Lp(a) lipoprotein is a major risk factor for cardiovascular disease: pathogenic mechanisms and clinical significance

The results of two previous and two recent studies of middle-aged males and females are presented to exemplify the clinical importance of lipoprotein (a) (Lp(a)) as a risk factor for atherosclerosis and coronary heart disease. In these studies various conventional and recently suggested risk factors were included and different methods for Lp(a) quantification were used. Lp(a) was a significant risk factor in all four studies. In the recent prospective case-control study, Lp(a) and cholesterol were found to act synergistically and predict primary acute myocardial infarction in Swedish males. A cholesterol level above 6.5 mmol/1 increased the risk of acute myocardial infarction if the Lp(a) level was above 200 mg/1. The plasma apo A-I level was a protective factor. In the other recent case-control study, an Lp(a) level above 500 mg/1 was a highly significant risk factor in Black and White US women with myocardial infarction or advanced coronary artery disease in addition to low density lipoprotein cholesterol levels above 130 mg/dl. A high apo A-I level was a protective factor. In these studies no other factors tested reached significance in multivariate logistic regression analysis. A hypothetical association between high Lp(a) levels and intracellular infection with Chlamydia pneumoniae is discussed. The results suggest that the Lp(a) level is useful in identifying high-risk individuals. Lowering low density lipoprotein cholesterol below 100 mg/dl (7lt;2.6 mmol/1) seems to be most important in both males and females with high-risk Lp(a) levels.     

Analysis of the mechanism of lipoprotein(a) assembly

We have assessed the ability of a battery of purified recombinant apolipoprotein(a) (r-apo(a)) derivatives to bind to immobilized low-density lipoprotein (LDL) by ELISA. Removal of the apo(a) kringle IV type 8 and type 9 sequences dramatically reduced apo(a) binding to LDL. The binding of apo(a) to LDL was effectively inhibited by arginine, lysine, the lysine analogue ε-aminocaproic acid and proline; comparable inhibition was observed using the 17K and KIV_5–8 r-apo(a) derivatives, suggesting a direct role for sequences contained in the latter species in mediating the initial non-covalent interactions which precede specific disulfide bond formation. We also determined that r-apo(a) binds directly to a synthetic apoB peptide spanning amino acid residues 3732–3745; this interaction appeared to be mediated by sequences present in apo(a) kringle IV types 8 and 9, and could be inhibited by arginine, lysine and proline. The results of this study indicate that the efficiency of Lp(a) assembly is a direct function of the initial non-covalent interactions between apo(a) and LDL; in addition, these studies suggest that Cys3734 in apoB mediates covalent linkage with apo(a) by virtue of the ability of the apoB sequences surrounding this residue to directly interact with apo(a) KIV type 9.     

Normal human IgG prevents endothelial cell activation induced by TNFalpha and oxidized low-density lipoprotein atherogenic stimuli

Normal human immunoglobulin G (IgG) has anti-inflammatory and immuno-regulatory properties, which are exploited in the therapy of selected diseases. A putative mechanisms of action is the direct regulation of endothelial cell function by natural antiendothelial cell antibodies. Endothelium activation is a critical event in atherosclerosis. We have verified the ability of normal human IgG to modulate endothelial responses to the atherogenic stimuli tumour necrosis factor-alpha (TNFalpha) and oxidized low-density lipoproteins (oxLDL) in vitro. Confocal microscopy was used to visualize vascular cell adhesion molecule-1 (CD106) expression on endothelial cells, cytoplasmic free calcium ([Ca++]i) modifications and fluorescein-coupled oxLDL internalization. Cytokine secretion was measured by ELISA on cell supernatants. IgG prevented TNFalpha induced CD106 membrane expression and an increase in [Ca++]i, and inhibited the secretion of interleukin-6 (IL-6) and macrophage-colony-stimulating factor (M-CSF). IgG also inhibited CD106 expression induced by oxLDL and one pathway of their internalization, but were ineffective on oxLDL induced [Ca++]i rise and apoptosis. F(ab)'2 fragments from IgG, but not monoclonal IgG, reproduce IgG effects. These findings point to a regulatory role for specific antibodies included in circulating normal IgG towards proinflammatory responses of endothelial cells in atherogenesis and suggest possible development of new therapeutic strategies.     

血管紧张素II对巨噬细胞(THP-1细胞)凝集素样氧化低密度脂蛋白受体表达的影响

目的:研究AngII对人单核/巨噬细胞(THP-1细胞)凝集素样氧化低密度脂蛋白受体(LOX-1)蛋白表达和基因转录的影响,从细胞蛋白、分子水平探讨AngII和巨噬细胞LOX-1相互之间的关系,以进一步了解两者在动脉粥样硬化中的地位。方法:将不同浓度AngII(1×10^-9-1×10^-5mol/L)与经0.1μmol/L佛波酯(PMA)诱导分化后的THP-1细胞共孵育24h,以及将1×10^-6mol/L浓度的AngII与诱导分化后的THP-1细胞作用不同时间0、3、6、12、24、48h后,用细胞酶联免疫法和半定量RT-PCR分别检测LOX-1蛋白和mRNA表达的情况。结果:未经诱导的THP-1细胞不表达LOX-1mRNA;而经PMA诱导后,THP-1细胞停止增殖,由单核细胞分化成为巨噬细胞,并表达LOX-1mRNA。不同浓度的AngII作用诱导分化后的THP-1细胞24h,细胞LOX-1蛋白和mRNA的表达呈浓度依赖性显著增加。同一浓度的AngII作用THP-1细胞,可呈时间依赖性诱导LOX-1蛋白和mRNA表达,其趋势是3h左右开始增加,24h左右至最高峰,之后逐渐减低。结论:经PMA诱导分化后的THP-1细胞表达LOX-1;AngII能明显增强分化后的THP-1细胞表达LOX-1蛋白和mRNA,并呈浓度和时间依赖性。AngII这种作用可能是促进动脉粥样硬化发生、发展的机制之一。     

LOX-1介导ox-LDL诱导的血管内皮细胞MCP-1的表达

目的：观察血凝素氧化低密度脂蛋白受体-1（LOX-1）对氧化LDL（ox-LDL）诱导的人脐静脉内皮细胞(human unbilical vein endothelial cells, HUVECs)表达单核细胞趋化蛋白（monocyte chemoattractant protein-1, MCP-1）基因及蛋白的影响。 方法： 用RT-PCR和Western blot的方法观察ox-LDL对培养的HUVECs表达LOX-1和MCP-1基因及蛋白的影响，然后用LOX-1的受体阻滞剂爱兰苔胶（carrageenan） 和聚肌苷酸［polyinosinic acid，poly(I)］与HUVECs预先作用后，再观察内皮细胞表达LOX-1和MCP-1基因和蛋白的变化。 结果： 用不同浓度的ox-LDL（0 mg/L、10 mg/L、20 mg/L 、50 mg/L、100 mg/L）与HUVECs培养24 h后，LOX-1和MCP-1的mRNA和蛋白的表达明显增加，呈浓度依赖性；用Carrageenan 和polyinosinic acid与HUVECs预先作用2 h后，再加入50 mg/L的ox-LDL培养24 h，与未加Carrageenan和polyinosinic acid相比，HUVECsLOX-1和MCP-1的mRNA和蛋白的表达明显减少。 结论： ox-LDL可以调节培养的HUVECsLOX-1和MCP-1基因和蛋白的表达，LOX-1作为ox-LDL的特异性受体，可能介导了ox-LDL诱导血管内皮细胞分泌MCP-1，从而在动脉粥样硬化的发生发展中起着重要的作用。     

血凝素样氧化低密度脂蛋白受体-1与动脉粥样硬化的研究进展

Lectin-like oxidized low density lipoprotein receptor-1 (LOX-1 } is a type-Ⅱ membrane protein belonging to the C-type lectin family molecules, which acts as a cell surface endocytosis receptor for atherogenic oxidized LDL (Ox-LDL）. LOX-1 supports the binding internalization and proteolytic degradation of oxidized LDL, but not of significant amounts of acetylated LDL. LOX-1 is initially synthesized as a 40 kD precursor protein with N-linked high mannose-type carbohydrate, which is further glycosylated and processed into a 48-kD mature form. In vivo, endothelial cells that cover early therosclerotic lesions, intimal macrophages and smooth muscle cells in advanced atherosclerotic plaques express LOX-1. LOX-1 is cleaved at membrane proximal extracellular domain and released from the cell surface. Measurement of soluble LOX-1 in vivo may provide novel diagnostic strategy for the evaluation and prediction of atherosclerosis and vascular diseases.     

Influence of serum paraoxonase polymorphism on serum lipids and apolipoproteins

One hundred and sixty-three healthy Chinese subjects of both sexes were studied for serum paraoxonase (PON) polymorphism, and levels of lipids and apolipoproteins in order to examine effects of PON alleles on these parameters. The level of serum triglyceride was significantly higher in high activity allele (PON*B) compared with that in low activity allele (PON*A) in both sexes (P less than 0.01). The subjects with PON A had significantly higher LDL cholesterol (P less than 0.05) and lower Apo A-II and ApoB levels. The influence of serum paraoxonase on serum lipids was estimated further by Spearman's rank correlation. In the males, there was a significant negative correlation of serum paraoxonase activity with total (P less than 0.05) and LDL (P less than 0.01) cholesterol levels, and positive correlation with HDL cholesterol and Apo A-II levels (P less than 0.05). Serum paraoxonase activity had a high positive correlation with serum triglyceride levels in both sexes (P less than 0.001). Serum ApoB level had a positive correlation with the enzyme activity only in females (P less than 0.01). The allelic effect of PON on these parameters was studied by multiple regression analysis. The high activity allele (PON*B) was associated with higher serum triglyceride level (P less than 0.001) and ApoB (P less than 0.001), while it had lowering influence on total cholesterol (P less than 0.05) and LDL cholesterol (P less than 0.005) in men. The average allelic effect of PON was found to be about 22% for serum triglycerides, 11% for LDL cholesterol, 14% for Apo A-II and 19% for Apo B in the present study. This study suggests a possible significant role of serum paraoxonase alleles in the metabolism of serum lipids and apolipoproteins.     

β-血小板球蛋白对小牛主动脉内皮细胞的LDL受体活性的抑制作用的初步研究

本文首次报告了β-血小板球蛋白(β-TG)能明显抑制小牛主动脉内皮细胞的LDL受体活性,但不影响该受体的生成。初步分析提示β-TG的这种抑制作用可能不完全是由于β-TG和~(125)I-LDL之间存在的竞争性抑制作用所致。此外,对于β-TG的这种抑制作用在动脉粥样硬化形成中的意义进行了讨论。     

核因子-κB活化参与Ox-LDL诱导人肾小球系膜细胞表达单核细胞趋化蛋白-1(英文)

目的：研究核因子-κB(NF-κB)在氧化低密度脂蛋白(Ox-LDL)诱导的体外培养的人肾小球系膜细胞表达单核/巨噬细胞趋化蛋白-1(MCP-1)中的作用。方法： 采用凝胶迁移率变动分析检测NF-κB的DNA结合活性变化，以免疫组化观测细胞内REL P65的核转位，用细胞ELISA法检测细胞内MCP-1及IκBα蛋白含量变化。结果： 不同浓度(10、25、50、100 mg/L)Ox-LDL刺激肾小球系膜细胞均可引起细胞NF-κB的DNA结合活性增强，50 mg/L Ox-LDL活化MCs效果最明显(8.50±1.14，P＜0.01 vs control； P＜0.05 vs 10, 25和100 mg/L Ox-LDL)。Ox-LDL刺激MCs 30-240 min均可以活化NF-κB，60 min时相点活性最强(11.0±2.11，P＜0.01 vs control； P＜0.05 vs 30 min or 240 min)。以50 mg/L Ox-LDL刺激MCs 1 h后，细胞内IκBα蛋白水平最低(0.050±0.006，n=5,P＜0.01 vs control)，作用24 h MCP-1表达水平最高(0.331±0.016， n=5,P＜0.01 vs control)。NF-κB活化的同时伴有REL P65核转位。上述效应可被NF-κB特异性抑制剂吡咯二硫氨基甲酸酯(PDTC)所抑制。结论： Ox-LDL刺激人肾小球系膜细胞产生MCP-1是由NF-κB调控，NF-κB参与了脂质肾损害的发病过程。