Objectives-A low level of high-density lipoprotein (HDL) in plasma has been recognized as an aspect of metabolic syndrome and as a crucial risk factor of cardiovascular events. However, the physiological regulation of plasma HDL levels has not been completely defined. Current studies aim to reveal the contribution of angiopoietin-like protein3 (angptl3), previously known as a plasma suppressor of lipoprotein lipase, to HDL metabolism. Methods and Results-Angptl3-deficient mice showed low plasma HDL cholesterol and HDL phospholipid (PL), and which were increased by ANGPTL3 supplementation via adenovirus. In vitro, ANGPTL3 inhibited the phospholipase activity of endothelial lipase (EL), which hydrolyzes HDL-PL and hence decreases plasma HDL levels, through a putative heparin-binding site in the N-terminal domain of ANGPTL3. Post-heparin plasma in Angptl3-knockout mice had higher phospholipase activity than did that in wild-type mice, suggesting that the activity of endogenous EL is elevated in Angptl3-deficient mice. Furthermore, we established an ELISA system for human ANGPTL3 and found that plasma ANGPTL3 levels significantly correlated with plasma HDL cholesterol and HDL-PL levels in human subjects. Key Words: angptl3 Ⅲ high density lipoprotein Ⅲ endothelial lipase Ⅲ phospholipase Ⅲ triglyceride P lasma concentrations of high-density lipoprotein (HDL) cholesterol are inversely correlated with the risk of atherosclerotic cardiovascular disease. 1 HDL cholesterol levels are low in patients with metabolic disorders, such as obesity, insulin resistance, and diabetes. 2,3 However, the genetic and metabolic factors that regulate HDL metabolism remain to be elucidated. Recently, endothelial lipase (EL) has been recognized as one factor that influences HDL metabolism. EL was originally discovered as a member of the family of triglyceride (TG)-lipases together with lipoprotein lipase (LPL) and hepatic lipase (HL). In contrast to LPL or HL, however, EL has relatively lower triglyceride lipase activity and substantially higher phospholipid lipase activity and can hydrolyze HDL phospholipids (PL). 4 Overexpression of EL in mice resulted in reduced plasma HDL levels and EL knockout mice showed significant increase in HDL levels, [5][6][7] indicating that EL regulates HDL metabolism. Conclusions-Angptl3In the colony of KK mice, characterized by obesity, diabetes mellitus, and hypertriglyceridemia, we recently identified a mutant subgroup of KK/Snk mice with low plasma TG levels despite maintaining the phenotype of obesity and diabetes. Genetic mapping and positional cloning identified the gene of angiopoietin-like protein 3 (Angptl3), which was mutated in the KK/Snk mice. The Angptl3 gene in KK/Snk mice contained a 4-bp nucleotide insertion in exon 6, which caused a premature stop codon attributable to a frameshift, leading to a lack of production of the protein. 8 Angptl3 mRNA is expressed exclusively in the livers of humans and mice. ANGPTL3 protein contains a signal sequence of 18 amino acids at the N terminus, followed b...

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A new member of the lipase gene family, initially termed endothelial lipase (gene nomenclature, LIPG; protein, EL), is expressed in a variety of different tissues, suggesting a general role in lipid metabolism. To assess the hypothesis that EL plays a physiological role in lipoprotein metabolism in vivo, we have used gene targeting of the native murine locus and transgenic introduction of the human LIPG locus in mice to modulate the level of EL expression. Evaluation of these alleles in a C57Bl/6 background revealed an inverse relationship between HDL cholesterol level and EL expression. Fasting plasma HDL cholesterol was increased by 57% in LIPG–/– mice and 25% in LIPG+/– mice and was decreased by 19% in LIPG transgenic mice as compared with syngeneic controls. Detailed analysis of lipoprotein particle composition indicated that this increase was due primarily to an increased number of HDL particles. Phospholipase assays indicated that EL is a primary contributor to phospholipase activity in mouse. These data indicate that expression levels of this novel lipase have a significant effect on lipoprotein metabolism

Objective-C-reactive protein (CRP), a predictor of cardiovascular events, localizes in atherosclerotic arteries and exerts proinflammatory effects on vascular cells. Reactive oxygen species (ROS) have been implicated in atherogenesis and plaque instability. Methods and Results-Expressional pattern of CRP in directional coronary atherectomy specimens from 39 patients was examined. Characteristics of histological plaque instability and higher levels of serum CRP and fibrinogen were associated with the CRP immunoreactivity. In situ hybridization revealed the presence of CRP mRNA in coronary vasculature. Furthermore, the expression of CRP mRNA and protein was detected in cultured human coronary artery smooth muscle cells (CASMCs) by reverse transcriptase-polymerase chain reaction and Western blotting. In addition, CRP was frequently colocalized with p22 phox , an essential component of NADH/NADPH oxidase, which is an important source of ROS in vasculature. Moreover, the incubation of cultured CASMCs with CRP resulted in the enhanced p22 phox protein expression and in the generation of intracellular ROS. Conclusions-The expression of CRP in coronary arteries was associated with histological and clinical features of vulnerable plaque, and it had a prooxidative effect on cultured CASMCs, suggesting that it might play a crucial role in plaque instability and in the pathogenesis of acute coronary syndrome via its prooxidative effect. Key Words: C-reactive protein Ⅲ inflammation Ⅲ oxidative stress Ⅲ free radicals Ⅲ coronary artery diseases A therosclerosis is a chronic inflammatory disease. This concept is supported by recent findings where systemic inflammatory markers such as C-reactive protein (CRP) and fibrinogen are regarded as strong predictors of cardiovascular complications in various clinical settings. [1][2][3] Fibrinogen, a key coagulation factor, is considered to contribute atherogenesis by promoting platelet aggregation, fibrin formation, and plasma viscosity. 4 However, the role of CRP in the pathogenesis of atherosclerotic vascular diseases remains unknown. Recent histological investigations have demonstrated that CRP is present in the human arterial intima at atherosclerotic lesions and is frequently colocalized with the terminal complement complex. 5 Moreover, in vitro studies have shown that the stimulation of human endothelial cells with CRP induces the expression of adhesion molecules and monocyte chemoattractant protein-1 (MCP-1). 6,7 These data suggest that CRP might have direct proinflammatory effects on vascular cells which might, in part, explain the involvement of inflammation in atherogenesis.Reactive oxygen species (ROS) have been implicated in the pathogenesis of a variety of vascular diseases, including atherosclerosis. To date, many types of cells in vasculature have been shown to generate ROS. There are various potential sources that generate ROS in vascular cells: the mitochondrial electron transport chain, cyclooxygenase, lipoxygenase, xanthine oxidase, and NADH/NADPH oxidase. 8,9 Recent ...

BackgroundThe objective of this study was to investigate the impact of sodium glucose cotransporter type 2 (SGLT2) inhibitors on left ventricular (LV) diastolic function of type 2 diabetes mellitus (T2DM) patients with heart failure (HF).MethodsThis trial was a prospective multicenter study of 58 T2DM patients with stable HF at five institutions in Japan. Patients who had been taking at least one antidiabetic drugs other than SGLT2 inhibitors started the administration of 5 mg/day of dapagliflozin. The physical examinations, blood tests, and echocardiography were performed at baseline and 6 months after administration of dapagliflozin. The primary endpoint was defined as a change in mitral inflow E and mitral e′ annular velocities (E/e′) between baseline and 6 months after the administration of dapagliflozin. The secondary end points consisted of a change in brain natriuretic peptide (BNP), LV mass index (LVMI) and left atrial volume index (LAVI).ResultsE/e′ significantly decreased from 9.3 to 8.5 cm/s (p = 0.020) 6 months after administration of dapagliflozin. LAVI and LVMI significantly decreased from 31 to 26 mL/m2 (p = 0.001), and from 75.0 to 67.0 g/m2 (p < 0.001), respectively, 6 months after administration of dapagliflozin. No significant change was observed in BNP (from 27.9 to 28.9 pg/mL; p = 0.132) 6 months after administration of dapagliflozin, except for a significant decrease from 168.8 to 114.3 pg/mL (p = 0.012) in patients with BNP ≥ 100 pg/mL.ConclusionThis prospective multicenter trial showed the beneficial effect of SGLT2 inhibitors on LV diastolic functional parameters for T2DM patients with HF. Our findings may thus offer a new insight into the management of T2DM patients.Trial registration UMIN000019789, Registered 28 September 2014, Date of registration: 11/14/2015, Date of enrolment of the first participant to the trial: 6/15/2016, Date of enrolment of the last participant to the trial: 12/9/2017

The literature concerning Schwann cells (SCs) and macrophages in myelin phagocytosis during Wallerian degeneration is reviewed. SCs carry out the first step in the removal of myelin by segmenting myelin and then incorporating the degraded myelin. The recruited macrophages then join in the myelin-phagocytosis event, appearing to make full use of their original phagocyte abilities until the end of myelin clearance. The molecular mechanisms of the two cells underlying myelin phagocytosis are thought to be different; myelin phagocytosis by SCs being lectin-mediated, i.e., opsonin-independent, whereas that of macrophages is mainly opsonin-dependent. It is important to note that SCs and macrophages cooperatively accomplish myelin phagocytosis.

Objective-To determine whether the administration of an active form of vitamin D 3 (calcitriol) could prevent atherosclerosis through anti-inflammatory actions. Methods and Results-Recent clinical studies have shown that lack of vitamin D 3 is a risk factor for cardiovascular events.Oral calcitriol administration decreased atherosclerotic lesions, macrophage accumulation, and CD4 ϩ T-cell infiltration at the aortic sinus, when compared with the corresponding observations in control mice. We observed a significant increase in Foxp3 ϩ regulatory T cells and a decrease in CD80 ϩ CD86 ϩ dendritic cells (DCs) in the mesenteric lymph nodes, spleen, and atherosclerotic lesions in oral calcitriol-treated mice in association with increased interleukin 10 and decreased interleukin 12 mRNA expression. CD11cϩ DCs from the calcitriol group showed reduced proliferative activity of T lymphocytes, suggesting the suppression of DC maturation. Neutralization of CD25 in vivo revealed that calcitriol inhibited atherosclerosis mainly in a regulatory T cell-dependent manner but also partly because of a decrease in DC maturation. , is a secosteroid hormone that not only plays a central role in bone and calcium metabolism but also modulates the immune response. Recent epidemiological studies have shown a relationship between low plasma levels of vitamin D 3 and a predisposition to cardiovascular events. [1][2][3] This finding is supported by a meta-analysis showing that oral vitamin D 3 treatment contributes to the improvement of mortality from all causes, in part by decreasing cardiovascular deaths. 4 Transgenic rats constitutively expressing vitamin D-24-hydroxylase, a model of vitamin D 3 deficiency, showed aggravated atherosclerosis under a high-fat and high-cholesterol diet, when compared with control rats. 5 However, there are no reports about the direct effects of an orally administered active form of vitamin D 3 on atherosclerosis. Conclusion-Oral See accompanying article on page 2317It is widely recognized that atherosclerosis is a complex inflammatory disease of the arterial wall, 6,7 in which the T-lymphocyte-mediated pathogenic immune response plays a critical role. Clinical strategies developed to modulate the immune response have been insufficient for preventing atherosclerosis. Cumulative data based on experimental animal models suggest that CD4 ϩ T cells are present within plaques from the initial stages of the disease in mice, and adaptive transfer of these cells is potentially proatherogenic. 8 Accumulating evidence has revealed novel functions of several subsets of regulatory T cells (Tregs), which maintain immunologic tolerance to self-antigens and inhibit atherosclerosis development by suppressing the inflammatory response of effector T cells. 9 -12 These studies have provided new insights into the immunopathogenesis of atherosclerosis and imply that promotion of regulatory immune responses may have therapeutic potential for suppression of atherosclerotic diseases.In addition to Tregs, dendritic cells (DCs) are al...