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(Circulation. 2004;110:452-459.)
© 2004 American Heart Association, Inc.

Original Articles

Aggregated Low-Density Lipoprotein Uptake Induces Membrane Tissue Factor Procoagulant Activity and Microparticle Release in Human Vascular Smooth Muscle Cells

Vicenta Llorente-Cortés, PhD; Marta Otero-Viñas, PhD; Sandra Camino-López, MS; Oriol Llampayas, MS; Lina Badimon, PhD, FESC

From the Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Correspondence to Professor Lina Badimon, Cardiovascular Research Center, ICCC/CSIC-Hospital de la Santa Creu i Sant Pau, Jordi i Girona 18-26, 08041 Barcelona, Spain.

Received October 14, 2003; de novo received March 12, 2004; revision received April 22, 2004; accepted May 11, 2004.

Background— Tissue factor (TF) is the main initiator of the arterial blood coagulation system, and aggregated LDL (agLDL) are found in the arterial intima. Our hypothesis is that agLDL internalization by vascular smooth muscle cells (VSMCs) may trigger TF-procoagulant activity.

Methods and Results— Cultured human VSMCs were obtained from human coronary arteries of explanted hearts during transplant operations. VSMCs were incubated with native LDL (nLDL) or agLDL. TF mRNA was analyzed by real-time polymerase chain reaction, and cellular and released TF protein antigen were analyzed by Western blot. TF microparticle (MP) content was analyzed by flow cytometry and TF activity by a factor Xa generation test. Both nLDL and agLDL strongly and equally increased TF mRNA and cell membrane protein expression, by approximately 5- and 9-fold, respectively. A sustained TF procoagulant activity was induced by agLDL but not by nLDL (agLDL 2.46±0.22 versus nLDL 0.72±0.12 mU/mg protein at 12 hours). AgLDL increased TF antigen release (agLDL 5.64±0.4 versus nLDL 3.28±0.22 AU) and TF MP release (agLDL 89.85±8.51 versus nLDL 19.69±4.59 TF MP/10³ cells). TF activation and release induced by agLDL is not related to apoptosis. Blockade of LDL receptor-related protein, a receptor for agLDL, prevented the agLDL-induced release of TF protein and TF MP.

Conclusions— VSMC-TF expression is upregulated by both nLDL and agLDL. However, only agLDL engagement to LDL receptor-related protein induced cellular TF procoagulant activity and TF release by human VSMCs.

Key Words: tissue factor • cells • lipoproteins • proteins

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