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Arteriosclerosis, Thrombosis, and Vascular Biology. 1995;15:1987-1994

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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1995;15:1987-1994.)
© 1995 American Heart Association, Inc.


Articles

High-Density Lipoproteins Inhibit Cytokine-Induced Expression of Endothelial Cell Adhesion Molecules

Gillian W. Cockerill; Kerry-Anne Rye; Jennifer R. Gamble; Mathew A. Vadas; Philip J. Barter

From the Hanson Center for Cancer Research, Department of Human Immunology, Department of Lipid Research (G.W.C., J.R.G., M.A.V.), the Cardiovascular Investigation Unit, Royal Adelaide Hospital (K.-A.R.), and the University of Adelaide, Department of Medicine, Royal Adelaide Hospital (P.J.B.), Adelaide, Australia.

Correspondence to Gillian Cockerill, Hanson Center for Cancer Research, Department of Human Immunology, IMVS, PO Box 14, Rundle Mall, Adelaide 5000, South Australia. E-mail gcockeri@immuno.imvs.sa.gov.au.


*    Abstract
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*Abstract
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Abstract While an elevated plasma concentration of HDLs is protective against the development of atherosclerosis and ensuing coronary heart disease (CHD), the mechanism of this protection is unknown. One early cellular event in atherogenesis is the adhesion of mononuclear leukocytes to the endothelium. This event is mediated principally by vascular cell adhesion molecule-1 (VCAM-1) but also involves other molecules, such as intercellular adhesion molecule-1 (ICAM-1) and E-selectin. We have investigated the effect of isolated plasma HDLs and reconstituted HDLs on the expression of these molecules by endothelial cells. We show that physiological concentrations of HDLs inhibit tumor necrosis factor-{alpha} (TNF-{alpha}) or interleukin-1 (IL-1) induction of these leukocyte adhesion molecules in a concentration-dependent manner. Steady state mRNA levels of TNF-{alpha}–induced VCAM-1 and E-selectin are significantly reduced by physiological concentrations of HDLs. At an HDL concentration of 1 mg/mL apolipoprotein A-I, the protein expressions of VCAM-1, ICAM-1, and E-selectin were inhibited by 89.6±0.4% (mean±SD, n=4), 64.8±1.0%, and 79.2±0.4%, respectively. In contrast, HDLs have no effect on the expression of platelet endothelial cell adhesion molecule (PECAM) or on the expression of the p55 and p75 subunits of the TNF-{alpha} receptor. HDLs were effective when added from 16 hours before to 5 minutes after cytokine stimulation. HDLs had no effect on TNF-{alpha}–induced expression of ICAM-1 by human foreskin fibroblasts, suggesting that the effect is cell-type restricted. This study provides the first evidence that HDLs may protect against CHD by inhibiting the expression of adhesion molecules, which are required for the interaction between leukocytes and the endothelium.


Key Words: inflammation • coronary heart disease • VCAM-1 • E-selectin


*    Introduction
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Atherosclerotic CHD is still one of the major causes of death in the western world.1 Epidemiological studies have shown a strong inverse correlation between the concentration of plasma HDLs and the incidence of CHD.2 3 Direct evidence of a protective effect of HDLs has come from the studies of transgenic mice, in which high levels of expression of human apoA-I, the major apolipoprotein in HDLs, increased the HDL concentrations and gave protection against diet-induced atherosclerosis.4 It is not yet known whether the protection relates to the involvement of HDLs in reverse cholesterol transport or whether HDLs protect against CHD by a mechanism unrelated to their lipid transport function.

An early event in atherogenesis is the adhesion of monocytes to the endothelium via adhesion molecules such as VCAM-1, ICAM-1, and E-selectin, all of which are rapidly synthesized in response to cytokines. VCAM-1 (CD106) is a member of the immunoglobulin-like superfamily and is primarily involved in the adhesion of mononuclear leukocytes to the endothelium. VCAM-1 is rapidly induced by the inflammatory cytokines IL-1 and TNF-{alpha}, and its induction is sustained for 48 to 72 hours. ICAM-1 (CD54) is expressed on many cell types and is involved in both monocyte and lymphocyte adhesion to activated endothelium. E-selectin (CD62E) is an endothelial-specific adhesion molecule important in the adhesion of polymorphonuclear leukocytes, monocytes, and lymphocytes to cytokine-treated HUVECs.5 6 7 8 9 10 11 12 13 14 It has also been shown to be important in capturing leukocytes from the axial stream to roll along the endothelium.15

There is considerable evidence for the involvement of adhesion molecules in the development of early atherosclerotic lesions16 and in mature atherosclerotic plaques.17 The expression of VCAM-1 is coincident with early foam cell lesions in hypercholesterolemic rabbits.16 Variable and low levels of E-selectin and VCAM-1 have been detected in the arterial endothelium over plaques.17 18 VCAM-1 has also been observed in areas of neovascularization and inflammatory infiltrates at the base of plaques, suggesting that intimal neovascularization may be an important site of inflammatory cell recruitment into advanced coronary lesions.19 ICAM-120 and P-selectin, another member of the selectin family also involved in the rolling of leukocytes, have also been shown to be expressed on the endothelium overlaying atheromatous plaques, suggesting that leukocyte adhesion and recruitment into the plaque may be mediated through a synergy between the selectins and members of the immunoglobulin-like superfamily of adhesion molecules.21

The concept of the critical role of adhesion molecules in atherogenesis has been strengthened by reports showing that LDLs,22 especially if minimally oxidized,23 increase monocyte adhesion to endothelial cells. Furthermore, it has been shown that lysophosphatidylcholine, a major component of oxidatively modified LDLs, induces expression of VCAM-1 and ICAM-1.24 25 These observations suggest that LDLs promote atherogenesis at least in part by this mechanism. In this study we test the hypothesis that HDLs may have a direct effect on the endothelium by inhibiting the induced expression of adhesion molecules.

We show that physiological levels of native and reconstituted HDLs inhibit the induction of adhesion molecules on endothelial cells. These observations strongly point to a specific role for HDLs in preventing the adhesion-dependent early events in atherogenesis and in preventing the progression of atheromata by a similar mechanism. Therefore, this study demonstrates a function of HDL beyond those previously described.


*    Methods
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*Methods
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Cell Culture
HUVECs were isolated as described previously.26 All cells were cultured on gelatin-coated culture flasks in medium M199 with Earle's salts (Cytosystems) supplemented with 20% fetal calf serum (GIBCO), 20 mmol/L HEPES, 2 mmol/L glutamine, 1 mmol/L sodium pyruvate, nonessential amino acids, penicillin, streptomycin, 50 µg/mL endothelial growth supplement (Collaborative Research), and 50 µg/mL heparin (Sigma). Confluent HUVECs were incubated for 16 hours in varying concentrations of HDLs; then TNF-{alpha} or IL-1 (100 U/mL) was added to the culture medium and incubated for an additional 4 hours, at which time the cell-surface expression of VCAM-1, E-selectin, and ICAM-1 were measured by flow cytometry. In the case of TNF-{alpha} receptor and PECAM, cells were incubated for 20 hours in HDLs but were not cytokine stimulated before assay of their expression by flow cytometry.

Flow Cytometry Analysis
Cells were harvested by trypsinization, and then washed in PBS. Levels of cell-surface expression of proteins were measured by incubation of the cell suspension in 50 µL of primary antibody for 30 minutes at 4°C. Cells were then washed in FACS wash (PBS containing 0.02% azide and 5% newborn calf serum) at 4°C, resuspended in 50 µL of FACS wash containing the appropriate FITC-conjugated secondary antibody, and incubated at 4°C for an additional 30 minutes. After another wash, the cell pellet was resuspended in FACS fixative (PBS containing 2% glucose, 0.02% azide, and 2.5% formaldehyde), and expression of cell-surface molecules was measured as fluorescence intensity by use of a Coulter Epics Profile II flow cytometer. Each sample counted 1x104 cells. Controls for each assay included the absence of primary antibody and the incubation of the cells with an isotype-matched, nonrelevant antibody.

Antibodies Used
Mouse monoclonal antibody to VCAM-1 (10C9) and mouse monoclonal antibody to E-selectin (49-1B11) were generated in our laboratory and characterized by their ability to bind to VCAM-1– and E-selectin–transfected Chinese hamster ovary cells, respectively. The TNF receptor antibodies for the p75 subunit (utr-1) and the p55 subunit (htr-9) were a gift from Dr Brockhaus (Roche). The rabbit polyclonal antibody against PECAM was a gift from Dr Micheal Berndt (Baker Institute).

Northern Blot Analysis
Total RNA was prepared as described by Chomczynski and Sacchi.27 Equal aliquots of total RNA (10 µg) were electrophoresed in a 1% formaldehyde gel and transferred to nylon membrane (Hybond N, Amersham). RNA was fixed in a UV strata-linker (Stragagene). The blots were prehybridized according to Church and Gilbert28 and hybridized with 10 ng/mL {alpha}32P-labeled cDNA probes. After washing, the blots were exposed on Kodak XAR5 film (Eastman Kodak). Relative amounts of RNA per lane were normalized to the ethidium bromide–stained ribosomal RNAs.

Isolation of HDLs
Blood samples from normal healthy donors under 40 years of age were collected in EDTA-Na2 (final concentration, 1 mg/mL). Plasma was separated by centrifugation at 4°C. HDLs were isolated by sequential ultracentrifugation in the 1.07- to 1.21-g/mL density range, as described elsewhere.29 Resulting preparations of HDLs were dialyzed against four changes of PBS before filter sterilization with 0.2-mm acrodiscs (Gelman Sciences).

The concentrations of apoA-I and apoB in the preparations of HDLs were determined immunoturbidimetrically on a Cobas-Fara centrifugal analyzer (Roche Diagnostic). The apoA-I and apoB antibodies and standards were obtained from Boehringer Mannheim. HDL particle size distribution was evaluated by electrophoresis on a 3% to 35% nondenaturing gradient gel according to manufacturer's recommendations (Pharmacia LKB Biotechnology). All preparations of HDLs contained two main populations: one with particles of Stokes' diameter 10.45 nm (HDL2b) and one with particles of diameter 8.6 nm (HDL3a). There was no evidence of contamination by particles in the size range of LDLs, and no apoB was detected in the HDL preparations.

Preparation of Reconstituted HDL Particles
Discoidal reconstituted A-I HDL was prepared by the cholate dialysis method from egg-yolk phosphatidylcholine, unesterified cholesterol, and apoA-I.30 ApoA-I was prepared from human plasma, as described elsewhere.31 Egg-yolk phosphatidylcholine, unesterified cholesterol, and sodium cholate were obtained from Sigma and used without further purification. Particle size was measured by nondenaturing gradient gel electrophoresis, and concentration of apoA-I was measured immunoturbidimetrically, as described above.


*    Results
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*Results
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HDLs Inhibit Both TNF-{alpha}–Induced and IL-1–Induced VCAM-1 Expression on Endothelial Cells
Both IL-1 and TNF-{alpha} have been shown to induce the expression of VCAM-1 on endothelial cells.32 To test the hypothesis that HDLs inhibit cytokine-induced expression of VCAM-1, confluent HUVEC monolayers were incubated for 16 hours in the presence of HDLs at an apoA-I concentration of 1 mg/mL before the addition of IL-1 or TNF-{alpha}. After an additional 4 hours of incubation, cell-surface expression of VCAM-1 was determined by flow cytometry. Fig 1Down shows that both IL-1 (A) and TNF-{alpha} (B) induce the expression of VCAM-1 on HUVECs (solid line), and that HDLs (1 mg/mL apoA-I, dashed line) inhibit the expression of VCAM-1 in both IL-1–stimulated (A) and TNF-{alpha}–stimulated (B) HUVECs. In similarly designed experiments, preincubation of HUVECs with native LDL or oxidized LDL did not alter the level of cytokine-induced expression of adhesion molecules (data not shown). Consistent with the findings of Khan et al,33 we showed no induction of endothelial cell adhesion molecule expression by native or oxidized LDL per se (data not shown).



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Figure 1. Flow cytometry profiles showing the effect of HDLs on cytokine induction of VCAM-1. After a 16-hour preincubation of confluent HUVECs with HDLs (1 mg/mL of apoA-I), either TNF-{alpha} or IL-1 was added to the culture medium (100 U/mL). Cells were then cultured for an additional 4 hours. After this treatment, cell-surface expression of VCAM-1 was measured by flow cytometry. Graphs show the expression of VCAM-1 after IL-1 activation (A) compared with that after TNF-{alpha} activation (B) in the presence of HDLs (dashed lines) and the absence of HDLs (solid lines). A negative control profile with the isotype-matched, nonrelevant antibody (dotted lines) is also shown. These data are representative of three such experiments.

Concentration-Dependent Effects of HDLs on TNF-{alpha}–Induced Expression of Adhesion Molecules
Cytokine stimulation of HUVECs also leads to the induced expression of ICAM-1 and E-selectin, as well as VCAM-1.32 To compare the effects of HDLs on VCAM-1 with those on ICAM-1 and E-selectin expression, we incubated endothelial monolayers for 16 hours with a range of concentrations of HDLs before the addition of TNF-{alpha}. HDLs inhibited the TNF-{alpha}–induced expression of VCAM-1 in a concentration-dependent manner (Fig 2Down). At a concentration of 1 mg/mL apoA-I, HDLs reduce the expression of VCAM-1 by 89.6±0.4% (mean±SD, n=4). TNF-{alpha}–induced expression of ICAM-1 and E-selectin was also inhibited in a concentration-dependent manner, with inhibition of 64.8±1.0% and 79.2±0.4%, respectively, at an apoA-I concentration of 1 mg/mL. To exclude the possibility that the decrease in cytokine-induced expression of adhesion molecules was an artifact resulting from residual HDLs sterically hindering access of the antibodies to their respective antigens, flow cytometry was performed in the presence and absence of exogenous HDLs. Monolayers of HUVECs were stimulated with TNF-{alpha} (100 U/mL for 4 hours). After removal of the cell monolayer by trypsinization, the cells were resuspended in the respective primary antibodies in the presence of HDLs over a range of concentrations. The TableDown shows that HDL concentrations of up to 1.0 mg/mL apoA-I did not change the detectability of cell-surface molecules.



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Figure 2. Bar graphs showing the concentration-dependent effect of HDLs on TNF-{alpha}–induced expression of adhesion molecules. Confluent monolayers of endothelial cells were incubated in the presence of a range of HDLs for 16 hours. At this time TNF-{alpha} (100 U/mL) was added to the culture medium. The incubation was then continued for an additional 4 hours. The cell-surface expression of adhesion molecules was measured by using flow cytometry. The values represent the mean fluorescence intensity detected with antibodies directed against the respective proteins (as indicated) in response to TNF-{alpha} (hatched), relative to unstimulated basal levels (solid). The results represent data from one experiment but are representative of four experiments conducted with four different HUVEC donors and four different HDL preparations. Each experiment was conducted in quadruplicate. Means and SD are shown. Differences between means were evaluated using unpaired t tests. *P<.005, **P<.001.


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Table 1. Effect of HDLs on the Assay of Adhesion Molecules

HDLs Reduce Steady State mRNA Levels of VCAM-1 and E-Selectin
The effects of HDLs on steady state levels of mRNA of VCAM-1 and E-selectin in endothelial cells were investigated. Confluent endothelial cells were incubated (1) for 20 hours with no addition, (2) for 16 hours with no addition followed by 4 hours in the presence of TNF-{alpha} (100 U/mL), and (3) for 16 hours with HDLs at a physiological concentration (1 mg/mL apoA-I) before adding TNF-{alpha} for an additional 4 hours of incubation. After completion of the incubations, total RNA was extracted, and the levels of mRNA specific for VCAM-1 and E-selectin were measured by Northern blot analysis with cDNA probes (Fig 3Down). In the uninduced samples there was no detectable message for either VCAM-1 or E-selectin. In the samples induced by TNF-{alpha} in the absence of HDL, the level of message for both adhesion molecules was substantial. The levels of message for both VCAM-1 and E-selectin were markedly reduced by HDLs.



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Figure 3. Autoradiograph showing the effect of HDLs on the steady state mRNA levels of VCAM-1 and E-selectin in endothelial cells. Confluent HUVECs were incubated (1) for 20 hours with no addition (NIL), (2) for 16 hours with no addition followed by 4 hours in the presence of TNF-{alpha} (100 U/mL) (TNF), and (3) for 16 hours with HDLs (1 mg/mL apoA-I) before adding TNF-{alpha} for an additional 4 hours of incubation (TNF HDL). After the above treatment, total RNA was extracted and 10 mg per sample size fractionated in a 1% formaldehyde gel. Equivalent loading was assessed by ethidium-bromide staining of the 28S and 18S ribosomal bands (as indicated). Levels of mRNA for VCAM-1 and E-selectin (as indicated) after autoradiography were detected by hybridization to specific radiolabeled cDNA probes ("Methods").

HDLs Have No Effect on Expression of PECAM and TNF Receptor
PECAM is constitutively expressed on endothelial cells.34 To investigate the possibility that incubation of endothelial cells with HDLs had a nonspecific effect on the expression of all molecules, we examined the effect of HDLs on the expression of PECAM. There was no change in PECAM expression after a 20-hour incubation of HUVEC monolayers with a range of concentrations of HDLs (Fig 4Down).



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Figure 4. Bar graph showing the effect of HDLs on PECAM expression. Confluent endothelial-cell monolayers were incubated for 20 hours in the presence of a range of concentrations of HDLs (as indicated). Cells were then assayed for cell-surface PECAM by flow cytometry by using a rabbit polyclonal anti-PECAM antibody. The mean and SDs shown are data from one experiment representative of three experiments. There was no significant effect of HDLs in any of these experiments.

The p55 and p75 subunits of the TNF-{alpha} receptor are also constitutively expressed on endothelial cells.35 We examined whether incubation of HUVECs with HDLs could result in a reduction in cell-surface expression of TNF-{alpha} receptor. We incubated confluent HUVECs with HDLs (1 mg/mL apoA-I) for 20 hours. TNF-{alpha} receptor expression was then assayed by flow cytometry. Fig 5Down shows flow cytometric profiles of HUVECs stained with antibodies against the p55 (dashed line) and p75 (dotted line) subunits of the TNF-{alpha} receptor in the presence versus the absence of HDLs. The presence of HDLs had no effect on the levels of expression of these molecules.



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Figure 5. Flow cytometric profiles showing the effect of HDLs on expression of TNF receptor. Confluent cultures of HUVECs were incubated for 20 hours in the absence or in the presence of HDLs (1 mg/mL of apoA-I). The level of TNF-{alpha}–receptor expression was subsequently measured by flow cytometry by using antibodies against the p55 (utr-1) (dashed lines) and the p75 (htr-9) (dotted lines) subunits. Profiles of HUVECs stained with antibodies against the p55 (dashed lines) and the p75 (dotted lines) subunits of the TNF-{alpha} receptor and an isotype-matched control antibody (solid lines) were obtained after incubations conducted in the absence (NO HDL) and presence (HDL) of HDLs.

Time Course of Inhibition of VCAM-1 Expression by HDLs
To establish the time dependence of the inhibitory effect of HDLs on HUVECs, we examined the level of VCAM-1 expression 4 hours after TNF-{alpha} treatment in cells to which HDLs (1 mg/mL apoA-I) were added from 16 hours before to 4 hours after TNF-{alpha}. Fig 6Down shows that the inhibitory effect of HDLs does not require preincubation, since significant inhibition (86.4±0.6%) is obtained when HDLs (1 mg/mL apoA-I) are added at the same time or even 5 minutes after the TNF-{alpha}. However, when added 1 or more hours after TNF-{alpha} activation, the level of VCAM-1 expression is comparable with the control cultures to which HDLs have not been added (NA). When cell cultures were incubated for 16 hours with HDLs followed by two washes in PBS, which removes >95% of the HDL (as determined by measuring the recovered HDL according to the method described in "Methods"), maximal inhibition of expression of TNF-{alpha}–induced VCAM-1 expression was observed (R).



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Figure 6. Bar graph showing time dependence of inhibition of VCAM-1 expression by HDLs. Confluent cultures of HUVECs were incubated for varying lengths of time with HDLs (1 mg/mL apoA-I) both before (-) and after the addition of TNF-{alpha} (100 U/mL) at time zero. The cells were trypsinized 4 hours after the addition of TNF-{alpha} and levels of VCAM-1 were measured by flow cytometry. Samples to which HDLs were not added are indicated by the bar labeled NA. The bar labeled R indicates the level of expression of VCAM-1 when cultures were incubated with HDLs for 16 hours and then washed twice in PBS to remove the HDLs before being incubated for an additional 4 hours in fresh growth medium containing TNF-{alpha} (100 U/mL). Results represent the means and ranges of two experiments, using two different HUVEC donors of similar passage. The same preparation of HDLs was used in both experiments.

Since the inhibition of cytokine-induced VCAM-1 expression could be sustained when HDLs were removed before TNF-{alpha} stimulation, we investigated the kinetics of this acquired inhibition. HDLs (1 mg/mL apoA-I) were added over a range of times to confluent monolayers of HUVECs before being removed from the cultures by two washes in PBS. Fresh medium containing TNF-{alpha} was then added, and the VCAM-1 expression was determined by flow cytometry 4 hours later. Fig 7Down shows that the acquisition of inhibition was time dependent, with 50% maximal inhibition requiring {approx}60 minutes of incubation. With 10 minutes of preincubation with HDLs, no significant difference in VCAM-1 expression is observed. After 30 minutes and 1 hour of preincubation, VCAM-1 expression was suppressed by 42.3±1.31% and 56.5±0.6%, respectively. In cultures in which HDLs have been preincubated for 2 hours, the level of TNF-{alpha}–induced expression of VCAM-1 was inhibited by 88.4±0.76%.



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Figure 7. Bar graph showing time dependence of the inhibitory effect of HDLs. Confluent HUVECs were preincubated with HDLs (1 mg/mL apoA-I) for varying lengths of time and then washed twice in PBS to remove the HDLs before being incubated for an additional 4 hours in fresh medium containing TNF-{alpha} (100 U/mL). Results, representing levels of VCAM-1 expression measured by flow cytometry, show the mean and SD of quadruplicates of one experiment and are representative of three such experiments.

HDLs Do Not Inhibit TNF-{alpha}–Induced Induction of ICAM-1 in Fibroblasts
ICAM-1 is expressed and regulated on fibroblasts. We examined the ability of HDLs to inhibit the TNF-{alpha}–induced expression of this molecule on fibroblasts. Fig 8Down shows that after a 4-hour stimulation with TNF-{alpha} (100 U/mL), ICAM-1 expression was significantly (P<.005) induced from a basal level of 20.46±0.43 to 60.06±11.4 mean fluorescence intensity. When incubated with HDLs (1 mg/mL apoA-I), the level of TNF-{alpha}–induced expression of ICAM-1 was not significantly altered (66.46±12.3).



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Figure 8. Bar graph showing the effect of HDLs on TNF-{alpha}-induced ICAM-1 expression on human foreskin fibroblasts. Confluent cultures of human foreskin fibroblasts were incubated for 4 hours either with nothing (NIL), TNF-{alpha} (100 U/mL) (TNF), or TNF-{alpha} and HDL (1 mg/mL apoA-I) (TNF/HDL), after which the cells were trypsinized and levels of ICAM-1 measured by flow cytometry ("Methods"). The data represent one experiment representative of three experiments and show means and SDs of triplicate samples. Differences between means were evaluated using an unpaired t test. *P<.005, **P=NS. NS indicates not significant.

Reconstituted HDLs Inhibit the TNF-{alpha}-Induced Expression of VCAM-1
To exclude the possibility that the inhibiting effects of plasma HDLs were mediated by contaminating plasma components that co-isolated with the HDLs, we investigated the effects of reconstituted HDLs. Reconstituted discoidal HDLs containing purified apoA-I as their sole protein, egg-derived phosphatidylcholine as their sole phospholipid, and unesterified cholesterol30 were incubated with HUVEC monolayers before the addition of TNF-{alpha}. We found that these reconstituted HDLs inhibit the expression of VCAM-1 in a concentration-dependent manner comparable with that of plasma HDLs (Fig 9Down).



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Figure 9. Bar graph showing the effect of reconstituted HDLs containing apoA-I on TNF-{alpha}-induced VCAM-1 expression. Confluent monolayers of HUVECs were incubated at 37°C either with no added lipoproteins, with native HDLs (1 mg/mL apoA-I), or with reconstituted discoidal HDLs that contained apoA-I as their sole apolipoprotein (concentrations as shown). After 10 minutes, TNF-{alpha} was added (100 U/mL) to the culture medium, and the incubation was continued for an additional 4 hours. Expression of cell-surface VCAM-1 was then measured by flow cytometry. Means and SDs shown represent the cumulative data of three experiments, using three HUVEC donors and the same batch of plasma HDLs and reconstituted HDLs.


*    Discussion
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up arrowAbstract
up arrowIntroduction
up arrowMethods
up arrowResults
*Discussion
down arrowReferences
 
Our studies show an effect of HDLs on endothelial cells that is consistent with the proposition that HDLs have a direct inhibitory effect on one of the earliest events in atherogenesis. Their ability to inhibit cytokine-induced cell-surface expression of adhesion molecules raises the possibility that HDLs may inhibit atherogenesis at an early stage by preventing monocyte adhesion to the endothelium. The inhibitory effects of HDLs may also influence the progression of atheromata by altering the expression of adhesion molecules shown to be important in trafficking T lymphocytes to these lesions.

HDLs have been shown to have other functions unrelated to their role in plasma cholesterol transport; these include acting as an antioxidant,36 acting as a mitogen,37 and having the ability to bind lipopolysaccharide.38 A mitogenic effect of HDLs on endothelial cells may protect against vascular disease by maintaining an intact endothelium. Finally, the binding of lipopolysaccharide to HDLs protects against septic shock by rendering the toxin inaccessible to its receptor (CD14)39 on the monocyte/macrophage, thus preventing the subsequent release of cytokines, such as TNF-{alpha}, IL-1, and IL-6.40 Our current findings that physiological concentrations of HDLs are able to significantly inhibit the cytokine activation of adhesion molecules on the endothelial cell suggest that HDLs may also contribute to the protective effects of an acute inflammatory response.

Experiments were conducted to exclude the possibility that the effects of HDLs on the adhesion protein expression had a trivial explanation. The possibility of artifact as a result of HDLs inhibiting the detection of cell-surface proteins was excluded because we found no interference of detection in the flow cytometry assay. Our results also show that it is unlikely that HDLs are preventing access to the cytokine receptor or are affecting the level of receptor expression on the endothelial cell. We demonstrate no difference in the ability to detect TNF-receptor subunit levels on endothelial cells after 20 hours of incubation in HDLs. It is also unlikely that HDLs are restricting availability of the cytokine by binding it, as we show that removal of HDLs after a 2-hour preincubation followed by TNF-{alpha} stimulation resulted in maximal inhibition of VCAM-1 expression. Provided endothelial cells had undergone a 2-hour incubation with HDLs before cytokine stimulation, HDLs were not required during the cytokine stimulation to achieve maximal inhibition. The possibility that the inhibition of adhesion molecule expression may be due to cytotoxic effects was excluded by the observation that cell viability, as determined by the standard dye exclusion method and plating efficiency of the cultures, remained >95% after a 20-hour incubation in the presence of HDLs (1 mg/mL apoA-I). In addition, confluent cultures maintained a healthy "cobblestone" morphology in the presence of HDLs (data not shown), further suggesting that the general metabolic state of the cell cultures was not compromised. Inhibition was not donor specific and is highly reproducible, as evidenced by the fact that all the experiments reported have been completed on more than 20 donors of HUVECs with different batches of HDLs.

In addition, all the above experiments with TNF-{alpha} have been performed and identical results obtained with the spontaneously transformed HUVEC line C11STH,41 demonstrating that this cell line is an appropriate model for future studies. In contrast to these results with endothelial cells, the cytokine induction of ICAM-1 on fibroblasts was unaffected by the presence of HDLs, suggesting that the inhibitory effect of HDLs is restricted to certain cell types.

We show that the addition of HDLs to endothelial cell cultures at the same time or 5 minutes after the addition of TNF-{alpha} can inhibit cytokine-induced expression of adhesion molecules. However, when HDLs were added to the cultures 1 hour after TNF-{alpha}, they were no longer able to inhibit the cytokine-induced VCAM-1 expression, suggesting that HDLs are operating to inhibit an early cell-signaling response to the cytokine. TNF-{alpha} has many overlapping actions with IL-1, which has led to a suggestion of shared signal transduction mechanisms. We show a qualitative similarity in the ability of HDLs to suppress IL-1–induced or TNF-{alpha}–induced adhesion molecule expression, indicating that the mechanism of action is not receptor specific but may be through a common signaling pathway.

It is noteworthy that HDLs inhibit the expression of all the adhesion proteins shown to support monocyte adhesion. Although there are other cytokines that also inhibit adhesion protein expression, these operate only on some proteins. Transforming growth factor-ß, for example, suppresses E-selectin but not VCAM-1 expression,42 and IL-4 increases VCAM-1 while decreasing E-selectin.43 Thus, HDLs appear unique in the breadth of their actions. Demonstration that the selectins and the immunoglobulin-like class of adhesion molecules may synergize to enable the recruitment and adhesion of leukocytes into the plaques is important in understanding the development of the atheroma.20 21 We demonstrate that HDLs are able to reduce the protein and mRNA levels of both classes of molecules; in this capacity they may be able to prevent the progression of existing atherosclerotic lesions. This suggestion is consistent with studies in which regression of atherosclerotic lesions occurs when animals are infused with HDLs.44

The demonstration that reconstituted HDLs that contain only apoA-I are able to mimic the effects of native HDL is very important because it suggests that the most protective apolipoprotein has a function ascribable to the whole plasma HDL. In addition, it makes it less likely that unidentified molecules copurified along with native HDL particles, rather than known components of HDL, are responsible for these effects. Clarification of the mechanism by which HDLs inhibit the expression of adhesion molecules and elucidation of the HDL subpopulations that are responsible may ultimately lead to the development of novel strategies for the prevention and treatment of atherosclerosis.


*    Selected Abbreviations and Acronyms
 
apo = apolipoprotein
CHD = coronary heart disease
FACS = fluorescence-activated cell sorting
HUVEC = human umbilical vein endothelial cell
ICAM-1 = intercellular adhesion molecule-1
IL = interleukin
PECAM = platelet endothelial cell adhesion molecule
TNF = tumor necrosis factor
VCAM-1 = vascular cell adhesion molecule-1


*    Acknowledgments
 
This work was supported by funding from the National Health and Medical Council of Australia, the National Heart Foundation, and the Royal Adelaide Hospital Research Fund. We thank Neil Hime and Leanne Noack for technical assistance and Dr Peter Cockerill for many helpful discussions and critical reading of the manuscript. cDNAs for VCAM-1 and E-selectin were gifts from Brian Seed and Tucker Collins, respectively. We thank the staff of the delivery wards of Queen Victoria Hospital and Burnside War Memorial Hospital for collecting umbilical cords.

Received July 10, 1995; accepted August 18, 1995.


*    References
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*References
 
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