Lipid transfer inhibitor protein (LTIP) is an important regulator of cholesteryl ester transfer protein function. We report the development of an immunoassay for LTIP and its use to quantify LTIP in plasma of varying lipid contents. A rabbit antibody against bacterially produced recombinant LTIP detected two LTIP isoforms in plasma differing in carbohydrate content. This antibody was used in a competitive, enzyme-linked immunoassay that uses partially purified LTIP bound to microtiter plates. To optimize LTIP immunoreactivity, plasma samples required preincubation in 1% Tween-20 and 0.5% Nonidet P-40. In normolipidemic plasma, LTIP averaged 83.5 mg/ml. LTIP was 31% higher in males than in females. LTIP was positively associated with HDL cholesterol in normolipidemic males but not in females. In hypertriglyceridemic males, LTIP was only 56% of control values, whereas in hypertriglyceridemic females, LTIP tended to increase. Additionally, in males with normal cholesterol and triglyceride (TG) ≤ 200 mg/dl, LTIP varied inversely with plasma TG. Overall, we have confirmed the negative association between plasma TG levels and LTIP previously suggested by a small data set, but now we demonstrate that this effect is seen only in males. The mechanisms underlying this gender-specific response to TG, and why LTIP and HDL levels correlate in males but not in females, remain to be determined.

Orientador: Helena Coutinho Franco de Oliveira / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-17T04:29:13Z (GMT). No. of bitstreams: 1 Patricio_PatriciaRiva_D.pdf: 4980020 bytes, checksum: e474966c1b7c224e3d8de5468871eefc (MD5) Previous issue date: 2010 / Resumo: A CETP é uma proteína plasmática que promove a transferência de lípides entre lipoproteínas, causando redução de HDL-colesterol e, portanto, aumento do risco de aterosclerose. Neste trabalho, investigamos o efeito da expressão desta proteína sobre a adiposidade e a expressão diferencial de genes em dois modelos animais. Inicialmente, comparamos camundongos transgênicos para a CETP humana (Tg) e controles irmãos não-transgênicos (NTg), que não expressam esta proteína. Verificamos que os camundongos CETP-Tg apresentaram redução do peso corporal, dos níveis plasmáticos de leptina, da massa dos depósitos de gordura perigonadal e subcutâneo e da área dos adipócitos. Também observamos que a expressão do RNAm da CETP é maior no tecido adiposo subcutâneo que no perigonadal. Quando comparados aos controles, os animais CETP-Tg tiveram as concentrações de RNAm no depósito perigonadal alteradas: apresentaram redução do fator de transcrição SREBP2 e da lipoproteína lipase e aumento da proteína quinase dependente de AMP (AMPK). Em relação ao tecido subcutâneo, houve diminuição do fator de transcrição PPAR_ e aumento da lipase hormônio sensível e da AMPK. Além disso, verificou-se também uma elevação de PPAR_ no fígado das fêmeas CETP-Tg, e uma elevação da lipase hepática no fígado de machos CETP-Tg. Em um segundo estudo, hamsters Golden Syrian, que expressam naturalmente a CETP, foram utilizados para confirmar se a inibição da CETP afetaria a adiposidade. Tratamento com anticorpo monoclonal neutralizante da CETP (TP2) durante um mês resultou em 70% de redução da atividade plasmática da proteína e em aumentos significativos de ganho de peso, massa de tecido adiposo visceral e área do adipócito, em comparação ao grupo controle (tratado com IgG irrelevante). Desta maneira, concluímos que a CETP induz a expressão diferencial de genes lipolíticos e lipogênicos no tecido adiposo, o que resulta em redução do conteúdo de gordura corporal. Esses resultados indicam, portanto, um novo papel antiadipogênico para a CETP. / Abstract: CETP is a plasma protein that promotes lipid transfer among plasma lipoproteins causing reduction of HDL-cholesterol and, thus, increases the risk of atherosclerosis. In this work we investigated the effect of CETP expression on differential gene expression and adiposity in two animal models. Human CETP expressing transgenic (Tg) mice and control CETP non-expressing littermates were compared. CETP-Tg mice had reduced body weight, plasma leptin levels, perigonadal and subcutaneous fat depots and adipocyte area. We also observed that CETP mRNA levels were higher in subcutaneous than in perigonadal adipose tissue. As compared to controls, CETP-Tg had altered tissue mRNA levels in the perigonadal adipose tissue: reduction of SREBP2 and lipoprotein lipase and elevation in AMPK. Regarding subcutaneous depot, there was a decrease in PPAR_ and marked elevation of hormone sensitive lipase and AMPK. In addition, an elevation in liver PPAR_ was found in female and hepatic lipase in male CETP Tg mice. Naturally CETP expressing Golden Syrian hamsters were used to confirm whether the inhibition of CETP would affect adiposity. Treatment with a neutralizing CETP monoclonal antibody (TP2) during one month resulted in 70% reduction in plasma CETP activity and significant increases in weight gain, visceral adipose tissue mass and adipocyte area, as compared to the control group (irrelevant IgG treated). In conclusion, CETP induces differential lipolitic and lipogenic gene expression in adipose tissue, resulting in reduction of body fat content. These findings disclose a novel anti-adipogenic role for CETP. / Doutorado / Fisiologia / Doutor em Biologia Funcional e Molecular

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24795号 / 医博第4987号 / 新制||医||1066(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 小林 恭, 教授 波多野 悦朗, 教授 羽賀 博典 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

<p>  </p> <p><strong>ABSTRACT</strong></p> <p>The worldwide obesity prevalence has almost tripled since 1973 according to the World Health Organization. In the United States, the disease is especially prevalent, with a recorded prevalence of 41.9 percent in 2017, as reported by the National Health and Nutrition Examination Survey. Obesity is associated with an increased risk of heart disease, type 2 diabetes, stroke, non-alcoholic fatty liver disease (NAFLD), and certain types of cancers, including prostate cancer (PCa). While obesity is preventable and reversible, it is a relapsing disease that requires long-term intervention. Furthermore, accumulating evidence shows obesity is not simply a matter of lack of willpower but the re-wired and altered biology that may need medical treatment. Therefore, researchers have been searching for effective approaches to treat obesity and obesity-related diseases. To this end, my research focuses on exploring the role of the sterol O-acyltransferase (SOAT) enzyme and how the inhibition of the enzyme benefits the treatment of obesity and PCa. In addition, I also studied the molecular signatures of NAFLD, with a special focus on altered lipid metabolism using proteomics and determined the protein oligomerization profiles. The major lines of research are summarized in the following and discussed in greater detail in chapters 2 to 5. </p> <p>SOAT enzyme catalyzes the conversion of free cholesterol into its storage form, cholesteryl ester. Our group previously showed that increased SOAT1 expression is associated with increased adipogenesis <em>in vitro</em> and increased adiposity in adipose tissue. When SOAT1 activity was blocked using the pharmacological inhibitor avasimibe, lipid droplet formation and expansion during adipogenesis were suppressed. We further showed that non-orally administered avasimibe led to significant fat mass loss in diet-induced obese (DIO) mice with concomitant food intake suppression and decreased expression of lipogenic genes in adipose tissue. Based on the promising use of avasimibe as an anti-obesity medication, I sought to answer whether avasimibe can enhance the weight loss effect of glucagon-like peptide-1 receptor agonist (GLP-1RA) by accelerating fat mass loss (chapter 2). We found subcutaneous administration of avasimibe can significantly potentiate the weight-reducing effect of the GLP-1RA in DIO mice.</p> <p>Inspired by the lipid droplet modulatory role of the SOAT1 enzyme, I also expanded my dissertation project to cancer (chapter 3). I found that low SOAT1 expression is associated with favorable patient outcomes among PCa patients who had previously undergone anti-hormone therapy. Since the current treatment option, anti-androgen drug enzalutamide, induces mechanisms of resistance in a short period, I hypothesized that blockage of SOAT1 activity using avasimibe would enhance the enzalutamide action and help overcome the resistance. To test this hypothesis, I characterized lipidomic signatures of PCa cells in response to enzalutamide and avasimibe treatments. Then, I tested the anti-cancer effect of the combined treatment in cell cultures and in xenograft tumors in nude mice. I found the combined treatment was significantly more effective in inhibiting cancer cell proliferation and tumor growth than each drug treatment alone. These findings provide insights into molecular signatures associated with enzalutamide treatment outcomes and can serve as a prelude to developing a therapeutic regimen targeting cholesterol metabolism. </p> <p>Among the comorbidities of obesity, NAFLD is very common in obese adults and the prevalence is close to 50–90%. We launched the third project (chapter 4) where we compared the liver proteome from lean mice and DIO mice. To date, most of the omics studies on DIO have been monolithic and very few have explored the multi-omic aspects of fatty liver tissue. To address this gap, we integrated global proteomics, phosphoproteomics and lipidomics to determine molecular signatures of the fatty liver. We identified a range of biological pathways that were altered, and we showed how the alterations in lipid content and amount were correlated with the alterations in the liver proteome and phosphoproteome. The results shed light on the interrelated nature of these biological processes. This was hypothesis-generating study that provided extensive data that could guide future investigations. </p> <p>We followed up on the third project and employed extensive measures to determine the protein oligomerization profiles of the fatty liver (chapter 5). Understanding the modes of protein oligomerization is important since proteins typically exert their biological functions by interacting with other proteins to form protein complexes. We used size exclusion chromatography (SEC) to fractionate liver proteins into 32 fractions based on their size and conducted label-free quantitation of each fraction using mass spectrometry. We successfully obtained elution profiles of individual proteins for subsequent comparison. Our approach enabled the identification of 1172 proteins found common in four liver samples (two lean livers and two fatty livers) for correlation profiling. We discovered that protein elution profiles were highly conserved in the fatty livers despite the metabolic disease state. At the same time, we identified several proteins with different elution profiles between the lean and the fatty livers, which could potentially mediate the hepatic dysfunctions displayed in NAFLD. This study delivers novel pieces of information about protein complex formation in fatty livers.</p> <p>The four research projects included in this dissertation explored obesity and obesity related diseases. Cholesterol accumulation is manifested as lipid metabolism is altered during the progression of obesity in adipose tissue and in PCa. Pharmacological inhibition of SOAT is responsible for cholesterol accumulation was effective in weight management in DIO and demonstrated anti-cancer effect in PCa models together with enzalutamide. These findings suggest that SOAT could be a therapeutic target for diseases featuring cholesteryl ester accumulation. Subsequent projects explored the liver proteome and revealed. In the subsequent projects, liver proteome showed a clear distinction between lean mice and obese mice. The identified proteins in these studies could facilitate the development of targeted therapies for treating NAFLD.</p>

In biomechano-transducing, cellular generated tension can be measured by soft substrates based on polymers but these techniques are limited either by spatial resolution or ability to detect localised cell traction forces (CTF) due to their non-linear viscous behaviour under shear rates. A newly developed cell traction force transducer system based on cholesteryl ester lyotropic liquid crystals (LCTFT) was developed to sense localised traction forces of human keratinocyte cell lines (HaCaTs), in which the length of the deformation line induced represents the intensity of the CTF exerted. The physical properties of the cholesteryl ester based lyotropic liquid crystals (LLC) were characterised by using polarising microscopy, rheology, atomic force microscopy (AFM) based nano-indentation, spherical indentation, and micro-tensile tests. The interactions of LLC with cells were studied by using cell viability studies, cytochemical treatments, widefield surface plasmon resonance (WSPR) microscopy and various immuno-staining techniques. The results show that LLC is thermally stable (0 - 50 oC) and linearly viscoelastic below 10 % shear strain at shear rates of < 1 s-1. AFM nano and spherical indentations show a good agreement on the Young¿s modulus of both determined at ~110 kPa which is close to the elastic modulus of the epidermis. The Poisson¿s ratio of LLC was determined at ~0.58 by using micro tensile tests. The biophysical interaction studies indicated that LLC is biocompatible and allowed cell attachment. Cell relaxation technique by cytochalasin-B treatment suggested that the attachment and contraction of cells on LLC was due to the contractile activity of actin cytoskeletons that are mediated by focal adhesions. The staining experiments showed that cells consistently expressed the same suites of integrins (¿2, ¿3, ¿5 and ¿1) and ECM proteins (collagen type IV, laminin and fibronectin) on both glass and LLC coated substrates. Interfacial interaction of cells with LLC observed via the staining of actin and vinculin, and WSPR imaging suggest the association of marginal actin filaments and focal adhesions in attaching HaCaT cells to the LLC. Linear static analysis applied in the Finite Element model of focal adhesion-LC confirmed the compressive force patterns induced by cells. By applying cell relaxation techniques and Hooke¿s theorem, the force-deformation relationships of the LLC were derived and used for direct quantification of CTF in culture. The sensitivity of the LCTFT was implied by a wide range of CTF (10 - 140 nN) measured at high resolutions (~2 ¿m). Nonetheless, a custom-built cell traction force measurement and mapping software (CTFM) was developed to map CTF of single cells. Reliability of the LCTFT was evaluated by using a known pharmacological active cytokine, TGF-¿1, in inducing contraction of human keratinocytes. This study inferred internal consistency and repeatability of the LCTFT in sensing contraction responses of HaCaT cells in a concentration dependent manner of TGF-¿1. The overall LCTFT and CTFM software had shown good potential for use in the study of contraction and migration of keratinocytes. / Malaysia Ministry of Higher Education

No / This study aimed at examining the biophysical characteristics of human derived keratinocytes (HaCaT) cultured on cholesteryl ester liquid crystals (CELC). CELC was previously shown to improve sensitivity in sensing cell contractions. Characteristics of the cell integrin expressions and presence of extracellular matrix (ECM) proteins on the liquid crystals were interrogated using various immunocytochemical techniques. The investigation was followed by characterization of the chemical properties of the liquid crystals (LC) after immersion in cell culture media using Fourier transform infrared spectroscopy (FTIR). The surface morphology of cells adhered to the LC was studied using atomic force microscopy (AFM). Consistent with the expressions of the integrins α2, α3 and β1, extracellular matrix proteins (laminin, collagen type IV and fibronectin) were found secreted by the HaCaT onto CELC and these proteins were also secreted by cells cultured on the glass substrates. FTIR analysis of the LC revealed the existence of spectrum assigned to cholesterol and ester moieties that are essential compounds for the metabolizing activities of keratinocytes. The immunostainings indicated that cell adhesion on the LC is mediated by self-secreted ECM proteins. As revealed by the AFM imaging, the constraint in cell membrane spread on the LC leads to the increase in cell surface roughness and thickness of cell membrane. The biophysical expressions of cells on biocompatible CELC suggested that CELC could be a new class of biological relevant material.

In biomechano-transducing, cellular generated tension can be measured by soft substrates based on polymers but these techniques are limited either by spatial resolution or ability to detect localised cell traction forces (CTF) due to their non-linear viscous behaviour under shear rates. A newly developed cell traction force transducer system based on cholesteryl ester lyotropic liquid crystals (LCTFT) was developed to sense localised traction forces of human keratinocyte cell lines (HaCaTs), in which the length of the deformation line induced represents the intensity of the CTF exerted. The physical properties of the cholesteryl ester based lyotropic liquid crystals (LLC) were characterised by using polarising microscopy, rheology, atomic force microscopy (AFM) based nano-indentation, spherical indentation, and micro-tensile tests. The interactions of LLC with cells were studied by using cell viability studies, cytochemical treatments, widefield surface plasmon resonance (WSPR) microscopy and various immuno-staining techniques. The results show that LLC is thermally stable (0-50 °C) and linearly viscoelastic below 10% shear strain at shear rates of < 1 s⁻¹. AFM nano and spherical indentations show a good agreement on the Young's modulus of both determined at ~110 kPa which is close to the elastic modulus of the epidermis. The Poisson's ratio of LLC was determined at ~0.58 by using micro tensile tests. The biophysical interaction studies indicated that LLC is biocompatible and allowed cell attachment. Cell relaxation technique by cytochalasin-B treatment suggested that the attachment and contraction of cells on LLC was due to the contractile activity of actin cytoskeletons that are mediated by focal adhesions. The staining experiments showed that cells consistently expressed the same suites of integrins (α2, α3, α5 and β1) and ECM proteins (collagen type IV, laminin and fibronectin) on both glass and LLC coated substrates. Interfacial interaction of cells with LLC observed via the staining of actin and vinculin, and WSPR imaging suggest the association of marginal actin filaments and focal adhesions in attaching HaCaT cells to the LLC. Linear static analysis applied in the Finite Element model of focal adhesion-LC confirmed the compressive force patterns induced by cells. By applying cell relaxation techniques and Hooke's theorem, the force-deformation relationships of the LLC were derived and used for direct quantification of CTF in culture. The sensitivity of the LCTFT was implied by a wide range of CTF (10 - 140 nN) measured at high resolutions (~2 μm). Nonetheless, a custom-built cell traction force measurement and mapping software (CTFM) was developed to map CTF of single cells. Reliability of the LCTFT was evaluated by using a known pharmacological active cytokine, TGF-β1, in inducing contraction of human keratinocytes. This study inferred internal consistency and repeatability of the LCTFT in sensing contraction responses of HaCaT cells in a concentration dependent manner of TGF-β1. The overall LCTFT and CTFM software had shown good potential for use in the study of contraction and migration of keratinocytes.

Η στεφανιαία νόσος αποτελεί ένα από τα πιο συχνά αίτια νοσηρότητας και θνητότητας στο γενικό πληθυσμό. Ένα μεγάλο ποσοστό από τους ασθενείς με στεφανιαία νόσο οδηγείται σε αγγειοπλαστική στεφανιαίων αρτηριών (PTCA) με ή χωρίς εμφύτευση stent, όταν η στένωση στο αγγείο είναι ≥ 70-75%. Παρά την πρόοδο στον τομέα της αγγειοπλαστικής, με τη χρήση των drug-eluting stents και την ελάττωση της επαναστένωσης σε ποσοστό <5-10%, το υψηλό ποσοστό (20-25%) επαναστένωσης παραμένει η Αχίλλειος πτέρνα στα συμβατικά, μεταλλικά(bare)stents. Η χρήση των drug-eluting stents περιορίζεται σε περιπτώσεις με επαναστένωση, σε σακχαροδιαβητικούς και σε υψηλού κινδύνου βλάβες για επαναστένωση. Τα μεγάλα ποσοστά όψιμης επαναστένωσης(≥ 9-10%) και το υψηλό κόστος τους, κάνουν ακόμα πιο επιτακτική την ανάγκη εντατικοποίησης της έρευνας προς την κατεύθυνση εντοπισμού παραγόντων σχετιζόμενων με την επαναστένωση. Σκοπός της εργασίας μας ήταν να διερευνήσει τον πιθανό ρόλο πολυμορφισμών γονιδίων στην υποτροπή ισχαιμίας μετά από αγγειοπλαστική στεφανιαίων αρτηριών και εμφύτευση μεταλλικών stents. Συγκεκριμένα, εξετάσθηκε αναλυτικά ο γενετικός πολυμορφισμός των γονιδίων α2Β-αδρενεργικού υποδοχέα και της CETP(πρωτεΐνη μεταφοράς εστέρων χοληστερόλης). Η υπόθεση στηρίχτηκε στο γεγονός ότι σε μια σημαντική μελέτη 912 αρρένων Φινλανδών μέσης ηλικίας, αποδείχτηκε ότι ο D/D γονότυπος σε σχέση με τον I/D γονότυπο και τον I/I γονότυπο, εμφανίζει 2,5 φορές μεγαλύτερο κίνδυνο για οξέα στεφανιαία επεισόδια, συμπεριλαμβανομένου του εμφράγματος μυοκαρδίου. Η εκσεσημασμένη αγγειοσύσπαση, τόσο στην περιφέρεια, όσο και στις στεφανιαίες αρτηρίες μέσω του πολυμορφισμού του γονιδίου α2Β που θεωρείται πιθανό αίτιο για τα οξέα στεφανιαία επεισόδια, μαζί με το σημαντικό ρόλο του α2Β αδρενεργικού υποδοχέα στην υπερπλασία και μετανάστευση των λείων μυϊκών κυττάρων, πιθανόν να έχει μεγάλη συμβολή στη διεργασία της υποτροπής ισχαιμίας. Μελετήσαμε προοπτικά 96 Έλληνες που υπέστησαν επιτυχή PTCA και εμφύτευση stents, εκ των οποίων 81 ήταν άνδρες και 15 γυναίκες(μέση ηλικία ± σταθερά απόκλιση=57,7± 10,1 ετών, με όρια 37-76 ετών) που προσήλθαν με συμπτωματική στεφανιαία νόσο. Όλοι οι παραπάνω ασθενείς συμμετείχαν στη μελέτη μεταξύ των ετών 2001 και 2003 και παρακολουθήθηκαν κλινικά για 6-8 μήνες μετά από μια επιτυχή τεχνική διάνοιξης του αποφραγμένου αγγείου. Αμέσως μετά την PTCA και για ένα(1) μήνα οι ασθενείς έλαβαν ασπιρίνη(100-325mg/day) και κλοπιδογρέλη 75mg/day. Η εκτίμηση της υποτροπής ισχαιμίας βασίστηκε σε στατικό και δυναμικό σπινθηρoγράφημα θαλλίου στους 3 και 6-8 μήνες μετά την PTCA. Αιμοδυναμικά, σε όσους υπέστησαν νέα στεφανιογραφία μέχρι και τους 6-8 μήνες, η επαναστένωση ορίσθηκε ως ≥ 50% στένωση του αυλού του αγγείου στο σημείο όπου έγινε η αγγειοπλαστική. Εκτός από την ομάδα των ασθενών και μια ομάδα υγιών μαρτύρων 83 ατόμων, συμμετείχε στη μελέτη για σύγκριση της συχνότητας του γονότυπου. Το τελικό καταληκτικό σημείο για την παραπάνω μελέτη, ήταν η συχνότητα της υποτροπής ισχαιμίας στους 8 μήνες κλινικής παρακολούθησης. Υποτροπή ισχαιμίας και της επαναστένωσης ≥ 50% σε όσους υπεβλήθησαν σε νέα στεφανιογραφία, συνέβη σε 15 από τους 96 ασθενείς. Ας σημειωθεί ότι οι περισσότεροι ασθενείς (70/96) είχαν το φυσιολογικό γονότυπο με το αλληλόμορφο I, λιγότεροι ασθενείς (23/96) είχαν το Insertion/Deletion και μόλις 3/96 είχαν το Deletion/ Deletion γονότυπο. Από το γονοτυπικό group, υποτροπή ισχαιμίας παρουσιάσθηκε σε 11/70 για τον I/I, 3/23 για τον I/D γονότυπο και 1/3 για τον D/D γονότυπο. Δε βρέθηκε συσχέτιση μεταξύ πολυμορφισμού γονιδίου και υποτροπής ισχαιμίας στους ασθενείς μετά από αγγειοπλαστική στεφανιαίων αρτηριών. Προηγούμενες μελέτες έχουν ερευνήσει τη συσχέτιση των πολυμορφισμών των γονιδίων της ACE, του AT1 υποδοχέα της αγγειοτενσίνης II και της CETP με την επαναστένωση μετά από αγγειοπλαστική. Εντούτοις, καμιά μελέτη δεν πραγματοποιήθηκε που να συγκρίνει τον α2Β-AR πολυμορφισμό και την υποτροπή ισχαιμίας μετά από αγγειοπλαστική στεφανιαίων αρτηριών. Όπως αρχικά αναφέρθηκε, ο γονότυπος α2Β ευνοεί τη μετανάστευση των αγγειακών SMCs, επηρεάζει τη λειτουργία του Α.Ν.Σ. και συσχετίζει το α2Β-AR αλληλόμορφο D deletion με οξέα στεφανιαία επεισόδια. Όλα τα παραπάνω στοιχεία μπορεί να δικαιολογούν το ρόλο του α2Β-AR πολυμορφισμού στην υποτροπή ισχαιμίας και πιθανόν την επαναστένωση μετά από αγγειοπλαστική στεφανιαίων αρτηριών. Βέβαια, η αρνητική συσχέτιση των πολυμορφισμών του α2Β-AR και της CETP ΤaqIB με την υποτροπή ισχαιμίας μετά από αγγειοπλαστική, μπορεί να θεωρηθεί προκαταρκτική, δεδομένου ότι συμμετείχε σχετικά μικρός αριθμός ασθενών συγκριτικά με μεγάλες πληθυσμιακές μελέτες και επειδή ο D/D γονότυπος δεν είναι ιδιαίτερα συχνός(για τη μελέτη των α2Β-AR). Όσον αφορά τη μελέτη με τη CETP, διερευνήσαμε τον πολυμορφισμό ΤaqIB που είναι μια σιωπηρή μετάλλαξη βάσης στο 277 νουκλεοτίδιο της CETP(η οποία μπορεί να αναγνωρισθεί με την περιοριστική ενδονουκλεάση ΤaqI), με την πιθανότητα υποτροπής ισχαιμίας μετά από αγγειοπλαστική στεφανιαίων αρτηριών. Οι όροι Β1 και Β2 αντίστοιχα χρησιμοποιήθηκαν για να δηλώσουν την ύπαρξη ή μη της περιοριστικής περιοχής (site) της ΤaqIB. Το Β2 αλληλόμορφο σχετίζεται με αυξημένα επίπεδα HDL και ελαττωμένα επίπεδα CETP, τόσο σε υγιείς όσο και σε άτομα με στεφανιαία νόσο(μοιάζει με ήπιας μορφής ανεπάρκεια CETP). Αντίθετα το Β1 αλληλόμορφο σχετίζεται με ελαττωμένα επίπεδα HDL και με αυξημένα επίπεδα και δραστηριότητα CETP. Επειδή η ΤaqIB σχετίζεται με χαμηλά επίπεδα HDL και αυξημένο κίνδυνο για CHD(επηρεάζοντας το μεταβολισμό των λιποπρωτεϊνών), μπορεί να συμμετέχει στην παθοφυσιολογία της υποτροπής ισχαιμίας μετά από αγγειοπλαστική. Μελετήσαμε 204 ασθενείς από το έτος 2001 έως και το 2003 με την προοπτική να διερευνηθεί η συσχέτιση ΤaqIB στον Ελλαδικό πληθυσμό με την πιθανότητα υποτροπής ισχαιμίας μετά από αγγειοπλαστική σε άτομα που φέρουν τον παραπάνω γονότυπο. Η συχνότητα της ΤaqIB(54%) ήταν παρόμοια με τη συχνότητα του πολυμορφισμού σε μια ομάδα 35 υγιών μαρτύρων. Το αποτέλεσμα από αυτή τη μελέτη δεν αποδεικνύει ότι ο ΤaqIB πολυμορφισμός στο γονίδιο της CETP είναι σημαντικός προγνωστικός παράγων για εκτίμηση του κινδύνου υποτροπής ισχαιμίας μετά από αγγειοπλαστική στεφανιαίων αρτηριών. Συμπερασματικά, η υποτροπή ισχαιμίας μετά από αγγειοπλαστική στεφανιαίων αρτηριών οφείλεται σε έναν πολύπλοκο μηχανισμό και σε ένα πολυπαραγοντικό φαινόμενο. Μπορεί οι πολυμορφισμοί του α2Β και της CETP, να μην αναδείχθηκαν ως ανεξάρτητοι παράγοντες υποτροπής ισχαιμίας μετά από αγγειοπλαστική στεφανιαίων αρτηριών, αλλά σε συνδυασμό με άλλους πολυμορφισμούς γονιδίων και υπό την επίδραση συγκεκριμένων περιβαλλοντικών παραγόντων, είναι πολύ πιθανόν να συμμετέχουν στην παραπάνω διεργασία της υποτροπής ισχαιμίας και κατ’επέκταση της επαναστένωσης μετά από PTCA. / Coronary heart disease is one of the most common causes of morbidity and mortality in the population. A great percent of the patients with coronary heart disease may undergo percutaneous coronary angioplasty (PTCA) with or without the implantation of stents, mainly when the stenosis of the vessel is ≥ 70-75%. Despite the progress made with the introduction of drug-eluting stents and the reduction of the restenosis rate up to 5%-10%, the Achillean heel of the angioplasty using bare metal stents, is the restenosis rate which is 20%-25% of all cases. The use of drug-eluting stents is limited in cases with restenosis, in patients with diabetes mellitus and in high-risk for restenosis lesions. The great percent of late restenosis(≥ 9-10%) and the high price of drug-eluting stents, make more urgent the necessity for more intense research on the identification of the exact factors involved in the pathophysiology of restenosis. The primary objective of our study is to define the role of gene polymorphisms in the recurrence of ischaemia after PTCA and the implantation of the stents. Virtually, we scrutinely examined the role of the genetic polymorhisms of α2Badrenergic receptor and the CETP(Cholesteryl Ester Transfer Protein)-TaqIB polymorphism. Our assumption was based on the conclusion drawn by a study conducted in Finnish patients, which showed that D/D genotype confers 2,5 increase in the risk for acute coronary events(including acute myocardial infarction). The intense vasoconstriction properties of the α2Badrenergic polymorphism both on the coronary arteries and the periphery is considered to be the primary cause of the acute coronary events. The aforementioned statement with the significant role of α2B adrenergic receptor α2B-AR on the hyperplasia and mainly the migration of smooth muscle cells, probably correlates well with the pathophysiology of the recurrence of ischaemia after PTCA. We conducted a genetic association/prospective follow-up study in 96 Greek coronary artery disease patients undergoing coronary angioplasty and stent implantation. 81 patients were men and 15 women(mean age ± standard deviation=57,7± 10,1 years, ranges 37-76 years old) who presented with symptomatic CAD. All patients were enrolled in the study between 2001 and 2003 and were followed-up clinically for 6-8 months after an initially successful procedure. Post-angioplasty and for one (1) month following the procedure, all the patients received aspirin(100-325mg/day) and clopidogrel(75mg/day). Assessment of recurrence of ischaemia was based on positive thallium stress testing(at least moderate defect to the distribution of the culprit lesion of the vessel which was revascularised). Hemodynamically, restenosis was defined as ≥50% narrowing of the vessel at the point where angioplasty was performed. In addition to the patient group, a control group of totally 83 asymptomatic individuals were included in the study for comparison of the frequency of the genotype. The final end-point of the current study was the incidence of restenosis at 8 months of clinical follow-up. Recurrence of ischaemia (including restenosis rate ≥50% to the patients who underwent coronary angiography) occurred in 15 of the 96 patients. In note, the majotiy of patients (70/96) had the Insertion/Insertion genotype, fewer patients (23/96) had the Insertion/Deletion genotype and only 3/96 had the Deletion /Deletion genotype. With regard to to the genotype groups , restenosis was found in 11/70 for I/I, 3/23 for I/D and 1/3 for the D/D genotype. No association between gene polymorphisms and recurrence of ischaemia was detected to the patients who underwent coronary angioplasty. Previous studies have investigated the association between gene polymorhisms of angiotensin-converting enzyme(ACE), the AT1 receptor for angiotensin II and cholesteryl ester transfer protein (CETP) with restenosis in patients after coronary angioplasty. However, no study has been performed to involve the α2B-AR polymorphism with recurrence of ischaemia after percutaneous angioplasty of coronary vessels. As it was initially mentioned, α2B genotype promotes the migration of vascular SMCs, influences the function of autonomic nervous system and the α2B-AR deletion variant is associated with acute coronary events. All these data might correlate the role of α2B-AR polymorphism with the recurrence of ischaemia and probably with the restenosis after an angioplasty of coronary vessels. Nevertheless, the negative findings of our study might be considered preliminary, taking into account the small number of patients that were studied and the rarity of the Deletion/Deletion(D/D) genotype. As far as the CETP study, we investigated the TaqIB polymorphism, which is a silent base change affecting the 277th nucleotide and can be identified by the restriction endonuclease TaqI, with the chance of recurrence of ischaemia after PTCA. The terms B1 and B2 are used to denote the presence and absence, respectively, of the TaqI restriction site. The B2 allele has been associated with increased HDL levels and decreased CETP levels and activity in both patients with CHD and healthy subjects(resembling a mild form of CETP deficiency). On the other hand, the B1 allele has been associated with decreased HDL levels and increased CETP levels and activity. Due to the fact that TaqIB is associated with decreased HDL levels and increased risk for CHD, affecting the lipoprotein metabolism might be involved in the pathophysiology of reccurence of ischaemia after PTCA. We studied 204 patients between 2001 and 2003 with the primary objective to investigate the frequency of TaqIB and possible association with reccurence of ischaemia after PTCA in the patients who have this genotype. The frequency of TaqIB was 54% similar to the frequency of the polymorphism in a group of 35 healthy controls. The results from this study does not indicate that the TaqIB polymorphism at the CETP gene locus is a significant predictor for assessing the risk of reccurence of ischaemia after PTCA. As a conclusion, reccurence of ischaemia after PTCA is due to a complicated mechanism and to a multifactoral phenomenon. Virtually, we didn’t find any correlation of α2ΒAR polymorphism and CETP TaqIB with reccurence of ischaemia, especially as causitive factors, but based on their role in the pathophysiology, under certain circumstances, especially with the cooperation of other genes, these polymorphisms can not be definitely excluded in the reccurence of ischaemia and the restenosis after PTCA.

Orientadores: Andrei Carvalho Sposito, Eliana Cotta de Faria / Texto em português e inglês / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T06:33:21Z (GMT). No. of bitstreams: 1 Parra_ElianeSoler_D.pdf: 3645332 bytes, checksum: 085ab65e147faa7a1f1684591c22e6d8 (MD5) Previous issue date: 2014 / Resumo: A lipoproteína de alta densidade (HDL) é um complexo heterogêneo e versátil de partículas com variações funcionais resultantes da integração de uma vasta gama de componentes, como apolipoproteínas, receptores, transportadores, enzimas e fosfolípides, com ações indiretas ou diretas sobre o seu metabolismo. Além disso, as concentrações plasmáticas do colesterol da HDL (HDL-C) e seu tamanho representam importantes fatores inversos ao desenvolvimento de doenças cardiovasculares, particularmente em indivíduos em prevenção primária. A proteína de transferência de colesterol esterificado (CETP) desempenha uma função importante no transporte reverso do colesterol (TRC) que é umas das principais funções antiaterogênicas da HDL. No entanto, a atividade da CETP é inversamente associada às concentrações de HDL-C e ao tamanho da partícula. Adicionalmente, HDL grande demonstra ser mais efetiva no efluxo do colesterol, parte integrante do TRC, comparada à partícula de HDL menor. Nesse contexto, o objetivo do estudo foi avaliar, em indivíduos livres de doença aterosclerótica manisfesta, a associação entre o tamanho da HDL e a redução da atividade da CETP induzida geneticamente com a carga aterosclerótica carotídea. Utilizamos para esse fim dois polimorfismos da CETP, TaqIB e I405V, que foram bem caracterizados funcionalmente e encontrados frequentemente na população. Assim, os objetivos desta tese foram: (i) investigar se a presença dos polimorfismos TaqIB e I405V do gene da CETP está associada às concentrações de HDL-C e à aterosclerose carotídea subclínica (n=207); (ii) pesquisar se, além das concentrações de HDL-C, o tamanho da partícula de HDL está associado à aterosclerose subclínica (n=284). Para estes estudos foram determinados os perfis lipídicos, lipoproteícos e apoproteícos, proteína C-reativa (PCR), anticorpos anti-LDL oxidada, atividades das proteínas CETP e de transferência de fosfolípides (PLTP), HDL2 e HDL3 e o diâmetro da HDL. Os polimorfismos TaqIB e I405V da CETP também foram detectados. A espessura da camada íntima-medial da artéria carótida comum (EIMc) foi mensurada por ultrassonografia. Na presença do menor alelo dos polimorfismos TaqIB e I405V da CETP, EIMc correlacionou-se inversamente com atividade da CETP e positivamente com atividade da PLTP e anticorpos anti-LDL oxidada. Na análise multivariada, a presença do menor alelo do polimorfismo TaqIB, mas não do I405V, foi associado a um aumento de 5,1 vezes de risco de maior EIMc. No entanto, a atividade da CETP não diferiu entre os grupos de presença e ausência do menor alelo do polimorfismo TaqIB. Com relação ao tamanho das partículas, HDL maiores foram associadas a menores EIMc e foram melhores indicadores de risco de aterosclerose carotídea subclínica comparadas às concentrações de HDL-C. Em conclusão, o aumento do tamanho da HDL tem associação independente com a carga aterosclerótica e, embora o polimorfismo TaqIB também se associe, sua interação parece ser independente da atividade da CETP / Abstract: High-density lipoproteins ( HDL ) are a group of heterogeneous and complex particles with versatile functional changes resulting from the integration of a wide range of components, such as apolipoproteins, receptors, transporters, enzymes and phospholipids with indirect or direct actions on your metabolism. In addition, plasma concentrations of HDL cholesterol (HDL -C) and its size are inversely related to the development of cardiovascular diseases, particularly in primary prevention in individuals. The cholesterol ester transfer protein (CETP) plays an important role in reverse cholesterol transport (RCT), which is one of the main functions of HDL. However, CETP activity is inversely related to HDL-C and particle size. Additionally, largest HDL particles have demonstrated a higher cholesterol efflux capacity. In this context, the aim of the study was to evaluate, in individuals free of manifest atherosclerotic disease, the association between the size of HDL and CETP activity genetically induced with carotid atherosclerosis burden. We used for this purpose, two polymorphisms of CETP TaqIB and I405V, which have been well characterized functionally and often found in the population. The objectives of this thesis were: (i) to investigate whether the presence of polymorphisms I405V and TaqIB of CETP gene is associated with HDL-C and subclinical carotid atherosclerosis (n= 207); (ii) to investigate if, in addition to HDL-C, the particle size of HDL is associated with atherosclerosis (n= 284). We determined lipid, lipoprotein profiles and apolipoprotein, C-reactive protein (CRP), antibodies against oxidized LDL, CETP and phospholipid transfer protein (PLTP) activities, HDL2 and HDL3 and HDL size. The TaqIB and I405V CETP polymorphisms were also analyzed. Common carotid artery intima-media thickness (cIMT) was measured using ultrasonography. In the presence of the minor alleles of the TaqIB and I405V polymorphisms of CETP, cIMT was inversely correlated with CETP activity and positively with PLTP activity and antibodies against oxidized LDL. In multivariate analysis, the presence of the minor allele of the TaqIB polymorphism, but not the I405V, was associated with a 5.1 times increased risk of higher cIMT. However, CETP activity did not differ between the presence and absence of minor allele groups of the TaqIB polymorphism. Regarding HDL size, increased HDL size was associated with lower cIMT and was better marker of risk of subclinical carotid atherosclerosis compared to HDL-C. In conclusion, increased size of HDL is independently associated with atherosclerotic and, although TaqIB polymorphism is also associated, its interaction seems to be independent of CETP activity / Doutorado / Clinica Medica / Doutora em Clínica Médica

Generation of foam cells, an essential step for reverse cholesterol transport (RCT) studies, uses the technique of receptor dependent macrophage loading with radiolabeled acetylated Low Density Lipoprotein (Ac-LDL). In this study, we used the ability of a biologically relevant detergent molecule, Lysophosphatidylcholine (Lyso PtdCho), to form mixed micelles with cholesterol or cholesteryl ester (CE) to generate macrophage foam cells. Fluorescent or radiolabelled cholesterol / Lyso PtdCho mixed micelles were prepared and incubated with RAW 264.7 or mouse peritoneal macrophages. Results showed that such micelles were quite stable at 4°C and retained the solubilized cholesterol during one month storage. Macrophages incubated with cholesterol or CE (unlabeled, fluorescently labeled or radiolabeled) / Lyso PtdCho mixed micelles accumulated CE as documented by microscopy, lipid staining, labeled oleate incorporation, and by thin layer chromatography (TLC). Such foam cells unloaded cholesterol when incubated with high density lipoprotein (HDL) and not with oxidized HDL (Ox-HDL). We propose that stable cholesterol or CE / Lyso PtdCho micelles would offer advantages over existing methods. Oxidative stress is associated with heart failure (HF). Previously our research group observed that the patients with low left-ventricular ejection fraction showed accumulation of high level of oxidized LDL (Ox-LDL) when compared with the heart failure patients with normal range of ejection fraction (EF). HDL is known to be atheroprotective and one of its important antioxidative functions is to protect LDL from oxidative modifications. However, HDL itself undergoes oxidation and Ox-HDL becomes functionally poor. It is expected to have a diminished ability to promote reverse cholesterol transport. Therefore, it was hypothesized that the quality of HDL present in the patients with EF would more compromised than those present in the patients with normal EF. Functionality of HDL was evaluated by measuring its cholesterol efflux capacity from foam cells generated in vitro. Functionality of HDL, which is strongly related to the oxidative modifications of HDL was further estimated by measuring paraoxonase 1 (PON1) enzyme activity associated with HDL. Higher the PON1 activity and RCT ability, better is the functionality of HDL.