The role of the monocyte/macrophage system in lipoprotein metabolism.
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Biomedical subjects
Publications and source records attributed to J Shepherd.
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Biplanar radiography was used to assess the normal three-dimensional movements of the lumbar spine in the erect posture in a group of asymptomatic volunteers. The primary movements investigated were flexion and extension, while the three-dimensional analysis also measured any associated coupled lateral bends and axial rotations. The results showed that each intervertebral joint had a total range of flexion and extension of approximately 14 degrees, the lower levels moving slightly more than the upper levels. All the intervertebral joints had more movement in flexion than extension from the upright position, except for the L5/S1 joint, which showed no consistent pattern, some subjects extending more than flexing. Coupled movements of 4 degrees or more in flexion and 3 degrees or more in extension were shown to be abnormal.
The function of the low density lipoprotein receptor has been reviewed at the cell level and in man. Its key role in cholesterol metabolism is unquestioned and it is central to the actions of a number of important hypocholesterolaemic agents. Clearly it must be involved in atherogenesis since its dysfunction leads to premature and severe atherosclerosis in both animals and man. The tools are now available to address this question and answers should be forthcoming in the near future.
This study describes the effects of bezafibrate, an analogue of clofibrate, on the plasma lipid and lipoprotein profiles of 11 hypertriglyceridemic subjects and on their metabolism of apolipoproteins A-I, A-II, and B. The major action of the drug was to lower plasma triglyceride (by 58%; P less than 0.01). This was accompanied by a reduction in the level of very low density lipoprotein apoprotein B (Svedberg units of flotation [Sf] 60-400), whose mean residence time in the plasma fell threefold (from 3.4 to 1.0 h). Synthesis of the B protein in this fraction was not significantly altered, so the drug acts to accelerate the transit of very low density lipoprotein particles down the delipidation cascade. The metabolism of very low density lipoprotein remnant apoprotein B (Sf 12-100) changed little in response to treatment, although we detected a 30% increment (P less than 0.05) in the plasma concentration of this fraction. The mean residence time of these remnant particles in the plasma did not correlate with that of Sf 100-400 very low density lipoprotein apoprotein B, nor was this parameter altered by the drug. The most consistent and significant perturbation seen in the Sf 0-12 fraction (low density lipoprotein) was a reduction in the fractional catabolism of its apoprotein B moiety (26%; P less than 0.05). In those subjects who were grossly hypertriglyceridemic and who responded well to treatment, the level of this protein rose substantially owing to a combined increase in its synthesis and a reduction in its catabolism. In the group as a whole, high density lipoprotein cholesterol rose 13% (P less than 0.02), and detailed examination showed that this was associated with a small but significant increment in the plasma concentration of the high density lipoprotein subfraction 2. High density lipoprotein subfraction 3 also rose on the average, but this was not a consistent feature in all patients. The plasma concentrations and turnovers of the A proteins (A-I and A-II) were not significantly altered by bezafibrate therapy.
The metabolic fate of very low density lipoprotein can be examined by following the transit of its apolipoprotein B moiety through the delipidation cascade, which leads to low density lipoprotein. In this study we have used cumulative flotation ultracentrifugation to follow the metabolism of various lipoprotein subclasses that participate in this process in normal, hypertriglyceridemic (Type IV), and dysbetalipoproteinemic (Type III) subjects. Large triglyceride-rich very low density lipoproteins of Svedberg units of flotation (Sf) 100-400 were converted virtually quantitatively in normal subjects to smaller Sf 12-100 remnant particles. Only a minor fraction appeared thereafter in low density lipoproteins (Sf 0-12), most being removed directly from the plasma. Type IV hyperlipoproteinemic individuals converted the larger Sf 100-400 very low density lipoproteins to intermediate particles at approximately 50% of the control rate but thereafter their metabolism was normal (fractional clearance of Sf 12-100 particles in controls, 1.29 +/- 0.23 pools/d; in Type IV hypertriglyceridemics, 1.38 +/- 0.23 pools/d; n = 4 in each case). Since the apolipoprotein B in large triglyceride-rich particles did not contribute significantly to the mass of the low density lipoprotein apoprotein pool, the latter must come largely from another source. This was examined by following the metabolic fate of small very low density lipoproteins of Sf 20-60 or of the total lipoprotein spectrum of d less than 1.006 kg/liter (approximate Sf 20-400). The small particles were rapidly and substantially converted to low density lipoproteins, suggesting that the major precursor of the latter was to be found in this density range. Whereas only 10% of apolipoprotein B in Sf 100-400 lipoproteins reached the low density lipoprotein flotation range, greater than 40% of Sf 20-100 B protein eventually appeared in Sf 0-12 particles; and when very low density lipoprotein of d less than 1.006 kg/liter is used as a tracer of apolipoprotein B metabolism it is primarily this population of small very low density lipoprotein particles in the Sf 12-100 flotation range that is labeled. A detailed examination was made of apolipoprotein B metabolism in three dysbetalipoproteinemic subjects. The plasma clearance curves of their Sf 100-400 lipoproteins were distinctly biphasic. The quickly decaying component converted rapidly into remnants of Sf 20-60 at a near normal rate (0.56 vs. 0.62 pools/d in normal subjects). Its subsequent processing, however, was retarded. The more slowly catabolized fraction, comprising 30% of the total apolipoprotein B radioactivity, had no counterpart in normal or Type IV hyperlipoproteinemic individuals. These data, taken together, suggest that the very low density lipoprotein consists of a complex mixture of particles with different origins and fates. Within the Sf 20-100 flotation range there are at least two subcomponents. One represents remnants of larger triglyceride-rich particles which are catabolized slowly and feeds little apolipoprotein B into low density lipoprotein. The other is apparently secreted directly into this flotation interval and transfers significant amounts of B protein rapidly into Sf 0-12 lipoproteins.
Monoclonal antibodies to epithelial cells, antigenic determinants labelled with I123 and I125, were administered to 10 immunodeficient mice bearing subcutaneous xenografts of human ovarian cancer. Radio scans of the body taken with a gamma camera at various time intervals demonstrated the presence of the cancer in all the mice. The smallest detectable tumor was approximately 1 mm in diameter. In a subsequent clinical study using 123I-labelled monoclonal antibodies in 10 patients with ovarian cancer, tumor detection was achieved in 8 patients, with tumor uptake of labelled antibody ranging between 0.2-2.6%. As a complementary method to existing forms of diagnosis, the targeting of monoclonal antibodies to ovarian cancer cells in vivo raises the hope of achieving early diagnosis in otherwise undetectable ovarian cancer, and provides encouragement to the concept of selective therapy in oncology.
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The DNA sequence of a new IS element, the IS26, is 820 bp long and carries 14 bp perfect terminal inverted repeats. Upon integration, IS26 generates an 8 bp duplication of its target sequence. A large open reading frame within IS26 could code for a protein of 234 amino acids. On its reverse strand, IS26 also carries one large open reading frame, 591 bp long, which contains no stop codon within IS26.
In this study immunological procedures were used to detect and quantify high-density lipoprotein (HDL) particles of differing apolipoprotein A composition. In the plasma of eight healthy female subjects, 45% of the total apolipoprotein A-I existed in particles (called '(AI)HDL') devoid of apolipoprotein A-II. The remainder circulated in association with apolipoprotein A-II at a molar ratio of approximately 1:1. Nicotinic acid selectively raised the plasma apolipoprotein A-I/A-II ratio by increasing the proportion of (AI)HDL particles. Probucol produced the opposite effect, lowering the plasma concentration of these particles. The kinetic properties of apolipoprotein A-I in total HDL and in the (AI)HDL particle were the same despite the fact that apolipoprotein A-I equilibration between these two species was incomplete. Therefore, there appear to be at least two apolipoprotein A-containing particle populations in HDL which are immunochemically and metabolically distinct.
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This study examines the effects of increased dietary cholesterol (6 eggs/d) on the metabolism of low density lipoproteins in a group of seven healthy volunteers. Egg supplementation raised high density and low density lipoprotein cholesterol levels by 18 and 40%, respectively. The composition of the low density lipoprotein was unaltered and therefore the number of circulating particles must have increased. Kinetic studies indicated that this was due primarily to a 23% rise in the rate of synthesis of the lipoprotein. Catabolism was also affected. The fractional removal rate of native low density lipoprotein fell by 10% (P less than 0.05). However, the clearance of the 1,2 cyclohexanedione-treated lipoprotein remained unchanged (control fractional clearance rate [FCR] = 0.188 pools/d; cholesterol feeding FCR = 0.183 pools/d). Therefore, the reduction in low density lipoprotein catabolism appeared to be due to a fall in receptor activity. Consequently, an increased sterol load (34.2 mumol/kg per d vs. 27.7 mumol/kg per d in the control phase, P less than 0.02) was channelled into the receptor-independent route during egg feeding.
Plasma samples obtained from 69 fasting retinitis pigmentosa (RP) patients and 110 controls were assayed for cholesterol, triglycerides, lipoproteins, and fatty acids. It was found that many RP patients were hyperlipidaemic compared to their spouses and siblings, as well as compared to unrelated controls. This hyperlipideaemia was particularly severe in men over 35 years of age, and in hemizygotes in X-linked families. In contrast, hypocholesterolaemia was observed in albipunctate retinal dystrophy. Plasma fatty acid titres were, in general, similar in RP patients and controls; however, patients in three families (two X-linked, one autosomal dominant) showed a significant reduction in docosahexaenoic acid (C22:6) compared to their unaffected relatives. These various plasma lipid abnormalities may reflect disorders in lipid metabolism which also may lead to retinal dystrophy.
This study examines the effects of probucol (1 g/day) on the plasma concentration, composition, and metabolism of low and high density lipoproteins (LDL and HDL) in eleven hyperlipidemic subjects, (seven Type II and four Type IV). The drug lowered plasma cholesterol in the Type II patients by 11% (P < 0.02) without affecting triglyceride. Both LDL and HDL cholesterol levels fell by 6% and 26%, respectively. The small reduction in the former was not associated with a change in the composition of the lipoprotein nor with a measurable alteration in the level of circulating apoLDL. Kinetic studies revealed that probucol had no consistent effect on either the synthesis or catabolism of apoLDL. However, probucol did exert a potent influence on HDL, lowering the level of this lipoprotein in both the Type II and Type IV patients despite the fact that total plasma cholesterol in the latter group was unchanged by treatment. The fall in HDL mass largely affected the HDL(3) subfraction; HDL(2), which was initially low in our subjects, did not show a consistent response to therapy. Not all of the constituents in HDL were equally affected by the drug. Specifically, the fall in total plasma apoA levels (which derived from significant reductions in the rates of synthesis of apoproteins A-I and A-II) was less than that of HDL cholesterol. Direct measurement of the composition of the lipoprotein confirmed that during therapy it carried less cholesterol per unit protein. The significance of these observations in relation to the prophylaxis of ischemic heart disease is not yet clear, but it seems prudent at present to use probucol selectively in subjects who show a substantial hypocholesterolemic response that derives primarily from a reduction in circulating LDL.-Atmeh, R. F., J. M. Stewart, D. E. Boag, C. J. Packard, A. R. Lorimer, and J. Shepherd. The hypolipidemic action of probucol: a study of its effects on high and low density lipoproteins.
The LDL receptor pathway, which was delineated in cultured cells, is now known to operate in vivo. In this study we have measured the plasma clearances and tissue uptakes of native and chemically modified (1,2-cyclohexanedione-treated or reductively methylated) LDL in rabbits in order to determine the response of the pathway to a high-cholesterol diet. 1 week on the diet increased circulating LDL and suppressed its receptor-mediated plasma clearance and uptake into all tissues. The fractional catabolic rate of the lipoprotein via the receptor-independent route also fell. Continuation of the feeding program for 12 weeks accentuated these changes and virtually eliminated receptor uptake into all tissues so that the plasma decay curves of native and cyclohexanedione-treated LDL were superimposable. Lipoprotein assimilation by the aorta, however, did not follow this general trend. This tissue, after 12 weeks, was variably infiltrated by atheromatous deposits and the appearance of these lesions was associated with a substantial increase in the relative uptakes of both native and chemically modified (cyclohexanedione-treated and reductively methylated) LDL. We concluded (a) that expansion of tissue cholesterol pools virtually abolishes LDL receptor activity in rabbits; and (b) that LDL assimilation (both apparently receptor-mediated and receptor-independent) paradoxically increases at sites where the aorta is affected by atheromatous lesions.
Two tumour-associated monoclonal antibodies, HMFG1 and HMFG2, were labelled with iodine-123 and used to detect primary and metastatic ovarian, breast, and gastrointestinal neoplasms by external body scintigraphy in twenty patients with advanced disease. Tumours became visible 3 min to 18 h after injection of labelled antibody. The presence of antibody in the tumours was confirmed by autoradiography and immunoperoxidase staining of surgically removed tissues. The mean tumour uptake of radiolabel was 0.6% of the injected amount. These antibodies can therefore localise specifically to tumours and successful imaging can thus be achieved. This method can complement existing diagnostic techniques and also provide a basis for a selective therapeutic approach to malignant disease.
This study examines the role of the reticuloendothelial system in the metabolism and tissue uptake of chemically modified human low density lipoprotein (LDL) in rabbits. Treatment with 1,2-cyclohexanedione or HCHO/NaBH4 abolishes receptor-mediated catabolism of the lipoprotein and restricts its clearance to receptor-independent pathways. When the plasma clearances of the two modified lipoproteins were measured in rabbits the 1,2-cyclohexanedione-treated LDL was removed 19% faster (P less than 0.001) than HCHO/NaBH4-treated LDL. This was associated with an increased uptake of 1,2-cyclohexanedione-treated LDL over HCHO/NaBH4-treated LDL into tissues, particularly the liver and spleen, suggesting that their differential clearance may have involved the reticuloendothelial system. To examine this possibility the experiment was repeated in animals whose reticuloendothelial activity had been suppressed by injections of an ethyl oleate emulsion. This reduced the difference in the plasma clearance rates of 1,2-cyclohexanedione-treated LDL and HCHO/NaBH4-treated LDL and virtually abolished their differential tissue uptakes, adding weight to the proposal that the reticuloendothelial system may be involved in the receptor-independent catabolism of LDL.