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Objective: In view of the recognized association between thrombosis and atherosclerosis, it is hypothesized that exposure of arterial smooth muscle cells (SMC) to thrombogenic agents such as platelets and thrombin will alter the oxidation of low-density lipoprotein (LDL) and that this effect may be diminished by thrombin inhibition., Methods: Quiescent human aortic SMC in culture were exposed to LDL (40 microg protein/ml) alone or with washed human platelets (5 x 10(6)/ml), thrombin (40 units/ml), or a combination of these agents for 48 h. The media were removed, and both media and cell lysate fractions were assayed for malondialdehyde (MDA) content as an index of oxidation. Isolated platelets exposed to LDL and thrombin were studied in a similar manner to determine their individual oxidative activity. Finally, SMC and platelets were incubated with LDL and varying concentrations of thrombin (10-80 units/ml), both alone and in the presence of the thrombin inhibitors hirudin (u/u), and heparin (u/u), and MDA was measured., Results: SMC and platelets each demonstrated an ability to oxidize LDL, increasing MDA concentrations by 1.8- (P < 0.05) and 4- (P < 0.01) fold, respectively, compared to lipid-free media. Both platelets (P < 0.05) and thrombin (P < 0.001) enhanced the oxidation of LDL by SMC, while a combination of these two agents resulted in an additive effect (P < 0.001). The SMC lysate fraction showed an increase in oxidative products following exposure to platelets (P < 0.01) but not thrombin, suggesting that platelets stimulated uptake of the oxidized lipid by the SMC. Isolated platelets responded to thrombin with an increase in MDA within the media (P < 0.001). Smooth muscle cells exposed to thrombin also showed a dose-dependent increase in LDL oxidation (P < 0.01). This effect was not altered by hirudin, but was significantly inhibited by heparin (P < 0.05)., Conclusions: These results indicate that the oxidative potential of SMC and platelets is enhanced by their coincubation and by their concurrent exposure to thrombin. Heparin appears to block thrombin-stimulated oxidation. This interaction could be relevant to the dynamic interaction between atherosclerosis and thrombogenesis.

Although clinical and experimental studies have supported a role of calcium in atherogenesis, the nature of this relationship has not been determined. The following investigation was performed to examine the effect of transmembrane calcium flux on the oxidative modification of low-density lipoprotein (LDL) by arterial smooth muscle cells (SMC). Confluent SMC were incubated in basal medium alone or in medium containing either nifedipine (0.25 microM), a calcium channel blocker, or dantrolene (10 microM), a blocker of calcium release from the endoplasmic reticulum. Cells were then suspended in medium with either physiologic (1.25 mM) or supraphysiologic (2.5 mM) calcium concentrations ([Ca2+]e) and were exposed to oxidized LDL (20 micrograms/protein/ml; 4.96 +/- 0.76 nmole malondialdehyde/mg LDL protein). Changes in cytosolic calcium ([Ca2+]i) were measured by spectrofluorometric analysis using a Fura 2-AM indicator. In similar studies, the cellular oxidation of native LDL was determined by fluorometric measurement of thiobarbituric acid-reactive substances in the media. Nifedipine and, to a lesser extent, dantrolene lowered steady-state [Ca2+]i at supraphysiologic [Ca2+]e (2.5 mM; P < 0.0002). Exposure of SMC to Ox-LDL increased [Ca2+]i (P < 10(7), which was further augmented by increasing [Ca2+]e (P < 10(-7). Nifedipine significantly reduced the calcium response to Ox-LDL proportionate to [Ca2+]e (P < 0.0002). A similar reduction in [Ca2+]i vs control was seen with dantrolene, but was independent of [Ca2+]e. TBARS assays revealed a significantly greater degree of cellular oxidation of native LDL following preincubation of SMC with Ox-LDL (P < 10(8). This effect was markedly inhibited by both nifedipine (P < 10(-8) and dantrolene (P < 10(-8), which showed some degree of synergism. These results indicate that the increase in cytosolic calcium in SMC exposed to Ox-LDL may occur through both membrane channels and reticular release. Inhibition of transmembrane calcium flux severely limits the cellular oxidation of low-density lipoprotein. These alternate means of calcium signal generation may allow a more varied response of the SMC to atherogenic stimuli and provide an opportunity for specific therapeutic intervention.

Background: We postulated that the response of vascular smooth muscle cells (SMCs) to oxidized low-density lipoprotein (LDL) may be modulated through calcium and 3', 5' cyclic adenosine monophosphate (Ca+2-cAMP) second-messenger activity., Methods: Changes in cytosolic calcium [Ca+2]i in aortic SMCs exposed to native (N-) and oxidized (Ox-) LDL were measured with a Fura 2-AM indicator. The influence of cAMP on this response was determined by incubating the cells with either forskolin or 8-bromo-cAMP (stimulatory) or galanin (inhibitory). The cells were then activated by an initial preincubation with N- or Ox-LDL, and the subsequent cellular oxidation of N-LDL was measured. The effect of cAMP mediators alone or in conjunction with calcium antagonism was studied., Results: Exposure of SMCs to Ox-LDL resulted in a marked elevation of [Ca+2]i(306 +/- 12 nmol/L) compared with that in the control group (192 +/- 15 nmol/Liter; p < 10(-6)). This response was augmented by cAMP stimulation (406 +/- 8 nmol/L; p < 10(-6)) but reduced by cAMP inhibition (247 +/- 8 nmol/L; p < 10(-6)). The activation of intracellular signaling by initial Ox-LDL priming increased the subsequent oxidation of N-LDL (0.40 +/- 0.02 nmol malondialdehyde versus 0.24 +/- 0.02 nmol MDA control; p < 10(-4)). This response was enhanced by cAMP (0.45 +/- 0.03 nmol MDA; p < 10(-4)) and inhibited by galanin (0.26 +/- 0.02; p < 10(-4)). The cAMP effect was reversed by the blockade of calcium mobilization via membrane channels and reticular release., Conclusions: Oxidized LDL-induced Ca+2-cAMP signaling modulates the cellular oxidation of N-LDL. This finding suggests a mechanism through which the scavenger uptake of modified LDL may potentially be regulated.

The present study was designed to examine the role of calcium-dependent signal transduction as a common link between the atherogenic effect of LDL and the mitigating influence of sex hormones in aortic endothelial (EC) and smooth muscle cells (SMC). Human aortic EC and SMC were pre-incubated for 48 hr in media containing no hormone, 17-beta-estradiol (20 ng/ml) or testosterone (300 ng/ml). Low density lipoprotein (N-LDL) or its minimally oxidized species (Ox-LDL) was added to the media at different concentrations (0, 2, 5, 10, 20, and 40 micrograms protein/ml), and changes in cytosolic calcium [Ca+2]i were measured by spectrofluorometric analysis using a Fura 2-AM indicator. Cell viability was determined with a 51chromium release assay. In EC, exposure to N-LDL resulted in a weak and unsustained increase in [Ca+2]i, (max. 21.9 +/- 4.6%) while a more marked rise was seen in SMC (max. 79.1 +/- 11.5%; P < 0.005). There was an amplified response to the more atherogenic Ox-LDL in both EC (max. 130.9 +/- 22.9%) and SMC (max. 240.5 +/- 14.2%; P < 0.0002). Estrogen was associated with a lower resting level of [Ca+2]i in both cell types, and resulted in a significant, dose-dependent inhibition of cytosolic calcium mobilization in SMC exposed to Ox-LDL (P < 0.05). Alternatively, testosterone increased cytosolic calcium response in SMC exposed to either N-LDL (P < 0.05) or Ox-LDL (P < 0.05). Similar trends were seen in EC, but failed to reach statistical significance. These changes could not be attributed to cell toxicity. Sex hormones may modulate the atherogenic potential of LDL by influencing intracellular, calcium-dependent signaling mechanisms.

Increasing clinical and experimental evidence suggests a multifunctional role of calcium in determining the response of the arterial intima to atherogenic stimuli. In this study, an endothelial cell (EC)-smooth muscle cell (SMC) bilayer model of the arterial wall was used to investigate the effect of calcium manipulation on the sequestration of 125I-labeled LDL within the subendothelial space. Bilayer cell cultures were exposed to EGTA (0.25-2.0 mM), ionophore A23187 (5 x 10(-6) M), lanthanum chloride (0.1 mM), and trifluoperazine (TFP; 0.25 microM). The movement of 125I-labeled LDL (10 micrograms/ml) through the endothelial barrier was measured, as was the binding and cellular uptake of 125I-labeled LDL by each cell type. Extracellular Ca2+ chelation with EGTA and intracellular Ca2+ mobilization with A23187 both increased EC permeability to LDL (P < 0.05; P = 0.0001, respectively), while not significantly affecting EC binding or uptake of lipoprotein. Conversely, these agents increased SMC uptake of LDL (P < 10(-7); P < 10(-8), respectively). Calcium blockade with lanthanum chloride had the opposite effect, reducing EC permeability (P = 0.011) and SMC uptake (P < 10(-5)), while increasing EC uptake (P = 0.016). TFP, a calmodulin inhibitor, had an effect similar to A23187, although reducing SMC uptake of LDL (P = 0.015). Alteration of the calcium gradient across the plasma membrane appears to influence EC permeability. This effect may be stabilized by Ca2+ blockade or calmodulin regulation of cytoplasmic Ca2+. Additional anti-atherogenic effects of calcium blockade may include a reduction in SMC uptake by the SMC.

Purpose: Calcium channel blockade has been shown to inhibit experimental atherosclerosis in cholesterol-fed animals, and early clinical trials suggest its benefit in human subjects as well., Methods: To determine the effect of the calcium channel blocker nifedipine on lipid and monocyte infiltration of the subendothelial space, an endothelial cell (EC)-smooth muscle cell (SMC) bilayer model of the arterial wall was incubated for 18 hours with nifedipine (0.1 micrograms/ml). Iodine 125-labeled low-density lipoprotein (125I-LDL) (10 micrograms protein/ml) was then added to the upper-well medium., Results: After a 3-hour incubation period, nifedipine-treated bilayers showed an increased permeability to LDL (p < 10(-7). Nifedipine had no effect on the membrane binding or cellular uptake of LDL by the EC but did increase SMC binding and uptake (p < 0.0005). U937 monocytes were found to incorporate 125I-LDL in a concentration-dependent fashion, without saturation to 25 micrograms/ml, the highest concentration studied. Nifedipine increased monocyte uptake of LDL (10 micrograms/ml; p < 0.003 but reduced monocyte movement through the EC barrier (p < 10(-7). A study of the selective preincubation of each cell type (EC, SMC, and monocyte) with nifedipine indicated that this reduction was likely the result of a direct effect on the monocyte., Conclusions: Given the potential cytotoxic effects of the monocyte within the subendothelial space, nifedipine-induced inhibition of monocyte infiltration and enhancement of lipoprotein uptake by the SMC may be protective.

Thrombin, a mediator of thrombosis, has been shown to directly alter the function of vascular cells. We studied the effect of thrombin on low-density lipoprotein permeability and uptake by an arterial endothelial cell-smooth muscle cell bilayer to determine its potential role in atherogenesis. Confluent cell bilayers were incubated in media containing thrombin (10 or 50 units/ml) for a period of 24 hours to 9 days. Iodine 125 (125I)-LDL (10 micrograms protein/ml) was then added to the media, and after a 3-hour incubation, 125I-LDL transit through the endothelial cell layer as well as membrane binding and uptake by each cell type were measured. The lower concentration of thrombin caused a delayed increase in both the permeability (p less than 0.0001) and uptake (p less than 0.05) of LDL, but had no effect on membrane binding of the lipoprotein. The higher thrombin concentration led to an immediate increase in endothelial cell permeability to LDL (p less than 10(-7)) and a significant reduction in both cellular uptake (p less than 10(-7)) and membrane binding (p less than 0.0005). In contrast, smooth muscle cell binding and uptake were unaffected at the lower concentration of thrombin. At the higher concentration, smooth muscle cell uptake of LDL was increased (p less than 10(-7)) disproportionately to a more limited increase in membrane binding (p less than 0.05). Endothelial DNA content, reflecting cell number, was increased at 10 units/ml thrombin (p less than 0.001) but markedly reduced at 50 units/ml thrombin (p less than 0.0005), whereas smooth muscle cell DNA content remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

There is evidence to suggest that the deposition of lipid within the arterial wall, which is characteristic of atherosclerosis, involves a break in the integrity of the endothelial barrier. Oxidative modification of low density lipoproteins by reactive oxygen species may enhance this process. In this study, an aortic endothelial (EC) smooth muscle cell (SMC) bilayer was briefly exposed to a free-radical generating system to determine the effect of superoxides on lipid permeability and uptake. 125I-LDL (10 micrograms/ml) was added to the EC medium at various time intervals (3, 24, and 48 hr and 9 days). The amount of lipid reaching the subendothelial space was measured. Measurements of EC and SMC binding and uptake of LDL were also obtained and compared with those of untreated cells. The results demonstrate a significant increase in the permeability of the treated EC layer to LDL (P less than 10(-6)), which was sustained over time. Superoxide exposure led to a limited initial increase in EC binding and uptake of LDL, which later returned to control values. In contrast, SMC uptake of LDL was significantly (P less than 10(-3)) and persistently increased over control values and disproportionately increased over cellular binding. Such results suggest that superoxides can increase LDL permeability of the EC barrier. Because this was not associated with a comparable increase in EC binding and uptake, it is unlikely to be due to changes in receptor-mediated, transcellular transport.(ABSTRACT TRUNCATED AT 250 WORDS)

To study the interaction of endothelial and smooth muscle cells, and the means by which such interaction may affect lipid permeability of the arterial wall, cell bilayers were established by use of a transwell culture system. After confluent growth of both cell types had been achieved, iodine 125 bound to low-density lipoprotein (10 ng protein/ml) was added to the media of the upper well. After a 3-hour incubation period, the iodine 125-bound low-density lipoprotein content of the upper and lower media demonstrated an impedance to lipoprotein movement across the endothelial cell monolayer as compared to the bare porous polycarbonate filter of the transwell (p less than 10(-6)). The presence of smooth muscle cells in the bottom well significantly enhanced the permeability of the endothelial cell layer (p less than 10(-60). This effect remained unchanged over a 9-day time course. Membrane binding and cellular uptake of low-density lipoprotein by endothelial cells was not altered by smooth muscle cells, indicating that this change in permeability could not be easily attributed to changes in receptor-mediated transport or transcytosis. Membrane binding (p less than 0.02) and cellular uptake (p less than 10(-6)) of low-density lipoprotein by smooth muscle cells in the bilayer, when adjusted for counts available in the smooth muscle cell media, were both reduced in the early incubation period as compared to isolated smooth muscle cells. The disproportionate reduction in uptake as compared to binding would suggest that this was not entirely a receptor-dependent process.(ABSTRACT TRUNCATED AT 250 WORDS)

The antiatherogenic effect of high density lipoprotein (HDL) has been attributed to either an inhibition of cholesterol uptake or to reversed cholesterol transport from peripheral cells. In order to determine whether HDL competitively blocks receptor-mediated low density lipoprotein (LDL) binding and uptake, bovine aortic endothelial cells (BAECs) were cultured in Dulbecco's modified Eagles Medium (DMEM) containing 10% LDL-free fetal bovine serum, and incubated with 125I-LDL in concentrations of either 10 or 25 micrograms protein/mL. Varying amounts of HDL (0-200 micrograms/mL) were added to the media. Following a twenty-four hour incubation period at 37 degrees C, 125I-LDL binding and uptake were measured. At the lower concentration of 125I-LDL, which represents high-affinity receptor binding, there was no significant difference in either binding or uptake within the range of HDL concentrations studied. At the higher concentration of LDL, however, there was a marked inhibition of 125I-LDL binding (p less than .006) and uptake (p less than, 001; ANOVA), which did not saturate at the highest HDL concentrations used. These data suggest that HDL does not influence high-affinity, receptor-mediated binding and uptake of LDL but that its effect is seen at a concentration of LDL representing nonspecific binding. The lack of saturation at increasing concentrations of HDL also indicates that HDL-receptor interaction is not essential for the effect.

High-density lipoprotein (HDL) may inhibit the binding and cellular uptake of low-density lipoprotein (LDL) as one means of regulating the delivery of exogenous cholesterol to nonhepatic tissues. This may play an important role in atherogenesis, by altering lipid metabolism in cells of the arterial wall. To verify and better characterize this effect, endothelial cells were harvested from bovine aorta and maintained in tissue culture. Following initial preincubation in lipid-deficient culture media, these cells were incubated for 2 hr at 4 degrees C in media containing 125I-LDL (10 micrograms protein/ml) and varying concentrations of either HDL (0-400 micrograms protein/ml) or comparable amounts of Apoprotein A (Apo A), the major protein component of HDL. Intracellular and trypsin-released counts were assayed separately, as a measurement of cellular uptake and membrane bound LDL, respectively. Results of this study indicated an inhibition of LDL binding and uptake by HDL (P less than 0.005, ANOVA). A similar inhibition was found with Apo A alone (P less than 0.005). When identical studies were performed using 125I-Apoprotein B, the protein component of LDL, and Apo A, the latter was found to inhibit the binding of Apo B to the same extent (P less than 0.0006). These results indicate that HDL does inhibit LDL binding and uptake by bovine aortic endothelial cells and that, because this effect is seen equally with only the protein component of these lipoprotein particles, it is most likely due to competitive binding at the receptor level rather than to stearic hindrance or an alteration of the cell membrane.

The inhibition of atherosclerosis by estrogen has been shown clinically and experimentally, but the mechanism by which this occurs is unknown. Previous studies have shown that estrogen enhances the uptake of low-density lipoprotein (LDL) by bovine aortic endothelial cells (BAEC) while not altering membrane binding at saturating levels of LDL. In this study the effect of estrogen on LDL binding kinetics has been investigated. Computer-assisted Scatchard analysis of binding data suggests a single-site binding model. Estrogen-treated BAEC showed a lower binding affinity (Ka = 2.47 +/- 0.74 E7 M-1) than control cells (1.95 +/- 0.21 E7 M-1) (p = 0.0012). Estrogen-treated cells, however, had a greater binding capacity (Bmax = 1.26 +/- 0.07 E-10M) than control cells (Bmax = 8.49 +/- 0.44 E-11M) (p = 0.0004). The latter was due primarily to a difference in LDL binding at higher concentrations of LDL (greater than 40 micrograms/ml). These findings are consistent with an estrogen-stimulated increase in low-affinity binding of LDL to BAEC, which may not be directly receptor mediated and which appears to enhance the uptake of LDL at higher lipoprotein concentrations. Such alterations in LDL uptake by endothelial cells could influence the formation of atherosclerotic plaque.

The means by which estrogen retards atherosclerosis cannot be explained solely by changes in circulating lipoprotein levels. We studied the effects of 17 beta-estradiol on the binding, incorporation, and degradation of low density lipoprotein (LDL) by cultured bovine aortic endothelial cells (BAEC). Estrogen receptors in the cytoplasm and nucleus of BAEC could be demonstrated by immunofluorescent staining. Estradiol was found not to affect surface binding of LDL to BAEC. However, at physiologic concentrations (50 pg/ml), estradiol did enhance LDL uptake by the BAEC (P less than 0.005). This enhancement was present but somewhat reduced at higher concentrations of estrogen (P less than 0.05). Only approximately 10% of incorporated LDL was trichloroacetic acid soluble, indicating a low rate of LDL degradation. The relative rate of LDL breakdown within the BAEC was not altered by estrogen. These results, showing estrogen stimulation of LDL uptake by the BAEC, do not clarify the protective effect of this hormone. It is speculated that estrogen may augment the cellular clearance of LDL.