Th.J.C. van Berkel

Lesional Overexpression of Matrix Metalloproteinase-9 Promotes Intraplaque Hemorrhage in Advanced Lesions But Not at Earlier Stages of Atherogenesis

Background—Matrix metalloproteinase-9 (MMP-9) is involved in atherosclerosis and elevated MMP-9 activity has been found in unstable plaques, suggesting a crucial role in plaque rupture. This study aims to assess the effect of MMP-9 on plaque stability in apolipoprotein E-deficient mice at different stages of plaque progression. Methods and Results—Atherosclerotic lesions were elicited in carotid arteries by perivascular collar placement. MMP-9 overexpression in intermediate or advanced plaques was effected by intraluminal incubation with an adenovirus (Ad.MMP-9). A subset was coincubated with Ad.TIMP-1. Mock virus served as a control. Plaques were analyzed histologically. In intermediate lesions, MMP-9 overexpression induced outward remodeling, as shown by a 30% increase in media size (p=0.03). In both intermediate and advanced lesions, prevalence of vulnerable plaque morphology tended to be increased. Half of MMP-9–treated lesions displayed intraplaque hemorrhage, whereas in controls and the Ad.MMP-9/Ad.TIMP-1 group this was 8% and 16%, respectively (p=0.007). Colocalization with neovessels may point to neo-angiogenesis as a source for intraplaque hemorrhage. Conclusion—These data show a differential effect of MMP-9 at various stages of plaque progression and suggest that lesion-targeted MMP-9 inhibition might be a valuable therapeutic modality in stabilizing advanced plaques, but not at earlier stages of lesion progression.

Attenuated atherosclerosis upon IL-17R signaling disruption in LDLr deficient mice.

Atherosclerosis is an inflammatory disease characterized by the influx of macrophages and T cells and IL-17 may connect innate and adaptive immune responses involved in atherogenesis. We investigated the role of IL-17 receptor signaling in atherosclerosis and transplanted LDLr deficient recipient mice with IL-17R deficient bone marrow. Induction of atherosclerosis by Western-type diet induced a 46% reduction in lesion size in the aortic root and the plaque composition revealed no significant changes in collagen content and neutrophil counts, but a reduction in mast cell number and an increase in macrophage number. In addition, we observed a decrease in anti-oxLDL antibodies of the IgG class upon IL-17R BMT, while introduction of IL-17R deficient bone marrow resulted in a reduced IL-6 production and an increased IL-10 production. In conclusion, signaling via the IL-17 receptor in bone marrow derived cells enhances the process of atherosclerosis.

Effect of dietary elaidic versus vaccenic acid on blood and liver lipids in the hamster

Male hamsters (30 per group) were fed five different semi-purified diets ad libitum. The diets, containing 30% of energy (en%) as fat, differed in their dietary fat composition (specified fatty acids exchanged at 10 en%) and were fed for 4 weeks. The five fatty acids compared in mixed triglycerides were elaidic acid (C18:1 9t), vaccenic acid (C18:1 11t), their cis-counterpart oleic acid (C18:1 9c), medium-chain fatty acids (MCFA; C8:0 and C10:0), and palmitic acid (C16:0). Compared with oleic acid, dietary MCFA and palmitic acid tended to increase blood cholesterol levels in the hamsters. The effect of elaidic and vaccenic acid on blood cholesterol did not differ from that of oleic acid. When elaidic acid and vaccenic acids were compared directly, the ratio of LDL/HDL-cholesterol in plasma was significantly higher in hamsters fed vaccenic acid than in those fed elaidic acid, and elaidic acid was incorporated at low levels, but more efficiently than vaccenic acid at the sn-2 position of platelet phospholipids. Biological consequences of this low incorporation are considered unlikely as levels of arachidonic acid (C20:4 n-6) and docosohexaenoic acid (C22:6 n-3) in the platelet phospholipids of all dietary groups did not differ. With respect to the effect on the LDL/HDL-cholesterol ratio, elaidic acid may be preferable to vaccenic acid. We conclude that this animal study does not provide evidence for the suggestion, based on epidemiological observations, that elaidic acid would be more detrimental to cardiovascular risk than vaccenic acid.

Differential effects of regulatory T cells on the initiation and regression of atherosclerosis

OBJECTIVE Regulatory T cells (Tregs) play an important role in the regulation of T cell-mediated immune responses through suppression of T cell proliferation and cytokine production. In atherosclerosis, a chronic autoimmune-like disease, an imbalance between pro-inflammatory cells (Th1/Th2) and anti-inflammatory cells (Tregs) exists. Therefore, increased Treg numbers may be beneficial for patients suffering from atherosclerosis. In the present study, we determined the effect of a vast expansion of Tregs on the initiation and regression of well-established lesions. METHODS AND RESULTS For in vivo Treg expansion, LDL receptor deficient (LDLr(-/-)) mice received repeated intraperitoneal injections of a complex of IL-2 and anti-IL-2 mAb. This resulted in a 10-fold increase in CD4(+)CD25(hi)Foxp3(+) T cells, which potently suppressed effector T cells ex vivo. During initial atherosclerosis, IL-2 complex treatment of LDLr(-/-) mice fed a Western-type diet reduced atherosclerotic lesion formation by 39%. The effect on pre-existing lesions was assessed by combining IL-2 complex treatment with a vigorous lowering of blood lipid levels in LDLr(-/-) mice. This did not induce regression of atherosclerosis, but significantly enhanced lesion stability. CONCLUSION Our data show differential roles for Tregs during atherosclerosis: Tregs suppress inflammatory responses and attenuate initial atherosclerosis development, while during regression Tregs can improve stabilization of the atherosclerotic lesions.

Low density lipoprotein binding and uptake by human and rat islet beta cells.

Abnormalities in lipoprotein metabolism are common in diabetes. It is unknown whether variations in form or concentration of lipoproteins influence the function of pancreatic beta cells. This study investigates whether low density lipoproteins (LDL) exhibit specific interactions with islet beta cells. Radioactively labeled LDL (125I-LDL) and fluorescently labeled LDL (DiI-LDL) were used as tracers. Rat islet cells express high affinity LDL binding sites (K(d) = 9 nM), which are also recognized by very low density lipoproteins and which are down-regulated by LDL. Binding of LDL appears restricted to the beta cells, as it was not detected on islet endocrine non-beta cells. At 37 C, LDL is taken up and lysosomally degraded by islet beta cells but not by islet non-beta cells. Human islet cells were also found to present LDL binding, uptake, and degradation. Compared with rat islet cells, human islet cells exhibit 10-fold less binding sites (2.10(7) vs. 2.10(8) per 10(3) cells) with a 2-fold lower K(d) value (5 nM) and an equal sensitivity to LDL-induced down-regulation. In conclusion, human and rat islet beta cells express LDL receptors that can internalize the lipoprotein. This pathway should be examined for its potential role in (dys)regulating pancreatic beta cell functions.

Leukocyte Cathepsin S Is a Potent Regulator of Both Cell and Matrix Turnover in Advanced Atherosclerosis

Objective—A dysbalance of proteases and their inhibitors is instrumental in remodeling of atherosclerotic plaques. One of the proteases implicated in matrix degradation is cathepsin-S (CatS). To address its role in advanced lesion composition, we generated chimeric LDLr−/− mice deficient in leukocyte CatS by transplantation with CatS−/−×LDLr−/− or with LDLr−/− bone marrow and administered a high-fat diet. Methods and Results—No difference in aortic root lesion size could be detected between CatS+/+ and CatS−/− chimeras. However, leukocyte CatS deficiency markedly changed plaque morphology and led to a dramatic reduction in necrotic core area by 77% and an abundance of large foam cells. Plaques of CatS−/− chimeras contained 17% more macrophages, 62% less SMCs, and 33% less intimal collagen. The latter two could be explained by a reduced number of elastic lamina fractures. Moreover, macrophage apoptosis was reduced by 60% with CatS deficiency. In vitro, CatS was found to be involved in cholesterol metabolism and in macrophage apoptosis in a collagen and fibronectin matrix. Conclusion—Leukocyte CatS deficiency results in considerably altered plaque morphology, with smaller necrotic cores, reduced apoptosis, and decreased SMC content and collagen deposition and may thus be critical in plaque stability.

High-density lipoprotein and cerebral endothelial cells in vitro: interactions and transport.

Primary cultures of bovine cerebral endothelial cells were used as an in vitro model for the blood-brain barrier to study the transport and interactions of high-density lipoprotein (HDL) across monolayers of these cells. Transport of 125I-apoE free HDL across a monolayer of bovine cerebral endothelial cells occurred in a linear fashion up to a concentration of 70 micrograms/mL, suggesting paracellular transport of HDL. Bovine cerebral endothelial cells possess a high affinity binding site for HDL with a mean dissociation constant (KD) of 10.8 +/- 2.6 micrograms/mL (N = 4). Maximal binding of apoE free HDL to cerebral endothelial cells proved to be temperature-dependent: at 4 degrees a Bmax value of 42 +/- 9.3 ng/mg cell protein was found, while at 37 degrees this value was 177 +/- 70.4 ng/mg cell protein. Cell association of 125I-HDL could be effectively displaced by HDL, not by low-density lipoprotein or acetylated low-density lipoprotein, and association was not coupled to degradation. The in vitro blood-brain barrier cell system possesses high affinity binding sites for HDL, which are probably not involved in the transport of HDL across cerebral endothelial cells.

Receptor-mediated endocytosis of tissue-type plasminogen activator (t-PA) by liver cells

Tissue-type plasminogen activator (t-PA) has a short half-life in the circulation because the enzyme is rapidly cleared by the liver. This short review summarizes recent literature concerning mechanisms of uptake and degradation of t-PA in the liver. In vivo studies in rats show that degradation takes place via a lysosomal pathway. Saturation of the uptake system at high t-PA concentrations suggests a receptor-mediated mechanism. Competition experiments with various glycoproteins indicate that the asialoglycoprotein receptor is not involved, but they point to a role for the mannose receptor, which recognizes t-PA via its high mannose-type oligosaccharide on the first kringle domain. Both in vivo and in vitro studies with isolated liver cells demonstrate that parenchymal cells, as well as liver endothelial cells, are involved in the clearance of t-PA. Parenchymal cells, as the hepatoma cell line Hep G2, endocytose t-PA via a still unknown, possibly t-PA specific receptor, while liver endothelial cells catabolize t-PA via the mannose receptor.

Characterization of the scavenger receptor on bovine cerebral endothelial cells in vitro

Abstract— Primary cultures of bovine brain capillary endo‐thelial cells (BCEC), possessing tight junctions and high levels of γ‐glutamyl transpeptidase, were used as an in vitro model for the blood‐brain barrier. The interaction of acetylated low density lipoprotein (AcLDL) with BCEC was studied to characterize the scavenger receptor on these cells. A saturable high affinity binding site was found with a dissociation constant of AcLDL of 5.4 μg/ml (3.1 nM) and a maximal binding ranging from 284 to 626 ng of AcLDL/mg of cell protein for eight primary cultures, and independent of the presence of calcium. Cell association was coupled to degradation, and both could be effectively competed for by polyinosinic acid and AcLDL but not by low density lipoprotein or by high density lipoprotein. Prolonged incubation showed an accumulation of the ligand in the cells. The rate of degradation of AcLDL was ∼ 10–20‐fold lower in BCEC than that of peripheral endothelial cells. No evidence for lysosomal degradation could be obtained. Binding of 1,1′‐dioctadecyl‐3,3,3,3′‐tetramethylindocar‐boxyamine perchlorate‐labeled AcLDL by BCEC was observed, which could be competed for by an excess of un‐labeled AcLDL and polyinosinic acid. We have shown that in vitro BCEC possesses specific binding sites for AcLDL, whereas these cells show a relatively low degradative capacity.

Drug targeting : application of endogenous carriers for site-specific delivery of drugs

Abstract Lipoproteins are endogenous particulate carriers responsible for the transport of cholesterol and other lipids in the blood circulation. Structurally, they consist of an apolar core, composed of triglycerides and/or cholesteryl esters, surrounded by a monolayer of phospholipids in which cholesterol and apolipoproteins are embedded. Being endogenous carriers, lipoproteins are not immunogenic and escape recognition by the reticulo-endothelial system. Four main lipoprotein classes with characteristic sizes, densities, lipids and apoproteins can be distinguished: chylomicrons, very low density lipoprotein (VLDL), low density lipoprotein (LDL) and high density lipoprotein (HDL). Lipoproteins are cleared from the circulation by specific lipoprotein receptors, which recognize the apolipoproteins. Chylomicron remnants and a particular type of VLDL, β-VLDL, are rapidly taken up by remnant receptors present on parenchymal liver cells. LDL is cleared mainly via specific LDL receptors in the liver. In addition, some types of tumor cells show a very high rate of LDL uptake. Lipoproteins can also be directed to non-lipoprotein receptors by chemical modification of the apolipoproteins. Acetylation of LDL induces rapid uptake by scavenger receptors on endothelial liver cells. Lactosylation of LDL and HDL induced rapid, galactose-specific uptake by Kupffer and parenchymal liver cells, respectively. The oily core of lipoproteins provides an ideal domain for lipophilic drugs. Some lipophilic compounds incorporate spontaneously into lipoproteins. More hydrophilic drugs, however, have to be provided with lipophilic anchors to enable incorporation (prodrugs). These (pro)-drugs can be incorporated into lipoproteins by aqueous addition, contact methods or reconstitution methods. Because (modified) lipoproteins can be taken up by specific receptors on tumor cells or liver cells they are attractive potential carriers of (pro)-drugs to these cell types.