Encrustation and Atherosclerosis: The Analogy Between Early in Vivo Lesions and Deposits Which Occur in Extracorporeal Circulations

A study was made of the relation between the pattern and topography of thrombus formation in models of various vessel configurations coupled into extracorporeal shunts in swine and the development of atherosclerosis at corresponding sites on swine aortas. The pattern and distribution of deposits formed in the models were strikingly similar to the pattern and distribution of incipient atherosclerosis at comparable sites in the vascular tree. The earliest and only consistent component of the flow chamber deposits was the blood platelet. The platelet deposits would frequently stain with oil red O. The cholesterol level of washed human platelets was found to show a good correlation with that in the plasma. This evidence suggests that deposition of particulate matter (chiefly platelets), largely determined by the hydraulic factors, may be an important factor in the early, as well as later, stages of atherosclerosis.     

Assignment of the pig apolipoprotein B locus (APOB) to chromosome region 3q24-qter

The locus for apolipoprotein-B (APOB) has been chromosomally assigned in swine by in situ hybridization of a genomic probe to metaphase chromosomes. As expected based on the observation of extensive linkage conservation and based on the previous assignment of the malate dehydrogenase locus (MDH1) in swine, APOB maps to chromosome 3, specifically to region 3q24-qter. Variations at APOB may represent both in humans and in swine risk factors for hypercholesterolaemia and atherosclerosis. Evidence presented here that the human and porcine APOB occupy evolutionarily conserved chromosome regions provides a basis for using the pig as an animal model to study the APOB associated atherosclerosis risk.     

Inflammation in atherosclerosis: a cause or a result of vascular disorders?

Sound data support the concept that in atherosclerosis, inflammation and dyslipidemia intersect each other and that irrespective of the initiator, both participate from the early stages to the ultimate fate of the atheromatous plaque. The two partakers manoeuvre a vicious circle in atheroma formation: dyslipidaemia triggers an inflammatory process and inflammation elicits dyslipidaemia. Independent of the initial cause, the atherosclerotic lesions occur focally, in particular arterial-susceptible sites, by a process that, although continuous, can be arbitrarily divided into a sequence of consecutive stages that lead from fatty streak to the fibro-lipid plaque and ultimately to plaque rupture and thrombosis. In the process, the initial event is a change in endothelial cells (EC) constitutive properties. Then, the molecular alarm signals send by dysfunctional EC are decoded by specific blood immune cells (monocytes, T lymphocytes, neutrophils, mast cells) and by the resident vascular cells, that respond by initiating a robust inflammatory process, in which the cells and the factors they secrete hasten the atheroma development. Direct and indirect crosstalk between the cells housed within the nascent plaque, complemented by the increase in risk factors of atherosclerosis lead to atheroma development and outcome. The initial inflammatory response can be regarded as a defense/protective reaction mechanism, but its further amplification, speeds up atherosclerosis. In this review, we provide an overview on the role of inflammation and dyslipidaemia and their intersection in atherogenesis. The data may add to the foundation of a novel attitude in the diagnosis and treatment of atherosclerosis.     

Pancreatectomized swine as a model of diabetes mellitus

The development of a model of diabetes mellitus using swine offers the potential for new investigations in the study of human diabetic complications. In particular, animal models for the study of accelerated atherosclerosis associated with diabetes are important and presently lacking. Swine were selected because they have a natural susceptibility to atherosclerosis and have plasma lipoprotein patterns which are close to those of humans. Diabetes mellitus was induced in nine miniature swine by total pancreatectomy. Following surgery, they were maintained on porcine derived insulin at doses predicated on blood glucose levels. Pancreatic enzymes were replaced by dietary supplementation. Eight of the nine pigs were pancreatectomized successfully and stabilized with insulin. After initial weight loss, the pancreatectomized pigs maintained growth rates comparable to controls. Hypoglycemia and bacterial infections were the major problems experienced. Post-operative survival ranged from 50 days to 455 days. Our study shows that swine can be pancreatectomized successfully and maintained as insulin dependent animals, presenting a realistic model for research on the complications of diabetes.     

Diabetic dyslipidemia and exercise alter the plasma low‐density lipoproteome in Yucatan pigs

Although low‐density lipoprotein (LDL) plays a predominant role in atherogenesis, the low‐density lipoproteome has not been fully characterized. Moreover, alterations from a Western diet, diabetes, and physical inactivity on this proteome have yet to be determined. Accordingly, relative quantification was determined in LDL proteins from male Yucatan diabetic dyslipidemic (DD) swine in the early stages of atherosclerosis compared to healthy control (C) and non‐diabetic hyperlipidemic (H) swine. Importantly, coronary vascular dysfunction was prevented by aerobic exercise training in these animals (DDX) without altering total LDL concentration. Using 2‐DE, Western blot, label‐free quantitative MS, and selected reaction monitoring, alterations in the abundance of apolipoproteins A‐I, B, C‐III, D, E, and J and noncovalently associated proteins were determined in LDL isolated using fast protein liquid chromatography. At least 28 unique proteins, many of which were novel, were identified with high confidence. An apolipoprotein E isoform demonstrated stronger correlation to disease (percent of coronary artery segments with intimal thickening) than some traditional risk factors (total cholesterol, LDL cholesterol, and LDL/HDL cholesterol). Taken together, this work identifies new possible biomarkers, potential therapeutic targets for atherosclerosis, and generates new hypotheses regarding the role of LDL in atherogenesis.     

Changes of lysosomes in the earliest stages of the development of atherosclerosis

One of hypotheses of atherosclerosis is based on a presumption that the zones prone to the development of atherosclerosis contain lysosomes which are characterized by enzyme deficiency and thus, are unable to dispose of lipoproteins. The present study was undertaken to investigate the characteristics and changes of lysosomes in the earliest stages of the development of atherosclerosis. Electron microscopic immunocytochemistry revealed that there were certain changes in the distribution of CD68 antigen in lysosomes along the ‘normal intima‐initial lesion‐fatty streak’ sequence. There were no significant changes found in the key mRNAs encoding for the components of endosome/lysosome compartment in initial atherosclerotic lesions, but in fatty streaks, the contents of EEA1 and Rab5a mRNAs were found to be diminished while the contents of CD68 and p62 mRNAs were increased, compared with the intact tissue. The study reinforces a view that changes occurring in lysosomes play a role in atherogenesis from the very earlier stages of the disease.     

Pharmacological basis of different targets for the treatment of atherosclerosis

The development of atherosclerotic plaque is a highly regulated and complex process which occurs as a result of structural and functional alterations in endothelial cells, smooth muscle cells (SMCs), monocytes/macrophages, T-lymphocytes and platelets. The plaque formation in the coronary arteries or rupture of the plaque in the peripheral vasculature in latter stages of atherosclerosis triggers the onset of acute ischemic events involving myocardium. Although lipid lowering with statins has been established as an important therapy for the treatment of atherosclerosis, partially beneficial effects of statins beyond decreasing lipid levels has shifted the focus to develop newer drugs that can affect directly the process of atherosclerosis. Blockade of renin angiotensin system, augmentation of nitric oxide availability, reduction of Ca(2+) influx, prevention of oxidative stress as well as attenuation of inflammation, platelet activation and SMC proliferation have been recognized as targets for drug treatment to control the development, progression and management of atherosclerosis. A major challenge for future drug development is to formulate a combination therapy affecting different targets to improve the treatment of atherosclerosis.     

Hyperlipidaemia and aortic valve disease

PURPOSE OF REVIEW: Degenerative aortic valve stenosis is a common disease in the elderly, and traditional risk factors for atherosclerotic disease including hyperlipidaemia have been associated with the condition in several studies. This review addresses the role of the various risk factors and the potential for intervention. RECENT FINDINGS: The association of lipid abnormalities such as high lipoprotein(a) levels and the presence of the apolipoprotein E4 allele with aortic stenosis, as well as the presence of several inflammatory markers both in plasma and in surgically excised valves, suggest that the stenotic process is driven by many of the same factors behind atherosclerosis. The aortic valves of animals fed a cholesterol-rich diet exhibit many characteristics in common with the early stages of aortic stenosis. This opens up the potential of retarding the process through intervention strategies. SUMMARY: Hyperlipidaemia is associated with degenerative aortic valve stenosis, and the disease resembles the inflammatory process of atherosclerosis. Randomized controlled clinical trials will be needed to demonstrate the role of lipid intervention in patients with this condition.     

Thermochemical conversion of livestock wastes: Carbonization of swine solids

Slow pyrolysis or carbonization promotes the conversion of animal manures such as swine manure into charcoal. In this paper, the carbonizing kinetics of swine solids taken from different treatment stages were investigated with a thermogravimetric analyzer. Compared to their biologically stabilized counterpart (lagoon sludge) with an activation energy of 160 kJ mol⁻¹, the activation energies for fresh swine solid samples such as homogenized flushed manure and dewatered solids were much lower between 92 and 95 kJ mol⁻¹. Compared to the kinetics of first order decomposition of cellulose, the pyrolytic decomposition of the swine manures were more complex with the reaction orders varying at 3.7 and 5.0. The two different mathematical methods employed in this paper yielded the similar values of activation energy (E) and pre-exponential factor (A), confirming the validity of these methods. The results of this study provide useful information for development of farm-scale swine solid carbonization process.     

Prostanoids suppress the coronary vasoconstrictor influence of endothelin after myocardial infarction

Myocardial infarction (MI) is associated with endothelial dysfunction resulting in an imbalance in endothelium-derived vasodilators and vasoconstrictors. We have previously shown that despite increased endothelin (ET) plasma levels, the coronary vasoconstrictor effect of endogenous ET is abolished after MI. In normal swine, nitric oxide (NO) and prostanoids modulate the vasoconstrictor effect of ET. In light of the interaction among NO, prostanoids, and ET combined with endothelial dysfunction present after MI, we investigated this interaction in control of coronary vasomotor tone in the remote noninfarcted myocardium after MI. Studies were performed in chronically instrumented swine (18 normal swine; 13 swine with MI) at rest and during treadmill exercise. Furthermore, endothelial nitric oxide synthase (eNOS) and cyclooxygenase protein levels were measured in the anterior (noninfarcted) wall of six normal and six swine with MI. eNOS inhibition with N(ω)-nitro-L-arginine (L-NNA) and cyclooxygenase inhibition with indomethacin each resulted in coronary vasoconstriction at rest and during exercise, as evidenced by a decrease in coronary venous oxygen levels. The effect of l-NNA was slightly decreased in swine with MI, although eNOS expression was not altered. Conversely, in accordance with the unaltered expression of cyclooxygenase-1 after MI, the effect of indomethacin was similar in normal and MI swine. L-NNA enhanced the vasodilator effect of the ET(A/B) receptor blocker tezosentan but exclusively during exercise in both normal and MI swine. Interestingly, this effect of L-NNA was blunted in MI compared with normal swine. In contrast, whereas indomethacin increased the vasodilator effect of tezosentan only during exercise in normal swine, indomethacin unmasked a coronary vasodilator effect of tezosentan in MI swine both at rest and during exercise. In conclusion, the present study shows that endothelial control of the coronary vasculature is altered in post-MI remodeled myocardium. Thus the overall vasodilator influences of NO as well as its inhibition of the vasoconstrictor influence of ET on the coronary resistance vessels were reduced after MI. In contrast, while the overall prostanoid vasodilator influence was maintained, its inhibition of ET vasoconstrictor influences was enhanced in post-MI remote myocardium.     

Measurement by electrical impedance aggregometry of porcine platelets response to selected physiological agonists

Although the domestic swine is commonly employed for physiological studies of the coronary circulation, there is relatively little data available concerning the responsiveness in whole blood of normal porcine platelets to standard physiological agonists. Such information is essential if the domestic swine is to be used as an animal model for studying potential interactions between platelets and the coronary circulation. Accordingly, the present study was undertaken to characterize the responses (aggregation and ATP release) observed in whole blood of normal porcine platelets to selected physiological agonists. The responses of platelets from 10 normal human volunteers also were studied with this system for comparison. Agents tested included ADP, arachidonic acid, collagen, epinephrine, norepinephrine, and thrombin. Studies were conducted with the Chronolog impedance aggregometer. The results demonstrate that platelets of domestic swine are reactive to ADP, arachidonic acid, and collagen. In contrast, neither epinephrine nor norepinephrine alone induced aggregation or release. Norepinephrine, however, caused modest potentiation of aggregation in response to ADP only. At 1 mM concentration each catecholamine inhibited the release response to collagen while at 10 mM each inhibited aggregation and release in response to either ADP or collagen. The data obtained indicate the domestic swine may be employed as a useful model to examine interactions between platelets and the coronary circulation.     

Fatty acids modulate calcium-induced calcium release from skeletal muscle heavy sarcoplasmic reticulum fractions: implications for malignant hyperthermia

Based on studies in swine, the malignant hyperthermia syndrome has been postulated to result from an enhanced sensitivity (low threshold) of the Ca2(+)-induced Ca2(+)-release process. However, fatty acid production is elevated in homogenates of skeletal muscle from pigs and humans susceptible to malignant hyperthermia. In the present study, we demonstrate that the threshold of Ca2(+)-induced Ca2+ release is normal in susceptible humans and in susceptible swine depleted of triglycerides. Exogenously added unsaturated fatty acids decreased the threshold of Ca2(+)-induced Ca2+ release to a much greater extent in porcine and equine muscle than in human muscle. When triglyceride and free fatty acid values were reduced to about 40 and 60%, respectively, of control values, malignant hyperthermia-susceptible swine did not exhibit muscle rigidity when challenged in vivo with halothane and succinylcholine and the threshold of the Ca2(+)-induced Ca2(+)-release process in heavy sarcoplasmic reticulum fractions was normal. Despite the reduced triglyceride and fatty acid levels, these swine had a positive in vitro contracture test for malignant hyperthermia. A low Ca2(+)-induced Ca2(+)-release threshold is not essential for malignant hyperthermia susceptibility, but appears to be the result of excessive free fatty acids produced during organelle isolation.     

Neovascularization in human atherosclerosis

In the absence of disease, microvessels provide vessel wall nutrients to the tunica media, while the intima is fed by oxygen diffusion from the lumen. As disease evolves and the tunica intima thickens, oxygen diffusion is impaired, and microvessels become the major source for nutrients to the vessel wall. Microvessels serve as a port of entry for inflammatory cells, from the systemic circulation to the nascent atherosclerotic lesion. As disease progress, microvessels also play a role in intraplaque hemorrhage, lipid core expansion, and plaque rupture. In addition, microvessels are also involved in stent restenosis, and plaque regression. Therefore, microvessels are a pivotal component of atherosclerosis, and proper patient risk-stratification in the near future may include the detection of increased neovascularization in atherosclerotic lesions. This review divided in two parts summarizes the current understanding of atherosclerosis neovascularization, starting with the normal anatomy and physiology and progressing to more advanced stages of the disease. We will review the structure and function of vasa vasorum in health and disease, the mechanisms responsible for the angiogenic process, the role of the immune system, including inflammation and Toll-like receptors, and the pathology of microvessels in early atherosclerotic plaques. Furthermore, the review addresses the advanced stages of atherosclerosis, summarizing the progressive role for microvessels during disease progression, red blood cell extravasation, lipid core expansion, plaque rupture, healing, repair, restenosis, and disease regression, offering the clinician a state-of-the-art, "bench to bedside" approach to neovascularization in human atherosclerosis.     

The role of cytokines in the development of atherosclerosis

Atherosclerosis contributes to the development of many cardiovascular diseases, which remain the leading cause of death in developed countries. Atherosclerosis is a chronic inflammatory disease of large and medium-sized arteries. It is caused by dyslipidemia and mediated by both innate and adaptive immune responses. Inflammation is a key factor at all stages of atherosclerosis progression. Cells involved in pathogenesis of atherosclerosis were shown to be activated by soluble factors, cytokines, that strongly influence the disease development. Pro-inflammatory cytokines accelerate atherosclerosis progression, while anti-inflammatory cytokines ameliorate the disease. In this review, we discuss the latest findings on the role of cytokines in the development and progression of atherosclerosis.     

Intravenous lysine vasopressin lowers body temperature in normal and febrile pigs.

Vasopressin has been implicated as a centrally acting endogenous antipyretic. However, in several species, including the pig, plasma vasopressin concentrations increase during the early stages of fever. This experiment investigated the effects of intravenous lysine vasopressin on core temperature in normal and febrile swine. Lysine vasopressin (20 microg/pig) stimulated cortisol release and induced a 60-min hypothermic episode in normal animals, although a 10-fold lower dose was without effect. The peptide also delayed the pyretic response to bacterial endotoxin (20 microg intravenously). It is speculated that the hypothermic action of circulating vasopressin may involve nitric oxide.     

G?ttingen miniature swine as a model for diet-induced atherosclerosis

Twenty-four G?ttingen Miniature Swine/csk, in order to evaluate their potential usefulness as a model for experimental atherosclerosis studies, were fed diets of three types, a high-fat plus high cholesterol diet, a high-fat diet, and a commercial diet. Each group consisted of 4 males and 4 females. Swine fed the experimental diet were investigated by gross, microscopic and serum biochemical examination on the 1st, 3rd, 6th and 9th month after start of experimentation. Lesions of atherosclerosis were observed in the high-fat plus high-cholesterol diet group. After a month on the experimental diet, intimal thickening was detected in the abdominal aorta just above the origin of internal iliac artery, left coronary artery and ascending aorta by microscopic examination. Thereafter, on the 9th month after the start, there was more extensive and severe atherosclerosis. These lesions were classified into two types by the difference in the histologic architecture of arterial wall. One was fatty streaks that were in thoracic aorta belonging to the elastic type and the other was fibrous plaques that were in abdominal aorta and iliac artery and so on, belong to the transitional or muscular type. High-fat plus high-cholesterol diet feeding led to elevated serum cholesterol and beta-lipoprotein levels, and had an effect on several kinds of metabolism. All of the swine fed high-fat or commercial diet had little gross, microscopic lesions and had no change in serum cholesterol and beta-lipoprotein levels. Hypercholesterolemia and hyper-beta-lipoproteinemia had a close relation to the development and acceleration of atherosclerosis. It was possible to show that the diet induced atherosclerosis was similar in quality to that observed in humans, and that the G?ttingen miniature swine was a suitable animal for the study of atherosclerosis.     

Method for detection and isolation of cholesteryl ester-containing "foam" cells using flow cytometry

Accumulation of cholesteryl ester within vascular cells is a defining characteristic of atherosclerotic lesions. Therefore, it is of interest to be able to monitor this critical event in the development of atherosclerosis. With this objective in mind, we have developed a method for the detection of cholesteryl ester-containing cells (i.e., foam cells) in cell suspensions prepared from enzymatically dissociated aortas. Cholesteryl ester in aortic cells was selectively stained with the fluorescent dye filipin. Because filipin binds to unesterified cholesterol but not to esterified cholesterol, it was necessary first to remove unesterified cholesterol from cells by ethanol extraction so that its presence would not interfere with the specific detection of cholesteryl ester. Then unesterified cholesterol made available by enzymatic hydrolysis of cellular cholesteryl ester could be specifically stained with filipin. The filipin-stained cell suspensions were analyzed using flow cytometry. With a flow cytometer it was possible to detect and sort cholesteryl ester-containing cells onto glass slides for microscopic analysis. Cell suspensions prepared from either grossly normal or atherosclerotic swine aortas contained cells with cholesteryl ester inclusions. As expected, these cells were more numerous in the atherosclerotic aortas. Cells with higher levels of fluorescence contained more numerous cholesteryl ester inclusions. Flow cytometric detection of cholesteryl ester-containing cells should be generally useful in studies of cellular cholesterol metabolism as well as in specific studies of cellular cholesterol accumulation in atherosclerotic vessels.     

Microalgae-based processes for the biodegradation of pretreated piggery wastewaters

The potential and limitations of photosynthetic oxygenation on carbon and nitrogen removal from swine slurry were investigated in batch experiments using Chlorella sorokiniana and an acclimated activated sludge as model microorganisms. While algal-bacterial systems exhibited similar performance than aerated activated sludge in tests supplied with four and eight times diluted slurry, a severe inhibition of the biodegradation process was recorded in undiluted and two times diluted wastewater. Daily pH adjustment to 7 in enclosed algal-bacterial tests at several swine slurry dilutions allowed the treatment of up to two times diluted slurries (containing up to 1,180 mg N-NH(4) (+) l(-1)). The combination of high pH levels and high NH(4) (+) concentrations was thus identified as the main inhibitory factor governing the efficiency of photosynthetically oxygenated processes treating swine slurry. Measurements of soluble total organic carbon (TOC) and volatile fatty acids (VFA) present in the slurry suggested that VFA degradation (mainly acetic and propionic acid) accounted for most of the soluble TOC removal, especially during the initial stages of the biodegradation process. On the other hand, assimilation into biomass and nitrification to NO(2) (-) constituted the main NH(4) (+) removal processes in enclosed algal-bacterial systems.     

Zinc deficiency in Chronic Kidney Disease: Is there a Relationship with Adipose Tissue and Atherosclerosis?

Cardiovascular complications caused by an accelerated atherosclerotic disease consist the major cause of morbidity and mortality in patients with chronic kidney disease (CKD). These patients present multiple atherosclerotic risk factors, considered traditional, as well as nontraditional risk factors such as inflammation and oxidative stress. These complications are also seen in obesity, in which endothelial dysfunction is one of the early stages of atherosclerosis. The impact of trace metal deficiencies on this process is not well studied in patients with CKD and in obese people, although the influence of trace elements depletion, particularly zinc (Zn), may have significant clinical implications. This brief review describes the functions of Zn as well as the respective role of this trace element in atherosclerosis processes, with a particular emphasis on obese patients with chronic kidney disease.     

The role of vitamin E in atherosclerosis

Epidemiological and biochemical studies infer that oxidative processes, including the oxidation of low-density lipoprotein (LDL), are involved in atherosclerosis. Vitamin E has been the focus of several large supplemental studies of cardiovascular disease, yet its potential to attenuate or even prevent atherosclerosis has not been realised. The scientific rationale for vitamin E supplements protecting against atherosclerosis is based primarily on the oxidation theory of atherosclerosis, the assumption that vitamin E becomes depleted as disease progresses, and the expectation that vitamin E prevents the oxidation of LDL in vivo and atherogenic events linked to such oxidation. However, it is increasingly clear that the balance between vitamin E and other antioxidants may be crucial for in vivo antioxidant protection, that vitamin E is only minimally oxidised and not deficient in atherosclerotic lesions, and that vitamin E is not effective against two-electron oxidants that are increasingly implicated in both early and later stages of the disease. It also remains unclear as to whether oxidation plays a bystander or a casual role in atherosclerosis. This lack of knowledge may explain the ambivalence of vitamin E and other antioxidant supplementation in atherosclerosis.