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Published on: October 12, 2017
Compositional and functional properties of high-density lipoproteins in relation to coronary in-stent restenosis
Shiva Ganjali1, Elahe Mahdipour1, Seyed Hamid Aghaee-Bakhtiari2
1Department of Medical Biotechnology and Nanotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
High-density lipoprotein (HDL) function in cholesterol efflux was not linked to in-stent restenosis (ISR) despite some compositional changes. This finding suggests HDL
Area of Science:
- Cardiovascular Research
- Lipid Metabolism
- Biochemistry
Background:
- In-stent restenosis (ISR) remains a challenge after coronary stenting, with limited efficacy of current treatments.
- Low high-density lipoprotein cholesterol (HDL-C) is a known cardiovascular risk factor.
- Understanding HDL composition and function is crucial for managing cardiovascular diseases.
Purpose of the Study:
- To investigate compositional and functional alterations of HDL subfractions in patients with ISR.
- To evaluate the role of HDL's cholesterol efflux and uptake capacities in ISR development.
Main Methods:
- A case-control study comparing ISR, non-ISR, angiography-negative, and healthy subjects.
- Sequential ultracentrifugation to isolate HDL2 and HDL3 subfractions.
- Assessment of HDL's capacity for cellular cholesterol efflux and free cholesterol uptake from triglyceride-rich lipoproteins.
Main Results:
- No significant differences in free cholesterol and total protein content within HDL subfractions across groups.
- Non-ISR subjects showed altered triglyceride and phospholipid content in HDL2 and HDL3 compared to healthy controls.
- Cholesterol efflux capacity of HDL2 correlated positively with its phospholipid content in healthy, angiography-negative, and ISR groups.
Conclusions:
- HDL's cholesterol efflux and uptake capacities were not directly associated with in-stent restenosis in this study.
- Despite observed compositional variations in HDL, its functional role in cholesterol transport does not appear to be a primary driver of ISR.
- Further research may be needed to explore other factors contributing to ISR.
Introduction:
In-stent restenosis (ISR) is an unfavorable outcome that occurs in patients after coronary stenting. Use of drugs such as statins as well as drug-eluting stents has only been partially effective in reducing the rate of ISR. Since low high-density lipoprotein cholesterol (HDL-C) concentration is a pivotal cardiovascular disease risk factor, this study aimed to evaluate the compositional and functional alterations of HDL in individuals with ISR.
Material And Methods:
This case-control study included 21 ISR, 26 non-ISR (NISR), 16 angiography-negative, and 18 healthy subjects. Serum HDL2 (d: 1.063-1.125 g/ml) and HDL3 (d: 1.125-1.210 g/ml) subfractions were extracted from each subject using sequential ultracentrifugation. The capacity of HDL to efflux cellular cholesterol from lipid-loaded macrophages as well as to take up free cholesterol (FC) from triglyceride-rich lipoproteins (TGRLs) during lipolysis was assessed.
Results:
No difference was found in the HDL2 and HDL3 content of free cholesterol and total protein among the groups. The NISR group showed lower triglyceride content in HDL2 and higher phospholipid content in HDL3 relative to healthy subjects. Strong positive correlations were found between the cholesterol efflux capacity (CEC) of HDL2 and its phospholipid content in the healthy (r = 0.50), angiography-negative (r = 0.55) and ISR (r = 0.52) groups. The capacity of apolipoprotein B (apoB)-depleted serum to take up free cholesterol was not different among the groups.
Conclusions:
Despite some compositional alterations, the capacity of HDL to efflux cholesterol from lipid-loaded macrophages as well as to take up free cholesterol from TGRLs during lipolysis was not associated with ISR in this study.
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