Summary: Blood monocytes or intimal smooth muscle cells from normal aorta were incubated with low density lipoprotein (LDL) from patients with coronary atherosclerosis, or with LDL from diabetic patients, or with lipoprotein(a) (Lp(a)). In each case there was a 2-to 4-fold rise in the intracellular cholesteryl ester content. LDL from healthy subjects failed to induce intracellular lipid accumulation in these cells. LDL from patients with coronary atherosclerosis, LDL from diabetic patients, and Lp(a) form aggregates under cell culture conditions. The ability of these lipoproteins to increase the cholesteryl ester content of cultured cells is directly correlated to the degree of lipoprotein aggregation. When aggregates were removed from the lipoprotein preparations by filtration, the latter became less effective in promoting intracellular lipid accumulation. Incubation of cells with lipoprotein aggregates, isolated by gel filtration, induced a 3-to 5-fold elevation of the cellular cholesteryl ester content.These results suggest that LDL from artherosclerotic patients, or LDL from diabetic patients, or Lp(a) have a tendency to form aggregates and that these aggregates are avidly taken up by intimal smooth muscle cells followed by lipid accumulation. This aggregation tendency may play a role in atherogenesis.
Introduction. . . -« " u cations in vitro form aggregates under cell culture The accumulation of cholesteryl esters in intimal conditions (11). The degree of aggregation of modified smooth muscle cells is one of the earliest manifesta-LDL is correlated with their ability to increase the tionsof atherosclerosis. Despite intensive investigative intracellular cholesterol ester content. Removal of work, the molecular mechanisms underlying lipid dep-these aggregates from preparations of modified LDL osition within the cells still remain unknown. Native resulted in a marked suppression of lipid accumula-LDL properly isolated from healthy subjects fails to tion in cultured cells. These findings demonstrate that induce intracellular lipid accumulation in cultured the ability of in vitro modified LDL to promote incells (1 -3), while incubation of cells with LDL chem-tracellular lipid deposition depends largely on its agically modified by acetylation, methylation, glyc-gregation. Several types of modified LDL have been ation, oxidation, desialylation, or by malondialde-shown to occur in human blood. Thus Curtiss & hyde, glutaraldehyde or 4-hydroxynonenal treatment Witztum (12) demonstrated the presence of glycresults in deposition of lipid within the cells (1,3, ated LDL in the circulation of hyperglycaemic dia-4 -10). We recently reported that LDL after modifi-betic patients, and recently it was shown that LDL