Vascular Biology – Hemodynamics – Hypertension

Kidney International (2004) 65, 228–237; doi:10.1111/j.1523-1755.2004.00373.x

Nephrotic livers secrete normal VLDL that acquire structural and functional defects following interaction with HDL

GREGORY C SHEARER, WILLIAM G COUSER and GEORGE A KAYSEN

Department of Veterans Affairs Northern California Health Care System, Mather, California; Department of Medicine, Division of Nephrology University of Washington, Seattle Washington; and Division of Nephrology, Department of Medicine, UC Davis, Davis, California

Correspondence: George Kaysen, M.D., Ph.D., Professor and Chief, Division of Nephrology, TB 136 University of California, Davis, Davis, CA 95616. E-mail:gakaysen@ucdavis.edu

Received 23 May 2003; Revised 28 July 2003; Accepted 15 August 2003.

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Abstract

Nephrotic livers secrete normal VLDL that acquire structural and functional defects following interaction with HDL.

Background

 

Binding of very low-density lipoprotein (VLDL) isolated from serum of nephrotic rats VLDL to endothelial cells is defective. This defect is conferred on normal VLDL by prior incubation with high-density lipoprotein (HDL) from nephrotic, but not control rats. It is not known whether the defect is present in nascent VLDL (nVLDL) or is acquired after secretion. We test the hypothesis that VLDL is normal at the time of secretion from the liver and the defect in binding to endothelium is conferred following secretion through interaction with HDL.

Methods

 

VLDL was synthesized by and collected from isolated perfused livers from either control or nephrotic rats. nVLDL was labeled with 3H-oleate to measure binding and 35S methionine to evaluate apolipoprotein exchange and composition. To test whether HDL conferred a binding defect, nVLDL was incubated with HDL obtained either from control or nephrotic rats prior to measurement of binding. To distinguish the effects of proteinuria from reduced albumin concentration we additionally incubated nVLDL with HDL obtained from rats with hereditary analbuminemia. Both HDL and VLDL were reisolated by centrifugation prior to subsequent binding and lipolysis determination. Exchange of 35S-labeled apolipoprotein E (apoE) among the subsequent VLDL and HDL fractions was determined. To determine the effect of HDL on lipolysis, HDL-treated VLDL was exposed to lipoprotein lipase–coated 96-well plates and 3H-oleate release measured. To establish whether differences in apoE content could explain the differences in binding and lipolysis, apoE was restored to nephrotic VLDL and lipolysis and binding were subsequently measured.

Results

 

Binding of nephrotic nVLDL was greater than control nVLDL (0.58 plusminus 0.13 vs. 0.75 plusminus 0.07 ng protein bound/mg cell protein) (P = 0.04, N = 6). Lipolysis was similarly elevated (0.091 plusminus 0.010 vs 0.064 plusminus 0.002 nmol NEFA released/well/hour) (P < 0.05). Prior incubation with nephrotic HDL reduced binding of nVLDL obtained from either nephrotic or control livers (P = 0.02, N = 6). Treatment with nephrotic (vs. control) HDL reduced both binding (control nVLDL + control HDL, 0.64 plusminus 0.02; control + nephrotic, 0.43 plusminus 0.06; nephrotic + control, 0.69 plusminus 0.05; and nephrotic + nephrotic, 0.62 plusminus 0.04 mg VLDL protein/mg cell protein) and lipolysis (control nVLDL + control HDL, 0.053 plusminus 0.004; control + nephrotic, 0.038 plusminus 0.004; nephrotic + control, 0.069 plusminus 0.004; and nephrotic + nephrotic, 0.062 plusminus 0.004 nmol NEFA/well/hour) (P < 0.05 vs. nVLDL + control HDL) of nVLDL from either source. The apoE content of nVLDL coincubated with control HDL or analbuminemic HDL was increased compared nVLDL incubated with either no HDL or nephrotic HDL (P < 0.05). Similarly, the apoE/apoA-I ratio was reduced in HDL from nephrotic rats but not in HDL from controls (P < 0.05). Reintroduction of apoE to nephrotic VLDL resulted in increased binding.

Conclusion

 

Unlike circulating VLDL, binding of nVLDL from isolated livers from nephrotic rats to endothelial cells is greater and its lipolysis is increased compared to control nVLDL. Decreased binding and lipolysis is conferred following incubation with HDL isolated from control, but not nephrotic rats and binding can be restored by reintroduction of apoE. Thus both defects are conferred on VLDL by exposure to HDL obtained from nephrotic animals, possibly a consequence of a failure of nephrotic HDL to enrich VLDL with apoE during clearance.

Keywords:

nephrotic syndrome, apolipoprotein E, apolipoprotein A-I, proteinuria, lipoprotein lipase, analbuminemia, lipolysis, endothelium

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