Cholesterolemia and cardiovascular abnormalities in rats caused by copper deficiency

Dietary Cholesterol Supplements Disturb Copper Homeostasis in Multiple Organs in Rabbits: Aorta Copper Concentrations Negatively Correlate with the Severity of Atherosclerotic Lesions

Dietary cholesterol causes atherosclerosis along with a reduction of copper concentrations in the atherosclerosis wall. This study was to determine the relationship between aorta copper concentrations and the severity of atherosclerotic lesions as well as copper homeostasis in multiple organs in cholesterol-fed rabbits. Male New Zealand white rabbits, 10-week-old and averaged 2.0 kg, were fed a diet containing 1% (w/w) cholesterol or the same diet without cholesterol as controls. Twelve weeks after the feeding, aortic atherosclerotic lesions, serum cholesterol, and multiple organ copper concentrations were measured. Compared to controls, rabbits fed cholesterol-supplemented diet displayed higher serum cholesterol levels and developed atherosclerosis. Copper concentrations in the cholesterol-fed rabbits were increased in the serum and kidney but decreased in the atherosclerosis wall and multiple organs, including heart, liver, spleen, and lung. Furthermore, aorta copper concentrations negatively correlated, respectively, with the severity of the atherosclerotic lesion (r = - 0.64, p = 0.01), the microscope atherosclerotic lesion area (r = - 0.60, p = 0.02), and the stenosis of the lumen (r = - 0.54, p = 0.04). Dietary cholesterol not only causes atherosclerosis but also disturbs copper homeostasis in multiple organ systems. The negative correlation between aorta copper concentrations and the severity of atherosclerotic lesions suggests a vicious cycle between copper reduction and the pathogenesis of atherosclerosis. These changes in copper homeostasis would be additive to atherosclerosis as a risk factor for cardiovascular disease in humans.

Copper and lipid metabolism: A reciprocal relationship

BACKGROUND

Copper and lipid metabolism are intimately linked, sharing a complex, inverse relationship in the periphery (outside of the central nervous system), which remains to be fully elucidated.

SCOPE

Copper and lipids have independently been implicated in the pathogenesis of diseases involving dyslipidaemia, including obesity, cardiovascular disease and non-alcoholic fatty liver disease and also in Wilson disease, an inherited disorder of copper overload. Here we review the relationship between copper and lipid regulatory pathways, which are potential druggable targets for therapeutic intervention.

MAJOR CONCLUSIONS

While the inverse relationship between copper and lipids is apparent, tissue-specific roles for the copper regulatory protein, ATP7B provide further insight into the association between copper and lipid metabolism.

GENERAL SIGNIFICANCE

Understanding the relationship between copper and lipid metabolism is important for identifying druggable targets for diseases with disrupted copper and/or lipid metabolism; and may reveal similar connections within the brain and in neurological diseases with impaired copper and lipid transport.

Associations between PM2.5 metal components and QT interval length in the Normative Aging Study

BACKGROUND

Several studies have found associations between increases in QT interval length, a marker of cardiac electrical instability, and short-term fine particulate matter (PM2.5) exposures. To our knowledge, this is the first study to examine the association between specific PM2.5 metal components and QT interval length.

METHODS

We measured heart-rate corrected QT interval (QTc) duration among 630 participants in the Normative Aging Study (NAS) based in Eastern Massachusetts between 2000 and 2011. We utilized time-varying linear mixed-effects regressions with a random intercept for each participant to analyze associations between QTc interval and moving averages (0-7 day moving averages) of 24-h mean concentrations of PM2.5 metal components (vanadium, nickel, copper, zinc and lead) measured at the Harvard Supersite monitoring station. Models were adjusted for daily PM2.5 mass estimated at a 1 km × 1 km grid cell from a previously validated prediction model and other covariates. Bayesian kernel machine regression (BKMR) was utilized to assess the overall joint effect of the PM2.5 metal components.

RESULTS

We found consistent results with higher lead (Pb) associated with significant higher QTc intervals for both the multi-pollutant and the two pollutant (PM2.5 mass and a PM2.5 component) models across the moving averages. The greatest effect of lead on QTc interval was detected for the 4-day moving average lead exposure. In the multi-pollutant model, each 2.72 ng/m3 increase in daily lead levels for a 4-day moving average was associated with a 7.91 ms (95% CI: 3.63, 12.18) increase in QTc interval. In the two-pollutant models with PM2.5 mass and lead, each 2.72 ng/m3 increase in daily lead levels for a 4-day moving average was associated with an 8.50 ms (95% CI: 4.59, 12.41) increase in QTc interval. We found that 4-day moving average of copper has a negative association with QTc interval when compared to the other PM2.5 metal components. In the multi-pollutant model, each 1.81 ng/m3 increase in daily copper levels for a 4-day moving average was associated with an -3.89 ms (95% CI: -6.98, -0.79) increase in QTc interval. Copper's essential function inside the human body could mediate its cardiotoxicity on cardiac conductivity and explain why we found that copper in comparison to the other metals was less harmful for QTc interval.

CONCLUSIONS

Exposure to metals contained in PM2.5 are associated with acute changes in ventricular repolarization as indicated by QT interval characteristics.

Mesh-like vascular changes in copper deficiency-induced rat cardiomyopathy

The pathological effects of copper deficiency (COD) are well known. However, the pathogenesis of cardiomyopathy resulting from COD remains unclear. In this study, aimed to elucidate the pathogenesis of COD-induced cardiomyopathy by examining the morphology of the cardiovascular system in copper-deficient rats using histopathology, immunohistochemistry, and scanning and transmission electron microscopy. Changes detected in the myocardium and interstitium were consistent with those reported for COD. Morphological changes included mesh-like changes in the capillary endothelial cells that appear to be a novel finding in COD-induced cardiomyopathy. These changes are hypothesized to result from abnormal vascular remodeling following damage to the basement membrane and due to the mechanical effects of myocardial contractions. Although cardiomyopathy may be associated with microcirculatory disorders arising from these lesions, further investigations are necessary to demonstrate a causal relationship between the pathogenesis of cardiomyopathy and the contribution of these lesions to disease progression.

Biomimetic regeneration of elastin matrices using hyaluronan and copper ion cues

Current efforts to tissue engineer elastin-rich vascular constructs and grafts are limited because of the poor elastogenesis of adult vascular smooth muscle cells (SMCs) and the unavailability of appropriate cues to upregulate and enhance cross-linking of elastin precursors (tropoelastin) into organized, mature elastin fibers. We earlier showed that hyaluronan (HA) fragments greatly enhance tropo- and matrix-elastin synthesis by SMCs, although the yield of matrix elastin is low. To improve matrix yields, here we investigate the benefits of adding copper (Cu(2+)) ions (0.01 M and 0.1 M), concurrent with HA (756-2000 kDa), to enhance lysyl oxidase (LOX)-mediated elastin cross-linking machinery. Although absolute elastin amounts in test groups were not different from those in controls, on a per-cell basis, 0.1 M of Cu(2+) ions slowed cell proliferation (5.6 +/- 2.3-fold increase over 21 days vs 22.9 +/- 4.2-fold for non-additive controls), stimulated synthesis of collagen (4.1 +/- 0.4-fold), tropoelastin (4.1 +/- 0.05-fold) and cross-linked matrix elastin (4.2 +/- 0.7-fold). LOX protein synthesis increased 2.5 times in the presence of 0.1 M of Cu(2+) ions, and these trends were maintained even in the presence of HA fragments, although LOX functional activity remained unchanged in all cases. The abundance of elastin and LOX in cell layers cultured with 0.1 M of Cu(2+) ions and HA fragments was qualitatively confirmed using immunoflourescence. Scanning electron microscopy images showed that SMC cultures supplemented with 0.1 M of Cu(2+) ions and HA oligomers and large fragments exhibited better deposition of mature elastic fibers ( approximately 1 mum diameter). However, 0.01 M of Cu(2+) ions did not have any beneficial effect on elastin regeneration. In conclusion, the results suggest that supplying 0.1 M of Cu(2+) ions to SMCs to concurrently (a) enhance per-cell yield of elastin matrix while allowing cells to remain viable and synthetic and not density-arrested in long-term culture because of their moderating effects on otherwise rapid cell proliferation and (b) provide additional benefits of enhanced elastin fiber formation and cross-linking within these tissue-engineered constructs.

Normolipidemic effect of antioxidants in low cholesterol-modified poultry eggPsi on Zn-induced dyslipidemia and liver pathology in Wistar rats

A low cholesterol (CH)-modified poultry egg (ME Psi) containing more vitamin E, lenolenic acid, and minerals Cu and Mg but low total lipid (TL) and Zn contents than the conventional egg evaluated to reduce the severity of dyslipidemia induced by excessive Zn in the diet. The experimental data was recorded on male rats fed on normolipidemic (NL) semi-synthetic basal diet containing 20 mg Zn/kg diet in control group I, Zn supplemented dyslipidemic diet-A (Zn-DL-A) and B (Zn-DL-B) containing 40 and 80 mg Zn/kg diet in groups II and III, and ME Psi-mixed Test diet-A (Zn-DL-A + 4 ME Psi) and Test diet-B (Zn-DL-B + 4 ME Psi) in groups IIEM and IIIEM, respectively, for 180 and 90 days. Data recorded on liver and blood lipid profiles showed reduction in the concentration of TL, CH, triglycerides, and glycogen (GG) in liver consequently leading to their rise in blood serum including rise in VLDL-c and LDL-c but fall in HDL-c in groups II and III rats that reversed after ME Psi treatment resulting in rise of their levels in the liver and fall in the blood of groups IIEM and IIIEM rats, respectively. Mineral status in the liver showed a rise in Zn but fall in Cu and Mg levels in groups II and III that was reversed after ME Psi treatment resulting in fall in Zn and rise in Cu and Mg concentration in the liver of groups IIEM and IIIEM rats. Hepatopathogical studies showed reduction in the dilatation of long citernal profile of endoplasmic reticulum and increase in GG and TL granules in the cytoplasm of hepatocytes of groups IIEM and IIIEM after ME Psi treatment than those of groups II and III rats. It was concluded that the inclusion of ME Psi would be helpful in reducing dyslipidemia by correcting the ionic imbalance generated by excessive Zn intake in rats or by drugs, even in chronic diseased conditions without aggravating risk factors for heart diseases in humans that need further studies.

Copper deficiency in ruminants

Copper deficiency can reduce the productivity of livestock. The effect of copper deficiency on a number of copper enzymes and copper-dependent systems is discussed, to highlight the areas where their role needs to be clarified. Special reference is made to cytochrome c oxidase, lysyl oxidase, superoxide dismutase and endoplasmic reticulum enzymes and to their role in the expression of disease. The modification of microbiological insult by a change in superoxide dismutase activity without any other direct metabolic consequences is discussed, to introduce the concept of an external challenge being necessary before any effect of an otherwise sub-clinical copper deficiency is observed. The changes in activity of the various copper enzymes are described in clinical and experimentally induced copper deficiency in sheep and cattle, two species in which copper deficiency can have economic consequences. The diagnostic value of various blood markers, such as copper, caeruloplasmin and erythrocyte superoxide dismutase is discussed. The measured degree of hypocupraemia is related to different types of sampling (e.g. plasma or serum), physiological status (e.g. in the pre- and postpartum cow), changes that occur in the neonate, and also to the effect of the acute-phase reaction. The use of erythrocyte superoxide dismutase as a marker for the copper status of sheep and cattle is compared with more conventional markers such as plasma concentration of copper. The use of blood markers to map the extent and location of hypocupraemia (due to reduced copper intake or availability) among suckler (beef) herds in Northern Ireland is also discussed.

Effect of copper supplementation on indices of copper status and certain CVD risk markers in young healthy women

Western diets containing suboptimal Cu concentrations could be widespread. A link between marginal Cu deficiency and CVD has been suggested. The objective of the present study was to investigate the effect of Cu supplementation on both Cu status and CVD risk factors in healthy young women. Sixteen women with a mean age of 24 (sd 2) years participated in a randomised crossover study of three 4-week periods with 3-week washouts between periods. During each intervention period, subjects received 0, 3 or 6 mg elemental Cu/d as CuSO4in addition to their habitual diet. Blood samples were taken to assess the effect of supplementation on putative markers of Cu status. The content of plasma lipids, lipoprotein (a), apo and certain haemostatic factors, as putative indices of CVD, was also analysed. Daily supplementation with 3 mg Cu significantly increased (P<0·05) serum Cu concentration and the activity of erythrocyte superoxide dismutase, although there was no further significant increase after an intake of 6 mg Cu/d. The concentration of the fibrinolytic factor plasminogen activator inhibitor type 1 was significantly reduced (P<0·05) by about 30% after supplementation with 6 mg Cu/d. No other marker of Cu status or CVD risk factor was affected by Cu supplementation. The results indicate that supplementation with 3 or 6 mg Cu/d may improve Cu status in these healthy young women. Increased Cu intake could reduce the risk of CVD and atherosclerosis in man by promoting improved fibrinolytic capacity.

Beneficial Effects of Dietary Copper Supplementation on Serum Lipids and Antioxidant Defenses in Rats

BACKGROUND

A nutrition experiment was utilized to investigate the effects of two levels of dietary copper (Cu) supplementation on lipid profile and antioxidant defenses in serum of rats.

METHODS

Male Wistar rats (180-200 g; n = 10) were divided into three groups: control group (A), fed a basal diet with 6 microg Cu/g, and rats fed a basal diet with Cu (CuSO4) supplementation from aqueous solutions, for 4 weeks at the final concentrations of 2 mg Cu/rat (B) and 3 mg Cu/rat (C).

RESULTS

No significant changes were observed in final body weight, body weight gain, food consumption, total serum protein and high-density lipoprotein. Cu supplementation reduced the triacylglycerol (TG), total cholesterol and low-density lipoprotein (LDL-C). The LDL-C/TG ratio and total antioxidant substances (TAS) were higher in (B) and (C) groups than in (A) group. There was a positive correlation between Cu supplementation and ceruloplasmin levels. The markers of oxidative stress, lipid hydroperoxide and lipoperoxide were decreased with Cu supplementation. No alterations were observed in superoxide dismutase, indicating saturation of Cu enzyme site. The glutathione peroxidase activities (GSH-Px) were increased in both Cu-supplemented groups. Considering that a copper-selenium interaction can affect mineral availability of both elements, the effects of Cu on TAS and GSH-Px activities were associated with increased selenium disposal.

CONCLUSIONS

Dietary Cu supplementation had beneficial effects on lipid profile by improving endogenous antioxidant defenses and decreasing the oxidative stress in vivo.

Marginal dietary copper restriction induces cardiomyopathy in rats

Prior studies have provided evidence of marginal dietary copper restriction in humans. The present study was undertaken to examine in a rat model the effect of a long-term marginal dietary Cu deficiency on the heart. Male adult Sprague-Dawley rats were fed AIN-76 diet containing 6.0 (control), 3.0, or 1.5 mg Cu/kg starting at 11 wk of age. Groups of rats were killed at 6, 9, 12, 15, or 18 mo after initiation of feeding, and the same experiment was repeated once. The only systemic change induced by marginal dietary Cu restriction (P < 0.05) was depression of organ Cu concentrations in rats fed 1.5 mg Cu/kg diet. Cardiac pathological manifestations in rats fed lower Cu diets were evidenced by histopathological, ultrastructural, and functional alterations. Myocyte hypertrophy and excessive collagen deposition in the heart occurred in rats fed 1.5 mg Cu/kg diet. Ultrastructural changes, including increased number and volume of mitochondria along with disruption of cristae structure, diastolic and systolic dysfunction, and electrocardiograph alterations, occurred in rats fed 1.5 or 3.0 mg Cu/kg diet. These results demonstrate that, in the absence of most indications of systemic Cu deficiency, heart morphology and function are sensitive to marginal Cu deficiency.

The effects of coadministration of dietary copper and zinc supplements on atherosclerosis, antioxidant enzymes and indices of lipid peroxidation in the cholesterol-fed rabbit

It has previously been shown that dietary copper can modulate the extent of atherosclerosis in the thoracic aorta of cholesterol-fed rabbits. The metabolism of copper and zinc are closely related, and it has been hypothesized that the balance of dietary copper to zinc may be important in determining coronary risk. Hence, we have investigated the interaction between dietary copper and zinc in atherogenesis in the New Zealand White rabbit. Juvenile male rabbits were randomly allocated to eight groups. Four groups were fed a normal chow diet with zinc (0.5%, w/w), copper (0.2%, w/w), copper plus zinc or neither in their drinking water for 12 weeks. Four other groups were fed a diet containing 0.25-1% (w/w) cholesterol plus zinc, copper, both or neither. Serum cholesterol of individual animals was maintained at approximately 20 mmol/l. Integrated plasma cholesterol levels were similar for all groups receiving cholesterol and significantly higher than those in the chow-fed groups (P < 0.001). Aortic copper concentrations were higher in the animals receiving cholesterol diets with copper compared to rabbits receiving normal chow and copper (P < 0.001). Aortic zinc content was significantly higher in cholesterol-fed rabbits supplemented with zinc alone or with copper than in those fed cholesterol alone (P < 0.001). Plasma ceruloplasmin concentrations were significantly higher in groups receiving cholesterol, irrespective of their trace element supplementation (P < 0.001). However, trace element supplementation increased the level significantly (P < 0.05). Trace element supplements did not appear to affect erythrocyte superoxide dismutase in the cholesterol-fed animals; however, zinc supplementation was associated with a significant increase in the enzyme in chow-fed animals (P < 0.05). The activity of the enzyme per mg of protein in aortic tissue was higher in animals receiving copper in the presence of cholesterol (P < 0.05) but not significantly so in its absence. Dietary trace element supplementation in cholesterol-fed animals was associated with a significant reduction in aortic lesion area. Plasma thiobarbituric acid-reactive substances and FOX concentrations were both significantly higher in the cholesterol-fed rabbits compared with the animals that fed on a chow diet (P < 0.001), and these were reduced significantly by dietary copper or zinc supplementation (P < 0.001). Hence, dietary supplements of copper or zinc at the doses used both inhibited aortic atherogenesis in the cholesterol-fed rabbits, although there was no significant additional effect when given in combination.

Liver copper content of rats hypo- or hyperresponsive to dietary cholesterol

The question addressed is whether cholesterol intake reduces the hepatic copper content in rats. For this purpose we have compared the hepatic copper content of two selected rat inbred strains after feeding the animals a control or a high fat, high cholesterol diet. One strain was dietary cholesterol resistant (SHR/OlaIpcv), whereas the other strain was susceptible to dietary cholesterol (BN-Lx/Cub). Dietary cholesterol-susceptible rats have a lower baseline hepatic copper content when compared with their resistant counterparts. The consumption of a hypercholesterolemic diet decreased the liver copper concentration (expressed in microg/g dry weight) to about the same extent in both strains. However, dietary cholesterol did not reduce the absolute (expressed as microg/whole liver) and relative (expressed as microg/whole liver/100 g body weight) copper store of rats. The decrease of liver copper concentration after the high fat, high cholesterol diet is probably not caused by a decrease in whole hepatic copper content, but rather due to dietary-induced hepatomegaly.

Copper deficiency induces hepatic fatty acid synthase gene transcription in rats by increasing the nuclear content of mature sterol regulatory element binding protein 1

Dietary copper (Cu) deficiency results in an accelerated rate of hepatic fatty acid synthase gene transcription and an enhanced rate of hepatic lipid synthesis. Because the nuclear transcription factor sterol regulatory element binding protein-1 (SREBP-1) is a strong enhancer of fatty acid synthase promoter activity, it was hypothesized that Cu deficiency induces fatty acid synthase gene transcription by increasing the nuclear localization of mature SREBP-1. Male weanling rats were pair-fed a Cu-adequate (6.0 mg/kg) or Cu-deficient (0.6 mg/kg) diet (AIN-93) for 28 d. DNase I hypersensitivity site mapping of the hepatic fatty acid synthase gene revealed the presence of four major hypersensitivity sites located at -8700 to -8600, -7300 to -6900, -600 to -400 and -100 to +50. Although Cu deficiency did not change the hypersensitivity site pattern or intensity, in vitro footprinting of the region between -100 and +50 indicated that Cu deficiency enhanced DNA protein interactions within this region. The sequence between -68 and -58 contains the DNA recognition sequence for SREBP-1 and upstream stimulatory element-1 (USF-1). Western blot analysis revealed that the dietary Cu deficiency increased the hepatic nuclear content of mature SREBP-1 by 150% (P: < 0.05), and it concomitantly decreased the membrane content of precursor SREBP-1 by 45% (P: < 0.05). Changes in the hepatic distribution of SREBP-1 associated with Cu deficiency were not accompanied by changes in SREBP-1 mRNA. The nuclear content of USF-1 was unaffected by dietary Cu status. The hepatic increase in mature SREBP-1 of Cu-deficient rats was accompanied by a 400% increase and an 80% decrease in the abundance of fatty acid synthase and cholesterol 7-alpha hydroxylase mRNA, respectively. hepatic These data indicate that a Cu deficiency stimulates hepatic lipogenic gene expression by increasing the hepatic translocation of mature SREBP-1.

Copper deficiency and cardiovascular disease: role of peroxidation, glycation, and nitration

Dietary copper deficiency causes a variety of cardiovascular deficits. Systemic effects include high blood pressure, enhancement of inflammation, anemia, reduced blood clotting, and possibly arteriosclerosis. Effects on specific organs or tissues include weakened structural integrity of the heart and blood vessels, impairment of energy use by the heart, reduced ability of the heart to contract, altered ability of blood vessels to control their diameter and grow, and altered structure and function of circulating blood cells. In some instances, the cause of a defect can be directly attributed to reduced activity of a specific copper-dependent enzyme. However, three nonspecific mechanisms of damage have been implicated in cardiovascular defects of copper deficiency. They are peroxidation, the interaction of oxygen-derived free radicals with lipids and proteins (possibly DNA); glycation, the nonenzymatic glycosylation of proteins; and nitration, the interaction of nitric oxide and its metabolites with peptides and proteins. Though independently these mechanisms present great potential for damage, the possibility that they may interact presents an added reason for concern. Furthermore, the fact that at least two of these mechanisms are associated with diabetes and aging suggests that copper deficiency may exacerbate deficits associated with these two conditions.Key words: copper, heart, circulation, peroxidation, glycation, nitric oxide.

Cardiovascular disease from copper deficiency--a history

Although the nutritional essentiality of copper was established in 1928, a preoccupation with hematology delayed the discovery of cardiovascular disease from copper deficiency for more than a decade. Anatomical studies of several species of deficient animals revealed, interalia, aortic fissures and rupture, arterial foam cells and smooth muscle migration, cardiac enlargement and rupture, coronary artery thrombosis and myocardial infarction. Abnormal biochemistry in deficiency probably contributes to these lesions, e.g., decreased activities of lysyl oxidase and superoxide dismutase which result in failure of collagen and elastin crosslinking and impaired defense against free radicals. Copper deficiency also decreases copper in hearts and other organs and cells and increases cholesterol in plasma. Abnormal physiology from deficiency includes abnormal electrocardiograms, glucose intolerance and hypertension. People with ischemic heart disease have decreased cardiac and leucocyte copper and decreased activities of some copper-dependent enzymes. Copper depletion experiments with men and women have revealed abnormalities of lipid metabolism, blood pressure control, and electrocardiograms plus impaired glucose tolerance. The Western diet often is as low in copper as that proved insufficient for these people. Knowledge of nutritional history can be useful in addressing contemporary nutritional problems.

Cholesterol-lowering nature of unsaturated fat in rats may be due to its inability to increase hepatic iron

The present investigation was conducted to determine whether the cholesterol-raising properties of saturated fat and cholesterol-lowering properties of unsaturated fat are associated with levels of hepatic iron. The magnitude of hepatic iron retention was manipulated by feeding rats diets that were either copper-deficient or -adequate, iron-adequate or -supplemented, and contained either beef tallow or corn oil. Weanling male Sprague-Dawley rats were randomly divided into eight dietary groups according to the type of dietary fat (beef tallow or corn oil) and level of dietary copper (0.74 or 6.9 microg Cu/g diet) or iron (44.4 or 86.7 microg Fe/g diet). Beef tallow and copper deficiency alone increased hepatic iron levels, which in turn were associated with increased plasma cholesterol. When the three dietary factors were combined, ie, iron, beef tallow, and copper deficiency, they induced the highest magnitude of hepatic iron retention, which in turn was associated with the highest concentration of plasma cholesterol. In contrast, when hepatic iron retention was not increased, such as by feeding a diet containing corn oil or by consumption of a copper-adequate diet, plasma cholesterol was not elevated. Based on these data, it is suggested that nutrients that have the ability to increase hepatic iron have the potential to increase plasma cholesterol.

The activation of eNOS by copper ion (Cu2+) in human pulmonary arterial endothelial cells (HPAEC)

We have previously reported that Cu2+ endothelium-dependently dilated rat pulmonary arterial rings in a few minutes by increasing NO production via constitutive endothelial nitric oxide synthase (eNOS) activation in rat pulmonary arterial endothelial cells (Eur. J. Pharmacol., 1997). In the present study, using cultured human pulmonary arterial endothelial cells (HPAEC), we assessed the effects of divalent cations (Cu2+, Mn2+, Zn2+, and Fe2+) on NOS activity in crude cell extracts and intact cells. NO synthase activity was measured by monitoring the conversion of L-[14C] arginine to L-[14C] citrulline. The NOS enzyme in crude HPAEC extract showed similar characteristics to previously reported eNOS from other sources. All the divalent cations tested suppressed the NOS activity in crude cell extract by about 50% at 1 x 10(-4) M, but only Cu2+ from 10(-6) M increased eNOS activation dose dependently with a significant elevation in whole-cell assay. Extracellular Ca2+ was prerequisite to the eNOS activation by Cu2+ in intact cells. Furthermore, we measured NO production determined as NOx (NO, .NO2-, and .NO3-) from HPAEC using NO chemiluminescence analyzer. HPAEC monolayers were treated with either buffer alone, Cu2+ (10(-4) M) or thapsigargin (10(-6) M). The amount of .NOx increased from 10.93 (pmoml/ml/10(6) cells) to 41.27 (pmol/ml/10(6) cells) by thapsigargin (10(-6) M) and to 45.24 (pmol/ml/10(6) cells) by Cu2+ (10(-4) M). The increase in NOx by Cu2+ was inhibited by L-NMMA. These results indicated that Cu2+, but not Mn2+, Zn2+, and Fe2+, causes the activation of eNOS, while Cu2+, Mn2+, Zn2+, and Fe2+ directly suppressed eNOS activity extracted from HPAEC. Further, our study showed that extracellular Ca2+ was essential for eNOS activation by Cu2+.

Benfluorex, a hypotriglyceridemic drug, reduces lipid peroxidation and alleviates adverse metabolic complications of copper deficiency

The pathologies associated with copper deficiency in rats fed fructose may be induced, in part, by hypertriglyceridemia and lipid peroxidation. Reducing triacylglycerol levels in plasma may result in lowering lipid peroxidation, which in turn could ameliorate metabolic effects resulting from the combination of fructose feeding and copper deficiency. Benfluorex, a hypolipidemic factor able to reduce hypertriglyceridemia, was administered to weanling male rats fed either copper-deficient (0.6 microgram Cu/g) or adequate (6.0 micrograms Cu/g) diets containing fructose as the sole dietary carbohydrate. In copper-deficient rats, benfluorex (50 micrograms.kg-1.d-1) reduced plasma triacylglycerols from 45 to 31 mg/dL, reduced lipid peroxidation by approximately 50%, and prevented the enlargements of heart and liver size and the atrophy of the pancreas, and ameliorated anemia. It is suggested that lipid peroxidation associated with hypertriglyceridemia may be responsible for the pathologies induced by the combination of fructose consumption and copper deficiency.

Serum copper and zinc concentrations in serum from patients with cancer and cardiovascular disease

A single cross-sectional study for serum copper and zinc levels was evaluated in 20 patients with cancer (respiratory, digestive, haematological, gynaecological) and 21 patients with cardiopathy (acute myocardial infarction and ischemic cardiomyopathy). A control group of 84 healthy subjects was selected. The mean serum zinc levels in patients with gynaecological cancer and ischemic cardiomyopathy were significantly lower than the control group (P < 0.05). However, the mean serum copper level was not statistically different among patients with cancer (P < 0.05) and cardiomyopathy (P > 0.05) than the control group. Male patients did not have statistically different values for serum Cu (P > 0.05) and Zn (P < 0.05) than those found in female patients. Patients' age did not have any statistical influence (P > 0.05) on serum Cu and Zn levels.

Hepatic iron overload may contribute to hypertriglyceridemia and hypercholesterolemia in copper-deficient rats

The present study was conducted in order to determine whether hepatic iron retention in rats fed a copper-deficient diet containing fructose is associated with hypertriglyceridemia and hypercholesterolemia, and whether a reduction of iron intake will prevent elevation of blood triglycerides and cholesterol. Rats were fed from weaning either a copper-deficient (0.6 microgram Cu/g) or copper-adequate (6.0 micrograms Cu/g) diet for 4 weeks. Half the rats consumed either an adequate level of iron (50 micrograms Fe/g) or a low level (17 micrograms Fe/g). Reduction of iron intake reduced blood levels of both triglycerides and cholesterol in rats fed a copper-deficient diet containing fructose. In addition, hepatic lipid peroxidation was also decreased. The combination of high iron, low copper, and fructose may be responsible for increased levels of risk-factor metabolites associated with heart disease.

Cardiovascular risk factors in relation to the serum concentrations of copper and zinc: epidemiological study on children and adolescents in the Spanish province of Navarra

This investigation was carried out to show the possible association between groups of children with extreme values of copper and zinc concentrations and cardiovascular risk indicators. Serum copper and zinc concentrations were analysed in a group of 3887 children from Navarra, Spain (both sexes. aged 4-17 years). Hypertension, unfavourable serum lipid profile (total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglycerides, and cholesterol/HDL and LDL/HDL ratios), and degree of adiposity (weight, height, subcutaneous skinfolds, Quetelet's index and mean of subcutaneous skinfolds) were evaluated. Positive correlation was found between several lipid parameters and copper and zinc concentrations, i.e. degree of correlation related with age, except for copper/HDL and triglycerides/zinc ratios, where correlation remained negative at all points. Copper levels were correlated with adiposity parameters in an age-dependent fashion (Quetelet's index: r = 0.01 for ages 4-7 years to r = 0.10, p < 0.01 for ages 14-17 years; mean skinfold thickness: r = 0.05 for ages 4-7 years up to r = 0.18, p < 0.01 for ages 14-17 years). Most correlations between lipid parameters and copper and zinc are markedly amplified if adiposity parameters are taken into account. However, the only significant association was the established relation between high copper concentrations (> x + 2SD) and unfavourable serum lipid profile (LDL/HDL > 2.2).

Serum zinc and serum lipid profiles in 778 adults

There has been increasing use of high-dosage zinc supplementation in the population, in particular as a potential treatment for age-related macular degeneration. We examined the relationship between fasting serum zinc and serum lipid levels in 778 adults, aged 22 to 80 years, who were control subjects in a multicenter, clinic-based case-control study. The samples were taken during 1987 to 1990, a time when vitamin/mineral supplementation was becoming increasingly common. We found that higher serum zinc levels, most notably those above the highest quintile, were associated with higher levels of total serum cholesterol, low-density-lipoprotein cholesterol, and triglycerides. No significant trend was noted for high-density-lipoprotein cholesterol. Previous studies demonstrated that high-dosage zinc supplements raise serum zinc levels. The possibility that use of such supplements can adversely affect serum lipid profiles suggests that chronic ingestion of such supplements should not be done without adequate medical supervision.

Zinc, copper, and zinc- or copper-dependent enzymes in human hypertension

Imbalance of zinc and copper status has been hypothesized in human hypertension. A case-control study was carried out to elucidate the possible relationship between zinc and copper status and essential hypertension. Thirty-one subjects affected by mild stable hypertension, pharmacologically untreated, were investigated together with 31 normotensive controls individually matched for sex, age, and smoking habits. Zinc and copper in serum and urine wee measured, and serum activities of alkaline phosphatase (AP), lactic dehydrogenase (LDH), copper-zinc superoxide dismutase (Cu-Zn SOD), lysyl oxidase (LOX), and monoamine oxidase (MAO) were evaluated. No significant difference in serum and urine zinc and copper content as far as in serum activity of zinc (AP and LDH) or copper (Cu-Zn SOD, LOX, and MAO)-dependent enzymes was found between hypertensives and normotensives. Positive relationships were found in normotensives between serum and urine levels of zinc (r = 0.577; p = 0.001) and copper (r = 0.394; p = 0.028), and between serum copper and Cu-Zn SOD (r = 0.534; p = 0.002). In normotensives, diastolic blood pressure and serum zinc were positively related (r = 0.370; p = 0.041). In hypertensives, inverse correlations were observed between diastolic blood pressure and AP (r = -0.498; p = 0.004) and Cu-Zn SOD (r = 0.452; p = 0.011), and between systolic blood pressure and LOX (r = -0.385; p = 0.033). Diastolic blood pressure was related to LDH inversely in hypertensives (r = -0.357; p = 0.049) and positively in normotensives (r = 0.457; p = 0.010). In normotensives, diastolic blood pressure was inversely related with MAO (r = -0.360; p = 0.046). These findings support the hypothesis that an imbalance of zinc and copper status might be involved in human hypertension.

Cardiac levels of fibronectin, laminin, isomyosins, and cytochrome c oxidase of weanling rats are more vulnerable to copper deficiency than those of postweanling rats

The relative quantities of cardiac laminin, fibronectin, cytochrome c oxidase (CCO), and isomyosin types were studied by gel electrophoresis in male rats fed copper-deficient diets beginning either from the time of weaning for 5 weeks or from 5 weeks postweaning for 6 weeks with one group of copper-repleted rats. Increased levels of fibronectin and V(3) isomyosin but decreased levels of CCO subunit IV and laminin were found in weanling copper-depleted rats. In contrast, postweanling copper-depleted rats exhibited only increased levels of fibronectin and decreased levels of cardiac CCO subunit IV. Repletion of copper-deficient rats for 6 weeks was not sufficient to restore CCO subunit IV to the same level as controls. These results confirm that biochemical lesions in the basal laminae are a result of copper restriction. The decreased nuclear encoded subunits of CCO may help explain some of the mitochondrial pathology observed in dietary copper restriction. Increased V(3) isomyosin levels with low ATPase activity may help to conserve to a limited extent the ATP levels in copper-deficient cardiac tissue. These protein changes are consistent with the known morphological alterations of hearts from copper-restricted rats.

Effect of cuprofilin on experimental atherosclerosis

The effect of Cuprofilin, a newly synthesized C.(II)-chlorophyll complex, was assessed in rats with experimental atherosclerosis. The study was focused on changes in serum cholesterol, lipids, and triglycerides concentration as well as on serum and abdominal aorta Cu and Zn values. It has been ascertained that after 90 d in animals fed a rich lipid diet there was a statistically significant increase in serum cholesterol, triglycerides, and lipid concentration (p < 0.01). A significant augmentation of serum Cu values (p < 0.01) accompanied by a marked lowering of the same element in abdominal aorta (p < 0.01) was also found, as compared to the results registered in the control group. However, Cuprofilin, administered for 90 d in the group of animals with experimental atherosclerosis, significantly decreased the serum cholesterol, triglycerides, and serum lipid values (p < 0.01), increased copper content in aortic tissue (p < 0.01) and lowered serum copper concentration (p < 0.01) as compared to the untreated group. Moreover, in the aorta of administered animals the lipid infiltration has been demonstrated to be significantly diminished vs the untreated group.

Antioxidant defense mechanisms in the male rat: interaction with alcohol, copper, and type of dietary carbohydrate

The activities of enzymes participating in cellular protection against free radical reactions were measured in hepatic tissues from copper-adequate and copper-deficient rats fed fructose or starch-based diets. Half of the rats consumed 20% ethanol in their drinking water. The consumption of ethanol depressed growth rate, reduced hematocrit, and hepatic copper concentration. Feed efficiency was greatly depressed by ethanol. Mortality due to copper deficiency occurred in fructose-fed rats and in starch-fed rats that drank ethanol. Ethanol had no effect on superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), or catalase. In contrast, copper deficiency reduced SOD and fructose feeding depressed catalase activity. GSH-Px was not affected by either the type of dietary carbohydrate, copper, or ethanol. Taken together, these data suggest that additional mechanisms to antioxidant defense systems are responsible for the metabolic changes that occur during the interactions between ethanol low copper and dietary carbohydrates.

Weak antioxidant defenses make the heart a target for damage in copper-deficient rats

Copper deficiency causes more salient pathologic changes in the heart than in the liver of rats. Although oxidative stress has been implicated in copper deficiency-induced pathogenesis, little is known about the selective toxicity to the heart. Therefore, we examined the relationship between the severity of copper deficiency-induced oxidative damage and the capacity of antioxidant defense in heart and liver to investigate a possible mechanism for the selective cardiotoxicity. Weanling rats were fed a purified diet deficient in copper (0.4 microgram/g diet) or one containing adequate copper (6.0 microgram/g diet) for 4 weeks. Copper deficiency induced a 2-fold increase in lipid peroxidation in the heart (thiobarbituric assay) but did not alter peroxidation in the liver. The antioxidant enzymatic activities of superoxide dismutase, catalase, and glutathione peroxidase were, respectively, 3-, 50- and 1.5-fold lower in the heart than in the liver, although these enzymatic activities were depressed in both organs by copper deficiency. In addition, the activity of glutathione reductase was 4 times lower in the heart than in the liver. The data suggest that a weak antioxidant defense system in the heart is responsible for the relatively high degree of oxidative damage in copper-deficient hearts.

Influence of 12-week nicotine treatment and dietary copper on blood pressure and indices of the antioxidant system in male spontaneous hypertensive rats

Nicotine treatment and copper (Cu) deficiency have been associated with an increased production of reactive oxygen species that may contribute to the development and/or progression of cardiovascular diseases (CVD). The present study investigated the influence of dietary Cu intake on the response to chronic nicotine treatment in spontaneous hypertensive rats (SHR) with respect to tissue trace mineral levels, several components of the oxidant defense system, and lipid peroxidation rates. SHR weighing 100-110 g were fed a Cu deficient diet (-Cu) (0.5 microgram Cu/g) for 14 d prior to nicotine treatment. SHR were inserted with tablets that released nicotine at a rate of 75 micrograms/h or placebo (control). Following tablet insertion, rats were fed a control diet (+Cu) (12.0 micrograms Cu/g) or the -Cu diet. Nicotine treatment lasted for 12 wk. Blood pressure (BP) was higher in nicotine-treated SHR than in control SHR at wk 3; BP was unaffected by diet. BP was higher in +Cu nicotine-treated SHR at wk 6 compared to -Cu nicotine and control rats. BP was not affected by nicotine or diet at wk 2. Liver, heart, and brain Cu levels and liver, heart, and red cell CuZn superoxide dismutase and plasma ceruloplasmin oxidase activities were lower in the -Cu SHR than in the +Cu SHR. Liver Fe levels were higher and plasma Fe levels were lower in the -Cu rats than in the +Cu rats. Liver selenium-dependent-glutathione peroxidase (Se-GSH-Px) activity was lower in the -Cu rats than in the +Cu rats; heart and thoracic aorta Se-GSH-Px activity was unaffected by -Cu diet. Thoracic aorta, liver, and heart GSH-reductase activities were unaffected by treatments. Plasma thiobarbituric acid reactive substances (TBARS) were higher in the -Cu than in the +Cu SHR. Liver and heart TBARS production was similar among the groups. These data show that nicotine can exacerbate the development of high BP in susceptible individuals; Cu deficiency did not exacerbate the effects of nicotine.

The role of the mast cell in acute inflammatory responses of copper-deficient rats

Macromolecular leakage associated with mast cell degranulation was studied in the cremaster muscle microcirculation of copper-deficient rats. Male Sprague-Dawley rats were fed a purified diet either adequate for copper (6 micrograms copper/gram diet) or deficient (no added copper) 4 weeks prior to experimentation. The rats were anesthetized and the cremasters (with nerve and blood supply intact) were spread in a tissue bath filled with Kreb's solution. In vivo television microscopy was used to observe the microcirculation. Intravascular fluorescein isothiocyanate conjugated to bovine serum albumin was injected and interstitial fluorescent emission intensity was used as an index of macromolecular leakage. Topical administration of the mast cell degranulator compound 48/80 (1.0 and 10.0 micrograms/ml) induced a significantly greater macromolecular leakage in the copper-deficient animals. The compound 48/80 leakage was blocked in both groups of rats by pretreatment with diphenhydramine which is a histamine H1 receptor blocker. Topical administration of the inflammatory mediators histamine, serotonin, and bradykinin all induced macromolecular leakage which was not significantly different between groups. These results suggest that copper deficiency increases macromolecular leakage associated with mast cell degranulation by a primary effect on the mast cell rather than on the endothelium.

Serum copper and zinc in industrial centers in Slovakia

The association between serum copper and zinc concentrations and age, sex, and other risk factors of cardiovascular disease in randomly selected adult volunteers aged 19-59 were investigated. There was a positive relationship between copper and age in both sexes, but zinc was negatively correlated with age in males only. Serum zinc was positively related to HDL-cholesterol in males. Serum copper was positively related to total cholesterol and LDL-cholesterol but negatively correlated to HDL-cholesterol in males. A positive relationship to body mass index was observed in females only. Subjects have been divided into a control group and a group with marked risk factors of cardiovascular disease. The levels of zinc were not different, whereas the levels of copper in both males and females were significantly higher in the risk group. Our results suggested a positive relationship between serum copper and cumulation of more factors of cardiovascular disease, however, their causal effect in human has to be investigated further.

Pathogenesis of acquired aneurysms of the abdominal aorta

The incidence of abdominal aortic aneurysm has recently increased. There is still no accurate definition of abdominal aortic aneurysm. The diameter of abdominal aortic aneurysms is the only factor permitting evaluation of the risk of rupture of aneurysms whose growth remains unpredictable. Abdominal aortic aneurysm is a multi-factorial disease associated with aortic aging and atheroma. It differs from stenotic disease by the intensity of degenerative or destructive phenomena in the media. Particular hemodynamic conditions in the infrarenal abdominal aorta seem to enhance the development of aneurysm at this level. While certain constitutional anomalies of the extracellular matrix of proteins seem to enhance the development of abdominal aortic aneurysm, protease activity of as yet undetermined origin also seems to play a prominent role. Family cases of abdominal aortic aneurysms have been reported but the mechanisms responsible remain to be determined. Several genetic markers have been suggested. The most reliable marker of aortic aneurysm is arteriomegaly.

Relation of serum zinc and copper to lipids and lipoproteins: the Yi People Study

The relations of serum zinc (Zn) and copper (Cu) to serum total cholesterol (TC), low-density-lipoprotein and high-density-lipoprotein cholesterol (LDL-C and HDL-C) and triglycerides were investigated in a population-based sample of 399 men in Southern China. Serum Cu was inversely related to HDL-C (r = -0.21), while Zn/Cu ratio showed a positive association (r = 0.19). These relationships remained significant after adjusting for age, body mass index (kg/m2), physical activity, tobacco smoking and dietary cholesterol, fat, and fiber. While no significant association was observed between serum Cu and serum TC in univariate analysis, a significant negative association was observed in multivariate analysis, after adjustment for the above mentioned independent variables. No significant association between serum Cu and LDL-C was found. These observations, as well as those reported in other studies reviewed herein, suggest that Cu is implicated in the metabolism of HDL-C, although the mechanism involved is not fully understood. No significant associations were found between serum Zn and the lipid variables.

Copper supplementation effects on indicators of copper status and serum cholesterol in adult males

Two 6-wk double-blind studies evaluated the effects of supplements of 2 or 3 mg Cu/d on serum copper, ceruloplasmin, red-blood-cell super oxide dismutase (RBC-SOD), total serum cholesterol, and serum lipoprotein-cholesterol fractions in adult males. Study I had 6 supplemented and 8 placebo subjects, whereas study II had 7 and 6, respectively. Copper supplementation did not appear to affect serum copper levels, RBC-SOD, hematocrit, and ceruloplasmin levels when assayed by radial immunoassay diffusion. Supplementation with 2 mg Cu/d produced an increase in LDL cholesterol and the percentage of cholesterol as LDL at wk 4 compared to the placebo group, and a concomitant decline in VLDL-cholesterol levels and the percentage of cholesterol as VLDL. At wk 6, the percentage of cholesterol as LDL increased and that of cholesterol as VLDL decreased compared to baseline values in the supplemented group. Supplements of 3 mg Cu/d increased hemoglobin levels, ceruloplasmin activity, and serum total-cholesterol levels at wk 6 compared to placebos. Differences in cholesterol may be partly explained by variability in the placebo groups in both studies. Copper supplementation effects on cholesterol deserves further investigation.

Immunolocalization of collagen types I, III and IV, elastin and fibronectin within the heart of normal and copper-deficient rats

Collagen types I, III and IV, fibronectin and elastin were detected by immunohistochemistry in the normal and copper-deficient rat heart. All rats maintained on a copper-deficient diet for at least 6 weeks were found to have areas of abnormal distribution of these connective tissue components within the endo- and perimysium although the normal appearance observed in control animals prevailed. It appeared that the proliferation of the fibrillar collagens and fibronectin was associated with fibrosis and scar tissue formation. In contrast, the fragmented and disorganized appearance of the myocyte basement membrane and the endomysial elastin did not seem to be associated with the fibrotic process and may be an early indication of copper deficiency. The vascular system of the copper-deficient hearts appeared normal. These results are discussed with reference to the functional and mechanical abnormalities that occur in copper-deficient animals.

Incorporation of tritiated water into sterol in copper-deficient rats

The effect of copper deficiency on absolute rates of cholesterol synthesis was investigated in the rat. Male weanling rats were fed semi-purified diets containing adequate (7.13 ppm) or deficient (0.621 ppm) levels of copper for 6 weeks. Copper-adequate and -deficient animals (n = 6/group) were injected intraperitoneally with 50 mCi 3H-labelled water and killed 1 h post-injection. Copper-deficient animals had elevated heart weights and reduced body and spleen weights. Plasma cholesterol levels were significantly elevated and hematocrits were reduced. Absolute rates of carcass cholesterol synthesis per organ were 1.9-fold higher in copper-deficient rats (P less than 0.025). Previous studies have indicated that hepatic 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (E.C.1.1.1.34) activity is increased by copper deficiency; however, de novo synthesis of cholesterol from 3H-labelled water was not significantly elevated in the liver. The present data indicate that newly synthesized cholesterol exported to the plasma was increased 2.1-fold (P less than 0.01) in copper-deficient rats. Since it has been demonstrated that hepatic export of cholesterol is increased with copper deficiency and that the major tissue for export of newly synthesized cholesterol is the liver, we hypothesize that the origin of radiolabeled cholesterol in the plasma was the liver. These data support the hypothesis that elevated levels of hepatic HMG-CoA reductase seen with copper deficiency are associated with an increased rate of whole body and hepatic cholesterol synthesis.

The effects of dietary copper deficiency and psychological stress on blood pressure in rats

In each of two experiments, adult, male Sprague-Dawley rats were deprived of copper and were subjected to the chronic stress of close confinement. A 2 X 2 factorial design was used because both copper deficiency and stress have been implicated in the regulation of blood pressure and are implicated in a major consequence of human hypertension--ischemic heart disease. Copper deficiency was verified by a decrease in copper in several organs. Both copper deficiency and stress increased blood pressure; results were independent. Sodium in heart was increased by deficiency in both experiments, but was increased in brain in only the second experiment. The combination of stress and deficiency produced an increase in mortality in one of two experiments. A decrease in cholesterol in plasma due to stress is consistent with earlier data from rats but is in contrast to data from humans. Both stress and copper deficiency produce potentially adverse changes in cardiovascular physiology and the chemistry of brain, heart and other organs. These results may be germane to humans because stress is frequent and some diets are low in copper.

Anemia plays a major role in myocardial hypertrophy of copper deficiency

The present study was undertaken to establish whether anemia plays a role in the cardiomegaly and myocardial pathology of copper deficiency. Fifteen weanling male rats were fed a copper-deficient (0.6 microgram Cu/g) diet for 5 weeks. Six rats were intraperitoneally injected once a week with packed red blood cells (RBC) that were obtained from copper-deficient rats fed starch. The remainder (n = 9) served as controls. The administration of RBC to copper-deficient rats fed fructose prevented the anemia. As a result, none of the injected rats exhibited heart hypertrophy or gross pathology and they all survived. In contrast, all other control, nontreated copper-deficient rats that were fed fructose were anemic and all exhibited severe signs of copper deficiency, which included heart hypertrophy with gross pathology, and four died of the deficiency. The data suggest that the anemia of copper deficiency contributes to heart pathology. Once the anemia is prevented, the copper-deficient rats should be protected against heart pathology and mortality.