Early atherogenesis in the White Carneau pigeon. III. Lipid accumulation in nascent foam cells.

The role of lysosomes in aortic atherogenesis in White Carneau pigeons was examined by means of acid phosphatase cytochemistry. Foam cells were the major constituent of nascent atherosclerotic lesions in pigeons fed a 0.5% cholesterol diet for either 5 or 10 weeks. Seventy-four percent of foam cell lipid from animals at 5 weeks was in cytoplasmic droplets. The remaining lipid appeared in secondary lysosomes. After 10 weeks of cholesterol feeding, lysosomal lipid accounted for 73% of the lipid volume. The lipid accumulation correlated with increases in both size and number of lysosomes. An average of 2.4 lysosomes per 10(4) cu mu of cytoplasm was observed at 5 weeks. This value doubled by 10 weeks. The average lysosome diameter also increased between 5 and 10 weeks from 2.2 mu to 5.75 mu. Concomitantly, the complexity of lysosomes increased from simple, spherical organelles at 5 weeks to complex, multichambered organelles at 10 weeks. In contrast, lipid storage within cytoplasmic lipid droplets did not change either in size or in number. These observations suggest that by 5 weeks lipid storage within cytoplasmic droplets was maximized, and continued increases in lipid stores occurred predominantly through lysosomal loading.     

Early atherogenesis in White Carneau pigeons. II. Ultrastructural and cytochemical observations.

The addition of cholesterol (0.5%) to the diet of White Carneau pigeons induces site specific, temporally predictable, atherosclerotic lesions. The earliest lesions, which occurred after 3 weeks, were small (less than 2500 sq mu in surface area) and were composed primarily of macrophage foam cells (94% of lesion volume). With a prolonged time on the diet the lesions expanded due to increases in the number and size of foam cells, increases in the amount of extracellular space, and influx of smooth muscle cells. Macrophage foam cells in advanced lesions composed 61% of the lesion volume, smooth muscle cells 25%, and extracellular space 14%. Concurrent with the alteration in the constituency of the lesion, redistribution of lipid within foam cells was noted. Lipid in small lesions was primarily cytoplasmic (88%), with the remaining 12% in acid-phosphatase-positive secondary lysosomes. In more advanced lesions, 34% of the lipid was cytoplastic and 66% was lysosomal. The changes in large lesions appeared to be a function of lesion age, because at the growing edge of large lesions both composition and lipid distribution resembled those of small early lesions.     

Lysosomal lipid accumulation in vascular smooth muscle cells

Using an inverted culture technique, the accumulation of lipid within vascular smooth muscle cells incubated with lipid droplets was studied. Initially, lipid was found exclusively within cytoplasmic inclusions but, as accumulation continued, lysosomes became the predominant site of lipid storage. After 3 hr of incubation, 84% of lipid was within lysosomes. This lysosomal lipid accumulation produced a tripling of the average size of lysosomes and resulted in lysosomes with complex, multilobed shapes. In contrast, although the number of cytoplasmic inclusions increased with lipid loading, individual inclusions maintained a spherical shape and a consistent diameter of 1-1.3 microns. Concomitant with changes in cellular lipid storage, incubation with lipid droplets induced development of an anastomosing network of acid phosphatase-containing tubules which were spatially related to sites of lysosomal lipid accumulation. Thus lipid accumulation produced ultrastructural alterations in a number of metabolic compartments. Similar alterations in the intracellular compartmentalization of acquired lipid have been demonstrated in foam cells during atherogenesis and have been hypothesized to have profound effects on lipid metabolism and disease progression.     

DRUG-INDUCED LYSOSOMAL CHANGES and NEPHROTOXICITY IN RATS

Lysosomal involvement In renal tubular lesions was studied mainly by electronmicroscopy after single and repeated administrations of cephacetrile, cephalothin, cephaloridine, gentamicin or leupeptin and combine administrations of cephalothin and gentamicin or gentamicin and leupeptin in female Wistar rats. Large cytosomes of high density were increased due probably to either reabsorption and secretion of drugs or their metabolites. These cytosomes displaying acid phosphatase activity were demonstrated histo-chemically and were identified as heterolysosomes. In rats treated with cephaloridine, gentamicin or leupeptin, disruption of lysosomal membrane was noted and regional cytoplasmic destruction'was seen in the vicinity of the disrupted heterolysosomes. Necrotic epithelial cells and renal insufficiency were observed in these animals. On the other hand, neither destruction of lysosomes nor cell lesion was found in rats treated with cephacetrile or cephalothin. It was speculated that lysosomal destruction might be the cause of the cell lesions found in cephaloridine, gentamicin or leupeptin treated rats.     

Pigeon monocyte/macrophage lysosomes during beta VLDL uptake. Induction of acid phosphatase activity. A model for complex arterial lysosomes.

Lysosomes have long been implicated as a factor contributing to the progression and complication of atherosclerosis. The authors' laboratory previously has shown that lysosomal ultrastructure in arterial macrophage foam cells is altered as primary lysosomes give rise to large pleiomorphic organelles on lipid accumulation during lesion progression. To further explore the subcellular alterations in lysosomes and associated organelles during foam cell formation, three-dimensional (3D) intermediate voltage electron microscopy was used to examine monocyte-derived macrophages (monocyte/macrophages) during early in vitro uptake of beta migrating very-low-density lipoproteins (beta VLDL). Lysosomes were identified using acid phosphatase cytochemistry, and in control cells these organelles constituted 3.5% of the total cytoplasmic volume. Both primary and secondary lysosomes were observed. Upon beta VLDL uptake, the total volume of acid-phosphatase-positive organelles increased threefold over 30 minutes, and the reaction product was found in three additional morphologically distinct structures: tubular lysosomes, membrane stacks, and endoplasmic reticulum with widened cisternae. The proportion of the cell occupied by each of the five acid-phosphatase-positive organelles was quantitated at 10 minutes, 30 minutes, 1 hour, and 4 hours of beta VLDL incubation, and their relative abundance was compared with controls that were processed either with no lipoprotein challenge or albumin incubation for 1 hour. Secondary lysosomes compartment volume peaked at 30 minutes; over the ensuing 3.5 hours, however, the reaction progressively shifted to three new membrane-limited locations. Our observations document the complex 3D organization and spacial relationships among the acid-phosphatase-positive structures induced by lipoprotein uptake. The 3D organization patterns for acid-phosphatase-positive lysosomes in lipoprotein-stimulated pigeon monocyte/macrophages were similar in several aspects to the complex lysosomes previously observed in the macrophages of pigeon arterial lesions.     

Cellular changes associated with triton WR-1339 accumulation in rat hepatocytes. II. Lysosomal triton WR-1339 accumulation.

Following a single intraperitoneal injection, Triton WR-1339 accumulated in rat hepatocyte lysosomes. The accumulation phenomenon followed a two-step process: (1) Sequestration of Triton and subsequent enlargement of lysosomes which occurred through 48 hr post-injection. (2) Fusion of lysosomes to form swollen, electron-lucid lysosomes which occurred from about 48 hr through 8 days post-injection. During the first phase, the dense lysosomal matrix was pushed to the periphery of the lysosome during enlargement. During phase 2 prominent swelling or enlargement of the lysosomes and increasing cellular damage was observed. From injection to 8 days post-injection, the number and size of the lysosomes increased. Hypertrophy of the Golgi apparatus, possibly associated with increased packaging, accompanied the increase in lysosome number. Lysosomal Triton accumulation exhibits morphological characteristics similar in many respects to storage diseases.     

Lipid accumulation in human aortic smooth muscle cell lysosomes.

Lipid deposition is a central feature of the human atherosclerotic lesion. Deficient lysosomal lipolytic activity has been implicated as a pathogenetic factor in atheroma formation. Cytochemical and ultrastructural examination of the abdominal aortas of 2 normal young males, ages 11 and 23, demonstrates lipid accumulation with lysosomes of intact mural smooth muscle cells. This appears to be an early stage in the process which eventually results in an overloading of lysosomes and the formation of lipid-laden foam cells.     

Glucosylceramide accumulation is not confined to the lysosome in fibroblasts from patients with Gaucher disease

Gaucher disease (GD) is an inborn error of glycosphingolipid metabolism resulting from a deficiency of the lysosomal enzyme β-glucosidase leading to the accumulation of glucosylceramide (GC) in lysosomes of affected cells. In order to determine the effect of GC accumulation on intracellular lipid content in fibroblasts from patients with GD, we measured individual species of ceramide, di- and trihexosylceramide, sphingomyelin, phosphatidylcholine, phosphatidylinositol and phosphatidylglycerol using electrospray ionisation-tandem mass spectrometry. The different subspecies of each lipid class correlated with each other and were summed to give total lipid concentrations. In addition to GC, we also noted secondary elevations in other lipids, especially in type 2 GD. Sub-cellular fractionation showed that GC was not confined to the lysosome but increased throughout the cell. The sequelae of extra-lysosomal accumulation may have implications in the pathogenic mechanisms of GD by interaction with biochemical and metabolic pathways located outside the lysosome. The elevation of ceramide in confluent type 2 GD fibroblasts redistributed from its primary site of accumulation in the lysosome to the endosomal region at four-weeks post-confluence. The accumulation of lipids in the endosome and lysosome suggests both impaired trafficking of lipids and reduced capacity of the lysosome to degrade lipids.     

Lysosomal function and dysfunction: mechanism and disease

SIGNIFICANCE: Lysosomes are organelles in which cellular degradation occurs in a controlled manner, separated from other cellular components. As several pathways terminate in the lysosome, lysosomal dysfunction has a profound impact on cell homeostasis, resulting in manifold pathological situations, including infectious diseases, neurodegeneration, and aging. RECENT ADVANCES: Lysosomal biology demonstrates that in addition to regulating the final steps of catabolic processes, lysosomes are essential up-stream modulators of autophagy and other essential lysosomal pathways. FUTURE DIRECTIONS AND CRITICAL ISSUES: Lysosomal membrane permeabilization offers therapeutic potential in the treatment of cancer, though the molecular regulators of this process remain obscure. This review focuses on recent discoveries in lysosomal function and dysfunction, primarily in in vivo situations.     

Lysosomes of the Arterial Wall: IV. Cytochemical Localization of Acid Phosphatase and Catalase in Smooth Muscle Cells and Foam Cells from Rabbit Atheromatous Aorta

Cytochemical methods for acid phosphatase and catalase were applied to atheromatous aortas from cholesterol-fed rabbits. Whole tissue, partially digested aortic slices and isolated cells were used for the study. Present in the atheromatous lesions were smooth muscle cells in all stages of foamy transformation, from virtually normal appearing smooth muscle cells to severely altered cells with pronounced lipid accumulation. The results with the acid phosphatase method show that lysosomes increase both in size and in number as the smooth muscle cells become foam cells. In normal appearing smooth muscle cells, acid phosphatase reaction product was found in stacked cisternae of the Golgi apparatus and in small vesicles located in the Golgi region and distributed throughout the cytoplasm. In foam cells, reaction product was found in membrane-limited vacuoles of varying size which typically contained membranous debris or myelin-like figures together with massive lipid deposits. No reaction was seen in “free” cytoplasmic lipid droplets lacking a surrounding membrane. These results confirm and extend previous biochemical findings indicating that, in the cholesterol-fed rabbit, the change from normal smooth muscle cell to foam cell is accompanied by marked physical and chemical changes of the lysosomes, including their progressive overloading with cholesteryl ester. Small diaminobenzidine-positive particles were present in normal smooth muscle cells and in those at all stages of foamy transformation. These particles were more frequent in foam cells, in agreement with the marked increase in catalase activity detected biochemically in these cells.     

Ultrastructural localization of peroxidase in atherosclerotic lesions of pigeons.

Atherosclerotic lesions are known to have metabolic alterations which are associated with progressive lipid accumulation. Among the changes, lysosomal enzyme activity has been extensively characterized and at the ultrastructural level has been correlated with the amount of foam cell lipid. In a fashion paralleling lysosomal change, artery wall peroxidase activity is also altered during disease progression. The present study focuses upon the ultrastructural localization of peroxidase activity in atherosclerotic lesions of the aorta and coronary arteries from White Carneau pigeons fed a cholesterol-supplemented (0.3%) diet for 3 years. This resulted in fibrous lesions, rich in smooth muscle cells. The birds were necropsied by perfusion fixation, and peroxidase cytochemistry was carried out using the diaminobenzidine reaction. Peroxidase activity was found within endothelial cells and smooth muscle cells in both the media and intima, but cytochemically demonstrable activity was not found in macrophage foam cells. Peroxidase was localized within the nuclear envelope and endoplasmic reticulum, especially within cells that had lipid inclusions. The degree of peroxidase positivity varied within and among the arteries. In nonlesion regions of the aorta 20% of medial smooth muscle cells was peroxidase positive; the value for coronary artery smooth muscle cells was less. The peroxidase activity within aortic lesions was increased with 44% of intimal smooth muscle cells being positive. Notably, 85-90% of the lipid-containing intimal smooth muscle cells were positive. In contrast, intimal smooth muscle cells in the coronary artery lacked peroxidase reaction product, even in cells containing lipid. We conclude from these studies that aortic lesions contain a cytochemically differentiated subset of lipid-containing, peroxidase-positive smooth muscle cells; but coronary lesions lack a comparable subset of smooth muscle cells.     

The role of the monocyte in atherogenesis: II. Migration of foam cells from atherosclerotic lesions.

A defined role in the atherogenic sequence is proposed for the circulating monocyte. The author has been able to demonstrate a "monocyte clearance system" in which large numbers of circulating monocytes invade the intima of lesion-prone areas in arteries, become phagocytic, and accumulate lipid. A fatty cell lesion results. Once lipid-laden, foam cells migrate back into the bloodstream by crossing the arterial endothelium. The ratio of penetrating monocytes to emerging foam cells decreases as fatty cell lesions develop until a one-to-one ratio is achieved in late fatty cell lesions, which do not progress further. Advanced fibroatherosclerotic plaques in the same animals do not show the same characteristics and have smooth muscle cell involvement. It would appear that advancement of the lesion is at least partially a result of failure of the monocyte clearance system to remove sufficient lipid. The invasion of monocytes and endothelial damage caused by foam cell clearance may, in late fatty lesions, contribute to plaque evolution by introducing growth factors from macrophages and platelets and allowing greater lipid influx. Elucidation of this system was facilitated by the examination of vessels from diet initiation onwards and by the observation of late nonprogressing fatty cell lesions. It is possible that this system exists in other models but has been overlooked by a predilection for the study of advanced lesions that prevails in the literature.     

Characterization of lipid-laden aortic cells from cholesterol-fed rabbits. III. Intracellular localization of cholesterol and cholesteryl ester.

The subcellular sites of accumulation of cholesterol and cholesteryl esters in rabbit atheromatous cells, were investigated by morphologic and biochemical techniques. Electron microscopy of lipid-filled cells in situ in atheromatous aortas of cholesterol-fed rabbits revealed lipid accumulation in the cytoplasm as lipid droplets and within lysosomes in the form of lipid globules, membranous whorls, and crystals. When such cells were isolated from the rabbit aortas by enzymic digestion, and then treated with Flickinger's aldehyde fixative containing 0.2 per cent digitonin, characteristic digitonide-lipid complexes ("spicules") were observed in discrete sites of the cytoplasm distinct from the cytoplasmic droplets. If these cells were first stained cytochemically for acid phosphatase and then treated with digitonin-aldehyde fixative, enzyme reaction product was found associated with the spicules indicating that the lysosomes of the atheromatous cells possess digitonin-reactive lipid. Subcellular fractionation of isolated rabbit aortic foam cells by sucrose density gradient centrifugation demonstrated the coequilibration of most of the intracellular unesterified cholesterol with low density lysosomes. Some cholesteryl ester was also associated with low density lysosomes, although most was found in a lipid droplet fraction of very low density. Together the results indicate that in rabbit atheromatous cells, lysosomes are the site of accumulation of intracellular cholesterol in excess of that structurally associated with membranes and that both cytoplasmic droplets and lysosomes are depot sites for cholesteryl esters.     

Coronary intimal sclerosis in Morquio's syndrome

Summary Mitral valve, coronary arteries, cartilage, and liver were studied by light and electron microscopy in a 15 year old boy with Morquio's syndrome, a genetic mucopolysaccharidosis, in which a deficiency of lysosomal hexosamine sulfatase is associated with accumulations of keratan sulfate in various organs. Coronary artery intimal sclerosis was a prominent feature of this disorder. Ultrastructural examination revealed numerous intimal smooth muscle cells containing storage vacuoles consistent with lysosomes. This was associated with marked interstitial deposition of collagen, elastin, and basement membrane material. Recent studies of human and experimental atherosclerosis have demonstrated the accumulation of cholesterol within vascular smooth muscle cell lysosomes. Intralysosomal accumulation of substrates other than cholesterol is also associated with vascular intimal sclerosis in genetic lysosomal disorders such as Fabry's disease and Hurler's syndrome. Lysosomal storage of undegraded substrate may be an important pathogenetic mechanism in the development of sclerotic vascular lesions.     

Dehydroepiandrosterone and related steroids induce multilamellar lipid structures in cultured human endothelial cells.

Pharmacologic doses of dehydroepiandrosterone (DHEA), a steroid hormone produced naturally by the adrenal cortex, may lower plasma lipoprotein levels in humans and reduce the severity of experimental atherosclerosis in rabbits. Effects of DHEA on cells of the vascular wall, particularly endothelial cells (EC), which are in direct contact with the plasma, have not been documented. The authors have found that micromolar doses of DHEA induce a consistent and reversible morphologic change in cultured EC derived from the human umbilical vein. During 24 hours of exposure to DHEA, cultured EC became loaded with phase-dense, perinuclear cytoplasmic granules, which persisted while DHEA remained in the culture medium. Certain steroids related to DHEA, particularly 17-ketosteroids, also induced perinuclear cytoplasmic granules. The granules lost their phase-density after fixed monolayers were extracted using ethanol or methanol. The granules did not form in media made with lipoprotein-deficient serum, suggesting that serum lipoproteins were involved in formation of the granules. Ultrastructurally, the granules were identical to multilamellar lipid structures, a type of pleomorphic lipid-containing lysosome found in foam cells. The granules were identified as lysosomes by positive reaction for acid phosphatase. The mechanism by which DHEA induces formation of lysosomal lipid structures remains to be determined.     

Early atherogenesis in White Carneau pigeons: effect of a short-term regression diet

The intracellular distribution of lipid shifts from cytoplasmic to lysosomal localization during the progression of atherosclerosis. It has been suggested that this shift may relate to regressability of lesions. The effects of reducing plasma cholesterol on the regression of early cholesterol-induced atherosclerosis were evaluated. Most small, early lesions disappeared after 5 weeks on the regression regimen. Larger lesions, however, did not change in extent even following 10 weeks regression. Although large lesions were not reduced in size under the regression conditions, total cytoplasmic lipid decreased. Paradoxically, the size of residual intracellular lipid deposits increased. The structural features of these remaining deposits suggest that they were lipid-filled lysosomes. Leukocyte adherence to endothelium, which increases 10- to 20-fold during progression, returned to control levels over most areas of large lesions. Levels of adherent leukocytes remained elevated, however, over small lesions and at the edges of larger lesions. Our data indicate that regression is not a uniform process, but rather, even in early lesions, varies within separate intimal microdomains. In addition, our data suggest that part of the difference may reside in differential partitioning of lipid into lysosomes.     

Lysosomes and the sclerotic arterial lesion in Hurler's disease

A case of Hurler's disease in a mentally retarded, six year old boy is reported. In Hurler's disease a lysosomal hydrolase, l-iduronidase, is deficient, and consequently undegradable mucopolysaccharide accumulates within lysosomes in many tissues. Severe occlusive coronary artery disease and sclerotic aortic lesions are common in very young patients, although their serum lipid and blood pressure levels are normal. Vascular collagen and elastin is increased, but little or no stainable lipid is present. Electron microscopy shows that aortic smooth muscle cells are distended by vacuoles, appearing empty in formalin fixed tissues, that identify them as the “gargoyle” cells in the proliferative lesion. The presence of a basic lysosomal defect and the absence of other contributing metabolic factors suggest that accumulation of an excess of undegradable substrate within smooth muscle lysosomes may be an initiating event in the development of proliferative sclerotic vascular lesions.     

Arterial prostaglandins and lysosomal function during atherogenesis. II. Isolated cells of diet-induced atherosclerotic aortas of rabbit

This report validates and expands further the interpretation of our findings on prostaglandins and lysosomes in rabbit aortic homogenates (see paper I of this series) to enzymatically isolated and separated aortic cell populations during atherogenesis. Evidence is provided by which isolated arterial cells may be considered representative of in situ increases of diseased aortic tissue prostaglandin I2 and E2 levels, as well as lysosomal acid hydrolase activities and total cholesterol content based on DNA. Increasing latency of aortic lysosomal N-acetyl-beta-glucosaminidase activity was confirmed and correlated with increasing severity of atherosclerosis, in parallel to increasing levels of prostaglandin I2 but not increasing levels of prostaglandin E2. Ultrastructural observations also confirmed aortic intracellular lipid accumulation within lysosomes and as lipid droplets. Consistent with these relationships, separated low density, lipid-filled aortic cells were especially increased in total (197%) and latent (15%) lysosomal acid hydrolase activities, catalase activity (274%), total cholesterol (151%), and in both prostaglandin I2 (67%) and E2 (325%) levels based on DNA, as compared to control aortic cells or more normal-appearing high-density diseased aortic smooth muscle cells; high-density diseased aortic cells were increased in prostaglandin E2 but similar in latent acid hydrolase activity compared to control aortic cells. Since the total cholesterol content of rabbit atherosclerotic aortas was evidenced more intracellularly (75%) than extracellularly (25%) in this study, the association of increased prostaglandin I2 and E2 levels with low-density lipid-filled cells suggest the participation of these prostaglandins in the genesis of aortic foam cells during arterial lipid accumulation in rabbit atherosclerosis. The association of increasing prostaglandin I2 levels and increasing latent lysosomal N-acetyl-beta-glucosaminidase activities also implicates a possible relationship between this prostaglandin and lysosomal membranes of aortic cells, either primary or secondary to intralysosomal lipid accumulation.     

Immunohistochemical and ultrastructural detection of advanced glycation end products in atherosclerotic lesions of human aorta with a novel specific monoclonal antibody.

To elucidate the deposition of advanced glycation end products (AGEs) in aortic atherosclerosis, aortic walls were obtained from 25 autopsy cases and examined immunohistochemically and immunoelectron microscopically with a monoclonal antibody specific for AGEs, 6D12. Among the autopsy cases, atherosclerotic lesions were found in the aortas of 22 cases and were composed of diffuse intimal thickening, fatty streaks, atherosclerotic plaques, and/or complicated lesions. In these cases, intracellular AGE accumulation was demonstrated in the intimal lesions of aortic atherosclerosis in 12 cases. Compared with the diffuse intimal thickening, intracellular AGE accumulation was marked in the fatty streaks and atherosclerotic plaques. Immunohistochemical double staining with 6D12 and monoclonal antibodies for macrophages or muscle actin or a polyclonal antibody for scavenger receptors demonstrated that the AGE accumulation in macrophages or their related foam cells was marked in the diffuse intimal thickening and fatty streak lesions and that almost all macrophages and macrophage-derived foam cells possessed scavenger receptors. Immunoelectron microscopic observation revealed the localization of 6D12-positive reaction in lysosomal lipid vacuoles or electron-dense granules of the foam cells. These results indicate that AGE accumulation occurs in macrophages, smooth muscle cells, and their related foam cells.     

An experimental study on the origin of foam cells in glomerulonephritis

Masugi nephritis induced in cholesterol-fed rabbits is characterized by accumulation of foam cells in glomeruli which vary in number almost in parallel with the natural course of the disease. From electron microscopic appearances these foam cells are apparently derived from migrant blood monocytes and mesangial cells, but not from endothelial cells. Location of monocytic foam cells is extremely variable, though most often observed in the subendothelial space. In addition, monocytes undergo transformation into multinucleated giant cells including Touton type's. Lipid deposits filling the cytoplasm of foam cells seem to be in two forms, free cytoplasmic droplets and membrane-bounded structures partly containing membranous debris or myelin figures. The latter accumulates preferentially in the cytocentrum and is considered to originate from lysosomes. It seems unlikely that glomerular lesions in Masugi nephritis are aggravated by foam cell accumulation.