Abstract

Mutations in the CETP gene resulting in defective CETP activity have been shown to cause remarkable elevations of plasma HDL-C levels, with the accumulation in plasma of large, buoyant HDL particles enriched in apolipoprotein E. Genetic CETP deficiency thus represents a unique tool to evaluate how structural alterations of HDL impact on HDL atheroprotective functions. Aim of the present study was to assess the ability of HDL obtained from CETP-deficient subjects to protect endothelial cells from the development of endothelial dysfunction. HDL isolated from one homozygous and seven heterozygous carriers of CETP null mutations were evaluated for their ability to down-regulate cytokine-induced cell adhesion molecule expression and to promote NO production in cultured endothelial cells. When compared at the same protein concentration, HDL and HDL3 from carriers proved to be as effective as control HDL and HDL3 in down-regulating cytokine-induced VCAM-1, while carrier HDL2 were more effective than control HDL2 in inhibiting VCAM-1 expression. On the other hand, HDL and HDL fractions from carriers of CETP deficiency were significantly less effective than control HDL and HDL fractions in stimulating NO production, due to a reduced eNOS activating capacity, likely because of a reduced S1P content. In conclusion, the present findings support the notion that genetic CETP deficiency, by affecting HDL particle structure, impacts on HDL vasculoprotective functions. Understanding of these effects might be important for predicting the outcomes of pharmacological CETP inhibition.

Highlights

  • Epidemiologic studies have clearly shown that high density lipoprotein cholesterol (HDL-C) levels are a strong, independent risk factor for the development of atherosclerotic coronary heart disease (CHD)

  • The plasma levels of the soluble forms of vascular cell adhesion molecule 1 (VCAM-1), intracellular cell adhesion molecule 1 (ICAM-1), and E-Selectin were significantly lower in carriers of cholesteryl ester transfer protein (CETP) mutations than in controls (Table 1)

  • The results demonstrate that HDL from carriers of CETP mutations are effective as control HDL in inhibiting cytokine-induced expression of VCAM-1 in cultured endothelial cells

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Summary

Introduction

Epidemiologic studies have clearly shown that high density lipoprotein cholesterol (HDL-C) levels are a strong, independent risk factor for the development of atherosclerotic coronary heart disease (CHD). Large randomized trials with two CETP inhibitors failed to show a beneficial effect of the drugs in reducing cardiovascular events [5,6] These unexpected results have been ascribed to either off-target effects of the drug [5,7,8], to weak CETP inhibition and HDL-C raising activity [6], or to mechanism-related effects [9]. Besides their major role in promoting cell cholesterol efflux and reverse cholesterol transport [10,11], HDL may exert atheroprotective activity by preventing endothelial dysfunction [12], a key step in the development of atherosclerosis. HDL downregulate cytokine-induced expression of cell adhesion molecules (CAMs) [12], and increase endothelial nitric oxide synthase (eNOS)

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