Influence of serum amyloid A on cholesterol esterification in human plasma.

Lecithin-cholesterol acyltransferase (EC 2.3.1.43, LCAT) is the enzyme responsible for the formation of the bulk of cholesteryl ester in human plasma. The LCAT-reaction takes place mainly on high-density lipoproteins and requires an apolipoprotein as activator. Besides apolipoprotein (apo) A-I several other potent activator apolipoproteins (AIV, E and CI) were identified, furthermore apo A-II was shown to be a modulator of the enzyme's reaction in the presence of apo A-I. Serum amyloid A, an apolipoprotein mainly associated with high-density lipoprotein, massively accumulates in plasma upon acute phase reactions. We therefore studied the possible influence of this acute phase reactant on cholesterol esterification in human plasma. There was a significant decrease of esterified cholesterol in plasma during acute phase reaction. We found a highly significant correlation between the unesterified part of plasma cholesterol and serum amyloid A levels (r = 0.694, P = 0.0001). Also, plasma LCAT activity was negatively correlated with serum amyloid A levels. Lipoproteins containing apo A-I and A-II (LpA-I: A-II) and lipoproteins containing apo A-I but no A-II (LpA-I) decreased significantly with the appearance in plasma of serum amyloid A. To study the influence of serum amyloid A on the LCAT reaction, artificial substrates were prepared either by a detergent dialysis procedure or by addition of apolipoprotein to a sonicated aqueous dispersion of lipid. In addition two different molar ratios of apolipoprotein/phospholipid (PC) (1:50 and 1:310) were chosen at a constant molar ratio of total cholesterol/PC of 1:20. The various substrates were incubated with purified LCAT enzyme. DMPC - or egg yolk phosphatidylcholine - cholesterol-[4-14C]cholesterol-serum amyloid A complexes per se did not stimulate LCAT activity significantly. However, apo serum amyloid A incorporated together with apo A-I by a detergent dialysis procedure lead at low concentrations of serum amyloid A to a marked increase in cholesteryl ester formation as compared to apo A-I alone but inhibited the cholesteryl ester formation at high concentrations. Thus, the low levels of esterified cholesterol in acute phase plasma are to some extent due to decreased plasma enzyme activity and in part may be due to interference of apo serum amyloid A with the natural substrate complexes of plasma HDL.

Effect of alcohol intake on human apolipoprotein A-I-containing lipoprotein subfractions.

High-density lipoprotein comprises two main types of lipoprotein particles: (1) those that contain apolipoproteins A-I and A-II, designated LpA-I:A-II, and (2) those that contain apolipoprotein A-I but not apolipoprotein A-II, designated LpA-I. Both have been extensively studied and are believed to represent distinct metabolic entities that may confer differing protection against coronary artery disease risk. We have previously suggested that LpA-I might represent the antiatherogenic effect, which has been ascribed mainly to its effect on high-density lipoprotein cholesterol; we set out to investigate, in 344 men, the relation between LpA-I:A-II and LpA-I levels and alcohol consumption. As the alcohol intake rose, LpA-I:A-II levels increased, while LpA-I levels fell. On the assumption that LpA-I is the antiatherogenic fraction of high-density lipoprotein, the putative protective action of alcohol consumption against coronary artery disease should be reconsidered.

Differential role of apolipoprotein AI-containing particles in cholesterol efflux from adipose cells.

Cholesterol efflux was studied in cultured Ob1771 adipose cells after preloading with LDL cholesterol. Exposure to particles containing apo AII (LpAI) and particles containing apo AI and apo AII (LpAI:AII) isolated from native human plasma, and from HDL2 or HDL3, showed that only LpAI were able to promote cholesterol efflux, despite the fact that both kinds of particles were able to bind to receptor sites within the same range of concentrations (apparent Kd values between 10 and 25 micrograms/ml). During this long-term exposure, LpAI:AII demonstrated a concentration-dependent inhibition (10-60 micrograms/ml) of LpAI-mediated cholesterol efflux from adipose cells under conditions where LpAI:AII did not deliver cholesterol to the cells and where no net change in the distribution of apo AI between LpAI and LpAI:AII was observed. The antagonizing and modulating role of LpAI:AII in preventing cholesterol efflux mediated by LpAI appears not to be related to the lipid composition and cholesterol content of the particles but, rather, appears dependent upon the presence of apo AI in LpAI particles and apo AII in LpAI:AII particles. The actual concentrations of these particles in the interstitial fluid bathing peripheral cells might be critical for the in vivo occurrence of cholesterol efflux.

Apolipoprotein A-I containing lipoproteins in coronary artery disease.

At least 2 main types of lipoprotein particles are identified within HDL. Those which contain apo A-I and apo A-II (LpA-I:A-II) and those which contain apo A-I but not apo A-II (LpA-I). This study was designed to elucidate to what degree the HDL cholesterol decrease observed in coronary artery disease affects these 2 types of lipoprotein particles. Concentrations of LpA-I:A-II and LpA-I were measured in plasma from 100 normolipidemic male subjects with angiographically defined coronary artery disease (CAD(+)) or without CAD (CAD(-)) and from 50 control subjects, matched for age. CAD(+) subjects had significantly lower levels of HDL cholesterol, total apo A-I, and LpA-I than controls. When compared to CAD(-) subjects, only their levels of HDL cholesterol and LpA-I were found lower. In both cases (CAD(+) vs CAD(-) and CAD(+) vs controls), LpA-I levels were decreased while LpA-I:A-II levels were unchanged. Even, when the levels of their total plasma lipids and lipoproteins are normal, atherosclerotic patients are characterized by a different distribution of apo A-I between LpA-I and LpA-I:A-II. These data support the view that LpA-I might represent the "antiatherogenic" fraction of HDL.

Detection of human apolipoprotein B polymorphic species with one monoclonal antibody (BIP 45) against low density lipoprotein. Influence of this polymorphism on lipid levels and coronary artery stenosis.

The immunoreactivity of apolipoprotein B (apo B) in plasma samples obtained from a variety of subjects was analysed by non-competitive ELISA with a polyclonal and a monoclonal (BIP 45) anti-LDL antibody. Three populations were tested: the first, comprising 244 healthy male volunteers, provided reference values; the second consisted of a population undergoing coronary angiography (n = 88) and was divided into a subgroup with (n = 64) and without (n = 24) coronary artery disease (CAD); the third was made up of 56 patients with heterozygous familial hypercholesterolemia. Total apo B (measured with the polyclonal antibody) was increased in the populations with CAD and in the heterozygous familial hypercholesterolemic subjects compared to the reference population. When monoclonal antibody BIP 45 was used in the non-competitive ELISA, three different patterns emerged in each population, corresponding to weak, intermediate and strong binding of the particles containing apo B to the monoclonal antibody. This may result from genetic polymorphism of apo B, and in the reference population the data fit a model consisting of two co-dominant apo B alleles (BIP(-) and BIP(+]; the 3 subpopulations then correspond to the 2 homozygotes and the heterozygote. The number of patients whose particles bound weakly to monoclonal BIP 45 antibody was low in the CAD population, while intermediate binding was increased in this group. Nevertheless, when the analysis of variance of allele BIP(-) was studied no significant difference between groups was established. This finding indicates that the genetic difference in apo B detected by BIP 45 may not be significant in the development of CAD. Furthermore, the apo B genetic polymorphism detected by BIP 45 is not associated with a particular lipoprotein level in the reference population.

A monoclonal antibody (BIP 45) detects Ag(c,g) polymorphism of human apolipoprotein B.

A monoclonal antibody (BIP 45) against human apolipoprotein B (apo B) was used to study the polymorphism of apo B in families and in unrelated subjects. BIP 45 bound to apo B-containing lipoprotein particles in one of three distinct patterns of immunoreactivity (strong, weak and intermediate). Family studies showed that these binding patterns result from co-dominant transmission of apo B allelic pairs which are temporarily designated allele BIP- and allele BIP+; allele BIP+ would code for the apo B BIP 45 epitope. Analysis of plasma samples from 244 unrelated men randomly chosen from the North French population indicated that 46.7% of them bound BIP 45 with low affinity (weak reactors), 44.7% with intermediate affinity (intermediate reactors) and 8.6% with high affinity (strong reactors). According to the Hardy-Weinberg equilibrium, this corresponds to gene frequencies of 0.690/0.310 for the type BIP-/BIP+ alleles. This corresponds to the gene frequencies of 0.695/0.305 at the Ag(g)/Ag(c) locus previously found in a Caucasian population. Furthermore, the investigation of Ag(c,g) and of monoclonal BIP 45 antibody immunoaffinity for 30 individual plasma samples showed that BIP 45 bound strongly to Ag(c) factor, whereas it bound weakly to the allelic Ag(g) factor. This monoclonal antibody will be useful for the detection of the two corresponding apo B species designated apo B (Ag(c) factor, BIP+) and apo B (Ag(g) factor, BIP-).

Quantitative determination of human plasma apolipoprotein A-I by a noncompetitive enzyme-linked immunosorbent assay.

A noncompetitive enzyme-linked immunosorbent assay (ELISA) for human plasma apolipoprotein A-I (ApoA-I) was developed. Microtiter plates were coated with purified antibodies to ApoA-I and blocked. Plasma samples from normolipidemic and hypertriglyceridemic subjects were added and ApoA-I was allowed to bind to coating antibodies. After washing, the amount of ApoA-I bound to microtiter plates was estimated with horseradish peroxidase-labeled antibodies to ApoA-I. A single step delipidization procedure was included to expose masked antigenic sites of ApoA-I in plasma. The average concentration of ApoA-I in plasma of normolipidemic subjects was 1.37 g/l. Recovery of ApoA-I added to plasma varied from 93-107%. Intra- and inter-assay coefficients of variations were 4 and 8%, respectively. The assay was also used for quantifying ApoA-I in lipoprotein density classes. There was a good correlation between this assay and electroimmunoassay (r = 0.84-0.92). The described sandwich ELISA is a specific, precise, sensitive and relatively simple method for measuring ApoA-I levels in human plasma.

Serum apolipoprotein A-II, a biochemical indicator of alcohol abuse.

The possible use of high density lipoprotein (HDL) cholesterol, HDL phospholipids, apolipoproteins (APO) A-I and A-II as markers of alcohol abuse was studied in 78 intemperate drinkers. The mean value for each of these parameters was higher in drinkers than in control subjects. The most significant increase was observed in the plasma apo A-II levels (+45%). A composite index of gammaglutamyltranspeptidase (GGTP) and apo A-II was superior to GGTP alone in discriminating drinkers (+14%). Moreover, apo A-II assay is simple to perform.

[Methods for analyzing lipoproteins]. / Méthodes d'analyse des lipoprotéines.

In recent years there have been considerable advances and changes in the investigations available to study lipoprotein metabolic disorders. The methods used up to now were based on physicochemical criteria (electrophoresis, ultracentrifugation, polyanionic precipitation). But the recent demonstration of the preponderant role of apoproteins in lipoprotein metabolism makes it essential to develop a method of analysis lipoproteins at the molecular level. Immunological methods seem to be the most appropriate and should allow us to study lipoprotein metabolism more closely.

[Receptors and molecular heterogeneity of lipoprotein particles containing apolipoprotein A-I]. / Récepteurs et hétérogénéité moléculaire des particules lipoprotéiques contenant l'apolipoprotéine A-I.

High density lipoproteins (HDL) are heterogeneous, with respect to their hydrated density (HDL2, HDL3), and to their apolipoprotein composition (Lp A-I : A-II contains both apolipoprotein A-I and A-II, Lp A-I contains apolipoprotein A-I but not apolipoprotein A-II). Lp A-I and Lp A-I and Lp A-I : A-II particles have different metabolic functions. Only Lp A-I particles seem to be involved in the antiatherogenic role of HDL. Alcohol consumption raises Lp A-I : A-II level but not Lp A-I. Different tissue possess specific binding sites for HDL: steroidogenic tissue, hepatocytes peripheral cells. Apolipoprotein A-I and/or A-II are possible ligands. HLD, after binding to the receptor, can provide the cells with cholesterol, or promote an efflux of cholesterol from the cells and the "reverse cholesterol transport" from the peripheral cells to the liver. The HDL subfractions possess different metabolic roles: binding of Lp A-I to mouse adipose cell receptors promotes cholesterol efflux. Apo A-II are antagonists for this effect.

[Quantitative analysis of apolipoproteins and lipoprotein particles in patients with head injuries]. / Analyse quantitative des apolipoprotéines et des particules lipoprotéiniques chez les traumatisés crâniens.

By head-injured patients, apo A-I and apo A-II concentrations were more decreased in HDL3 than in HDL2. Then, the plasmatic concentrations of the main lipoprotein particles present in HDL fraction were modified. For example, a significant decrease of Lp A-I: A-II particles was observed and this variation was similar to that of total apo A-I (r = 0.78). On the other hand, the concentration of Lp A-I particles was slightly modified, apo C-III concentration was markedly decreased whereas apo E concentration was significantly increased (p less than 0.05); in plasma samples obtained 10 days after a severe head injury, apo E reached three times the normal value.

[Assay of serum apolipoprotein A-II by electro-immunodiffusion on ready-for-use plates. Clinical applications]. / Dosage de l'apolipoprotéine A-II sérique par électro-immunodiffusion sur plaques prêtes à l'emploi. Applications cliniques.

Few papers have been devoted to the study of apolipoprotein A-II (apo A-II), one of the major peptides contained in HDL, probably because of the methodological difficulties associated with its assay. The aim of this study is to provide the clinical biochemist with a simply easy to use assay technique. We have been able to demonstrate the practical value of apo A-II assay in hepatology and in the detection of excessive drinkers. On the other hand, our results indicate that apo A-II is not a parameter of choice for the detection of coronary atherosclerosis.

[Influence of alcohol on plasma lipids and atherogenesis. Epidemiological and biochemical aspects]. / Influence de l'alcool sur les lipides plasmatiques et l'athérogenèse. Aspects épidémiologique et biochimique.

The results of epidemiological and clinical studies published since 1980 concerning the effects of alcohol intake on coronary artery disease are rather contradictory. Although some protective action of alcohol, notably of wine against atherosclerosis, has been described by some authors, the methodological limitations of these studies make it impossible to establish a cause-effect relationship in this matter. Biochemical studies have provided a more precise approach of the effect of alcohol on the mechanism of atherosclerosis. An increase of HDL has been shown in patients who regularly consume alcoholic drinks. However, a detailed analysis of HDL subfractions (and notably HDL2 regarded as an antiatherogenic lipoprotein) has given equally contradictory results. When the antiatherogenic lipoprotein particles present in HDL are accurately identified, the physiopathological consequences of regular alcohol consumption will be more clearly determined. Biochemical and epidemiological information is still insufficient for us to attribute an antiatherogenic effect to alcohol.