosphatidylcholine levels and presence of albuminuria were evaluated by multivariable linear and logistic regression. RESULTS Lipoprotein-associated phospholipase A2 activity was higher in male than female adolescents (P = 0.002). Albuminuria was present in 14% (22/158) of participants at baseline, and 5% (4/86) of participants without albuminuria at baseline developed albuminuria until follow-up. Lipoprotein-associated phospholipase A2 activity was associated neither with present nor with incident albuminuria. Lysophosphatidylcholine did not correlate with lipoprotein-associated phospholipase A2 activity. Cross-sectional bivariate correlation as well as multivariable linear regression analysis revealed a negative correlation of lipoprotein-associated phospholipase A2 activity with HbA1c and HDL-cholesterol. CONCLUSIONS Lipoprotein-associated phospholipase activity was not associated with surrogate markers for oxidative stress and early diabetic nephropathy. The association of decreased lipoprotein-associated phospholipase A2 activity with poor glucose control might limit its function as a predictor of micro- and macrovascular diseases in Type 1 diabetes.
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Affiliation(s)
- J Seyfarth
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Medical Faculty, Duesseldorf, Germany
| | - D Herebian
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Medical Faculty, Duesseldorf, Germany
| | - C Reinauer
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Medical Faculty, Duesseldorf, Germany
| | - C Baechle
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center at Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - M Roden
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center at Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - R W Holl
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
| | - T Reinehr
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany
| | - E Mayatepek
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Medical Faculty, Duesseldorf, Germany
| | - T Meissner
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Medical Faculty, Duesseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - J Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center at Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
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Fan D, Li L, Li Z, Zhang Y, Ma X, Wu L, Qin G. Effect of hyperlipidemia on the incidence of cardio-cerebrovascular events in patients with type 2 diabetes. Lipids Health Dis 2018; 17:102. [PMID: 29739462 PMCID: PMC5941465 DOI: 10.1186/s12944-018-0676-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 02/07/2018] [Indexed: 12/30/2022] Open
Abstract
Background This study was to explore the effect of hyperlipidemia on the incidence of cardio-cerebrovascular diseases in patients with type 2 diabetes. Methods Three hundred ninety five patients with type 2 diabetes in our hospital from January 2012 to January 2016 were followed up with an average of 3.8 years. The incidence of cardio-cerebrovascular diseases between diabetes combined with hyperlipidemia group (195 patients) and diabetes group (200 patients) were made a comparison. Multivariable Cox’s proportional hazards regression model was used to analyze the effect of hyperlipidemia on the incidence of cardio-cerebrovascular diseases in patients with type 2 diabetes. Results Diastolic blood pressure, systolic blood pressure, high-density lipoprotein, low-density lipoprotein, body mass index and hyper-sensitive C-reactive protein were higher in diabetes combined with hyperlipidemia group than in diabetes group (P < 0.05). At the end of the follow-up period, all-cause mortality, cardio-cerebrovascular diseases mortality, and the incidence of myocardial infarction, cerebral infarction, cerebral hemorrhage and total cardiovascular events were significantly higher in diabetes combined with hyperlipidemia group than in diabetes group (P < 0.05). The analysis results of multivariable Cox’s proportional hazards regression model showed that the risks of myocardial infarction and total cardiovascular events in diabetes combined with hyperlipidemia group were respectively 1.54 times (95%CI 1.13–2.07) and 1.68 times (95%CI 1.23–2.24) higher than those in diabetes group. Population attributable risk percent of all-cause mortality and total cardiovascular events in patients with type 2 diabetes combined with hyperlipidemia was 9.6% and 26.8%, respectively. Conclusions Hyperlipidemia may promote vascular endothelial injury, increasing the risk of cardio-cerebrovascular diseases in patients with type 2 diabetes. Medical staffs should pay attention to the control of blood lipids in patients with type 2 diabetes to delay the occurrence of cardio-cerebrovascular diseases.
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Affiliation(s)
- Dabei Fan
- Division of Endocrinology Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| | - Li Li
- Ophthalmologic Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhizhen Li
- Division of Endocrinology Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ying Zhang
- Division of Endocrinology Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaojun Ma
- Division of Endocrinology Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lina Wu
- Division of Endocrinology Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Guijun Qin
- Division of Endocrinology Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Mattina A, Rosenbaum D, Bittar R, Bonnefont-Rousselot D, Noto D, Averna M, Bruckert E, Giral P. Lipoprotein-associated phospholipase A₂ activity is increased in patients with definite familial hypercholesterolemia compared with other forms of hypercholesterolemia. Nutr Metab Cardiovasc Dis 2018; 28:517-523. [PMID: 29525223 DOI: 10.1016/j.numecd.2018.01.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 12/29/2017] [Accepted: 01/22/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM Lipoprotein-associated phospholipase A2 (Lp-PLA2) plays a key role in atherosclerosis development. It is considered a marker of increased risk of cardiovascular disease (CVD) and plaque vulnerability. Familial hypercholesterolemia (FH) is a genetic disorder characterized by elevated plasma levels of low-density lipoprotein cholesterol and a higher prevalence of early CVD. Our aim was to evaluate the differences in Lp-PLA2 activity in a population of hypercholesterolemic patients with and without definite FH. METHODS AND RESULTS Hypercholesterolemic patients were consecutively recruited. Definite FH was defined according to Dutch Lipid Clinic Network criteria ≥8. All patients underwent routine clinical examination and biological assessments and Lp-PLA2 activity was measured in blood samples. Among 469 patients, 118 had a definite diagnosis of FH. Lp-PLA2 activity was significantly higher in definite FH patients compared to non-definite FH patients (206.5 ± 54.5 vs. 180.8 ± 48.4 nmol/min/mL, p < 0.0001). Lp-PLA2 positively correlated with total cholesterol, LDL-C and apolipoprotein B and negatively with HDL-C and apolipoprotein A-1. In multivariate analysis, definite FH diagnosis, LDL-C, HDL-C and statin treatment remained correlates of Lp-PLA2 independently of systolic blood pressure. CONCLUSIONS Lp-PLA2 activity was higher in definite FH than in non-definite FH patients independently of LDL-C levels and statin treatment. These results highlight the particular phenotype of FH subjects among hypercholesterolemic patients. As increased Lp-PLA2 activity suggests, FH patients exhibit higher arterial inflammation that may contribute to their high cardiovascular risk. Our results reinforce the potential beneficial role of statins pleiotropic effects and the need for proper identification and treatment of FH patients.
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Affiliation(s)
- A Mattina
- Department of Endocrinology and Cardiovascular Disease Prevention, La Pitié-Salpêtrière-Charles Foix University Hospital (AP-HP), 48-83 boulevard de l'Hôpital, 75651 Paris Cedex 13, France; Sorbonne University, UPMC Univ Paris 06, INSERM 1146, - CNRS 7371, Laboratoire d'imagerie Biomédicale, 91 boulevard de l'Hôpital, 75013, Paris, France; Department of Biomedicine, Internal Medicine and Medical Specialties, Division of Internal Medicine and Genetic Dyslipidemias, University of Palermo, via del Vespro, 131, 90127, Palermo, Italy.
| | - D Rosenbaum
- Department of Endocrinology and Cardiovascular Disease Prevention, La Pitié-Salpêtrière-Charles Foix University Hospital (AP-HP), 48-83 boulevard de l'Hôpital, 75651 Paris Cedex 13, France; Sorbonne University, UPMC Univ Paris 06, INSERM 1146, - CNRS 7371, Laboratoire d'imagerie Biomédicale, 91 boulevard de l'Hôpital, 75013, Paris, France; Imaging Core Lab, Institute of Cardiometabolism and Nutrition, ICAN, 48-83 boulevard de l'Hôpital, 75651 Paris Cedex 13, France
| | - R Bittar
- Department of Metabolic Biochemistry, La Pitié-Salpêtrière-Charles Foix University Hospital (AP-HP), 48-83 boulevard de l'Hôpital, 75651 Paris Cedex 13, France
| | - D Bonnefont-Rousselot
- Department of Metabolic Biochemistry, La Pitié-Salpêtrière-Charles Foix University Hospital (AP-HP), 48-83 boulevard de l'Hôpital, 75651 Paris Cedex 13, France; Department of Biochemistry, Faculty of Pharmacy, Paris Descartes University, 4 avenue de l'Observatoire, 75006 Paris, France; CNRS UMR8258 - INSERM U1022, Faculty of Pharmacy, Paris Descartes University, 4 avenue de l'Observatoire, 75006 Paris, France
| | - D Noto
- Department of Biomedicine, Internal Medicine and Medical Specialties, Division of Internal Medicine and Genetic Dyslipidemias, University of Palermo, via del Vespro, 131, 90127, Palermo, Italy
| | - M Averna
- Department of Biomedicine, Internal Medicine and Medical Specialties, Division of Internal Medicine and Genetic Dyslipidemias, University of Palermo, via del Vespro, 131, 90127, Palermo, Italy
| | - E Bruckert
- Department of Endocrinology and Cardiovascular Disease Prevention, La Pitié-Salpêtrière-Charles Foix University Hospital (AP-HP), 48-83 boulevard de l'Hôpital, 75651 Paris Cedex 13, France; Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC - Paris VI), 48-83 boulevard de l'Hôpital, 75651 Paris Cedex 13, France
| | - P Giral
- Department of Endocrinology and Cardiovascular Disease Prevention, La Pitié-Salpêtrière-Charles Foix University Hospital (AP-HP), 48-83 boulevard de l'Hôpital, 75651 Paris Cedex 13, France; Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC - Paris VI), 48-83 boulevard de l'Hôpital, 75651 Paris Cedex 13, France
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Sairam SG, Sola S, Barooah A, Javvaji SK, Jaipuria J, Venkateshan V, Chelli J, Sanjeevi CB. The role of Lp-PLA 2 and biochemistry parameters as potential biomarkers of coronary artery disease in Asian South-Indians: a case-control study. Cardiovasc Diagn Ther 2017; 7:589-597. [PMID: 29302464 DOI: 10.21037/cdt.2017.08.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Coronary artery disease (CAD) is the leading cause of death and disability worldwide. Lipoprotein associated phospholipase A2 (Lp-PLA2) is an emerging biomarker for inflammation that has shown association with CAD. Its significance in the Asian Indian population is not clearly known. We sought to compare the possible association of various biomarkers of atherosclerosis along with Lp-PLA2, in symptomatic individuals with CAD vs. healthy controls in Asian South-Indians. Methods We conducted a cross-sectional case control study at three centers in a South Indian population. A total of 100 CAD patients with acute coronary syndrome (ACS), 100 age and gender matched healthy controls participated, of which, 166 subjects or 83 case-control pairs with complete data for both participants were identified for the statistical analysis. Lp-PLA2 concentration and activity were measured using PLAC test and PLAC activity assay respectively (diaDexus Inc., San Francisco, CA, USA), while all other parameters were measured using standard commercially available kits. Results We enrolled a total of 200 subjects (mean age 50.7±9.6 years, 87.5% males). A total of 83 subjects completed the study in the CAD group (mean age 51 ±8.9 years, 85% males) and 83 subjects in the control group (mean age 50±8.9 years, 86.5% males). In the CAD group, Lp-PLA2 concentration positively correlated with TC (ρ=0.19, P=0.02), non-HDL-C (ρ=0.20, P=0.02), Lp-PLA2 activity (ρ=0.27, P=0.001) and Lp(a) (r=0.25, P=0.02). Lp-PLA2 activity correlated positively with TC (ρ=0.28, P=0.001), LDL-C (ρ=0.30, P<0.001), non-HDL-C (ρ=0.35, P<0.001), ApoB (ρ=0.35, P<0.001) and negatively correlated to HDL-C (ρ=-0.24, P=0.004). Cox proportionality hazards model revealed Lp-PLA2 concentration (β=0.006, SE =0.002, P=0.009) to have positive association with the event of CAD, while negative association was observed for ApoA1 (β=-0.06, SE =0.02, P=0.001). ROC analysis revealed that the highest quartile of Lp-PLA2 concentration to have area under curve (AUC) of 0.80 (95% CI, 0.65-0.9; P<0.001) with cut off value of >427 ng/mL and ApoA1 with AUC of 0.78 (95% CI, 0.70-0.85; P<0.001) with cut off value of ≤129.6 mg/dL with the optimum balance of sensitivity and specificity. Conclusions In this study population, circulating plasma Lp-PLA2 was found to be elevated in CAD group. ApoA1 showed negative association and Lp-PLA2 concentration showed positive association with risk for CAD. In the highest quartile, Lp-PLA2 concentration had the best diagnostic utility. Our results support the hypothesis that Lp-PLA2 may be a potential risk marker for CAD in Asian Indians.
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Affiliation(s)
- Sai Giridhar Sairam
- Department of Chemistry, Sri Sathya Sai Institute of Higher Learning, Prasanthi Nilayam, India
| | - Srikanth Sola
- Department of Cardiology, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India
| | - Asha Barooah
- Department of Cardiology, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India
| | - Sai Kiran Javvaji
- Department of Cardiology, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India
| | - Jiten Jaipuria
- Department of Urology, Sri Sathya Sai Institute of Higher Medical Sciences, Prasanthi Gram, India
| | | | - Janardhana Chelli
- Department of Chemistry, Sri Sathya Sai Institute of Higher Learning, Prasanthi Nilayam, India
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Schliefsteiner C, Hirschmugl B, Kopp S, Curcic S, Bernhart EM, Marsche G, Lang U, Desoye G, Wadsack C. Maternal Gestational Diabetes Mellitus increases placental and foetal lipoprotein-associated Phospholipase A2 which might exert protective functions against oxidative stress. Sci Rep 2017; 7:12628. [PMID: 28974763 PMCID: PMC5626711 DOI: 10.1038/s41598-017-13051-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 09/18/2017] [Indexed: 12/13/2022] Open
Abstract
Increased Lipoprotein associated phospholipase A2 (LpPLA2) has been associated with inflammatory pathologies, including Type 2 Diabetes. Studies on LpPLA2 and Gestational Diabetes Mellitus (GDM) are rare, and have focused mostly on maternal outcome. In the present study, we investigated whether LpPLA2 activity on foetal lipoproteins is altered by maternal GDM and/or obesity (a major risk factor for GDM), thereby contributing to changes in lipoprotein functionality. We identified HDL as the major carrier of LpPLA2 activity in the foetus, which is in contrast to adults. We observed marked expression of LpPLA2 in placental macrophages (Hofbauer cells; HBCs) and found that LpPLA2 activity in these cells was increased by insulin, leptin, and pro-inflammatory cytokines. These regulators were also increased in plasma of children born from GDM pregnancies. Our results suggest that insulin, leptin, and pro-inflammatory cytokines are positive regulators of LpPLA2 activity in the foeto-placental unit. Of particular interest, functional assays using a specific LpPLA2 inhibitor suggest that high-density lipoprotein (HDL)-associated LpPLA2 exerts anti-oxidative, athero-protective functions on placental endothelium and foetus. Our results therefore raise the possibility that foetal HDL-associated LpPLA2 might act as an anti-inflammatory enzyme improving vascular barrier function.
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Affiliation(s)
| | - Birgit Hirschmugl
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Susanne Kopp
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Sanja Curcic
- Department of Clinical and Experimental Pharmacology, Medical University of Graz, Graz, Austria
| | - Eva Maria Bernhart
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Gunther Marsche
- Department of Clinical and Experimental Pharmacology, Medical University of Graz, Graz, Austria
| | - Uwe Lang
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Gernot Desoye
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Christian Wadsack
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria.
- BioTechMed-Graz, Graz, Austria.
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Garg S, Madhu SV, Suneja S. Lipoprotein associated phospholipase A2 activity & its correlation with oxidized LDL & glycaemic status in early stages of type-2 diabetes mellitus. Indian J Med Res 2016; 141:107-14. [PMID: 25857502 PMCID: PMC4405925 DOI: 10.4103/0971-5916.154512] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background & objectives: Lipoprotein associated phospholipase A2 (Lp-PLA2) is an important risk predictor of coronary artery disease (CAD). This study was aimed to evaluate Lp-PLA2 activity and oxidized low density lipoprotein (oxLDL) in newly diagnosed patients of type 2 diabetes mellitus and to determine the correlation of Lp-PLA2 activity with oxLDL and plasma glucose levels. Methods: Blood samples were collected in patients with newly diagnosed type 2 diabetes (n=40) before any treatment was started and healthy controls (n=40). These were processed for estimating plasma glucose: fasting and post prandial, ox LDL, and Lp-PLA2 activity. The parameters in the two groups were compared. Correlation between different parameters was calculated by Pearson correlation analysis in both groups. Results: Lp-PLA2 activity (24.48 ± 4.91 vs 18.63 ± 5.29 nmol/min/ml, P<0.001) and oxLDL levels (52.46 ± 40.19 vs 33.26 ± 12.54 μmol/l, P<0.01) were significantly higher in patients as compared to those in controls. Lp-PLA2 activity correlated positively with oxLDL in both controls (r=0.414, P<0.01), as well in patients (r=0.542, P<0.01). A positive correlation between Lp-PLA2 activity and fasting plasma glucose levels was observed only in patients (r=0.348, P<0.05). Interpretation & conclusions: Result of this study implies that higher risk of CAD in patients with diabetes may be due to increase in Lp-PLA2 activity during the early course of the disease. A positive correlation between enzyme activity and fasting plasma glucose indicates an association between hyperglycaemia and increased activity of Lp-PLA2. This may explain a higher occurrence of CAD in patients with diabetes. A positive correlation between oxLDL and Lp-PLA2 activity suggests that Lp-PLA2 activity may be affected by oxLDL also.
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Affiliation(s)
- Seema Garg
- Department of Biochemistr, University College of Medical Sciences & Guru Teg Bahadur Hospital, (University of Delhi), Delhi, India
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“Association between platelet activating factor acetylhydrolase and diabetic retinopathy: Does inflammation affect the retinal status?”. Prostaglandins Other Lipid Mediat 2016; 122:69-72. [PMID: 26791393 DOI: 10.1016/j.prostaglandins.2016.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 12/27/2015] [Accepted: 01/06/2016] [Indexed: 11/18/2022]
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Gruppen EG, Connelly MA, Dullaart RPF. Higher circulating GlycA, a pro-inflammatory glycoprotein biomarker, relates to lipoprotein-associated phospholipase A2 mass in nondiabetic subjects but not in diabetic or metabolic syndrome subjects. J Clin Lipidol 2015; 10:512-8. [PMID: 27206938 DOI: 10.1016/j.jacl.2015.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 11/06/2015] [Accepted: 11/12/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a cardiovascular risk marker, which is in part complexed to low-density lipoproteins, where it exerts pro-inflammatory properties. GlycA is a pro-inflammatory proton nuclear magnetic resonance spectroscopy biomarker whose signal originates from a subset of N-acetylglucosamine residues on the most abundant glycosylated acute-phase proteins. OBJECTIVE We compared plasma GlycA and Lp-PLA2 mass between subjects without type 2 diabetes mellitus (T2DM) or the metabolic syndrome (MetS) and subjects with T2DM and/or MetS. We also tested the relationship of GlycA with Lp-PLA2 in each group. METHODS Plasma GlycA, Lp-PLA2 mass, high-sensitivity C-reactivity protein (hsCRP) and lipids were measured in 40 subjects with neither T2DM nor MetS (group 1) and in 58 subjects with T2DM and/or MetS (group 2). RESULTS GlycA and hsCRP were higher (P < .01 for each), whereas Lp-PLA2 was lower in group 2 vs group 1 (P < .001). GlycA was positively related to hsCRP in each group (P < .001). In contrast, GlycA was correlated positively with Lp-PLA2 in group 1 (r = 0.384, P = .015), but not in group 2 (r = 0.045; P = .74; interaction term for difference: P = .059). Although Lp-PLA2 was correlated positively with non-high-density lipoprotein cholesterol and low-density lipoprotein cholesterol in each group (P ≤ .02), its inverse relationship with high-density lipoprotein cholesterol in group 1 (r = -0.381, P = .013) was absent in group 2 (r = -0.101, P = .42). CONCLUSIONS A pro-inflammatory glycoprotein biomarker, GlycA, is higher in subjects with either T2DM, MetS, or both. The normally present positive relationship of GlycA with Lp-PLA2 is blunted in subjects with T2DM and/or MetS.
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Affiliation(s)
- Eke G Gruppen
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | | | - Robin P F Dullaart
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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11
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Mayer O, Seidlerová J, Filipovský J, Timoracká K, Bruthans J, Vaněk J, Cerná L, Wohlfahrt P, Renata C, Trefil L. Unexpected inverse relationship between impaired glucose metabolism and lipoprotein-associated phospholipase A2 activity in patients with stable vascular disease. Eur J Intern Med 2014; 25:556-60. [PMID: 24930071 DOI: 10.1016/j.ejim.2014.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/16/2014] [Accepted: 05/20/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Elevated lipoprotein-associated phospholipase A2 activity (aLp-PLA2) is associated with increased risk of cardiovascular events. In patients with stable atherovascular disease, we aimed to investigate whether impaired glucose metabolism might be associated with higher risk of elevated aLp-PLA2. METHODS We conducted a cross-sectional study in 825 stable patients after acute coronary syndrome, coronary revascularization or after first ischemic stroke (Czech part of EUROASPIRE III surveys). We measured aLp-PLA2 using diaDexus commercial kit. RESULTS In multiple step-wise regression analysis, the aLp-PLA2 was significantly positively associated with male gender, current smoking, LDL cholesterol and metabolic syndrome and negatively with statin treatment, body mass index and LDL/apoB ratio. After adjustment for these confounders, we observed an inverse relationship between aLp-PLA2 and fasting glycemia [β coefficient -2.18 (p<0.0001)] or glycated hemoglobin A1c (HbA1c) [β coefficient -5.89 (p<0.0001)]. Moreover, we found a positive association between aLp-PLA2 and pancreatic β cell function [β coefficient +0.10 (p<0.0001)], but not with an insulin sensitivity. CONCLUSION In present study, we cannot confirm any additive risk of impaired glucose metabolism in terms of increased activity of Lp-PLA2. On the contrary, presence of inadequately controlled diabetes mellitus was independently associated with lower risk of elevated aLp-PLA2 .
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Affiliation(s)
- Otto Mayer
- 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic; Biomedical Center, Medical Faculty of Charles University, Pilsen, Czech Republic.
| | - Jitka Seidlerová
- 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic; Biomedical Center, Medical Faculty of Charles University, Pilsen, Czech Republic
| | - Jan Filipovský
- 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic; Biomedical Center, Medical Faculty of Charles University, Pilsen, Czech Republic
| | - Katarina Timoracká
- 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic
| | - Jan Bruthans
- 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic; Centre for Cardiovascular Prevention of the First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Jiří Vaněk
- 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic
| | - Lenka Cerná
- Department of Neurology, University Hospital, Pilsen, Czech Republic
| | - Peter Wohlfahrt
- Centre for Cardiovascular Prevention of the First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic; International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic
| | - Cífková Renata
- Centre for Cardiovascular Prevention of the First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic; International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic
| | - Ladislav Trefil
- Department of Clinical Biochemistry and Hematology, University Hospital Pilsen, Czech Republic
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12
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Dullaart RP, van Pelt LJ, Kwakernaak AJ, Dikkeschei BD, van der Horst IC, Tio RA. Plasma lipoprotein-associated phospholipase A2 mass is elevated in STEMI compared to non-STEMI patients but does not discriminate between myocardial infarction and non-cardiac chest pain. Clin Chim Acta 2013; 424:136-40. [DOI: 10.1016/j.cca.2013.05.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 05/30/2013] [Accepted: 05/31/2013] [Indexed: 01/21/2023]
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13
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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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14
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Ntzouvani A, Nomikos T, Petrogianni M, Dede V, Stamatakis G, Manios Y. Effect of fortified milk on lyso‐platelet‐activating factor acetyltranferase and lipoprotein‐associated phospholipase A
2
in hypercholesterolemic adults. EUR J LIPID SCI TECH 2013. [DOI: 10.1002/ejlt.201200190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Agathi Ntzouvani
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Tzortzis Nomikos
- Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Petrogianni
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Vasiliki Dede
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - George Stamatakis
- Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
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Dullaart RPF, de Boer JF, Annema W, Tietge UJF. The inverse relation of HDL anti-oxidative functionality with serum amyloid a is lost in metabolic syndrome subjects. Obesity (Silver Spring) 2013; 21:361-6. [PMID: 23404653 DOI: 10.1002/oby.20058] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 08/04/2012] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Anti-oxidative properties of high density lipoproteins (HDL) are relevant for atheroprotection. HDL carry serum amyloid A (SAA), which may impair HDL functionality. We questioned whether HDL anti-oxidative capacity is determined by SAA. DESIGN AND METHODS Relationships of HDL anti-oxidative capacity (% inhibition of low density lipoprotein oxidation in vitro) with SAA were determined in 54 non-diabetic subjects without metabolic syndrome (MetS) and 68 subjects with MetS (including 51 subjects with Type 2 diabetes mellitus). RESULTS SAA levels were higher in MetS subjects, coinciding higher high sensitive C-reactive protein (hs-CRP) and lower HDL cholesterol and apolipoprotein (apo) A-I levels (P<0.001 for all). HDL anti-oxidative capacity was not different between subjects with and without MetS (P=0.76), but the HDL anti-oxidation index (HDL anti-oxidative capacity multiplied by individual HDL cholesterol concentrations), as a measure of global anti-oxidative functionality of HDL, was lower in Mets subjects (P<0.001). HDL anti-oxidative capacity was correlated inversely with SAA levels in subjects without MetS (r=-0.286, P=0.036). Notably, this relationship was independent of HDL cholesterol or apoA-I (P<0.05 for both). In contrast, no relation of HDL anti-oxidative capacity with SAA was observed in MetS subjects (r=0.032, P=0.80). The relationship of SAA with HDL anti-oxidative capacity was different in subjects with MetS compared to subjects without MetS (P=0.039 for the interaction between the presence of MetS and SAA on HDL anti-oxidative capacity) taking age and diabetes status into account. CONCLUSION Higher SAA levels may impair HDL anti-oxidative functionality. The relationship of this physiologically relevant HDL functionality measure with circulating SAA levels is apparently disturbed in metabolic syndrome.
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Affiliation(s)
- Robin P F Dullaart
- Department of Endocrinology, Center for Liver, Digestive and Metabolic Diseases, University Medical Center Groningen and University of Groningen, Groningen.
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16
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Kujiraoka T, Nakamoto T, Sugimura H, Iwasaki T, Ishihara M, Hoshi T, Horie Y, Ogawa K, Todoroki M, Nakatani Y, Banba N, Yasu T, Hattori H. Clinical Significance of Plasma Apolipoprotein F in Japanese Healthy and Hypertriglyceridemic Subjects. J Atheroscler Thromb 2013; 20:380-90. [DOI: 10.5551/jat.13706] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Constantinides A, de Vries R, van Leeuwen JJJ, Gautier T, van Pelt LJ, Tselepis AD, Lagrost L, Dullaart RPF. Simvastatin but not bezafibrate decreases plasma lipoprotein-associated phospholipase A₂ mass in type 2 diabetes mellitus: relevance of high sensitive C-reactive protein, lipoprotein profile and low-density lipoprotein (LDL) electronegativity. Eur J Intern Med 2012; 23:633-8. [PMID: 22902096 DOI: 10.1016/j.ejim.2012.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 05/03/2012] [Accepted: 05/09/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Plasma lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) levels predict incident cardiovascular disease, impacting Lp-PLA(2) as an emerging therapeutic target. We determined Lp-PLA(2) responses to statin and fibrate administration in type 2 diabetes mellitus, and assessed relationships of changes in Lp-PLA(2) with subclinical inflammation and lipoprotein characteristics. METHODS A placebo-controlled cross-over study (three 8-week treatment periods with simvastatin (40 mg daily), bezafibrate (400mg daily) and their combination) was carried out in 14 male type 2 diabetic patients. Plasma Lp-PLA(2) mass was measured by turbidimetric immunoassay. RESULTS Plasma Lp-PLA(2) decreased (-21 ± 4%) in response to simvastatin (p<0.05 from baseline and placebo), but was unaffected by bezafibrate (1 ± 5%). The drop in Lp-PLA(2) during combined treatment (-17 ± 3%, p<0.05) was similar compared to that during simvastatin alone. The Lp-PLA(2) changes during the 3 active lipid lowering treatment periods were related positively to baseline levels of high sensitive C-reactive protein, non-HDL cholesterol, triglycerides, the total cholesterol/HDL cholesterol ratio and less LDL electronegativity (p<0.02 to p<0.01), and inversely to baseline Lp-PLA(2) (p<0.01). LpPLA(2) responses correlated inversely with changes in non-HDL cholesterol, triglycerides and the total cholesterol/HDL cholesterol ratio during treatment (p<0.05 to p<0.02). CONCLUSIONS In type 2 diabetes mellitus, plasma Lp-PLA(2) is likely to be lowered by statin treatment only. Enhanced subclinical inflammation and more severe dyslipidemia may predict diminished LpPLA(2) responses during lipid lowering treatment, which in turn appear to be quantitatively dissociated from decreases in apolipoprotein B lipoproteins. Conventional lipid lowering treatment may be insufficient for optimal LpPLA(2) lowering in diabetes mellitus.
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Affiliation(s)
- Alexander Constantinides
- Department of Endocrinology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
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18
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Effect of improving glycemic control in patients with type 2 diabetes mellitus on low-density lipoprotein size, electronegative low-density lipoprotein and lipoprotein-associated phospholipase A2 distribution. Am J Cardiol 2012; 110:67-71. [PMID: 22481012 DOI: 10.1016/j.amjcard.2012.02.051] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 02/21/2012] [Accepted: 02/21/2012] [Indexed: 11/22/2022]
Abstract
The aim of this study was to determine the effect of intensified hypoglycemic therapy in patients with type 2 diabetes mellitus on the distribution of lipoprotein-associated phospholipase A2 (Lp-PLA2) activity between high-density lipoprotein and low-density lipoprotein (LDL) and its relation with the lipid profile and other qualitative properties of LDL. Forty-two patients with type 2 diabetes on the basis of poor glycemic control and normal or near normal LDL cholesterol were recruited. Lifestyle counseling and pharmacologic hypoglycemic therapy were intensified to improve glycemic control, but lipid-lowering therapy was unchanged. At 4 ± 2 months, glycosylated hemoglobin had decreased by a mean of 2.1%, but the only effect on the lipid profile were statistically significant decreases in nonesterified fatty acids and apolipoprotein B concentration. LDL size increased and the proportion of electronegative LDL decreased significantly. In parallel, total Lp-PLA2 activity decreased significantly, promoting a redistribution of Lp-PLA2 activity toward a higher proportion in high-density lipoprotein. Improvements in glycemic control led to more marked changes in Lp-PLA2 activity and distribution in patients with diabetes who had not received previous lipid-lowering therapy. In conclusion, optimizing glycemic control in patients with type 2 diabetes promotes atheroprotective changes, including larger LDL size, decreased electronegative LDL, and a higher proportion of Lp-PLA2 activity in high-density lipoprotein.
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Gregson J, Stirnadel-Farrant HA, Doobaree IU, Koro C. Variation of lipoprotein associated phospholipase A2 across demographic characteristics and cardiovascular risk factors: a systematic review of the literature. Atherosclerosis 2012; 225:11-21. [PMID: 22784637 DOI: 10.1016/j.atherosclerosis.2012.06.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 06/11/2012] [Accepted: 06/13/2012] [Indexed: 12/23/2022]
Abstract
BACKGROUND Lipoprotein association phospholipase A2 (Lp-PLA(2)), an enzyme which has been found in atherosclerotic plaque is currently under investigation in large Phase III clinical trials of vascular disease prevention. We assessed in a variety of different population settings variation of Lp-PLA(2) mass and activity across gender, ethnicity, diabetes, kidney disease and metabolic syndrome. We also assessed correlations with measures of circulating lipids, systemic inflammation and adiposity. METHODS Systematic review of studies measuring Lp-PLA(2) and at least one of the relevant characteristics in >50 participants. RESULTS We identified a total of 77 studies involving 102,499 participants meeting the inclusion criteria. Lp-PLA(2) mass and activity were consistently approximately 10% higher in males than females and 15% higher in Caucasians than African Americans or Hispanics. There were no clear associations of Lp-PLA(2) mass or activity with type II diabetes, markers of systemic inflammation (C-reactive protein, fibrinogen) or with body mass index. Correlations of Lp-PLA(2) mass or activity with low density lipoprotein cholesterol and apolipoprotein B were moderate and positive, whilst correlations with high density lipoprotein cholesterol were negative and moderate to weak. There was no clear differences in associations with any of the above characteristics in groups defined based upon prevalent cardiovascular disease or its risk factors. CONCLUSIONS Despite considerable variability in absolute levels of Lp-PLA(2) across studies, the variability of Lp-PLA(2) across gender, ethnicity, and levels of circulating lipids and markers of systemic inflammation are more consistent and appear not to vary importantly across categories defined by CVD or its risk factors.
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Affiliation(s)
- John Gregson
- Department of Public Healthy and Primary Care, University of Cambridge, Cambridge CB1 8RN, United Kingdom.
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20
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Rosenson RS, Stafforini DM. Modulation of oxidative stress, inflammation, and atherosclerosis by lipoprotein-associated phospholipase A2. J Lipid Res 2012; 53:1767-82. [PMID: 22665167 DOI: 10.1194/jlr.r024190] [Citation(s) in RCA: 115] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)), also known as platelet-activating factor acetylhydrolase (PAF-AH), is a unique member of the phospholipase A(2) superfamily. This enzyme is characterized by its ability to specifically hydrolyze PAF as well as glycerophospholipids containing short, truncated, and/or oxidized fatty acyl groups at the sn-2 position of the glycerol backbone. In humans, Lp-PLA(2) circulates in active form as a complex with low- and high-density lipoproteins. Clinical studies have reported that plasma Lp-PLA(2) activity and mass are strongly associated with atherogenic lipids and vascular risk. These observations led to the hypothesis that Lp-PLA(2) activity and/or mass levels could be used as biomarkers of cardiovascular disease and that inhibition of the activity could offer an attractive therapeutic strategy. Darapladib, a compound that inhibits Lp-PLA(2) activity, is anti-atherogenic in mice and other animals, and it decreases atherosclerotic plaque expansion in humans. However, disagreement continues to exist regarding the validity of Lp-PLA(2) as an independent marker of atherosclerosis and a scientifically justified target for intervention. Circulating Lp-PLA(2) mass and activity are associated with vascular risk, but the strength of the association is reduced after adjustment for basal concentrations of the lipoprotein carriers with which the enzyme associates. Genetic studies in humans harboring an inactivating mutation at this locus indicate that loss of Lp-PLA(2) function is a risk factor for inflammatory and vascular conditions in Japanese cohorts. Consistently, overexpression of Lp-PLA(2) has anti-inflammatory and anti-atherogenic properties in animal models. This thematic review critically discusses results from laboratory and animal studies, analyzes genetic evidence, reviews clinical work demonstrating associations between Lp-PLA(2) and vascular disease, and summarizes results from animal and human clinical trials in which administration of darapladib was tested as a strategy for the management of atherosclerosis.
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Kizer JR, Umans JG, Zhu J, Devereux RB, Wolfert RL, Lee ET, Howard BV. Lipoprotein-associated phospholipase A(2) mass and activity and risk of cardiovascular disease in a population with high prevalences of obesity and diabetes: the Strong Heart Study. Diabetes Care 2012; 35:840-7. [PMID: 22338104 PMCID: PMC3308309 DOI: 10.2337/dc11-1639] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the association of lipoprotein-associated phospholipase A(2) (LpPLA(2)) mass and activity with incident cardiovascular disease (CVD) in a population with high prevalences of insulin resistance and diabetes, conditions for which epidemiological data remain sparse. RESEARCH DESIGN AND METHODS We conducted a nested, case-control study (n = 1,008) within a population-based cohort of American Indians. Case subjects were defined by incidence of first-ever CVD up to 10 years later. Control subjects comprised participants free of CVD events during the follow-up period who were frequency matched to case subjects by age, sex, and diabetes status. LpPLA(2) mass and activity were measured using commercially available assays. RESULTS LpPLA(2) mass and activity were moderately correlated with each other (r = 0.30), but only LpPLA(2) activity exhibited moderate correlations with lipid fractions. After extensive adjustment for covariates, both LpPLA(2) measures were significantly associated with incident CVD, but the relationship was inverse for LpPLA(2) mass (highest versus lowest tertile, relative risk [RR] 0.55 [95% CI 0.39-0.79]) and positive for LpPLA(2) activity (highest versus lowest tertile, 1.65 [1.12-2.42]). These associations were similar when participants with and without diabetes were examined separately. CONCLUSIONS In this population-based cohort enriched with dysmetabolic phenotypes, LpPLA(2) mass and activity showed divergent associations with CVD. The inverse relationship for LpPLA(2) mass is contrary to observations from predominantly nondiabetic populations and will require independent replication. Whether this finding relates to redistribution of LpPLA(2) to lipoprotein classes where it is less atherogenic or reflects incomplete measurement of LpPLA(2) mass associated with altered lipoprotein composition in insulin resistance warrants further investigation.
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Affiliation(s)
- Jorge R Kizer
- Department of Medicine, Weill Cornell Medical Center, New York, New York, USA.
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Constantinides A, van Pelt LJ, van Leeuwen JJJ, de Vries R, Tio RA, van der Horst ICC, Sluiter WJ, Dullaart RPF. Carotid intima media thickness is associated with plasma lipoprotein-associated phospholipase A2 mass in nondiabetic subjects but not in patients with type 2 diabetes. Eur J Clin Invest 2011; 41:820-7. [PMID: 21281278 DOI: 10.1111/j.1365-2362.2011.02471.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND A recent meta-analysis showed that both plasma lipoprotein-associated phospholipase A(2) (Lp-PLA(2) ) mass and activity independently predict cardiovascular events. Notably, Lp-PLA(2) activity but not mass was found to be a determinant of cardiovascular outcome in type 2 diabetes mellitus. We questioned whether relationships of carotid intima media thickness (IMT), a measure of subclinical atherosclerosis, with Lp-PLA(2) mass differ between diabetic and nondiabetic subjects. MATERIALS AND METHODS Relationships of IMT with plasma Lp-PLA(2) mass (turbidimetric immunoassay) were compared in 74 patients with type 2 diabetes and in 64 nondiabetic subjects. RESULTS IMT was increased (P=0·016), but plasma Lp-PLA(2) mass was decreased in patients with diabetes compared to nondiabetic subjects (277±66 vs. 327±62μgL(-1) , P<0·001). In nondiabetic subjects, IMT was correlated positively with Lp-PLA(2) (r=0·325, P<0·009); multiple linear regression analysis confirmed an independent association of IMT with Lp-PLA(2) (ß=0·192, P=0·048). In contrast, IMT was unrelated to Lp-PLA(2) in patients with diabetes (r=0·021, P=0·86), and the relationship of IMT with Lp-PLA(2) was different in diabetic and control subjects (P<0·001). The relationship of Lp-PLA(2) with the total cholesterol/high-density lipoprotein (HDL) cholesterol ratio also differed between diabetic and nondiabetic subjects (P<0·001). CONCLUSIONS Plasma Lp-PLA(2) may relate to early stages of atherosclerosis development. In diabetes mellitus, in contrast, the association of IMT with plasma Lp-PLA(2) mass is abolished, which could be partly ascribed to redistribution of Lp-PLA(2) mass from apolipoprotein B-containing lipoproteins towards HDL. These findings raise questions about the usefulness of plasma Lp-PLA(2) mass measurement as a marker of subclinical atherosclerosis in type 2 diabetes mellitus.
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Affiliation(s)
- Alexander Constantinides
- Department of Endocrinology Department of Cardiology Laboratory Center, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands
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Dullaart RPF, Constantinides A, Perton FG, van Leeuwen JJJ, van Pelt JL, de Vries R, van Tol A. Plasma cholesteryl ester transfer, but not cholesterol esterification, is related to lipoprotein-associated phospholipase A2: possible contribution to an atherogenic lipoprotein profile. J Clin Endocrinol Metab 2011; 96:1077-84. [PMID: 21252249 DOI: 10.1210/jc.2010-2139] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT Plasma lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) predicts incident cardiovascular disease and is associated preferentially with negatively charged apolipoprotein B-containing lipoproteins. The plasma cholesteryl ester transfer (CET) process, which contributes to low high-density lipoprotein cholesterol and small, dense low-density lipoproteins, is affected by the composition and concentration of apolipoprotein B-containing cholesteryl ester acceptor lipoproteins. OBJECTIVE We tested relationships of CET with Lp-PLA(2) in subjects with and without metabolic syndrome (MetS). DESIGN AND SETTING In 68 subjects with MetS and 74 subjects without MetS, plasma Lp-PLA(2) mass, cholesterol esterification (EST), lecithin:cholesterol acyltransferase (LCAT) activity level, CET, CET protein (CETP) mass, and lipoproteins were measured. RESULTS EST, LCAT activity, CET (P < 0.001 for all), and CETP (P = 0.030) were increased, and Lp-PLA(2) was decreased (P = 0.043) in MetS. CET was correlated positively with Lp-PLA(2) in subjects with and without MetS (P < 0.05 for both). EST and LCAT activity were unrelated to Lp-PLA(2), despite a positive correlation between EST and CET (P < 0.001). After controlling for age, sex, and diabetes status, CET was determined by Lp-PLA(2) in the whole group (β = 0.245; P < 0.001), and in subjects with (β = 0.304; P = 0.001) and without MetS (β = 0.244; P = 0.006) separately, independently of triglycerides and CETP. CONCLUSIONS Plasma CET is related to Lp-PLA(2) in subjects with and without MetS. The process of CET, but not EST, may be influenced by Lp-PLA(2). These findings provide a rationale to evaluate whether maneuvers that inhibit Lp-PLA(2) will reduce CET, and vice versa to document effects of CETP inhibition on Lp-PLA(2).
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Affiliation(s)
- Robin P F Dullaart
- Department of Endocrinology, University of Groningen and University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
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Omori M, Watanabe M, Matsumoto K, Honda H, Hattori H, Akizawa T. Impact of serum apolipoprotein A-IV as a marker of cardiovascular disease in maintenance hemodialysis patients. Ther Apher Dial 2010; 14:341-8. [PMID: 20609189 DOI: 10.1111/j.1744-9987.2010.00809.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to investigate the relationship between serum apolipoprotein (apo) A-IV levels and markers for atherosclerosis, including carotid intima-media thickness (CIMT) and the ankle-brachial index (ABI), in hemodialysis patients. We performed a cross-sectional study involving 116 maintenance hemodialysis patients (70 males; median age, 64 years), measuring CIMT, ABI, the usual laboratory examinations, and serum apo A-IV before the dialysis session. The apo A-IV concentration was measured by a noncompetitive ELISA. Serum apo A-IV concentrations were significantly lower in hemodialysis patients with cardiovascular disease and plaque in the carotid artery. The apo A-IV level was positively associated with urea nitrogen and creatinine, and negatively associated with age, interleukin-6, the neutrophil/lymphocyte ratio, and maximum CIMT. Moreover, serum apo A-IV concentrations were significantly lower in the low ABI group. On logistic analysis, patients with high apo A-IV levels had a lower odds ratio for atherosclerosis (maximum CIMT > 1.0) and cardiovascular disease compared to patients with low apo A-IV levels. On stepwise multivariate regression analysis, the serum apo A-IV level was independently associated with creatinine, the neutrophil/lymphocyte ratio, and the maximum CIMT. Serum apo A-IV is associated with atherosclerotic lesions in hemodialysis patients. Apo A-IV levels may be useful for estimating the risk of cardiovascular disease in dialysis patients.
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Affiliation(s)
- Maho Omori
- Department of Nephrology, Gyoutoku Sougou Hospital, Chiba, Japan
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Mitsutake R, Miura SI, Zhang B, Saku K. HDL-associated factors provide additional prognostic information for coronary artery disease as determined by multi-detector row computed tomography. Int J Cardiol 2010; 143:72-8. [DOI: 10.1016/j.ijcard.2009.01.058] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Revised: 01/15/2009] [Accepted: 01/23/2009] [Indexed: 01/07/2023]
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Srinivasan P, Bahnson BJ. Molecular Model of Plasma PAF Acetylhydrolase-Lipoprotein Association: Insights from the Structure. Pharmaceuticals (Basel) 2010; 3:541-557. [PMID: 27713267 PMCID: PMC4033968 DOI: 10.3390/ph3030541] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2010] [Revised: 02/07/2010] [Accepted: 03/05/2010] [Indexed: 11/18/2022] Open
Abstract
Plasma platelet-activating factor acetylhydrolase (PAF-AH), also called lipoprotein-associated phospholipase A2 (Lp-PLA2), is a group VIIA PLA2 enzyme that catalyzes the hydrolysis of PAF and certain oxidized phospholipids. Although the role of PAF-AH as a pro- or anti-atherosclerotic enzyme is highly debated, several studies have shown it to be an independent marker of cardiovascular diseases. In humans the majority of plasma PAF-AH is bound to LDL and a smaller portion to HDL; the majority of the enzyme being associated with small dense LDL and VHDL-1 subclasses. Several studies suggest that the anti- or pro-atherosclerotic tendency of PAF-AH might be dependent on the type of lipoprotein it is associated with. Amino acid residues in PAF-AH necessary for binding to LDL and HDL have been identified. However our understanding of the interaction of PAF-AH with LDL and HDL is still incomplete. In this review we present an overview of what is already known about the interaction of PAF-AH with lipoprotein particles, and we pose questions that are yet to be answered. The recently solved crystal structure of PAF-AH, along with functional work done by others is used as a guide to develop a model of interaction of PAF-AH with lipoprotein particles.
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Affiliation(s)
| | - Brian J Bahnson
- Department of Chemistry & Biochemistry, University of Delaware, Newark, DE, 19716, USA.
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Cheng L, Han X, Shi Y. A regulatory role of LPCAT1 in the synthesis of inflammatory lipids, PAF and LPC, in the retina of diabetic mice. Am J Physiol Endocrinol Metab 2009; 297:E1276-82. [PMID: 19773578 PMCID: PMC2793047 DOI: 10.1152/ajpendo.00475.2009] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Platelet-activating factor (PAF) and lysophosphatidylcholine (LPC) are potent inflammatory lipids. Elevated levels of PAF and LPC are associated with the onset of diabetic retinopathy and neurodegeneration. However, the molecular mechanisms underlying such defects remain elusive. LPCAT1 is a newly reported lysophospholipid acyltransferase implicated in the anti-inflammatory response by its role in conversion of LPC to PC. Intriguingly, the LPCAT1 enzyme also catalyzes the synthesis of PAF from lyso-PAF with use of acetyl-CoA as a substrate. The present studies investigated regulatory roles of LPCAT1 in the synthesis of inflammatory lipids during the onset of diabetes. Our work shows that LPCAT1 plays an important role in the inactivation of PAF by catalyzing the synthesis of alkyl-PC, an inactivated form of PAF with use of acyl-CoA and lyso-PAF as substrates. In support of a role of LPCAT1 in anti-inflammatory responses in diabetic retinopathy, LPCAT1 is most abundantly expressed in the retina. Moreover, LPCAT1 mRNA levels and acyltransferase activity toward lyso-PAF and LPC were significantly downregulated in retina and brain tissues in response to the onset of diabetes in Ins2(Akita) and db/db mice, mouse models of type 1 and type 2 diabetes, respectively. Conversely, treatment of db/db mice with rosiglitazone, an antidiabetes compound, significantly upregulated LPCAT1 mRNA levels concurrently with increased acyltransferase activity in the retina and brain. Collectively, these findings identified a novel regulatory role of LPCAT1 in catalyzing the inactivation of inflammatory lipids in the retina of diabetic mice.
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Affiliation(s)
- Long Cheng
- Department of Cellular and Molecular Physiology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033, USA
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Functional Consequences of Mutations and Polymorphisms in the Coding Region of the PAF Acetylhydrolase (PAF-AH) Gene. Pharmaceuticals (Basel) 2009; 2:94-117. [PMID: 27713227 PMCID: PMC3978535 DOI: 10.3390/ph2030094] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 11/10/2009] [Accepted: 11/19/2009] [Indexed: 12/03/2022] Open
Abstract
In the past several years a number of alterations in the PAF-AH/PLA2G7/LpPLA2 gene have been described. These include inactivating mutations, polymorphisms in the coding region, and other genetic changes located in promoter and intronic regions of the gene. The consequences associated with these genetic variations have been evaluated from different perspectives, including in vitro biochemical and molecular studies and clinical analyses in human subjects. This review highlights the current state of the field and suggests new approaches that can be used to evaluate functional consequences associated with mutations and polymorphisms in the PAF-AH gene.
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Nozue T, Yamamoto S, Tohyama S, Umezawa S, Kunishima T, Sato A, Miyake S, Takeyama Y, Morino Y, Yamauchi T, Muramatsu T, Hibi K, Sozu T, Michishita I, Kanagawa PTCA Conference Study Group. Treatment With Statin on Atheroma Regression Evaluated by Intravascular Ultrasound With Virtual Histology (TRUTH Study) Rationale and Design. Circ J 2009; 73:352-5. [DOI: 10.1253/circj.cj-08-0593] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Tsuyoshi Nozue
- Division of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital
| | | | - Shinichi Tohyama
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center
| | | | - Tomoyuki Kunishima
- Fourth Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine
| | - Akira Sato
- Cardiovascular Center, Yokosuka Kyosai Hospital
| | - Shogo Miyake
- Department of Cardiology, Ebina General Hospital
| | | | | | - Takao Yamauchi
- Department of Cardiology, Tokyo Women's Medical University
| | | | - Kiyoshi Hibi
- Division of Cardiology, Yokohama City University Medical Center
| | - Takashi Sozu
- The Center for Advanced Medical Engineering and Informatics, Osaka University
| | - Ichiro Michishita
- Division of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital
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Serum platelet-activating factor acetylhydrolase activity: A novel potential inflammatory marker in type 1 diabetes. Prostaglandins Other Lipid Mediat 2008; 87:42-6. [DOI: 10.1016/j.prostaglandins.2008.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Revised: 07/04/2008] [Accepted: 07/21/2008] [Indexed: 11/20/2022]
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Gardner AA, Reichert EC, Topham MK, Stafforini DM. Identification of a domain that mediates association of platelet-activating factor acetylhydrolase with high density lipoprotein. J Biol Chem 2008; 283:17099-106. [PMID: 18434304 DOI: 10.1074/jbc.m802394200] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The plasma form of platelet-activating factor (PAF) acetylhydrolase (PAF-AH), also known as lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) inactivates potent lipid messengers such as PAF and modified phospholipids generated in settings of oxidant stress. In humans, PAF-AH circulates in blood in fully active form and associates with high and low density lipoproteins (HDL and LDL). Several studies suggest that the location of PAF-AH affects both the catalytic efficiency and the function of the enzyme in vivo. The distribution of PAF-AH among lipoproteins varies widely among mammals. Here, we report that mouse and human PAF-AHs associate with human HDL particles of different density. We made use of this observation in the development of a binding assay to identify domains required for association of human PAF-AH with human HDL. Sequence comparisons among species combined with domain-swapping and site-directed mutagenesis studies led us to the identification of C-terminal residues necessary for the association of human PAF-AH with human HDL. Interestingly, the region identified is not conserved among PAF-AHs, suggesting that PAF-AH interacts with HDL particles in a manner that is unique to each species. These findings contribute to our understanding of the mechanisms responsible for association of human PAF-AH with HDL and may facilitate future studies aimed at precisely determining the function of PAF-AH in each lipoprotein particle.
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Affiliation(s)
- Alison A Gardner
- Huntsman Cancer Institute and Department of Internal Medicine, University of Utah, Salt Lake City, Utah 84112, USA
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Iwase M, Sonoki K, Sasaki N, Ohdo S, Higuchi S, Hattori H, Iida M. Lysophosphatidylcholine contents in plasma LDL in patients with type 2 diabetes mellitus: relation with lipoprotein-associated phospholipase A2 and effects of simvastatin treatment. Atherosclerosis 2007; 196:931-6. [PMID: 17350631 DOI: 10.1016/j.atherosclerosis.2007.02.012] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2006] [Revised: 02/08/2007] [Accepted: 02/13/2007] [Indexed: 11/23/2022]
Abstract
Increased lipoprotein-associated PLA(2) (Lp-PLA(2)) predicts the future development of cardiovascular diseases. Although lysophosphatidylcholine (lyso-PC) produced by Lp-PLA(2) may contribute to its proatherogenic activity, the relation between Lp-PLA(2) and lyso-PC content in LDL remains unclarified. We determined the correlation between lyso-PC content in LDL and serum concentrations of Lp-PLA(2), chemokines, oxidative and inflammatory markers and microvascular complications in 32 patients with type 2 diabetes mellitus free of macroangiopathy. We also investigated the effect of simvastatin treatment on Lp-PLA(2) and lyso-PC content in 26 hypercholesterolemic patients with type 2 diabetes mellitus. 1-palmitoyl lyso-PC was measured using electrospray ionization-liquid chromatography/mass spectrometry and Lp-PLA(2) by ELISA. Lyso-PC content in LDL was significantly higher in diabetic patients than in control healthy subjects. Lyso-PC content correlated significantly with Lp-PLA(2) levels (r=0.56, p<0.0001), and was significantly higher in patients with preproliferative or proliferative retinopathy and those with nephropathy than the control. Simvastatin treatment reduced serum Lp-PLA(2) and lyso-PC content in LDL. Our findings suggest that Lp-PLA(2) has the proatherogenic activity by contributing to the production of lyso-PC in circulating LDL.
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Affiliation(s)
- Masanori Iwase
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Shi Y, Zhang P, Zhang L, Osman H, Mohler ER, Macphee C, Zalewski A, Postle A, Wilensky RL. Role of lipoprotein-associated phospholipase A2 in leukocyte activation and inflammatory responses. Atherosclerosis 2007; 191:54-62. [PMID: 16765356 DOI: 10.1016/j.atherosclerosis.2006.05.001] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2005] [Revised: 04/04/2006] [Accepted: 05/01/2006] [Indexed: 11/16/2022]
Abstract
BACKGROUND Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an emerging cardiovascular risk marker. To explore the biologic role of Lp-PLA2 in atherosclerosis, we examined its expression and contribution to leukocyte activation under proatherogenic conditions. METHODS AND RESULTS Following the induction of diabetes and hypercholesterolemia in a porcine model, a rapid increase in plasma Lp-PLA2 activity was observed at 1 month. This was accompanied by upregulated Lp-PLA2 mRNA expression by peripheral blood mononuclear cells (PBMC) at 3 months, and elevated Lp-PLA2 mRNA expression in coronary arteries at 6 months. These changes were paralleled by increased inflammatory responses by circulating PBMC (ICAM-1, IL-6), in coronary tissues (ICAM-1, VCAM-1), and the subsequent accumulation of inflammatory cells. In human PBMC, proinflammatory mediators augmented the synthesis and release of functional Lp-PLA2. Furthermore, lysophosphatidylcholine (lysoPC), a product of Lp-PLA2 activity, induced an increase in several inflammatory cytokines (IL-1beta, IL-6, TNF-alpha) in a concentration-dependent manner. In contrast, Lp-PLA2 inhibition (SB677116; 1 microM) abrogated the inflammatory response elicited by oxidized LDL. CONCLUSIONS In an experimental model of diabetes and hypercholesterolemia, leukocyte activation was associated with augmented Lp-PLA2 expression. In vitro, Lp-PLA2 activity mediated leukocyte activation and inflammatory responses, whereas Lp-PLA2 inhibition abolished inflammatory responses induced by oxidized LDL. Collectively, these observations support a proatherogenic role for Lp-PLA2.
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Affiliation(s)
- Yi Shi
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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Noto H, Chitkara P, Raskin P. The role of lipoprotein-associated phospholipase A(2) in the metabolic syndrome and diabetes. J Diabetes Complications 2006; 20:343-8. [PMID: 17070436 DOI: 10.1016/j.jdiacomp.2006.07.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Accepted: 07/07/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is a novel inflammation marker. We investigated its association with other coronary risk factors and evaluated its role as a comprehensive marker of the metabolic syndrome in individuals with type 2 diabetes. METHODS Our cross-sectional study evaluated 92 insulin-treated subjects with type 2 diabetes. Biochemical measurements of Lp-PLA(2), glycemic control, lipid profiles, and C-reactive protein were carried out. Seventy-seven subjects were diagnosed as having the metabolic syndrome, which was defined according to the American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. RESULTS Lp-PLA(2) was significantly correlated with waist-hip ratio (r=.25), triglycerides (r=.50), high-density lipoprotein cholesterol (r=-.31), and low-density lipoprotein cholesterol (LDL-C; r=.27; all P<.02). In a multiple-regression model, triglycerides and LDL-C levels were the significant predictors of Lp-PLA(2). Lp-PLA(2) was significantly higher in subjects with the metabolic syndrome than in those without it (268+/-23.4 vs. 127+/-15.8 ng/ml, P<.001). There was a linear increase in Lp-PLA(2) with an increment of the number of the metabolic syndrome criteria (P(trend)=.041). Another multiple-regression model showed that the hypertriglyceridemia component was the only predictor of Lp-PLA(2). CONCLUSIONS Our findings suggest that Lp-PLA(2) assay potentially facilitates a more comprehensive assessment of the metabolic syndrome in patients with type 2 diabetes on insulin.
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Affiliation(s)
- Hiroshi Noto
- The University Diabetes Treatment Center, Parkland Memorial Hospital, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8858, USA
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Karasawa K. Clinical aspects of plasma platelet-activating factor-acetylhydrolase. Biochim Biophys Acta Mol Cell Biol Lipids 2006; 1761:1359-72. [PMID: 17049457 DOI: 10.1016/j.bbalip.2006.06.017] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2006] [Accepted: 06/15/2006] [Indexed: 11/25/2022]
Abstract
Plasma platelet-activating factor (PAF)-acetylhydrolase (PAF-AH), which is characterized by tight association with plasma lipoproteins, degrades not only PAF but also phospholipids with oxidatively modified short fatty acyl chain esterified at the sn-2 position. Production and accumulation of these phospholipids are associated with the onset of inflammatory diseases and preventive role of this enzyme has been evidenced by many recent studies including prevalence of the genetic deficiency of the enzyme in the patients and therapeutic effects of treatment with recombinant protein or gene transfer. With respect to the atherosclerosis, however, it is not fully cleared whether this enzyme plays an anti-atherogenic role or pro-atherogenic role because plasma PAF-AH also might produce lysophosphatidylcholine (LysoPC) and oxidatively modified nonesterified fatty acids with potent pro-inflammatory and pro-atherogenic bioactivities. These dual roles of plasma PAF-AH might be regulated by the altered distribution of the enzyme between low density lipoprotein (LDL) and high density lipoprotein (HDL) particles because HDL-associated enzymes are considered to contribute to the protection of LDL from oxidative modification. This review focuses on the recent findings which address the role of this enzyme in the human diseases especially including asthma, septic shock and atherosclerosis.
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Affiliation(s)
- Ken Karasawa
- Laboratory of Molecular Pharmaceutics, Faculty of Pharmaceutical Sciences, Teikyo University, Sagamihara, Kanagawa 199-0195, Japan.
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Abstract
Lipoprotein-associated phospholipase A2 (LP-PLA2) is an emerging inflammatory marker that is used to assess the risk for cardiovascular disease (CVD) and associated events. Several epidemiologic studies have demonstrated an independent association between plasma Lp-PLA2 concentration and risk for cardiovascular events. HMG-CoA reductase inhibitors (statins) and fenofibrates can reduce Lp-PLA2 concentrations in plasma, and orally active, specific Lp-PLA2 inhibitors have been developed and are in clinical trials to evaluate the potential of Lp-PLA2 as a therapeutic target. This article reviews recent studies of Lp-PLA2 in the setting of CVD, discusses the proposed mechanisms of action of Lp-PLA2, and describes methods for measurement and their clinical application. Recent evidence that suggests Lp-PLA2's potential usefulness as a therapeutic target also is reviewed.
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Affiliation(s)
- Joseph P McConnell
- Department of Laboratory Medicine and Pathology, The Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905, USA.
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Okada T, Miyashita M, Kuromori Y, Iwata F, Harada K, Hattori H. Platelet-activating factor acetylhydrolase concentration in children with abdominal obesity. Arterioscler Thromb Vasc Biol 2006; 26:e40-1. [PMID: 16627814 DOI: 10.1161/01.atv.0000217284.86123.2c] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ishihara M, Kujiraoka T, Iwasaki T, Nagano M, Takano M, Ishii J, Tsuji M, Ide H, Miller IP, Miller NE, Hattori H. A sandwich enzyme-linked immunosorbent assay for human plasma apolipoprotein A-V concentration. J Lipid Res 2005; 46:2015-22. [PMID: 15961791 DOI: 10.1194/jlr.d500018-jlr200] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Apolipoprotein A-V (apoA-V) is a recently discovered apolipoprotein that appears to have a role in plasma triglyceride (TG) transport. We have developed an ELISA for apoA-V using monoclonal antibodies that has a lower limit of detection of 0.3 ng/ml and linearity up to 20 ng/ml. The ELISA was then used to quantify plasma apoA-V in 196 healthy subjects and 106 patients with insulin-resistant diabetes mellitus. In the healthy subjects, total apoA-V concentration was 179.2 +/- 74.8 ng/ml, and it was greater in females than in males (P < 0.005). It was correlated positively with the plasma HDL cholesterol (r = 0.32, P < 0.0001), apoA-I (r = 0.27, P = 0.0001), and apoE (r = 0.18, P = 0.011) concentrations and negatively with plasma TG concentration (r = -0.22, P = 0.021). In relation to single nucleotide polymorphism 3 (-1131C/T) of the apoA-V gene, apoA-V concentration was higher in the T/T type than in the C/C type (P < 0.01). Plasma TG concentration was lower in the T/T type than in the C/C or C/T type (P < 0.05). ApoA-V concentration was lower in the diabetic patients (69.4 +/- 44.3 ng/ml; P < 0.01) than in the healthy controls.
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Affiliation(s)
- Mitsuaki Ishihara
- Department of Advanced Medical Technology and Development, BML, Inc., Saitama, Japan
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Kujiraoka T, Hattori H, Ito M, Nanjee MN, Ishihara M, Nagano M, Iwasaki T, Cooke CJ, Olszewski WL, Stepanova IP, Egashira T, Miller NE. Effects of intravenous apolipoprotein A-I/phosphatidylcholine discs on paraoxonase and platelet-activating factor acetylhydrolase in human plasma and tissue fluid. Atherosclerosis 2004; 176:57-62. [PMID: 15306175 DOI: 10.1016/j.atherosclerosis.2004.03.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2003] [Revised: 03/01/2004] [Accepted: 03/19/2004] [Indexed: 11/25/2022]
Abstract
We have previously shown that intravenous apolipoprotein (apo) A-I/phosphatidylcholine (apo A-I/PC) discs increase plasma high-density lipoprotein (HDL) concentration in humans. We have now studied the associated changes in two enzymes, paraoxonase (PON) and platelet-activating factor acetylhydrolase (PAF-AH) that are carried in whole or in part by HDLs, and are thought to influence atherogenesis by hydrolyzing oxidized phospholipids in lipoproteins. Apo A-I/PC discs (40 mg/kg over 4 h) were infused into eight healthy males. Although plasma apo A-I and HDL cholesterol increased on average by 178 and 158%, respectively, plasma total PON and total PAF-AH concentrations did not rise. By the end of the infusion, HDL-associated PAF-AH had increased by 0.56 +/- 0.14 microg/mL (mean +/- S.D., P < 0.01), and nonHDL-associated PAF-AH had decreased by 0.84 +/- 0.11 microg/mL (P < 0.05). These changes were accompanied by an increase in the HDL-associated PAF-AH/apo A-I ratio from 0.19 to 0.35 (P < 0.05), and by a decrease in the nonHDL-associated PAF-AH/apo B ratio from 2.1 to 1.4 (P < 0.05). No changes in PON or PAF-AH concentrations were detected in prenodal lymph (tissue fluid), collected continuously from the leg. Our results show that the total concentrations of PON and PAF-AH in plasma are uninfluenced by plasma HDL concentration. PAF-AH transfers readily between HDLs and LDLs in vivo, and its distribution between them is determined partly by their relative concentrations and partly by HDL composition.
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Affiliation(s)
- Takeshi Kujiraoka
- Department of Advanced Medical Technology and Development, BML Inc, 1361-1 Matoba, Kawagoe, Saitama 350-1101, Japan
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Ishihara M, Iwasaki T, Nagano M, Ishii J, Takano M, Kujiraoka T, Tsuji M, Hattori H, Emi M. Functional impairment of two novel mutations detected in lipoprotein-associated phospholipase A2 (Lp-PLA2) deficiency patients. J Hum Genet 2004; 49:302-307. [PMID: 15148590 DOI: 10.1007/s10038-004-0151-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2004] [Accepted: 03/10/2004] [Indexed: 11/30/2022]
Abstract
Plasma lipoprotein-associated phospholipase A2 (Lp-PLA2), also known as platelet-activating factor (PAF) acetylhydrolase (PAF-AH), is a member of the serine-dependent class of A2 phospholipases that hydrolyze sn2-ester bonds of fragmented or oxidized phospholipids at sites where atherosclerotic plaques are forming. Most circulating Lp-PLA2 is bound to low-density lipoprotein (LDL) particles in plasma and the rest to high-density lipoprotein (HDL). Deficiency of Lp-PLA2 is a predisposing factor for cardiovascular diseases in the Japanese population. We describe here two novel mutations of the gene encoding Lp-PLA2, InsA191 and I317N in Japanese subjects. The first patient, with partial Lp-PLA2 deficiency, was heterozygous for the InsA191 mutation; macrophages from this patient secreted only half the normal amount of Lp-PLA2 in vitro. The other patient, who showed complete Lp-PLA2 deficiency, was a compound heterozygote for the novel I317N mutation and a common V279F mutation; macrophages from that patient failed to secrete any Lp-PLA2. Measurement of Lp-PLA2 mass, activity and Western blotting verified impaired production and secretion of the enzyme after transfection of mutant construct into COS-7 cells. These results indicated that both novel mutants, InsA191 and I317N, impair function of the Lp-PLA2 gene.
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Affiliation(s)
- Mitsuaki Ishihara
- Department of Advanced Medical Technology and Development, BML, Inc., Kawagoe, Japan
| | - Tadao Iwasaki
- Department of Advanced Medical Technology and Development, BML, Inc., Kawagoe, Japan
| | - Makoto Nagano
- Department of Advanced Medical Technology and Development, BML, Inc., Kawagoe, Japan
| | - Jun Ishii
- Internal Medicine, Hokkaido Hospital for Social Health Insurance, Sapporo, Japan
| | - Mayumi Takano
- Department of Advanced Medical Technology and Development, BML, Inc., Kawagoe, Japan
| | - Takeshi Kujiraoka
- Department of Advanced Medical Technology and Development, BML, Inc., Kawagoe, Japan
| | - Masahiro Tsuji
- Institute of Medical Science, Health Sciences University of Hokkaido, Sapporo, Japan
| | - Hiroaki Hattori
- Department of Advanced Medical Technology and Development, BML, Inc., Kawagoe, Japan
| | - Mitsuru Emi
- Department of Molecular Biology, Institute of Gerontology, Nippon Medical School, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki 211-8533, Japan.
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