Identification and quantification of oxysterols in atheromas and plasma of individuals with occlusive peripheral arterial disease submitted to amputation surgery

Author(s)

Vitor Wilson de Moura Virginio

• Document type: Master's Dissertation
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2014-07-22

Examining board members

Andrei Carvalho Sposito; José Carlos Quinaglia e Silva; Orlando Petrucci Junior

• Advisor: Eliana Cotta de Faria; Andrei Carvalho Sposito

Abstract

Currently around 17 million people die from cardiovascular diseases (CVD). In Brazil, durant 2011 nearly 200.000 deaths occur mainly due atherosclerosis, classified as a chronic, immune-inflammatory disease that causes luminal narrowing and generates several outcomes as myocardial infarction, cerebrovascular accidents (stroke), peripheral arterial disease (PAD) and others. DAP predict other CVDs and is the leading cause of amputation due the clogged arteries in inferior members. Histological analysis indicates that plaque rupture, fibrous cap atheroma, plaque erosion and calcified nodules generate major CVD fatalities. So far, no plasma biomarkers for clinical use are available in order to evaluate the stability and extend of atherosclerotic plaques, therefore is necessary the investigation of the components involved in immune-inflammatory diseases and lipids metabolism such as oxysterols and cholesterol synthesis and absorption markers (CSAM). Oxidized sterols or oxysterols, manly 27-hidroxycholesterol and 7-ketocholesterol are involved in pathophysiological mechanisms of atherosclerosis and play a role in inflammation, apoptosis, necrosis and cytotoxicity, in addiction to lipid metabolism. Oxysterols 24S- and 25-hidroxycholesterol are involved with neurodegenerative diseases such Alzheimer¿s and resemble with atherosclerosis development since are chronical inflammatory diseases, for this reason is necessary an investigation of these oxysterols in atherosclerosis is needed. Cholesteryl ester transfer protein (CETP) and phospholipid transfer protein (PLTP) as well as lipoproteins, could mediate the transfer of the oxysterols. The aim of this work was quantified the levels of oxysterols (24S- 25-, 27- hidroxycholesterol and 7-ketocholesterol) and cholesterol synthesis (desmosterol and lathosterol) and absorption markers (?-sitosterol and campesterol) in atheroma and plaques from 10 individuals with PAD (PAD group) and compare with arteries without atheroma of 13 volunteers (CTL group). Also, relate these sterols with other parameters as clinical history, lipid transfer proteins and histological scores. Clinical and biochemical data were collected and sterols were quantified in arteries and plasma by gas chromatography coupled to a mass spectrophotometer (GCMS) and histological atheroma classification were determined. Comparison anlysis were performed using Mann-Whitney and correlations by Spearman¿s test. Both groups were not different regarding clinical and biochemical data, differencing only for systolic blood pressure, alcohol intake, PLTP activity, glucose and CRP, increased in PAD group. CRP was positively correlated with 24S-HDC, 25-HDC e 27-HDC from plasma. The comparisons of oxysterols levels in atheroma showed that 24-HDC and 27-HDC were increased in PAD group; interestingly, the 25-HDC was higher in CTL group. No significant differences were observed for CSAM between groups. The atheroma were classified as 50% plaque rupture, 20% fibrous cap, 10% calcified nodules and 10% of fibrocalcific injury. From the oxysterols from plasma of PAD group, only 25-HDC was increased compared to the CTL group. In conclusion, we demonstrated the accumulation of 24S-HDC in atherosclerotic plaques. The 27-HDC, as well as other studies, present higher levels in atheroma¿s, strongly indicating is role in the disease pathogenesis. All oxysterols measured in plasma were positively correlated with the systemic inflammatory activity. Finally, all atherosclerotic plaques were classified as lesions of advanced extension, according to the histological analysis (AU)

• FAPESP's process: 11/16477-5 - Identification and Quantification of Oxysterols in Atheromas and Plasma of Individuals With Peripheral Artery Occlusive Disease Submitted to Amputation Surgery
• Grantee: Vitor Wilson de Moura Virginio
• Support Opportunities: Scholarships in Brazil - Master