Abstract

The aim of this study was to test the hypothesis that C-reactive protein (CRP) protects against the development of atherosclerosis and that a conformational alteration of wild-type CRP is necessary for CRP to do so. Atherosclerosis is an inflammatory cardiovascular disease and CRP is a plasma protein produced by the liver in inflammatory states. The co-localization of CRP and low-density lipoproteins (LDL) at atherosclerotic lesions suggests a possible role of CRP in atherosclerosis. CRP binds to phosphocholine-containing molecules but does not interact with LDL unless the phosphocholine groups in LDL are exposed. However, CRP can bind to LDL, without the exposure of phosphocholine groups, if the native conformation of CRP is altered. Previously, we reported a CRP mutant, F66A/T76Y/E81A, generated by site-directed mutagenesis, that did not bind to phosphocholine. Unexpectedly, this mutant CRP, without any more conformational alteration, was found to bind to atherogenic LDL. We hypothesized that this CRP mutant, unlike wild-type CRP, could be anti-atherosclerotic and, accordingly, the effects of mutant CRP on atherosclerosis in atherosclerosis-prone LDL receptor-deficient mice were evaluated. Administration of mutant CRP into mice every other day for a few weeks slowed the progression of atherosclerosis. The size of atherosclerotic lesions in the aorta of mice treated with mutant CRP for 9 weeks was ~40% smaller than the lesions in the aorta of untreated mice. Thus, mutant CRP conferred protection against atherosclerosis, providing a proof of concept that a local inflammation-induced structural change in wild-type CRP is a prerequisite for CRP to control the development of atherosclerosis.

Highlights

  • Atherosclerosis is a chronic inflammatory disease whose development begins with the dysfunction of the endothelium of the arteries

  • In this study, we evaluated the effects of mutant C-reactive protein (CRP) (F66A/T76Y/E81A) on the development of atherosclerosis employing lowdensity lipoprotein (LDL) receptor-deficient (Ldlr−/−) mice, an animal model commonly used to investigate molecules involved in human atherosclerosis

  • CRP to either Oxidized LDL (ox-LDL), E-LDL, or acetylated LDL (ac-LDL) was independent of the PCh groups present in atherogenic LDL

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Summary

Introduction

Atherosclerosis is a chronic inflammatory disease whose development begins with the dysfunction of the endothelium of the arteries. Endothelial dysfunction leads to infiltration of plasma lowdensity lipoprotein (LDL) and monocytes in the arterial wall. LDL is subsequently deposited, modified and engulfed by monocyte-derived macrophages. Lipid-laden macrophage foam cells are proinflammatory which enhances the process of the formation of atherosclerotic lesions [1, 2]. The inflammatory microenvironment of atherosclerotic lesions is characterized by macrophage activation, hypoxia, and lactate and proton generation, resulting in an acidic extracellular pH [3,4,5,6,7].

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