[Detection of Autoantibodies Against the 1-Adrenergic Receptor in the Sera of Patients via the Competitive cell-Based Enzyme Linked Immunosorbent Assay].

OBJECTIVE: This study aimed to assess the level of anti-1-adrenergic receptor autoantibodies in patients with ventricular arrhythmias with no signs of organic heart disease and with presence of cardiovascular pathology in comparison with a group of healthy volunteers. MATERIAL AND METHODS: The study included 44 patients with ventricular arrhythmias with no signs of organic heart disease ("idiopathic"), 34 patients with diagnosed dilated cardiomyopathy (DCM) of inflammatory origin, 35 patients with coronary heart disease and ventricular arrhythmias, 12patients with coronary heart disease with no ventricular arrhythmias, and 19 healthy volunteers (control group). The level of autoantibodies against the 1-adrenergic receptor was determined by the developed competitive cell-based enzyme-linked immunosorbent assay (ELISA) and by the standard ELISA using peptides corresponding to the second extracellular loop of the 1-adrenergic receptor. RESULTS: Elevated level of autoantibodies detected by a competitive cell-based ELISA was observed in 62% of patients with DCM compared to 21% of healthy volunteers (p=0.0006). In patients with "idiopathic" ventricular arrhythmias, the level of 1-adrenergic receptor autoantibodies was lower than in healthy subjects (p=0.003). Coronary heart disease patients with or without ventricular arrhythmias exhibited no differences from the control group. The number of significantly positive signals in peptide-based ELISA did not exceed 10% in any of the groups. No correlation between the data from competitive cell-based ELISA and peptide-based ELISA was found. CONCLUSIONS: This study demonstrated that competitive cell-based ELISA technique can be applied for detection of 1-adrenergic receptor autoantibodies. The results in DCM patients generally correspond to the expected. Decreased level of autoantibodies in patients with "idiopathic" ventricular arrhythmias indicates that this disease is related to changes in the immune system. Such relation is not observed in the case of coronary heart disease patients.

Interrelation between malonyl dialdehyde-dependent modification and cholesterol content in low-density lipoproteins.

Epidemiological study of an independent representative sample of population revealed a strong positive correlation between the content of oxidized (MDA-modified) LDL and concentration of atherosclerosis biomarkers (total cholesterol and LDL cholesterol) in blood plasma from 348 probands. The correlation between these parameters was more significant in atherosclerotic patients, but was less pronounced in probands with diabetes mellitus. The correlation between the concentration of atherosclerosis markers and content of MDA was absent in probands with diabetes mellitus. These data attest to the presence of LDL-modifying agents differing from MDA (e.g., glyoxal and methylglyoxal) in the blood of diabetes mellitus patients. We conclude that the content of MDA-modified LDL can serve as an additional biomarker of atherosclerosis.

Localization of apolipoprotein E in normal and atherosclerotic human aorta.

To elucidate the role of apolipoprotein E (apo E) in atherogenesis, we have investigated the localization of apo E in normal and atherosclerotic aortas as well as in other tissues of 32 post-mortem individuals. Using double immunofluorescence it has been found that normal intima of individuals older than 20 years and some adolescents contained immunoreactive material that reacted with poly- and monoclonal antibodies to apo E. A staining pattern of apo E differed from that of apolipoprotein B, the latter being seen in normal intima of each child older than 7 years. Apo E was present extracellularly in lipid streaks and atheromatous plaques, where its staining was particularly intensive around the necrotic zone of plaques. Some macrophages in the plaques of 4 aortas exhibited apo E-positive staining, while aortic endothelial and smooth muscle cells never contained apo E. Apo E-positive staining was not found in the majority of vessel cells, it was always, however, observed in other types of cells including hepatocytes. Kupffer cells, spleen macrophages and cerebral astrocytes. Our findings indicate that only some macrophages in human aorta may be responsible for the production of apo E that can participate in reverse cholesterol transport. At the same time, apo E accumulation in the aortic wall may promote the development of atherosclerosis.

Proteolysis of apoprotein B-100 impairs its topography on LDL surface and reduces LDL association resistance.

Serine proteinases (trypsin and chymotrypsin) cause destruction of apolipoprotein B-100 on the surface of human blood LDL. Incubation of LDL with these enzymes increases the mean size of LDL particles. Proteolysis of apolipoprotein B-100 induces changes in surface structure, destabilizes LDL particles, and reduces their association resistance. Presumably, this proteolytic modification of LDL with subsequent association of these particles plays an important role in accumulation of cholesterol in the vascular wall and in the development of early stages of atherosclerosis.

Phospholipid hydrolysis with phospholipases A2 and C impairs apolipoprotein B-100 conformation on the surface of low density lipoproteins by reducing their association resistance.

Modification of apolipoprotein B-100 conformation on the surface of LDL isolated from human blood was demonstrated by enzyme immunoassay with a panel of monoclonal antibodies to this protein. The study by the light transmission fluctuation method showed that incubation of LDL with phospholipases A2 or C led to association of LDL particles. This lipolytic modification seems to impair LDL surface properties inducing association of these particles, which can play an important role in lipid accumulation in the vascular wall and at early stages promote the development of atherosclerosis.

Antigenic differences between apo-B in native and circulating modified low-density lipoproteins.

The state of apo-B in native and circulating modified low-density lipoproteins was studied by solid-phase enzyme immunoassay. We studied the interaction of these particles with monoclonal antibodies to apo-B of low-density lipoproteins. Native and circulating modified low-density lipoproteins had different affinity for the studied antigens. Our results illustrate conformational changes in apo-B of circulating modified low-density lipoproteins compared to native low-density lipoproteins. These changes probably contribute to increased accumulation of particles in vascular cells and their transformation into foam cells giving way to atherosclerotic vascular lesions.

Immunoreactivity of apolipoprotein B-100 in oxidatively modified low density lipoprotein.

Thirteen monoclonal antibodies (MAbs) against apolipoprotein B-100 (apo B) were used to analyze changes in immunoreactivity of human LDL resulting from oxidation mediated by cupric ions and oxygen. Decrease in immunoreactivity of oxidized LDL was demonstrated by competitive ELISA with MAbs 5F8, BL3, Mb43, 2G8, B3, B5, and BL7 for which the epitopes are located within residues 1-1297, 4235-4355, 4027-4081, 3728-4306, 2239-2331, 1854-1878, and in the vicinity of residue 2331, respectively. Immunoreactivity of the epitope B6 (2239-2331) increased during first 4 hours of oxidation and then diminished gradually. Epitope B1 (405-539) had slightly reduced immunoreactivity during first 8 h of LDL oxidation and then its minor increase was observed. MAb 12G10, specific to the epitope within apo B thrombin-digest fragment T4 (1-1297), displayed either weak or strong binding to LDL. LDL with weak binding pattern demonstrated significant increase in immunoreactivity upon oxidation. In contrast, LDL with strong binding pattern showed little to no change. Epitopes Mb47 (3441-3569) and 8G4 (1-1297) remained unchanged in oxidized LDL. Immunoreactivity of apo B-100 epitope recognized by MAb 4C11 (residues 2377-2658) was shown to be a function of oxidation time: it increased progressively up to 16 h and was stabilized for another 24 h of LDL oxidation. This epitope may be unmasked by LDL oxidation and may provide a useful immunochemical marker to monitor the extent of LDL oxidation.

Immunoreactivity of apolipoprotein B-100 and binding to LDL-receptor of phospholipase A2-treated low density lipoproteins.

Lipid--protein particles were obtained by treatment of low density lipoproteins (LDL) with phospholipase A2 from bee venom. Under these conditions, half of the phosphatidylcholine (PC) of LDL was changed to lysophosphatidylcholine (LPC). At the same time, the composition of other lipids and the apoprotein structure were unaffected. Three monoclonal antibodies (MAbs) against various apo B epitopes were used to test immunoreactivity of phospholipase A2-treated LDL (pl-LDL). The apo B epitope interacting with MAb 4C11 (amino acid residues 2377-2658) showed significantly decreased immunoreactivity. Increase in MAb 4C11 binding was demonstrated to depend on oxidation degree of LDL. Thus, changing of half of PC to LPC modified apo B translocation in the lipoprotein globule in an opposite manner as compared with changes induced by oxidative modification. A minor increase in immunoreactivity of pl-LDL with 1D1 MAb against a large middle part of apo B (residues 1297-3249) may be due to the effect of the change of surface lipid composition on the extent of immersion of apo B into the hydrophobic phase. No changes in the interaction of pl-LDL with MAb 2G8 (residues 3748-4306) were observed in comparison with native LDL. This fact demonstrates that 50% phospholipolysis of LDL does not affect the expression of apo B C-terminal residues in pl-LDL. Twofold increase in pl-LDL affinity to immobilized LDL-receptor was shown in contrast to LDL. The data indicate that LPC accumulation in LDL results in better elimination of LDL from the blood stream than in case of accumulation of oxidative products.