In vivo LDL receptor and HMG-CoA reductase regulation in human lymphocytes and its alterations during aging

The LDL receptor and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase play primary roles in the regulation of cellular cholesterol metabolism. To investigate the transcriptional regulation of lipid metabolism under physiological conditions ex vivo and its alterations during aging, we analyzed both the activity and mRNA concentration of the LDL receptor and HMG-CoA reductase in freshly isolated lymphocytes from healthy young and elderly donors. Data from fluorescent reverse transcriptase-polymerase chain reaction indicated that not only plasma LDL but also plasma HDL downregulates lymphocyte LDL receptor mRNA. Downregulation by HDL was three times more effective than that by LDL and presumably involved specific HDL binding sites. There was coordinate regulation of HMG-CoA reductase mRNA with LDL receptor mRNA that was independent of plasma lipoprotein concentrations. Despite elevated plasma concentrations of LDL, lymphocytes from elderly donors paradoxically expressed increased levels of the LDL receptor (P = .030) and HMG-CoA reductase mRNA (P = .062). The age-related dysregulation of the LDL receptor was predominantly due to impaired downregulation by plasma LDL rather than by HDL. Thus, not only LDL but also HDL and age significantly influences the transcriptional regulation of the LDL receptor in extrahepatic cells in vivo.

Effect of apolipoprotein E and A-IV phenotypes on the low density lipoprotein response to HMG CoA reductase inhibitor therapy

Our purpose was to assess the effect of apolipoprotein (apo) E and apo A-IV isoform variation on low density lipoprotein (LDL) cholesterol lowering response to the HMG CoA reductase inhibitor, pravastatin. Plasma samples were obtained from participants (apo E, n = 97; apo A-IV, n = 144) in the PLAC-I (Pravastatin Limitation of Atherosclerosis in Coronary Arteries Study-1). The mean LDL cholesterol reduction in these subjects who were randomized to pravastatin 40 mg/day was 28%. Subjects with the APOE*2 allele (n = 12) had significantly (P = 0.04) greater reductions at 36% than subjects homozygous for the APOE*3 allele (n = 66, 27%) or those with the APOE*4 allele (n = 19, 26%). No significant effect of apo A-IV phenotype on LDL cholesterol lowering in response to pravastatin was noted. A meta-analysis utilizing published data from 4 previously published studies as well as our own data with a total sample size of 625 subjects was carried out. This analysis indicates that the presence of the APOE*2 allele was associated with a significantly greater (P < 0.05) LDL-cholesterol lowering response at 37% than those subjects homozygous for the APOE*3 allele at 35%, while those with the APOE*4 allele had a significantly lower response (P < 0.05), at 33%. These data are consistent with the concept that apo E phenotype modulates the LDL cholesterol lowering response observed with the use of HMG CoA reductase inhibitors.

Circadian rhythm in hepatic low-density-lipoprotein (LDL)-receptor expression and plasma LDL levels

On the basis of studies in vivo and in vitro that involved the use of pharmacological amounts of drugs and hormones or excess cholesterol supplementation, the expression of the low-density lipoprotein (LDL) receptor appears to be tightly coupled to the regulation of 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase activity and to extracellular levels of LDL. The present study was undertaken to see how these three entities are regulated under normal physiological conditions over a 24 h period. The results show that, in the rat, hepatic LDL-receptor expression and plasma LDL levels exhibit diurnal periodicity, with a 2-3-fold difference between the peak and trough of each rhythm. Both rhythms showed high inverse correlation (r = -0.86, P < 0.01), plasma LDL levels being lowest at the onset of darkness when LDL-receptor expression was at its peak. The results also showed that the LDL-receptor protein in rat liver has a shorter half-life than that reported for cultured fibroblasts or HepG2 cells. The maximal expression of the LDL receptor occurred several hours before the peak activity of HMG-CoA reductase and appeared not to be influenced by cellular or membrane cholesterol levels during the 24 h cycle. Treatment with dexamethasone increased the LDL-receptor activity significantly at both the lowest and highest points of the rhythm, but the receptor rhythm was still maintained, suggesting that the signal for the circadian variation of the receptor expression is not mediated by adrenal hormones.

The effects of tannic acid on serum and liver lipids of RAIF and RICO rats fed on high fat diet

1. Male genetically hypercholesterolemic (RICO) and normocholesterolemic (RAIF) rats were divided into four groups and each group was fed one of the following diets for 10 weeks: a standard diet (STD); STD supplemented with tannic acid (STD + T); a high fat diet (HFD) and a high fat diet with tannic acid (HFD + T). 2. The RAIF and RICO rats when fed on HFD + T showed beneficial changes in serum lipids compared to the rats fed HFD. The lipid parameters between the groups fed STD and STD + T in both strains were unchanged. 3. The possible modes of hypocholesterolemic action of tannic acid in these rats is discussed.

Influence of age and gender on the plasma profiles of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitory activity following multiple doses of lovastatin and simvastatin

The effects of age and of gender on the plasma profiles of HMG-CoA reductase inhibitors following separate once-a-day dosage regimens (17 days) of lovastatin (80 mg/day) and simvastatin (40 mg/day) were studied in hypercholesterolemic patients. In general, plasma concentrations of active and total HMG-CoA reductase inhibitors were higher in elderly individuals (age, 70 to 78 years) and in females for both drugs. However, the Tmax of these inhibitors was not significantly affected by either age or gender. Following the last dose of lovastatin, the mean steady-stage plasma concentrations of total and active HMG-CoA reductase inhibitors were 30-60% higher in the elderly than in young individuals (age, 19 to 30 years). Also, the mean plasma concentrations were 20-50% higher in female than in male patients. Similarly, following the last dose of simvastatin, the mean plasma concentrations of HMG-CoA reductase inhibitors were 40-60% higher in the elderly than in young patients and were 20-50% higher in female than in male patients. These age- and gender-related differences do not appear to be large enough to warrant modification of dosage regimens, because plasma concentrations of these inhibitors are not necessarily indicative of efficacy and the therapeutic windows for lovastatin and simvastatin are broad.

Differential induction and suppression of potato 3-hydroxy-3-methylglutaryl coenzyme A reductase genes in response to Phytophthora infestans and to its elicitor arachidonic acid

Induction of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGR) is essential for the biosynthesis of sesquiterpenoid phytoalexins and steroid derivatives in Solanaceous plants following stresses imposed by wounding and pathogen infection. To better understand this complex step in stress-responsive isoprenoid synthesis, we isolated three classes of cDNAS encoding HMGR (hmg1, hmg2, and hmg3) from a potato tuber library using a probe derived from an Arabidopsis HMGR cDNA. The potato cDNAs had extensive homology in portions of the protein coding regions but had low homology in the 3' untranslated regions. RNA gel blot analyses using gene-specific probes showed that hmg1 was strongly induced in tuber tissue by wounding, but the wound induction was strongly suppressed by treatment of the tissue with the fungal elicitor arachidonic acid or by inoculation with an incompatible or compatible race of the fungal pathogen Phytophtora infestans. The hmg2 and hmg3 mRNAs also accumulated in response to wounding, but in contrast to hmg1, these mRNAs were strongly enhanced by arachidonic acid or inoculation. Inoculation with a compatible race of P. infestans resulted in similar patterns in HMGR gene expression of hmg2 and hmg3 except that the magnitude and rate of the changes in mRNA levels were reduced relative to the incompatible interaction. The differential regulation of members of the HMGR gene family may explain in part the previously reported changes in HMGR enzyme activities following wounding and elicitor treatment. The suppression of hmg1 and the enhancement of hmg2 and hmg3 transcript levels following elicitor treatment or inoculation with the incompatible race parallel the suppression in steroid and stimulation of sesquiterpenoid accumulations observed in earlier investigations. The results are discussed in relation to the hypothesis that there are discrete organizational channels for sterol and sesquiterpene biosynthesis in potato and other Solanaceous species.

Effect of lovastatin on hypercholesterolemia in chronic renal failure

Using a mouse model of chronic renal failure (CRF), the possibility of using lovastatin to treat hypercholesterolemia associated with CRF was examined. Renal failure was induced in 5 week-old, C57BL/6J mice by electrocoagulation of the right kidney surface followed by left nephrectomy 2 weeks later. Five weeks post-nephrectomy, BUN and serum total cholesterol levels were assessed and lovastatin treatment commenced. Upon sacrifice 4 weeks later, BUN, serum total cholesterol levels and hepatic HMG-CoA reductase activity were measured. Results showed that CRF induced significant increases in serum total cholesterol levels and enzyme activity. Treatment with lovastatin led to a dose-dependent reduction in serum total cholesterol levels without affecting the enzyme activity. These results suggest that the hyper-cholesterolemia in CRF is partly due to an increase in de novo cholesterol synthesis in the liver and that the lipid-lowering effect of lovastatin is mediated by an action other than the direct reduction of hepatic HMG-CoA reductase activity.

Inhibition of HMG-CoA reductase in mononuclear cells during gemfibrozil treatment

The effect of gemfibrozil treatment (900 mg/day) on serum levels of total cholesterol, HDL-cholesterol, triglyceride, apoproteins A-I, A-II and B as well as HMG-CoA reductase in mononuclear cells was studied in patients with hyperlipoproteinemia types IIa and IIb. After 4 weeks of treatment gemfibrozil reduced total serum cholesterol (IIa: -17%, IIb: -26%), triglyceride (IIa: -39%, IIb: -47%) and apoprotein B (IIa: -22%, IIb: -15%). HDL cholesterol was increased by 20-22% and apoproteins A-I and A-II by 4-11%. Concomitantly, HMG-CoA reductase activity in freshly isolated mononuclear cells was suppressed by 78% in type IIa and 51% in type IIb patients. Continuation of treatment for up to 16 weeks prompted a further decline to 8 and 5% of the initial values, respectively. However, gemfibrozil failed to affect HMG-CoA reductase directly in homogenized or cultured mononuclear cells and did not further promote the suppressive action of LDL when added to the culture medium. Similarly, preincubation with the drug did not significantly modulate the binding or degradation of LDL in the cultured cells. However, LDL from patients with hyperlipoproteinemia types IIa and IIb exhibited enhanced binding and more potent HMG-CoA reductase suppression when isolated after compared to before gemfibrozil treatment. It is suggested that the HMG-CoA reductase inhibition observed in mononuclear cells during gemfibrozil treatment is due to changes in LDL structure affecting LDL receptor binding rather than direct effects of the drug on cellular cholesterol metabolism.

Increase in serum and bile cholesterol and HMG-CoA reductase by lovastatin in rats

Lovastatin, a competitive inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, is effective in the treatment of hypercholesterolemic patients and is currently being evaluated as a potential agent for dissolving gallstones. We therefore evaluated its effect on cholesterol metabolism in a rat model. A low-cholesterol diet containing 0.1% lovastatin was fed 15 h and 7 and 21 days. Microsomal HMG-CoA reductase activity, hepatic cholesterol synthesis, blood cholesterol, and biliary lipid output were determined and compared with control rats. Hepatic cholesterol synthesis increased ninefold after 7 days and levels of HMG-CoA reductase activity sevenfold. Biliary cholesterol excretion maximally increased fourfold. Biliary lipid output was still elevated after 21 days of treatment (cholesterol 3-fold and phospholipid 2-fold, P less than 0.01). Bile salt output did not change. Augmented responses to lovastatin were present but less on the high-cholesterol diet. The data are consistent with the hypothesis that lovastatin increases HMG-CoA reductase activity through a feedback mechanism that promoted increased cholesterol synthesis, biliary lipid secretion, and elevated blood cholesterol. There was an apparent coupling of biliary cholesterol output with phospholipids but not with bile salts. Although lovastatin also increased microsomal HMG-CoA reductase activity in humans, cholesterol synthesis is not stimulated but is inhibited. This may be explained by higher permeability of the microsomal membranes for lovastatin. Thus the effect of HMG-CoA reductase inhibitors on cholesterol synthesis in different species should then depend on the properties of microsomal membranes.

Decreased cholesterol biosynthesis in sitosterolemia with xanthomatosis: diminished mononuclear leukocyte 3-hydroxy-3-methylglutaryl coenzyme A reductase activity and enzyme protein associated with increased low-density lipoprotein receptor function

We investigated the mechanism for reduced cholesterol biosynthesis in sitosterolemia with xanthomatosis. The conversion of acetate to cholesterol and total and active hydroxymethylglutaryl (HMG) coenzyme A (CoA) reductase activities, enzyme protein mass, and catalytic efficiency were related to low-density lipoprotein (LDL) receptor function in freshly isolated mononuclear leukocytes collected at 9 AM after a 12-hour fast from two affected sisters and 12 control subjects. Active HMG-CoA reductase activity was determined in mononuclear leukocyte microsomes prepared and assayed in the presence of sodium fluoride, while total HMG-CoA reductase activity was determined in the absence of the phosphatase inhibitor. Enzyme protein was assayed using rabbit polyclonal anti-rat liver microsomal HMG-CoA reductase serum. The rates at which [14C]acetate was transformed to cholesterol by sitosterolemic mononuclear leukocytes were decreased 29% and 41%, respectively, compared with the mean value for mononuclear leukocytes from 12 control subjects. Similarly, total HMG-CoA reductase activities were 71% and 68% lower in sitosterolemic mononuclear leukocyte microsomes and were associated with 62% and 65% less enzyme protein than the mean for the control microsomal preparations. This marked decrease in HMG-CoA reductase protein mass in sitosterolemic microsomes was partially compensated for by an increase in the proportion of active enzyme. Sitosterolemic plasma and mononuclear leukocyte cholesterol concentrations were not significantly different from control values, although total sterol levels were increased about 20% because of abundant plant sterols. In contrast, receptor-mediated LDL degradation by sitosterolemic mononuclear leukocytes was increased 50% over control.(ABSTRACT TRUNCATED AT 250 WORDS)

Determination of serum levels of unesterified lathosterol by isotope dilution-mass spectrometry

The synthesis of 2H3-labelled lathosterol is described. This compound was used together with 2H7-labelled cholesterol for simultaneous assay of unesterified lathosterol and cholesterol in serum by isotope dilution-mass spectrometry. After addition of a fixed amount of the two internal standards to a fixed amount of serum (in general 25 microliter), the steroids were extracted with chloroform and subjected to Lipidex 5000 chromatography. The fraction containing cholesterol and lathosterol was converted into trimethylsilyl ether and subjected to mass spectrometric analysis with selected monitoring of the ions at m/z 458 (molecular ion of the trimethylsilyl ether derivative of unlabelled cholesterol and lathosterol), m/z 461 (molecular ion of derivative of 2H3-labelled lathosterol) and m/z 465 (molecular ion of derivative of 2H7-labelled cholesterol). Individual standard curves were used for assay of each steroid. Under the conditions employed, the coefficient of variation of the two assays was less than 6%. In different recovery experiments the maximal difference between expected and found values was less than 7%. Using a less accurate method for analysis of lathosterol, we have shown previously that there is a high correlation between the hepatic HMG CoA reductase and the relative concentration of unesterified lathosterol in serum (concentration of lathosterol relative to cholesterol). This was confirmed with the present method and a correlation coefficient of about 0.94 was found between the two parameters. It is concluded that the present method may be suitable for detection of cases with accelerated rate of synthesis of cholesterol.

Erythrocyte contamination of leukocyte populations following density-gradient centrifugation results in artificially high levels of human leukocyte HMG-CoA reductase activity

When measuring human leukocyte HMG-CoA reductase activity, special care must be taken to prevent erythrocyte contamination of the leukocyte layer during isopycnic centrifugation. Contamination during leukocyte isolation and subsequent erythrocyte lysis during NH4Cl treatment results in increased leukocyte microsomal HMG-CoA reductase activity. Increased enzyme activity is not due to enzyme dephosphorylation, thiol-disulfide reduction or increased enzyme protein concentration. Leukocyte populations containing granulocytes appear to be most sensitive. Prevention of erythrocyte contamination during isopycnic centrifugation should aid in accurate measurement of human leukocyte HMG-CoA reductase activity.

Hepatic hydroxymethylglutaryl coenzyme A reductase activity in inbred strains of mice

Hydroxymethylglutaryl coenzyme A reductase (HMGR) activity is a major factor in the regulation of cholesterol homeostasis. Enzyme activity is known to vary with age, sex, diurnal cycle, and dietary properties in rats. Mice are available in numerous genetic strains and could be a useful inexpensive animal model for studying diet and genetic interactions in the regulation of cholesterol metabolism. Obese and non-obese C57BL/6J, CBA/J, and obese and non-obese DW dbPas mice were subjected to variations in light cycle, feeding schedule, and pectin and fat composition of their diets. They were then killed by decapitation, and hepatic microsomal HMGR analyzed. The mice responded in the same ways as rats to light cycle, feeding pattern, and sex difference. They exhibited marked differences in HMGR activity due to age, genotype, strain, and diet variations. We conclude that mice will, indeed, offer an excellent animal model for the study of cholesterol metabolism regulation.

Regulation of indices of cholesterol synthesis in human mononuclear leukocytes by dietary cholesterol and fat saturation

The responses of 2 indices of cholesterol synthesis, 3-hydroxy-3-methylglutaryl-CoA reductase activity and incorporation of [14C]acetate into sterols, in mononuclear leukocytes freshly isolated from peripheral blood to variation in the ratio of saturated to unsaturated fat (S:U) and the amount of cholesterol absorbed from the diet were examined in 24 free-living men. Increasing S:U was associated with increasing plasma cholesterol level (r = 0.27, P = 0.03) and increasing reductase activity in leukocytes (r = 0.60, p less than 0.001). This finding is consistent with the hypothesis that saturated fat decreases the flux of cholesterol from plasma into cells thereby releasing reductase from product feedback inhibition. Reductase activity, after controlling for the effect of S:U, was negatively correlated with absorbed cholesterol from sources other than eggs (r = 0.42, P = 0.02). Surprisingly, change in reductase activity was positively correlated with change in absorbed cholesterol upon eating eggs (r = 0.49, P = 0.008). Sterol labeling was negatively correlated with absorbed cholesterol from all sources including eggs (r = -0.64, P less than 0.001) and was uncorrelated with S:U. Reductase activity and sterol labeling responded in parallel to cholesterol in foods other than eggs but not to egg feeding nor to S:U, thus it is unclear which test best reflects endogenous sterol synthesis in these cells.

In vivo regulation of human mononuclear leukocyte 3-hydroxy-3-methylglutaryl coenzyme A reductase. Decreased enzyme catalytic efficiency in familial hypercholesterolemia

3-Hydroxy-3-methylglutaryl coenzyme A reductase (HMG CoA reductase) controls the rate of cholesterol biosynthesis and is itself modulated through feedback suppression by internalized low density lipoprotein (LDL) cholesterol. We measured HMG CoA reductase protein concentration and microsomal enzyme activity in freshly isolated mononuclear leukocytes from normal individuals and patients with heterozygous or homozygous familial hypercholesterolemia (FH). Reductase protein concentration was similar in normal and heterozygous subjects, but was over twofold elevated in patients with homozygous FH. Reductase protein concentration was inversely related to LDL receptor status. Total activity and catalytic efficiency of reductase, however, were decreased in heterozygous and homozygous FH patients. The decrease in catalytic efficiency was not due to enzyme phosphorylation or thiol-disulfide formation. Reduction of plasma cholesterol concentration over 2 h by plasmapheresis increased reductase activity, the degree of which was directly proportional to the LDL-receptor status of the subjects. Decreased HMG CoA reductase activity and catalytic efficiency in mononuclear leukocytes and perhaps other cells in FH may represent a fundamental abnormality in the regulation of this enzyme independent of that induced by the LDL-receptor defect and may provide new insight into the control of cholesterol metabolism in FH.

Development of a noncompetitive, solid phase, bridged biotin-avidin enzyme immunoassay for measurement of human leukocyte microsomal HMG-CoA reductase protein concentration

Methods were developed for determination of human mononuclear leukocyte HMG-CoA reductase protein concentration by a noncompetitive, solid phase, bridged biotin-avidin enzyme immunoassay procedure. Leukocyte microsomal HMG-CoA reductase, first immobilized onto a nitrocellulose filter, is sequentially reacted with 1) monospecific, polyclonal rabbit anti-rat liver HMG-CoA reductase antiserum, which crossreacts with the human liver and leukocyte enzymes; 2) biotinylated donkey anti-rabbit immunoglobulin; 3) a streptavidin-horseradish peroxidase conjugate; and 4) 4-chloro-1-naphthol and H2O2 to visualize the quantity of horseradish peroxidase bound to the immunocomplex. Color development was proportional to the quantity of either purified liver or leukocyte microsomal HMG-CoA reductase applied to the nitrocellulose. Color development was not observed, however, when HMG-CoA reductase was omitted from the nitrocellulose, when one of the reactant species was omitted from the incubation reactions, or when anti-rat liver HMG-CoA reductase antiserum was pre-absorbed with either rat liver or human leukocyte HMG-CoA reductase. Immunoreactivity of microsomal HMG-CoA reductase was independent of the phosphorylation state of the enzyme, but was inversely related to the concentration of thiol-reducing agents present in the microsomal preparation up to 4 mM. Further increases in thiol-reductant failed to produce changes in immunoreactivity. Freshly isolated mononuclear leukocyte microsomal HMG-CoA reductase protein concentration in leukocytes from 31 healthy, normocholesterolemic subjects was a linear function of HMG-CoA reductase activity (R = 0.65; P less than 0.001). The catalytic efficiency of the freshly isolated mononuclear leukocyte enzyme was 313 +/- 34 pmol of mevalonate formed per min of incubation at 37 degrees C per mg immunoreactive protein. This methodology, in conjunction with that recently developed to measure human leukocyte HMG-CoA reductase activity (1984. J. Lipid Res. 25: 967-978), should prove useful in discriminating between HMG-CoA reductase regulatory mechanisms involving changes in enzyme protein concentration and those resulting from changes in enzyme catalytic efficiency.

Inhibition of human leukocyte 3-hydroxy-3-methylglutaryl coenzyme A reductase activity by ascorbic acid. An effect mediated by the free radical monodehydroascorbate

3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activity in microsomes isolated from cultured lymphoid (IM-9) cells or freshly isolated human leukocytes was markedly decreased by either ascorbic acid or its oxidized derivative, dehydroascorbate. Inhibition of IM-9 leukocyte HMG-CoA reductase activity was log linear between 0.01 and 10 mM ascorbic acid (25 and 81% inhibition, respectively) and 0.1 and 10 mM dehydroascorbate (5 and 75% inhibition, respectively). Inhibition was noncompetitive with respect to HMG-CoA (Km = 10.2 microM (RS); ascorbic acid, Ki = 6.4 mM; dehydroascorbate, Ki = 15 mM) and competitive with respect to NADPH (Km = 16.3 microM; acetic acid, Ki = 6.3 mM; dehydroascorbate, Ki = 3.1 mM). Ascorbic acid and dehydroascorbate are interconverted through the free radical intermediate monodehydroascorbate. Reducing agents are required to convert dehydroascorbate to monodehydroascorbate, but prevent formation of the free radical from ascorbate. In microsomes from IM-9 cells, the reducing agent, dithiothreitol, abolished HMG-CoA reductase inhibition by ascorbate but enhanced inhibition by dehydroascorbate. In addition, the concentration of monodehydroascorbate present in ascorbate solutions was directly proportional to the degree of HMG-CoA reductase inhibition by 1.0 mM ascorbate. Fifty per cent inhibition of enzyme activity occurred at a monodehydroascorbate concentration of 14 microM. These data indicate that monodehydroascorbate mediates inhibition of HMG-CoA reductase by both ascorbate and dehydroascorbate. This effect does not appear to be due to free radical-induced membrane lipid modification, however, since both ascorbate and dehydroascorbate inhibited the protease-solubilized, partially purified human liver enzyme. Since inhibition of HMG-CoA reductase occurs at physiological concentrations of ascorbic acid in the human leukocyte (0.2-1.72 mM), this vitamin may be important in the regulation of endogenous cholesterol synthesis in man.

Fenofibrate treatment inhibits HMG-CoA reductase activity in mononuclear cells from hyperlipoproteinemic patients

The effect of fenofibrate treatment on serum cholesterol levels was studied in relation to the activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase in mononuclear cells from patients with hyperlipoproteinemia type IIa and IIb. When patients who had received fenofibrate (300 mg/day) for at least 8 weeks were given placebo during a subsequent 2-months period, both serum cholesterol concentration and mononuclear cell HMGR increased significantly in both types IIa and IIb. After reinstitution of fenofibrate treatment both parameters gradually declined and returned close to the initial level after another 28 weeks. It is concluded that a part of the lipid-lowering action of fenofibrate may be due to an inhibition of cholesterol synthesis.

Isoprenoid biosynthesis in multiple sclerosis

Recently discovered metabolites in urine have suggested a defect of isoprenoid metabolism in multiple sclerosis. Lymphocyte HMG-CoA reductase was found unaffected however, and so was lymphocyte biosynthesis of geraniol, farnesol and squalene from mevalonolactone. The level of dolichol in white matter of an MS brain was similar to that of a control sample. Serum ubiquinone, on the other hand, was decreased in multiple sclerosis. Ubiquinone in serum was both age-dependent and related to serum cholesterol. Active as well as stable MS displayed a decreased level of serum ubiquinone, and a reduced ubiquinone-cholesterol ratio. These results are compatible with a deficient ubiquinone biosynthesis in multiple sclerosis.

Measurement of human leukocyte microsomal HMG-CoA reductase activity

Methods were developed for determination of microsomal HMG-CoA reductase activity from freshly isolated human lymphocytes, monocytes, and granulocytes or cultured human lymphoid cells. Reductase activity in monocytes is approximately twice that in lymphocytes or granulocytes. The activity in cultured cells is approximately 34-fold greater than that in freshly isolated cells. Assay conditions were such as to preclude formation of HMG-CoA cleavage products. Leukocyte reductase activity was inhibited by dichloroacetate, a noncompetitive inhibitor of rat liver reductase and a serum cholesterol-lowering agent in man. Measurement of microsomal reductase activity from freshly isolated leukocytes may prove useful in assessing in vivo regulation of cholesterol synthesis in man.

Increased 3-hydroxy-3-methylglutaryl coenzyme A reductase activity and cholesterol biosynthesis in freshly isolated hairy cell leukemia cells

Freshly isolated hairy cells from the peripheral blood of patients with hairy cell leukemia (HCL) synthesize 3-5-fold greater amounts of cholesterol, lanosterol, and squalene from [1-14C]-acetate than do normal human peripheral blood mononuclear cells under basal conditions of culture (i.e., in the presence of low-density lipoprotein). HCL cells also exhibit an eightfold increase in the activity of the enzyme 3-hydroxy-3-methylglutaryl coenzyme A reductase. These changes cannot be ascribed to increased rates of cellular proliferation in the HCL cells, nor are they a consequence of an increased rate of loss of newly synthesized cholesterol into the culture medium. The increased rate of cholesterol biosynthesis in HCL cells may result in an increase in their total cellular cholesterol content, as well as in an increase in their plasma membrane cholesterol:phospholipid molar ratio. These changes, in turn, are probably responsible for some of the clinical manifestations of this disease.

Suppression of cholesterogenesis and reduction of LDL cholesterol by dietary ginseng and its fractions in chicken liver

The effects of ginseng root powder and of serially extracted solvent fractions of ginseng on avian hepatic cholesterol metabolism and lipogenesis and on avian serum lipoprotein cholesterol levels were examined. In one study, White Leghorn females were fed for 4 weeks a corn-based diet (control) or an experimental diet in which was incorporated 0.25% Wisconsin ginseng or an equivalent quantity of a serial solvent fraction [petroleum ether (PESF), methyl alcohol (MESF), water (WASF)] or of the residue. beta-hydroxy-beta-methylglutaryl-CoA (HMG-CoA) reductase activity was significantly lower (P less than 0.01) in each of the treatment groups (31-37% of control activity) except that fed the extracted residue (90% of control, N.S.). Cholesterol 7 alpha-hydroxylase activity was lowered in parallel (45-64% of control, P less than 0.01) by all treatments except the residue (100% of control). Also with the exception of the residue treatment, each ginseng treatment effected a lowering of the serum total cholesterol level (67-83% of control, P less than 0.01) and of serum low density lipoprotein cholesterol level (53-81% of control, P less than 0.01). Lipogenic activities and serum triglycerides levels were lowered (P less than 0.01) by two of the ginseng treatments. The PESF treatment was the most effective suppressor of each parameter, 74% and 68% respectively, of the control values. The WASF also had significant impact. Not one of the experimental diets influenced the serum high density lipoprotein level. The PESF, the potent source of suppressors, effected a change in the ratio of low to high density lipoprotein cholesterol from 1.46 (control) to 0.88. The levels of cholesterol and triglycerides in liver under these conditions showed a similar pattern as that of serum. In companion studies, broiler females were fed 0.28% Chinese red ginseng root powder or its various fractions. The results confirmed those recorded above. The factor(s) responsible for lowering the serum total and low density lipoprotein cholesterol levels were generally more concentrated in the PESF and WASF of ginseng and each was significantly more effective than was ginseng root powder. Ginsenosides (saponins) are considered to be the active agents for the suppression of cholesterogenesis and lipogenesis.

Indirect assay of beta hydroxy beta methyl glutaryl CoA reductase in the sera of leprosy patients--a further probe into cholesterol metabolism

With an aim to study the cholesterol biosynthetic capacity of the leprosy patients, the enzyme Beta hydroxy methyl glutaryl CoA reductase (HMG CoA) has been indirectly determined in the sera of leprosy patients and their family members by assaying the circulating levels of HMG CoA and mevalonate and finding out the ratio between two. The ratio was around 1 in leprosy patients indicating a normal HMG CoA reductase activity and approximately the same values were obtained in cases of healthy controls. The results suggest that cholesterol biosynthetic capacity of leprosy patients is normal. Whether cholesterol, the final product or intermediates like mevalonate are utilised by the invading M. leprae, thereby causing a lowered cholesterol level remains to be seen.

Plasma lipid alterations in patients with chronic renal disease

Hyperlipidemia is common in patients with renal disease. This fact may be of great clinical relevance in view of the overwhelming evidence associating disturbed lipid metabolism and atherogenesis. Thus, hyperlipidemia may predispose to vascular disease in patients with chronic renal disorders and premature atherosclerosis could be an important risk in renal disease and a major factor limiting survival of patients on long-term maintenance hemodialysis. The aim of the present review is to present a brief but clinically relevant description of lipoprotein physiology and then to survey the now considerable literature concerned with lipoprotein and thus lipid abnormalities in patients with renal disease. A particular emphasis is placed on the role of the plasma lipoproteins in forming an integrated and controlled pathway for lipid metabolism, and how altered regulatory control within the pathway may be associated with pathogenic mechanisms. Finally, the evidence for accelerated development of vascular disease associated with these lipid abnormalities is briefly considered.

Comparative study of the kinetics of 3-hydroxy-3-methylglutaryl coenzyme A reductase and [14C]-acetate incorporation into cholesterol in human lymphocytes stimulated by phytohemagglutinin or sterol efflux

The time course of sterol biosynthesis was compared after two different stimulations in normal human lymphocytes: culture either in the presence of phytohemagglutinin (PHA) or in a lipid-depleted medium (i. e. a condition which produces sterol efflux). Stimulation by PHA gives rise to an acute and rapid response in 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase activity and cholesterol synthesis. The sterol efflux induction produces a slower and milder response and the delayed sterol production consists mainly of lathosterol.

On the differential suppression of cholesterol synthesis by low density lipoprotein in B and T lymphocytes

Cholesterol synthesis and its suppression by low density lipoprotein cholesterol were measured in purified B and T peripheral blood lymphocytes. After preincubation for 53 h in lipoprotein-deficient serum, both B and T cells exhibited increased cholesterol synthesis as compared with synthesis measured in cells immediately after their isolation from blood and without preincubation with lipoprotein-deficient serum. The magnitude of this increase was far greater in T cells in comparison with that in B cells in all subjects studied. But, whereas there was an immediate and progressive suppression of cholesterol synthesis in lipoprotein-deficient serum-incubated T cells as the concentration of low density lipoprotein cholesterol in the medium was increased, synthesis in lipoprotein-deficient serum-incubated B cells remained insensitive to the presence of low density lipoprotein in the medium. Hydroxymethylglutaryl-CoA reductase activity was observed also to follow a similar pattern in both cell types. These observations may imply that one or more events, including binding of low density lipoprotein to its receptor, internalization and degradation of low density lipoprotein receptor complex finally leading to suppression of hydroxymethylglutaryl-CoA reductase activity and cholesterol synthesis, fail to take place in B cells.

Evidence for rate-limiting steps in sterol synthesis beyond 3-hydroxy-3-methylglutaryl-coenzyme A reductase in human leukocytes

When human blood leukocytes are incubated with [2-14C]acetate only about 32% of the nonsaponifiable lipid radioactivity is recovered in digitonin-precipitable material. Using thin-layer chromatography and gas-liquid radiochromatography, we have determined that most of the label from [2-14C]acetate in the nonsaponifiable fractions is in lanosterol, squalene and an unidentified sterol. Only 11% of the acetate radioactivity is contained in cholesterol. This distribution does not change when cholesterol synthesis is depressed by the addition of lipoproteins to the medium. These findings are in marked contrast to studies with liver, where most of the nonsaponifiable radioactivity derived from acetate is recovered in digitonin-precipitable sterols. Furthermore, they suggest that rate-limiting steps beyond the 3-hydroxy-3-methylglutaryl coenzyme A reductase reaction exist in the sterol synthesis pathway of human leukocytes.

Regulation of hydroxymethylglutaryl-CoA reductase in rat leukocytes

Methods were developed for the assay of hydroxymethylglutaryl-CoA reductase (NADPH) activity in microsomes from rat leukocytes. The activity in freshly isolated leukocytes is low compared to rat liver but can be assayed reliably. The patterns of response of leukocyte reductase in the assay to variation in substrate concentration, protein concentration, and time mimic those of rat liver reductase. Reductase activity in leukocyte microsomes, as in liver microsomes, is depressed by dietary cholesterol and by fasting and is elevated by dietary cholestyramine. Unlike liver reductase, leukocyte reductase activity does not exhibit a detectable diurnal rhythm. We conclude that the assay of reductase in freshly isolated leukocytes holds promise as a technique for detecting the effects of various factors on cholesterol synthesis in vivo.

Pathophysiology of myocardial infarction

Primary prevention of death from ischemic heart disease requires further understanding of the pathogenesis of this disorder. Cellular defects of cholesterol metabolism may be more significant markers that serum lipid levels for the identification and treatment of atherosclerotic risk. Coronary spasm has been shown to be an important cause of ischemia in the presence and absence of atherosclerotic lesions. Careful manipulation of physiologic variables with vasodilator agents during cardiopulmonary bypass can substantially alter the myocardial oxygen supply-demand relation, thereby minimizing ischemic injury. The cellular basis for loss of mechanical function during ischemia and the factors that determine irreversible injury are yet unknown.

Regulation of 3-hydroxy-3-methylglutaryl coenzyme-A reductase activity in type II hyperlipoproteinaemia

The regulation of 3-hydroxy-3-methylglutaryl coenzyme-A reductase activity in leucocytes was studied in a family with familial type II hyperlipoproteinaemia (WHO classification). The propositus was heterozygous and 16 other members of the family were studied. Leucocytes were isolated by a relatively quick and simple procedure and used for enzyme estimations. The results suggest that measurement of the regulation of this enzyme in leucocytes may be helpful in the diagnosis and management of the condition.

A new type of familial hypercholesterolaemia

Two members of a family (proband and daughter) with hypercholesterolaemia have an abnormal low-density lipoprotein which fails to suppress the activity of a rate-determining enzyme for cholesterol biosynthesis (3-hydroxy-3-methyl glutaryl-CoA reductase) in leucocytes of the patients and controls. However, the proband's leucocytes are inhibited by lipoproteins from other sources demonstrating that the mechanism for cellular regulation of the enzyme is intact. This mutant lipoprotein may have a role in the production of hypercholesterolaemia.