lesterol transport during the acute phase response but not group IIA secretory phospholipase A 2 . J. Lipid Res . 2010. 51: 743-754.
Supplementary key words feces • infl ammation • sepsis • atherosclerosis • miceEpidemiological studies established a strong inverse association between plasma HDL cholesterol levels and the risk of atherosclerotic cardiovascular disease (CVD) ( 1, 2 ). A major anti-atherogenic activity of HDL is regarded to be reverse cholesterol transport (RCT), a process comprising removal of excess cholesterol from peripheral cells, most importantly macrophage foam cells in atherosclerotic lesions, and transport back to the liver for subsequent excretion into bile and feces ( 2, 3 ). Understanding the pathophysiological factors regulating RCT is therefore of prime importance.Infl ammation is strongly linked to atherosclerosis ( 4-6 ). The atherosclerotic plaque itself is increasingly considered a site of chronic infl ammation within the vessel wall ( 5, 7 ). In addition, markers of infl ammation are elevated in plasma of patients with established atherosclerotic CVD, and circulating levels of several acute phase proteins Abstract Atherosclerosis is linked to infl ammation. HDL protects against atherosclerotic cardiovascular disease, mainly by mediating cholesterol effl ux and reverse cholesterol transport (RCT). The present study aimed to test the impact of acute infl ammation as well as selected acute phase proteins on RCT with a macrophage-to-feces in vivo RCT assay using intraperitoneal administration of [ 3 H]cholesterol-labeled macrophage foam cells. In patients with acute sepsis, cholesterol effl ux toward plasma and HDL were signifi cantly decreased ( P < 0.001). In mice, acute infl ammation (75 µg/mouse lipopolysaccharide) decreased [ 3 H] cholesterol appearance in plasma ( P < 0.05) and tracer excretion into feces both within bile acids ( ؊ 84%) and neutral sterols ( ؊ 79%, each P < 0.001). In the absence of systemic infl ammation, overexpression of serum amyloid A (SAA, adenovirus) reduced overall RCT ( P < 0.05), whereas secretory phospholipase A 2 (sPLA 2 , transgenic mice) had no effect. Myeloperoxidase injection reduced tracer appearance in plasma ( P < 0.05) as well as RCT ( ؊ 36%, P < 0.05). Hepatic expression of bile acid synthesis genes ( P < 0.01) and transporters mediating biliary sterol excretion ( P < 0.01) was decreased by infl ammation. In conclusion, our data demonstrate that acute infl ammation impairs cholesterol effl ux in patients and macrophage-to-feces RCT in vivo in mice. Myeloperoxidase and SAA contribute to a certain extent to reduced RCT during infl ammation but not sPLA 2 . However, reduced bile acid formation and decreased biliary sterol excretion might represent major contributing factors to decreased RCT in infl ammation. -Annema, W., N. Nijstad, M. Tölle, J. F. de Boer, R. V. C. Buijs, P. Heeringa, M. van der Giet, and U. J. F. Tietge. Myeloperoxidase and serum amyloid A contribute to impaired in vivo reverse cho-