Interferons have been shown to lower low density lipoprotein (LDL) cholesterol concentrations by 20-50%. To evaluate the effect of interferons on LDL metabolic behavior in individuals with normal and mildly elevated LDL cholesterol levels, autologous LDL labeled with '"I was administered to subjects at baseline and during interferon treatment Interferon beta^^,, (IFN-ft^.,,) was administered intravenously at 4.5 x 10' units daily for at least 3 weeks before the start of kinetic study and continued for an additional 2 weeks. Results were analyzed by using a multicompartmental model that allows for two intravascular LDL compartments. In normal subjects, TFN-fi mttIM reduced LDL cholesterol and apolipoprotein (apo) B levels by 25% and 27%, respectively (p<0.05); LDL apo B synthesis was decreased by 59% (p<0.05). In hypercholesterolemic subjects, IFN-^KH,, reduced LDL cholesterol levels by 38% (p<0.05); however, apo B concentrations and production rates were not significantly decreased. Clearance of LDL from the first intravascular apo B pool was markedly reduced in these subjects, resulting in a shift in the distribution of LDL apo B from the second to the first intravascular LDL apo B pool. We conclude that interferon's actions on LDL metabolism differ in normocholesterolemic and hypercholesterolemic subjects. In normal subjects, interferon decreased LDL cholesterol and apo B levels through a reduction in the LDL apo B production rate. However, in hypercholesterolemic subjects, interferon reduced LDL cholesterol by altering the distribution of apo B mass between LDL subspecies. ( lesterol of 20% and 50% at the two doses studied, 4.5xlO 6 and 9.0 xlO 7 units, respectively. 5 Both doses were well tolerated.The mechanism behind the effects of interferons in reducing LDL cholesterol and apo B concentrations is unknown. Administration of both interferon gamma and alfa inhibits hepatic and lipoprotein lipase activity, enzymes necessary for the synthesis of LDL from very low density lipoprotein (VLDL).46 Inhibition of this pathway may result in decreased synthesis of LDL. On the other hand, interferons may act as important modulators of cellular protein synthesis by upregulating LDL receptors and enhancing LDL clearance. Because LDL synthetic and catabolic rates are abnormal in hypercholesterolemic subjects, the extent to which interferon affects LDL kinetic behavior may also depend on the presence or absence of normal lipoprotein metabolism. The effect of interferon on individuals with hypercholesterolemia has not been studied. The purpose of this study was to evaluate the effect of recombinant human IFN-fte,,,* on LDL composition and metabolism when administered to normal and mildly hypercholesterolemic subjects.
Methods
SubjectsKinetic studies were performed before and after intravenous administration of IFM-fte^ injections to 10 subjects. Six had mild hypercholesterolemia with LDL