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Ganjali S, Hosseini S, Rizzo M, Kontush A, Sahebkar A. Capacity of HDL to Efflux Cellular Cholesterol from Lipid-Loaded Macrophages Is Reduced in Patients with Familial Hypercholesterolemia. Metabolites 2023; 13:metabo13020197. [PMID: 36837816 PMCID: PMC9961594 DOI: 10.3390/metabo13020197] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/29/2022] [Accepted: 01/10/2023] [Indexed: 01/31/2023] Open
Abstract
This study aimed to evaluate the high-density lipoprotein (HDL) capacity to efflux cellular cholesterol from lipid-loaded macrophages to find a reliable and low-cost biomarker with the purpose of better evaluating the risk of premature cardiovascular (CV) events in FH patients. This case-controlled study comprised 16 homozygous (HOFH) and 18 heterozygous (HEFH) FH patients, as well as 20 healthy subjects recruited as controls. Two main subfractions of HDL (HDL2 (d = 1.063-1.125 g/mL) and HDL3 (d = 1.125-1.210 g/mL)) were isolated from the patients' serum samples using sequential ultracentrifugation. After compositional characterization, the capacity of HDL to efflux cholesterol (CEC%) from lipid-laden macrophages was measured. The HDL2 and HDL3 subfractions showed some differences in lipid and protein composition between the studied groups. In addition, both HDL subfractions (p < 0.001) revealed significantly reduced CEC% in HOFH patients (HDL2: 2.5 ± 0.1 and HDL3: 3.2 ± 0.2) in comparison with the HEFH (HDL2: 3.2 ± 0.1% and HDL3: 4.1 ± 0.2%) and healthy (HDL2: 3.3 ± 0.2% and HDL3: 4.5 ± 0.3%) subjects. Additionally, multinomial logistic regression results indicated that the CEC% of both HDL2 (OR: 0.091; 95% CI: 0.018-0.452, p < 0.01) and HDL3 (OR: 0.118; 95% CI: 0.035-0.399, p < 0.01) subfractions are strongly and inversely associated with the homozygous form of FH. A decreased capacity of HDL particles to efflux cholesterol from macrophages might identify homozygous FH patients who are at elevated risk for premature CVDs. Prospective studies with a large sample size are warranted to evaluate this hypothesis.
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Affiliation(s)
- Shiva Ganjali
- Department of Medical Biotechnology and Nanotechnology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Hosseini
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, School of Medicine, University of Palermo, 90133 Palermo, Italy
| | - Anatol Kontush
- Cardiovascular Diseases Research Unit, National Institute of Health and Medical Research (INSERM), Metabolism and Nutrition, ICAN, Sorbonne University, F-75013 Paris, France
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
- Correspondence:
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Adorni MP, Biolo M, Zimetti F, Palumbo M, Ronda N, Scarinzi P, Simioni P, Lupo MG, Ferri N, Previato L, Bernini F, Zambon A. HDL Cholesterol Efflux and Serum Cholesterol Loading Capacity Alterations Associate to Macrophage Cholesterol Accumulation in FH Patients with Achilles Tendon Xanthoma. Int J Mol Sci 2022; 23:ijms23158255. [PMID: 35897824 PMCID: PMC9332368 DOI: 10.3390/ijms23158255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 02/05/2023] Open
Abstract
Achilles tendon xanthoma (ATX) formation involves macrophage cholesterol accumulation within the tendon, similar to that occurring in atheroma. Macrophage cholesterol homeostasis depends on serum lipoprotein functions, namely the high-density lipoprotein (HDL) capacity to promote cell cholesterol efflux (cholesterol efflux capacity, CEC) and the serum cholesterol loading capacity (CLC). We explored the HDL-CEC and serum CLC, comparing 16 FH patients with ATX to 29 FH patients without ATX. HDL-CEC through the main efflux mechanisms mediated by the transporters ATP binding cassette G1 (ABCG1) and A1 (ABCA1) and the aqueous diffusion (AD) process was determined by a cell-based radioisotopic technique and serum CLC fluorimetrically. Between the two groups, no significant differences were found in terms of plasma lipid profile. A trend toward reduction of cholesterol efflux via AD and a significant increase in ABCA1-mediated HDL-CEC (+18.6%) was observed in ATX compared to no ATX patients. In ATX-presenting patients, ABCG1-mediated HDL-CEC was lower (−11%) and serum CLC was higher (+14%) compared to patients without ATX. Considering all the patients together, ABCG1 HDL-CEC and serum CLC correlated with ATX thickness inversely (p = 0.013) and directly (p < 0.0001), respectively. In conclusion, lipoprotein dysfunctions seem to be involved in ATX physiopathology and progression in FH patients.
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Affiliation(s)
- Maria Pia Adorni
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy;
| | - Marta Biolo
- Department of Medicine, University of Padua, 35128 Padua, Italy; (M.B.); (P.S.); (P.S.); (M.G.L.); (N.F.); (L.P.)
| | - Francesca Zimetti
- Department of Food and Drug, University of Parma, 43124 Parma, Italy; (F.Z.); (M.P.); (N.R.)
| | - Marcella Palumbo
- Department of Food and Drug, University of Parma, 43124 Parma, Italy; (F.Z.); (M.P.); (N.R.)
| | - Nicoletta Ronda
- Department of Food and Drug, University of Parma, 43124 Parma, Italy; (F.Z.); (M.P.); (N.R.)
| | - Paolo Scarinzi
- Department of Medicine, University of Padua, 35128 Padua, Italy; (M.B.); (P.S.); (P.S.); (M.G.L.); (N.F.); (L.P.)
| | - Paolo Simioni
- Department of Medicine, University of Padua, 35128 Padua, Italy; (M.B.); (P.S.); (P.S.); (M.G.L.); (N.F.); (L.P.)
| | - Maria Giovanna Lupo
- Department of Medicine, University of Padua, 35128 Padua, Italy; (M.B.); (P.S.); (P.S.); (M.G.L.); (N.F.); (L.P.)
| | - Nicola Ferri
- Department of Medicine, University of Padua, 35128 Padua, Italy; (M.B.); (P.S.); (P.S.); (M.G.L.); (N.F.); (L.P.)
| | - Lorenzo Previato
- Department of Medicine, University of Padua, 35128 Padua, Italy; (M.B.); (P.S.); (P.S.); (M.G.L.); (N.F.); (L.P.)
| | - Franco Bernini
- Department of Food and Drug, University of Parma, 43124 Parma, Italy; (F.Z.); (M.P.); (N.R.)
- Correspondence: ; Tel.: +39-0521-905039
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Abstract
Infection with the human immunodeficiency virus (HIV), and subsequent treatment with antiretroviral therapy (ART), is often associated with perturbations in lipid profiles. Furthermore, persistent inflammation, in spite of suppression of viral replication by ART, likely contributes to modifications in lipid composition and function, exacerbating risk for development of cardiovascular disease (CVD). Increased levels of several pro-inflammatory lipid species, including oxidized low-density lipoprotein (LDL) and high-density lipoprotein (HDL), have been measured in HIV-infected persons and are associated with markers of immune activation. The mechanisms linked to this bidirectional relationship in which inflammation increases lipid levels and promotes their modification, and these modified lipid species perpetuate inflammatory processes, require further investigation. Treatment with statins and other lifestyle modifications, including improvement in dietary intake and exercise, are critical to reducing CVD risk. Well-designed clinical trials that take into account the complex relationships among lipids and inflammation within persons infected with HIV need to be considered.
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Affiliation(s)
- Nicholas T Funderburg
- School of Health and Rehabilitation Sciences, Division of Medical Laboratory Science, Ohio State University, 453 W. 10th Ave., 535A Atwell Hall, Columbus, OH, 43210, USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, Bethesda, MD, 20892, USA.
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Khalil H, Murrin C, O'Reilly M, Viljoen K, Segurado R, O'Brien J, Somerville R, McGillicuddy F, Kelleher CC. Total HDL cholesterol efflux capacity in healthy children - Associations with adiposity and dietary intakes of mother and child. Nutr Metab Cardiovasc Dis 2017; 27:70-77. [PMID: 27919542 DOI: 10.1016/j.numecd.2016.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 09/03/2016] [Accepted: 10/03/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS High-density lipoprotein (HDL) cholesterol efflux capacity in adults may be a measure of the atheroprotective property of HDL. Little however, is known about HDL cholesterol efflux capacity in childhood. We aimed to investigate the relationship between HDL cholesterol efflux capacity and childhood anthropometrics in a longitudinal study. METHODS AND RESULTS Seventy-five children (mean age = 9.4 ± 0.4 years) were followed from birth until the age of 9 years. HDL cholesterol efflux capacity was determined at age 9 by incubating serum-derived HDL-supernatants with 3H-cholesterol labeled J774 macrophages and percentage efflux determined. Mothers provided dietary information by completing food frequency questionnaires in early pregnancy and then 5 years later on behalf of themselves and their children. Pearson's correlations and multiple regression analyses were conducted to confirm independent associations with HDL efflux. There was a negative correlation between HDL cholesterol efflux capacity and waist circumference at age 5 (r = -0.3, p = 0.01) and age 9 (r = -0.24, p = 0.04) and BMI at age 5 (r = -0.45, p = 0.01) and age 9 (r = -0.19, p = 0.1). Multiple regression analysis showed that BMI at age 5 remained significantly associated with reduced HDL cholesterol efflux capacity (r = -0.45, p < 0.001). HDL-C was negatively correlated with energy-adjusted fat intake (r = -0.24, p = 0.04) and positively correlated with energy-adjusted protein (r = 0.24, p = 0.04) and starch (r = 0.29, p = 0.01) intakes during pregnancy. HDL-C was not significantly correlated with children dietary intake at age 5. There were no significant correlations between maternal or children dietary intake and HDL cholesterol efflux capacity. CONCLUSIONS This novel analysis shows that efflux capacity is negatively associated with adiposity in early childhood independent of HDL-C.
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Affiliation(s)
- H Khalil
- School of Public Health, Physiotherapy and Sports Science, Woodview House, Belfield, University College Dublin, Dublin 4, Ireland.
| | - C Murrin
- School of Public Health, Physiotherapy and Sports Science, Woodview House, Belfield, University College Dublin, Dublin 4, Ireland
| | | | - K Viljoen
- School of Public Health, Physiotherapy and Sports Science, Woodview House, Belfield, University College Dublin, Dublin 4, Ireland
| | - R Segurado
- School of Public Health, Physiotherapy and Sports Science, Woodview House, Belfield, University College Dublin, Dublin 4, Ireland
| | - J O'Brien
- School of Public Health, Physiotherapy and Sports Science, Woodview House, Belfield, University College Dublin, Dublin 4, Ireland
| | - R Somerville
- School of Public Health, Physiotherapy and Sports Science, Woodview House, Belfield, University College Dublin, Dublin 4, Ireland
| | - F McGillicuddy
- Nutrigenomics Research Group, Ireland; School of Medicine, UCD Conway Institute, Belfield, University College Dublin, Dublin 4, Ireland
| | - C C Kelleher
- School of Public Health, Physiotherapy and Sports Science, Woodview House, Belfield, University College Dublin, Dublin 4, Ireland
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