High-dose atorvastatin causes a rapid sustained increase in human serum PCSK9 and disrupts its correlation with LDL cholesterol

Proprotein convertase subtilisin kexin type 9 (PCSK9) is a key regulator of serum LDL-cholesterol (LDL-C) levels. PCSK9 is secreted by the liver into the plasma and binds the hepatic LDL receptor (LDLR), causing its subsequent degradation. We first demonstrated that a moderate dose of atorvastatin (40 mg) increases PCSK9 serum levels, suggesting why increasing statin doses may have diminished efficacy with regard to further LDL-C lowering. Since that initial observation, at least two other groups have reported statin-induced PCSK9 increases. To date, no analysis of the effect of high-dose atorvastatin (80 mg) on PCSK9 over time has been conducted. Therefore, we studied the time course of atorvastatin (80 mg) in human subjects. We measured PCSK9 and lipid levels during a 2-week lead-in baseline period and every 4 weeks thereafter for 16 weeks. We observed that atorvastatin (80 mg) caused a rapid 47% increase in serum PCSK9 at 4 weeks that was sustained throughout 16 weeks of dosing. Importantly, while PCSK9 levels were highly correlated with total cholesterol (TC), LDL-C, and triglyceride (TG) levels at baseline, atorvastatin (80 mg) completely abolished all of these correlations. Together, these results further suggest an explanation for why increasing doses of statins fail to achieve proportional LDL-C lowering.     

Cholesterol increase in mitochondria: a new method of cholesterol incorporation

In this study, we report a new method for cholesterol incorporation in mitochondria. This method is based on the coupling of cholesterol to bovine serum albumin (BSA) to form a structure with a spherical shape (designated C-BSA-C). The results show that C-BSA-C induces a specific cholesterol incorporation in mitochondria without interference from BSA. The cholesterol increase is complete in 1 minute, and is dose-related and pH-dependent. Temperature also has an effect. In mitochondria from dog adrenal glands, pregnenolone biosynthesis induced by C-BSA-C is increased, indicating that only cholesterol is transferred to the membrane.     

LDL-C calculated by Friedewald,Martin-Hopkins,or NIH equation 2 versus beta-quantification: pooled alirocumab trials

Accurate assessment of LDL-C levels is important, as they are often used for treatment recommendations. For many years, plasma LDL-C levels were calculated using the Friedewald equation, but there are limitations to this method compared with direct measurement via beta-quantification (BQ). Here, we assessed differences between the Friedewald, Martin-Hopkins, and NIH equation 2 methods of calculating LDL-C and the “gold standard” BQ method using pooled phase 3 data with alirocumab. All randomized patients were included irrespective of the treatment arm (n = 6,122). We compared pairs of LDL-C values (n = 17,077) determined by each equation and BQ. We found that BQ-derived LDL-C values ranged from 1 to 397 mg/dl (mean 90.68 mg/dl). There were strong correlations between Friedewald-calculated, Martin-Hopkins–calculated, and NIH equation 2–calculated LDL-C with BQ-determined LDL-C values (Pearson's correlation coefficient = 0.985, 0.981, and 0.985, respectively). Importantly, for BQ-derived LDL-C values ≥70 mg/dl, only 3.2%, 1.4%, and 1.8% of Friedewald-calculated, Martin-Hopkins–calculated, and NIH equation 2–calculated values were <70 mg/dl, respectively. When triglyceride (TG) levels were <150 mg/dl, differences between calculated and BQ-derived LDL-C values were minimal, regardless of the LDL-C level (<40, <55, or <70 mg/dl). However, when TG levels were >150 mg/dl, NIH equation 2 provided greater accuracy than Friedewald or Martin-Hopkins. When TGs were >250 mg/dl, inaccuracies were seen with all three methods, although NIH equation 2 remained the most accurate. In conclusion, LDL-C calculated by any of the three methods can guide treatment decisions for most patients, including those treated with proprotein convertase subtilisin/kexin type 9 inhibitors.     

Beyond guidelines: achieving the optimum in LDL cholesterol control

PURPOSE OF REVIEW: Despite clear treatment guidelines, a major part of the population is not achieving the recommended LDL cholesterol target levels. This fact is more prominent among high-risk populations in which the majority of patients are untreated or undertreated. RECENT FINDINGS: The review will elaborate on the key issues of treating large populations: patient compliance, drug efficacy, cost-benefit, and physician quality of care. SUMMARY: A programme aimed at improving control of hyperlipidemia should address all four issues. The primary care physician should be empowered and given tools for optimizing treatment.     

Determination of interleukin 2 activity by a new fluorometric method

Summary Interleukin 2 activity is usually determined by a proliferation assay using an IL-2-dependent cell line. Tritiated thymidine incorporation during DNA synthesis is a suitable method for this purpose, but its main drawback is the use of radioactive isotopes. We describe the use of Alamar Blue, a new fluorogenic growth indicator, for the measurement of interleukin 2 activity in microtitration plates. This assay is sensitive and economical. The lower limit of detection is about 400 cells per well with an intra-assay coefficient of variation of about 5 percent.     

Coherent optical correlation: a new method of cranial comparison.

In this paper an analog method known as coherent optical correlation is used to compare photographs of cercopithecine monkey skulls. Each comparison yields a measure of overall similarity in three-dimensional shape because the photographs are coded to preserve depth information. The coding system involves projecting an array of circular dots onto each specimen with an ordinary 35-mm slide projector. Photographs of the array taken from one side of the projector make ideal inputs for optical correlation analysis. Preliminary results indicate a reasonable ability to discriminate between different cercopithecine monkey skulls. This finding encourages further development of the proposed method as a shape investigation tool. Possibilities for application exist in many skeletal and somatological problems of form.     

PF 4 assay by an ELISA method: a good correlation with the usual RIA method

PF 4 is a specific platelet protein. This protein is released from alpha granules during the platelet activation and later it adheres to endothelium. Intravenous heparin injection displaces PF 4 from vessels wall. Thus, PF 4 levels are an index of in act or past platelet activation. We have compared two methods of PF 4 dosage on 39 blood samples taken from healthy volunteers and patients. The samples has been shared out tree groups according to the procedure of collecting; so the values of PF 4 are widely enough distributed. There was no difference between the mean values of each group obtained with two methods. Equally the mean value of all samples processed with radioimmunoassay was similar to the mean value obtained with immunoenzymatic method. The correlation index between the values of PF 4 obtained with radioimmunoassay and immunoenzymatic method was 0.97. Therefore the new immunoenzymatic method for the dosage of PF 4 is as sensitive and precise as the radioimmunoassay.     

Distinct regulation of plasma LDL cholesterol by eicosapentaenoic acid and docosahexaenoic acid in high fat diet-fed hamsters: Participation of cholesterol ester transfer protein and LDL receptor

Despite established anti-atherogenic action, previous reports have shown that fish oils or n-3 poly-unsaturated fatty acid (PUFA) increase plasma LDL-C in animals and humans. However, which component of n-3 PUFAs and what mechanisms contribute to this increase are unclear. We investigated the effects of the major components of n-3 PUFA, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on plasma LDL-C in high fat diet-fed hamsters. While LDL-C increased significantly with n-3 PUFA oil and DHA, EPA had no effect on LDL-C. Interestingly, a positive correlation was found between plasma cholesterol ester transfer protein (CETP) activity and LDL-C. Only DHA increased plasma CETP activity and significantly decreased LDL receptor expression in the liver. Our data suggest that DHA, not EPA, is a major factor in the LDL-C increasing effect of n-3 PUFA oil. These differential effects on LDL-C may arise from differences in plasma CETP activity and LDL receptor expression.     

Sequestration of acetylated LDL and cholesterol crystals by human monocyte-derived macrophages

Monocyte-derived macrophages accumulate and process cholesterol in atherosclerotic lesions. Because of the importance of this process, we examined the interaction of cholesterol crystals and acetylated low density lipoprotein (AcLDL) with human monocyte-macrophages in a combined chemical and morphological study. These two forms of cholesterol induced extensive compartmentalization of the macrophage cytoplasm. Unexpectedly, the compartments maintained a physical connection to the extracellular space as demonstrated with ruthenium red staining. The compartments formed through invagination of the top surface of the macrophage plasma membrane. Some cholesterol crystals and AcLDL were sequestered within these surface-connected compartments for up to five days in the case of the crystals and for one day in the case of AcLDL. Pulse-chase studies of fractionated macrophages indicated that [3H]cholesterol redistributed from the surface-connected compartments into lysosomes (where the cholesterol remained unesterified) and into lipid droplets (where the cholesterol was stored as cholesteryl ester). Intracellular uptake and esterification of cholesterol was blocked by cytochalasin D. However, once cholesterol was sequestered in the surface-connected compartments, subsequent esterification of the cholesterol could not be inhibited by cytochalasin D. Apolipoprotein E was localized within the surface- connected compartments by immunogold labeling suggesting a possible function for this protein in the processing of lipid taken up through the sequestration pathway. Removal of microcrystalline cholesterol from the medium resulted in release of most of the accumulated cholesterol microcrystals from the macrophages, as well as disappearance of the surface-connected compartments. Thus, sequestration is a novel endocytic mechanism in which endocytic compartments remain connected to the extracellular space. This differs from phagocytosis where endocytic vacuoles rapidly pinch off from the plasma membrane. Sequestration provides a means for macrophages to remove substances from the extracellular space and later release them.     

二氯苯磺酸沉淀毛发水解液中亮氨酸和精氨酸的新方法

本文介绍了一种以二氯苯磺酸为沉淀剂从毛发水解液中分步沉淀亮氨酸和精氨酸的方法。利用两种沉淀形成速度的不同,通过控制反应条件,实现了亮氨酸和精氨酸的分步沉淀,确定了沉淀条件对目标氨基酸沉淀效率的影响,得到合适的工艺条件:200g人发,水解得400mL水解液;加50g二氯苯磺酸沉淀剂,在5℃加晶种,间歇搅拌12h,过滤得亮氨酸复合物沉淀;在沉淀亮氨酸之后的母液中再加50g二氯苯磺酸沉淀剂,于相同的温度条件下加晶种,连续搅拌至生成稠厚的沉淀,再静置沉淀12h,过滤得精氨酸复合物沉淀。亮氨酸的沉淀率为71.0%,母液中残留亮氨酸浓度为7.6g/L;精氨酸的沉淀率为76.6%,母液中残留精氨酸浓度为8.9g/L。     

Plasmodium salvages cholesterol internalized by LDL and synthesized de novo in the liver

Our previous morphological studies illustrated the association of sterols with Plasmodium infecting hepatocytes. Because malaria parasites cannot synthesize sterols, they must scavenge these lipids from the host. In this paper, we have examined the source/s of sterols for intrahepatic Plasmodium and evaluated the importance of sterols for liver stage development. We show that Plasmodium continuously diverts cholesterol from hepatocytes until release of merozoites. Removal of plasma lipoproteins from the medium results in a 70% reduction of cholesterol content in hepatic merozoites but these parasites remain infectious in animals. Plasmodium salvages cholesterol that has been internalized by low-density lipoprotein but reduced expression of host low-density lipoprotein receptors by 70% does not influence liver stage burden. Plasmodium is also able to intercept cholesterol synthesized by hepatocytes. Pharmacological blockade of host squalene synthase or downregulation of the expression of this enzyme by 80% decreases by twofold the cholesterol content of merozoites without further impacting parasite development. These data enlighten that, on one hand, malaria parasites have moderate need of sterols for optimal development in hepatocytes and, on the other hand, they can adapt to survive in cholesterol-restrictive conditions by exploitation of accessible sterols derived from alternative sources in hepatocytes to maintain proper infectivity.     

Evaluation of the polyethylene glycol precipitation method for the estimation of chicken high density lipoprotein cholesterol

A neutral polymer precipitation procedure using polyethylene glycol 6000 (PEG) for fractionation of chicken plasma lipoproteins was optimized. Lipoprotein precipitation was dependent on PEG concentration and pH but was independent of PEG exposure time. A PEG concentration of 100 g/l (pH 8) precipitated chicken plasma very low density (VLDL) and low density (LDL) lipoproteins. Disc electrophoresis of supernates demonstrated that high density lipoprotein (HDL) was retained and LDL eliminated by PEG treatment of plasma. Gel filtration chromatography of whole plasma and PEG-treated supernatants on Bio-Gel A-5m demonstrated that HDL-cholesterol content of supernates was unchanged by PEG exposure, while VLDL-cholesterol was selectively removed.     

Determination of free cholesterol based on a novel flow‐injection chemiluminescence method by immobilizing enzyme

A novel flow injection chemiluminescence method is proposed for determination of cholesterol in this paper. The cholesterol oxidase was immobilized onto sol–gel and prepared as an enzymatic reaction column. The determination of cholesterol was performed by quantitative determination of hydrogen peroxide produced from an enzymatic reaction. The luminol–H₂O₂–metal chelate diperiodatocuprate(III) system ensured that the method was highly sensitive and selective. Free cholesterol was determined over the range 5.0 × 10^–8 mol/L–5.0 × 10^–7 mol/L, with a limit of detection (3σ) of 1.9 × 10^–8 mol/L. The relative standard deviation (RSD) for 2.5 × 10^–7 mol/L was 2.7% (n = 7). The proposed method offered the advantages of sensitivity, selectivity, simplicity and rapidity for free cholesterol determination, and was successfully applied to the direct determination of free cholesterol in serum. Copyright © 2008 John Wiley & Sons, Ltd.     

Transgelin: a new gene involved in LDL endocytosis identified by a genome-wide CRISPR-Cas9 screen

A significant proportion of patients with elevated LDL and a clinical presentation of familial hypercholesterolemia do not carry known genetic mutations associated with hypercholesterolemia, such as defects in the LDL receptor. To identify new genes involved in the cellular uptake of LDL, we developed a novel whole-genome clustered regularly interspaced short palindromic repeat-Cas9 KO screen in HepG2 cells. We identified transgelin (TAGLN), an actin-binding protein, as a potentially new gene involved in LDL endocytosis. In silico validation demonstrated that genetically predicted differences in expression of TAGLN in human populations were significantly associated with elevated plasma lipids (triglycerides, total cholesterol, and LDL-C) in the Global Lipids Genetics Consortium and lipid-related phenotypes in the UK Biobank. In biochemical studies, TAGLN-KO HepG2 cells showed a reduction in cellular LDL uptake, as measured by flow cytometry. In confocal microscopy imaging, TAGLN-KO cells had disrupted actin filaments as well as an accumulation of LDL receptor on their surface because of decreased receptor internalization. Furthermore, TAGLN-KO cells exhibited a reduction in total and free cholesterol content, activation of SREBP2, and a compensatory increase in cholesterol biosynthesis. TAGLN deficiency also disrupted the uptake of VLDL and transferrin, other known cargoes for receptors that depend upon clathrin-mediated endocytosis. Our data suggest that TAGLN is a novel factor involved in the actin-dependent phase of clathrin-mediated endocytosis of LDL. The identification of novel genes involved in the endocytic uptake of LDL may improve the diagnosis of hypercholesterolemia and provide future therapeutic targets for the prevention of cardiovascular disease.     

Determination of erythrocyte surface sialic acid residues by a new colorimetric method.

The 3-methyl-2-benzothiazolone hydrazone method has been applied to the determination of erythrocyte membrane sialic acid residues. This method requires a mild oxidation of sialic acid which results in the formation of analogs. Their separation by chromatography, after labeling, allows the choice of the best conditions for this oxidation. The concomitant liberated formaldehyde is determined. This method requires no prior release of sialic acid as opposed to the periodate-thiobarbituric method of Warren (1959, J. Biol. Chem., 234, 1971–1975). These two methods have been compared.     

Peg precipitation coupled with chromatography is a new and sufficient method for the purification of botulinum neurotoxin type B

Clostridium botulinum neurotoxins are used to treat a variety of neuro-muscular disorders, as well as in cosmetology. The increased demand requires efficient methods for the production and purification of these toxins. In this study, a new purification process was developed for purifying type B neurotoxin. The kinetics of C.botulinum strain growth and neurotoxin production were determined for maximum yield of toxin. The neurotoxin was purified by polyethylene glycol (PEG) precipitation and chromatography. Based on design of full factorial experiment, 20% (w/v) PEG-6000, 4 °C, pH 5.0 and 0.3 M NaCl were optimal conditions to obtain a high recovery rate of 87% for the type B neurotoxin complex, as indicated by a purification factor of 61.5 fold. Furthermore, residual bacterial cells, impurity proteins and some nucleic acids were removed by PEG precipitation. The following purification of neurotoxin was accomplished by two chromatography techniques using Sephacryl? S-100 and phenyl HP columns. The neurotoxin was recovered with an overall yield of 21.5% and the purification factor increased to 216.7 fold. In addition, a mouse bioassay determined the purified neurotoxin complex possessed a specific toxicity (LD(50)) of 4.095 ng/kg.     

Protamine sulfate precipitation: a new assay for the Ah receptor

The ability of protamine sulfate to effect the quantitative precipitation of 2,3,7,8-[3H]tetrachlorodibenzo-p-dioxin (TCDD):Ah receptor complexes from rat liver cytosol has been developed into a new assay for the identification, quantitation, and characterization of the Ah receptor. The method is reliable, uncomplicated, and rapid, and can be applied to large numbers of samples. The major advantage of the assay is that protamine sulfate appears to selectively precipitate the Ah receptor protein and does not precipitate a number of other proteins that bind [3H]TCDD nonspecifically.