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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:359.)
© 2006 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Increased Apolipoprotein Deposits in Early Atherosclerotic Lesions Distinguish Symptomatic From Asymptomatic Patients

Moritz Wyler von Ballmoos; Denise Dubler; Martina Mirlacher; Gieri Cathomas; Jürgen Muser; Barbara C. Biedermann

From the Department of Medicine (M.W.v.B., D.D., J.M., B.C.B.), University Hospital Bruderholz, Bruderholz, Switzerland; Department of Research (M.W.v.B., D.D., B.C.B.), University Hospital Basel, Basel, Switzerland; Institute of Pathology (M.M.), University of Hamburg-Eppendorf, Hamburg, Germany; and Cantonal Institute of Pathology (G.C.), Liestal, Switzerland.

Correspondence to Barbara C. Biedermann, Department of Medicine, University Hospital Bruderholz, Batteriestrasse 1, CH-4101 Bruderholz, Switzerland. E-mail barbara.biedermann{at}unibas.ch

Objective— Apolipoprotein E (apoE) and apolipoprotein B100 (apoB) are both involved in receptor-mediated uptake of atherogenic lipoproteins by the liver. Inefficient hepatic clearance of these lipoproteins leads to symptomatic atherosclerosis. Using arterial tissue microarrays, we tested the hypothesis that apoE and apoB accumulation in the arterial wall discriminates between patients with symptomatic atherosclerosis and patients who never experienced cardiovascular events.

Methods and Results— In a postmortem study involving 49 patients (22 patients with symptomatic atherosclerosis), we quantified apolipoprotein deposits in arterial rings obtained from the left main coronary, the common carotid, the common iliac, and the renal artery applying tissue microarray technology and semiquantitative immunohistochemistry. In early atherosclerotic lesions, even before atheroma appeared, symptomatic patients had significantly more arterial apoE and apoB deposits than patients without cardiovascular events (P<0.001). Among the symptomatic patients, those without diabetes had more intense apolipoprotein deposits than diabetics. Large amounts of apoE and apoB were found in advanced atherosclerotic lesions, regardless of the activity of the disease.

Conclusions— Increased apolipoprotein deposits are an early sign of symptomatic atherosclerosis. They may reflect either enhanced retention of atherogenic lipoproteins or impaired local apolipoprotein degradation. The arterial lipoprotein turnover may be different in diabetic patients.

Key Words: arteriosclerosis • lipoproteins • apolipoproteins • diabetes mellitus • tissue microarray

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