Scavenger receptor BI (SR-BI) is the major receptor for high-density lipoprotein (HDL) cholesterol (HDL-C). In humans, high amounts of HDL-C in plasma are associated with a lower risk of coronary heart disease (CHD). Mice that have depleted Scarb1 (SR-BI knockout mice) have markedly elevated HDL-C levels but, paradoxically, increased atherosclerosis. The impact of SR-BI on HDL metabolism and CHD risk in humans remains unclear. Through targeted sequencing of coding regions of lipid-modifying genes in 328 individuals with extremely high plasma HDL-C levels, we identified a homozygote for a loss-of-function variant, in which leucine replaces proline 376 (P376L), in SCARB1, the gene encoding SR-BI. The P376L variant impairs posttranslational processing of SR-BI and abrogates selective HDL cholesterol uptake in transfected cells, in hepatocyte-like cells derived from induced pluripotent stem cells from the homozygous subject, and in mice. Large population-based studies revealed that subjects who are heterozygous carriers of the P376L variant have significantly increased levels of plasma HDL-C. P376L carriers have a profound HDL-related phenotype and an increased risk of CHD (odds ratio = 1.79, which is statistically significant).

No abstract

We investigated the influence of sympathetic nervous system processes on mucosal immunity by comparing the effects of beta-adrenoceptor blockade with 40 mg propranolol and placebo on secretory immunoglobulin A (sIgA) at rest and during paced serial arithmetic, cold pressor, and submaximal cycling. These tasks produced patterns of cardiovascular activity indicative of combined alpha- and beta-adrenergic, alpha-adrenergic, and beta-adrenergic activation, respectively. The effectiveness of the beta blockade was confirmed by the attenuation under propranolol of the shortening of the cardiac preejection period and the tachycardia elicited by mental arithmetic and exercise. The cold pressor test did not affect sIgA under either the placebo or the propranolol. Mental arithmetic increased sIgA concentration, and this increase was not blocked by propranolol. Exercise elicited increases in both sIgA concentration and sIgA secretion rate, which were not diminished by beta blockade. These data suggest that sIgA is not regulated by beta-adrenergic mechanisms.

To examine gender differences in immune reactions to stress and relationships between immune and cardiovascular reactivity, measures of cellular and mucosal immunity and cardiovascular activity were recorded in 77 men and 78 women at rest and in response to active~mental arithmetic! and passive~cold pressor! stress tasks. Both tasks reduced CD4ϩ T cells and the CD408 ratio. Total lymphocytes, NK cells, CD8ϩ T cells, and secretory immunoglobulin à sIgA! increased with active stress. Passive stress decreased sIgA. At rest, men had more NK cells, less CD4ϩ T cells, and fewer neutrophils than women. Mental stress increased sIgA in men but not women. Cardiovascular reactivity to active stress was associated with increases in NK cells. The data support the hypothesis that stress-related increases in lymphocytes are beta-adrenergically mediated, and suggest that the fall in CD4ϩ T cells may be alpha-adrenergically driven. Mechanisms underlying sIgA reactions are more difficult to determine. Men and women differed in some cell counts, but not in reactivity, although gender influenced sIgA reactions to arithmetic.

The role of the autonomic nervous system in secretory immunoglobulin A (sIgA) responses to laboratory challenge was explored in a study in which sIgA and cardiovascular activity were recorded at rest and during mental arithmetic and paced breathing. These tasks were selected to preferentially engage the sympathetic and parasympathetic nervous systems, respectively. Mental arithmetic elicited a mixed pattern of increased alpha- and beta-adrenergic activity and a reduction in parasympathetic activity; diastolic blood pressure, total peripheral resistance, and systolic blood pressure increased, preejection period shortened, and heart rate variability decreased. In contrast, paced breathing primarily elicited an increase in parasympathetic activity; heart rate variability increased. Mental arithmetic also provoked an increase in sIgA concentration but no change in saliva volume, whereas paced breathing affected neither sIgA concentration nor saliva volume. These data suggest that sIgA responses to laboratory challenges are mediated by sympathetic rather than parasympathetic processes.