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High density lipoproteins (HDL) are susceptible to structural modifications mediated by various mechanisms including oxidation, glycation, homocysteinylation or enzymatic degradation. Structural alterations of HDL may affect their functional and atheroprotective properties. Oxidants, such as hypochlorous acid, peroxyl radicals, metal ions, peroxynitrite, lipoxygenases and smoke extracts, can alter both surface and core components of HDL. The formation of lipid peroxidation derivatives, such as thiobarbituric acid reactive substances, conjugated dienes, lipid hydroperoxides and aldehydes, is associated with changes of physical properties (fluidity, molecular order) and of apoprotein conformation. Non-enzymatic glycation, generally associated with lipoxidation, leads to form irreversible complexes called advanced glycation end products. These HDL modifications are accompanied with altered biological activities of HDL and associated enzymes, including paraoxonase, CETP and LCAT. Homocysteine-induced modification of HDL is mediated by homocysteine-thiolactone, and can be prevented by a calcium-dependent thiolactonase/paraoxonase. Tyrosylation of HDL induces the formation of dimers and trimers of apo AI, and alters cholesterol efflux. Phospholipases and proteolytic enzymes can also modify HDL lipid and apoprotein structure. HDL modification induces generally the loss of their anti-inflammatory and cytoprotective properties. This could play a role in the pathogenesis of atherosclerosis and neurodegenerative diseases such as Alzheimer's disease.

The aim of the present study was to determine if low-density lipoproteins (LDLs) and red blood cell (RBC) membranes from diabetic patients present an increased susceptibility to lipoperoxidation, which might be related to the increased incidence of atherosclerosis in diabetes. LDLs and RBC membranes were isolated from 11 insulin-dependent (IDDM) and 18 non-insulin-dependent diabetic (NIDDM) patients and exposed to a peroxidative stress by incubation with phenylhydrazine. The susceptibility to peroxidation was determined by measuring the production of thiobarbituric acid-reactive substances (TBARS) after the incubation. The following parameters were also evaluated: plasma glucose, triglycerides (TG), phospholipids (PL), total and high-density lipoprotein (HDL) cholesterol, apolipoprotein (apo) A-I, apo B, hemoglobin A1c (HbA1c), LDL PL and cholesterol, LDL fatty acid composition, and RBC membrane PL and cholesterol. Although they were apparently normolipidemic, diabetic patients showed an increased susceptibility to peroxidation in LDLs and erythrocyte membranes as compared with control subjects. The amount of arachidonic acid in LDLs and the PL concentration of RBC membranes from diabetic patients were significantly higher than in normal subjects. The increased lipoperoxidability of both RBC membranes and LDLs might play a central role in the pathogenesis of the vascular complications of diabetes mellitus.

— The relative abilities of UV-A, B and C radiations to initiate lipid peroxidation and apolipoprotein (apo) B modification of human purified low density lipoproteins have been compared. Ultraviolet-B and C (at 310 and 254 nm, respectively) exhibited similar efficacy as shown by the increase in lipid peroxidation markers (conjugated dienes, thiobarbituric acid reactive substances and fluorescent lipid soluble products) and in oxysterols, as well as by the decrease of the contents of natural antioxidants (tocopherols and carotenes) and in polyunsaturated fatty acids. In contrast, UV-A (at 360 nm) was found poorly effective and only at very high radiation intensities. Under all the conditions used, apoB was not affected by the UV radiations as shown by the stability of amino acid composition (except tryptophan level) and of trinitrobenzenesulfonic acid reactive amino group content. Similarly, the low density lipoprotein size was not altered. By comparison, low density lipoproteins oxidized by transition metal presented strong alterations of apoB and major changes of the apparent low density lipoprotein size. Finally, low density lipoproteins irradiated by UV-B or C exhibited a much higher cytotoxicity on cultured cells than those irradiated by UV-A. Under the conditions used in this paper, the cytotoxic effect of the irradiated low density lipoproteins was positively correlated with their content in lipid peroxidation products and inversely correlated with their tocopherol content.

The 'cytotoxicity' of ultraviolet-treated low-density lipoproteins (LDL) has been investigated using cultured lymphoid cell lines from normal subjects and from a patient with receptor-negative familial hypercholesterolemia. The ultraviolet-treated LDL were taken up by control lymphoblasts through the classical apo B/E-receptor pathway, while they were slowly taken up by receptor-negative lymphoblasts by non-specific endocytosis. These LDL were found highly 'cytotoxic' on normal lymphoblasts as demonstrated by Trypan blue dye uptake, [3H]thymidine incorporation, lactate dehydrogenase release and by electron microscopy. The 'cytotoxicity' increased progressively with the concentration of ultraviolet-treated LDL in the culture medium and with the incubation time. In contrast, lymphoblasts from familial hypercholesterolemia were not sensitive to low doses of ultraviolet-treated LDL (up to 150 micrograms apo-B/ml). The comparison of cells from normals and familial hypercholesterolemia showed that the 'cytotoxic' effect occurred subsequently to the LDL uptake, either receptor-mediated or receptor-independent. Experiments combining short-time (5 h) pulse with ultraviolet-treated LDL (labelled with [3H]cholesteryl oleyl ether) and a relatively long-chase period (72 h) showed: (1) a relationship between the delay for the appearance of the 'cytotoxicity' and the amount of ultraviolet-treated LDL taken up by the cells; and (2) the existence of a minimal dose (threshold dose) for triggering the 'cytotoxic' effect. The use of 'hybrid' LDL, prepared by partial delipidation of non-treated LDL and reconstitution by re-incorporating the neutral lipid fractions isolated from ultraviolet-treated LDL, demonstrated that the 'cytotoxic' effect is mainly mediated by triacylglycerols and cholesteryl esters. Scanning electron microscopy showed that the most prominent morphological change resulting from the uptake of ultraviolet-treated LDL was the early blebbing of plasma membranes.

Transgenic mice overexpressing human apolipoprotein A-II (huapoA-II) display high VLDL and low HDL levels. To evaluate the antioxidant potential of huapoA-II enriched HDL, we measured the activities of paraoxonase (PON) and platelet-activating factor acetylhydrolase (PAF-AH). Both activities decreased up to 43% in the serum of transgenic mice compared with controls, varied in parallel to HDL levels, but decreased less than HDL levels. The major part of PON and PAF-AH was associated with HDL, except in fed high huapoA-II-expressing mice, in which 20% of PAF-AH and 9% of PON activities were associated with VLDL. PON mRNA levels in the liver, its major site of synthesis, were similar in transgenic and control animals, indicating normal enzyme synthesis. In transgenic mice, the basal oxidation of lipoproteins was not increased, whereas their VLDL were more susceptible to oxidation than VLDL of controls. Interestingly, HDL of transgenic mice protected VLDL from oxidation more efficiently than HDL of controls. In conclusion, the decrease in both PON and PAF-AH activities in huapoA-II transgenic mice is best explained by their lower plasma HDL levels. However, the unchanged basal lipoprotein oxidation in transgenic mice suggests that huapoA-II-rich HDL may maintain adequate antioxidant potential.—Boisfer, E., D. Stengel, D. Pastier, P. M. Laplaud, N. Dousset, E. Ninio, and A-D. Kalopissis. Antioxidant properties of HDL in transgenic mice overexpressing human apolipoprotein A-II. J. Lipid Res. 2002. 43: 732–741.

Publisher Summary Low-density lipoproteins (LDL) can be oxidized by transition metals, by cells including endothelial cells, smooth muscle cells, monocytes, macrophages, and fibroblasts, and also by irradiation. Low-density lipoproteins oxidatively modified by metal ions are characterized by alterations in biochemical composition because of the hydrolysis of phospholipids, a decrease in unsaturated fatty acids, and the generation of aldehydes with a concomitant increase in thiobarbituric acid-reactive substances. The compositional changes observed in ox-LDL and the role of antioxidants in the process is also presented in the chapter. The compositional changes of ox-LDL are associated with modifications in properties, for example, density, electrophoretic mobility, and fluidity, and in functions. Ultraviolet radiation also induces a strong peroxidation of the lipid content of LDL without changing the apolipoprotein moiety. Beside the biochemical modifications, ox-LDL are toxic for cultured cells. The abnormal receptor-mediated interactions between ox-LDL and cells are mainly related to the modifications of apoB structure, as the apoprotein plays a key role in receptor recognition; ox-LDL are cleared through the scavenger receptor pathway in macrophages and can induce the formation of foam cells involved in the atherogenesis pathway.

A new experimental model system constituted by ultraviolet-treated low-density lipoproteins (LDL) has been designed in order to investigate the biological effects of lipid peroxides entering the cell through the endocytotic pathway. This paper reports the chemical modifications of the lipid components and apolipoproteins of the ultraviolet-treated LDL. Human LDL were submitted to short ultraviolet radiations (254 nm, 0.5 m W/cm2, for variable periods of time) and compared to LDL peroxidized by iron. The lipid peroxidation was monitored by following the formation of the peroxidation products (conjugated dienes, thiobarbituric acid-reactive substances (TBARS) and fluorescent lipid-soluble products) and the change of the composition in polyunsaturated fatty acids, carotenes and vitamin E. Several parameters of the apo B-100 structure were investigated: molecular size (by SDS-PAGE) and TNBS-reactive amino groups (chemical determination by trinitrobenzene sulfonic acid). The most important feature was the absence of major modification of apo B-100 in ultraviolet-treated LDL: the molecular weight and the content in TNBS-reactive amino groups of apo B-100 were not modified. In contrast, iron-treated LDL exhibited a loss of the apo B-100 band and a decrease in the number of TNBS-reactive amino group. Both ultraviolet radiations and iron ions induced a significant decrease in the content of polyunsaturated fatty acids, carotenes and vitamin E together with a large formation of lipid peroxidation products. However, the time-course of the formation of conjugated dienes, TBARS and fluorescent lipid-soluble products was quite different using the two oxidative systems. These results demonstrate that ultraviolet radiations induced a strong peroxidation of the lipid content of LDL and no (or only minor) changes in the apolipoprotein moiety whereas iron-catalyzed peroxidation resulted in the formation of lipid peroxidation products as well as apo B alterations.