1
|
Gillard BK, Rosales C, Gotto AM, Pownall HJ. The pathophysiology of excess plasma-free cholesterol. Curr Opin Lipidol 2023; 34:278-286. [PMID: 37732779 PMCID: PMC10624414 DOI: 10.1097/mol.0000000000000899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
PURPOSE OF REVIEW Several large studies have shown increased mortality due to all-causes and to atherosclerotic cardiovascular disease. In most clinical settings, plasma HDL-cholesterol is determined as a sum of free cholesterol and cholesteryl ester, two molecules with vastly different metabolic itineraries. We examine the evidence supporting the concept that the pathological effects of elevations of plasma HDL-cholesterol are due to high levels of the free cholesterol component of HDL-C. RECENT FINDINGS In a small population of humans, a high plasma HDL-cholesterol is associated with increased mortality. Similar observations in the HDL-receptor deficient mouse (Scarb1 -/- ), a preclinical model of elevated HDL-C, suggests that the pathological component of HDL in these patients is an elevated plasma HDL-FC. SUMMARY Collective consideration of the human and mouse data suggests that clinical trials, especially in the setting of high plasma HDL, should measure free cholesterol and cholesteryl esters and not just total cholesterol.
Collapse
Affiliation(s)
- Baiba K. Gillard
- Center for Bioenergetics, Houston Methodist, Houston, Texas
- Weill Cornell Medicine, New York, New York, USA
| | - Corina Rosales
- Center for Bioenergetics, Houston Methodist, Houston, Texas
- Weill Cornell Medicine, New York, New York, USA
| | - Antonio M. Gotto
- Center for Bioenergetics, Houston Methodist, Houston, Texas
- Weill Cornell Medicine, New York, New York, USA
| | - Henry J. Pownall
- Center for Bioenergetics, Houston Methodist, Houston, Texas
- Weill Cornell Medicine, New York, New York, USA
| |
Collapse
|
2
|
Wang Z, Yelamanchili D, Liu J, Gotto AM, Rosales C, Gillard BK, Pownall HJ. Serum opacity factor normalizes erythrocyte morphology in Scarb1 -/- mice in an HDL-free cholesterol-dependent way. J Lipid Res 2023; 64:100456. [PMID: 37821077 PMCID: PMC10641538 DOI: 10.1016/j.jlr.2023.100456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/16/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023] Open
Abstract
Compared with WT mice, HDL receptor-deficient (Scarb1-/-) mice have higher plasma levels of free cholesterol (FC)-rich HDL and exhibit multiple pathologies associated with a high mol% FC in ovaries, platelets, and erythrocytes, which are reversed by lowering HDL. Bacterial serum opacity factor (SOF) catalyzes the opacification of plasma by targeting and quantitatively converting HDL to neo HDL (HDL remnant), a cholesterol ester-rich microemulsion, and lipid-free APOA1. SOF delivery with an adeno-associated virus (AAVSOF) constitutively lowers plasma HDL-FC and reverses female infertility in Scarb1-/- mice in an HDL-dependent way. We tested whether AAVSOF delivery to Scarb1-/- mice will normalize erythrocyte morphology in an HDL-FC-dependent way. We determined erythrocyte morphology and FC content (mol%) in three groups-WT, untreated Scarb1-/- (control), and Scarb1-/- mice receiving AAVSOF-and correlated these with their respective HDL-mol% FC. Plasma-, HDL-, and tissue-lipid compositions were also determined. Plasma- and HDL-mol% FC positively correlated across all groups. Among Scarb1-/- mice, AAVSOF treatment normalized reticulocyte number, erythrocyte morphology, and erythrocyte-mol% FC. Erythrocyte-mol% FC positively correlated with HDL-mol% FC and with both the number of reticulocytes and abnormal erythrocytes. AAVSOF treatment also reduced FC of extravascular tissues to a lesser extent. HDL-FC spontaneously transfers from plasma HDL to cell membranes. AAVSOF treatment lowers erythrocyte-FC and normalizes erythrocyte morphology and lipid composition by reducing HDL-mol% FC.
Collapse
Affiliation(s)
- Ziyi Wang
- Center for Bioenergetics, Houston Methodist, Houston, TX, USA; Departments of Endocrinology and Xiangya Hospital, Central South University, Changsha, China
| | | | - Jing Liu
- Center for Bioenergetics, Houston Methodist, Houston, TX, USA; Departments of Endocrinology and Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Antonio M Gotto
- Center for Bioenergetics, Houston Methodist, Houston, TX, USA; Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Corina Rosales
- Center for Bioenergetics, Houston Methodist, Houston, TX, USA; Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Baiba K Gillard
- Center for Bioenergetics, Houston Methodist, Houston, TX, USA; Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Henry J Pownall
- Center for Bioenergetics, Houston Methodist, Houston, TX, USA; Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
| |
Collapse
|
3
|
Stroes ESG, Bays HE, Banach M, Catapano AL, Duell PB, Laufs U, Mancini GBJ, Ray KK, Sasiela WJ, Zhang Y, Gotto AM. Bempedoic acid lowers high-sensitivity C-reactive protein and low-density lipoprotein cholesterol: Analysis of pooled data from four phase 3 clinical trials. Atherosclerosis 2023; 373:1-9. [PMID: 37075696 DOI: 10.1016/j.atherosclerosis.2023.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND AND AIMS High-sensitivity C-reactive protein (hsCRP), a marker for atherosclerotic cardiovascular disease risk, is reduced by bempedoic acid. We assessed the relationship between changes in low-density lipoprotein cholesterol (LDL-C) and hsCRP in relation to baseline statin use. METHODS Pooled data from four phase 3 trials (patients on maximally tolerated statins [Pool 1] and patients receiving no or low-dose statins [Pool 2]) were used to determine the proportion of patients with baseline hsCRP ≥2 mg/L who achieved hsCRP <2 mg/L at week 12. The percentage of patients who achieved hsCRP <2 mg/L and guideline-recommended LDL-C (Pool 1, <70 mg/dL; Pool 2, <100 mg/dL) was determined for patients on statins in Pool 1 and those not on statins in Pool 2, as was the correlation between percent changes in hsCRP and LDL-C. RESULTS Overall, 38.7% in Pool 1 and 40.7% in Pool 2 with baseline hsCRP ≥2 mg/L achieved hsCRP <2 mg/L with bempedoic acid, with little effect from background statin. Among patients taking a statin in Pool 1 or not taking a statin in Pool 2, 68.6% and 62.4% achieved hsCRP <2 mg/L. Both hsCRP <2 mg/L and United States guideline-recommended LDL-C were achieved more often with bempedoic acid vs. placebo (20.8% vs. 4.3%, respectively, in Pool 1 and 32.0% vs. 5.3%, in Pool 2). Changes in hsCRP and LDL-C were only weakly correlated (Pool 1, r = 0.112; Pool 2, r = 0.173). CONCLUSIONS Bempedoic acid significantly reduced hsCRP irrespective of background statin therapy; the effect was largely independent of LDL-C lowering.
Collapse
Affiliation(s)
- Erik S G Stroes
- Department of Vascular Medicine, Academic Medical Centre, Amsterdam, the Netherlands.
| | - Harold E Bays
- Louisville Metabolic and Atherosclerosis Research Center, Louisville, KY, USA
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Łódź and Polish Mother's Memorial Hospital Research Institute (PMMHRI), Łódź, Poland
| | | | - P Barton Duell
- Knight Cardiovascular Institute, School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Ulrich Laufs
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - G B John Mancini
- Division of Cardiology, Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kausik K Ray
- Imperial Centre for Cardiovascular Disease Prevention, Department of Primary Care and Public Health, Imperial College London, London, UK
| | | | - Yang Zhang
- Esperion Therapeutics, Inc, Ann Arbor, MI, USA
| | - Antonio M Gotto
- Houston Methodist Research Institute, Houston, TX, USA; Weill Cornell Medicine, New York, NY, USA
| |
Collapse
|
4
|
Buckler AJ, Gotto AM, Rajeev A, Nicolaou A, Sakamoto A, St Pierre S, Phillips M, Virmani R, Villines TC. Atherosclerosis risk classification with computed tomography angiography: A radiologic-pathologic validation study. Atherosclerosis 2023; 366:42-48. [PMID: 36481054 DOI: 10.1016/j.atherosclerosis.2022.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/28/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS The application of machine learning to assess plaque risk phenotypes on cardiovascular CT angiography (CTA) is an area of active investigation. Studies using accepted histologic definitions of plaque risk as ground truth for machine learning models are uncommon. The aim was to evaluate the accuracy of a machine-learning software for determining plaque risk phenotype as compared to expert pathologists (histologic ground truth). METHODS Sections of atherosclerotic plaques paired with CTA were prospectively collected from patients undergoing carotid endarterectomy at two centers. Specimens were annotated for lipid-rich necrotic core, calcification, matrix, and intraplaque hemorrhage at 2 mm spacing and classified as minimal disease, stable plaque, or unstable plaque according to a modified American Heart Association histological definition. Phenotype is determined in two steps: plaque morphology is delineated according to histological tissue definitions, followed by a machine learning classifier. The performance in derivation and validation cohorts for plaque risk categorization and stenosis was compared to histologic ground truth at each matched cross-section. RESULTS A total of 496 and 408 vessel cross-sections in the derivation and validation cohorts (from 30 and 23 patients, respectively). The software demonstrated excellent agreement in the validation cohort with histological ground truth plaque risk phenotypes with weighted kappa of 0.82 [0.78-0.86] and area under the receiver operating curve for correct identification of plaque type was 0.97 [0.96, 0.98], 0.95 [0.94, 0.97], 0.99 [0.99, 1.0] for unstable plaque, stable plaque, and minimal disease, respectively. Diameter stenosis correlated poorly to histologically defined plaque type; weighted kappa 0.25 in the validation cohort. CONCLUSIONS A machine-learning software trained on histological ground-truth tissue inputs demonstrated high accuracy for identifying plaque stability phenotypes as compared to expert pathologists.
Collapse
Affiliation(s)
- Andrew J Buckler
- Department of Molecular Medicine, Karolinska Institute, Stockholm, Sweden; Elucid Bioimaging Inc., Boston, MA, USA.
| | - Antonio M Gotto
- Weill Medical College of Cornell University, New York, NY, USA
| | | | | | | | | | | | - Renu Virmani
- Cardiovascular Pathology Institute, Gaithersburg, MD, USA
| | - Todd C Villines
- Elucid Bioimaging Inc., Boston, MA, USA; Cardiology Division, University of Virginia Health System, Charlottesville, VA, USA
| |
Collapse
|
5
|
Rosales C, Yelamanchili D, Gillard BK, Liu J, Gotto AM, Pownall HJ. Serum opacity factor rescues fertility among female Scarb1 -/- mice by reducing HDL-free cholesterol bioavailability. J Lipid Res 2023; 64:100327. [PMID: 36596339 PMCID: PMC9932678 DOI: 10.1016/j.jlr.2022.100327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/08/2022] [Accepted: 12/05/2022] [Indexed: 01/02/2023] Open
Abstract
Human female infertility, 20% of which is idiopathic, is a public health problem for which better diagnostics and therapeutics are needed. A novel cause of infertility emerged from studies of female mice deficient in the HDL receptor gene (Scarb1). These mice are infertile and have high plasma HDL cholesterol (C) concentrations, due to elevated HDL-free cholesterol (FC), which transfers from HDL to all tissues. Previous studies have indicated that oral delivery of probucol, an HDL-lowering drug, to female Scarb1-/- mice reduces plasma HDL-C concentrations and rescues fertility. Additionally, serum opacity factor (SOF), a bacterial virulence factor, disrupts HDL structure, and bolus SOF injection into mice reduces plasma HDL-C concentrations. Here, we discovered that delivering SOF to female Scarb1-/- mice with an adeno-associated virus (AAVSOF) induces constitutive SOF expression, reduces HDL-FC concentrations, and rescues fertility while normalizing ovary morphology. Although AAVSOF did not alter ovary-FC content, the ovary-mol% FC correlated with plasma HDL-mol% FC in a fertility-dependent way. Therefore, reversing the abnormal plasma microenvironment of high plasma HDL-mol% FC in female Scarb1-/- mice rescues fertility. These data provide the rationale to search for similar mechanistic links between HDL-mol% FC and infertility and the rescue of fertility in women by reducing plasma HDL-mol% FC.
Collapse
Affiliation(s)
- Corina Rosales
- Center for Bioenergetics and the Department of Medicine, Houston Methodist Research Institute, Houston, TX, USA; Weill Cornell Medicine, Department of Medicine, New York, NY, USA.
| | - Dedipya Yelamanchili
- Center for Bioenergetics and the Department of Medicine, Houston Methodist Research Institute, Houston, TX, USA
| | - Baiba K Gillard
- Center for Bioenergetics and the Department of Medicine, Houston Methodist Research Institute, Houston, TX, USA; Weill Cornell Medicine, Department of Medicine, New York, NY, USA
| | - Jing Liu
- Center for Bioenergetics and the Department of Medicine, Houston Methodist Research Institute, Houston, TX, USA
| | - Antonio M Gotto
- Weill Cornell Medicine, Department of Medicine, New York, NY, USA
| | - Henry J Pownall
- Center for Bioenergetics and the Department of Medicine, Houston Methodist Research Institute, Houston, TX, USA; Weill Cornell Medicine, Department of Medicine, New York, NY, USA
| |
Collapse
|
6
|
Yelamanchili D, Gillard BK, Gotto AM, Pownall HJ, Rosales C. Abstract 238: Serum Opacity Factor Normalizes Dysfunctional High Density Lipoproteins In Srbi -/- Female Mice And Rescues Fertility. Arterioscler Thromb Vasc Biol 2022. [DOI: 10.1161/atvb.42.suppl_1.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Although plasma HDL-C levels negatively correlate with atherosclerotic cardiovascular disease (ACVD), attempts to reduce ACVD risk by raising plasma HDL have disappointed. Thus, hypotheses about salutary HDL effects have shifted from higher-is-better to function-is-more-important. The SRBI-/- mouse is an extreme model of HDL dsyfunctionality; compared to WT mice, SRB1-/- mice have higher plasma HDL levels and an HDL surface that is free cholesterol (FC)-rich (60 vs. 15 mol%). This would be expected to increase HDL-FC bioavailability to cytotoxic levels. HDL dysfunctionality among SRB1-/- mice is associated with multiple metabolic abnormalities—impaired cell membrane structure and function and atherosusceptibility, despite having high plasma HDL-C levels, and infertility among female SRB1-/- mice. Dietary probucol, an HDL-lowering drug, partially reverses infertility in SR-B1-/- mice. The mechanisms underlying ovaritoxicity is not known and interventions that fully reverse this state has not been identified. We hypothesized that a bacterial protein, serum opacity factor (SOF), which acts on HDL and lowers cholesterol in WT mice by 43% in 3 hours, would normalize HDL functionality and rescue infertility in SRBI-/- female mice. SOF DNA was cloned into a TBG-AAV8 plasmid and virus produced by UPENN Vector Lab. The AAV-SOF was delivered by IP injection leading to the endogenous expression of SOF. Probucol-fed and AAV-GFP mice were used as controls. SOF expression drastically decreased plasma cholesterol and normalized the size of HDL in SRBI-/- females comparable to that of WT mice. Fertility was restored in female mice injected with SOF while GFP controls remained infertile. Compared to Probucol-fed mice, AAV-SOF females had a higher percentage of fertile females and shorter time to first litter drop. We concluded that SOF performed equally or better than probucol in rescuing fertility and normalizing HDL.
Collapse
|
7
|
Leiter LA, Banach M, Catapano AL, Duell PB, Gotto AM, Laufs U, Mancini GBJ, Ray KK, Hanselman JC, Ye Z, Bays HE. Bempedoic acid in patients with type 2 diabetes mellitus, prediabetes, and normoglycaemia: A post hoc analysis of efficacy and glycaemic control using pooled data from phase 3 clinical trials. Diabetes Obes Metab 2022; 24:868-880. [PMID: 34981622 PMCID: PMC9306638 DOI: 10.1111/dom.14645] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/22/2021] [Accepted: 01/01/2022] [Indexed: 12/30/2022]
Abstract
AIM To evaluate the effect of bempedoic acid on glycaemic and lipid variables in patients with hypercholesterolaemia. METHODS A patient-level pooled analysis of four phase 3, randomized, double-blind, placebo-controlled trials evaluated changes in glycaemia, change from baseline in LDL-C, and adverse events. Patients (N = 3621) on maximally tolerated statins were randomized 2:1 to oral bempedoic acid 180 mg or placebo once daily for 12 to 52 weeks with the results analysed by baseline glycaemic status (diabetes, prediabetes, or normoglycaemia). RESULTS The annual rate of new-onset diabetes for bempedoic acid versus placebo in patients with normoglycaemia at baseline (n = 618) was 0.3% versus 0.8%, and for patients with prediabetes at baseline (n = 1868) it was 4.7% versus 5.9%. In patients with diabetes or prediabetes, bempedoic acid significantly (P < .0001) reduced HbA1c by -0.12% and -0.06%, respectively, and did not worsen fasting glucose versus placebo. Bempedoic acid significantly and consistently lowered LDL-C levels versus placebo, regardless of baseline glycaemic status (placebo-corrected difference range, -17.2% to -29.6%; P < .001 for each stratum). The safety of bempedoic acid was comparable with placebo and similar across glycaemic strata. CONCLUSIONS Bempedoic acid significantly lowered LDL-C across glycaemic strata and did not worsen glycaemic variables or increase the incidence of new-onset diabetes versus placebo over a median follow-up of 1 year.
Collapse
Affiliation(s)
- Lawrence A. Leiter
- Li Ka Shing Knowledge Institute, St. Michael's HospitalUniversity of TorontoTorontoOntarioCanada
| | | | | | | | | | | | | | | | | | - Zhan Ye
- Esperion Therapeutics Inc.Ann ArborMichiganUSA
| | - Harold E. Bays
- Louisville Metabolic and Atherosclerosis Research CenterLouisvilleKentuckyUSA
| |
Collapse
|
8
|
Gillard BK, Wang Z, Liu J, Yelamanchili D, Gotto AM, Rosales C, Pownall HJ. Abstract 499: Serum Opacity Factor Therapy Alters Plasma, Erythrocyte And Tissue Cholesterol Content In The Dysfunctional High Density Lipoprotein Scarb1
-/-
Mouse Model. Arterioscler Thromb Vasc Biol 2022. [DOI: 10.1161/atvb.42.suppl_1.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Aim:
In humans, very high plasma HDL-cholesterol concentrations are associated with increased all cause- and atherosclerotic cardiovascular disease (ASCVD)-mortality. The HDL receptor-deficient mouse (Scarb1
-/-
) is a robust model of this phenotype having high free cholesterol (FC) bioavailability due to too many FC-rich HDL particles. Clinically, plasma LDL and HDL are quantified according to total cholesterol = FC + cholesteryl esters (CE), which likely contribute to ASCVD pathophysiology differently. Despite higher HDL, Scarb1
-/-
mice have more ASCVD on a Western diet, and increased mol% FC in ovaries, erythrocytes, heart, lung, female liver and macrophages, tissues that are associated with female infertility, impaired cell maturation, cardiac dysfunction and atherosclerosis. Bacterial serum opacity factor (SOF) reduces plasma cholesterol ~ 40% by diverting HDL-cholesterol to the hepatic LDLR.
Hypothesis:
Adeno-associated virus delivery of SOF (AAV
SOF
) normalizes plasma and tissue FC accretion and reverses the pathologies associated with Scarb1
-/-
mice.
Methods:
The lipid compositions of plasma, HDL, erythrocytes, and tissues of Scarb1
-/-
mice treated with AAV
SOF
at 12-13 weeks of age for three weeks were compared with age- and sex-matched wild type (WT) C57BL6 and Scarb1
-/-
mice.
Results:
As hypothesized, AAV
SOF
reduced plasma and HDL-FC and CE, as well as mol% FC in Scarb1
-/-
mice towards WT levels. Erythrocyte FC levels also fell, but mol% FC remained elevated. Some changes were sex-specific: AAV
SOF
reduced the elevated FC only in female livers to WT levels. AAV
SOF
reduced FC and CE in lungs of females to WT levels, but not among males; the mol% FC remained high in both sexes. In steroidogenic tissues, adrenals, ovaries and testis, AAV
SOF
treatment increased FC. Unexpectedly, in Scarb1
-/-
mice, AAV
SOF
increased mol% FC and FC in heart beyond already elevated levels.
Conclusions:
These findings support the hypothesis that plasma and HDL cholesterol levels determine tissue cholesterol levels that drive the pathologies specific to Scarb1
-/-
mice. This evolving model of the role of HDL-FC in RCT provides a rationale for human studies to determine the utility of HDL-FC bioavailability as a risk factor for ASCVD and other pathologies.
Collapse
Affiliation(s)
| | - Ziyi Wang
- Dept of Endocrinology, Xiangya Hosp, Central South Univ, Changsha, China
| | - Jing Liu
- The First Affiliated Hosp College of Medicine Dept of Cardiovascular Surgery, Hangzhou, China
| | | | | | | | | |
Collapse
|
9
|
Gotto AM, Olsson AG. Professor Jeremiah Stamler (1919-2022), "Father of Preventive Cardiology". Atherosclerosis 2022; 346:S0021-9150(22)00110-1. [PMID: 35292152 DOI: 10.1016/j.atherosclerosis.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
| | - Anders G Olsson
- Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine, Linköping University, Sweden.
| |
Collapse
|
10
|
Laufs U, Ballantyne CM, Banach M, Bays H, Catapano AL, Duell PB, Goldberg AC, Gotto AM, Leiter LA, Ray KK, Bloedon LT, MacDougall D, Zhang Y, Mancini GBJ. Efficacy and safety of bempedoic acid in patients not receiving statins in phase 3 clinical trials. J Clin Lipidol 2022; 16:286-297. [DOI: 10.1016/j.jacl.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/18/2022] [Accepted: 03/07/2022] [Indexed: 02/03/2023]
|
11
|
Liu J, Gillard BK, Yelamanchili D, Gotto AM, Rosales C, Pownall HJ. High Free Cholesterol Bioavailability Drives the Tissue Pathologies in Scarb1 -/- Mice. Arterioscler Thromb Vasc Biol 2021; 41:e453-e467. [PMID: 34380332 PMCID: PMC8458258 DOI: 10.1161/atvbaha.121.316535] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Overall and atherosclerosis-associated mortality is elevated in humans with very high HDL (high-density lipoprotein) cholesterol concentrations. Mice with a deficiency of the HDL receptor, Scarb1 (scavenger receptor class B type 1), are a robust model of this phenotype and exhibit several additional pathologies. We hypothesized that the previously reported high plasma concentration of free cholesterol (FC)-rich HDL in Scarb1-/- mice produces a state of high HDL-FC bioavailability that increases whole-body FC and dysfunction in multiple tissue sites. Approach and Results: The higher mol% FC in Scarb1-/- versus WT (wild type) HDL (41.1 versus 16.0 mol%) affords greater FC bioavailability for transfer to multiple sites. Plasma clearance of autologous HDL-FC mass was faster in WT versus Scarb1-/- mice. FC influx from Scarb1-/- HDL to LDL (low-density lipoprotein) and J774 macrophages was greater ([almost equal to]4x) than that from WT HDL, whereas FC efflux capacity was similar. The higher mol% FC of ovaries, erythrocytes, heart, and macrophages of Scarb1-/- versus WT mice is associated with previously reported female infertility, impaired cell maturation, cardiac dysfunction, and atherosclerosis. The FC contents of other tissues were similar in the two genotypes, and these tissues were not associated with any overt pathology. In addition to the differences between WT versus Scarb1-/- mice, there were many sex-dependent differences in tissue-lipid composition and plasma FC clearance rates. Conclusions: Higher HDL-FC bioavailability among Scarb1-/- versus WT mice drives increased FC content of multiple cell sites and is a potential biomarker that is mechanistically linked to multiple pathologies.
Collapse
Affiliation(s)
- Jing Liu
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha 410008, China
- Center for Bioenergetics, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston TX 77030, USA
| | - Baiba K. Gillard
- Center for Bioenergetics, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston TX 77030, USA
- Department of Medicine, Weill Cornell Medicine, 1300 York Ave, New York, NY, 10065, USA
| | - Dedipya Yelamanchili
- Center for Bioenergetics, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston TX 77030, USA
| | - Antonio M. Gotto
- Center for Bioenergetics, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston TX 77030, USA
- Department of Medicine, Weill Cornell Medicine, 1300 York Ave, New York, NY, 10065, USA
| | - Corina Rosales
- Center for Bioenergetics, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston TX 77030, USA
- Department of Medicine, Weill Cornell Medicine, 1300 York Ave, New York, NY, 10065, USA
| | - Henry J. Pownall
- Center for Bioenergetics, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston TX 77030, USA
- Department of Medicine, Weill Cornell Medicine, 1300 York Ave, New York, NY, 10065, USA
| |
Collapse
|
12
|
Gotto AM. In memoriam of Rodolfo Paoletti a tribute to a friend. J Clin Lipidol 2021. [DOI: 10.1016/j.jacl.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
13
|
Liu J, Gillard BK, Yelamanchili D, Wang Z, Gotto AM, Rosales C, Pownall HJ. Abstract MP30: Excess HDL Free Cholesterol Bioavailability Drives Free Cholesterol Accretion Into Macrophages And Erythrocytes In Scarb1
-/-
Mice. Arterioscler Thromb Vasc Biol 2021. [DOI: 10.1161/atvb.41.suppl_1.mp30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim:
In humans, very high plasma HDL-cholesterol concentrations are associated with increased all cause- and atherosclerotic cardiovascular disease (ASCVD)-mortality. The HDL receptor-deficient mouse (Scarb1
-/-
), a robust model of this phenotype, is characterized by high free cholesterol (FC) bioavailability due to too many HDL particles that are FC-rich. Clinically, plasma LDL and HDL are quantified according to total cholesterol content, the sum of FC and esterified cholesterol, which likely contribute to ASCVD pathophysiology differently. A Western diet induces ASCVD in Scarb1
-/-
mice, despite an attendant increase in HDL. We tested the hypothesis that high HDL-FC bioavailability contributes to ASCVD in Scarb1
-/-
mice by increasing FC flux into macrophage cells, erythrocytes and other major tissues.
Methods:
Influx of HDL-FC and efflux of macrophage FC were determined between WT and Scarb1
-/-
HDL and J774 macrophage cells. HDL of both genotypes were radiolabelled with [
3
H]FC, injected into autologous mice, and the rates of plasma clearance and erythrocyte uptake were determined.
Results:
The magnitude of FC transfer from Scarb1
-/-
HDL to LDL is greater than that from WT HDL; APOB-containing lipoproteins from Scarb1
-/-
vs. WT mice are FC-enriched due likely to greater HDL-FC transfer. While macrophage efflux to HDL of Scarb1
-/-
vs. WT HDL was not different, FC influx from Scarb1
-/-
vs. WT HDL to macrophages was three-fold greater, a net effect that increased the FC burden of macrophages. In vivo studies showed that compared to WT mice, in Scarb1
-/-
mice, autologous HDL-FC cleared more slowly and more FC transferred to erythrocytes. We compared the FC, CE, PL, and TG contents of all major tissues and determined that FC accretion by some tissues is higher among Scarb1
-/-
vs. WT mice whereas in other tissues FC homeostasis is maintained. Lastly, we determined that the tissue compositions and plasma FC clearance kinetics varied according to sex, particularly among Scarb1
-/-
mice.
Conclusions:
These findings are relevant to pathologies specific to Scarb1
-/-
mice and to the evolving model of the role of HDL-FC in RCT. They provide a rationale for human studies to determine the utility of HDL-FC bioavailability as a risk factor for ASCVD and other pathologies.
Collapse
Affiliation(s)
- Jing Liu
- Houston Methodist Rsch Institute, Houston, TX
| | | | | | - Ziyi Wang
- Houston Methodist Rsch Institute, Houston, TX
| | | | | | | |
Collapse
|
14
|
Banach M, Duell PB, Gotto AM, Laufs U, Leiter LA, Mancini GBJ, Ray KK, Flaim J, Ye Z, Catapano AL. Association of Bempedoic Acid Administration With Atherogenic Lipid Levels in Phase 3 Randomized Clinical Trials of Patients With Hypercholesterolemia. JAMA Cardiol 2020; 5:1124-1135. [PMID: 32609313 PMCID: PMC7330832 DOI: 10.1001/jamacardio.2020.2314] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Question Does an association exist between the administration of bempedoic acid and decreased levels of low-density lipoprotein cholesterol in patients with hypercholesterolemia? Findings In this pooled analysis of 3623 patients included in 4 pivotal randomized clinical trials, bempedoic acid administration was associated with decreased mean low-density lipoprotein cholesterol levels by 18% vs placebo when added to maximally tolerated statin therapy in patients with atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia or both and by 24% vs placebo in patients with a history of statin intolerance. Increased uric acid levels and gout occurred more frequently among patients treated with bempedoic acid than with placebo. Meaning Treatment with bempedoic acid was associated with decreased levels of low-density lipoprotein cholesterol in patients with hypercholesterolemia when added to background statin therapy and in patients with a history of statin intolerance. Importance Additional lipid-lowering therapy options are needed for patients who cannot achieve sufficient decreases in low-density lipoprotein cholesterol (LDL-C) levels using statins alone or for those who are statin intolerant. Objective To conduct a pooled analysis of phase 3 randomized clinical trials of bempedoic acid vs placebo. Design, Setting, and Participants This analysis pooled data from 4 double-blind, placebo-controlled randomized clinical trials conducted from 2016 to 2018. Patients were enrolled in North America and Europe. Eligibility criteria included hypercholesterolemia while receiving stable lipid-lowering therapy and high cardiovascular risk or hypercholesterolemia and statin intolerance. Interventions Patients were randomized 2:1 to bempedoic acid, 180 mg (n = 2425), or placebo (n = 1198) once daily for 12 to 52 weeks. Main Outcomes and Measures Primary efficacy end point was percentage change from baseline in LDL-C level at week 12 in the intention-to-treat population. Patients were parsed into 2 groups according to enrollment criteria: (1) patients with hypercholesterolemia and atherosclerotic cardiovascular disease (ASCVD) or with heterozygous familial hypercholesterolemia (HeFH) or with both and receiving statins and (2) patients with hypercholesterolemia who were statin intolerant receiving maximally tolerated statins. Results In this analysis of 3623 patients, the overall mean (SD) patient age was 65.5 (9.2) years (similar in both pools). Among patients with ASCVD or HeFH or both, the mean (SD) baseline LDL-C level was 107.6 (32.7) mg/dL. At week 12, the LDL-C level percentage change from baseline was −16.0% with bempedoic acid vs 1.8% with placebo (difference, −17.8%; 95% CI, −19.5% to −16.0%; P < .001). Patients with statin intolerance had a mean (SD) baseline LDL-C level of 144.4 (38.8) mg/dL. The percentage changes in LDL-C levels at week 12 were −23.0% in the bempedoic acid group and 1.5% in the placebo group (difference, −24.5%; 95% CI, −27.8% to −21.1%; P < .001). The decrease in LDL-C levels with bempedoic acid was sustained during long-term follow-up in both pools (patients with ASCVD or HeFH or both receiving a maximally tolerated statin, difference of −12.7% at week 52; patients with statin intolerance, difference of −22.2% at week 24). Decreases in non–high-density lipoprotein cholesterol, total cholesterol, apolipoprotein B, and high-sensitivity C-reactive protein levels were greater with bempedoic acid vs placebo. Treatment-emergent adverse events associated more frequently with bempedoic acid than with placebo included increased blood uric acid level (2.1% vs 0.5%), gout (1.4% vs 0.4%), decreased glomerular filtration rate (0.7% vs <0.1%), and increased levels of hepatic enzymes (2.8% vs 1.3%). Conclusions and Relevance Bempedoic acid added to maximally tolerated statins, including moderate- or high-intensity statins or no background statin, was associated with decreased LDL-C levels vs placebo in patients with hypercholesterolemia with an acceptable safety profile. As a nonstatin adjunct or statin alternative, bempedoic acid has potential for use in a broad spectrum of patients. Trial Registration ClinicalTrials.gov Identifiers: NCT02666664, NCT02991118, NCT03001076, and NCT02988115
Collapse
Affiliation(s)
- Maciej Banach
- Department of Hypertension, Medical University of Łódź, Łódź, Poland.,Polish Mother's Memorial Hospital Research Institute, Łódź, Poland
| | - P Barton Duell
- Knight Cardiovascular Institute, School of Medicine, Oregon Health & Science University, Portland
| | - Antonio M Gotto
- Cardiovascular Unit, Weill Cornell Medical College, New York, New York
| | - Ulrich Laufs
- Clinic and Polyclinic for Cardiology, Leipzig University, Leipzig, Germany
| | - Lawrence A Leiter
- Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - G B John Mancini
- Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, Canada
| | - Kausik K Ray
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - JoAnn Flaim
- Esperion Therapeutics Inc, Ann Arbor, Michigan
| | - Zhan Ye
- Esperion Therapeutics Inc, Ann Arbor, Michigan
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan and IRCCS Multimedica, Milan, Italy
| |
Collapse
|
15
|
Singh G, Hussain Y, Xu Z, Sholle E, Michalak K, Dolan K, Lee BC, van Rosendael AR, Fatima Z, Peña JM, Wilson PWF, Gotto AM, Shaw LJ, Baskaran L, Al'Aref SJ. Comparing a novel machine learning method to the Friedewald formula and Martin-Hopkins equation for low-density lipoprotein estimation. PLoS One 2020; 15:e0239934. [PMID: 32997716 PMCID: PMC7526877 DOI: 10.1371/journal.pone.0239934] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022] Open
Abstract
Background Low-density lipoprotein cholesterol (LDL-C) is a target for cardiovascular prevention. Contemporary equations for LDL-C estimation have limited accuracy in certain scenarios (high triglycerides [TG], very low LDL-C). Objectives We derived a novel method for LDL-C estimation from the standard lipid profile using a machine learning (ML) approach utilizing random forests (the Weill Cornell model). We compared its correlation to direct LDL-C with the Friedewald and Martin-Hopkins equations for LDL-C estimation. Methods The study cohort comprised a convenience sample of standard lipid profile measurements (with the directly measured components of total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], and TG) as well as chemical-based direct LDL-C performed on the same day at the New York-Presbyterian Hospital/Weill Cornell Medicine (NYP-WCM). Subsequently, an ML algorithm was used to construct a model for LDL-C estimation. Results are reported on the held-out test set, with correlation coefficients and absolute residuals used to assess model performance. Results Between 2005 and 2019, there were 17,500 lipid profiles performed on 10,936 unique individuals (4,456 females; 40.8%) aged 1 to 103. Correlation coefficients between estimated and measured LDL-C values were 0.982 for the Weill Cornell model, compared to 0.950 for Friedewald and 0.962 for the Martin-Hopkins method. The Weill Cornell model was consistently better across subgroups stratified by LDL-C and TG values, including TG >500 and LDL-C <70. Conclusions An ML model was found to have a better correlation with direct LDL-C than either the Friedewald formula or Martin-Hopkins equation, including in the setting of elevated TG and very low LDL-C.
Collapse
Affiliation(s)
- Gurpreet Singh
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | - Yasin Hussain
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Zhuoran Xu
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | - Evan Sholle
- Information Technologies & Services Department, Weill Cornell Medicine, New York, New York, United States of America
| | - Kelly Michalak
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | - Kristina Dolan
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | - Benjamin C Lee
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | | | - Zahra Fatima
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | - Jessica M Peña
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | - Peter W F Wilson
- Emory Clinical Cardiovascular Research Institute, Emory University, Atlanta, Georgia, United States of America
| | - Antonio M Gotto
- Weill Cornell Medicine, New York, New York, United States of America
| | - Leslee J Shaw
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| | - Lohendran Baskaran
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America.,Department of Cardiovascular Medicine, National Heart Centre, Singapore, Singapore
| | - Subhi J Al'Aref
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine, New York, New York, United States of America
| |
Collapse
|
16
|
Yelamanchili D, Liu J, Gotto AM, Hurley AE, Lagor WR, Gillard BK, Davidson WS, Pownall HJ, Rosales C. Highly conserved amino acid residues in apolipoprotein A1 discordantly induce high density lipoprotein assembly in vitro and in vivo. Biochim Biophys Acta Mol Cell Biol Lipids 2020; 1865:158794. [PMID: 32810603 DOI: 10.1016/j.bbalip.2020.158794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Apolipoprotein A1 (APOA1) is essential to reverse cholesterol transport, a physiologically important process that protects against atherosclerotic cardiovascular disease. APOA1 is a 28 kDa protein comprising multiple lipid-binding amphiphatic helices initialized by proline residues, which are conserved across multiple species. We tested the hypothesis that the evolutionarily conserved residues are essential to high density lipoprotein (HDL) function. APPROACH We used biophysical and physiological assays of the function of APOA1P➔A variants, i.e., rHDL formation via dimyristoylphosphatidylcholine (DMPC) microsolubilization, activation of lecithin: cholesterol acyltransferase, cholesterol efflux from human monocyte-derived macrophages (THP-1) to each variant, and comparison of the size and composition of HDL from APOA1-/- mice receiving adeno-associated virus delivery of each human variant. RESULTS Differences in microsolubilization were profound and showed that conserved prolines, especially those in the C-terminus of APOA1, are essential to efficient rHDL formation. In contrast, P➔A substitutions produced small changes (-25 to +25%) in rates of cholesterol efflux and no differences in the rates of LCAT activation. The HDL particles formed following ectopic expression of each variant in APOA1-/- mice were smaller and more heterogeneous than those from control animals. CONCLUSION Studies of DMPC microsolubilization show that proline residues are essential to the optimal interaction of APOA1 with membranes, the initial step in cholesterol efflux and HDL production. In contrast, P➔A substitutions modestly reduce the cholesterol efflux capacity of APOA1, have no effect on LCAT activation, but according to the profound reduction in the size of HDL formed in vivo, P➔A substitutions alter HDL biogenesis, thereby implicating other cellular and in vivo processes as determinants of HDL metabolism and function.
Collapse
Affiliation(s)
- Dedipya Yelamanchili
- Center for Bioenergetics, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA.
| | - Jing Liu
- Center for Bioenergetics, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA; Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
| | - Antonio M Gotto
- Center for Bioenergetics, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA; Weill Cornell Medicine, 1305 York Avenue, New York, NY 10065, USA.
| | - Ayrea E Hurley
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
| | - Willam R Lagor
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
| | - Baiba K Gillard
- Center for Bioenergetics, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA; Weill Cornell Medicine, 1305 York Avenue, New York, NY 10065, USA.
| | - W Sean Davidson
- Department of Pathology and Laboratory Medicine, University of Cincinnati, Cincinnati, OH 45237, USA.
| | - Henry J Pownall
- Center for Bioenergetics, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA; Weill Cornell Medicine, 1305 York Avenue, New York, NY 10065, USA.
| | - Corina Rosales
- Center for Bioenergetics, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA; Weill Cornell Medicine, 1305 York Avenue, New York, NY 10065, USA.
| |
Collapse
|
17
|
Rosales C, Gillard BK, Gotto AM, Pownall HJ. The Alcohol-High-Density Lipoprotein Athero-Protective Axis. Biomolecules 2020; 10:E987. [PMID: 32630283 PMCID: PMC7408510 DOI: 10.3390/biom10070987] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 01/22/2023] Open
Abstract
Ingestion of alcohol is associated with numerous changes in human energy metabolism, especially that of plasma lipids and lipoproteins. Regular moderate alcohol consumption is associated with reduced atherosclerotic cardiovascular disease (ASCVD), an effect that has been attributed to the concurrent elevations of plasma high-density lipoprotein-cholesterol (HDL-C) concentrations. More recent evidence has accrued against the hypothesis that raising plasma HDL concentrations prevents ASCVD so that other metabolic processes associated with alcohol consumption have been considered. This review explored the roles of other metabolites induced by alcohol consumption-triglyceride-rich lipoproteins, non-esterified free fatty acids, and acetate, the terminal alcohol metabolite in athero-protection: Current evidence suggests that acetate has a key role in athero-protection but additional studies are needed.
Collapse
Affiliation(s)
| | | | | | - Henry J. Pownall
- Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA; (C.R.); (B.K.G.); (A.M.G.J.)
| |
Collapse
|
18
|
Momtazi-Borojeni AA, Sabouri-Rad S, Gotto AM, Pirro M, Banach M, Awan Z, Barreto GE, Sahebkar A. PCSK9 and inflammation: a review of experimental and clinical evidence. Eur Heart J Cardiovasc Pharmacother 2020; 5:237-245. [PMID: 31236571 DOI: 10.1093/ehjcvp/pvz022] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/28/2019] [Accepted: 06/20/2019] [Indexed: 12/13/2022]
Abstract
Proprotein convertase subtilisin/kexin Type 9 (PCSK9) is now identified as an important and major player in hypercholesterolaemia and atherosclerosis pathophysiology. PCSK9, through promoting lysosomal degradation of hepatic low-density lipoprotein (LDL) receptor, can decrease the clearance of plasma LDLs, leading to hypercholesterolaemia and consequent atherosclerotic plaque formation. Hypercholesterolaemia has been found to promote systemic and vascular inflammation, which can cause atherosclerotic lesion formation and progression and subsequent incidence of cardiovascular disease. Recent studies have shown the involvement of PCSK9 in the inflammatory pathway of atherosclerosis. Although trials with PCSK9 inhibitors have not shown any alteration in plasma C-reactive protein levels, there is accumulating evidence showing lessened inflammatory response in the arterial wall that could attenuate atherosclerotic plaque development beyond the established LDL-lowering effect of PCSK9 inhibition. In this review, we represent mounting evidence indicating that PCSK9 can locally increase vascular inflammation and contribute to atherosclerotic plaque progression in patients with hypercholesterolaemia.
Collapse
Affiliation(s)
- Amir Abbas Momtazi-Borojeni
- Nanotechnology Research Center, Bu-Ali Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biotechnology, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | - Matteo Pirro
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Zeromskiego 113, Lodz, Poland.,Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Zuhier Awan
- Department of Clinical Biochemistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - George E Barreto
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.,Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
19
|
Wipperman MF, Montrose DC, Gotto AM, Hajjar DP. Mammalian Target of Rapamycin: A Metabolic Rheostat for Regulating Adipose Tissue Function and Cardiovascular Health. Am J Pathol 2019; 189:492-501. [PMID: 30803496 DOI: 10.1016/j.ajpath.2018.11.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 11/03/2018] [Accepted: 11/28/2018] [Indexed: 12/31/2022]
Abstract
The complex relationship between diet and metabolism is an important contributor to cellular metabolism and health. Over the past few decades, a central role for mammalian target of rapamycin (mTOR) in the regulation of multiple cellular processes, including the response to food intake, maintaining homeostasis, and the pathogenesis of disease, has been shown. Herein, we first review our current understanding of the biochemical functions of mTOR and its response to fluctuations in hormone levels, like insulin. Second, we highlight the role of mTOR in lipogenesis, adipogenesis, β-oxidation of lipids, and ketosis of carbohydrates, lipids, and proteins. Special attention is paid to recent advances in mTOR signaling in white versus brown adipose tissues. Finally, we review how mTOR regulates cardiovascular health and disease. Together, these insights define a clearer picture of the connection between mTOR signaling, metabolic health, and disease.
Collapse
Affiliation(s)
- Matthew F Wipperman
- Immunology Program, Memorial Sloan Kettering Cancer Center, New York; Clinical and Translational Science Center, Weill Cornell Medicine, Cornell University, New York
| | - David C Montrose
- Department of Pathology, Stony Brook Medicine, Stony Brook, New York
| | - Antonio M Gotto
- Department of Medicine, Weill Cornell Medicine, Cornell University, New York
| | - David P Hajjar
- Department of Pathology and Biochemistry, Weill Cornell Medicine, Cornell University, New York.
| |
Collapse
|
20
|
|
21
|
Rosales C, Gillard BK, Xu B, Gotto AM, Pownall HJ. Revisiting Reverse Cholesterol Transport in the Context of High-Density Lipoprotein Free Cholesterol Bioavailability. Methodist Debakey Cardiovasc J 2019; 15:47-54. [PMID: 31049149 DOI: 10.14797/mdcj-15-1-47] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Dysregulated free cholesterol (FC) metabolism has been implicated in nearly all stages of atherosclerosis, the underlying cause of most cardiovascular disease. According to a widely cited model, the burden of macrophage FC in the arterial wall is relieved by transhepatic reverse cholesterol transport (RCT), which comprises three successive steps: (1) macrophage FC efflux to high-density lipoprotein (HDL) and/or its major protein, apolipoprotein AI; (2) FC esterification by lecithin:cholesterol acyltransferase (LCAT); and (3) HDL-cholesteryl ester (CE) uptake via the hepatic HDL-receptor, scavenger receptor class B type 1 (SR-B1). Recent studies have challenged the validity of this model, most notably the role of LCAT, which appears to be of minor importance. In mice, most macrophage-derived FC is rapidly cleared from plasma (t1/2 < 5 min) without esterification by hepatic uptake; the remainder is taken up by multiple tissue and cell types, especially erythrocytes. Further, some FC is cleared by the nonhepatic transintestinal pathway. Lastly, FC movement among lipid surfaces is reversible, so that a higher-than-normal level of HDL-FC bioavailability-defined by high plasma HDL levels concurrent with a high mol% HDL-FC-leads to the transfer of excess FC to cells in vivo. SR-B1-/- mice provide an animal model to study the mechanistic consequences of high HDL-FC bioavailability that provokes atherosclerosis and other metabolic abnormalities. Future efforts should aim to reduce HDL-FC bioavailability, thereby reducing FC accretion by tissues and the attendant atherosclerosis.
Collapse
Affiliation(s)
- Corina Rosales
- HOUSTON METHODIST RESEARCH INSTITUTE, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS.,WEILL CORNELL MEDICINE, NEW YORK, NEW YORK
| | - Baiba K Gillard
- HOUSTON METHODIST RESEARCH INSTITUTE, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS.,WEILL CORNELL MEDICINE, NEW YORK, NEW YORK
| | - Bingqing Xu
- XIANGYA HOSPITAL, CENTRAL SOUTH UNIVERSITY, CHANGSHA, CHINA
| | - Antonio M Gotto
- HOUSTON METHODIST RESEARCH INSTITUTE, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS.,WEILL CORNELL MEDICINE, NEW YORK, NEW YORK
| | - Henry J Pownall
- HOUSTON METHODIST RESEARCH INSTITUTE, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS.,WEILL CORNELL MEDICINE, NEW YORK, NEW YORK
| |
Collapse
|
22
|
Affiliation(s)
- Henry J Pownall
- HOUSTON METHODIST RESEARCH INSTITUTE, HOUSTON, TEXAS; WEILL CORNELL MEDICINE, NEW YORK, NEW YORK
| | - Antonio M Gotto
- HOUSTON METHODIST RESEARCH INSTITUTE, HOUSTON, TEXAS; WEILL CORNELL MEDICINE, NEW YORK, NEW YORK
| |
Collapse
|
23
|
Abstract
Given its role in many biochemical processes essential to life, cholesterol remains a topic of intense research. Of all the plasma lipids, cholesterol is distinctive because it is a precursor to steroidogenic molecules, some of which regulate metabolism, and its blood concentration in the form of low- and high-density lipoprotein cholesterol (HDL-C) are positive and negative risk factors for atherosclerotic cardiovascular disease (ASCVD). New research, however, has challenged the widely held belief that high HDL-C levels are atheroprotective and is showing that both low and high plasma HDL-C levels confer an increased risk of ASCVD. Furthermore, it is disputing the widely cited mechanism involved in reverse cholesterol transport. This review explores the evolution of cholesterol research starting with the Gofman and Framingham studies, the development of traditional and emerging lipid-lowering therapies, and the role of reverse cholesterol transport in HDL cardioprotection.
Collapse
Affiliation(s)
- Henry J Pownall
- HOUSTON METHODIST RESEARCH INSTITUTE, HOUSTON, TEXAS; WEILL CORNELL MEDICINE, NEW YORK, NEW YORK
| | - Antonio M Gotto
- HOUSTON METHODIST RESEARCH INSTITUTE, HOUSTON, TEXAS; WEILL CORNELL MEDICINE, NEW YORK, NEW YORK
| |
Collapse
|
24
|
|
25
|
Ganjali S, Gotto AM, Ruscica M, Atkin SL, Butler AE, Banach M, Sahebkar A. Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases. J Cell Physiol 2018; 233:9237-9246. [PMID: 30076716 DOI: 10.1002/jcp.27028] [Citation(s) in RCA: 131] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/25/2018] [Indexed: 01/04/2023]
Abstract
Inflammation and lipid accumulation are two basic hallmarks of atherosclerosis as a chronic disease. Inflammation not only is a local response but can also be considered as a systemic process followed by an elevation of inflammatory mediators. Monocytes are a major source of proinflammatory species during atherogenesis. In atherosclerosis, modified low-density lipoproteins (LDLs) are removed by macrophages; these are recruited in the vessel wall, inducing the release of inflammatory cytokines in inflamed tissue. Hence, inflammatory cholesterol ester-loaded plaque is generated. High-density lipoprotein-cholesterol (HDL-C) exhibits antiatherosclerotic effects by neutralizing the proinflammatory and pro-oxidant effects of monocytes via inhibiting the migration of macrophages and LDL oxidation in addition to the efflux of cholesterol from these cells. Furthermore, HDL plays a role in suppressing the activation of monocytes and proliferation-differentiation of monocyte progenitor cells. Thus, accumulation of monocytes and reduction of HDL-C may participate in atherosclerosis and cardiovascular diseases (CVD). Given that the relationship between the high number of monocytes and low HDL-C levels has been reported in inflammatory disorders, this review focused on understanding whether the monocyte-to-HDL ratio could be a convenient marker to predict atherosclerosis development and progression, hallmarks of CV events, instead of the individual monocyte count or HDL-C level.
Collapse
Affiliation(s)
- Shiva Ganjali
- Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Massimiliano Ruscica
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Alexandra E Butler
- Life Sciences Research Division, Anti-Doping Laboratory Qatar, Doha, Qatar
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland.,Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
26
|
Rosales C, Yelamanchili D, Gillard BK, Gotto AM, Pownall HJ. Abstract 394: Bacterial Serum Opacity Factor Rescues HDL Functionality in SR-B1
-/-
Mice. Arterioscler Thromb Vasc Biol 2018. [DOI: 10.1161/atvb.38.suppl_1.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although plasma HDL-C levels negatively correlate with atherosclerotic cardiovascular disease (ACVD), attempts to reduce ACVD risk by raising plasma HDL have disappointed. Thus, hypotheses about salutary HDL effects have shifted from higher-is-better to function-is-more-important. The SR-B1
-/-
mouse is an extreme model of HDL dsyfunctionality; compared to WT mice, SR-B1
-/-
mice have higher plasma HDL levels and an HDL surface that is free cholesterol (FC)-rich (60 vs. 15 mol%). This would be expected to increase HDL-FC bioavailability to cytotoxic levels. HDL dysfunctionality among SR-B1
-/-
mice is associated with multiple metabolic abnormalities—impaired cell membrane structure and function and atherosusceptibility, despite having high plasma HDL-C levels; moreover, female SR-B1
-/-
mice are infertile. Liver-specific SR-B1 expression in SR-B1
-/-
mice normalizes HDL size and FC content. Thus, the SR-B1
-/-
mouse phenotype is due to lack of hepatic clearance of lipids from dysfunctional HDL. Serum opacity factor (SOF) is a bacterial protein that catalyzes the quantitative disproportionation of HDL into a cholesteryl ester-rich micro emulsion (CERM), neo HDL, and lipid-free apo AI. The CERM contains apo E and all HDL-CE. Injection of SOF (4 μg) into WT mice lowers plasma cholesterol by diverting the CERM to hepatic LDLR. Thus, we began testing whether adeno-viral delivery of SOF (AAV
SOF
) to SR-B1
-/-
mice rescues HDL functionality. A plasmid encoding the SOF gene was synthesized; SOF DNA was isolated by restriction enzyme digestion and cloned into a pAAV-TBG-mcs plasmid that was submitted to the PENN Vector Lab for virus production and isolation. AAV
GFP
plasmid (UPENN) was used as control. Good SOF production and secretion was confirmed by transfection of Huh7 hepatocytes. AAV
SOF
injection into SR-B1
-/-
mice induced constitutive plasma SOF activity and reduced HDL-C levels to nil. Superposition of high plasma HDL levels and a high mol% FC in SR-B1
-/-
is expected to increase HDL-FC bioavailablity that contributes to whole-body FC-toxicity and the observed metabolic abnormalities. Future tests will determine whether ablation of dysfunctional HDL in SR-B1
-/-
mice rescues their pathological phenotype, especially atherosclerosis.
Collapse
|
27
|
Gillard BK, Yelamanchili D, Gotto AM, Rosales C, Pownall HJ. Abstract 551: Is Free Cholesterol Bioavailability a Determinant of Dysfunctional, Atherogenic High Density Lipoproteins? Refining the Model of Reverse Cholesterol Transport. Arterioscler Thromb Vasc Biol 2018. [DOI: 10.1161/atvb.38.suppl_1.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although cardiovascular disease (CVD) negatively correlates with high-density lipoprotein-cholesterol (HDL-C) levels, to date HDL-raising therapies have not reduced CVD; thus, in the context of reverse cholesterol transport (RCT), HDL quality, i.e., functionality, may be more important to atheroprotection than HDL quantity. The current RCT model comprises free cholesterol (FC) efflux from macrophages to apo AI to give nHDL, LCAT-mediated nHDL-FC esterification forming mature HDL, SR-B1-mediated hepatic uptake of HDL lipids, followed by sterol metabolism and excretion. Our recent studies challenge this model: We observed that nHDL apo AI, FC and phospholipid (PL) metabolically segregate. In mice, plasma nHDL FC and PL are hepatically cleared with t
1/2
~3 min; nHDL-apo AI is cleared more slowly with t
1/2
= 460 min. FC esterification is 100X slower, and thus a minor RCT step. These results and the observation that nHDL is FC-rich (~64 mol%) led to a revised model of RCT, with a focus on FC bioavailabilty rather than CE uptake. HDL from SR-B1
-/-
mice is also FC-rich and associated with atherosclerosis. Moreover, the magnitude of HDL-C content/particle is associated with carotid artery atheroprogression (Qi et al JACC 2015 65:355-363), and HDL from hyperlipidemic HIV patients, which are at increased CVD risk, also have a high mol% FC compared to controls (29 vs 16 mol%, p<0.05). Thus, we hypothesize that high HDL-FC bioavailability, measured as the product of mol% HDL-FC and HDL particle number, is a metric for dysfunctional, atherogenic HDL. We studied SRB1
-/-
mice, which are atherosusceptible and a model of dysfunctional HDL. Compared to WT mice, SR-B1
-/-
mice have a higher HDL particle number and mol% FC (~58 vs. 15). Compared to WT HDL, SRB1
-/-
HDL is more resistant to disruption by GdmHCl and serum opacity factor, indicating a resistance to remodeling. We plan to compare FC bioavailability of WT and SRB1
-/-
HDL according to the kinetics of HDL-FC transfer to LDL. Our studies will determine if increased HDL-FC bioavailability in dysfunctional FC-rich HDL supports whole-body hypercholesterolemia that could increase CVD risk.
Collapse
|
28
|
Gillard BK, Rosales C, Xu B, Gotto AM, Pownall HJ. Rethinking reverse cholesterol transport and dysfunctional high-density lipoproteins. J Clin Lipidol 2018; 12:849-856. [PMID: 29731282 DOI: 10.1016/j.jacl.2018.04.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/26/2018] [Accepted: 04/03/2018] [Indexed: 12/31/2022]
Abstract
Human plasma high-density lipoprotein cholesterol concentrations are a negative risk factor for atherosclerosis-linked cardiovascular disease. Pharmacological attempts to reduce atherosclerotic cardiovascular disease by increasing plasma high-density lipoprotein cholesterol have been disappointing so that recent research has shifted from HDL quantity to HDL quality, that is, functional vs dysfunctional HDL. HDL has varying degrees of dysfunction reflected in impaired reverse cholesterol transport (RCT). In the context of atheroprotection, RCT occurs by 2 mechanisms: one is the well-known trans-hepatic pathway comprising macrophage free cholesterol (FC) efflux, which produces early forms of FC-rich nascent HDL (nHDL). Lecithin:cholesterol acyltransferase converts HDL-FC to HDL-cholesteryl ester while converting nHDL from a disc to a mature spherical HDL, which transfers its cholesteryl ester to the hepatic HDL receptor, scavenger receptor B1 for uptake, conversion to bile salts, or transfer to the intestine for excretion. Although widely cited, current evidence suggests that this is a minor pathway and that most HDL-FC and nHDL-FC rapidly transfer directly to the liver independent of lecithin:cholesterol acyltransferase activity. A small fraction of plasma HDL-FC enters the trans-intestinal efflux pathway comprising direct FC transfer to the intestine. SR-B1-/- mice, which have impaired trans-hepatic FC transport, are characterized by high plasma levels of a dysfunctional FC-rich HDL that increases plasma FC bioavailability in a way that produces whole-body hypercholesterolemia and multiple pathologies. The design of future therapeutic strategies to improve RCT will have to be formulated in the context of these dual RCT mechanisms and the role of FC bioavailability.
Collapse
Affiliation(s)
- Baiba K Gillard
- Center for Bioenergetics, Houston Methodist Research Institute, Houston, TX, USA; Weill Cornell Medicine, New York, NY, USA
| | - Corina Rosales
- Center for Bioenergetics, Houston Methodist Research Institute, Houston, TX, USA; Weill Cornell Medicine, New York, NY, USA
| | - Bingqing Xu
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Antonio M Gotto
- Center for Bioenergetics, Houston Methodist Research Institute, Houston, TX, USA; Weill Cornell Medicine, New York, NY, USA
| | - Henry J Pownall
- Center for Bioenergetics, Houston Methodist Research Institute, Houston, TX, USA; Weill Cornell Medicine, New York, NY, USA.
| |
Collapse
|
29
|
Gower EW, Lovato JF, Ambrosius WT, Chew EY, Danis RP, Davis MD, Goff DC, Greven CM, Gotto AM, Bailey K, Gohdes D, Haffner S, Hiss R, Jamerson K, Lee K, Nathan D, Sowers J, Walters L. Lack of Longitudinal Association Between Thiazolidinediones and Incidence and Progression of Diabetic Eye Disease: The ACCORD Eye Study. Am J Ophthalmol 2018; 187:138-147. [PMID: 29275147 DOI: 10.1016/j.ajo.2017.12.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 12/13/2017] [Accepted: 12/13/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the longitudinal association between use of thiazolidinediones (TZDs), visual acuity (VA) change, and diabetic eye disease incidence and progression. DESIGN Cohort study ancillary to a randomized clinical trial. METHODS We analyzed baseline and 4-year follow-up data of 2856 ACCORD trial participants with no history of proliferative diabetic retinopathy. Based on stereoscopic fundus photographs, we evaluated diabetic macular edema (DME) progression and DR progression. We also evaluated 10- and 15-letter change on the ETDRS visual acuity chart. Main outcome measures were incidence or progression of DME or DR and change in visual acuity. RESULTS TZD use was not associated with DME incidence in either the analysis of any use (adjusted odds ratio [aOR] [95% CI]: 1.22 [0.72-2.05]) or duration of use (aOR: 1.02 [0.99-1.04]). Diabetic retinopathy (DR) incidence/progression was more common in patients with no or mild DR at baseline who were ever treated with TZDs (aOR: 1.68 [1.11-2.55]), but this association disappeared when adjusting for the time on TZD (aOR: 1.02 [1.00-1.04]). DR progression among those with moderate or worse DR at baseline was no different between TZD users and non-users. TZD usage had no effect on the ultimate visual acuity outcome. CONCLUSION In this longitudinal study of patients with type 2 diabetes, we found no association between TZD use and visual acuity outcomes or DME progression, and no consistent evidence of increased DR progression in patients ever treated with TZDs vs those never treated with TZDs.
Collapse
|
30
|
Ganjali S, Momtazi-Borojeni AA, Banach M, Kovanen PT, Gotto AM, Sahebkar A. HDL functionality in familial hypercholesterolemia: effects of treatment modalities and pharmacological interventions. Drug Discov Today 2018; 23:171-180. [DOI: 10.1016/j.drudis.2017.09.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/02/2017] [Accepted: 09/25/2017] [Indexed: 01/14/2023]
|
31
|
Simental-Mendía LE, Gotto AM, Atkin SL, Banach M, Pirro M, Sahebkar A. Effect of soy isoflavone supplementation on plasma lipoprotein(a) concentrations: A meta-analysis. J Clin Lipidol 2018; 12:16-24. [PMID: 29129666 DOI: 10.1016/j.jacl.2017.10.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 10/08/2017] [Accepted: 10/10/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Soy supplementation has been shown to reduce total and low-density lipoprotein cholesterol, while increasing high-density lipoprotein cholesterol. However, contradictory effects of soy isoflavone supplementation on lipoprotein(a) [Lp(a)] have been reported suggesting the need for a meta-analysis to be undertaken. OBJECTIVE The aim of the study was to investigate the impact of supplementation with soy isoflavones on plasma Lp(a) levels through a systematic review and meta-analysis of eligible randomized placebo-controlled trials. METHODS The search included PubMed-Medline, Scopus, ISI Web of Knowledge, and Google Scholar databases (by March 26, 2017), and quality of studies was evaluated according to Cochrane criteria. Quantitative data synthesis was performed using a random-effects model, with standardized mean difference and 95% confidence interval as summary statistics. Meta-regression and leave-one-out sensitivity analysis were performed to assess the modifiers of treatment response. RESULTS Ten eligible studies comprising 11 treatment arms with 973 subjects were selected for the meta-analysis. Meta-analysis did not suggest any significant alteration of plasma Lp(a) levels after supplementation with soy isoflavones (standardized mean difference: 0.08, 95% confidence interval: -0.05, 0.20, P = .228). The effect size was robust in the leave-one-out sensitivity analysis. In meta-regression analysis, neither dose nor duration of supplementation with soy isoflavones was significantly associated with the effect size. CONCLUSION This meta-analysis of the 10 available randomized placebo-controlled trials revealed no significant effect of soy isoflavones treatment on plasma Lp(a) concentrations.
Collapse
Affiliation(s)
| | | | | | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Matteo Pirro
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Institute of Pharmaceutical Technology, Mashhad University of Medical Sciences, Mashhad, Iran; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
32
|
Hamilton DJ, Gotto AM. Coronary Disease Survival with Diabetes. Cardiology 2017; 139:40-42. [PMID: 29224007 DOI: 10.1159/000484518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 10/23/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Dale J Hamilton
- Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA
| | | |
Collapse
|
33
|
Simental-Mendía LE, Pirro M, Gotto AM, Banach M, Atkin SL, Majeed M, Sahebkar A. Lipid-modifying activity of curcuminoids: A systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2017; 59:1178-1187. [DOI: 10.1080/10408398.2017.1396201] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
| | - Matteo Pirro
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | | | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Zeromskiego 113, Lodz, Poland
- Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | | | | | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
34
|
Xu B, Gillard BK, Gotto AM, Rosales C, Pownall HJ. ABCA1-Derived Nascent High-Density Lipoprotein-Apolipoprotein AI and Lipids Metabolically Segregate. Arterioscler Thromb Vasc Biol 2017; 37:2260-2270. [PMID: 29074589 DOI: 10.1161/atvbaha.117.310290] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/16/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Reverse cholesterol transport comprises cholesterol efflux from ABCA1-expressing macrophages to apolipoprotein (apo) AI, giving nascent high-density lipoprotein (nHDL), esterification of nHDL-free cholesterol (FC), selective hepatic extraction of HDL lipids, and hepatic conversion of HDL cholesterol to bile salts, which are excreted. We tested this model by identifying the fates of nHDL-[3H]FC, [14C] phospholipid (PL), and [125I]apo AI in serum in vitro and in vivo. APPROACH AND RESULTS During in vitro incubation of human serum, nHDL-[3H]FC and [14C]PL rapidly transfer to HDL and low-density lipoproteins (t1/2=2-7 minutes), whereas nHDL-[125I]apo AI transfers solely to HDL (t1/2<10 minutes) and to the lipid-free form (t1/2>480 minutes). After injection into mice, nHDL-[3H]FC and [14C]PL rapidly transfer to liver (t1/2=≈2-3 minutes), whereas apo AI clears with t1/2=≈460 minutes. The plasma nHDL-[3H]FC esterification rate is slow (0.46%/h) compared with hepatic uptake. PL transfer protein enhances nHDL-[14C]PL but not nHDL-[3H]FC transfer to cultured Huh7 hepatocytes. CONCLUSIONS nHDL-FC, PL, and apo AI enter different pathways in vivo. Most nHDL-[3H]FC and [14C]PL are rapidly extracted by the liver via SR-B1 (scavenger receptor class B member 1) and spontaneous transfer; hepatic PL uptake is promoted by PL transfer protein. nHDL-[125I]apo AI transfers to HDL and to the lipid-free form that can be recycled to nHDL formation. Cholesterol esterification by lecithin:cholesterol acyltransferase is a minor process in nHDL metabolism. These findings could guide the design of therapies that better mobilize peripheral tissue-FC to hepatic disposal.
Collapse
Affiliation(s)
- Bingqing Xu
- From the Center for Bioenergetics and Department of Medicine, Houston Methodist Research Institute, TX (B.X., B.K.G., A.M.G., C.R., H.J.P.); and Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China (B.X.)
| | - Baiba K Gillard
- From the Center for Bioenergetics and Department of Medicine, Houston Methodist Research Institute, TX (B.X., B.K.G., A.M.G., C.R., H.J.P.); and Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China (B.X.)
| | - Antonio M Gotto
- From the Center for Bioenergetics and Department of Medicine, Houston Methodist Research Institute, TX (B.X., B.K.G., A.M.G., C.R., H.J.P.); and Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China (B.X.)
| | - Corina Rosales
- From the Center for Bioenergetics and Department of Medicine, Houston Methodist Research Institute, TX (B.X., B.K.G., A.M.G., C.R., H.J.P.); and Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China (B.X.)
| | - Henry J Pownall
- From the Center for Bioenergetics and Department of Medicine, Houston Methodist Research Institute, TX (B.X., B.K.G., A.M.G., C.R., H.J.P.); and Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China (B.X.).
| |
Collapse
|
35
|
Gillard B, Bassett GR, Rosales C, Gotto AM, Pownall HJ. The HDL receptor, SR-B1, forms remnant HDL by a nibbling mechanism and releases apo AI. Atherosclerosis 2017. [DOI: 10.1016/j.atherosclerosis.2017.06.696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
36
|
Orringer CE, Jacobson TA, Saseen JJ, Brown AS, Gotto AM, Ross JL, Underberg JA. Update on the use of PCSK9 inhibitors in adults: Recommendations from an Expert Panel of the National Lipid Association. J Clin Lipidol 2017; 11:880-890. [PMID: 28532784 DOI: 10.1016/j.jacl.2017.05.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/02/2017] [Indexed: 12/25/2022]
Abstract
An Expert Panel convened by the National Lipid Association was charged with updating the recommendations on the use of proprotein convertase subtilisin/kexin type 9 (PCSK9) antibody therapy that were provided by the 2015 National Lipid Association Recommendations for the Patient-Centered Management of Dyslipidemia: Part 2. Recent studies have demonstrated the efficacy of these agents in reducing low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol and have confirmed their excellent safety profile. A cardiovascular outcomes study has shown that these agents reduce incident atherosclerotic cardiovascular disease (ASCVD) events in patents with stable ASCVD and concomitant risk factors. The current update provides the Expert Panel's evidence-based recommendations on the clinical utility of PCSK9 inhibitors in patients with stable ASCVD, progressive ASCVD, LDL-C ≥ 190 mg/dL (including polygenic hypercholesterolemia, heterozygous familial hypercholesterolemia and the homozygous familial hypercholesterolemia phenotype) and very-high-risk patients with statin intolerance.
Collapse
Affiliation(s)
- Carl E Orringer
- Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Terry A Jacobson
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Joseph J Saseen
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alan S Brown
- Division of Cardiology, Advocate Lutheran General Hospital, Park Ridge, IL, USA
| | - Antonio M Gotto
- Cardiac Disease Prevention, Weill Cornell Medical College, New York, NY, USA
| | - Joyce L Ross
- University of Pennsylvania Health System, Philadelphia, PA, USA
| | - James A Underberg
- NYU School of Medicine & NYU Center for Prevention of Cardiovascular Disease, New York, NY, USA
| |
Collapse
|
37
|
Gillard BK, Bassett GR, Gotto AM, Rosales C, Pownall HJ. Scavenger receptor B1 (SR-B1) profoundly excludes high density lipoprotein (HDL) apolipoprotein AII as it nibbles HDL-cholesteryl ester. J Biol Chem 2017; 292:8864-8873. [PMID: 28373285 DOI: 10.1074/jbc.m117.781963] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 03/24/2017] [Indexed: 01/12/2023] Open
Abstract
Reverse cholesterol transport (transfer of macrophage-cholesterol in the subendothelial space of the arterial wall to the liver) is terminated by selective high density lipoprotein (HDL)-cholesteryl ester (CE) uptake, mediated by scavenger receptor class B, type 1 (SR-B1). We tested the validity of two models for this process: "gobbling," i.e. one-step transfer of all HDL-CE to the cell and "nibbling," multiple successive cycles of SR-B1-HDL association during which a few CEs transfer to the cell. Concurrently, we compared cellular uptake of apoAI with that of apoAII, which is more lipophilic than apoAI, using HDL-[3H]CE labeled with [125I]apoAI or [125I]apoAII. The studies were conducted in CHO-K1 and CHO-ldlA7 cells (LDLR-/-) with (CHO-SR-B1) and without SR-B1 overexpression and in human Huh7 hepatocytes. Relative to CE, both apoAI and apoAII were excluded from uptake by all cells. However, apoAII was more highly excluded from uptake (2-4×) than apoAI. To distinguish gobbling versus nibbling mechanisms, media from incubations of HDL with CHO-SR-B1 cells were analyzed by non-denaturing PAGE, size-exclusion chromatography, and the distribution of apoAI, apoAII, cholesterol, and phospholipid among HDL species as a function of incubation time. HDL size gradually decreased, i.e. nibbling, with the concurrent release of lipid-free apoAI; apoAII was retained in an HDL remnant. Our data support an SR-B1 nibbling mechanism that is similar to that of streptococcal serum opacity factor, which also selectively removes CE and releases apoAI, leaving an apoAII-rich remnant.
Collapse
Affiliation(s)
- Baiba K Gillard
- From the Houston Methodist Research Institute, Houston Texas 77030, .,Weill Cornell Medicine, New York, New York 10065, and
| | | | - Antonio M Gotto
- From the Houston Methodist Research Institute, Houston Texas 77030.,Weill Cornell Medicine, New York, New York 10065, and
| | - Corina Rosales
- From the Houston Methodist Research Institute, Houston Texas 77030.,Weill Cornell Medicine, New York, New York 10065, and
| | - Henry J Pownall
- From the Houston Methodist Research Institute, Houston Texas 77030.,Weill Cornell Medicine, New York, New York 10065, and
| |
Collapse
|
38
|
Rodriguez PJ, Gillard BK, Barosh R, Gotto AM, Rosales C, Pownall HJ. Neo High-Density Lipoprotein Produced by the Streptococcal Serum Opacity Factor Activity against Human High-Density Lipoproteins Is Hepatically Removed via Dual Mechanisms. Biochemistry 2016; 55:5845-5853. [PMID: 27662183 DOI: 10.1021/acs.biochem.6b00946] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Injection of streptococcal serum opacity factor (SOF) into mice reduces the plasma cholesterol level by ∼40%. In vitro, SOF converts high-density lipoproteins (HDLs) into multiple products, including a small HDL, neo HDL. In vitro, neo HDL accounts for ∼60% of the protein mass of the SOF reaction products; in vivo, the accumulated mass of neo HDL is <1% of that observed in vitro. To identify the underlying cause of this difference, we determined the fate of neo HDL in plasma in vitro and in vivo. Following incubation with HDL, neo HDL-PC rapidly transfers to HDL, giving a small remnant, which fuses with HDL. An increased level of SR-B1 expression in Huh7 hepatoma cells and a reduced level of LDLR expression in CHO cells had little effect on neo HDL-[3H]CE uptake. Thus, the dominant receptors for neo HDL uptake are not LDLR or SR-B1. The in vivo metabolic fates of neo HDL-[3H]CE and HDL-[3H]CE were different. Thirty minutes after the injection of neo HDL-[3H]CE and HDL-[3H]CE into mice, plasma [3H]CE counts were 40 and 53%, respectively, of injected counts, with 10 times more [3H]CE appearing in the livers of neo HDL-[3H]CE-injected than in those of HDL-[3H]CE-injected mice. These data support a model of neo HDL-[3H]CE clearance by two parallel pathways. At early post-neo HDL-[3H]CE injection times, some neo HDL is directly removed by the liver; the remainder transfers its PC to HDL, leaving a remnant that fuses with HDL, which is also hepatically removed more slowly. Given that SR-B1 and SOF both remove CE from HDL, this novel mechanism may also underlie the metabolism of remnants released by hepatocytes following selective SR-B1-mediated uptake of HDL-CE.
Collapse
Affiliation(s)
- Perla J Rodriguez
- Houston Methodist Research Institute , 6670 Bertner Avenue, Houston, Texas 77030, United States.,Baylor College of Medicine , One Baylor Plaza, Houston, Texas 77030, United States
| | - Baiba K Gillard
- Houston Methodist Research Institute , 6670 Bertner Avenue, Houston, Texas 77030, United States
| | - Rachel Barosh
- Houston Methodist Research Institute , 6670 Bertner Avenue, Houston, Texas 77030, United States
| | - Antonio M Gotto
- Houston Methodist Research Institute , 6670 Bertner Avenue, Houston, Texas 77030, United States
| | - Corina Rosales
- Houston Methodist Research Institute , 6670 Bertner Avenue, Houston, Texas 77030, United States
| | - Henry J Pownall
- Houston Methodist Research Institute , 6670 Bertner Avenue, Houston, Texas 77030, United States
| |
Collapse
|
39
|
Abstract
High plasma concentrations of low-density lipoprotein-cholesterol (LDL-C) are a well-accepted risk factor for cardiovascular disease (CVD), and the statin class of hypolipidemic drugs has emerged as an effective means of lowering LDL-C and reducing CVD risk. In contrast, the role of plasma high-density lipoproteins (HDL) in protection against atherosclerotic vascular disease is the subject of considerable controversy. Although the inverse correlation between plasma HDL-C and CVD is widely acknowledged, reduction of CVD risk by interventions that increase HDL-C have not been uniformly successful. Several studies of large populations have shown that the first step in reverse cholesterol transport (RCT), the transfer of cholesterol from the subendothelial space of the arterial wall via the plasma compartment to the liver for disposal, is impaired in patients with CVD. Here we review HDL function, the mechanisms by which HDL supports RCT, and the role of RCT in preventing CVD.
Collapse
Affiliation(s)
- Corina Rosales
- Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas
| | - Baiba K Gillard
- Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas
| | - Antonio M Gotto
- Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas ; Weill Cornell Medical College, New York, New York
| | - Henry J Pownall
- Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas ; Weill Cornell Medical College, New York, New York
| |
Collapse
|
40
|
Yang Y, Rosales C, Gillard BK, Gotto AM, Pownall HJ. Acylation of lysine residues in human plasma high density lipoprotein increases stability and plasma clearance in vivo. Biochim Biophys Acta Mol Cell Biol Lipids 2016; 1861:1787-1795. [PMID: 27594697 DOI: 10.1016/j.bbalip.2016.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 08/29/2016] [Accepted: 08/30/2016] [Indexed: 10/21/2022]
Abstract
Although human plasma high density lipoproteins (HDL) concentrations negatively correlate with atherosclerotic cardiovascular disease, underlying mechanisms are unknown. Thus, there is continued interest in HDL structure and functionality. Numerous plasma factors disrupt HDL structure while inducing the release of lipid free apolipoprotein (apo) AI. Given that HDL is an unstable particle residing in a kinetic trap, we tested whether HDL could be stabilized by acylation with acetyl and hexanoyl anhydrides, giving AcHDL and HexHDL respectively. Lysine analysis with fluorescamine showed that AcHDL and HexHDL respectively contained 11 acetyl and 19 hexanoyl groups. Tests with biological and physicochemical perturbants showed that HexHDL was more stable than HDL to perturbant-induced lipid free apo AI formation. Like the reaction of streptococcal serum opacity factor against HDL, the interaction of HDL with its receptor, scavenger receptor class B member 1 (SR-B1), removes CE from HDL. Thus, we tested and validated the hypothesis that selective uptake of HexHDL-[3H]CE by Chinese Hamster Ovary cells expressing SR-B1 is less than that of HDL-[3H]CE; thus, selective SR-B1 uptake of HDL-CE depends on HDL instability. However, in mice, plasma clearance, hepatic uptake and sterol secretion into bile were faster from HexHDL-[3H]CE than from HDL-[3H]CE. Collectively, our data show that acylation increases HDL stability and that the reaction of plasma factors with HDL and SR-B1-mediated uptake are reduced by increased HDL stability. In vivo data suggest that HexHDL promotes charge-dependent reverse cholesterol transport, by a mechanism that increases hepatic sterol uptake via non SR-B1 receptors, thereby increasing bile acid output.
Collapse
Affiliation(s)
- Yaliu Yang
- Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA; Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, PR China.
| | - Corina Rosales
- Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA; Weill Cornell Medicine, 1305 York Avenue, New York, NY 10065, USA.
| | - Baiba K Gillard
- Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA; Weill Cornell Medicine, 1305 York Avenue, New York, NY 10065, USA.
| | - Antonio M Gotto
- Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA; Weill Cornell Medicine, 1305 York Avenue, New York, NY 10065, USA.
| | - Henry J Pownall
- Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA; Weill Cornell Medicine, 1305 York Avenue, New York, NY 10065, USA.
| |
Collapse
|
41
|
Zhang H, Lamon BD, Moran G, Sun T, Gotto AM, Hajjar DP. Pitavastatin Differentially Modulates MicroRNA-Associated Cholesterol Transport Proteins in Macrophages. PLoS One 2016; 11:e0159130. [PMID: 27415822 PMCID: PMC4945056 DOI: 10.1371/journal.pone.0159130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 06/21/2016] [Indexed: 01/29/2023] Open
Abstract
There is emerging evidence identifying microRNAs (miRNAs) as mediators of statin-induced cholesterol efflux, notably through the ATP-binding cassette transporter A1 (ABCA1) in macrophages. The objective of this study was to assess the impact of an HMG-CoA reductase inhibitor, pitavastatin, on macrophage miRNAs in the presence and absence of oxidized-LDL, a hallmark of a pro-atherogenic milieu. Treatment of human THP-1 cells with pitavastatin prevented the oxLDL-mediated suppression of miR-33a, -33b and -758 mRNA in these cells, an effect which was not uniquely attributable to induction of SREBP2. Induction of ABCA1 mRNA and protein by oxLDL was inhibited (30%) by pitavastatin, while oxLDL or pitavastatin alone significantly induced and repressed ABCA1 expression, respectively. These findings are consistent with previous reports in macrophages. miRNA profiling was also performed using a miRNA array. We identified specific miRNAs which were up-regulated (122) and down-regulated (107) in THP-1 cells treated with oxLDL plus pitavastatin versus oxLDL alone, indicating distinct regulatory networks in these cells. Moreover, several of the differentially expressed miRNAs identified are functionally associated with cholesterol trafficking (six miRNAs in cells treated with oxLDL versus oxLDL plus pitavastatin). Our findings indicate that pitavastatin can differentially modulate miRNA in the presence of oxLDL; and, our results provide evidence that the net effect on cholesterol homeostasis is mediated by a network of miRNAs.
Collapse
Affiliation(s)
- Haijun Zhang
- Department of Cell and Developmental Biology, Weill Medical College of Cornell University, 1300 York Ave, New York, New York, 10065, United States of America
- Department of Genetic Medicine, Weill Medical College of Cornell University, 1300 York Ave, New York, New York, 10065, United States of America
| | - Brian D. Lamon
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, 1300 York Ave, New York, New York, 10065, United States of America
- Center of Vascular Biology, Weill Medical College of Cornell University, 1300 York Ave, New York, New York, 10065, United States of America
| | - George Moran
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, 1300 York Ave, New York, New York, 10065, United States of America
- Center of Vascular Biology, Weill Medical College of Cornell University, 1300 York Ave, New York, New York, 10065, United States of America
| | - Tao Sun
- Department of Cell and Developmental Biology, Weill Medical College of Cornell University, 1300 York Ave, New York, New York, 10065, United States of America
| | - Antonio M. Gotto
- Department of Medicine, Weill Medical College of Cornell University, 1300 York Ave, New York, New York, 10065, United States of America
| | - David P. Hajjar
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, 1300 York Ave, New York, New York, 10065, United States of America
- Center of Vascular Biology, Weill Medical College of Cornell University, 1300 York Ave, New York, New York, 10065, United States of America
- * E-mail:
| |
Collapse
|
42
|
Abstract
Muscle problems and other adverse symptoms associated with statin use are frequent reasons for non-adherence and discontinuation of statin therapy, which results in inadequate control of hyperlipidemia and increased cardiovascular risk. However, most patients who experience adverse symptoms during statin use are able to tolerate at least some degree of statin therapy. Given the profound cardiovascular benefits derived from statins, an adequate practical approach to statin intolerance is, therefore, of great clinical importance. Statin intolerance can be defined as the occurrence of myalgia or other adverse symptoms that are attributed to statin therapy and that lead to its discontinuation. In reality, these symptoms are actually unrelated to statin use in many patients, especially in those with atypical presentations following long periods of treatment. Thus, the first step in approaching patients with adverse symptoms during the course of statin therapy is identification of those patients for whom true statin intolerance is unlikely, since most of these patients would probably be capable of tolerating adequate statin therapy. In patients with statin intolerance, an altered dosing regimen of very low doses of statins should be attempted and, if tolerated, should gradually be increased to achieve the highest tolerable doses. In addition, other lipid-lowering drugs may be needed, either in combination with statins, or alone, if statins are not tolerated at all. Stringent control of other risk factors can aid in reducing cardiovascular risk if attaining lipid treatment goals proves difficult.
Collapse
Affiliation(s)
- Tomáš Stulc
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, U Nemocnice 1, CZ 128 21, Praha 2 / Prague, Czech Republic.
| | - Richard Ceška
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, U Nemocnice 1, CZ 128 21, Praha 2 / Prague, Czech Republic
| | - Antonio M Gotto
- Weill Cornell Medical College, New York, 1305 York Avenue, Y-807, New York, NY, 10021, USA
| |
Collapse
|
43
|
Xu B, Bell JM, Gillard BK, Gotto AM, Pownall HJ. Abstract 635: Cholesterol Loading Increases the Size and Cholesterol Content of Nascent HDL Formed via the Interaction of Apo AI With Cellular ABCA1. Arterioscler Thromb Vasc Biol 2016. [DOI: 10.1161/atvb.36.suppl_1.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cardiovascular disease (CVD) is a major cause of mortality and morbidity and development of new therapies that address its underlying causes is an important public health priority. Although CVD negatively correlates with high-density lipoprotein-cholesterol (HDL-C), HDL-raising therapies have not reduced CVD risk, particularly with statin co-therapy. Current data suggests that improving HDL functionality is more important to cardioprotection than increasing plasma HDL-C. Thus, it is important to identify structure-function relationships for various HDL and their precursors, nascent HDL. Nascent HDL is formed via the interaction of apo AI with ATP-binding cassette transporter A1 (ABCA1); rHDL formed via the interaction of apo AI with multilamellar membranes are
in vitro
models of nascent HDL. Both rHDL and nascent HDL are discoidal and their sizes increase with the cholesterol content of membranes from which they are derived. Given that very large rHDL, ~36 nm are formed at high cholesterol concentrations, ~15 mol%, we tested the hypothesis that similar large nascent HDL form via the interaction of apo AI with cells after hyperloading with cholesterol. To test this hypothesis, we incubated BHK-ABCA1 cells with cholesterol-loaded methyl β-cyclodextrin (CDX) for two hours. The free cholesterol (FC) content of the cells increased with increasing CDX:cholesterol concentration, from 29 ± 2 to 52 ± 6 μg FC/ mg cell protein. Concurrently, the size and cholesterol content of the nascent HDL produced by the interaction of apo AI with the cells also increased, with sizes ranging from ~ 7 to ~20 nm. These data suggest that the same membrane qualities and their modification by cholesterol determine the size of both rHDL and nascent HDL. Future studies will identify their structure in greater detail by a combination of physicochemical methods.
Collapse
Affiliation(s)
- Bingqing Xu
- Cardiology, Houston Methodist Rsch Institute, Houston, TX
| | - James M Bell
- Structural, Computational Biology and Molecular Biophysics, Baylor College of Medicine, Houston, TX
| | | | | | | |
Collapse
|
44
|
Rosales C, Gillard BK, Yelamanchili D, Gotto AM, Pownall HJ. Abstract 429: Structural Stability of Streptococcal Serum Opacity Factor. Arterioscler Thromb Vasc Biol 2016. [DOI: 10.1161/atvb.36.suppl_1.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite its putative cardioprotective qualities, raising plasma high density lipoprotein-cholesterol (HDL-C) levels via pharmacologic means has failed to add protection against atherosclerosis, particularly when used as co-therapy with a statin. Two scenarios argue against the raising-plasma-HDL-is-better hypothesis and suggest that enhancing the final RCT step, hepatic cholesterol disposal, is a better cardioprotective strategy. First, probucol prevents CVD events and increases survival in humans and reduces CVD in SR-BI/apo E DKO mice. Despite its anti atherogenic properties, probucol lowers plasma HDL-C levels. Second, SR-BI over expressing vs. WT mice have lower plasma HDL-C but less atherosclerosis whereas the converse is true in SR-BI KO mice, suggesting that increasing HDL-C disposal is a rational cardioprotective strategy. One possible agent for therapeutic development is streptococcal serum opacity factor (SOF), a 100 kDa protein that clouds human serum via a novel HDL-targeting mechanism. SOF diverts HDL-CE to the LDL receptor and to bile acid secretion in vitro and in vivo, increases plasma HDL-C clearance in mice in an apo E-, LDLR-dependent mechanism thereby increasing hepatic CE uptake and reducing plasma cholesterol levels. SOF is active at 10
-14
M. Given its novel mechanism and potent reduction of plasma cholesterol levels in mice, we studied the structure and stability of SOF using its activity as a marker of its integrity versus several physicochemical challenges—extremes of pH, the denaturant, guanidinium chloride, heat, and ionic strength. SOF was highly resistant to all of these challenges. SOF has only one cysteine so it cannot be stabilized by internal disulfide bonds. Thus, SOF is an unusually stable protein that undergoes reversible unfolding-folding when challenged with a variety of physicochemical perturbants. These studies have helped us identify optimal conditions for crystallizing SOF for X-ray structure analysis.
Collapse
Affiliation(s)
- Corina Rosales
- Cardiology, Houston Methodist Rsch Institute, Houston, TX
| | | | | | | | | |
Collapse
|
45
|
Abstract
Although high-density lipoprotein-cholesterol (HDL-C) concentration is a negative risk factor for atherosclerotic cardiovascular disease (CVD), efforts to reduce CVD risk by raising HDL-C have not been uniformly successful. Many studies have shown that alcohol consumption, that increases plasma HDL-C concentration, reduces CVD incidence. However, recent genetic studies in large populations have not only removed HDL-C from the causal link between plasma HDL-C concentration and reduced CVD risk, but also suggest that the association is weak. We propose here that the cardioprotective effects of alcohol are mediated by the interaction of its terminal metabolite, acetate, with the adipocyte free fatty acid receptor 2 (FFAR2), which elicits a profound antilipolytic effect that may increase insulin sensitivity without necessarily raising plasma HDL-C concentration.
Collapse
Affiliation(s)
- Henry J. Pownall
- Houston Methodist Research Institute and Weill Cornell Medical College, 6670 Bertner Avenue, Houston TX 77030
| | - Antonio M. Gotto
- Houston Methodist Research Institute and Weill Cornell Medical College, 1305 York Avenue, New York, NY, USA
| |
Collapse
|
46
|
Rosenson RS, Hegele RA, Gotto AM. Integrated Measure for Atherogenic Lipoproteins in the Modern Era. J Am Coll Cardiol 2016; 67:202-204. [DOI: 10.1016/j.jacc.2015.10.059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 10/06/2015] [Indexed: 11/27/2022]
|
47
|
Gillard BK, Rodriguez PJ, Fields DW, Raya JL, Lagor WR, Rosales C, Courtney HS, Gotto AM, Pownall HJ. Streptococcal serum opacity factor promotes cholesterol ester metabolism and bile acid secretion in vitro and in vivo. Biochim Biophys Acta Mol Cell Biol Lipids 2015; 1861:196-204. [PMID: 26709142 DOI: 10.1016/j.bbalip.2015.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/16/2015] [Accepted: 12/11/2015] [Indexed: 11/15/2022]
Abstract
Plasma high density lipoprotein-cholesterol (HDL-C) concentrations negatively correlate with atherosclerotic cardiovascular disease. HDL is thought to have several atheroprotective functions, which are likely distinct from the epidemiological inverse relationship between HDL-C levels and risk. Specifically, strategies that reduce HDL-C while promoting reverse cholesterol transport (RCT) may have therapeutic value. The major product of the serum opacity factor (SOF) reaction versus HDL is a cholesteryl ester (CE)-rich microemulsion (CERM), which contains apo E and the CE of ~400,000 HDL particles. Huh7 hepatocytes take up CE faster when delivered as CERM than as HDL, in part via the LDL-receptor (LDLR). Here we compared the final RCT step, hepatic uptake and subsequent intracellular processing to cholesterol and bile salts for radiolabeled HDL-, CERM- and LDL-CE by Huh7 cells and in vivo in C57BL/6J mice. In Huh7 cells, uptake from LDL was greater than from CERM (2-4X) and HDL (5-10X). Halftimes for [(14)C]CE hydrolysis were 3.0±0.2, 4.4±0.6 and 5.4±0.7h respectively for HDL, CERM and LDL-CE. The fraction of sterols secreted as bile acids was ~50% by 8h for all three particles. HDL, CERM and LDL-CE metabolism in mice showed efficient plasma clearance of CERM-CE, liver uptake and metabolism, and secretion as bile acids into the gall bladder. This work supports the therapeutic potential of the SOF reaction, which diverts HDL-CE to the LDLR, thereby increasing hepatic CE uptake, and sterol disposal as bile acids.
Collapse
Affiliation(s)
- Baiba K Gillard
- The Laboratory of Atherosclerosis and Lipoprotein Research, Houston Methodist Research Institute, 6670 Bertner St., Houston, TX 77030, USA.
| | - Perla J Rodriguez
- The Laboratory of Atherosclerosis and Lipoprotein Research, Houston Methodist Research Institute, 6670 Bertner St., Houston, TX 77030, USA.
| | - David W Fields
- The Laboratory of Atherosclerosis and Lipoprotein Research, Houston Methodist Research Institute, 6670 Bertner St., Houston, TX 77030, USA.
| | - Joe L Raya
- Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
| | - William R Lagor
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
| | - Corina Rosales
- The Laboratory of Atherosclerosis and Lipoprotein Research, Houston Methodist Research Institute, 6670 Bertner St., Houston, TX 77030, USA.
| | - Harry S Courtney
- University of Tennessee Health Science Center, 956 Court Avenue Room H300A, Memphis, TN 38163 USA.
| | - Antonio M Gotto
- The Laboratory of Atherosclerosis and Lipoprotein Research, Houston Methodist Research Institute, 6670 Bertner St., Houston, TX 77030, USA; Department of Medicine, Weill Cornell Medical College, 1305 York Ave., New York, NY 10021, USA.
| | - Henry J Pownall
- The Laboratory of Atherosclerosis and Lipoprotein Research, Houston Methodist Research Institute, 6670 Bertner St., Houston, TX 77030, USA; Department of Medicine, Weill Cornell Medical College, 1305 York Ave., New York, NY 10021, USA.
| |
Collapse
|
48
|
Gillard BK, Rodriguez PJ, Fields DW, Raya JL, Lagor WR, Courtney HS, Gotto AM, Pownall HJ. Abstract 326: Streptococcal Serum Opacity Factor Product, Cholesteryl Ester Rich Particles, Induce Cholesterol Ester Metabolism and Bile Acid Secretion after Uptake by Human Huh7 Hepatocytes. Arterioscler Thromb Vasc Biol 2015. [DOI: 10.1161/atvb.35.suppl_1.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Plasma concentrations of HDL-cholesterol (C) negatively correlate with atherosclerotic cardiovascular disease. Nevertheless, current evidence suggests that this correlation is not axiomatic and that some forms of HDL are dysfunctional and atherogenic. Interventions that raise HDL-C have not been uniformly successful suggesting that mechanisms by which HDL-C is increased determine its anti atherogenic potency. Additionally, mice overexpressing the HDL receptor, SR-BI, have lower plasma HDL-C levels and
less
atherosclerosis. Thus, new strategies that reduce HDL-C while promoting reverse cholesterol transport (RCT) may have therapeutic value. Serum opacity factor (SOF) disrupts HDL and forms three products, including a cholesteryl ester-rich microemulsion (CERM) containing apo E and the CE of ~400,000 HDL particles. Hepatic CE uptake in Huh7 cells is faster when delivered by CERM than by HDL, and cleared both
in vitro
and
in vivo,
in part, via the LDL-receptor (LDLR). We investigated the therapeutic potential of SOF in promoting RCT by comparing the final RCT steps, hepatic uptake, CE metabolism to cholesterol and bile salts, and secretion, of [
14
C]-CE-HDL, -CERM and [[Unable to Display Character: –]]LDL. Cells were pulse-labeled for 2 h with 20-50 ug/mL HDL protein (6-17 ug/mL [
14
C]-CE), or the CE-equivalent as CERM or LDL, and chased for 0, 2 or 6 h. Cells, pulse media and chase media were analyzed for sterols by beta-counting, TLC and solvent partitioning. [
14
C]CE uptake from LDL was greater than from CERM (2-4X) and HDL (5-10X). Halftimes for [
14
C]CE hydrolysis were 3.0 ± 0.2, 4.4 ± 0.6 and 5.4 ± 0.7 h respectively for HDL, CERM and LDL-CE. Bile acids in cells after uptake from HDL or CERM were low, <0.2% of total sterol but higher in cells after uptake from LDL, 4.2 ± 2.2 % of total sterol (
p = 0.03
) at the 2 h chase time. The fraction of sterols secreted as bile acids was comparable for all three donor particles. After the 2 h chase, ~40% of the secreted sterols were bile acids, and after 6 h, ~ 50% were bile acids. These ratios were the same for cells treated with
14
C-CE-HDL, CERM or LDL. Thus, the rates of hepatic metabolism of CERM-CE to free cholesterol, to bile acids and secretion are intermediate between those for HDL- and LDL-CE, supporting the therapeutic potential of SOF as a promoter of RCT.
Collapse
Affiliation(s)
| | | | - David W Fields
- Cardiology, Houston Methodist Rsch Institute, Houston, TX
| | - Joe L Raya
- Medicine, Baylor College of Medicine, Houston, TX
| | - William R Lagor
- Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX
| | | | | | | |
Collapse
|
49
|
Rosales C, Patel N, Gillard BK, Yelamanchili D, Yang Y, Courtney HS, Santos RD, Gotto AM, Pownall HJ. Apolipoprotein AI deficiency inhibits serum opacity factor activity against plasma high density lipoprotein via a stabilization mechanism. Biochemistry 2015; 54:2295-302. [PMID: 25790332 DOI: 10.1021/bi501486z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The reaction of Streptococcal serum opacity factor (SOF) against plasma high-density lipoproteins (HDL) produces a large cholesteryl ester-rich microemulsion (CERM), a smaller neo HDL that is apolipoprotein (apo) AI-poor, and lipid-free apo AI. SOF is active versus both human and mouse plasma HDL. In vivo injection of SOF into mice reduces plasma cholesterol ∼40% in 3 h while forming the same products observed in vitro, but at different ratios. Previous studies supported the hypothesis that labile apo AI is required for the SOF reaction vs HDL. Here we further tested that hypothesis by studies of SOF against HDL from apo AI-null mice. When injected into apo AI-null mice, SOF reduced plasma cholesterol ∼35% in 3 h. The reaction of SOF vs apo AI-null HDL in vitro produced a CERM and neo HDL, but no lipid-free apo. Moreover, according to the rate of CERM formation, the extent and rate of the SOF reaction versus apo AI-null mouse HDL were less than that against wild-type (WT) mouse HDL. Chaotropic perturbation studies using guanidine hydrochloride showed that apo AI-null HDL was more stable than WT HDL. Human apo AI added to apo AI-null HDL was quantitatively incorporated, giving reconstituted HDL. Both SOF and guanidine hydrochloride displaced apo AI from the reconstituted HDL. These results support the conclusion that apo AI-null HDL is more stable than WT HDL because it lacks apo AI, a labile protein that is readily displaced by physicochemical and biochemical perturbations. Thus, apo AI-null HDL is less SOF-reactive than WT HDL. The properties of apo AI-null HDL can be partially restored to those of WT HDL by the spontaneous incorporation of human apo AI. It remains to be determined what other HDL functions are affected by apo AI deletion.
Collapse
Affiliation(s)
- Corina Rosales
- †Laboratory of Atherosclerosis and Lipoprotein Research, Department of Cardiology, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, Texas 77030, United States
| | - Niket Patel
- †Laboratory of Atherosclerosis and Lipoprotein Research, Department of Cardiology, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, Texas 77030, United States
| | - Baiba K Gillard
- †Laboratory of Atherosclerosis and Lipoprotein Research, Department of Cardiology, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, Texas 77030, United States
| | - Dedipya Yelamanchili
- †Laboratory of Atherosclerosis and Lipoprotein Research, Department of Cardiology, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, Texas 77030, United States
| | - Yaliu Yang
- †Laboratory of Atherosclerosis and Lipoprotein Research, Department of Cardiology, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, Texas 77030, United States
| | - Harry S Courtney
- ‡Veterans Affairs Medical Center and Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee 38104, United States
| | - Raul D Santos
- §Heart Institute-INCOR, University of Sao Paulo, 05409-003 Sao Paulo, Brazil
| | - Antonio M Gotto
- †Laboratory of Atherosclerosis and Lipoprotein Research, Department of Cardiology, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, Texas 77030, United States.,⊥Weill Cornell Medical College, 1305 York Avenue, New York, New York 10021, United States
| | - Henry J Pownall
- †Laboratory of Atherosclerosis and Lipoprotein Research, Department of Cardiology, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, Texas 77030, United States.,⊥Weill Cornell Medical College, 1305 York Avenue, New York, New York 10021, United States
| |
Collapse
|
50
|
Gotto AM. Optimizing statin treatment. Trends Cardiovasc Med 2015; 25:226-7. [DOI: 10.1016/j.tcm.2014.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 10/24/2014] [Indexed: 10/24/2022]
|