Articles |
From the Department of Pathology, Institute of Laboratory Medicine, Göteborg University, Sahlgrenska University Hospital, Göteborg, Sweden.
| Abstract |
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Key Words: arterial smooth muscle cell macrophage cell growth apoptosis oxidized LDL
| Introduction |
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It is well established that LDL promotes the growth of arterial SMCs and that oxidatively changed LDL has cytotoxic properties (for review see Reference 5). Excessive intimal growth alternating with focal massive cell death are characteristics typical of the atherosclerotic lesion,6 and the aim of this study was to investigate whether these extreme changes in the lesions could be related to the extreme effects of LDL and oxLDL on cells. The type of cell damage induced by oxLDL is not known, and an additional purpose of the study was to determine whether the cytotoxic reaction of oxLDL reflects nonspecific cell death or the possible induction of programmed cell death, apoptosis, in cells of the types present in the atherosclerotic artery.
The most important results of this study are that shortly oxidized LDL had a very powerful mitogenic effect that was many times greater than that of the parent unoxidized LDL. LDL oxidized for a longer period induced apoptosis in human arterial SMCs, in a macrophage cell line, and in human fibroblasts, ie, in cells of the types present in the atherosclerotic artery.
| Methods |
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Human fetal lung fibroblasts were obtained from Statens Bakteriologiska Laboratorium and used up to the 20th passage. They were cultivated in Ham's medium F-12 (GIBCO) with 5% donor calf serum and with penicillin, streptomycin, and ascorbic acid, as above.
The macrophage-like cell line THP-1 (acute monocytic leukemia, human) was obtained from American Type Culture Collection and was cultivated in RPMI 1640 (GIBCO), with 7.5% fetal calf serum and with L-glutamine, penicillin, and streptomycin, as above, with the addition of 2 mmol of sodium pyruvate (GIBCO) and 50 µmol of mercaptoethanol (E. Merck) per liter.
For experiments in which apoptosis was to be visualized by the in situ detection of internucleosomal DNA degradation or by DNA staining with gallocyanin-chrome alum stain (see below), the cells were plated onto chamber slides (Lab-Tek Chamber-slides, catalog No. 177445, Nunc Inc) that had been coated with plasma fibronectin11 (15 µg/cm2) and under the conditions described below for plating in multiwells.
Assays of Growth and Cytotoxic Effects
For growth
measurements, fibroblasts or SMCs detached by
trypsinization and THP-1 cells were suspended in Iscove's modified
Dulbecco's medium (GIBCO), which does not contain copper and iron
components, with 2.6 mmol of L-glutamate per liter, 100
µg of streptomycin, and 100 U of penicillin per milliliter. The
plating medium also contained 5% donor calf serum (GIBCO) for
fibroblasts and 3% human platelet-poor plasma
serum12 for SMCs and THP-1 cells. The cells were plated
into multiwells (96-well plates for tissue culture; Falcon) that were
coated with 15 µg/cm2 of fibronectin isolated from human
plasma.11 The number of cells plated was low enough (the
precise number is given in the description for each separate
experiment) to keep the cultures well under confluence during the
experiments. After 24 hours, the platelet-poor plasma
serumcontaining medium was changed to serum- and plasma-free
medium, and the cells were incubated for at least 72 hours to obtain
quiescence. For this purpose, Iscove's medium was used with 2.6 mmol
of L-glutamate, 100 mg of streptomycin, 105
U of penicillin, 10 mg of transferrin (Collaboratory Research), and 2 g
of ovalbumin per liter (Grade V, Sigma). For the subsequent
period of exposure to samples, this medium was used, with the addition
of 5 µg of cholesterol per milliliter (purified by
chromatography on aluminum oxide5 ).
For studies of DNA replication, the cultures were exposed to the samples and to 5 µCi of methyl[3H]thymidine (NET-027, NEN, DuPont) per well for 24 hours, after which the cells were detached by trypsinization and loaded onto a glass filter by using a cell harvester. The activity was measured by liquid scintillation counting.
The culture size was determined by measuring mitochondrial activity using the MTT method, as described,5 13 by the reduction of MTT to blue formazan product. In short, a solution of MTT in PBS (5 mg/mL) was added to each well culture, and the cultures were incubated for 5 hours. When MTT is reduced, it is converted to blue formazan crystals during incubation. After incubation, these crystals were dissolved by adding SDS during an additional incubation period of 16 hours. The absorbency was read at 590 nm in an enzyme immunoassay multiwell photometer. Growth, as measured by the MTT method, was recorded as the net increase in absorbency after the subtraction of the background absorbency and expressed as "MTT units." Control experiments, described in a previous report,5 had shown that there was a direct and linear relationship between the number of cells and the MTT values.
Isolation and Fractionation of Serum Lipoproteins
The serum
lipoproteins were isolated and fractionated with
density gradient ultracentrifugation in sodium
bromide density solutions, as previously described in
detail.5 14 The lipoproteins were protected from
proteolytic degradation and from oxidation by a number of proteolytic
inhibitors, bacteriocide, EDTA, and an antioxidant (BHT)
during the entire isolation and fractionation procedure, which was
carried out at 10°C.
Total lipoproteins were isolated by density-cushion ultracentrifugation at 302 000g max for 26 hours in a Beckman L8M ultracentrifuge with an angle rotor (50.2 Ti), essentially as described by Rudel et al,15 with minor modifications.5 The total lipoproteins were further fractionated by density-gradient ultracentrifugation at 288 000g max for 22 hours in a swinging-out rotor (SW 41 Ti, Beckman). The density gradient was shaped by layering density cushions to cover a density range of 1.06 to 1.21, as described by Pitas and Mahley.16 If not used within 2 days, the lipoprotein fractions were stored at -135°C under nitrogen after cryopreservation, as described by Rumsey et al.17 18 LDL was measured by its content of protein, with a modification19 of the method described by Lowry et al.20
Oxidation of LDL and Fractionation of OxLDL
LDL was oxidized
by exposure to UV light at 257 nm with an
intensity of 1 mW/cm2 (Osram HNF 200 W and a 16-cm distance
between sample cuvette and lamp). Before exposure to UV light, the LDL
was extensively dialyzed in a Pierce microdialysis
apparatus at 4°C against 5 mmol of Tris buffer, pH 7.4,
per liter in saline followed by saline or against PBS during the whole
dialysis for experiments with unfractionated oxLDL. For experiments in
which oxLDL was fractionated into a low-molecular-weight and
high-molecular-weight fraction, LDL was dialyzed against a
volatile buffer, viz 0.15 mol of ammonium bicarbonate buffer, pH 7.8
per liter, to remove EDTA and nonvolatile buffer material. The buffer
solutions had been deoxygenated with oxygen-free
nitrogen. Before exposure to UV, the dialyzed LDL was diluted with
respective buffer to a protein concentration of
0.25 mg/mL and
transferred to a quartz cuvette.
The oxidation of LDL mediated by Fe ions was carried out as follows. LDL was extensively dialyzed in a Pierce microdialysis apparatus at 4°C against buffered saline followed by saline, as described above. The concentration of LDL was adjusted to 0.25 mg of protein per milliliter and FeCl3 added, to 0.2 mmol/L concentration, and the sample was incubated at +37°C for the periods indicated for each experiment.
The oxidation was monitored by the TBARS method, as described by Wallin et al21 and by the increased motility of oxLDL in agarose electrophoresis.22 The latter was performed with a kit for agarose gel electrophoresis for the diagnostic determination of lipoproteins (Hydragel LIPO+Lp(a); Sebia) and used under the conditions recommended by the manufacturer.
Changes induced by exposure to UV light were also examined by using PAGE with minigels (PhastGel gradients 4 to 15 or 8 to 25), using the Phast-System (Pharmacia LKB Biotechnology) as recommended by the manufacturer and with inclusion of appropriate molecular-weight standards (high and low range, Bio-Rad; polypeptides, Pharmacia Biotech). The gels were silver stained using procedures slightly modified from that described by Heukeshoven and Dernick23 and as recommended by the manufacturer of the gels.
High- and low-molecular-weight derivatives of LDL on oxidation were separated by ultrafiltration with an Amicon ultrafiltration device with filter cutoff of 30 000 D (YM30, Amicon Division, W.R. Grace & Co). The low-molecular fraction was concentrated in a vacuum in a Speed-Vac (Hetovac, VR-1, Heto-Holten), by which excessively volatile buffer material was also eliminated.
Extraction and Fractionation of LDL Lipids
The lipid
component of LDL was extracted as described by Bligh
and Dyer,24 as modified by Parthasarathy et
al,25 with the addition of BHT to the
solvents26 to avoid oxidation. LDL corresponding to 2
milligrams of protein was exhaustively dialyzed in a Pierce
microdialysis device against PBS and diluted to 2.2 mL with PBS.
Ice-cooled methanol (2.0 mL) with 0.1% BHT was rapidly added to
1.8 mL of the chilled LDL material in a glass centrifuge tube,
the mixture was vortexed, 2.0 mL of ice-cooled chloroform was
added, and the contents were once again mixed by vortexing. The mixture
was centrifuged at 4°C, 1800g for 10 minutes, and
the subnatant layer, which contained the lipids, was collected. The
solvent was evaporated under oxygen-free nitrogen, and the lipids
were dissolved in toluene and stored under nitrogen, at 4°C in the
dark. For experiments on the distribution of
apoptosis-inducing material in the methanol-water phase
and the subnatant, lipid phase, the phases were collected and washed
with chloroform and methanol-water, respectively. The
methanol-water phase was concentrated in a vacuum in a Speed-Vac
and the lipid phase under oxygen-free nitrogen, as described above.
The total LDL lipids were further fractionated into neutral lipids and phospholipids with chromatography on silicic acid.27 In short, the total lipids were dried under nitrogen and redissolved in 2.0 mL methyl-tert-butyl ether/hexane (1:9) and applied to a silica Sep-Pak cartridge (Sep-Pak Classic Silica, catalog No. 51900, Millipore Intertech) preequilibrated with hexane. The neutral lipids were eluted with 20 mL of methyl-tert-butyl ether/hexane (1:1) and the phospholipids with 20 mL methanol. For incubation with cells, the total lipids and the lipid fractions were dried under nitrogen and suspended in PBS with 2% lipid-free bovine serum albumin (A8806, Sigma) by vigorous vortexing under nitrogen and with slight warming. Before use, the albumin solution in PBS had been neutralized.
Detection of Apoptosis
Detection of Internucleosomal
DNA Fragmentation With Methods for
the In Situ Labeling of Degraded DNA
In the first part of this study,
in situ nonisotopic
labeling techniques for apoptosis involving avidin-biotin
binding28 29 were used, but the reproducibility was
not
satisfactory with our material and in our hands. We therefore applied a
technique involving the template-independent addition by terminal
deoxynucleotidal transferase (TdT) of digoxigenin-dUTP to 3'-OH DNA
ends generated by the internucleosomal degradation of DNA in
apoptosis (TdT-mediated dUTP nick end labeling [TUNEL]) and
the visualization of the digoxigenin-labeled DNA by direct
immunoperoxidase detection (ApopTag, Oncor).
Detection of
Light-Microscopic Nuclear Changes in
Apoptosis
The standard May-Grünwald-Giemsa method has been used
for
the detection of apoptosis in cell cultures, especially for
cells that do not exhibit endonuclease activity in conjunction with
apoptosis, such as nontransformed vascular
SMCs.30 31 The human arterial SMCs flatten out
very strongly in the cultures, and the staining of the very attenuated
cells with May-Grünwald-Giemsa was too weak and indistinct for
our purpose to permit the detection of apoptosis.
Different specific DNA-staining techniques were therefore tried. Staining of DNA with Einarson's gallocyanin-chrome alum method32 was found to be satisfactory. It was performed essentially as previously described33 with cultures on chamber slides fixed in cacodylate-buffered formalin solution prepared from paraformaldehyde.34 The staining solution was prepared with 5 g of chrome alum and 0.15 g of gallocyanin in 100 mL of distilled water that was boiled for 5 minutes, cooled, and filtered (final pH 1.64). The volume was adjusted to 100 mL and staining was performed for 96 hours at room temperature.
Apoptotic
cells were counted as follows. The counting was
guided by a grid mounted in one of the oculars and covering
80% of
the microscope field. Apoptotic cells contained within the grid
were counted, and the grid was then moved to a new field. Approximately
500 cells were counted for each chamber culture, and care was taken to
cover the culture as evenly as possible.
| Results |
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The development of TBARS is shown in Fig 2A
. With Fe,
TBARS developed more rapidly and reached a higher concentration than
with UV treatment. Consequently, there was no relationship between the
development of TBARS and the degree of cytotoxicity. As evaluated with
SDS-PAGE of UV-treated LDL (Fig 2B
),
very-high-molecular-weight, intact apoB decreased as the
duration of treatment increased, with the formation of degradation
products of varying molecular sizes. With prolonged exposure (25
hours), almost all the medium-sized molecules also disappeared, and
fairly small amounts of very-high-molecular-weight material
(apoB) remained (Fig 2B
).
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The cytotoxic effects of oxLDL on fibroblasts (Fig 1
) were
very
pronounced in the case of LDL exposed to UV, in contrast to that of LDL
treated with Fe. The exposure of LDL to UV in the specified conditions
(see "Methods") for 25 hours was therefore chosen for the studies
of the induction of apoptosis. Fig 3
illustrates
the effect of LDL exposed to UV for different time intervals on the
replication of DNA in fibroblasts and the macrophage-like
cell line THP-1. Replication was stimulated for both cell types by LDL
exposed to UV for short and moderately long time intervals. After
prolonged UV treatment, the synthesis of DNA was reduced, thus
indicating cytotoxicity. In the same way as for the fibroblasts (Fig
1
), analogous results were obtained with the
macrophage-like cell line for the effects on culture size
(Fig 4
). The macrophages were more sensitive to
the cytotoxic effects of oxLDL than the fibroblasts, as demonstrated by
the reduction in culture size and the replication of the former, even
with LDL that had been exposed to UV during a somewhat short time
interval (Figs 1
, 3
, and 4
).
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Apoptosis could be readily visualized in fibroblasts and in the
macrophage-like cell line THP-1 by the in situ staining of
the internucleosomal degradation of DNA. The combination with
phase-contrast microscopy also permitted the detection of other
signs of apoptosis such as blebbing, retraction, and
fragmentation. Fig 5
shows micrographs in the phase
contrast (Fig 5A
) and light field (Fig 5B
) of
chamber-slide
fibroblast cultures that had been exposed to UV-oxLDL at a
concentration corresponding to 400 µg of parent LDL per milliliter
and fixed and stained for internucleosomal DNA degradation. The
numerical values for the appearance of apoptosis at different
concentrations of oxLDL in this experiment are given in Table
1
.
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The internucleosomal degradation of DNA could not be detected in
arterial SMCs by agarose electrophoresis of the extracted
DNA (not shown) or by the in situ staining of internucleosomally
degraded DNA, in agreement with other reports.30 31
Apoptosis could be readily detected, however, from chromatin
condensation visualized by staining DNA using the
gallocyanin-chrome alum method (Fig 6
). Even the
degree of chromatin condensation could be roughly estimated. In an
experiment with graded exposure to oxLDL, the degree of chromatin
condensation was roughly proportional to the concentration of oxLDL in
the culture medium (Fig 6A
through 6D). Additional information
on
changes indicating apoptosis could be obtained by combination
with phase-contrast microscopy (see above).
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The effect on fibroblasts of exposure to increasing concentrations of
low- and high-molecular derivatives of oxLDL is shown in Table
1
.
Apoptosis was visualized by the in situ staining of the
internucleosomal degradation of DNA. The incidence of apoptotic
cells increased gradually as the concentration of low-molecular
derivatives of oxLDL increased and reached a level of
10% at the
highest concentration of low-molecular oxLDL derivatives. Exposure
to the high-molecular fraction of oxLDL was not followed by the
appearance of apoptotic cells.
The incidence of apoptosis in SMCs in ordinary cultures without
oxLDL and in the presence of 10% WBS was slightly higher than 1%, as
evaluated from the appearance of chromatin condensation with
gallocyanin-chrome alum stain (Table 2
). Lipids from
native unoxidized LDL apparently did not promote apoptosis in
SMCs even at concentrations corresponding to high levels of unoxidized
LDL (Table 2
).
|
As for the fibroblasts (Table 1
), oxLDL induced apoptosis in
SMCs (Table 3
), and this capacity was confined to the
low-molecular derivatives of oxLDL. The effect on SMCs was very
marked, and at the highest concentration of low-molecular oxLDL
derivatives, all cells were apoptotic (Table 3
).
|
Exposure of SMCs to the low-molecular fraction of oxLDL under
serum-free conditions had a stronger apoptosis-inducing
effect than in the presence of 10% WBS (Table 4
).
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OxLDL was separated into a water-methanol and a chloroform (lipid-soluble) fraction by phase separation during the extraction of lipids from oxLDL, but the apoptosis-inducing effect of the fractions was not clearly different (not shown).
| Discussion |
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A wide variety of methods have been used for the experimental oxidation of LDL. Oxidation is commonly promoted by exposure to UV light35 39 40 or to transition metal ionmediated oxidation with Fe or Cu ions (for a review see Reference 4). Exposure to UV light was found to be far more effective when it came to the production of cytotoxic and apoptosis-inducing material from LDL than exposure to Fe ions, and the former method was therefore used for LDL oxidation in the present work.
The detection of apoptosis by using extracted DNA material was not suitable for the present purpose, but the in situ staining was very useful, except for SMCs in which the internucleosomal degradation of DNA did not accompany the structural changes of apoptosis.30 41 For this cell type, we applied the gallocyanin-chrome alum stain for DNA to visualize the condensation of the chromatin as an indication of apoptosis. This method proved to be very sensitive and permitted a semiquantitative assessment of the degree of chromatin condensation.
Relatively short exposure of LDL to UV or Fe ions increased the mitogenic effect of oxLDL to several times that of the native LDL. This effect was preserved even after the prolonged treatment of LDL with Fe. The fact that oxidation strongly increased the mitogenicity of LDL for SMCs and for macrophages may be a very important observation pathophysiologically. The increased growth of SMCs is regarded as a key mechanism for the development of intimal thickening and for the development of the thickened intima to a fibroatheroma or fibrous plaque. Macrophages tend to clear away accumulations of lipoproteins to become foam cells, and many of them may end up as cell debris and extracellular lipids to add instability to the atherosclerotic plaque. These changes are important components of the atherogenic process (for a review see References 6 and 42), and the above-mentioned results of the present work may therefore contribute to a pathophysiological explanation for one of the potential roles of oxLDL in atherogenesis. There could be several mechanisms underlying the strongly increased mitogenicity of shortly oxidized LDL. It has recently been shown that the mitogenic and growth-promoting effects of native, unoxidized LDL require the presence of LDL receptors.14 It is known that lightly oxidized LDL, in contrast to native LDL, may be internalized by multiple receptor-mediated pathways (for a review see Reference 3), which could increase the efficiency of internalization and thereby the effects on the cells. In addition, there is evidence that low concentrations of oxLDL may increase the production of PDGF-AA and the expression of PDGF receptors in SMCs and could thereby perhaps increase growth by autocrine stimulation.43
The cytotoxic effects of experimentally oxidized LDL and even of LDL that had not been intentionally oxidized have been described in many reports,5 40 43 44 45 46 47 48 but the nature of the cell death has not been clarified. Death by apoptosis induced by various means in vitro has been reported for macrophages49 50 51 52 53 and fibroblasts (for a review see Reference 54) of different origins and for arterial SMCs.30 31 55 Little information is available on the apoptosis-inducing effects of oxLDL. OxLDL was found to induce apoptosis in a macrophage-like murine cell line,49 in mouse peritoneal macrophages,50 and in lymphoblastoid cells.56 57 To our knowledge, no data on the apoptosis-inducing effects of oxLDL on arterial SMCs and fibroblasts have previously been presented. Sparse information is available on the occurrence of apoptosis in conditions more like those in the arterial wall in vivo. The occurrence of apoptosis was reported for reconstituted (spheroidal) human arterial smooth muscle tissue55 and for SMCs in human saphenous vein grafts.58 Evidence was recently presented for the occurrence of apoptosis in atherosclerotic lesions.59 60 Apoptosis has been described for myofibroblasts in granulation tissue,61 which have many properties in common with the modulated, synthetic phenotype of the arterial SMCs.
The generation of cytotoxic and apoptosis-inducing material on prolonged UV treatment was related to the degradation of apoB to low-molecular-weight material, in agreement with several reports on the oxidative degradation of apoB after various types of oxidative treatment.25 35 62 63 The results of the present study clearly demonstrate that the prolonged oxidation of LDL promoted by UV generates derivatives with apoptosis-inducing effects in SMCs, in a macrophage line and in fibroblasts. The apoptosis-inducing effect was confined to the low-molecular-weight material after prolonged exposure to UV.
Apoptosis was induced in vitro at a concentration of oxLDL material corresponding to slightly above the concentration of LDL in the interstitial fluid (100 to 150 µg of apoB per milliliter64 ). This is clearly within the pathophysiological range for the arterial wall tissue, especially in certain atherogenic situations such as endothelial injury or hyperlipidemic states.
Serum had a protective effect on apoptosis (Table 4
), in
agreement with other studies in which serum65 or growth
factors in serum, such as insulin-like growth
factor-I66 and PDGF,67 inhibited the
appearance of apoptosis. Since oxLDL contained both lipid- and
water-soluble components with the capacity to induce
apoptosis, it was not possible to conclude from the present
results whether the apoptosis-inducing material was derived
from the lipid68 or the apoB component of LDL.
Proliferative tissue changes alternating with necrosis are apparent in atherosclerotic lesions. Such changes are the basis of several of the most severe complications of atherosclerosis, such as arterial stenosis or arterial rupture with hemorrhage or plaque rupture or fissuring with mural hemorrhage, atheroembolism, and/or thrombosis with subsequent occlusion. OxLDL is currently believed to play an important atherogenic role. The dual effect of oxLDL, ie, its strong growth-promoting effect or the induction of cell death by apoptosis, depending on the degree of change by oxidation, as demonstrated in this report is compatible with the conclusion that oxLDL plays a role not only in atherogenesis but also more extensively in the development of the structure typical of the atherosclerotic lesion and thereby contributes to the important clinical effects of the lesion.
| Selected Abbreviations and Acronyms |
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| Acknowledgments |
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| Footnotes |
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Received May 8, 1995; accepted November 7, 1995.
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