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      Modified Low Density Lipoprotein and Lipoprotein-Containing Circulating Immune Complexes as Diagnostic and Prognostic Biomarkers of Atherosclerosis and Type 1 Diabetes Macrovascular Disease

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          Abstract

          In atherosclerosis; blood low-density lipoproteins (LDL) are subjected to multiple enzymatic and non-enzymatic modifications that increase their atherogenicity and induce immunogenicity. Modified LDL are capable of inducing vascular inflammation through activation of innate immunity; thus, contributing to the progression of atherogenesis. The immunogenicity of modified LDL results in induction of self-antibodies specific to a certain type of modified LDL. The antibodies react with modified LDL forming circulating immune complexes. Circulating immune complexes exhibit prominent immunomodulatory properties that influence atherosclerotic inflammation. Compared to freely circulating modified LDL; modified LDL associated with the immune complexes have a more robust atherogenic and proinflammatory potential. Various lipid components of the immune complexes may serve not only as diagnostic but also as essential predictive markers of cardiovascular events in atherosclerosis. Accumulating evidence indicates that LDL-containing immune complexes can also serve as biomarker for macrovascular disease in type 1 diabetes.

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          Most cited references205

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          Sphingosine-1-phosphate: an enigmatic signalling lipid.

          The evolutionarily conserved actions of the sphingolipid metabolite, sphingosine-1-phosphate (S1P), in yeast, plants and mammals have shown that it has important functions. In higher eukaryotes, S1P is the ligand for a family of five G-protein-coupled receptors. These S1P receptors are differentially expressed, coupled to various G proteins, and regulate angiogenesis, vascular maturation, cardiac development and immunity, and are important for directed cell movement.
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            Beyond cholesterol. Modifications of low-density lipoprotein that increase its atherogenicity.

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              Protein carbamylation links inflammation, smoking, uremia and atherogenesis.

              Post-translational modification and functional impairment of proteins through carbamylation is thought to promote vascular dysfunction during end-stage renal disease. Cyanate, a reactive species in equilibrium with urea, carbamylates protein lysine residues to form epsilon-carbamyllysine (homocitrulline), altering protein structure and function. We now report the discovery of an alternative and quantitatively dominant mechanism for cyanate formation and protein carbamylation at sites of inflammation and atherosclerotic plaque: myeloperoxidase-catalyzed oxidation of thiocyanate, an anion abundant in blood whose levels are elevated in smokers. We also show that myeloperoxidase-catalyzed lipoprotein carbamylation facilitates multiple pro-atherosclerotic activities, including conversion of low-density lipoprotein into a ligand for macrophage scavenger receptor A1 recognition, cholesterol accumulation and foam-cell formation. In two separate clinical studies (combined n = 1,000 subjects), plasma levels of protein-bound homocitrulline independently predicted increased risk of coronary artery disease, future myocardial infarction, stroke and death. We propose that protein carbamylation is a mechanism linking inflammation, smoking, uremia and coronary artery disease pathogenesis.
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                Author and article information

                Journal
                Int J Mol Sci
                Int J Mol Sci
                ijms
                International Journal of Molecular Sciences
                MDPI
                1422-0067
                21 July 2014
                July 2014
                : 15
                : 7
                : 12807-12841
                Affiliations
                [1 ]Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow 125315, Russia; E-Mails: a.h.opexob@ 123456gmail.com (A.N.O.); igor.sobenin@ 123456gmail.com (I.A.S.); zavod@ 123456ifarm.ru (A.A.M.)
                [2 ]Institute for Atherosclerosis Research, Skolkovo Innovative Center, Moscow 143025, Russia
                [3 ]Faculty of Medicine, School of Medical Sciences, University of New South Wales, Kensington, Sydney, NSW 2052, Australia
                [4 ]School of Medicine, University of Western Sydney, Campbelltown, Sydney, NSW 2560, Australia
                [5 ]Laboratory of Medical Genetics, Russian Cardiology Research and Production Complex, Moscow 121552, Russia
                [6 ]Department of Medical Nanobiotechnology, Pirogov Russian State Medical University, Moscow 117997, Russia; E-Mail: dimitry.chistiakov@ 123456lycos.com
                Author notes
                [* ]Author to whom correspondence should be addressed; E-Mail: y.bobryshev@ 123456unsw.edu.au ; Tel./Fax: +61-2-9385-1217.
                Article
                ijms-15-12807
                10.3390/ijms150712807
                4139876
                25050779
                b8c5205a-c2f6-484c-8c1f-016525454825
                © 2014 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                : 11 May 2014
                : 29 June 2014
                : 03 July 2014
                Categories
                Review

                Molecular biology
                atherosclerosis,atherogenesis,immune complexes,low-density lipoproteins,inflammation

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