F2-isoprostanes are bioactive prostaglandin (PG)-like compounds that are produced from arachidonic acid through a nonenzymatic process of lipid peroxidation catalyzed by oxygen free-radicals. 8-Epi-PGF2 alpha may amplify the platelet response to agonists, circulates in plasma, and is excreted in urine. We examined the hypothesis that the formation of 8-epi-PGF2 alpha is altered in patients with hypercholesterolemia and contributes to platelet activation in this setting. Urine samples were obtained from 40 hypercholesterolemic patients and 40 age- and sex-matched control subjects for measurement of immunoreactive 8-epi-PGF2 alpha. Urinary excretion of 11-dehydro-thromboxane (TX) B2, a major metabolite of TXA2, was measured as an in vivo index of platelet activation. Low-dose aspirin, indobufen, and vitamin E were used to investigate the mechanism of formation and effects of 8-epi-PGF2 alpha on platelet activation. Urinary 8-epi-PGF2 alpha was significantly (P = .0001) higher in hypercholesterolemic patients than in control subjects: 473 +/- 305 versus 205 +/- 95 pg/mg creatinine. Its rate of excretion was inversely related to the vitamin E content of LDL and showed a positive correlation with urinary 11-dehydro-TXB2. Urinary 8-epi-PGF2 alpha was unchanged after 2-week dosing with aspirin and indobufen despite complete suppression of TX metabolite excretion. Vitamin E supplementation was associated with dose-dependent reductions in both urinary 8-epi-PGF2 alpha and 11-dehydro-TXB2 by 34% to 36% and 47% to 58% at 100 and 600 mg daily, respectively. We conclude that the in vivo formation of the F2-isoprostane 8-epi-PGF2 alpha is enhanced in the vast majority of patients with hypercholesterolemia. This provides an aspirin-insensitive mechanism possibly linking lipid peroxidation to amplification of platelet activation in the setting of hypercholesterolemia. Dose-dependent suppression of enhanced 8-epi-PGF2 alpha formation by vitamin E supplementation may contribute to the beneficial effects of antioxidant treatment.

Low density llpoproteins (LDL) collected from 18 fasting humans were subjected to ion exchange chromatography on DEAE Sepharose. By this procedure, a LDL subfraction was isolated with an electric charge more negative than the LDL bulk. This LDL appeared to be mainly characterized by low phospholipld content, high free cholesterol and protein content, low esterlfled/free cholesterol ratio, and a high content of conjugated dlenes, particularly of cholesterol esters. This subtraction, In an amount ranging from 5% to 20% of total LDL, was characterized by the presence of apo B-100 and protein aggregates that were reactive to anti-apo B monoclonal antibodies. Electron microscopy showed the more electronegative LDL to be heterogeneous in size with a tendency to aggregate. This LDL had low binding capacity with high affinity receptors of flbroblasts and low Immunoreactlvlty with the monoclonal antibodies that recognize the receptor binding domain of apo B. Finally, the Incubation of this LDL subtraction with cultured macrophages led to a higher Increase In cellular cholesterol In spite of a lower rate of uptake as compared to the LDL bulk and to acetyl-LDL. The more electronegative LDL subtraction that we Isolated for chemlcophyslcal behavior and conjugated dlene content may represent the peroxldized aliquot of human LDL (Arteriosclerosis 8:79-87, January/February 1988) N umerous studies have demonstrated that the plasma low density lipoproteins (LDL) are a heterogeneous collection of particles that vary in size, 1 density, 2 composition, 3 and electric charge. 4 The metabolic basis and physiological significance of LDL subtractions are unknown, although it now seems possible that some LDL forms are more atherogenic than others.5 Recently a series of in vitro studies proved that modified forms of LDL, being more negatively charged than native LDL, cause accumulation of cholesterol esters in cultured macrophages 6 -7 -8 and induce cytotoxicity in cultured endothelial cells.9 ' 10 The in vivo correlate of modified forms of LDL has not yet been identified although negatively charged LDL have been demonstrated in human atherosclerotic lesions.11 This paper reports data on the isolation and partial characterization of a subtraction of plasma LDL more electronegative than normal LDL. This was accomplished through separation of LDL collected from fasting subjects by ion exchange chromatography. Because modification of LDL mostly involves a free radical-initiated lipoprotein peroxidation, 91 10 ' 12 the extent of lipid peroxidation was also analyzed in the two LDL fractions obtained. Chemical and chemicophysical characterization of the more electronegative LDL, as well as its content of conjugated dienes of cholesterol and triglyceride free fatty acids, supports the From the Regional General Hospital, Regional Center for Atherosclerosis, Venice, Italy.Address for reprints: Pietro Avogaro, Regional General Hospital, 30100 Venice, Italy.This work was partly supported by Grant 84.02179.56 CNR, Consiglio Nazionale delle Ricerche, ...

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Objective-To better understand the role of lecithin:cholesterol acyltransferase (LCAT) in lipoprotein metabolism through the genetic and biochemical characterization of families carrying mutations in the LCAT gene. Methods and Results-Thirteen families carrying 17 different mutations in the LCAT gene were identified by Lipid Clinics and Departments of Nephrology throughout Italy. DNA analysis of 82 family members identified 15 carriers of 2 mutant LCAT alleles, 11 with familial LCAT deficiency (FLD) and 4 with fish-eye disease (FED). Forty-four individuals carried 1 mutant LCAT allele, and 23 had a normal genotype. Plasma unesterified cholesterol, unesterified/total cholesterol ratio, triglycerides, very-low-density lipoprotein cholesterol, and pre-␤ high-density lipoprotein (LDL) were elevated, and high-density lipoprotein (HDL) cholesterol, apolipoprotein A-I, apolipoprotein A-II, apolipoprotein B, LpA-I, LpA-I:A-II, cholesterol esterification rate, LCAT activity and concentration, and LDL and HDL 3 particle size were reduced in a gene-dose-dependent manner in carriers of mutant LCAT alleles. No differences were found in the lipid/lipoprotein profile of FLD and FED cases, except for higher plasma unesterified cholesterol and unesterified/total cholesterol ratio in the former. Conclusion-In a large series of subjects carrying mutations in the LCAT gene, the inheritance of a mutated LCAT genotype causes a gene-dose-dependent alteration in the plasma lipid/lipoprotein profile, which is remarkably similar between subjects classified as FLD or FED. Key Words: familial lecithin:cholesterol acyltransferase deficiency Ⅲ fish eye disease Ⅲ high-density lipoproteins Ⅲ lecithin:cholesterol acyltransferase Ⅲ mutation T he lecithin:cholesterol acyltransferase (LCAT) (phosphatidylcholine:sterol-O-acyltransferase; EC 2.3.1.43) enzyme is responsible for the synthesis of cholesteryl esters (CE) in plasma. 1 Through this action, LCAT plays a central role in the formation and maturation of high-density lipoproteins (HDL), and in the intravascular stage of reverse cholesterol transport, the major mechanism by which HDL modulate the development and progression of atherosclerosis. A defect in LCAT function would be expected to enhance atherosclerosis by interfering with this process.The human LCAT gene encompasses 4.2 kilobases and is localized in the q21-22 region of chromosome 16. Methods SubjectsProbands with primary hypoalphalipoproteinemia (HALP), defined by a plasma HDL-C level below the fifth percentile for the age-and sex-matched general population, were identified by Lipid Clinics and Departments of Nephrology throughout Italy. Plasma samples were analyzed for total and unesterified cholesterol; in 18 unrelated index cases, the results were suggestive of a defect in the LCAT gene. Genetic analysis revealed that 13 of 18 index cases carried at least 1 mutant LCAT allele. Relatives of the 13 probands were invited to participate in the study. All subjects gave an informed consent. Blood samples were collected after an overni...