Introdução: As dislipidemias representam um dos principais fatores de risco para as doenças cardiovasculares e, particularmente, para a aterosclerose. Portanto, todos os fatores nutricionais capazes de reduzir a sua incidência ou melhorar seu quadro clínico, representam ferramentas importantes para sua prevenção ou tratamento. Além das dislipidemias, as modificações oxidativas da lipoproteína de baixa densidade (LDL) têm relação direta com o processo aterosclerótico. Objetivos: O objetivo deste estudo foi avaliar a possível influência dos Parâmetros Nutricional (alimentar e antropométrico) e Bioquímicos sobre a geração de LDL- em indivíduos com diferentes níveis de risco cardiovascular Métodos: Para a consecução destes objetivos foram avaliados indivíduos com hipercolesterolemia associada à LDL com (n = 10) ou sem (n = 33) aterosclerose, quando comparados aos indivíduos normocolesterolêmicos (n = 30). A partir desta amostra avaliou-se o hábito alimentar (questionário quantitativo de freqüência alimentar), a antropometria (peso, altura, circunferência da cintura, % de gordura corporal e % de massa magra), o perfil lipídico (colesterol e triacilgliceróis), o conteúdo de LDL- (plasma, LDL total e sub-frações de LDL) e os auto-anticorpos anti-LDL- no plasma. O diagnóstico de aterosclerose foi feito através da pesquisa dos prontuários e da avaliação do índice tornozelo-braço (ITB). Resultados: A análise do perfil lipídico indicou que a concentração de colesterol plasmático no grupo Controle (180,5 ± 19,6 mg/dL) foi menor que a observada nos grupos Hipercolesterolêmico – Hiper (-) (243,5 ± 29,7 mg/dL) e Hipercolesterolêmico com aterosclerose – Hiper (+) (221,1 ± 19,6 mg/dL), sendo a dislipidemia observada resultante do acúmulo de colesterol na LDL. O monitoramento da LDL- no plasma e de seus auto-anticorpos não apresentou diferença significativa entre os grupos. Entretanto, quando se analisou a LDL- na LDL total verificamos que o grupo Controle apresentou conteúdo inferior (850,2 ± 337,8 DO) aos grupos Hiper (-) (1253,1 ± 340,9 DO) e Hiper (+) (1258,5 ± 207,4 DO). Em relação ao hábito alimentar, o grupo Controle apresentou menor consumo de carboidratos e vitamina C, quando comparado ao grupo Hiper (+), e este consumo inferior de ácido graxo monoinsaturado (AGM), ácido graxo poliinsaturado (AGP) e ácido linoléico que o grupo Hiper (-). Não observamos diferença significativa nos parâmetros antropométricos. Considerando que o conteúdo de LDL- no plasma e na LDL (+) densa apresentou correlação positiva, além das correlações positivas entre LDL- isolada e normalizada pelas proteínas e colesterol tanto no plasma, quanto na LDL total e nas sub-frações de LDL, estabelecemos correlações entre estas variáveis e os parâmetros clínicos, de consumo, de composição corporal e bioquímicos. Neste sentido, observamos que houve correlação da pressão arterial sistólica com LDL- no plasma (r = 0,26 e p = 0,03) e escore de risco de Framingham com LDL- na LDL (r = 0,36 e p = 0,01). Em relação ao consumo alimentar, houve correlação entre o consumo de gordura e colesterol com o conteúdo de LDL- no plasma (r = 0,27 e p = 0,02; r = 0,27 e p = 0,02, respectivamente). Verificamos também correlação entre LDL- presente na sub-fração menos densa da LDL com o consumo de AGM (r = -0,27 e p = 0,02), AGP (r = -0,23 e p = 0,05), ácido oléico (r = -0,23 e p = 0,05), ácido linoléico (r = -0,31 e p = 0,01) e vitamina A (r = -0,25 e p = 0,03). As variáveis antropométricas e de composição corporal não apresentaram correlação significativa com a geração de LDL- no plasma, na LDL total e nas sub-frações de LDL, nem com seus auto-anticorpos. Quando avaliamos o perfil lipídico e a LDL- na LDL, observamos correlação positiva com colesterol total (r = 0,52 e p ≤ 0,001), colesterol associado à LDL, pela equação de Friedewald e analisado na lipoproteína isolada (r = 0,59 e p ≤ 0,001; r = 0,75 e p ≤ 0,001, respectivamente), as relações colesterol total/HDL (r= 0,45, p ≤ 0,001) e LDL/HDL (r= 0,47, p ≤ 0,001) e colesterol não HDL (r= 0,74, p ≤ 0,001). Conclusões: Os resultados obtidos mostram que a LDL-, sobretudo quando analisada na LDL, é um importante e sensível parâmetro bioquímico associado ao perfil lipídico, a outros parâmetros de risco cardiovascular e ao consumo alimentar. Portanto, sugere-se que o monitoramento da LDL- faça parte dos protocolos clínicos, visto que este marcador sofre variação em função de fatores exógenos, clínicos e bioquímicos. / Introduction: The dyslipidemias is very important to coronary artery disease (CAD) development, specially in atherosclerosis. Therefore, all nutritional factors able to decrease its incidence represent important tools in the prevent or treatment. In this respect, oxidized low-density lipoprotein (LDL) has been associated to atherosclerotic process. Objectives: Our goal was to evaluate the influence of the Nutritional (intake and anthropometria) and Biochemical Parameters in generation of LDL- in subjects with different levels of cardiovascular risk. Methods: Subjects with hypercholesterolemia associated to LDL with (n = 10) or without (n = 33) atherosclerosis and normocholesterolemic (n = 30) were selected. Habitual food intake (quantitative food frequency questionnaire), anthropometric parameters (weight, heath, waist circumference, % body fat and % mass muscular) were evaluated. In plasma we evaluated lipid profile (cholesterol and triglycerides), LDL- content (plasma, LDL and LDL subfractions) and auto-antibodies anti-LDL-. Atherosclerosis was confirmed by register and ankle-brachial blood pressure index (ABI). Results: The plasma cholesterol in group Control (180.5 ± 19.6 mg/dL) was lower than compared to Hiper (-) group (243.5 ± 29.7 mg/dL) and Hiper (+) group (221.0 ± 19.6 mg/dL). This dyslipidemia was associated to high levels of LDL-cholesterol. The content of LDL- in plasma and its autoantibodies against did not have any significant difference between groups. However, when LDL- content was analyzed in total LDL we verified that Control group showed menas lower (850.2 ± 337.8 DO) than Hiper (-) (1253.1 ± 340.9 DO) and Hiper (+) (1258.5 ± 207.4 DO) groups. Carbohydrate and vitamin C intake in Control group was lower than Hiper (+) group. Monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA) and acid linoleic intake in Hiper (+) was higher than Hiper (-) group. No significant differences in anthropometric parameters were observed when all groups were evaluated. When we analyzed the possible association between variables, we verified positive correlation between blood pressure arterial systolic with LDL- plasma (r = 0.26 and p = 0.03) and Framingham risk score with LDL- in LDL (r = 0.36 and p = 0.01). Total fat and cholesterol intake was correlated to LDL- plasma (r = 0.27 and p = 0.02; r = 0.27 and p = 0.02, respectively). In addition we observed a correlation between LDL- in dense low LDL subfraction with MUFA (r = -0.27 and p = 0.02), PUFA (r = -0.23 and p = 0.05), acid oleic (r = -0.23 and p = 0.05), acid linoleic (r = -0.31 and p = 0.01) and vitamin A (r = -0.25 and p = 0.03). The anthropometric parameters did not show any significant correlation with the LDL- content and its autoantibodies. LDL- in LDL had positive correlation with total cholesterol (r = 0.52 and p ≤ 0.001), cholesterol associated LDL as calculated by Friedewald equation and crude analysis (r = 0.59 and p ≤ 0.001; r = 0.75 and p ≤ 0.001, respectively), TC/HDL ratio (r= 0.45 and p ≤ 0.001), LDL/HDL ratio (r= 0.47 and p ≤ 0.001) and non cholesterol HDL (r= 0.74 and p ≤ 0.001). Conclusion: These results showed that certain component diet could modulate LDL- generation. Furthermore, this particle was correlated with the lipid profile and some of the factors that predispose for cardiovascular desiase.

O presente trabalho tem como objetivo avaliar se o complexo Európio- Clorotetraciclina (EuCTc) ou o corante Tioflavina T (ThT) podem atuar como biossensores precisos e eficientes de colesterol numa fração específica, através de procedimentos simples. Para isso estudaram-se as propriedades ópticas do complexo EuCTc e ThT na presença da Lipoproteína de Baixa Densidade (LDL) em seu estado nativo e em seu estado oxidado. O primeiro estudo realizado verificou a melhor razão molar entre o Európio e a Clorotetraciclina, em seguida verificou-se a influência da diálise da LDL na emissão do complexo EuCTc, para obtenção de um protocolo para quantificação da concentração da LDL. Foram traçadas as curvas de calibração da emissão do complexo EuCTc com várias concentrações da LDL nativa, LDL oxidada com íons de Cobre e LDL oxidada com íons de Ferro. Em seguida obteve-se o tempo de vida do íon Európio no complexo EuCTc na presença de diferentes concentrações de LDL nativa e LDL oxidada por íons de Cobre. Na segunda parte do trabalho estudou-se a emissão do corante Tioflavina T na presença da LDL nativa e LDL oxidada. Na terceira etapa as propriedades ópticas dos biossensores EuCTc e ThT foram investigadas na presença do plasma sanguíneo e foram comparadas às emissões do complexo EuCTc e o corante ThT com a LDL ultracentrifugada, para verificar a possibilidade de quantificar a LDL diretamente no plasma sanguíneo. Na última etapa do trabalho desenvolveu-se uma nova metodologia para oxidar a partícula de LDL a partir da irradiação com laser de pulsos ultracurtos, a fim de produzir uma oxidação branda da partícula de LDL e controlada. / The present study aims at assessing the complex Europium-Clorotetracycline (EuCTc) or the dye Thioflavin T (ThT) can act as biosensors accurate and efficient in a specific fraction of cholesterol through simple procedures.For this purpose, it was studied the optical properties of Europium- Chlortetracycline (EuCTc) complex and the thioflavin T (ThT) dye in the presence of low-density lipoprotein (LDL) in native state and in oxidized state in vitro. First study realized it was verified the influence of dialysis in the emission of complex EuCTc in the presence of LDL, thereby producing a protocol for use of the complex to obtain the concentration of LDL. It was obtained the calibration curves of the complex with various concentrations of native LDL, the oxidized LDL with copper ions and oxidized LDL with iron ions. It was also obtained from the calibration curve of the emission of the complex in the presence of calcium interferent ion with the concentration found in blood plasma with the oxidized LDL with copper ions. It was obtained the lifetime of the europium ion in the complex in the presence of different concentrations of Native LDL and oxidized LDL by copper ions. In the second part of the work it was studied the emission of the dye thioflavin T in the presence of native LDL and oxidized LDL. In the third part the optical properties of biosensors EuCTc and ThT were investigated in the presence of blood plasma and compared to the emission of the complex EuCTc and the dye ThT with LDL ultracentrifugated to verify the possibility of quantifying directly LDL in blood plasma.In the final part of this work it has developed a new methodology for the LDL particles oxidation from the irradiation of ultrashort laser pulses in order to produce mild and controlled oxidation of the LDL particle.

The co-localization of plasma C-reactive protein (CRP) and atherogenic low-density lipoprotein (LDL) at the atherosclerotic lesions raises the possibility of a role of CRP in the disease process. In vitro, in its native pentameric structural form, CRP does not bind to oxidized LDL. However, in its non-native pentameric structural form, CRP is capable of binding to oxidized LDL. It has been proposed that CRP changes its structure at sites of inflammation to gain the oxidized LDL-binding activity. In vivo, native CRP is neither pro-atherosclerotic nor atheroprotective in animal models of atherosclerosis. We assumed that native CRP shows no effect because inflammatory microenvironment in the arterial wall in animal models of atherosclerosis is not appropriate and, therefore, the structure of CRP remains unchanged. Accordingly, we hypothesized that a CRP mutant, generated by site-directed mutagenesis, capable of binding to oxidized LDL without the requirement of any further structural change should show an effect on the disease. In the current study, we evaluated the impact of such a CRP mutant on the development of atherosclerosis employing LDL receptor knockout mouse model of atherosclerosis. We found that there was a two-week delay in the development of atherosclerotic lesions in the aortic root of mice treated with mutant CRP compared to mice that did not receive CRP. The development of atherosclerotic lesions in the whole aorta was also reduced; there was 30% reduction in the size of lesions in mice treated with mutant CRP. Overall, the data indicate that CRP is indeed an atheroprotective molecule.

Magister Pharmaceuticae - MPharm / Cardiovascular diseases (CVDs) such as ischaemic heart diseases, heart failure and stroke remain a major cause of death globally. Various deep-rooted factors influence CVD development; these include but are not limited to elevated blood lipids, high blood pressure, obesity and diabetes. A considerable number of proteins are involved directly and indirectly in the transport, maintenance and elimination of plasma lipids, including high and low-density lipoprotein cholesterol (HDL-C and LDL-C). There are several mechanisms involved in the removal of LDL particles from systemic circulation. One such mechanism is associated with the gene that encodes proprotein convertase subtilisin/kexin type 9 (PCSK9), which has become an exciting therapeutic target for the reduction of residual risk of CVDs. Currently, statins are the mainstay treatment to reduce LDL-C, and a need exists to further develop more effective LDL-C-lowering drugs that might supplement statins.

C-reactive protein (CRP) is a pentameric molecule made up of identical monomers. CRP can be seen in three different forms: native pentameric CRP (native CRP), non-native pentameric CRP (nonnative CRP), and monomeric CRP (mCRP). Both native and nonnative CRP execute ligand-recognition functions for host defense. The fate of any pentameric CRP after binding to a ligand is dissociation into ligand-bound mCRP. If ligand-bound mCRP is proinflammatory, like free mCRP has been shown to be in vitro, then mCRP along with the bound ligand must be cleared from the site of inflammation. Once pentameric CRP is bound to atherogenic low-density lipoprotein (LDL), it reduces both formation of foam cells and proinflammatory effects of atherogenic LDL. A CRP mutant, that is non-native CRP, which readily binds to atherogenic LDL, has been found to be atheroprotective in a murine model of atherosclerosis. Thus, unlike statins, a drug that can lower only cholesterol levels but not CRP levels should be developed. Since non-native CRP has been shown to bind to all kinds of malformed proteins in general, it is possible that non-native CRP would be protective against all inflammatory states in which host proteins become pathogenic. If it is proven through experimentation employing transgenic mice that non-native CRP is beneficial for the host, then using a small-molecule compound to target CRP with the goal of changing the conformation of endogenous native CRP would be preferred over using recombinant non-native CRP as a biologic to treat diseases caused by pathogenic proteins such as oxidized LDL.

The aim of this study was to test the hypothesis that C-reactive protein (CRP) protects against the development of atherosclerosis and that a conformational alteration of wild-type CRP is necessary for CRP to do so. Atherosclerosis is an inflammatory cardiovascular disease and CRP is a plasma protein produced by the liver in inflammatory states. The co-localization of CRP and low-density lipoproteins (LDL) at atherosclerotic lesions suggests a possible role of CRP in atherosclerosis. CRP binds to phosphocholine-containing molecules but does not interact with LDL unless the phosphocholine groups in LDL are exposed. However, CRP can bind to LDL, without the exposure of phosphocholine groups, if the native conformation of CRP is altered. Previously, we reported a CRP mutant, F66A/T76Y/E81A, generated by site-directed mutagenesis, that did not bind to phosphocholine. Unexpectedly, this mutant CRP, without any more conformational alteration, was found to bind to atherogenic LDL. We hypothesized that this CRP mutant, unlike wild-type CRP, could be anti-atherosclerotic and, accordingly, the effects of mutant CRP on atherosclerosis in atherosclerosis-prone LDL receptor-deficient mice were evaluated. Administration of mutant CRP into mice every other day for a few weeks slowed the progression of atherosclerosis. The size of atherosclerotic lesions in the aorta of mice treated with mutant CRP for 9 weeks was ~40% smaller than the lesions in the aorta of untreated mice. Thus, mutant CRP conferred protection against atherosclerosis, providing a proof of concept that a local inflammation-induced structural change in wild-type CRP is a prerequisite for CRP to control the development of atherosclerosis.

The effects of oxidatively modified low density lipoprotein (oxLDL) on atherogenesis may be partly mediated by alterations in the production of nitric oxide (NO) by vascular cells. Lipid hydroperoxides (LOOH) and lysophosphatidylcholine (lysoPC) are the major primary products of LDL oxidation. The purpose of this study was to characterize the effects of oxLDL, LOOH and lysoPC on NO production and the expression of inducible nitric oxide synthase (iNOS) gene in lipopolysaccharide (LPS) stimulated macrophages. LDL was oxidized using an azo-initiator 2,2'-azobis (2- amidinopropane) HCl (ABAP) and octadecadienoic acid was oxidized by lipoxygenase to generate 13-hydroperoxyl octadecadienoic acid (13-HPODE). Our study showed that oxLDL markedly decreased the production of NO, the levels of iNOS protein and iNOS mRNA in LPS stimulated macrophages. The inhibition potential of oxLDL on NO production and iNOS gene expression depended on the levels of LOOH formed in oxLDL and was not due to oxLDL cytotoxicity. Furthermore, 13-HPODE markedly reduced NO production and iNOS protein levels, whereas lysoPC showed only slight reduction. The effects of 13-HPODE and lysoPC did not require an acetylated LDL carrier. Our results suggest that 13-HPODE is a much more potent inhibitor of NO production and iNOS gene expression than lysoPC in LPS stimulated RAW264.7 macrophages.

Background: C-reactive protein (CRP) is an acute phase plasma protein. An important binding specificity of CRP is for the modified forms of low-density lipoprotein (LDL) in which the phosphocholine-binding sites of CRP participate. CRP, however, does not bind to native LDL. Methods: We investigated the interaction of CRP with native LDL using sucrose density gradient ultracentrifugation. Results: We found that the blocking of the phosphocholine-binding sites of CRP with phosphoethanolamine (PEt) converted CRP into a potent molecule for binding to native LDL. In the presence of PEt, CRP acquired the ability to bind to fluid-phase purified native LDL. Because purified native LDL may undergo subtle modifications, we also used whole human serum as the source of native LDL. In the presence of PEt, CRP bound to native LDL in serum also. The effect of PEt on CRP was selective for LDL because PEt-complexed CRP did not bind to high-density lipoprotein in the serum. Conclusions: The pharmacologic intervention of endogenous CRP by PEt-based compounds, or the use of exogenously prepared CRP-PEt complexes, may turn out to be an effective approach to capture native LDL cholesterol in vivo to prevent the development of atherosclerosis.

No description available.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第23802号 / 医博第4848号 / 新制||医||1058(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 永井 洋士, 教授 羽賀 博典, 教授 木村 剛 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM