Faculty Bibliography

Alzheimer's disease (AD) is the most common cause of dementia in North America and Europe. The incidence of the disease rises dramatically with age. AD is a complex multifactorial disorder that involves numerous susceptibility genes, but the exact pathogenesis and biochemical basis of AD is not well understood Cholesterol is receiving a great deal of attention as a potentially crucial factor in the etiology of AD. Almost all cholesterol in the brain is synthesized in the brain. Cholesterol exits the brain through the blood-brain barrier (BBB) in the form of apolipoprotein E (ApoE) or by first being converted to a more polar compound, 24(S)-hydroxycholesterol, which is elevated in individuals with AD. The key event leading to AD appears to be the formation and aggregation in the brain of amyloid beta (Abeta) peptide, a proteolytically derived product of amyloid precursor protein (APP). Cholesterol has been demonstrated to modulate processing of APP to Abeta. High levels of cholesterol are associated with increased risk of AD. Patients taking cholesterol-lowering statins have a lower prevalence of AD. ApoE, which transports cholesterol throughout the brain, exhibits an isoform-specific association with AD such that the E4 isoform, by unknown mechanisms, shifts the onset curve toward an earlier age

BACKGROUND: Cholesterol 27-hydroxylase, an enzyme expressed at high levels by human monocytes/macrophages, provides a first line of defense against the development of atherosclerosis. Prior studies have suggested that the cytokine interferon-gamma (IFN-gamma) promotes atherosclerosis. We therefore examined the effect of IFN-g on macrophage foam cell formation and on expression of the anti-atherogenic 27-hydroxylase in THP-1 human monocytes/macrophages. MATERIAL/METHODS: THP-1 monocytes and acetylated LDL-treated THP-1 macrophages were incubated in the presence or absence of IFN-gamma (500 U/ml) with or without the addition of IFN- gamma receptor blocking or neutralizing antibody. Foam cell formation was quantified based on percentage of macrophages harboring oil red O-stained globules. Cellular mRNA and protein were isolated. 27-Hydroxylase message was measured by RT-PCR and 27-hydroxylase protein by immunoblot. RESULTS: IFN-gamma -treated THP-1 macrophages exhibit increased foam cell transformation compared to untreated cells under cholesterol loading conditions. IFN-gamma-promoted foam cell formation is abolished by pre-treatment with either IFN-gamma neutralizing or IFN-gamma receptor blocking antibody. IFN-gamma diminishes cholesterol 27-hydroxylase expression in THP-1, and this IFN-gamma -induced downregulation is prevented by pre-treating the cultured cells with either IFN-gamma neutralizing or IFN-gamma receptor blocking antibody. CONCLUSIONS: Imbalances in cellular cholesterol flux within macrophages lead to formation of lipid-laden foam cells, a critical step in the pathogenesis of atherosclerosis. We have demonstrated that IFN-gamma, acting through the IFN-gamma receptor, decreases expression of 27-hydroxylase and increases propensity to foam cell formation in the cell line THP-1. These observations suggest that one mechanism by which IFN-g promotes atherosclerosis may involve affecting expression of cholesterol 27-hydroxylase, a cholesterol homeostatic protein

Transport of cholesterol out of macrophages is critical for prevention of foam cell formation, the first step in the pathogenesis of atherosclerosis. Proteins involved in this process include cholesterol 27-hydroxylase and adenosine 5'-triphosphate-binding cassette transporter A1 (ABCA1). Proinflammatory cytokines and immune complexes (IC) down-regulate cholesterol 27-hydroxylase and impede cholesterol efflux from macrophages, leading to foam cell formation. Prior studies have suggested occupancy of the anti-inflammatory adenosine A2A receptor (A2AR) minimizes early atherosclerotic changes in arteries following injury. We therefore asked whether A2AR occupancy affects macrophage foam cell formation in response to IC and the cytokine interferon-gamma. We found that the selective A2AR agonist 2-p-(2-carboxyethyl)phenethylamino-5'-N-ethylcarboxamido-adenosine (CGS-21680) inhibited foam cell formation in stimulated THP-1 human macrophages, and the effects of CGS-21680 were reversed by the selective A2AR antagonist 4-(2-[7-amino-2-(2-furyl) [1, 2, 4]triazolo[2,3-a] [1, 3, 5]triazin-5-ylamino]ethyl)phenol. In confirmation of the role of A2AR in prevention of foam cell formation, CGS-21680 also inhibited foam cell formation in cultured murine peritoneal macrophages but did not affect foam cell formation in A2AR-deficient mice. Agents that increase foam cell formation also down-regulate cholesterol 27-hydroxylase and ABCA1 expression. Therefore, we determined the effect of A2AR occupancy on expression of these reverse cholesterol transport (RCT) proteins and found that A2AR occupancy stimulates expression of message for both proteins. These results indicate that one mechanism for the antiatherogenic effects of adenosine is stimulation of the expression of proteins involved in RCT. These findings suggest a novel approach to the development of agents that prevent progression of atherosclerosis