Marian C. Cheung

Shotgun proteomics implicates protease inhibition and complement activation in the antiinflammatory properties of HDL.

HDL lowers the risk for atherosclerotic cardiovascular disease by promoting cholesterol efflux from macrophage foam cells. However, other antiatherosclerotic properties of HDL are poorly understood. To test the hypothesis that the lipoprotein carries proteins that might have novel cardioprotective activities, we used shotgun proteomics to investigate the composition of HDL isolated from healthy subjects and subjects with coronary artery disease (CAD). Unexpectedly, our analytical strategy identified multiple complement-regulatory proteins and a diverse array of distinct serpins with serine-type endopeptidase inhibitor activity. Many acute-phase response proteins were also detected, supporting the proposal that HDL is of central importance in inflammation. Mass spectrometry and biochemical analyses demonstrated that HDL3 from subjects with CAD was selectively enriched in apoE, raising the possibility that HDL carries a unique cargo of proteins in humans with clinically significant cardiovascular disease. Collectively, our observations suggest that HDL plays previously unsuspected roles in regulating the complement system and protecting tissue from proteolysis and that the protein cargo of HDL contributes to its antiinflammatory and antiatherogenic properties.

The Measurement of Apolipoprotein A-I and A-II Levels in Men and Women by Immunoassay

To study apolipoprotein A-II, a simple, precise, and accurate immunodiffusion assay was developed and applied in a population sample of industrial employees. Apolipoprotein A-II (A-II) did not increase with age in men (r = -0.20, n = 172), but showed a slight increase with age in women (0.1 mg/dl per yr, r = 0.20, n = 188). A-II correlated significantly with apolipoprotein A-I (A-I) (r = 0.71) and high density lipoprotein (HDL) cholesterol (men, r = 0.64; women, r = 0.49). The A-I/A-II ratio was significantly related to HDL cholesterol (men, r = 0.29; women, r = 0.44). Women on no medication (n = 92) had A-II levels similar to men (34+/-5 and 33+/-5 mg/dl, mean+/-SD, respectively), whereas women on oral contraceptives or estrogens had significantly higher levels (39+/-6 mg/dl, n = 75, P < 0.01). The plasma A-I/A-II weight ratio was 3.6+/-0.4 for men and 3.8+/-0.5 for women. In the d = 1.10-1.21 subfraction, both males and females had similar A-I, A-II, and HDL cholesterol levels (men: mean, 97, 27, and 32 mg/dl, respectively; women: mean, 104, 28, and 36 mg/dl, respectively). Women had approximately twice the amount of A-I, A-II, and HDL cholesterol than men in the d = 1.063-1.10 fraction (men: mean, 10, 2, and 10 mg/dl, respectively; women: mean, 24, 4, and 19 mg/dl, respectively). The A-I/A-II weight ratio in the d = 1.063-1.10 fraction (men, 5.1+/-0.7; women, 6.1+/-1.3) was significantly greater (P < 0.01) than that in the d = 1.10-1.21 fraction (men, 3.7+/-0.2; women, 3.8+/-0.2). Furthermore, the weight ratio of cholesterol to total apoprotein A in the d = 1.063-1.10 fraction (men, 0.75+/-0.09; women, 0.67+/-0.05) was significantly higher (P < 0.01) than that found in the d = 1.10-1.21 fraction (men, 0.26+/-0.04, women, 0.28+/-0.05). Thus, the compositions of HDL hydrated density subclasses are significantly different from each other. These results suggest that the differences in HDL between men and women are due primarily to differences in the relative proportions of HDL subclasses rather than to the intrinsic differences in HDL structure.

Functional expression of human and mouse plasma phospholipid transfer protein: effect of recombinant and plasma PLTP on HDL subspecies

The molecular cloning of mouse plasma phospholipid transfer protein (PLTP) and the eukaryotic cell expression of complementary DNA for mouse and human PLTP are described. Mouse PLTP was found to share 83% amino acid sequence identity with human PLTP. PLTP was produced in baby hamster kidney cells. Conditioned medium from BHK cells expressing PLTP possessed both phospholipid transfer activity and high density lipoprotein (HDL) conversion activity. PLTP mRNA was detected in all 16 human tissues examined by Northern blot analysis with ovary, thymus, and placenta having the highest levels. PLTP mRNA was also examined in eight mouse tissues with the highest PLTP mRNA levels found in the lung, brain, and heart. The effect of purified human plasma-derived PLTP and human recombinant PLTP (rPLTP) on the two human plasma HDL subspecies Lp(A-I) and Lp(A-I/A-II) was evaluated. Plasma PLTP or rPLTP converted the two distinct size subspecies of Lp(A-I) into a larger species, an intermediate species, and a smaller species. Lp(A-I/A-II) particles containing multiple size subspecies were significantly altered by incubation with either plasma or rPLTP with the largest but less prominent subspecies becoming the predominant one, and the smallest subspecies increasing in concentration. Thus, PLTP promoted the conversion of both Lp(A-I) and Lp(A-I/A-II) to populations of larger and smaller particles. Also, both human PLTP and mouse rPLTP were able to convert human or mouse HDL into larger and smaller particles. These observations suggest that PLTP may play a key role in extracellular phospholipid transport and modulation of HDL particles.

High-density lipoproteins in myocardial infarction survivors

Abstract Subjects with existing coronary heart disease and those with many of the conditions associated with increased risk of coronary disease have reduced levels of high-density lipoprotein (HDL) cholesterol. Since HDL cholesterol is only one index of HDL composition, a reduction of HDL cholesterol could reflect a change in HDL composition and/or a decrease in all HDL constituents. Therefore the present studies assessed the major apolipoproteins of HDL, A-I and A-II, in addition to HDL cholesterol in 90 male myocardial infarction (MI) survivors and their lipid-matched male controls. The MI survivors had significantly lower (p

Reduction in high density lipoproteins by anabolic steroid (stanozolol) therapy for postmenopausal osteoporosis.

The effects of stanozolol, 17-methyl-2H-5 alpha-androst-2-eno [3,2-c] pyrazol-17 beta-ol, on lipoprotein levels were assessed in a short-term (6 wk) prospective study of 10 normolipidemic, postmenopausal, osteoporotic women. While total cholesterol and triglyceride levels remained constant, equal and offsetting responses were seen in low density lipoprotein (LDL) cholesterol (+30.9 +/- 28.1 mg/dl [mean +/- S.D.], p less than 0.01, a 21% increase) and high density lipoprotein (HDL) cholesterol (-32.5 +/- 11.9 mg/dl [mean +/- S.D.], p less than 0.001, a 53% decline). Hence the LDL/HDL ratio increased dramatically, from 2.5 +/- 0.7 to 6.8 +/- 2.5. Within HDL, stanozolol was associated with a greater decline in HDL2 (from 26.0 +/- 7.4 mg/dl to 3.8 +/- 1.9 mg/dl, p less than 0.001, an 85% decrease) than HDL3 (which diminished from 35.7 +/- 3.2 to 24.1 +/- 5.8 mg/dl. p less than 0.001, a 35% decrease). The major HLD apolipoproteins also declined (A-I by a mean of 41% and A-II by 24%, both p less than 0.001). Postheparin hepatic triglyceride lipase increased (off treatment 74 +/- 42 nmole free fatty acid min-1 mole-1, on treatment 242 +/- 110, n = 6, p = 0.06). All changes were reversed by 5 wk following termination of the drug. These lipoprotein changes suggest caution in the long term prescription of stanozolol, particularly in those without overriding clinical indications for its use.

High Density Lipoprotein Composition in Insulin-dependent Diabetes Mellitus

Although atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in insulin-dependent diabetics, plasma levels of high density lipoprotein (HDL) cholesterol (an independent “negative” risk factor for ASCVD) have been reported to be normal or high. To test whether alterations in HDL composition might increase potential risk of insulin-dependent diabetics to ASCVD, their major constituent apolipoproteins, A-I and A-II, were measured and compared with levels in controls. HDL cholesterol levels were slightly higher (P = NS) in diabetics than in controls. The HDL cholesterol/LDL cholesterol ratio (an inverse index of relative risk of developing ASCVD) was significantly higher in diabetic men than in controls (P < 0.02). HDL composition differed markedly in diabetics and controls: the apolipoprotein A-I/A-II ratio was significantly higher (P < 0.001) in both diabetic men and women (diabetic men—4.1 ± 0.5, mean ± SD, controls 3.6 ± 0.4; diabetic women—4.6 ± 0.4, controls 3.9 ± 0.5). Subsequent analysis of plasma from four patients by analytic ultracentrifugation demonstrated a high correlation (r = 0.993, P < 0.01) between the apolipoprotein A-I/A-II ratio and HDL2, the cholesterol-rich lighter subclass of HDL thought to be the group of particles involved in reduced risk of ASCVD. Therefore, the alteration of HDL composition in insulin-dependent diabetics appears similar to that associated with reduced risk in nondiabetics. Thus, whether a genetic or acquired abnormality, the high apolipoprotein A-I/A-II ratio in insulin-dependent diabetics does not appear to counteract their increased risk Of developing ASCVD.

Plasma phospholipid mass transfer rate: relationship to plasma phospholipid and cholesteryl ester transfer activities and lipid parameters.

Human plasma phospholipid transfer protein (PLTP) has been shown to facilitate the transfer of phospholipid from liposomes or isolated very low and low density lipoproteins to high density lipoproteins. Its activity in plasma and its physiological function are presently unknown. To elucidate the role of PLTP in lipoprotein metabolism and to delineate factors that may affect the rate of phospholipid transfer between lipoproteins, we determined the plasma phospholipid mass transfer rate (PLTR) in 16 healthy adult volunteers and assessed its relationship to plasma lipid levels, and to phospholipid transfer activity (PLTA) and cholesteryl ester transfer activity (CETA) measured by radioassays. The plasma PLTR in these subjects was 27.2 +/- 11.8 nmol/ml per h at 37 degrees C (mean +/- S.D.), and their PLTA and CETA were 13.0 +/- 1.7 mumol/ml per h and 72.8 +/- 15.7 nmol/ml per h, respectively. Plasma PLTR was correlated directly with total, non-HDL, and HDL triglyceride (rs = 0.76, P < 0.001), total and non-HDL phospholipid (rs > 0.53, P < 0.05), and inversely with HDL free cholesterol (rs = -0.54, P < 0.05), but not with plasma PLTA and CETA. When 85% to 96% of the PLTA in plasma was removed by polyclonal antibodies against recombinant human PLTP, phospholipid mass transfer from VLDL and LDL to HDL was reduced by 50% to 72%, but 80% to 100% of CETA could still be detected. These studies demonstrate that PLTP plays a major role in facilitating the transfer of phospholipid between lipoproteins, and suggest that triglyceride is a significant modulator of intravascular phospholipid transport. Furthermore, most of the PLTP and CETP in human plasma is associated with different particles. Plasma PLTA and CETA were also measured in mouse, rat, hamster, guinea pig, rabbit, dog, pig, and monkey. Compared to human, PLTA in rat and mouse was significantly higher and in rabbit and guinea pig was significantly lower while the remaining animal species had PLTA similar to humans. No correlation between PLTA and CETA was observed among animal species.

Characterization and immunoassay of apolipoprotein D.

Abstract Apolipoprotein D (apoD) is a protein component of human plasma high density lipoprotein. It recently has been suggested to be a cholesteryl ester transfer protein, responsible for the transfer of cholesteryl ester from high density lipoproteins (HDL) to low density lipoproteins (LDL) and very low density lipoproteins (VLDL). We characterized apoD and anti-apoD sera and report a simple, specific and precise (CV 6–7%) radial immunodiffusion assay for apoD with application to whole plasma. Purified apoD had an apparent molecular weight of 32,500 ± 700 (n = 11) by sodium dodecyl sulfate electrophoresis and exhibited 3 major isoforms by isoelectric focusing with isoelectric points (pI) and percentage of total apoD as follows: (1) pI 5.20 ± 0.07 (24 ± 19%); (2) pI 5.08 ± 0.05 (55 ± 11%); and (3) pI 5.00 ± 0.05 (21 ± 9%). Immunoadsorption affinity chromatography with antibodies specific for apoD removed essentially all the apoD in plasma and approximately 64% of the lecithin-cholesterol acyltransferase (LCAT) and 11% of the plasma apolipoprotein A-I. However, the plasma did not lose any cholesteryl ester transfer activity assayed as the transfer of [ 14 C]cholesteryl ester from labeled HDL to LDL or VLDL; or from labeled LDL to HDL. This suggests that apoD does not contribute significantly to the transfer of cholesteryl ester in whole plasma and that another factor can transfer cholesteryl ester between lipoproteins. Analysis of apoD in fresh plasma from normolipidemic (n = 74) and hyperlipoproteinemic (n = 44) adults indicates that males tend to have slightly higher apoD levels (6.2 ± 1.0 mg/dl, n=77) than females (5.6 ± 1.4 mg/dl, n=41) P P P P P

Antioxidant Vitamins and Lipid Therapy: End of a Long Romance?

During the past decade, the perception flourished that lipid and antioxidant therapy were 2 independent avenues for cardiovascular protection. However, studies have shown that commonly used antioxidant vitamin regimens do not prevent cardiovascular events. We found that the addition of antioxidant vitamins to simvastatin-niacin therapy substantially blunts the expected rise in the protective high density lipoprotein (HDL)2 cholesterol and lipoprotein(A-I) subfractions of HDL, with apparent adverse effects on the progression of coronary artery disease. To better understand this effect, 12 apolipoproteins, receptors, or enzymes that contribute to reverse cholesterol transport have been examined in terms of their relationship to HDL2 and lipoprotein(A-I) levels and the potential for antioxidant modulation of their gene expression. Three plausible candidate mechanisms are identified: (1) antioxidant stimulation of cholesteryl ester transfer protein expression/activity, (2) antioxidant suppression of macrophage ATP binding cassette transmembrane transporter A1 expression, and/or (3) antioxidant suppression of hepatic or intestinal apolipoprotein A-I synthesis or increase in apolipoprotein A-I catabolism. In summary, antioxidant vitamins E and C and beta-carotene, alone or in combination, do not protect against cardiovascular disease. Their use for this purpose may create a diversion away from proven therapies. Because these vitamins blunt the protective HDL2 cholesterol response to HDL cholesterol-targeted therapy, they are potentially harmful in this setting. We conclude that they should rarely, if ever, be recommended for cardiovascular protection.

Role of plasma phospholipid transfer protein in lipid and lipoprotein metabolism.

The understanding of the physiological and pathophysiological role of PLTP has greatly increased since the discovery of PLTP more than a quarter of century ago. A comprehensive review of PLTP is presented on the following topics: PLTP gene organization and structure; PLTP transfer properties; different forms of PLTP; characteristics of plasma PLTP complexes; relationship of plasma PLTP activity, mass and specific activity with lipoprotein and metabolic factors; role of PLTP in lipoprotein metabolism; PLTP and reverse cholesterol transport; insights from studies of PLTP variants; insights of PLTP from animal studies; PLTP and atherosclerosis; PLTP and signal transduction; PLTP in the brain; and PLTP in human disease. PLTPs central role in lipoprotein metabolism and lipid transport in the vascular compartment has been firmly established. However, more studies are needed to further delineate PLTPs functions in specific tissues, such as the lung, brain and adipose tissue. Furthermore, the specific role that PLTP plays in human diseases, such as atherosclerosis, cancer, or neurodegenerative disease, remains to be clarified. Exciting directions for future research include evaluation of PLTPs physiological relevance in intracellular lipid metabolism and signal transduction, which undoubtedly will advance our knowledge of PLTP functions in health and disease. This article is part of a Special Issue entitled Advances in High Density Lipoprotein Formation and Metabolism: A Tribute to John F. Oram (1945-2010).