Background-Hypercholesterolemia and sickle cell disease (SCD) impair endothelium-dependent vasodilation by dissimilar mechanisms. Hypercholesterolemia impairs vasodilation by a low-density lipoprotein (LDL)-dependent mechanism. SCD has been characterized as a chronic state of inflammation in which xanthine oxidase (XO) from ischemic tissues increases vascular superoxide anion (O 2 ·Ϫ ) generation. Recent reports indicate that apolipoprotein (apo) A-1 mimetics inhibit atherosclerosis in LDL receptor-null (Ldlr Ϫ/Ϫ ) mice fed Western diets. Here we hypothesize that L-4F, an apoA-1 mimetic, preserves vasodilation in hypercholesterolemia and SCD by decreasing mechanisms that increase O 2 ·Ϫ generation.
Methods and Results-Arterioles were isolated from hypercholesterolemic LdlrϪ/Ϫ mice and from SCD mice that were treated with either saline or L-4F (1 mg/kg per day). Vasodilation in response to acetylcholine was determined by videomicroscopy. Effects of L-4F on LDL-induced increases in endothelium-dependent O 2 ·Ϫ generation were determined on arterial segments via the hydroethidine assay and on stimulated endothelial cell cultures via superoxide dismutase-inhibitable ferricytochrome c reduction. Effects of L-4F on XO bound to pulmonary arterioles and content in livers of SCD mice were determined by immunofluorescence. Hypercholesterolemia impaired vasodilation in Ldlr Ϫ/Ϫ mice, which L-4F dramatically improved. L-4F inhibited LDL-induced increases in O 2 ·Ϫ in arterial segments and in stimulated cultures. SCD impaired vasodilation, increased XO bound to pulmonary endothelium, and decreased liver XO content. L-4F dramatically improved vasodilation, decreased XO bound to pulmonary endothelium, and increased liver XO content compared with levels in untreated SCD mice. Conclusions-These data show that L-4F protects endothelium-dependent vasodilation in hypercholesterolemia and SCD.Our findings suggest that L-4F restores vascular endothelial function in diverse models of disease and may be applicable to treating a variety of vascular diseases. Clinical studies clearly indicate that HDL plays an important role in protecting vascular function against atherosclerosis. 8 Transgenic expression of apoA-1, the major atheroprotective apolipoprotein of HDL, retards the progression of advanced lesions in transplanted aortas from apoE-null mice and remodels them to a more stable-appearing phenotype. 9 Intraperitoneal injection of an apoA-1 mimetic (5F) and parental administration of another apoA-1 mimetic (D-4F) enhances the ability of HDL to inhibit LDL oxidation and to protect mice from diet-induced atherosclerosis without changing plasma cholesterol levels. 6,10 Indeed, infusion of reconstituted HDL rapidly improves endothelium-and endothelial nitric oxide synthase (eNOS)-dependent forearm blood flow in hypercholesterolemic men, 11 confirming that HDL plays a critical role in protecting endothelial cell function.The mechanisms by which SCD have been shown to impair vasodilation at first glance appear distinctly different from tho...