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The high density lipoprotein (HDL) receptor Scavenger Receptor, Class B, Type I (SRBI) is a 509 amino acid integral membrane protein which has been shown to have an important role in HDL-mediated reverse cholesterol transport. SR-BI has been shown to mediate selective uptake of cholesterol, and also mediates efflux of cholesterol to HDL as seen in in vitro cell culture studies. SR-BI is abundant in the liver and steroidogenic tissues, and is also present in macrophages, which play an important role in the initial stages of atherosclerotic development. SR-BI has been shown to be protective against atherosclerosis by way of overexpression and knockout (KO) studies in murine atherosclerosis models, including low density lipoprotein receptor (LDLR) knockout mice, apolipoprotein E (ApoE) knockout mice, and human apolipoprotein B (ApoB) transgenic mice. SR-BI/LDLR double knockout (dKO) mice show a 6-fold increase in diet-induced atherosclerosis compared to LDLR single KO controls, and SR-BI/ApoE dKO mice show severe coronary occlusion, myocardial infarction, and premature death on a normal chow diet. In both, plasma total cholesterol levels are significantly elevated, and associated with abnormally large HDL particles. The majority ofSR-BI's atheroprotective effect has been shown to result from plasma cholesterol clearance by way of selective uptake in the liver. Recently, Covey et al showed that elimination of SRBI expression in macrophages of LDLR KO mice resulted in increased diet-induced atherosclerosis. To see if SR-BI in macrophages contributes to the overall atheroprotective effect of SR-BI in ApoE KO mice, presumably by mediating cellular cholesterol efflux to HDL, selective deletion ofSR-BI was induced in bone marrow derived cells of ApoE KO mice using bone marrow transplantation. Female ApoE -/recipient mice were transplanted with either SR-BI +/+ ApoE -/-or SR-BI -/- ApoE -/bone marrow from male donor mice, and fed a high fat diet for 12 weeks. This resulted in significantly increased atherosclerosis in mice transplanted with SR-BI -/- ApoE -/-bone marrow, with a concomitant decrease in cholesterol associated with HDL-sized lipoproteins. No significant differences were seen in plasma total cholesterol levels or levels of cholesterol associated with non-HDL lipoproteins. These data suggest that SRBI in macrophages contributes to SR-BI's overall protective effect against atherosclerosis, and also plays a role in the regulation ofHDL cholesterol, in ApoE deficient mice. / Thesis / Master of Science (MSc)

L’effet athéroprotecteur des Lipoprotéines de Haute Densité (HDL) est principalement attribué à leur rôle clé dans Transport Retour du Cholestérol (RCT), un processus par lequel le cholestérol excédentaire des cellules périphériques est capté par les particules HDL pour être amené au foie où il sera préférentiellement sécrété dans les voies biliaires, puis excrété dans les fèces. Deux voies indépendantes ont été identifiées comme étant impliquées dans l’endocytose hépatique du HDL. La première est la voie ecto-F1-ATPase/P2Y13 dans laquelle l’apoA-I (apolipoprotéine majoritaire des HDL) se lie à la F1-ATPase exprimé à la surface des hépatocytes (ecto-F1-ATPase) et stimule l’hydrolyse d’ATP en ADP. L’ADP ainsi généré active le récepteur purinergique P2Y13 pour stimuler l’endocytose de l’holoparticule HDL (protéines + lipides) via un troisième récepteur différent de SR-BI. Les souris invalidées pour P2Y13 présentent une diminution des sécrétions de lipides biliaires accompagnée d’une diminution du RCT des macrophages vers les fèces sous régime normolipidique. Un régime riche en cholestérol (1.25% cholestérol) accentue ce phénotype. La voie SR-BI, quant à elle, est responsable de la captation sélective du cholestérol estérifié des HDL par le foie. Les souris invalidées pour SR-BI spécifiquement au niveau du foie (SR-BI KOfoie) présentent une hypercholestérolémie principalement attribuée à une augmentation du HDL-C et développent des plaques d’athérosclérose sous régime hypercholestérolémique. Dans une étude récente, nous avons montré que l’invalidation de P2Y13 dans le modèle murin proathérogène apoE KO induit une augmentation du développement d’athérosclérose associée à une diminution des sécrétions de lipides biliaires et du RCT des macrophages vers les fèces. De plus, dans ces souris, l’expression hépatique transcriptionnelle et protéique de SR-BI étaient fortement augmentées par rapport aux souris apoE KO, suggérant qu’un possible mécanisme de compensation pourrait exister entre les récepteurs P2Y13 et SR-BI. L’objectif de ma thèse a été d’étudier la contribution respective des récepteur P2Y13 et SR-BI dans le métabolisme du HDL-C et le développement de l’athérosclérose. Nous avons croisé des souris P2Y13 KO avec des souris SR-BI KOfoie et nous avons obtenu des souris doublement invalidées (P2Y13 x SR-BIfoie dKO). Le phénotype métabolique des souris dKO a été étudié sous régime normolipidique et hypercholestérolémique et le développement d’athérosclérose sous régime hypercholestérolémique. Par rapport aux souris sauvages, les souris dKO sous régime normolipidique, présentent une augmentation du cholestérol plasmatique similaire à celle observée chez les souris SR-BI KOfoie, principalement imputable à une augmentation du HDL-C. Les souris dKO, mais pas les souris SR-BI KO, montrent une diminution des sécrétions de lipides biliaires comparable à celle observée chez les souris P2Y13 KO. Ce phénotype métabolique observé chez les souris dKO est accentué sous régime hypercholestérolémique et est associé à une augmentation des plaques d’athérosclérose par rapport aux souris SR-BI KOfoie. L’ensemble des résultats montrent que la délétion hépatique de SR-BI contribue essentiellement à une augmentation des taux plasmatiques de cholestérol, et plus particulièrement HDL-C. La délétion de P2Y13, quant à elle, n’induit aucune variation des lipides plasmatiques mais contribue principalement à une diminution des sécrétions de lipides biliaires qui contribue au développement de l’athérosclérose chez les souris invalidées pour SR-BI hépatique. Ces résultats soutiennent le concept selon lequel le flux de cholestérol transporté par les HDL des tissus périphériques vers le foie et les voies de sécrétions biliaires est plus important dans l’athéro-protection que la concentration plasmatique en HDL-C. L’activation du récepteur P2Y13 constitue une approche thérapeutique intéressante pour cibler les HDL contre le développement de l’athérosclérose. / The atheroprotective effect of High Density Lipoproteins (HDL) is mostly attributed to their central role in Reverse Cholesterol Transport (RCT), a process whereby excess cholesterol is taken up from peripheral cells to be processed into HDL particles, then later delivered to the liver where it is preferentially secreted into the bile, either as free cholesterol or after transformation into bile acids, to be further excreted into the feces. Two independent pathways have been identified as being involved in the hepatic HDL uptake. The first one involves the ecto-F1-ATPase/P2Y13 pathway. Briefly, apoA-I (main HDL apolipoprotein) binds to the F1-ATPase expressed ectopically at the surface of the hepatocyte (ecto-F1-ATPase) and stimulates hydrolysis of extracellular ATP into ADP. The generated ADP selectively activates the purinergic receptor P2Y13 resulting in subsequent endocytosis of the HDL-holoparticle (i.e. protein and lipid moieties) through a low-affinity binding site distinct from SR-BI. Mice deficient for P2Y13 display decreased biliary lipids secretion associated to an impaired macrophage-to-feces RCT when fed a Chow Diet (CD), phenotype emphasized when fed a High Cholesterol Diet (HCD). Differently, the SR-BI pathway mediates selective HDL-cholesteryl ester uptake by the liver. Mice with liver-specific SR-BI deficiency (SR-BI-KOliver) display a hypercholesterolemia mainly due to an increase on HDL-C and develop atherosclerosis when fed a HCD. In a recent study, we showed that P2Y13 extinction in the pro-atherogenic mouse model apoE-KO resulted in an increase of atherosclerotic plaque development associated to a decreased biliary lipid secretion and macrophage-to-feces RCT. Moreover, in these mice, mRNA and protein level of hepatic SR-BI were consistently increased as compared to apoE KO mice, suggesting that a possible compensatory mechanism might exist between P2Y13 and SR-BI receptors. My thesis aimed to study the respective contribution of P2Y13 and hepatic SR-BI in HDL-C metabolism and atherosclerosis development. We crossbred P2Y13 KO with SR-BI KOliver mice and obtained double knockout mice (P2Y13 x SR-BIliver dKO). The phenotype of dKO mice was analysed with regards to HDL-C metabolism either on CD or after 20 weeks of HCD, and to atherosclerosis development on HCD. When fed a CD, dKO mice, showed an increase in plasma cholesterol compared to WT mice similar to that observed in SR-BI KOliver mice, mainly due to an increase in HDL-C. DKO, but not SR-BI KOliver mice, showed impaired biliary lipid secretion to the same extent than P2Y13 KO mice. HCD accentuated the metabolic phenotype of dKO mice, with an increase in atherosclerotic lipid lesions in dKO mice compared to SR-BI KOliver mice. The phenotypic features of P2Y13 x SR-BIliver dKO mice show that hepatic extinction of SR-BI essentially contributes to an increase of HDL-C levels. Conversely, P2Y13 extinction does not induce any change in plasma lipoprotein levels but mainly contributes to a decrease of hepato-biliary cholesterol secretions, which translates into an increased atherosclerosis development, on top of SR-BI hepatic extinction. These results support the concept that the dynamic flux of cholesterol transported by HDL from macrophage foam cells to the liver for further bile secretion is essential for athero-protection rather than steady-state HDL-C concentration. In the future of HDL-therapies, P2Y13 receptor activation constitutes an interesting therapeutic approach against atherosclerosis development.

The ABCG5 ABCG8 (G5G8) sterol transporter promotes cholesterol secretion into bile and opposes dietary sterol absorption in the small intestine. An emerging body of literature suggests that G5G8 links sterol flux to various risk factors for metabolic syndrome (MetS) and nonalcoholic fatty liver disease (NAFLD). Therapeutic approaches that accelerate G5G8 activity may augment reverse cholesterol transport (RCT) and provide beneficial effects in the prevention and treatment of cardiovascular and liver disease. Mice lacking leptin (ob/ob) or its receptor (db/db) are obese, insulin resistant in part due to the reduced levels of hepatic G5G8 and biliary cholesterol. The underlying mechanisms responsible for the reduced G5G8 protein expression in these mice may provide a clue to the drug development for this target. My studies show that neither acute leptin replacement nor liver-specific deletion of leptin receptor alters G5G8 abundance or biliary cholesterol. Similarly, hepatic vagotomy has no effect on G5G8 expression. Conversely, expression of the ER chaperone, GRP78, rescues G5G8 in db/db mice. Previous studies suggest an interdependent relationship between liver and intestine for cholesterol elimination. A combination therapy that increases G5G8-mediated biliary cholesterol secretion and simultaneously reduces intestinal absorption is likely to act additively in cholesterol elimination. My studies show that treatment with ursodiol (Urso) increases hepatic G5G8 protein and both biliary and fecal sterols in a dose-dependent manner. Ezetimibe (EZ), a potent inhibitor of intestinal cholesterol absorption, produces an additive and dose-dependent increase in fecal sterol excretion in the presence of Urso. However, the stimulatory effects of both Urso and Urso-EZ are not G5G8-dependent. Beyond increasing G5G8 protein expression and biliary cholesterol secretion, my studies also show that Urso stimulates ileal FGF15 expression in mice. Our data of the stimulated ileal FGF15 expression in LIRKO and reduced hepatic G5G8 protein levels in Atsb KO mice both indicate the previous unrecognized role of FGF15/19 in the regulation of G5G8 and its activity. Indeed, this is subsequently confirmed by our results from the direct test of recombinant human FGF19 on G5G8. Thus, FGF15/19 may provide an alternative strategy in drug development to target G5G8 activity and accelerate cholesterol elimination.

ATP-binding cassette transporters ABCA1 and ABCG1 initiate reverse cholesterol transport generating HDL particles, whereas ABCG5/G8 promote biliary cholesterol secretion thereby facilitating the last step of reverse cholesterol transport. Mutations in the leptin axis result in obesity and dyslipidemia in ob/ob and db/db mice. These mice have defective HDL clearance, increased plasma cholesterol and decreased biliary cholesterol elimination. My studies demonstrate that ABCG5/G8 protein is low in these animals and can be restored with caloric restriction or leptin replacement. To directly test whether ABCG5/G8 alone is able to correct reverse cholesterol transport defect, liver specific ABCG5/G8 expression was achieved in db/db mice by administration of adenoviral ABCG5 and ABCG8. Restoration of biliary cholesterol is able partially to correct dyslipidemia in obese mice, but only in the presence of ezetimibe, an inhibitor of cholesterol absorption. ABCG5/G8 is the body’s primary defense against toxic effects of plant sterols. Plant sterols are used as cholesterol lowering food supplements. However, increased plasma plant sterol concentrations are associated with vascular lesions in dyslipidemic patients and animals. My in vitro studies demonstrate that individual plant sterol alter ABCA1 and ABCG1 abundance, cholesterol efflux and inflammatory cytokine secretion in macrophage foam cells at levels found in humans that consume plant sterol supplements.

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Enzymatic and lipid transfer reactions involved in reverse cholesterol transport were studied in HDL deficient plasma systems. Fasting plasma samples were obtained from control and cholesterol fed guinea pigs as well as from a fish eye disease patient and were used to localize the enzyme LCAT among plasma lipoproteins (VLDL, LDL, and HDL). In both guinea pig and fish eye disease patient plasma, the LCAT activity was found in association with the HDL type particles. Cholesterol feeding in guinea pigs altered the properties of lipoprotein substrates for LCAT resulting in some changes, specifically: 1) decreased fractional rate of plasma cholesterol esterification and, 2) lower transfer of free cholesterol (FC) and esterified cholesterol (CE) within the lipoprotein fractions.

The mammalian brain is the most cholesterol-rich organ of the body, requiring in situ de novo cholesterol synthesis to maintain its cholesterol requirement. Defects in brain cholesterol homeostasis are implicated in cognitive deficits related to aging and in neurodegenerative diseases such as Alzheimer's Disease (AD). Oxysterol-binding protein (OSBP) - related proteins are highly conserved cytosolic proteins that coordinate lipid homeostasis by regulating cell signaling, inter-organelle membrane contact sites and non-vesicular transport of cholesterol. Previously, ORP6, a poorly characterized member of this family, was found to be part of complex transcriptional cascade coordinated by SBREP2 and emerged as a novel regulator of intracellular cholesterol trafficking in hepatocytes and macrophages. Yet how ORP6 regulates these pathways and its function in the brain where it is most highly expressed is unknown. Here, we show that ORP6 is highly expressed in the brain, where it exhibits spatial and cell-type specific expression. ORP6 expression is enriched in the hippocampus and caudal-putamen brain regions, specifically within neurons and astrocytes. ORP6 knockdown in astrocytes altered the expression of cholesterol biosynthesis, cholesterol efflux and cholesterol esterification genes, resulting in the accumulation of esterified cholesterol within cytoplasmic lipid droplets and reduced cholesterol efflux highlighting a role for ORP6 in astrocytic cholesterol metabolism. We also present in this thesis, the newly generated second viable ORP family member knockout mouse. ORP6 ablation in mice results in the dysregulation of brain and whole-body lipid homeostasis, increased Aβ deposition in the brain and neuroanatomical alterations. Together, our findings highlight a critical role for cholesterol trafficking proteins in brain cholesterol homeostasis and identify ORP6 as a potential novel target for AD.

Les maladies cardiovasculaires sont la principale cause de morbidité et de mortalité dans les pays industrialisés. Le récepteur CD36, exprimé à la surface des macrophages, joue un rôle déterminant dans l’internalisation des lipoprotéines oxydées menant à la formation des cellules spumeuses dans l’espace sous endothélial, première étape du développement des lésions athérosclérotiques. Nous avons montré précédemment que les sécrétines de l’hormone de croissance sont des ligands du récepteur CD36 qui possèdent un site de liaison qui chevauche celui des lipoprotéines oxydées. Cependant, aucune étude n’avait rapporté les effets potentiels des ligands sélectifs du CD36 sur la progression des lésions athérosclérotiques et le métabolisme lipidique au niveau des macrophages. Ainsi, ce projet de doctorat visait à évaluer le potentiel anti-athérosclérotique du EP 80317, un ligand sélectif du CD36, et élucider les mécanismes à l’origine de ses effets sur le métabolisme et le transport des lipides au niveau des macrophages. À cette fin, des souris déficientes en apolipoprotéine E (apoE-/-), nourries avec une diète riche en lipides et en cholestérol, ont été traitées quotidiennement pendant 12 semaines avec le EP 80317, montrant un puissant effet anti-athérosclérotique associé à une réduction de 51% des lésions aortiques et de 30% du taux plasmatique de cholestérol total. Cette même étude a permis de montrer une réduction de l’internalisation des lipoprotéines oxydées ainsi qu’une augmentation de l’expression des gènes/protéines impliqués dans l’efflux du cholestérol au niveau des macrophages, comme le peroxisome proliferator-activated receptor γ (PPARγ), liver x receptor α (LXRα) et les transporteurs ABCA1 et ABCG1, entraînant une réduction de la formation des cellules spumeuses. Ces observations nous ont conduits à élucider les mécanismes moléculaires engendrés par la liaison d’un ligand sélectif au récepteur CD36 dans les macrophages. Les études ont permis de montrer que les ligands du CD36 entraînent une augmentation de l’efflux du cholestérol vers les transporteurs ABCA1 et ABCG1 en augmentant l’expression protéique de la cyclooxygénase 2 (COX-2) consécutive à la phosphorylation de la MAP kinase ERK1/2. L’activation de COX-2 stimule la production intracellulaire de la prostaglandine 15d-PGJ2, cette dernière conduisant à l’activation du PPARγ. Finalement, une troisième étude nous a permis de mettre en évidence les effets du EP 80317 sur le transport inverse du cholestérol in vivo. L’injection de macrophages J774 radiomarqués avec du cholestérol tritié dans la cavité péritonéale de souris avec le EP 80317 nous a permis de montrer que le EP 80317 entraîne une réduction de la radioactivité retrouvée dans le foie tandis qu’il augmente celle retrouvée dans les fèces par comparaison aux souris contrôles, sans néanmoins modifier le profil plasmatique du radiotraceur entre les deux groupes. De plus, l’expression des gènes impliqués dans le transport du cholestérol au niveau intestinal comme le LXRα, ABCA1, ABCG5 ainsi que ABCG8 ont été régulés à la hausse par le EP 80317 tandis que l’expression de NPC1L1, un transporteur impliqué dans l’absorption du cholestérol, a été régulé à la baisse. Toutefois, les gènes impliqués dans le métabolisme du cholestérol au niveau du foie ne sont pas modulés par le EP 80317. En conclusion, les travaux effectués dans le cadre de cette thèse nous ont permis de montrer que l’activation du récepteur CD36 par le EP 80317 pourrait s’avérer être une nouvelle approche thérapeutique pour le traitement de l’athérosclérose. Les effets anti-athérosclérotiques et hypocholestérolémiants des ligands synthétiques du récepteur CD36 sont en partie engendrés par 1) la régulation du métabolisme des lipides au niveau des macrophages en réponse à l’activation du PPARγ par son ligand endogène, le 15d-PGJ2 et 2) par une augmentation du transport inverse du cholestérol, particulièrement par une augmentation de l’efflux transintestinal. / Cardiovascular diseases are the major cause of mortality and morbidity in industrialized countries. CD36, a type B scavenger receptor expressed on macrophages, appears to play a major role in foam cell formation through scavenging oxidatively modified lipoproteins, thus leading to fatty streak lesion formation in the arterial wall. We have previously reported that growth hormone-releasing peptides (GHRP) are synthetic ligands that share the same binding site as oxidized low density lipoprotein (oxLDL) on the CD36 receptor. However, no study has reported the anti-atherosclerotic effects of CD36 ligands and their role in macrophage lipid metabolism. Thus, this project aimed to evaluate the anti-atherosclerotic effects of EP 80317, a CD36 selective ligand, and to elucidate the role of GHRP on macrophage lipid metabolism and transport. Apolipoprotein E deficient mice (apoE-/-) fed a high fat high cholesterol diet were treated for 12 weeks with EP 80317. Our study showed that EP 80317 exerted potent anti-atherosclerotic effects as shown by reduced lesion areas (up to 51%) and hypocholesterolemia. We further showed that a chronic treatment with EP 80317 reduced oxLDL uptake and increased the expression of genes/proteins involved in macrophage cholesterol efflux, such as peroxisome proliferator-activated receptor γ (PPARγ), liver x receptor α (LXRα) and ATP-binding cassette A1 (ABCA1) and ABCG1, thus reducing foam cell formation. Our second study aimed to elucidate the molecular mechanisms by which CD36 ligands lead to an increase in macrophage cholesterol efflux following PPARγ activation. [3H]-cholesterol-labeled murine macrophages incubated in the presence of EP 80317 showed a significant increase in cholesterol efflux to both ABCA1 and ABCG1 transporters of cholesterol. EP 80317-mediated macrophage cholesterol efflux through PPARγ involved an increase in intracellular 15d-PGJ2 levels that were elicited by extracellular signal-regulated kinase 1/2 (ERK1/2) stimulation, itself dependent on COX-2 activation. The third and last study of this thesis aimed to investigate the effect of CD36 selective ligand on reverse cholesterol transport in vivo. ApoE-/- mice treated or not with EP 80317 were injected intraperitoneally with [3H]-cholesterol-labeled murine J774 macrophage-like cells. The radioactivity recovered in the livers of EP 80317-treated mice was significantly lower than that found in vehicle-treated mice whereas feces radioactivity was higher. Yet, the radioactivity in plasma did not achieve statistical differences between the two groups. Furthermore, the expression of genes involved in intestinal cholesterol transport such as LXRα, ABCA1, ABCG5 and ABCG8 was upregulated in EP 80317-treated mice while the expression of NPC1L1, a transporter involved in cholesterol absorption, was downregulated compared to vehicle-treated mice. In contrast, genes involved in hepatic cholesterol metabolism were not modulated by EP 80317. In conclusion, the work conducted in this thesis supported that activation of CD36 signaling pathways by EP 80317 may constitute a novel therapeutic approach for the treatment of atherosclerosis. The anti-atherosclerotic and hypocholesterolemic effects of synthetic CD36 selective ligands might be explained, at least in part, by 1) the regulation of macrophage cholesterol metabolism as a result of an increase in PPARγ activation by its endogenous ligand, 15d-PGJ2 and 2) the stimulation of reverse cholesterol transport, in particular that of transintestinal cholesterol efflux.