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      Accumulation of Oxidized LDL in the Tendon Tissues of C57BL/6 or Apolipoprotein E Knock-Out Mice That Consume a High Fat Diet: Potential Impact on Tendon Health

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          Abstract

          Objective

          Clinical studies have suggested an association between dyslipidemia and tendon injuries or chronic tendon pain; the mechanisms underlying this association are not yet known. The objectives of this study were (1) to evaluate the impact of a high fat diet on the function of load-bearing tendons and on the distribution in tendons of oxidized low density lipoprotein (oxLDL), and (2) to examine the effect of oxLDL on tendon fibroblast proliferation and gene expression.

          Methods

          Gene expression ( Mmp2, Tgfb1, Col1a1, Col3a1), fat content (Oil Red O staining), oxLDL levels (immunohistochemistry) and tendon biomechanical properties were examined in mice (C57Bl/6 or ApoE -/-) receiving a standard or a high fat diet. Human tendon fibroblast proliferation and gene expression ( COL1A1, COL3A1, MMP2) were examined following oxLDL exposure.

          Results

          In both types of mice (C57Bl/6 or ApoE -/-), consumption of a high fat diet led to a marked increase in oxLDL deposition in the load-bearing extracellular matrix of the tendon. The consumption of a high fat diet also reduced the failure stress and load of the patellar tendon in both mouse types, and increased Mmp2 expression. ApoE -/- mice exhibited more pronounced reductions in tendon function than wild-type mice, and decreased expression of Col1a1 compared to wild type mice. Human tendon fibroblasts responded to oxLDL by increasing their proliferation and their mRNA levels of MMP2, while decreasing their mRNA levels for COL1A1 and COL3A1.

          Conclusion

          The consumption of a high fat diet resulted in deleterious changes in tendon function, and these changes may be explained in part by the effects of oxLDL, which induced a proliferative, matrix-degrading phenotype in human tenocytes.

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          Most cited references21

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          The distribution and chemical composition of ultracentrifugally separated lipoproteins in human serum.

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            OxLDL up-regulates microRNA-29b, leading to epigenetic modifications of MMP-2/MMP-9 genes: a novel mechanism for cardiovascular diseases.

            MicroRNAs (miRNAs), small noncoding RNAs, can control gene expression by binding to their target genes for degradation and/or translational repression. Epigenetic mechanisms are defined as heritable changes in gene expression that do not involve coding sequence modifications. Both mechanisms play an important role in maintaining physiological functions and are also related to disease development. However, few studies report that miRNA-mediated epigenetic regulations are involved in atherosclerosis. In the present study, oxidized low-density lipoprotein (oxLDL) significantly increased primary human aortic smooth muscle cell (HASMC) migration through MMP-2/MMP-9 up-regulation associated with decreased DNA methylation levels. Either mRNA or protein level of DNA methyltransferase 3b (DNMT3b) showed a dose-dependent down-regulation in oxLDL-mediated HASMCs. Knockdown DNMT3b expression enhanced oxLDL-induced DNA demethylation levels of MMP-2/MMP-9. The expression of miRNA-29b (miR-29b), directly targeting DNMT3b, was up-regulated by oxLDL treatment in a dose-dependent manner. OxLDL-mediated MMP-2/MMP-9 up-regulation, DNMT3b down-regulation, and DNA demethylation were all attenuated after knockdown miR-29b expression by antagomiR-29b. We find that oxLDL can up-regulate miR-29b expression, resulting in DNMT3b down-regulation in HASMCs and epigenetically regulated MMP-2/MMP-9 genes involved in cell migration. These results show that miRNA-mediated epigenetic regulation may be a novel mechanism in atherosclerosis.
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              The effect of hypercholesterolemia on rotator cuff disease.

              The causes of rotator cuff tendon rupture are multifactorial and still unclear. Intrinsic and extrinsic factors have been implicated as predisposing risk factors for rotator cuff rupture. Previous studies have suggested a relationship between elevated serum lipid profiles and tendon ruptures, although not rotator cuff tears specifically. We therefore asked whether patients with rotator cuff tears were more likely to have higher levels of hypercholesterolemia than patients with shoulder pain but without tears. We prospectively collected serum cholesterol and lipid profiles on two age-matched populations of patients; 74 (mean age, 66.3 years) had ruptures of their rotator cuff tendons, whereas a control group of 73 patients (mean age, 67.4 years) were seen for nontendon-related shoulder complaints. Total cholesterol, triglycerides, and low-density lipoprotein cholesterol concentrations of the patients with rotator cuff tendon tears were higher, and their high-density lipoprotein cholesterol showed a trend to being lower than the control group. Forty-seven of 74 patients (63%) with rotator cuff tears had an elevated serum cholesterol (total cholesterol greater than 240 mg/dL) as compared with an overall rate of 28% in our control group. Patients with rotator cuff tears were more likely to have hypercholesterolemia when compared with the control group. Measurement of serum cholesterol in patients presenting with torn rotator cuff tendons should be considered in patients whose cholesterol profiles are unknown. Future consideration of drug treatment may reduce risk for future tendon degeneration, as well as improve quality of life and reduce mortality. Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                12 December 2014
                : 9
                : 12
                : e114214
                Affiliations
                [1 ]Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
                [2 ]Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
                [3 ]McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
                [4 ]Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
                [5 ]Deptartment of Medicine, University of British Columbia and Vancouver Coastal Health Research Institute, Jack Bell Research Centre, Vancouver, BC, Canada
                [6 ]Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
                [7 ]Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
                [8 ]Institute for Heart + Lung Health, St. Paul's Hospital, Vancouver, BC, Canada
                Queen Mary University of London, United Kingdom
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: NG GMT HB A. Sharma AL PZ DJG A. Scott. Performed the experiments: NG HB A. Sharma AL PZ. Analyzed the data: NG GMT HB A. Sharma AL PZ A. Scott. Contributed reagents/materials/analysis tools: PZ WDR DJG. Wrote the paper: NG GMT HB A. Sharma A. Scott AL PZ WDR DJG.

                Article
                PONE-D-14-19792
                10.1371/journal.pone.0114214
                4264764
                25502628
                51b67c23-c87f-43ff-b483-9d2d0658e97a
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 9 May 2014
                : 3 November 2014
                Page count
                Pages: 15
                Funding
                A. Scott received grant funding from the Canadian Institutes of Health Research ( www.cihr.ca), Institute of Musculoskeletal Health and Arthritis Priority Announcement (126604-1) and a Michael Smith Clinical Scholar Award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Anatomy
                Biological Tissue
                Connective Tissue
                Tendons
                Biomechanics
                Musculoskeletal Mechanics
                Tissue Mechanics
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Pathogenesis
                Rheumatology
                Sports and Exercise Medicine
                Custom metadata
                The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper and its Supporting Information files.

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                Uncategorized

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