Retention Of Lipoproteins Research Articles

Vascular Smooth Muscle-Specific Progerin Expression Accelerates Atherosclerosis and Death in a Mouse Model of Hutchinson-Gilford Progeria Syndrome.

Progerin, an aberrant protein that accumulates with age, causes the rare genetic disease Hutchinson-Gilford progeria syndrome (HGPS). Patients who have HGPS exhibit ubiquitous progerin expression, accelerated aging and atherosclerosis, and die in their early teens, mainly of myocardial infarction or stroke. The mechanisms underlying progerin-induced atherosclerosis remain unexplored, in part, because of the lack of appropriate animal models. We generated an atherosclerosis-prone model of HGPS by crossing apolipoprotein E-deficient (Apoe-/-) mice with LmnaG609G/G609G mice ubiquitously expressing progerin. To induce progerin expression specifically in macrophages or vascular smooth muscle cells (VSMCs), we crossed Apoe-/-LmnaLCS/LCS mice with LysMCre and SM22αCre mice, respectively. Progerin expression was evaluated by polymerase chain reaction and immunofluorescence. Cardiovascular alterations were determined by immunofluorescence and histology in male mice fed normal chow or a high-fat diet. In vivo low-density lipoprotein retention was assessed by intravenous injection of fluorescently labeled human low-density lipoprotein. Cardiac electric defects were evaluated by electrocardiography. Apoe-/-LmnaG609G/G609G mice with ubiquitous progerin expression exhibited a premature aging phenotype that included failure to thrive and shortened survival. In addition, high-fat diet-fed Apoe-/-LmnaG609G/G609G mice developed a severe vascular pathology, including medial VSMC loss and lipid retention, adventitial fibrosis, and accelerated atherosclerosis, thus resembling most aspects of cardiovascular disease observed in patients with HGPS. The same vascular alterations were also observed in Apoe-/-LmnaLCS/LCSSM22αCre mice expressing progerin specifically in VSMCs, but not in Apoe-/-LmnaLCS/LCSLysMCre mice with macrophage-specific progerin expression. Moreover, Apoe-/-LmnaLCS/LCSSM22αCre mice had a shortened lifespan despite the lack of any overt aging phenotype. Aortas of ubiquitously and VSMC-specific progerin-expressing mice exhibited increased retention of fluorescently labeled human low-density lipoprotein, and atheromata in both models showed vulnerable plaque features. Immunohistopathological examination indicated that Apoe-/-LmnaLCS/LCSSM22αCre mice, unlike Apoe-/-LmnaG609G/G609G mice, die of atherosclerosis-related causes. We have generated the first mouse model of progerin-induced atherosclerosis acceleration, and demonstrate that restricting progerin expression to VSMCs is sufficient to accelerate atherosclerosis, trigger plaque vulnerability, and reduce lifespan. Our results identify progerin-induced VSMC death as a major factor triggering atherosclerosis and premature death in HGPS.

Novel Anti-proteoglycan Antibody Inhibits Arterial Lipoprotein Retention and Prevents Cardiac Hypertrophy in a Rat Model of Insulin Resistance

Novel Anti-proteoglycan Antibody Inhibits Arterial Lipoprotein Retention and Prevents Cardiac Hypertrophy in a Rat Model of Insulin Resistance

Abstract 612: Low Expression of Lysosomal Acid Lipase in Smooth Muscle Cells Relative to Macrophages Provides New Insights into Foam Cell Lipid Accumulation

Background and Hypothesis: Smooth muscle cells (SMCs) are the predominant cell type within the intima of human atherosclerosis-prone arteries and promote initial retention of atherogenic lipoproteins in the deep intima. We previously found that ≥50% of foam cells in intermediate coronary atheromas are of SMC origin and that intimal SMCs have reduced expression of the ATP-binding cassette transporter A1 (ABCA1). Previously we also found that ABCA1 expression is acutely dependent on the flux of cholesterol out of lysosomes and subsequent generation of oxysterols for promotion of gene transcription by the nuclear liver X receptor (LXR). Hypothesis: In the present studies we tested the hypothesis that SMCs have lysosomal dysfunction that contributes to foam cell formation. Methods and Results: Human monocyte-derived macrophages (HMMs) and arterial SMCs were treated with aggregated LDL (agLDL) to increase intracellular cholesterol. Unlike HMMs, agLDL treatment failed to upregulate ABCA1 expression in SMCs and did not significantly increase 27-hydroxycholesterol levels. Also in contrast to HMMs, SMCs did not downregulate new cholesterol synthesis and displayed minimal increases in cholesteryl ester formation with agLDL loading. This data suggested retention of lipids within lysosomal compartments. Indeed, confocal microscopy revealed retention of lipids identified by the neutral lipid dye BODIPY within lysosomal compartments stained with LAMP1 in SMCs, while HMMs showed mostly cytosolic lipid droplets [Pearson correlation of colocalization of +0.3197±0.0123 in SMCs and -0.0897±0.0143 in HMMs (p<0.0001, avg±SEM, n>100 cells)]. LIPA mRNA levels and LAL protein were markedly reduced in SMCs relative to HMMs, with LAL activity being 23.4-times higher in HMMs compared to SMCs (p<0.0001, n=4). Similarly, we found reduced LAL levels in mouse SMCs relative to macrophages. Incubation of SMCs with medium containing LAL reduced lysosomal lipid accumulation, resulting in decreased new cholesterol synthesis and increased cholesterol efflux. Conclusions: We find that arterial SMCs have a relative deficiency in LAL expression resulting in defects in downstream sterol regulatory events compared to macrophages. Our results provide a novel reason for SMC foam cell formation and a potential therapeutic target.

Causal Effect of Lipids and Lipoproteins on Atherosclerosis

Mendelian randomization studies demonstrate that apolipoprotein B-containing lipoproteins have both causal and cumulative effects on the risk of atherosclerotic cardiovascular disease. The clinical benefit of lipid-lowering therapies depends on both the absolute reduction in circulating apolipoprotein B-containing lipoproteins and the total duration of exposure to these particles. Because atherosclerosis seems to be caused by the retention of apolipoprotein B-containing lipoproteins rather than by the cholesterol content carried by those lipoproteins, high-density lipoprotein-mediated efflux of cholesterol from the arterial wall may not reduce the risk of atherosclerotic cardiovascular disease.

Modeling Effects of a High‐Fat (Almonds) vs. High‐Carbohydrate (Graham Crackers) Snack on Metabolic Outcomes in College Freshmen

Biomedical research has provided support for the benefits of consuming almonds, a high‐fat food. However, most of the studies to date have considered only adult populations (age 40+). The objective of the study was to model the impact of consuming a high‐fat almond snack vs. a high‐carbohydrate graham cracker (control) snack for 4–8‐weeks in college freshmen. Seventy‐three UC Merced freshmen (Age: 18–19 years, BMI: 18–45 kg/m2) underwent a dietary intervention for eight weeks. Thirty‐eight participants consumed 2 ounces (325 kcal) of almonds and 35 participants consumed an isoenergetic control snack of graham crackers for 8 weeks. Anthropometric, biochemical and clinical measurements were conducted before the study began and at the fourth and the eighth week of the intervention. Several multivariate models were generated to model the effects of chronic almond and graham cracker snacking on the aforementioned outcomes. The most profound effect was the retention of high‐density lipoprotein (HDL) cholesterol and improvements in glucose tolerance in the almond snack group in comparison to the graham cracker snack group. This suggests that chronic almond snacking has the potential to improve the metabolic profile independent of profound changes in body mass or adiposity. We continue to perform the robust multivariate analyses factoring in BMI and sex effects.Support or Funding InformationAlmond Board of California, MARC U STAR, and UROCThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Signalling pathways regulating galactosaminoglycan synthesis and structure in vascular smooth muscle: Implications for lipoprotein binding and atherosclerosis.

Atherosclerosis commences with the trapping of low density lipoproteins (LDLs) in blood vessels by modified proteoglycans (PGs) with hyperelongated glycosaminoglycan (GAG) chains. GAG chain synthesis and growth factor mediated hyperelongation regulates the composition and size of PGs in a manner that would cause low density lipoprotein (LDLs) retention in vessel wall. Galactosaminoglycans are a class of GAGs, commonly observed on PGs. Multiple enzymes are involved in galactosaminoglycan biosynthesis. Galactosaminoglycan synthesis is regulated by various signalling pathways which are amenable to pharmacological manipulation to treat atherosclerosis. Receptor mediated signalling pathways including protein tyrosine kinase receptors (PTKRs), serine/threonine kinase receptors (S/TKRs) and G-protein coupled receptors (GPCRs) pathways regulate galactosaminoglycan synthesizing enzyme expression. Increased expression of these enzymes modify galactosaminoglycan chain structure by making them hyperelongated. This review focuses on the signalling pathways regulating the expression of genes involved in galactosaminoglycan synthesis and modification. Furthermore, there are multiple other processes for inhibiting the interactions between LDL and galactosaminoglycans such as peptide mimetics of ApoB100 and anti-galactosaminoglycan antibodies and the therapeutic potential of these strategies is also addressed.

Comprehensive proteomic profiles of mouse AApoAII amyloid fibrils provide insights into the involvement of lipoproteins in the pathology of amyloidosis

Amyloidosis is a disorder characterized by extracellular fibrillar deposits of misfolded proteins. The amyloid deposits commonly contain several non-fibrillar proteins as amyloid-associated proteins, but their roles in amyloidosis pathology are still unknown. In mouse senile amyloidosis, apolipoprotein A-II (ApoA-II) forms extracellular amyloid fibril (AApoAII) deposits with other proteins (AApoAII-associated proteins) in many organs. We previously reported that R1.P1-Apoa2c mice provide a reproducible model of AApoAII amyloidosis. In order to investigate the sequential alterations of AApoAII-associated protein, we performed a proteomic analysis of amyloid fibrils extracted from mouse liver tissues that contained different levels of AApoAII deposition. We identified 6 AApoAII-associated proteins that constituted 20 of the top-ranked proteins in mice with severe AApoAII deposition. Although the amount of AApoAII-associated proteins increased with the progression of amyloidosis, the relative abundance of AApoAII-associated proteins changed little throughout the progression of amyloidosis. On the other hand, plasma levels of these proteins showed dramatic changes during the progression of amyloidosis. In addition, we confirmed that AApoAII-associated proteins were significantly associated with lipid metabolism based on functional enrichment analysis, and lipids were co-deposited with AApoAII fibrils from early stages of development of amyloidosis. Thus, these results demonstrate that lipoproteins are involved in AApoAII amyloidosis pathology. SignificanceThis study presented proteomic profiles of AApoAII amyloidosis during disease progression and it revealed co-deposition of lipids with AApoAII deposits based on functional analyses. The relative abundance of AApoAII-associated proteins in the amyloid fibril fractions did not change over the course of development of AApoAII amyloidosis pathology. However, their concentrations in plasma changed dramatically with progression of the disease. Interestingly, several AApoAII-associated proteins have been found as constituents of lipid-rich lesions of other degenerative diseases, such as atherosclerosis and age-related macular degeneration. The common protein components among these diseases with lipid-rich deposits could be accounted for by a lipoprotein retention model.

Non-toxic concentrations of cadmium accelerate subendothelial retention of atherogenic lipoproteins in humanized atherosclerosis-susceptible mice

Aim: Cadmium is an important risk factor for cardiovascular disease (CVD). However, the underlying mechanism(s) are unclear. Cadmium has been shown to increase proteoglycan synthesis in vitro. Because proteoglycans mediate a critical step in atherosclerosis by trapping apoB-containing lipoproteins in the artery wall, we hypothesized that cadmium can increase proteoglycan mediated LDL binding and thereby promote subendothelial LDL accumulation. Here we tested the hypothesis that cadmium enhances the subendothelial accumulation of atherogenic lipoproteins in the setting of intimal hyperplasia and modest hypercholesterolemia.

Intimal hyperplasia induced by vascular intervention causes lipoprotein retention and accelerated atherosclerosis.

Accelerated atherosclerosis diminishes the long term patency of vascular interventions, such as percutaneous coronary intervention and implantation of saphenous vein grafts. However, the cause of this accelerated atherosclerosis is unclear. In this study, we tested the hypothesis that intimal hyperplasia formed following vascular intervention promotes retention of atherogenic lipoproteins. Intimal hyperplasia was surgically induced in the mouse common carotid artery. The surgery was combined with different mouse models of hypercholesterolemia to obtain different cholesterol levels and to control the onsets of hypercholesterolemia. Three weeks after surgery, samples were immunostained for apoB lipoproteins, smooth muscle cells and leukocytes. Already at mild hypercholesterolemia (193 mg/dL), pronounced apoB lipoprotein retention was found in the extracellular matrix in both intimal hyperplasia and the injured underlying media. In contrast, minimal retention was detected in the uninjured proximal region of the same vessel, or in vessels from mice with normal cholesterol levels (81 mg/dL). Induction of aggravated hypercholesterolemia 3 weeks after surgery, when a mature intimal hyperplasia had been formed, caused a very rapid development of atherosclerotic lesions. Mechanistically, we show that lipoprotein retention was almost exclusively dependent on electrostatic interactions to proteoglycan glycosaminoglycans, and the lipoprotein retention to intimal hyperplasia could be inhibited in vivo using glycosaminoglycan‐binding antibodies. Thus, formation of intimal hyperplasia following vascular intervention makes the vessel wall highly susceptible for lipoprotein retention and accelerated atherosclerosis. The increased lipoprotein retention in intimal hyperplasia can be targeted by blocking the interaction between apoB lipoproteins and glycosaminoglycans in the extracellular matrix.

Type 1 diabetes increases retention of low-density lipoprotein in the atherosclerosis-prone area of the murine aorta

Background and aimsIndividuals with type 1 diabetes mellitus are at high risk of developing atherosclerotic cardiovascular disease, but the underlying mechanisms by which type 1 diabetes accelerates atherosclerosis remain unknown. Increased retention of low-density lipoprotein (LDL) in atherosclerosis-prone sites of the diabetic vascular wall has been suggested, but direct evidence is lacking. In the present study, we investigated whether retention of LDL is increased in atherosclerotic-prone areas using a murine model of type 1 diabetes. MethodsFluorescently-labeled human LDL from healthy non-diabetic individuals was injected into diabetic Ins2Akita mice and non-diabetic, wild-type littermates. The amount of retained LDL after 24 h was quantified by fluorescence microscopy of cryosections and by scans of en face preparations. Vascular gene expression in the inner curvature of the aortic arch was analyzed by microarray and quantitative polymerase chain reaction. ResultsLDL retention was readily detected in atherosclerosis-prone areas of the aortic arch being located in both intimal and medial layers. Quantitative microscopy revealed 8.1-fold more retained LDL in type 1 diabetic mice compared to wild-type mice. These findings were confirmed in independent experiments using near-infrared scanning of en face preparations of the aorta. Diabetic status did not affect arterial expression of genes known to be involved in LDL retention. ConclusionsType 1 diabetes increases the ability of the vascular wall to retain LDL in mice. These changes could contribute to the increased atherosclerotic burden seen in type 1 diabetic patients.

Abstract 15: Serum Amyloid A is Not Just an HDL-Associated Lipoprotein

Serum Amyloid A (SAA) is traditionally thought to be only found with HDL; however, recently several groups have found that SAA is found on apoB-containing lipoproteins (LDL and VLDL) under some circumstances. The goal of this study was to determine the relative lipoprotein association of SAA. Native human acute phase SAA was isolated from acute phase plasma collected from patients undergoing cardiovascular bypass surgery; the SAA was purified and delipidated. Plasma was collected from a group of healthy, non-obese humans with low levels of SAA (< 2 mg/L) and lipoproteins (VLDL, LDL and HDL) were isolated by density gradient ultracentrifugation. The delipidated SAA (at 2 concentrations) was incubated in vitro with the various lipoprotein preparations then samples were re-isolated by fast protein liquid chromatography and SAA was analyzed by ELISA and immunoblot. When SAA was incubated with any single lipoprotein all of the SAA was found associated with that lipoprotein and none remained in a lipid-free form. When SAA was incubated with a mixture of VLDL, LDL and HDL (based on equal protein and corresponding to concentrations in plasma) a majority of SAA (50-60%) was found on HDL with the remaining SAA found on VLDL and LDL. When SAA first complexed to HDL was added to a mixture of SAA-free LDL and VLDL the majority of SAA remained with the HDL (76-86%) but 5-10% of the SAA was found on each of LDL and VLDL. When SAA first complexed to either apoB-containing lipoprotein was then added to a mixture of HDL and the other apoB-containing lipoprotein most SAA moved to HDL (55-70%) but the remainder was found on the apoB-containing particles. Thus, SAA can move between lipoprotein particles in vitro. To determine if the presence of SAA on apoB-containing lipoproteins had a functional effect we evaluated lipoprotein-proteoglycan binding affinity. Proteoglycan mediated lipoprotein retention in the vessel wall is thought to be one of the key steps in initiation of atherosclerosis. Compared to SAA-free LDL or VLDL, the presence of SAA on apoB-containing lipoproteins caused increased proteoglycan binding affinity. Thus, SAA is not simply an HDL lipoprotein, but SAA can move between lipoprotein particles, and the presence of SAA on apoB particles may increase their atherogenicity.

Distinct roles for dietary lipids and Porphyromonas gingivalis infection on atherosclerosis progression and the gut microbiota

Mounting evidence in humans supports an etiological role for the microbiota in inflammatory atherosclerosis. Atherosclerosis is a progressive disease characterized by accumulation of inflammatory cells and lipids in vascular tissue. While retention of lipoprotein into the sub-endothelial vascular layer is believed to be the initiating stimulus leading to the development of atherosclerosis, activation of multiple pathways related to vascular inflammation and endothelial dysfunction sustain the process by stimulating recruitment of leukocytes and immune cells into the sub-endothelial layer. The Gram-negative oral pathogen Porphyromonas gingivalis has been associated with the development and acceleration of atherosclerosis in humans and these observations have been validated in animal models. It has been proposed that common mechanisms of immune signaling link stimulation by lipids and pathogens to vascular inflammation. Despite the common outcome of P. gingivalis and lipid feeding on atherosclerosis progression, we established that these pro-atherogenic stimuli induced distinct gene signatures in the ApoE−/− mouse model of atherosclerosis. In this study, we further defined the distinct roles of dietary lipids and P. gingivalis infection on atherosclerosis progression and the gut microbiota. We demonstrate that diet-induced lipid lowering resulted in less atherosclerotic plaque in ApoE−/− mice compared to ApoE−/− mice continuously fed a Western diet. However, the effect of diet-induced lipid lowering on plaque accumulation was blunted by P. gingivalis infection. Using principal component analysis and hierarchical clustering, we demonstrate that dietary intervention as well as P. gingivalis infection result in distinct bacterial communities in fecal and cecal samples of ApoE−/− mice as compared to ApoE−/− mice continuously fed either a Western diet or a normal chow diet. Collectively, we identified distinct microbiota changes accompanying atherosclerotic plaque, suggesting a future avenue for investigation on the impact of the gut microbiota, diet, and P. gingivalis infection on atherosclerosis.

The immunology of atherosclerosis.

Cardiovascular disease is the leading cause of death worldwide, both in the general population and among patients with chronic kidney disease (CKD). In most cases, the underlying cause of the cardiovascular event is atherosclerosis - a chronic inflammatory disease. CKD accelerates atherosclerosis via augmentation of inflammation, perturbation of lipid metabolism, and other mechanisms. In the artery wall, subendothelial retention of plasma lipoproteins triggers monocyte-derived macrophages and T helper type 1 (TH1) cells to form atherosclerotic plaques. Inflammation is initiated by innate immune reactions to modified lipoproteins and is perpetuated by TH1 cells that react to autoantigens from the apolipoprotein B100 protein of LDL. Other T cells are also active in atherosclerotic lesions; regulatory T cells inhibit pathological inflammation, whereas TH17 cells can promote plaque fibrosis. The slow build-up of atherosclerotic plaques is asymptomatic, but plaque rupture or endothelial erosion can induce thrombus formation, leading to myocardial infarction or ischaemic stroke. Targeting risk factors for atherosclerosis has reduced mortality, but a need exists for novel therapies to stabilize plaques and to treat arterial inflammation. Patients with CKD would likely benefit from such preventive measures.

Reactive oxygen species mediate angiotensin II-induced transcytosis of low-density lipoprotein across endothelial cells.

The retention of plasma low-density lipoprotein (LDL) particles to subendothelial spaces through transcytosis across the endothelium is the initial step of atherosclerosis (AS). Angiotensin II (Ang II), as the principal effector molecule of the renin-angiotensin system (RAS), is implicated in several important steps of AS development. However, whether or not Ang II can directly exert a pro-atherogenic effect by promoting LDL transcytosis across endothelial barriers, has not been defined. In the present study, we found that Ang II upregulated intracellular reactive oxygen species (ROS) levels in endothelial cells (ECs) by measuring fluorescence of 2′,7′-dichlorofluorescein (DCF-DA). Based on our transcytosis model, we observed that Ang II significantly accelerated LDL transcytosis, whereas transcytosis inhibitor methyl-β-cyclodextrin (MβCD) and ROS inhibitor dithiothreitol (DTT), markedly blocked the Ang II-stimulated increase in LDL transcytosis. Confocal imaging analysis revealed that both LDL uptake by cells and LDL retention in human umbilical venous walls were highly elevated after Ang II exposure, while MβCD and DTT significantly inhibited the effects of Ang II. What is more, proteins involved in caveolae-mediated transcytosis, including LDL receptor (LDLR), caveolin-1 and cavin-1, were associated with Ang II-induced LDL transcytosis across the ECs. Nevertheless, this process was independent of clathrin in our study. Of note, ROS inhibitor, DTT, markedly decreased the expression levels of those proteins. Consequently, ROS are critical mediators in Ang II-induced LDL transcytosis. Hopefully, these findings will provide novel insight into the crosstalk between dyslipidemia and RAS in atherogenesis.

Abstract 630: Novel Chimeric Anti-proteoglycan Antibody Inhibits Arterial Retention of Proatherogenic Lipoproteins in a Rat Model of Insulin Resistance

Background: The response-to-retention hypothesis for atherosclerosis describes subendothelial retention of apolipoprotein B-containing lipoproteins mediated by proteoglycans (PG). Further we know that diabetes is also associated with both increased circulating chylomicron remnants and remodeling of proatherogenic PGs. We have recently reported antiatherogenic properties of a novel chimeric monoclonal antibody (chP3R99) that recognizes PG sulfated molecules. Hypothesis: chP3R99 monoclonal antibody may interfere with the interaction of atherogenic lipoproteins with arterial sulfated PGs during insulin resistance. Methods and Results: chP3R99 antibody recognized sulfated glycosaminoglycans by ELISA showing a preferential binding to chondroitin sulfate. Also, chP3R99 blocked the interaction of proatherogenic lipoproteins with this glycosaminoglycan in vitro in a dose-dependent manner and its intravenous injection into healthy Sprague-Dawly rats (n=6, 1 mg/animal) inhibited LDL (4 mg/kg; intraperitoneally) aortic retention. To further assess this property in an insulin resistant condition, carotid arteries from control and JCR:LA-cp rats (n=4) were perfused ex vivo with apoB48 containing remnant lipoproteins (prepared via rabbit hepatectomy procedure), with or without Cy3-LDL (150 μg/mL) for 20 minutes. Confocal microscopy analysis revealed an increased arterial retention of both remnants (3.6 fold) and LDL (2.8 fold) in carotid vessels from insulin resistant rats relative to control. However, chP3R99 pre-perfusion resulted in decreased retention of remnants (-30%) and LDL (-60%) associated arterial cholesterol. Data suggests that the chP399 antibody may interfere with the arterial attachment of both remnants and LDL in vivo, but with differential efficacy. Conclusions: Relative to LDL, remnant lipoproteins had preferential accumulation in arterial vessels from insulin resistant rats ex vivo , which could then be inhibited by acute pre-exposure to the chP3R99 antibody. These in vivo data support the concept for an innovative approach to target the retention of proatherogenic lipoproteins in a pre-clinical setting.

Abstract 466: Therapeutic Immunization with an Antiglycosaminoglycan Antibody Reduces Atherosclerotic Lesion Progression in Apolipoprotein E-Deficient Mice

Subendothelial retention of apoB-containing lipoproteins by interaction with glycosaminoglycan-side chains of proteoglycans is considered the key initiating step of atherogenesis. Previously, we characterized the antiatherogenic properties of the chimeric mAb chP3R99, which binds sulfated GAG, inhibits LDL-chondroitin sulfate (CS) association, and abrogates LDL oxidation in vitro and in vivo. In preventive settings, rabbits and mice immunized with this mAb showed reduced atherosclerotic lesions, related with the induction of anti-chondroitin sulfate (CS) antibodies. Now we focus in define the immunization schedule which can induce in apolipoprotein E-deficient (apoE-/-) the highest anti-CS antibody response and the greater reduction of atherosclerotic lesion progression. ApoE - / - mice (6-8 wk. old) fed a chow diet received four s.c. injections of 50 or 200 μg of chP3R99 mAb. Autologous antichondroitin sulfate (CS) antibody response was evaluated in sera by ELISA. Mice who were immunized with 200 μg generated a significant higher response against CS than the ones that received 50 μg. Then, to evaluate the association of the induction of a higher anti-CS response in the atherosclerotic lesion progression, apoE-/- mice fed with a high-fat high-cholesterol diet from 4 to 18 wk. of age, received 6 doses of 50, 100 or 200 μg of the mAb starting when 5% of the aortic area was covered by lesions. Animals were sacrificed and aortas isolated to determine the presence of lesions by histologic studies. Mean aortic lesion areas of 50 and 100 μg chP3R99-treated mice were significant reduced by ~40% in comparison with mice treated with an isotype-matched control mAb. In contrast, 62% reduction in total lesion area was observed in mice treated with 200 μg of chP3R99. Again, there was an association between the level of anti-CS antibody response and the reduction of atherosclerotic lesion progression. In conclusion, this study demonstrated the dose dependence of the anti-CS antibody response and its relationship with the arresting of the atherosclerotic progression induced by chP3R99 mAb immunization. Our results also supports the potential use of this antiglycosaminoglycan antibody-based immunotherapy as a novel approach to target advanced atherosclerosis

Stimulating antigen-specific regulatory T cells for an atherosclerosis vaccine

Abstract Atherosclerosis is a chronic inflammatory disease of the large and medium sized arteries affecting millions of people world-wide. It is characterised by sub-endothelial retention of low density lipoprotein (LDL), which, over time, leads to the formation of an atherosclerotic plaque. Regulatory T cells (Treg) have been shown to reduce chronic inflammation in atherosclerosis and provide a protective effect. Whereas repeated immunisations with high doses of plaque-specific antigens can induce Treg and reduce the atherosclerotic plaques, particulate formulations may require fewer immunisations and less antigen by specific targeting of the immune system. Therefore, we optimised liposomal formulations to elicit potent Treg responses. Liposomes (average diameter 150–200 nm) consisting of the lipids DSPC, DSPG and cholesterol in different molar ratios were loaded with an ovalbumin-derived CD4+ T cell-specific peptide (OVA323). Murine BMDCs were pulsed with formulations and subsequently cultured with OT-II transgenic CD4+T cells. Compared to free OVA323 or OVA323 mixed with empty liposomes, encapsulation of OVA323 induced increased numbers of Treg as measured by FoxP3 expression. Interestingly, liposomes with the composition 4:1:2 DSPC:DSPG:cholesterol induced the highest Treg responses and also prevented Th1 differentiation as determined by IFN-γ production. Subsequent studies suggest that the 4:1:2 liposomes achieve the optimal balance of antigen loading, flexibility and surface charge to induce Treg. In conclusion, this indicates that liposome composition influences Treg differentiation and liposomes may be used to elicit antigen-specific Treg responses for atherosclerosis vaccination.

So Much Cholesterol: the unrecognized importance of smooth muscle cells in atherosclerotic foam cell formation.

Smooth muscle cells (SMCs) form the thickened intimal layer in atherosclerosis-prone arteries in early life, and provide the initial site for retention and uptake of atherogenic lipoproteins. Here we review current knowledge regarding the importance of SMCs in the deposition of cholesterol in atherosclerotic plaque. SMCs were found to comprise at least 50% of total foam cells in human coronary artery atherosclerosis, and exhibit a selective loss of expression of the cholesterol efflux promoter ATP-binding cassette transporter A1. Cholesterol loading induced a loss of SMC gene expression and an increase in macrophage and proinflammatory marker expression by cultured mouse and human arterial SMCs, with reversal of these effects upon removal of the excess cholesterol. Mice engineered to track all cells of SMC lineage indicated that, at most, SMCs make up about one-third of total cells in atherosclerotic plaque in these animals. SMCs appear to be the origin of the majority of foam cells in human atherosclerotic plaque. Recent studies suggest a renaissance of research on the role of SMCs in atherosclerosis is needed to make the next leap forward in the prevention and treatment of this disease.

Adaptive Response of T and B Cells in Atherosclerosis.

Atherosclerosis is a chronic inflammatory disease that is initiated by the retention and accumulation of cholesterol-containing lipoproteins, particularly low-density lipoprotein, in the artery wall. In the arterial intima, lipoprotein components that are generated through oxidative, lipolytic, and proteolytic activities lead to the formation of several danger-associated molecular patterns, which can activate innate immune cells as well as vascular cells. Moreover, self- and non-self-antigens, such as apolipoprotein B-100 and heat shock proteins, can contribute to vascular inflammation by triggering the response of T and B cells locally. This process can influence the initiation, progression, and stability of plaques. Substantial clinical and experimental data support that the modulation of adaptive immune system may be used for treating and preventing atherosclerosis. This may lead to the development of more selective and less harmful interventions, while keeping host defense mechanisms against infections and tumors intact. Approaches such as vaccination might become a realistic option for cardiovascular disease, especially if they can elicit regulatory T and B cells and the secretion of atheroprotective antibodies. Nevertheless, difficulties in translating certain experimental data into new clinical therapies remain a challenge. In this review, we discuss important studies on the function of T- and B-cell immunity in atherosclerosis and their manipulation to develop novel therapeutic strategies against cardiovascular disease.

Sterol O-Acyltransferase 2-Driven Cholesterol Esterification Opposes Liver X Receptor-Stimulated Fecal Neutral Sterol Loss.

Statin drugs have proven a successful and relatively safe therapy for the treatment of atherosclerotic cardiovascular disease (CVD). However, even with the substantial low-density lipoprotein (LDL) cholesterol lowering achieved with statin treatment, CVD remains the top cause of death in developed countries. Selective inhibitors of the cholesterol esterifying enzyme sterol-O acyltransferase 2 (SOAT2) hold great promise as effective CVD therapeutics. In mouse models, previous work has demonstrated that either antisense oligonucleotide (ASO) or small molecule inhibitors of SOAT2 can effectively reduce CVD progression, and even promote regression of established CVD. Although it is well known that SOAT2-driven cholesterol esterification can alter both the packaging and retention of atherogenic apoB-containing lipoproteins, here we set out to determine whether SOAT2-driven cholesterol esterification can also impact basal and liver X receptor (LXR)-stimulated fecal neutral sterol loss. These studies demonstrate that SOAT2 is a negative regulator of LXR-stimulated fecal neutral sterol loss in mice.