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Arteriosclerosis, Thrombosis, and Vascular Biology. 1999;19:1162-1167

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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1999;19:1162-1167.)
© 1999 American Heart Association, Inc.


Vascular Biology

Proteoglycans Contribution to Association of Lp(a) and LDL With Smooth Muscle Cell Extracellular Matrix

Ulf Lundstam; Eva Hurt-Camejo; Gun Olsson; Peter Sartipy; Germán Camejo; Olov Wiklund

From the Wallenberg Laboratory, Sahlgren's University Hospital, Göteborg, S-41345, Sweden (U.L., E.H.-C., G.O., P.S., G.C., O.W.); and the Astra Hässle AB, Preclinical Research Laboratories, Mölndal, S-431 83, Sweden (G.C.).

Correspondence to Germán Camejo, Astra Hässle AB, Preclinical Research Laboratories, Mölndal, S-431 83, Sweden. E-mail german.camejo{at}hassle.se.astra.com


*    Abstract
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Abstract—Lp(a) interference with fibrinolysis could contribute to atherothrombosis. Additionally, accumulation of Lp(a) and LDLs, could lead to cholesterol deposition and foam cell formation in atherogenesis. The interactions between Lp(a) and LDL could cause their entrapment in the extracellular matrix of lesions. We found that association of Lp(a) with matrix secreted by cultured human arterial smooth muscle cells increased 2 to 3 times the subsequent specific binding of radioactive LDL. Chondroitin sulfate proteoglycans seem responsible for formation of the specific matrix-Lp(a) and matrix-LDL aggregates. The proteoglycans appeared also to participate in a cooperative increase of radioactive LDL binding to matrix pretreated with Lp(a). In the matrix preincubated with LDL, {approx}50% of the additional lipoprotein was bound by ionic interactions. In the matrix preincubated with Lp(a), 20% of the additional LDL was held by ionic bonds, and the rest was held by strong nonionic associations. Binding analysis in physiological solutions confirmed that chondroitin sulfate-rich proteoglycans from the smooth muscle cell matrix have a high affinity for Lp(a) and LDL. The results provide an explanation to the observed localization of Lp(a) and LDL in the extracellular matrix of arterial lesions and suggest a mechanism for their cooperative accumulation there.


Key Words: lipoprotein(a) • LDL • smooth muscle cells • extracellular matrix


*    Introduction
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Lp(a) is an LDL-like particle distinguished by an apo(a) attached to apoB100 by a disulfide bridge and by noncovalent associations. Circulating levels of Lp(a) are an independent risk factor for atherosclerosis-related cardiovascular disease.1 2 Lp(a) contribution to atherothrombosis may be caused by its competition with plasminogen for binding at sites of fibrin deposition, thus inhibiting plasmin formation and clot lysis.3 4 A second hypothesis for the atherogenicity of Lp(a) suggests that it has special affinity for components of the extracellular intima. Therefore, together with other apoB100 containing lipoproteins, Lp(a) could be deposited at sites of lesion development.5 6 7 Lp(a) and LDL accumulate in the extracellular matrix of human lesions at regions rich in proteoglycans from where they can be extracted and measured.5 Furthermore, there is preferential retention of Lp(a) in the intima of atherosclerotic lesions when compared with normal regions.8 Lp(a) may interact with one or several of the intima extracellular matrix proteins and proteoglycans (PGs) by its apoB100 and apo(a) apolipoproteins.9 Recently, Hughes et al10 and Boonmark et al11 reported on the important role that lysine-binding sites in apo(a) kringles 4–10 may have for binding to the arterial wall in human-apoB transgenic mice. The apoB100 in Lp(a) could be another ligand for interacting with components of intima extracellular matrix. It contains glycosaminoglycan-binding, positively charged sequences, in its surface that may associate with intima PGs.7 Twenty years ago Dahlen et al12 suggested that glycosaminoglycans (GAGs) of the intima may be involved in the specific retention of Lp(a). More recently, Bihari-Varga et al13 concluded that Lp(a) may complex with arterial GAGs by the interaction of its apoB100 moiety and not by means of its apo(a). This conclusion is supported by the fact that the apo(a) does not have GAG-binding consensus sequences, such as those present in apoB100 or apolipoprotein E.14 15 Another possibility for Lp(a) association with the extracellular matrix is suggested by results in which the extracellular matrix was treated with exogenous lipoprotein lipase (LPL) and sphingomyelinase (SML). This was found to increases the binding of LDL and Lp(a), probably by formation of ternary complexes Lp(a)-LPL-GAG or Lp(a)-SML-GAG and the equivalents with LDL.16 17 Extracellular matrix fibronectin was also proposed as an Lp(a)-binding agent in arteries if unmasked of heparan PGs.18 An additional possibility is that, after specific noncovalent association of Lp(a) with LDL, this complex may associate with intima components. This idea is supported by findings from Trieu et al19 20 showing that Lp(a) and LDL can form noncovalent complexes and that a specific segment in apoB100, 3304-3317, is responsible for the association with kringle 36. However, to our knowledge no data about a cooperative effect between Lp(a) and LDL on their binding to the extracellular matrix of arterial cells is available. Smooth muscle cells are probably the main contributors of macromolecular matrix components of the arterial intima and are prominently involved in atherogenesis.9 21 We have explored the interactions of LDL and Lp(a) in a model of extracellular matrix secreted by human arterial smooth muscle cells (HASMCs).22 The results indicate that there is a cooperative binding of LDL and Lp(a) to the matrix and that the GAGs of the PGs present mediate most of this effect.


*    Methods
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Chemicals
Guanidine-HCl, Triton X-100, N-ethylmaleimide, epsilon aminocaproic-acid, benzaminidine-HCl, phenylmethylsulfonylfluoride, cetylpyridinium bromide, ethylaminihexanoic acid, cell culture tested BSA, HEPES buffer, and trypsin-EDTA were purchased from Sigma. Chondroitin-4-sulfate (C4S), chondroitin-6-sulfate (C6S), and heparan sulfate were purchased from Seikagaku Co. Cyanogen activated sepharose, PD-10 columns, Lysine sepharose 4B columns, and Hi-Trap Q columns were from Pharmacia Fine Chemicals. The immunoreaction kit for Lp(a) was from Boehringer Mannheim. Collagen I was purchased from Collaborative Biomedical Products. Cell culture media, antibiotics, FCS, and culture vessels were from Flow Laboratories. Na2[35S]SO4,(25 to 40 Ci/mg); L-4,5-[3H]leucine,(120 to 190 mCi/mmol), 125I-iodine monochloride, and hyperfilms for autoradiography were from Amersham International. Other salts and solvents were of analytical grade and bought from Merck. NuSieve agarose was from FMC BioProducts.

Plasma Lipoproteins
LDL (d=1.019 to 1.063 g/mL) and HDL (d=1.063 to 1.21 g/mL) were isolated by differential ultracentrifugation from fresh plasma containing Na2EDTA and with adjustment of densities with KBr.23 Lipoprotein preparations were stored at 2°C to 4°C in KBr and 1 mg/mL EDTA until used. Lipoproteins were used within a week after preparation. Immediately before use, the lipoproteins were equilibrated in the desired buffer solution using PD-10 gel filtration columns. The number of LDL particles was calculated with an electroimmunoassay for apoB100.24 Lipoprotein(a) was obtained from plasma pools from 3 to 4 healthy donors containing a minimum of 210 mg/L apo(a). The plasma lipoprotein fraction with d=1.063 to 1.21 g/mL was used as the Lp(a) source. Lp(a) was purified by affinity chromatography on lysine-sepharose 4B with the use of {epsilon}-amino caproic acid to elute the bound lipoprotein.25 The identity and purity of each preparation of LDL and Lp(a) were verified by agarose gel electrophoresis and by immunodiffusion against polyclonal antibodies against human apoB100, Lp(a), apoA1, apoE, and serum albumin. The binding experiments required appreciable amounts of Lp(a); therefore, we used pooled preparations from 3 to 4 individuals that contained different isoforms. The amount of Lp(a) in the binding experiments was estimated from the apoB100 content measured by electroimmunoassay.26 LDL was labeled with 125I-iodide monochloride to a specific activity of {approx}50 cpm/ng of protein.27

Arterial Smooth Muscle Cells Extracellular Matrix and Proteoglycans
Extracellular matrix (ECM) produced by confluent cultured HASMCs was prepared as described.16 22 Briefly, confluent HASMC cultures in collagen-pretreated 48-well plates were used. The subcellular layer of ECM was exposed by dissolving the cell layer by a sequential treatment with 0.5% triton X-100 in PBS followed by 25 mmol/L NH4OH in PBS. The remaining ECM layer remained firmly attached, covered the bottom of the wells, and under phase microscopy was free of nuclear and other cellular debris. Extracellular matrix proteoglycan, rich in chondroitin sulfate and made mostly of biglycan and labeled with 35SO4, was prepared and characterized from batches of HASMC cultured to confluence in 75-cm2 bottles as described.28

Solid Phase Binding of LDL and Lp(a) to ECM
Three types of competition experiments were carried out to evaluate the association of Lp(a) and LDL to the ECM. In all cases the ECM-covered wells were first treated for 1 hour at 37°C with a blocking buffer to diminish nonspecific binding. The blocking buffer contained 10 mmol/L HEPES, 20 mmol/L NaCl, 5 mmol/L CaCl2, 2 mmol/L MgCl2, 0.2% BSA, pH 7.4. In preliminary experiments we found that radioiodination of Lp(a) caused a rapid time-dependent decrease in its affinity for ECM. Also, incorporation of nonpolar fluorescent labels into Lp(a), as the octadecyl indocarbocyanines, was found to modify the binding to the extracellular matrix, and the probe rapidly exchanged with the LDL in competition experiments. The use of covalent–bound fluorescent probes was not possible because changes in charged amino acid side chains of the apolipoproteins also modify its interaction with GAGs.7 Therefore, in all 3 types of experiments to be described, LDL was used as the radioactive probe to avoid labeling the Lp(a). The association of LDL to the ECM after radiolabeling ECM was more stable than that of Lp(a). In the first competition experiment a fixed amount of 125I-LDL (150 000 cpm, {approx}3 µg apoB protein, or 6 pmol) was added to the ECM-containing wells together with increasing amounts of unlabeled LDL and Lp(a) in binding buffer that was similar to the blocking buffer but contained no albumin. After incubation for 2 hours at 37°C and removal of unbound ligands, the wells were rapidly washed 3 times with cold binding buffer and the bound 125I-LDL dissolved in 0.2 M NaOH and counted. This was the only type of experiment in which unlabeled Lp(a) was used as a competitor because of the large amounts required to run a complete displacement curve (2 to 4 mg). In the other 2 types of experiments to be described unlabeled LDL was used as the displacing molecule. To evaluate if associations between LDL or Lp(a) with the ECM could affect further binding of LDL a second type of competition experiment was performed. The blocked ECM wells were pretreated with 0.2 nmol/well of either unlabeled Lp(a) or LDL, measured as apoB protein. After 2 hours preincubation at 37°C the unbound LDL or Lp(a) were removed and the wells were rapidly washed once with cold binding buffer. After the preincubation, a constant amount of 125I-LDL (150 000 cpm, {approx}6 pmol apoB/well) was incubated with increasing amounts of unlabeled LDL in binding buffer for 2 hours at 37°C. After removal of unbound ligands, the wells were washed 3 times with cold binding buffer. The third type of competition experiment was similar to the previous one but included a pretreatment of the ECM with chondroitinase ABC. Solutions of 0.16 U/mL of the enzyme were applied to digest the chondroitin and dermatan sulfate GAGs of the ECM overnight at 37°C.22 The wells were washed 3 times with cold binding buffer, treated with blocking buffer, and preincubated with unlabeled Lp(a) or LDL (0.2 nmol apoB/well). The wells were then washed and used for competition experiments with a constant amount of 125I-LDL and increasing concentrations of unlabeled LDL or Lp(a). Radioactivity in the samples was followed with a gamma counter (Ria-Gamma, Wallac).

To study the nature of the association of LDL with ECM pretreated with Lp(a) or LDL a binding and extraction experiment according to Moscatelli29 was performed. In this experiment the ECM-containing wells were preincubated with unlabeled Lp(a) or LDL and increasing amounts of labeled LDL were added. After incubation for 2 hours at 37°C the wells were rapidly washed 3 times with cold binding buffer. The amount of 125I-LDL attached to the matrix was discriminated into a loosely bound and a tightly bound fraction. The first was detached by adding a hypertonic buffer made of 10 mmol/L HEPES, 2 mmol/L Na2-EDTA, 500 mmol/L NaCl, pH 7.4 to the wells for 30 minutes at 37°C . This buffer should dissociate mostly ionic complexes promoted by divalent cations. The fraction of labeled LDL that remained bound by other forces (tightly bound) was collected by dissolving the ECM in 0.2 mol/L NaOH.29 30

Fluid Phase Binding of Lp(a) to ECM Proteoglycans
Direct binding of Lp(a) and LDL with the versican-like PGs secreted by the HASMC was evaluated using an agarose gel mobility shift assay. This assay was developed for evaluation of reversible binding of lipoproteins to PGs at physiological ionic strength.31 In brief, a constant amount of 35S-labeled chondroitin sulfate-rich PGs, containing 0.4 to 0.5 µg/mL of GAGs and 8000 to 10 000 cpm was mixed with increasing concentrations of Lp(a) or LDL. The lipoproteins, GAGs, and PGs were dissolved in "fluid phase binding buffer" that was made of 10 mmol/L HEPES, 140 mmol/L NaCl, 5 mmol/L CaCl2, 2 mmol/L MgCl2, pH 7.4. After incubation for 2 hours at room temperature, the samples were made 10% vol/vol in glycerol to increase the density and 10 µL was applied to 0.7% agarose gels. The agarose was prepared in buffer made of 10 mmol/L HEPES, 2 mmol/L CaCl2, and MgCl2, pH 7.2.

After the electrophoretic step, the gels were fixed in 0.1% cetylpyridinium bromide for 16 hours, dried, and the radioactive PGs bands were evaluated in a digital autoradiograph (Berthold Laboratories, Wilband, Germany) and by autoradiography.

Data Analysis
All experiments were run in triplicate and repeated at least once with LDL from 2 different individuals, 2 different pools of Lp(a), and 2 different cell preparations. The binding experiments for each preparation were run in triplicate cell culture wells and in duplicate electrophoresis gels. Statistical analysis, mean±SD and nonlinear curve fitting was done with the PRISM program of GraphPad Software Inc.32


*    Results
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*Results
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Solid Phase Competition Experiments
The ECM in each well retained 0.08 pmol of the 6 pmol added 125I-LDL when no unlabeled ligands were present (Figure 1Down). In the experiments, designed as simple competition of radioactive LDL with unlabeled Lp(a) or LDL, the Lp(a) always showed a very unusual displacement curve. At the lowest concentration of Lp(a) used, there was a net increase in the binding of 125I-LDL, and even at the highest concentration there was little displacement of radioactive LDL (Figure 1Down). The displacement curve with unlabeled LDL was more predictable with a 65% displacement obtained at the highest concentration of LDL. The data suggested that that Lp(a) increased the binding of radioactive LDL to the matrix. To explore this possibility further, a second type of competition experiment was carried out. In these experiments the ECM-containing wells were preincubated with unlabeled Lp(a) or LDL before adding the 125I-LDL probe followed by increasing amounts of unlabelled LDL as a competitor. With no competitor, 2 to 3 times more 125I-LDL was bound to the Lp(a)-treated ECM than to the LDL-treated one. Such increased binding of radioactive LDL by pretreatment with Lp(a) could be competed by increasing amounts of unlabeled LDL (Figure 2Down). However, 2 to 3 times more unlabeled LDL was required to compete 50% (IC50) off the displaceable labeled LDL in the Lp(a)-treated ECM than in the LDL-treated ECM.



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Figure 1. Competition of unlabelled LDL and Lp(a) with 125I-LDL binding to ECM synthesized by smooth muscle cells. A constant amount of radioactive LDL ({approx}150 000 cpm) was mixed with increasing concentrations of unlabeled Lp(a) (solid bars) or LDL (open bars) and added to the wells containing the ECM. After binding, the excess ligands were discarded and the remaining bound 125I-LDL was measured. Values are average±SD of at least 3 wells.



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Figure 2. Competition of 125I-LDL bound to ECM-covered wells that were preincubated with excess LDL or Lp(a). Wells were preincubated with 100 µg/well of unlabeled LDL ({circ}) or Lp(a) ({bullet}), measured as apoB protein. After washing, a constant amount of 125I-LDL was added to each well (6 pmol/well, {approx}150 000 cpm) together with the indicated increasing concentrations of unlabeled LDL. After washing, the radioactive LDL bound to the ECM was measured. The points are means± SD of at least triplicate measurements. Some of the error bars are covered by the symbols. Notice that the values listed as corresponding to a log of -9.0 mol/L are identical to the values obtained with no competitor.

The possible contribution of the extracellular matrix GAGs on the association of the lipoproteins was explored in ECM that was treated with chondroitinase ABC before preincubation with Lp(a) or LDL. This caused {approx}50% to 60% reduction of the increased 125I-LDL binding related to the preformed lipoproteins–ECM complexes, indicating that chondroitin sulfate GAGs are responsible for the majority, but not all, of the effect of pretreatment of ECM with Lp(a) (Figure 3ADown) or LDL (Figure 3BDown). The binding of radioactive LDL, before and after chondroitinase ABC treatment, was also competed by unlabeled LDL. This suggests that the residual excess binding was also specific for LDL. The IC50 for the competition curves were not different. As indicated by the size of the standard deviations in the figures, for each batch of lipoprotein and ECM preparation, the data points have acceptable dispersions. However, the net amount of LDL bound to the matrix varied with the batch of ECM and lipoprotein preparation. To allow for an easier comparison of the effects of chondroitinase treatment on the ECM preincubated with Lp(a) and LDL, the results in Figure 3Down are expressed as a percentage of the initial radioactive LDL bound.



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Figure 3. Effect of chondroitinase treatment on the binding of 125I-LDL to ECM preincubated with Lp(a) (A) or LDL (B). This experiment was similar to that in Figure 2Up, but before the preincubation of the ECM with unlabeled LDL or Lp(a), the wells were treated with chondroitinase ABC for 2 hours (0.1 U/mL) (triangles, A and B). The points are means±SD of triplicate points. Some of the error bars are covered by the symbols. The values listed as corresponding to a log of -9.0 mol/L are identical to the values obtained with no competitor.

The nature of the LDL interaction with the ECM preincubated with Lp(a) or LDL was investigated by separation of the LDL retained into a loosely (Figure 4ADown) and a tightly bound fraction (Figure 4BDown). The results in Figure 4ADown and 4BDown show again that more radioactive LDL was immobilized to the Lp(a)-pretreated ECM than to the LDL-pretreated ECM. Additionally, the data indicate that, at near saturation, >80% of the radioactive LDL bound to the Lp(a)-preincubated ECM was in a tightly bound form (Figure 4BDown). Whereas on the LDL-preincubated ECM, only 40% of the total bound LDL (tightly plus loosely bound, empty circles in Figure 4ADown and 4BDown) LDL was in the tightly bound form (Figure 4BDown).



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Figure 4. Radioactive LDL loosely (A) and tightly bound (B) to ECM preincubated with Lp(a) and LDL. After preincubation of the wells containing ECM with the lipoproteins, increasing amounts of 125LDL were added to triplicate wells. After washing, the retained radioactive LDL was first extracted with a buffer containing 500 mmol/L NaCl and 2 mmol/L EDTA (loosely bound, A). The remaining radioactivity was dissolved with 0.2 mol/L NaOH (tightly bound, B). The total amount of radioactive LDL bound was the sum of the values for tightly and loosely bound (filled circles in A and B) for ECM preincubated with Lp(a) and (open circles in A and B) for ECM preincubated with LDL. The values are means±SD.

Lp(a) Interactions With ECM Proteoglycans in Fluid Phase
The described experiments in Figure 3Up indicated that chondroitin sulfate and dermatan sulfate GAGs were responsible for >1/2 the increased LDL binding associated with pretreatment of ECM with Lp(a) or LDL. To test if, at physiological ionic conditions, Lp(a) or LDL could interact directly with the chondroitin sulfate-rich PGs isolated from the ECM, we used electrophoretic mobility assays. The fraction isolated from smooth muscle cell ECM and used here is made mostly of biglycan. In the conditions selected the interaction took place in the fluid phase. The electrophoretic step was designed to measure complex formation by the change in electrophoretic mobility of the PGs induced by association with the Lp(a) or LDL (Figure 5Down). The patterns obtained indicated that, at low concentrations of LDL and Lp(a), associations were formed that depleted the radioactivity of the band corresponding to the free versican-like PG (most anodic band). Increasing the lipoprotein concentration led to changes in the electrophoretic behavior of the PGs. This suggested that associations were formed that retarded the mobility of subclasses of PGs until part of them was not capable of entering the gel at high LDL and Lp(a) concentrations (Figure 5Down). The experiments allowed us to measure an apparent Kd of the lipoproteins for the PG. The affinity of LDL for the versican was higher than that of Lp(a), Kd=27 nmol/L and 180 nmol/L, respectively. The amount of PG used in the incubation corresponded to {approx}50 mol/L, assuming a molecular weight of 200 000kDa for biglycan. Therefore, it can be roughly estimated that 1 to 2 molecules of LDL were sufficient to bind the PGs whereas 4 to 6 times more Lp(a) molecules were required.



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Figure 5. Autoradiographic image of the electrophoretic mobility assay of the fluid phase association between Lp(a) or LDL and 35S-labeled versican proteoglycans secreted by human arterial smooth muscle cells. The indicated amounts of Lp(a) or LDL, expressed as apoB protein, were mixed with a constant amount of 35S-labeled versican proteoglycan (0.4 to 0.5 µg of GAGs) in binding buffer. After a 2-hour incubation the samples were subjected to the electrophoretic separation.


*    Discussion
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Part of the atherogenicity of Lp(a) may be caused by its accumulation at sites of lesion development because of its special affinity for components of the intima extracellular matrix.10 12 13 Although Lp(a) particles are generally much less abundant in plasma than those containing only apoB100, their relative content in human lesions is not very different. This suggests that there should be an efficient trapping mechanism in the arterial intima for Lp(a).5 13 17 33 Most of the Lp(a) and apoB particles in lesions are detected in the extracellular intima and can be extracted from it as partially modified structures.5 33 34 In vivo studies confirm that, in the intima of lesions, there is increased retention of Lp(a) particles compared with normal regions.8 Recently, extensive Lp(a) deposits in lesions of transgenic mice expressing the human lipoprotein were described.11 Our experiments explored additional mechanisms that could contribute to the high affinity of Lp(a) for the extracellular intima.

Progressing lesions have an intima rich in chondroitin sulfate proteoglycans of the versican type with a special affinity for apoB100-containing particles. This may be related to secretion of PGs with larger chondroitin sulfate chains after smooth muscle cell migration from the media and proliferation at the intima.31 35 Another source of proteoglycans, in this case heparan PGs, with special affinity for apoB lipoproteins, could be macrophages accumulating in growing lesions.36 Fibronectin is another ECM macromolecule prominent in the intima of lesions that is product of migrating and proliferating smooth muscle cells.9 Fibronectin is another ECM protein that binds Lp(a). This protein may bind Lp(a) by means of the apoB100 and through specific sequences in the apo(a).37 Also laminin and fibrinogen bind recombinant apo(a).10 18 38 Lp(a) and LDL can also associate with macromolecules residing temporally in the extracellular and pericellular matrix, such as lipoprotein lipase or sphingomyelinase.16 17 Additionally, apo(a) has specific sequences in its kringle 4 that recognize the apoB sequence 3304–3317 by ionic interactions of high affinity (10-8 M).20 This suggests the possibility that, in the intima fluid phase, associations of Lp(a) and LDL can be formed in different states of aggregation. These hypothetical complexes may have restricted capacity to return to the circulation across the endothelial barrier. This may lead to its focal accumulation and eventual associations with the arterial intima.19 20 39 An alternate, but not exclusive, possibility may be that cooperative associations are formed at the surface of extracellular matrix fibril structures.

Our results, obtained with ECM secreted by HASMCs, suggest that Lp(a), after interacting with chondroitin sulfate proteoglycans, increased the further binding of apoB-containing lipoproteins to the matrix. Once bound to the matrix, Lp(a), and to a lesser extent, LDL, created new binding sites, probably by self-aggregation. The competition curves (Figure 2Up) suggest that the affinity of LDL for the ECM-Lp(a) complex is 2 to 3 times greater than for the ECM-LDL complex (IC50=6.1x10-8 and 2.8x10-8 mol/L, respectively). The maximal binding of LDL to the ECM-Lp(a) was also 2 to 3 times greater than for ECM-LDL. Dissimilar types of noncovalent bonds may be responsible for these differences in affinity and capacity. This idea is supported by the experiments showing that 80% of the LDL bound by ECM presaturated with Lp(a) was tightly bound, probably by hydrophobic associations (Figure 4Up). The apoB100 peptide 3284-3317, identified by Trieu et al20 as the main segment responsible for the hydrophobic association between Lp(a) and LDL, was not an effective competitor in our model of ECM-Lp(a)-LDL aggregates (data not shown). It is then possible that the preliminary binding of Lp(a) to the ECM leads to complex formation with additional components of the apolipoproteins and to fusion of the particles that the peptide cannot compete. Insoluble aggregates of Lp(a) with LDL in calcium-containing buffers have been described.39 Also, the association with arterial PGs induces large aggregates of LDL in calcium-containing buffers.7 40

The interaction of Lp(a) with GAGs of the proteoglycans appears responsible for about half of the ECM-Lp(a)-LDL or ECM-LDL-LDL aggregation phenomenon observed. The remaining effect may be contributed by other components of the ECM or GAGs resistant to the chondroitinase ABC treatment (Figure 3Up). The fact that, in the competition experiments, no total displacement was achieved with Lp(a) (Figure 1Up) or LDL (Figures 2Up and 3Up) indicates that the association with the ECM is not a fully reversible process. Furthermore, it indicates that other nonspecific associations are present. This complicates the quantitative characterization of the solid phase system in terms of association constants, and therefore we only have used the concept of IC50 to compare the curves. The fluid phase binding experiments using electrophoretic band shift showed complex formation of Lp(a) with the PGs secreted by smooth muscle cells at physiological ionic conditions (Figure 5Up). These results support the conclusion that chondroitin sulfate PGs in the ECM secreted by the arterial smooth muscle could be important contributors to the binding of Lp(a) and LDL, and to the possible cooperativity of this association. The apparent affinity of the PG-LDL associations was 6 to 7 times higher than that of PG-Lp(a) association, but both were in the nanomolar range. Therefore, in the experiments with pretreatment of ECM, Lp(a) and LDL may have easily saturated the initial ECM binding sites. The subsequent enhancement of LDL binding could be then mediated by associations with the preformed complexes of ECM-proteoglycans and the lipoproteins. Bihari-Varga et al measured the binding capacity of arterial PGs and GAGs for LDL and Lp(a) by titration with increasing concentrations of the purified polysaccharides at low ionic strength and measuring turbidity. These researchers concluded that the binding capacity at saturation of Lp(a) for arterial PGs and GAGs was 4 times higher than that of LDL.12 However they did not report the values for the Kd. On the other hand, our band shift procedure expresses the affinity in terms of an apparent Kd and measures the interaction at physiological ionic strength. This discrepancy should be evaluated with a procedure that allows evaluation of Kd and maximal binding at physiological salt concentrations using similar PGs and GAGs. One aspect not explored in the present experiments is the possibility that Lp(a) isoforms with different numbers of kringles may have dissimilar affinity for PGs. We used pools of plasma to prepare Lp(a) and therefore our preparations contained different isoforms. In conclusion, our results and those from the cited literature suggest that several mechanisms are likely involved in the entrapping of Lp(a) and LDL in the matrix of the intima. We speculate that Lp(a) and LDL may contribute to their focal accumulation at sites of progressing lesions by its interaction with chondroitin sulfate proteoglycans secreted by smooth muscle cells. Once formed, the PG-Lp(a) or PG-LDL complexes may serve as additional anchoring sites for other apoB lipoproteins. These hypothetical cooperative effects of Lp(a) and LDL in lesions could be related to the observed additive effect of these 2 apoB lipoproteins as risk factors for atherosclerotic disease.41


*    Acknowledgments
 
This work was supported by grants from the Swedish Heart and Lung Foundation (projects No. 61026 and 61358) and from Astra Hässle AB.

Received May 27, 1998; accepted September 2, 1998.


*    References
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up arrowAbstract
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*References
 
1. Rosengren A, Wilhelmsen L, Eriksson E, Risberg B, Widel H. Lipoprotein(a) and coronary heart disease: A prospective case-control study in a population sample of middle aged men. BMJ. 1990;301:1248–1251.

2. Schaefer E, Lamon-Fava S, Jenner L, McNamara J, Ordovas J, Davis C, Abolafia J, Lippel K, Levy R. Lipoprotein(a) levels and risk for coronary artery disease in men: The lipid Research Clinics Primary Prevention Trial. JAMA. 1994;271:999–1003.[Abstract/Free Full Text]

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