Atherosclerosis and Lipoproteins |
From the Division of Endocrinology, Diabetes, and Hypertension (A.R.C., W.P.M., U.K., S.J., S.W., G.N., W.A.H., R.E.L.), Department of Medicine, UCLA School of Medicine, Los Angeles, Calif; the Molecular Biology Institute (W.A.H., R.E.L.), Los Angeles, Calif; the Department of Medicine/Cardiology (U.K.), Virchow-Klinikum, Humboldt University, and the German Heart Institute (U.K.), Berlin, Germany; and the Department of Medicine (W.P.), UCSD, La Jolla, Calif.
Correspondence to Ronald E. Law, PhD, University of California, Los Angeles, Division of Endocrinology, Diabetes, and Hypertension, 900 Veteran Ave, Suite 24-130, Box 957073, Los Angeles, CA 90095. E-mail rlaw{at}mednet.ucla.edu
AbstractPeroxisome
proliferatoractivated receptor-
(PPAR
) is a
ligand-activated nuclear receptor expressed in all of the major
cell types found in atherosclerotic lesions:
monocytes/macrophages, endothelial cells, and
smooth muscle cells. In vitro, PPAR
ligands inhibit cell
proliferation and migration, 2 processes critical for vascular lesion
formation. In contrast to these putative antiatherogenic activities,
PPAR
has been shown in vitro to upregulate the CD36 scavenger
receptor, which could promote foam cell formation. Thus, it is unclear
what impact PPAR
activation will have on the development and
progression of atherosclerosis. This issue is important
because thiazolidinediones, which are ligands for PPAR
, have
recently been approved for the treatment of type 2 diabetes, a state of
accelerated atherosclerosis. We report herein that the
PPAR
ligand, troglitazone, inhibited lesion formation in male low
density lipoprotein receptordeficient mice fed either a high-fat
diet, which also induces type 2 diabetes, or a high-fructose diet.
Troglitazone decreased the accumulation of macrophages in
intimal xanthomas, consistent with our in vitro observation
that troglitazone and another thiazolidinedione, rosiglitazone,
inhibited monocyte chemoattractant protein-1directed
transendothelial migration of monocytes. Although
troglitazone had some beneficial effects on metabolic risk
factors (in particular, a reduction of insulin levels in the diabetic
model), none of the systemic cardiovascular risk
factors was consistently improved in either model. These
observations suggest that the inhibition of early atherosclerotic
lesion formation by troglitazone may result, at least in part, from
direct effects of PPAR
activation in the artery
wall.
Key Words: atherosclerosis diabetes mellitus pharmacology
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