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(Circulation. 2004;110:2024-2031.)
© 2004 American Heart Association, Inc.
Molecular Cardiology |
From the University of Virginia (Y.H., M.C.H., P.S., B.L.H., T.B., S.B.F., M.A.S., D.F.S., S.C., S.S., C.C.H., J.L.N., K.L.), Charlottesville, Va; University of Pennsylvania (L.Z., D.P., C.D.F.), Philadelphia, Pa; and University of California (J.L.W), San Diego, Calif.
Correspondence to Yuqing Huo, MD, PhD, Cardiovascular Division and Vascular Biology Center, University of Minnesota, MMC 508, 420 Delaware St SE, Minneapolis, MN 55455. E-mail Yuqing{at}umn.edu
Received May 23, 2004; revision received July 10, 2004; accepted July 21, 2004.
| Abstract |
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Methods and Results Bone marrow from 12/15-LO//apoE/ mice was transplanted into apoE/ mice and vice versa. Deficiency of 12/15-LO in bone marrow cells protected apoE/ mice fed a Western diet from atherosclerosis to the same extent as complete absence of 12/15-LO, although plasma 8,12-iso-iPF2
-IV, a measure of lipid peroxidation, remained elevated. 12/15-LO//apoE/ mice regained the severity of atherosclerotic lesion typical of apoE/ mice after replacement of their bone marrow cells with bone marrow from apoE/ mice. Peritoneal macrophages obtained from wild-type but not 12/15-LO/ mice caused endothelial activation in the presence of native LDL. Absence of 12/15-LO decreased the ability of macrophages to form foam cells when exposed to LDL.
Conclusions We conclude that macrophage 12/15-LO plays a dominant role in the development of atherosclerosis by promoting endothelial inflammation and foam cell formation.
Key Words: atherosclerosis cell adhesion molecules endothelium lipids
| Introduction |
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12/15-Lipoxygenase (12/15-LO) is a nonheme iron-containing dioxygenase that forms 12-hydroperoxy-eicosatetraenoic acid (12-HPETE) and 15-HPETE and oxidizes esterified fatty acids in lipoproteins (cholesteryl esters) and phospholipids.2,3 On the basis of its product from arachidonic acid, it is classified as 15-lipoxygenase (15-LO) in humans and rabbits4,5 and as "leukocyte-type" 12-lipoxygenase (12-LO) in pig, rat, and mouse.6 12/15-LO can also produce 13-hydroperoxy-octadecadienoic acid (13-HPODE) from linoleic acid.2,3 Mouse leukocyte 12/15-LO is highly related to 15-LO in humans in that they are
74% identical in primary structure, and both are dual-specificity lipoxygenases.7 Mouse 12/15-LO probably represents the orthologue of 15-LO in humans.3,7
Pharmacological inhibition of 15-LO in hypercholesterolemic rabbits resulted in attenuation of atherosclerosis.8,9 In the apoE/, LDLR/, and apobec-1//LDL-R/ mouse models of atherosclerosis, disruption of the 12/15-LO gene significantly retarded the initiation and progression of atherosclerosis.1012 A variety of vascular cells are able to express 12/15-LO, including endothelial cells,13,14 smooth muscle cells,13,14 and monocytes/macrophages.13,15 Overexpression of 12/15-LO in mouse endothelial cells16 and rabbit monocytes/macrophages17 resulted in completely opposite effects: The former was proatherogenic and the latter antiatherogenic, which indicates a possibility that different cellular expression of 12/15-LO may have different effects on atherosclerosis or that species differences may exist.
In the present study, we used bone marrow transfer to determine the role of 12/15-LO in macrophages and vascular cells (including endothelial cells and smooth muscle cells) in the development of atherosclerosis. We also examined the effects of 12/15-LO on endothelial activation and monocyte adhesion using in vitro endothelium-monocyte interaction systems. Finally, we compared in vitro foam cell formation in bone marrowderived and peritoneal macrophages isolated from 12/15-LO/ or wild-type mice.
| Methods |
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Determination of 12/15-LO mRNA Expression With Real-Time Reverse TranscriptionPolymerase Chain Reaction
Total RNA was isolated with an RNeasy Mini Kit (Qiagen Inc). The primers used to analyze mRNA for mouse 12/15-LO were CTCTCAAGGCCTGTTCAGGA (sense) and GTCCATTGTCCCCAGAACCT (antisense). Reverse transcriptionpolymerase chain reaction (RT-PCR) was performed on the iCycler (Bio-Rad Laboratories) with SYBR Green I (Molecular Probes).
Preparation of Mouse Aortas and Quantification of Atherosclerosis
The aortas of mice were collected and stained with oil red O.19 Images were scanned into a Macintosh computer, and the percent surface areas occupied by lesions were determined with Image-ProPlus (Media Cybernetics).
Measurement of Plasma Lipids, Isoprostanes, and Autoantibody Titers Against Oxidized LDL Epitopes
Plasma triglyceride and total cholesterol levels were determined via an automated enzymatic technique (Boehringer Mannheim GmbH). Plasma 8,12-iso-iPF
-VI levels were measured by gas chromatography/mass spectrometry.11 The titers of IgG and IgM autoantibodies against malondialdehyde LDL (MDA-LDL) and oxidized LDL (OxLDL) were analyzed as described previously.20
Isolation and Culture of Murine Aortic Endothelial Cells and Macrophages
Endothelial cells from mouse thoracic aortas were isolated and cultured as described previously.21 Endothelial cells from passage 3 to 5 were used in this study. Macrophages used in this study were either harvested by peritoneal lavage or differentiated from bone marrow cell by cytokines that included interleukin-4 (IL-4), granulocyte-macrophage colonystimulating factor (GM-CSF), and macrophage colonystimulating factor (M-CSF).
Monocyte Adhesion Assay
Confluent murine endothelial monolayers were washed and cultured in serum-free DMEM supplemented with Nutridoma-HU (Roche Diagnostics GmbH). LDL (Biomedical Technologies, Inc) was added at a final concentration of 200 µg/mL. After 20 hours, cell media were removed, and the endothelial monolayer was washed 3 times for the monocyte adhesion assay. The confluent murine endothelial monolayer was cocultured with macrophages for 24 hours in serum-free DMEM supplemented with Nutridoma-HU in the presence of LDL at a concentration of 200 µg/mL. Then, washed endothelial monolayers were incubated with 106 carboxyfluorescein diacetate succinimidyl ester-labeled WEHI78/24 cells (a murine monocytic cell line) suspended in 1 mL of binding buffer for 20 minutes. After a vigorous wash, adherent cells were determined by fluorescence intensity.
In Vitro Foam Cell Assay
Thioglycollate-elicited or bone marrowderived macrophages were used. For some experiments, macrophages were stimulated with IL-4. LDL, OxLDL, or acetylated LDL (Biomedical Technologies, Inc) was added at different concentrations for different periods. Then, macrophages were washed with PBS, fixed with 4% paraformaldehyde, and stained with oil red O. Images were scanned into a Macintosh computer, and the percentage of oil red Opositively stained cells or surface area occupied by oil red Ostained droplets in each cell was determined with Image-Pro Plus.
Statistical Analysis
Statistical analysis was performed with Instat software (GraphPad Software). Data are represented as mean±SE. Data were compared with either 1-way ANOVA followed by Bonferroni correction post hoc test or Student t test to evaluate 2-tailed levels of significance. The null hypothesis was rejected at P<0.05.
| Results |
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1000 times higher than that in other tissues, including lung, heart, atherosclerotic vessel, liver, gut, spleen, lymph node, kidney, and adipose tissue. 12/15-LO was undetectable in brain and muscle (Figure 1). 12/15-LO was decreased by 90% in most tissues 12 weeks after 12/15-LO/ bone marrow replacement (Figure 1), which suggests that 12/15-LO exists mainly in macrophages in these tissues. Alternatively, 12/15-LO expression of native cells in these tissues may be regulated by 12/15-LOexpressing macrophages, although no autocrine and paracrine loops of 12/15-LO expression have been reported. The amount of 12/15-LO mRNA in kidney and adipose tissues did not change significantly as a result of transplantation with 12/15-LO/ bone marrow, which suggests 12/15-LO expression in tissue-resident cells. Under the conditions employed, 12/15-LO mRNA was not detectable in atherosclerotic arteries of apoE/ mice that received 12/15-LOdeficient bone marrow, which indicates that 12/15-LO in atherosclerotic lesions exists mainly in macrophages/foam cells (Figure 1).
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Role of Bone MarrowDerived 12/15-LO in Atherosclerosis
Bone marrowderived macrophages contribute to foam cell formation in atherosclerotic lesions.22 To determine the influence of macrophage 12/15-LO in the formation of atherosclerotic lesions, we generated 4 groups of chimeric mice (Table) by transplanting bone marrow from 12/15-LO//apoE/ mice into apoE/ mice and vice versa, as well as 2 control groups. BMT did not affect blood monocyte counts or tissue macrophages as reflected by the number of macrophages in the peritoneal cavity of thioglycollate-challenged mice (data not shown). Aortic lesion sizes in the 4 groups are shown in Figure 2b. ApoE/ mice reconstituted with bone marrow of apoE/ mice had lesions that covered 4.5% to 8.7% of the aortic surface. The lesion size in apoE/ mice receiving the bone marrow of 12/15-LO//apoE/ mice, similar to that in 12/15-LO//apoE/ mice receiving the bone marrow of 12/15-LO//apoE/, was reduced by 50% ( 2.0% to 4.2%) compared with that in their controls (Figure 2b). This suggests that 12/15-LO from bone marrowderived cells is critical for lesion development in this model. Consistent with this interpretation, reconstitution of 12/15-LO//apoE/ mice with bone marrow of apoE/ mice fully restored their lesion sizes to the levels of apoE/ mice.
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Plasma Lipids, Lipid Peroxidation, and Immune Response in Reconstituted apoE/ Mice
Mean cholesterol and triglyceride levels in bone marrowtransferred mice in different groups were not different (data not shown). Because the apoE/ mice reconstituted with bone marrow from 12/15-LO//apoE/ mice had small atherosclerotic lesions, indistinguishable from the lesion size found in mice completely lacking 12/15-LO, we tested whether plasma 8,12-iso-iPF2
-VI levels in these mice would also be suppressed. Interestingly, isoprostane levels in these mice were the same as in apoE/ or 12/15-LO//apoE/ mice reconstituted with the bone marrow of apoE/ mice (Figure 3a).
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In atherosclerosis, an immune response to oxidized lipids is prominent and results in the formation of autoantibodies of the IgM and IgG isotypes to modified LDL.23 In all groups of BMT mice, autoantibody levels, especially levels of IgG autoantibodies, were much lower than those of age-matched controls, presumably because the immune system had not completely recovered from the lethal irradiation and reconstitution at the time serum was harvested. Interestingly, autoantibody (IgM Ab against copper-modified LDL) levels were higher in mice reconstituted with the bone marrow of apoE/ mice than in those receiving the bone marrow of 12/15-LO//apoE/ mice, irrespective of the genotype of the recipient (Figure 3b). Consistent with protection of mice receiving 12/15-LO//apoE/ bone marrow, we found a highly significant positive correlation of autoantibody (IgM Ab against copper-modified LDL) levels with lesion size (Figure 3c). Autoantibody levels did not correlate with levels of plasma isoprostanes (Figure 3d).
Endothelial Activation by Autocrine 12/15-LO Products
Aortic endothelium of apoE/ mice fed a Western diet is activated and expresses various adhesion molecules.24 Because endothelial cells are known to express 12/15-LO,13 we tested whether endothelial activation is caused by endothelial cell 12/15-LO by an autocrine mechanism. Figure 4 shows that there was no difference in the expression of either vascular cell adhesion molecule-1 (VCAM-1) or intercellular adhesion molecule-1 (ICAM-1) between cultured wild-type and 12/15-LOdeficient aortic endothelial cells, either incubated with LDL, stimulated with tumor necrosis factor-
, or under resting conditions. Similarly, adhesion of WEHI78/24 cells, a murine monocytic cell line, also was not dependent on endothelial 12/15-LO (Figure 4a).
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Endothelial Activation by Macrophage 12/15-LO Activity
To test whether macrophage 12/15-LO has an influence in endothelial activation and endothelium-monocyte interactions, we developed a coculture system (Figure 5a) in which peritoneal macrophages from 12/15-LO/ or wild-type mice were incubated in the upper well of a transwell system with and without native (nonmodified) LDL, and endothelial cells in the lower well were used as indicators of endothelial activation, measured by adhesion of WEHI78/24 cells. In the absence of LDL, neither wild-type nor 12/15-LOdeficient macrophages induced much endothelial activation (Figures 5b and 5c). By contrast, when LDL was added to the culture media, wild-type but not 12/15-LOdeficient macrophages had a large and significant activating effect on endothelial cells, as demonstrated by a 3-fold elevation of WEHI78/24 cell adhesion (Figures 5b and 5c) and significant upregulation of VCAM-1 on endothelial cells (Figures 5d and 5e).
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Foam Cell Formation by 12/15-LO Deficient Macrophages
Foam cell formation is a hallmark of atherosclerosis.25 Therefore, we tested whether 12/15-LO might influence foam cell formation in peritoneal macrophages loaded with acetylated LDL. After 24 and 48 hours in culture, oil red O uptake as a marker of lipid accumulation was indistinguishable in macrophages from wild-type and 12/15-LO/ mice (Figure 6a). Similar results were obtained with OxLDL (data not shown).
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When 12/15-LOdeficient peritoneal macrophages were cultured in the presence of native LDL, their lipid uptake was much reduced compared with wild-type controls. The intensity of oil red O staining was decreased in peritoneal macrophages from 12/15-LO/ mice (Figures 6b and 6c). The difference was further enhanced in macrophages stimulated with IL-4 (Figures 6b and 6c). This may be due to an increase of 12/15-LO protein and activity induced by IL-4 in vitro.26 Similar results were obtained on macrophages differentiated from bone marrow cells in the presence of GM-CSF, IL-4, and M-CSF (data not shown).
| Discussion |
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The BMT study suggests that macrophage 12/15-LO is proatherogenic in mice. This is inconsistent with previous studies by Shen et al,17 who found that 15-LO in monocytes/macrophages is antiatherogenic in a rabbit atherosclerotic model. The conflicting conclusions from these studies may be due to differences in species (rabbit versus mouse), lipoxygenase gene products (ratio of 12HETE:15HETE), and genetic manipulation (knockout versus transgenic overexpression). The expression level of the enzyme in transgenic monocyte-derived rabbit macrophages is >20-fold higher than in macrophages of normal rabbits and comparable to that of highly activated human monocytes by cytokines.27 12/15-LO and its products at high concentrations may play a role different from that at their physiological concentration. Recent studies have shown that several 12/15-LO products are ligands of peroxisome proliferatoractivated receptor-
(PPAR
).28 PPAR
ligands have potent antiinflammatory effects at a high concentration.29 Overexpression of 15-LO in monocytes/macrophages may result in substantial accumulation of 12/15-LO products and consequently trigger the PPAR
pathway in these cells.
Circulating precursor cells can be recruited to the vessel wall and differentiate to various vascular cells under different pathological conditions, especially in the setting of vascular injury.30 In spontaneous atherosclerotic vessels, only a very limited number of endothelial cells and smooth muscle cells are replaced by differentiated donor-derived stem cells within 8 to 12 weeks after BMT.30 In the same time frame, 12/15-LO//apoE/ mice receiving bone marrow from apoE/ mice developed the same extent of atherosclerotic lesions as control mice. Therefore, the contribution of circulating precursor cells to the observed effects, if there is any, is likely to be small.
Human monocytes and macrophages express a 15-LO that can also produce 12-HETE and probably represents the human orthologue of mouse 12/15-LO.3 The presence of specific 15-lipoxygenase products,31 15-LO protein and 15-LO mRNA,32 in human atherosclerotic arteries has been clearly demonstrated in samples obtained from patients aged 15 to 37 years. In a recent report, Spanbroek et al33 did not detect 15-LO in very advanced atherosclerotic arterial samples. The present study was performed at the time when mice start to develop atherosclerosis, showing participation of macrophage 12/15-LO in the early phase of atherogenesis in mice, which is consistent with the findings in humans.
In the absence of LDL, macrophage 12/15-LO causes little increase in endothelial activation. However, in the presence of LDL, macrophage 12/15-LO significantly increases expression of endothelial adhesion molecules and endothelial-monocyte interactions. A suppression of lipid uptake and foam cell formation in macrophages lacking 12/15-LO was observed after incubation with native LDL but not modified LDL.12 These results suggest that the proatherogenic role of macrophage 12/15-LO may be related to its oxidative action on LDL.1012 However, in this BMT study, levels of isoprostane do not correlate with the sizes of atherosclerotic lesions. Overall levels of isoprostane may not reflect the local accumulation of oxidative products generated by 12/15-LO in the vessel wall, which may be important for the formation of atherosclerotic lesions. Alternatively, other 12/15-LOdependent mechanisms may be involved. A recent study has demonstrated a decrease in production of IL-12 in 12/15-LOdeficient macrophages,34 which suggests a reduced immune response. This correlates with lower titers of autoantibodies to OxLDL in BMT mice in the present study. Therefore, in addition to its oxidative action, macrophage-derived 12/15-LO may also be involved in regulating the immune response during initiation and progression of atherosclerosis.
| Acknowledgments |
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| Footnotes |
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M. K. Middleton, A. M. Zukas, T. Rubinstein, M. Jacob, P. Zhu, L. Zhao, I. Blair, and E. Pure Identification of 12/15-lipoxygenase as a suppressor of myeloproliferative disease J. Exp. Med., October 30, 2006; 203(11): 2529 - 2540. [Abstract] [Full Text] [PDF] |
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S.-l. Li, M. A. Reddy, Q. Cai, L. Meng, H. Yuan, L. Lanting, and R. Natarajan Enhanced Proatherogenic Responses in Macrophages and Vascular Smooth Muscle Cells Derived From Diabetic db/db Mice Diabetes, September 1, 2006; 55(9): 2611 - 2619. [Abstract] [Full Text] [PDF] |
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S. Sukhanov, Y. Higashi, S.-Y. Shai, H. Itabe, K. Ono, S. Parthasarathy, and P. Delafontaine Novel Effect of Oxidized Low-Density Lipoprotein: Cellular ATP Depletion via Downregulation of Glyceraldehyde-3-Phosphate Dehydrogenase Circ. Res., July 21, 2006; 99(2): 191 - 200. [Abstract] [Full Text] [PDF] |
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J. Sainz and M. Sata Maintenance of Vascular Homeostasis by Bone Marrow-Derived Cells. Arterioscler Thromb Vasc Biol, June 1, 2006; 26(6): 1196 - 1197. [Full Text] [PDF] |
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C. D. Funk Lipoxygenase Pathways as Mediators of Early Inflammatory Events in Atherosclerosis. Arterioscler Thromb Vasc Biol, June 1, 2006; 26(6): 1204 - 1206. [Full Text] [PDF] |
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S. Saika, K. Ikeda, O. Yamanaka, K. C. Flanders, Y. Okada, T. Miyamoto, A. Kitano, A. Ooshima, Y. Nakajima, Y. Ohnishi, et al. Loss of Tumor Necrosis Factor {alpha} Potentiates Transforming Growth Factor {beta}-mediated Pathogenic Tissue Response during Wound Healing Am. J. Pathol., June 1, 2006; 168(6): 1848 - 1860. [Abstract] [Full Text] [PDF] |
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D. T. Bolick, S. Srinivasan, A. Whetzel, L. C. Fuller, and C. C. Hedrick 12/15 Lipoxygenase Mediates Monocyte Adhesion to Aortic Endothelium in Apolipoprotein E-Deficient Mice Through Activation of RhoA and NF-{kappa}B Arterioscler Thromb Vasc Biol, June 1, 2006; 26(6): 1260 - 1266. [Abstract] [Full Text] [PDF] |
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A. Boullier, Y. Li, O. Quehenberger, W. Palinski, I. Tabas, J. L. Witztum, and Y. I. Miller Minimally Oxidized LDL Offsets the Apoptotic Effects of Extensively Oxidized LDL and Free Cholesterol in Macrophages Arterioscler Thromb Vasc Biol, May 1, 2006; 26(5): 1169 - 1176. [Abstract] [Full Text] [PDF] |
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H. Pei, J. Gu, P.-R. Thimmalapura, A. Mison, and J. L. Nadler Activation of the 12-lipoxygenase and signal transducer and activator of transcription pathway during neointima formation in a model of the metabolic syndrome Am J Physiol Endocrinol Metab, January 1, 2006; 290(1): E92 - E102. [Abstract] [Full Text] [PDF] |
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G. Li, J. M. Sanders, E. T. Phan, K. Ley, and I. J. Sarembock Arterial Macrophages and Regenerating Endothelial Cells Express P-Selectin in Atherosclerosis-Prone Apolipoprotein E-Deficient Mice Am. J. Pathol., December 1, 2005; 167(6): 1511 - 1518. [Abstract] [Full Text] [PDF] |
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B. Zhang, H. Cao, and G. N. Rao 15(S)-Hydroxyeicosatetraenoic Acid Induces Angiogenesis via Activation of PI3K-Akt-mTOR-S6K1 Signaling Cancer Res., August 15, 2005; 65(16): 7283 - 7291. [Abstract] [Full Text] [PDF] |
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K. Choy, K. Beck, F. Y. Png, B. J. Wu, S. B. Leichtweis, S. R. Thomas, J. Y. Hou, K. D. Croft, T. A. Mori, and R. Stocker Processes Involved in the Site-Specific Effect of Probucol on Atherosclerosis in Apolipoprotein E Gene Knockout Mice Arterioscler Thromb Vasc Biol, August 1, 2005; 25(8): 1684 - 1690. [Abstract] [Full Text] [PDF] |
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Y. I. Miller, S. Viriyakosol, D. S. Worrall, A. Boullier, S. Butler, and J. L. Witztum Toll-Like Receptor 4-Dependent and -Independent Cytokine Secretion Induced by Minimally Oxidized Low-Density Lipoprotein in Macrophages Arterioscler Thromb Vasc Biol, June 1, 2005; 25(6): 1213 - 1219. [Abstract] [Full Text] [PDF] |
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