Copper-induced and photosensitive oxidation of serum low-density lipoprotein. The relation to cholesterol level and...

Hypercholesterolemia is associated with a higher risk for developing atherosclerotic coronary heart disease. During the past few years, evidence has been increasing that modification of lipoproteins, particularly low-density lipoprotein (LDL) oxidation, might be involved in the pathogenesis of atherosclerosis. To compare these factors metal-dependent and -independent photodynamic methods were used for the screening of several indexes of LDL oxidation. Lipid oxidation has been continuously monitored by the increase of conjugated dienes and verified by iodometric and thiobarbituric reaction assay. A close association between LDL cholesterol concentration (and/or serum cholesterol concentration) and LDL maximum diene formation was found using both methods and different sources of sera. With copper-induced oxidation, highly significant correlation coefficient r = 0.86, and with photo-sensitive oxidation r = 0.84 were noted. The data standardized to protein unit showed a reduced but still significant correlation. The extent of LDL oxidation was also closely related to preformed dienes, i.e., to the data obtained before the start of oxidation (r = 0.91). The rate of LDL oxidation was positively linked to LDL cholesterol using both oxidation methods but with photo-sensitive oxidation the rate was much higher. The lag time was inversely related to LDL cholesterol (standardized data) with Cu2+ induced oxidation but it was absent in the photosensitive oxidation. In animals known to be resistant to spontaneous atherosclerosis (rats, guinea pigs) a prolonged lag time, markedly reduced diene formation and lower LDL cholesterol in LDL in parallel was demonstrated. The fact that, using various methods (epidemiology, arteriography, autopsy), the cholesterol level in men was found positively linked to atherosclerosis development on the one hand, and positively associated to oxidation of human LDL on the other, strongly supports the concept on the important role of LDL oxidative modification in this pathological process.