David S. Leake

Flavonoids inhibit the oxidative modification of low density lipoproteins by macrophages

Low density lipoproteins (LDL) can be oxidatively modified in vitro by macrophages and certain other cell types so that macrophages will take them up much faster. This process may be important in the formation of cholesterol-laden foam cells derived from macrophages in atherosclerotic lesions. In this study, we have shown that certain flavonoids, plant constituents found in the diet, are potent inhibitors of the modification of 125I-labelled LDL by macrophages, with IC50 values in the micromolar range (e.g. morin and fisetin 1 microM; quercetin and gossypetin 2 microM). The potencies of individual flavonoids in inhibiting LDL modification did not correlate with their previously determined potencies as inhibitors of 5-lipoxygenase and cyclo-oxygenase. The modification of LDL by macrophages exhibits a lag period of about 4-6 hr before enhanced uptake is detected. During this time, there is a rapid depletion in its content of alpha-tocopherol (an endogenous antioxidant found in lipoproteins) followed by a large increase in the level of hydroperoxides. The flavonoids conserved the alpha-tocopherol content of LDL and delayed the onset of detectable lipid peroxidation. Flavonoids also inhibited the cell-free oxidation of LDL mediated by CuSO4. These findings raise the possibility that flavonoids may protect LDL against oxidation in atherosclerotic lesions and may therefore be natural anti-atherosclerotic components of the diet, although this will depend to a large extent on their pharmacokinetics.

The modification of low density lipoprotein by the flavonoids myricetin and gossypetin

Myricetin and gossypetin, two hexahydroxylated flavonoids, are capable of modifying low density lipoprotein (LDL) to increase greatly its uptake by macrophages. When human 125I-labelled LDL was incubated with 100-1000 microM myricetin or gossypetin, it was subsequently endocytosed much faster by mouse peritoneal macrophages. This modification did not occur at a concentration of 10 microM. Nine other flavonoids containing up to five hydroxyl substituents did not modify LDL to any great extent at 100 microM. The modification of LDL by 100 microM myricetin was time-dependent and complete by 6 hr. Flavonoids can sometimes act as pro-oxidants but myricetin did not act by oxidizing the LDL, as the LDL lipid hydroperoxide content was not increased by myricetin, nor did it promote the depletion of the endogenous antioxidant alpha-tocopherol in the LDL. High concentrations of myricetin caused the aggregation of LDL particles, as judged by light microscopy, agarose gel electrophoresis, retention by a membrane filter and sedimentability by centrifugation. SDS-PAGE indicated that the apolipoprotein B-100 molecules of LDL particles were covalently crosslinked. The uptake and degradation by macrophages of myricetin-modified 125I-labelled LDL reached saturation at about 10 micrograms protein/mL, suggesting the existence of a high affinity uptake process for the modified LDL. The uptake of myricetin-modified 125I-labelled LDL was not competed for by a large excess of non-labelled native LDL or acetylated LDL. We conclude that myricetin and gossypetin at high concentrations are capable of modifying LDL by a novel non-oxidative mechanism to a form taken up by macrophages by a high affinity process.

The Role of Oxidative Modification and Antioxidants in LDL Metabolism and Atherosclerosis

Recent studies have shown that low-density lipoprotein (LDL), when incubated with certain cell types in culture (including endothelial cells, smooth muscle cells and macrophages) is subject to a number of alterations in its physical and chemical properties1. Most interestingly, this ‘modified’ LDL is endocytosed by macrophages up to 20 times more rapidly than native LDL1,2. It is possible that the formation of foam cells from macrophages in the developing atherosclerotic plaque could be the result of the generation of similar ‘modified’ LDL particles by cells of the artery wall. Because the route for endocytosis of ‘modified’ LDL largely bypasses the normal ApoB/E receptor, target cells such as the macrophage are unable to regulate their intake of this ligand and so accumulate large amounts of cholesteryl esters intracellularly.

The effect of macrophage stimulation on the uptake of acetylated low-density lipoproteins

The rapid uptake of modified low-density lipoproteins (LDL) by macrophages in the arterial wall may lead to their conversion into lipid-laded foam cells in atherosclerotic lesions. We have therefore investigated the effects of macrophage stimulation on their rate of uptake of modified LDL. The uptake of 125I-labelled acetyl-LDL by mouse resident peritoneal macrophages was reduced by about 60-85% by zymosan (250 micrograms/ml), by 25-45% by lipopolysaccharide (0.1-1 mg/ml) and 50-60% by phorbol myristate acetate (100 nM). The inhibition was dose-dependent and was observed at the earliest times studied (about 1 h). Binding studies at 0 degrees C showed that all three stimulating agents decreased the number of cell-surface receptors for acetyl-LDL. If macrophages are stimulated in atherosclerotic lesions, this may therefore be beneficial in that it may decrease their numbers of receptors for modified LDL, although it may be harmful in other ways in that stimulated macrophages may release factors that damage the arterial wall.

Macrophages possess both neutral and acidic protease activities toward low density lipoproteins

Low density lipoproteins (LDL) have been strongly implicated in the pathogenesis of atherosclerosis. We have studied the proteolytic degradation of these lipoproteins by macrophages, which are a major cellular constituent of atherosclerotic lesions. Mouse peritoneal macrophages contained both an acidic and a less active but distinct neutral/alkaline protease activity toward human 125I-labelled LDL. The acidic activity had a pH optimum of 4.5 and the neutral/alkaline activity one of 8-8.5. The acidic activity started to plateau with increasing lipoprotein concentrations whereas the neutral activity was directly proportional to the lipoprotein concentration up to at least 150 micrograms of protein/ml. The acidic protease activity had a complex time course whereas the neutral activity was directly proportional to the time of incubation up to at least 48 h. Leupeptin (35 microM) and pepstatin (5 microM) inhibited the acidic activity by about 70% individually and almost entirely in combination, indicating that cathepsins B and D are important in the degradation of LDL by lysosomal cathepsins. In contrast, there was little, if any, inhibition of the neutral protease activity by leupeptin or pepstatin. The acidic protease activity was increased by both DL-dithiothreitol (5 mM) and disodium EDTA (1 mM) whereas the neutral protease activity was increased by dithiothreitol but inhibited partially by EDTA. The possible significance of macrophage neutral and acidic protease activities toward LDL in atherosclerosis needs to be assessed.

Macrophage proteases can modify low density lipoproteins to increase their uptake by macrophages

When low density lipoprotein (LDL) was incubated with sonicated macrophages at acidic pH, its protein moiety was partially degraded by cathepsins B and D. The reisolated LDL was taken up by intact macrophages up to about 20 times as fast as control LDL. LDL proteolysis and its enhanced uptake could be inhibited almost entirely by the selective protease inhibitors leupeptin and pepstatin. If macrophages in atherosclerotic lesions were to release acidic proteases (either by exocytosis or following cell death) and these were to modify LDL, this may help to explain why so much cholesteryl ester accumulates in these cells.