Rationale: There is strong evidence that oxidative modification of low-density lipoprotein (oxLDL) plays a critical role in atherogenesis and that oxLDL may profoundly influence the mechanical stability of atherosclerotic plaques.Objective: To block oxLDL, we designed, expressed, and tested Fc-CD68, a soluble oxLDL binding protein consisting of human Fc and the extracellular domain of the human oxLDL-binding receptor CD68.
Methods and Results:Fc-CD68 bound with high specific affinity to oxLDL and strongly bound and colocalized with oxLDL in plaques. To study the effects of repeated administrations of Fc-CD68 on the progression of atherosclerosis and plaque vulnerability, 12-and 16-week old cholesterol-fed ApoE ؊/؊ mice received either Fc-CD68 (n)6؍ or Fc control protein (n6؍ to 8) thrice weekly for 4 weeks. Macroscopic and histological analysis of Sudan red lipid staining showed strong and significant reduction of plaque extension in the aorta and in the aortic root, respectively. Histological analysis of pentachrome-and Sirius-stained sections of the brachiocephalic arteries of 20 week-old ApoE ؊/؊ mice revealed that Fc-CD68 significantly reduced the occurrence of spontaneous ruptures of established plaques by Ϸ20%, compared with Fc and drastically increased the collagen content of plaques. Furthermore, in immunostained sections of the brachiocephalic artery and the aortic root, Fc-CD68 reduced the infiltration of plaques with T lymphocytes, and macrophages by Ϸ50% and 30%, respectively. Key Words: oxLDL Ⅲ atherosclerosis Ⅲ Fc-CD68 Ⅲ soluble oxLDL binding protein O xidatively modified low-density lipoprotein (oxLDL) plays a critical role in atherogenesis and contributes to the progression of atherosclerosis in various ways. 1,2 It can induce the transformation of macrophages into lipid-laden foam cells, 3,4 it is a chemotactic agent for monocytes, and it reduces the motility of macrophages which then become resident in the arterial intima. 5 In addition, oxLDL is recognized as foreign by the immune system. 6 oxLDL-specific T lymphocytes are present in the vessel wall where they are locally restimulated and further stimulate macrophages by cytokine release. 7,8 Furthermore, oxLDL is cytotoxic and damages the endothelium, 9 thereby favoring platelet adhesion. 10 In advanced atherosclerotic lesions, the cytotoxicity of oxLDL may even result in irreversible cell necrosis. 10,11 In addition to contributing to atherosclerosis, oxLDL may profoundly influence the mechanical stability of atherosclerotic plaques, because foam cells offer little mechanical stability and because activated macrophages may secrete factors that weaken plaques, ie, metalloproteinases. 12,13 Rupture of atherosclerotic plaques leads to vascular injury and subsequent myocardial infarction and stroke. Several studies have demonstrated conclusively that the morphology of the atherosclerotic plaques, rather than their size, is predictive for the frequency of plaque ruptures (summarized by Rekhter 14 ). The most relevant morphological characteris...