ATP-binding cassette transporters G1 and G4 mediate cellular cholesterol efflux to high-density lipoproteins

The mechanisms responsible for the inverse relationship between plasma high-density lipoprotein (HDL) levels and atherosclerotic cardiovascular disease are poorly understood. The ATP-binding cassette transporter A1 (ABCA1) mediates efflux of cellular cholesterol to lipid-poor apolipoproteins but not to HDL particles that constitute the bulk of plasma HDL. We show that two ABC transporters of unknown function, ABCG1 and ABCG4, mediate isotopic and net mass efflux of cellular cholesterol to HDL. In transfected 293 cells, ABCG1 and ABCG4 stimulate cholesterol efflux to both smaller (HDL-3) and larger (HDL-2) subclasses but not to lipid-poor apoA-I. Treatment of macrophages with an liver X receptor activator results in up-regulation of ABCG1 and increases cholesterol efflux to HDL. RNA interference reduced the expression of ABCG1 in liver X receptor-activated macrophages and caused a parallel decrease in cholesterol efflux to HDL. These studies indicate that ABCG1 and ABCG4 promote cholesterol efflux from cells to HDL. ABCG1 is highly expressed in macrophages and probably mediates cholesterol efflux from macrophage foam cells to the major HDL fractions, providing a mechanism to explain the relationship between HDL levels and atherosclerosis risk.     

Regulation of plasma high-density lipoprotein levels by the ABCA1 transporter and the emerging role of high-density lipoprotein in the treatment of cardiovascular disease

High-density lipoproteins (HDL) protect against cardiovascular disease. HDL removes and transports excess cholesterol from peripheral cells to the liver for removal from the body. HDL also protects low-density lipoproteins (LDL) from oxidation and inhibits expression of adhesion molecules in endothelial cells, preventing monocyte movement into the vessel wall. The ABCA1 transporter regulates intracellular cholesterol levels in the liver and in peripheral cells by effluxing excess cholesterol to lipid-poor apoA-I to form nascent HDL, which is converted to mature alpha-HDL by esterification of cholesterol to cholesteryl esters (CE) by lecithin cholesterol acyltransferase. The hepatic ABCA1 transporter and apoA-I are major determinants of levels of plasma alpha-HDL cholesterol as well as poorly lipidated apoA-I, which interact with ABCA1 transporters on peripheral cells in the process of reverse cholesterol transport. Cholesterol in HDL is transported directly back to the liver by HDL or after transfer of CE by the cholesteryl ester transfer protein (CETP) by the apoB lipoproteins. Current approaches to increasing HDL to determine the efficacy of HDL in reducing atherosclerosis involve acute HDL therapy with infusions of apoA-I or apoA-I mimetic peptides and chronic long-term therapy with selective agents to increase HDL, including CETP inhibitors.     

高糖对THP-1巨噬细胞ABC转运体的表达和功能的影响

目的:探讨高糖对体外培养的THP-1巨噬细胞中三磷酸腺苷结合盒（ABC）转运体的表达及功能的影响。方法: 以不同浓度的D-葡萄糖干预培养的THP-1单核巨噬细胞5 d,用实时定量PCR和Western blot检测巨噬细胞中ABCG1、ABCA1 mRNA和其蛋白的表达。用酶荧光化学法检测培养基中及细胞内胆固醇的含量。结果: 高糖可抑制巨噬细胞中ABCG1的表达,但是对ABCA1的表达影响不明显。随着D-葡萄糖浓度的增加,从巨噬细胞中流出的胆固醇量减少,同时细胞内胆固醇的含量增加。结论: 高糖可抑制巨噬细胞中ABCG1的表达及功能,有助于促进巨噬细胞内脂质堆积。     

HDL metabolism and the role of HDL in the treatment of high-risk patients with cardiovascular disease

Developing new therapeutic approaches to treating residual cardiovascular risk of recurrent clinical events in statin-treated patients has been a major challenge for the cardiovascular field. Data from epidemiological evidence, animal models, and initial clinical trials indicate that increasing high-density lipoprotein (HDL) may be an effective new target for treating residual cardiovascular risk. Over the past several years, major advances have occurred in our understanding of HDL metabolism and of the important roles of the ABCA1 and ABCG1 transporters as well as the SR-BI receptor in cholesterol transport. Current approaches to HDL therapy include acute HDL infusion therapy in acute coronary syndrome patients and chronic oral HDL therapy in stable patients with cardiovascular disease. Definitive clinical trials will now be required to establish the safety and efficacy of increasing HDL in the treatment of patients with cardiovascular disease.     

Cholesterol efflux pathways and other potential mechanisms involved in the athero-protective effect of high density lipoproteins

Plasma high density lipoprotein (HDL) levels bear a strong independent inverse relationship with atherosclerotic cardiovascular disease. Although HDL has anti-oxidant, anti-inflammatory, vasodilating and anti-thrombotic properties, the central anti-atherogenic activity of HDL is likely to be its ability to remove cholesterol and oxysterols from macrophage foam cells, smooth muscle cells and endothelial cells in the arterial wall. To some extent, the pleotropic athero-protective properties of HDL may be related to its ability to promote sterol and oxysterol efflux from arterial wall cells, as well as to detoxify oxidized phospholipids. In cholesterol-loaded macrophages, activation of liver X receptors (LXRs) leads to increased expression of adenosine triphosphate (ATP) binding cassetter transporter (ABCA1), ATP binding cassetter transporter gene (ABCG1) and apoE and promotes cholesterol efflux. ABCA1 stimulates cholesterol efflux to lipid-poor apolipoproteins, whilst ABCG1 promotes efflux of cholesterol and oxysterols to HDL. Despite some recent setbacks in the clinical arena, there is still intense interest in therapeutically targeting HDL and macrophage cholesterol efflux pathways, via treatments with niacin, cholesterol ester transfer protein inhibitors, LXR activators and infusions of apoA-1, phospholipids and peptides.     

HDL therapy for the acute treatment of atherosclerosis

Although pharmacologic intervention to treat atherosclerosis originally focused on lowering LDL-cholesterol levels as a therapeutic target, a number of intervention trials have also highlighted the powerful effect of elevating HDL-cholesterol levels to reduce cardiovascular morbidity and mortality. Although the mechanism(s) by which HDL beneficially alters the atherosclerotic disease process is (are) still unknown, it is presumed that high levels of HDL facilitate the efflux of cholesterol from the arterial wall, thereby enhancing the transport of cholesterol and other lipids from arteries back to the liver for biliary excretion as fecal sterols and bile acids. It has therefore been hypothesized that through a rapid facilitation of HDL mediated cholesterol efflux from arteries by infusion of synthetic apolipoprotein A-I (apoA-I)/phospholipid (A-I/PL) complexes, HDL therapy could have an acute therapeutic application to treat cardiovascular disease at the site of action, namely the vulnerable, unstable atherosclerotic plaque. Single high dose infusions and repeated injections of lower doses of apoA-I variants or mimetics complexed to phospholipids have produced remarkable effects on the progression and regression of atherosclerosis in animal models. The positive results of these preclinical experiments have compelled researchers to perform exploratory studies in human subjects in which reconstituted HDL and synthetic A-I/PL complexes are infused through a peripheral vein. These clinical studies are testing the hypothesis and the potential use of synthetic HDL as a new treatment modality for acute coronary syndromes. Given that there is an unmet medical need for new and more effective therapies to elevate HDL-cholesterol levels and improve HDL function, a historical review, update and discussion of the preclinical and clinical studies which support the use of HDL therapy for reducing cardiovascular morbidity and mortality is warranted.     

Advanced glycation of apolipoprotein A-I impairs its anti-atherogenic properties

Aims/hypothesis AGE contribute to the pathogenesis of diabetic complications, including dyslipidaemia and atherosclerosis. However, the precise mechanisms remain to be established. In the present study, we examined whether AGE modification of apolipoprotein A-I (apoA-I) affects its functionality, thus altering its cardioprotective profile. Materials and methods The ability of AGE-modified apoA-I to facilitate cholesterol and phospholipid efflux, stabilise ATP-binding cassette transporter A1 (ABCA1) and inhibit expression of adhesion molecules in human macrophages and monocytes was studied. Results The ability of AGE-modified apoA-I to promote cholesterol efflux from THP-1 macrophages, isolated human monocytes and from ABCA1-transfected HeLa cells was significantly reduced (>70%) compared with unmodified apoA-I. This effect was reversed by preventing AGE formation with aminoguanidine or reversing AGE modification using the cross-link breaker alagebrium chloride. AGE-modification of HDL also reduced its capacity to promote cholesterol efflux. AGE–apoA-I was also less effective than apoA-I in stabilising ABCA1 in THP-1 cells as well as in inhibiting expression of CD11b in human monocytes. Conclusions/interpretation AGE modification of apoA-I considerably impairs its cardioprotective, antiatherogenic properties, including the ability to promote cholesterol efflux, stabilise ABCA1 and inhibit the expression of adhesion molecules. These findings provide a rationale for targeting AGE in the management of diabetic dyslipidaemia.     

ATP结合盒转运子A1与动脉粥样硬化(2)

ATP结合盒转运子A1(ABCA1)在血清脂蛋白代谢及细胞胆固醇平衡的维持中起重要作用。贫脂的载脂蛋白A-I是ABCA1介导的磷脂/胆固醇流出的接受体。ABCA1可以通过将胆固醇从肠壁吸收细胞运至肠腔而调节胆固醇的吸收,肠道ABCA1mRNA含量与胆固醇吸收呈负相关。不饱和脂肪酸减少非脂化胆固醇和磷脂的流出,而饱和脂肪酸没有这种作用。动脉硬化饮食15周后,ABCA1转基因鼠主动脉硬化明显减少。     

Myeloperoxidase: an inflammatory enzyme for generating dysfunctional high density lipoprotein

PURPOSE OF REVIEW: Evidence indicates that high density lipoprotein (HDL) is cardioprotective and that several mechanisms are involved. One important pathway is a membrane-associated ATP-binding cassette transporter, ABCA1, that clears cholesterol from macrophage foam cells. Anti-inflammatory and antioxidant properties also might contribute to HDL's ability to inhibit atherosclerosis. RECENT FINDINGS: Myeloperoxidase targets HDL for oxidation, raising the possibility that the enzyme provides a specific mechanism for generating dysfunctional HDL in humans. Myeloperoxidase-dependent oxidation of apolipoprotein A-I, the major protein in HDL, blocks HDL's ability to remove excess cholesterol from cells by the ABCA1 pathway. Analysis of mutated forms of apoA-I and oxidized apoA-I treated with methionine sulfoxide reductase implicate oxidation of specific tyrosine and methionine residues in impairing the ABCA1 transport activity of apoA-I. The crystal structure of lipid-free apoA-I suggests that such oxidative damage might disrupt negatively charged regions on the protein's surface or alter its remodeling, resulting in conformations that fail to interact with ABCA1. SUMMARY: Oxidation of HDL by myeloperoxidase may represent a specific molecular mechanism for converting the cardioprotective lipoprotein into a dysfunctional form, raising the possibility that the enzyme represents a potential therapeutic target for preventing vascular disease in humans. Moreover, oxidized HDL might prove useful as a blood marker for clinically significant cardiovascular disease in humans.     

Focusing on high-density lipoprotein for coronary heart disease risk reduction

A low level of high-density lipoprotein (HDL) is an acknowledged risk factor for coronary heart disease (CHD). HDL cholesterol (HDL-C) exerts its primary cardioprotective effect through a reverse cholesterol transport process, and suppression of this process has been the focus of the development of novel therapeutic agents for increasing HDL-C levels. Several strategies can be used to increase HDL-C levels to target cardiovascular risk reduction. This article presents a review of the biologic actions of HDL that can serve as a potential basis for antiatherosclerotic activity and discusses strategies for targeting HDL for CHD risk reduction.     

ATP结合盒转运蛋白A1研究进展

动脉粥样硬化是心脑血管疾病的重要基础病理改变,而胆固醇在巨噬细胞内聚集和泡沫细胞形成是动脉粥样硬化的始动环节。ATP结合盒转运蛋白Al（ABCAl）是一种重要的胆固醇流出调节蛋白,能介导细胞内胆固醇逆向转运到细胞外,使之与载脂蛋白A-Ⅰ结合并包装形成高密度脂蛋白（HDL）的膜转运蛋白。因此,ABCAl是调节血浆HDL及细胞内胆固醇水平的重要膜蛋白,ABCAl的表达水平与动脉粥样硬化的发生关系密切。同时,细胞内脂质、核受体PPAR、LXR、RXR和细胞因子等对ABCAl蛋白表达具有凋控作用。本文将ABCAl研究进展作一综述。     

低HDL-C者外周血白细胞胆固醇流出调节基因表达及相关研究

目的 研究低HDL-C患者外周血白细胞ABCA1和ABCG1 mRNA的表达状态.方法 采用实时荧光定量PCR方法,测定外周血白细胞ABCA1和ABCG1 mRNA表达水平.结果 低HDL-C患者ABCA1表达水平较对照组显著降低（0.23±0.09比1.18±0.49,P=0.042）,ABCG1 mRNA表达差异无统计学意义（3.09±1.08比3.94±1.48,P=0.355）;低HDL-C者高敏CRP（hs-CR P）水平明显高于对照组（2.34±1.68比1.15±0.48,P=0.008）;血清hsCRP水平与ABCA1 mRNA表达呈负相关（r=-0.330,P=0.043）,与血清HDL-C水平无相关性（r=0.19,P=0.254）.多因素线性回归分析表明,ABCA1mRNA表达水平与血清hs-CRP水平呈边缘性相关（β=-0.330,P=0.079）.结论 低HDL-C患者外周血ABCA1 mRNA表达水平降低,炎症因素或许是其机制之一.这可能是低HDL-C者心血管病风险增高的一个因素.     

Reverse cholesterol transport in type 2 diabetes mellitus

High-density lipoprotein (HDL) plays an important protective role against atherosclerosis, and the anti-atherogenic properties of HDL include the promotion of cellular cholesterol efflux and reverse cholesterol transport (RCT), as well as antioxidant, anti-inflammatory and anticoagulant effects. RCT is a complex pathway, which transports cholesterol from peripheral cells and tissues to the liver for its metabolism and biliary excretion. The major steps in the RCT pathway include the efflux of free cholesterol mediated by cholesterol transporters from cells to the main extracellular acceptor HDL, the conversion of free cholesterol to cholesteryl esters and the subsequent removal of cholesteryl ester in HDL by the liver. The efficiency of RCT is influenced by the mobilization of cellular lipids for efflux and the intravascular remodelling and kinetics of HDL metabolism. Despite the increased cardiovascular risk in people with type 2 diabetes, current knowledge on RCT in diabetes is limited. In this article, abnormalities in RCT in type 2 diabetes mellitus and therapeutic strategies targeting HDL and RCT will be reviewed.     

GDF11通过上调ABCA1表达促进小鼠体内胆固醇逆转运

目的研究生长分化因子11(GDF11)对巨噬细胞胆固醇逆转运的影响,并探究GDF11发挥作用的具体机制。方法提取小鼠腹腔巨噬细胞后给予氧化型低密度脂蛋白(ox-LDL)、GDF11和激活素受体样激酶7(ALK7)抑制剂SB431542孵育24 h。利用油红O染色观察细胞脂质蓄积,提取总m RNA和总蛋白后,利用realtime PCR和Western blot检测GDF11、三磷酸腺苷结合盒转运体A1(ABCA1)和三磷酸腺苷结合盒转运体G1(ABCG1)的m RNA和蛋白表达水平。给予小鼠腹腔注射外源GDF11,提取腹腔巨噬细胞用3H标记的胆固醇孵育后注射回小鼠腹腔内,每8 h收集一次小鼠粪便,48 h后收集小鼠肝脏和血液样本,检测样本3H含量,计算胆固醇逆转运水平。结果 ox-LDL孵育24 h显著诱导巨噬细胞内脂质蓄积,同时抑制GDF11 m RNA及蛋白的表达。GDF11处理能有效抑制ox-LDL诱导的巨噬细胞脂质蓄积,同时显著诱导ABCA1 m RNA及蛋白的表达。经外源补充GDF11后显著提高小鼠体内胆固醇逆转运水平。GDF11孵育巨噬细胞后,在给予巨噬细胞ALK7抑制剂SB431542孵育后,GDF11对ox-LDL诱导细胞内脂质蓄积的抑制作用被拮抗,对ABCA1表达的调控作用也被抑制。结论 GDF11通过ALK7调节ABCA1的表达,从而促进巨噬细胞胆固醇逆转运。     

POPC/apoA-I discs as a potent lipoprotein modulator in Tangier disease

Tangier disease (TD) is a rare familial disorder with mutations in the ATP-binding cassette transporter A1 (ABCA1) gene. It results in extremely low levels of HDL cholesterol. Since TD is a genetic disorder, a therapeutic approach to TD has not been established. We report a typical case of TD with a homozygous novel point mutation in the ABCA1 gene by using genomic DNA sequencing. Primary monocyte-derived macrophages of blood from a patient with TD and normolipidemic subjects were compared for cholesterol efflux. The macrophages from the TD patient showed no apoA-I-mediated cholesterol efflux. In contrast, POPC/apoA-I discs were able to take up cholesterol from macrophages from both the TD and normolipidemic subject. Capillary isotachophoresis (cITP), which separates lipoprotein into subfractions according to electrophoretic mobility, was used to characterize plasma lipoprotein subfractions. Both slow-migrating HDL (sHDL) and slow-migrating LDL (sLDL; unmodified LDL) subfractions were extremely low in the patient with TD. After incubation of plasma from the TD patient with POPC/apoA-I discs, sHDL and sLDL subfractions rapidly appeared. In conclusion, POPC/apoA-I discs not only have beneficial effects on cholesterol efflux, but also have potential as a lipoprotein modulator in patients with TD.     

Cholesterinrücktransport und HDL-Funktion

Changes in high-density lipoprotein (HDL) metabolism are causally linked to atherosclerosis. Knowledge about HDL metabolism is necessary to use this relationship as a therapeutic approach to address atherosclerosis. Different proteins are involved in HDL metabolism and include structural proteins, such as apolipoprotein A1 (apoA1), apoA2 and apoE, enzymes or transport proteins, such as lecithin-cholesterol acyltransferase (LCAT) or cholesteryl ester transfer protein (CETP) and cellular transporters, such as ATP-binding cassette transporter A1 (ABCA1), ATP-binding cassette transporter G1 (ABCG1) and scavenger receptor B1 (SR-B1). These components are necessary to warrant cholesterol efflux and also for the anti-inflammatory, antioxidative and antithrombotic properties of HDL. Because of the complexity of HDL metabolism it is difficult to predict whether interventions affecting HDL levels or function will be proatherogenic, antiatherogenic or neutral. However, the epidemiological as well as the genetic data indicate that modulations of the HDL system will influence atherosclerosis. Therefore, HDL modifying interventions are an interesting approach to address residual risks associated with statin therapy.     

Hypocholesterolemia, foam cell accumulation, but no atherosclerosis in mice lacking ABC-transporter A1 and scavenger receptor BI

High-density lipoprotein (HDL) mediated reverse cholesterol transport (RCT) is regarded to be crucial for prevention of foam cell formation and atherosclerosis. ABC-transporter A1 (ABCA1) and scavenger receptor BI (SR-BI) are involved in the biogenesis of HDL and the selective delivery of HDL cholesterol to the liver, respectively. In the present study, we phenotypically characterized mice lacking these two proteins essential for HDL metabolism. ABCA1 × SR-BI double knockout (dKO) mice showed severe hypocholesterolemia mainly due to HDL loss, despite a 90% reduction of HDL cholesterol uptake by liver. VLDL production was increased in dKO mice. However, non-HDL cholesterol levels were reduced, probably due to enhanced clearance via LRP1. Hepatobiliary cholesterol transport and fecal sterol excretion were not impaired in dKO mice. In contrast, the macrophage RCT in dKO mice was markedly impaired as compared to WT mice, associated with the accumulation of macrophage foam cells in the lung and Peyer's patches. Strikingly, no atherosclerotic lesion formation was observed in dKO mice. In conclusion, both ABCA1 and SR-BI are essential for maintaining a properly functioning HDL-mediated macrophage RCT, while the potential anti-atherosclerotic functions of ABCA1 and SR-BI are not evident in dKO mice due to the absence of pro-atherogenic lipoproteins.     

The ABCA1 transporter and ApoA-I: obligate or facultative partners?

Premature cardiovascular disease, the leading cause of death in the Western world, is frequently associated with disorders of lipid metabolism and, in particular, with low levels of circulating high-density lipoprotein (HDL) cholesterol. However, the relationship among HDL, centripetal cholesterol transport, and early atherogenesis has remained elusive until the characterization of the molecular defect leading to Tangier disease. In this disorder, the loss of function of the adenosine triphosphate-binding cassette transporter, ABCA1, leads to an impaired formation of nascent HDL particles by preventing the release of cellular lipids and cholesterol to the acceptor apolipoprotein (apo)A-I. Lipids bound to circulating apoA-I are derived from cell membranes via active effluxes experimentally elicited by the interaction of nascent lipid-free apoA-I with the membrane itself. The nature of this key interaction is still enigmatic, however, and a large number of controversial results (discussed in this article) have been reported. Indeed, although the active mechanism that assists the extraction of cellular lipids entails as a simplest option the existence of a dedicated receptor at the membrane, the unambiguous identification of this molecule has not been achieved. This lack of precise evidence makes it necessary to consider alternative models, taking into account the dynamic and functional constraints that regulate the interaction between apoA-I and the plasma membrane.