ESC Congress 2011 Wednesday August 31st 2011

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CAD Kathrin Heinrich, Christian Besler, Victoria Makrides, Meliana Riwanto, Katja Huggel, Francois Verrey,

1 ESC Congress 211 Wednesday August 31st 211 stimulates endothelial CAT-1 expression and L-arginine uptake: a novel mechanism leading to endothelial-protective effects of that is profoundly impaired in patients with CAD Kathrin Heinrich, Christian Besler, Victoria Makrides, Meliana Riwanto, Katja Huggel, Francois Verrey, Thomas F. Lüscher, Ulf Landmesser Cardiology, CardioVascular Center University Hospital Zurich Zurich, Switzerland

2 Conflict of interest statement Nothing to declare

3 Reduced -C levels are associated with increased risk of cardiovascular disease Hazard Ratio Hazard Ratio Risk of coronary disease Risk of ischemic stroke Mean -C level, mg/dl Mean -C level, mg/dl Emerging Risk Factors Collaboration; JAMA 29; 32(18):

4 : Proposed anti-atherogenic effects VLDL/ LDL Bile LDL-R FC Liver 1. -mediated promotion of RCT (reverse cholesterol transport) CE TG CE SR-BI PLTP CETP A-I FC CE Mature LCAT A-I FC Nascent ABCG1 ABCA1 Macrophage 2. Direct -mediated endothelial-protective effects SR-BI? Endothelial NO Production Besler C, Heinrich K et al. & Landmesser U; Curr Pharm Des 21; 16(13):148-93

5 Effect of from healthy subjects on enos-activating signaling pathways apoa-i SPC, S1P, LSF? L-Arginine SR-BI Src1 S1P3 CAT-1 PI3-K p-mapk p-akt Akt / ERK1/2 enos Ser1177 phosporylation enos protein stability NO

6 Vascular effects of in patients with cardiovascular disease Vascular effects of are likely heterogeneous Navab M et al., Nat Clin Pract Endocrinol Metab 26; 2(9):54-11 Khera AV et al., N Engl J Med 211; 364(2): We and others have recently demonstrated that loses important endothelial-vasoprotective properties in patients with coronary artery disease, diabetes and antiphospholipid syndrome Besler C, Heinrich K et al., J Clin Invest 211; 121()7: Charakida M, Besler C et al., JAMA 29; 32(11):121-7 Sorrentino SA*, Besler C*, et al., Circulation 21; 121(1):11-22

7 Effects of on gene expression in endothelial cells (Affymetrix array) (Healthy) (CAD) CAT-1: L-arginine transporter 1,8,6,4,2 -,2 (Healthy) (CAD)

8 Aim of the present study To characterize the effects of on endothelial L- arginine uptake and expression of endothelial CAT-1 To characterize the relevance of L-arginine uptake and CAT-1 expression for stimulation of endothelial nitric oxide (NO) production by To compare the effects of from healthy subjects and patients with coronary artery disease (CAD) on endothelial L-arginine uptake

9 Effect of from healthy subjects on endothelial uptake of L-[ 3 H]arginine [pmol arg/min] ΔTotal L-[ 3 H]Arginine uptake P< Buffer Healthy

10 Role of CAT-1 for the effects of on endothelial L-[ 3 H]arginine uptake L-[ 3 H] Arginine uptake (normalized to buffer-treated cells, %) P<.1 n.s. 3 P<.1 Δ Endothelial CAT-1 sirna scrambled sirna NEM

11 CAT-1 protein expresion [change vs. buffer-treated cells, in %] Effect of from healthy subjects on protein expression of endothelial CAT-1 CAT-1 protein expresion [change vs. buffer-treated cells, in %] * ** ** * * ** concentration [μg/ml] Time course [hours] CAT-1 CAT-1 GAPDH GAPDH

12 Effect of from healthy subjects on mrna expression of endothelial CAT-1 [change vs. buffer-treated cells, in %] 12 Δ CAT-1 mrna (NV) ** ** 5 1 concentration [μg/ml]

13 Arginase I protein expression [in % of buffer-treated cells] Effect of from healthy subjects on endothelial Arginase I and II expression Arginase II protein expression [in % of buffer-treated cells] n.s. n.s Buffer Healthy Buffer Healthy Arginase I Arginase II GAPDH GAPDH

14 CAT-1 protein expresion [change vs. buffer-treated cells, in %] Critical role of endothelial SR-BI for the effects of on CAT-1 expression CAT-1 protein expresion [change vs. buffer-treated cells, in %] CAT-1 protein expresion [change vs. buffer-treated cells, in %] 1 P< S1P3 Healthy + S1P3 receptor antagonist Healthy + buffer 2 1 ABCG-1 CAT-1 GAPDH Healthy Healthy + scrambled + SR-BI sirna sirna Healthy + ABCG1 sirna Healthy + scrambled sirna

15 Effect of on membrane translocation of endothelial CAT-1 CAT-1 membrane translocation [vs. PBS-treated cells, in %] PBS 3 P< Healthy IB: CAT-1 PBS Healthy Membrane Cytosol PBS Healthy

16 Role of endothelial CAT-1 for stimulation of endothelial NO production by D Endothelial nitric oxide production [in % of buffer-treated cells] P<.1 P< P<.1 Healthy CAT-1 sirna Scr. RNA + + NEM Lys

17 CAT-1 protein expresion [in % of buffer-treated cells] Effect of from CAD patients on endothelial CAT-1 expression and L-[ 3 H]arginine uptake L-[ 3 H] Arginine uptake (normalized to buffer-treated cells, %) n.s. 2 P< CAT-1 PBS CAD Δ Endothelial PBS CAD GAPDH

18 Effect of from CAD patients on CAT-1/eNOS colocalization and L-[ 3 H]arginine uptake CAT-1 membrane translocation [vs. PBS-treated cells, in %] n.s. 3 P< IB: CAT-1 Membrane Cytosol PBS PBS CAD CAD

19 Summary apoa-i CE TG L-Arginine PL / FC SR-BI enos arginine uptake, likely contributing to a loss Membrane translocation CAT-1 NO However, from patients with CAD fails to stimulate endothelial CAT-1 expression and L- of the capacity of to stimulate ERK1/2 endothelial NO production in these patients mrna/protein expression

20 Thank you

22 Characteristics of the study population Healthy subjects (n=16) Stable coronary artery disease (n=18) Acute coronary syndrome (n=18) Age (years) 53±4 56±6 54±6 Sex (male/female) 11/5 12/6 12/6 Body mass index (kg/m 2 ) 24.9± ± ±3.1 Total cholesterol (mmol/l) 4.9±.8 4.2± ±.7 cholesterol (mmol/l) 1.47± ± ±.32 LDL cholesterol (mmol/l) 2.8±.8 2.6±.9 2.8±.6 C-reactive protein (μmol/l) 2±1 3±5 4±8

23 Critical role of ERK1/2 for the effects of on endothelial CAT-1 expression CAT-1 protein expresion [change vs. buffer-treated cells, in %] 1 8 P< Healthy + buffer Healthy + PD9859

24 Effect of on colocalization of CAT-1 and enos in endothelial cells Buffer Healthy

25 Effect of from CAD patients on CAT-1/eNOS colocalization and L-[ 3 H]arginine uptake CAT-1 membrane translocation [vs. PBS-treated cells, in %] n.s. P<.1 3 Buffer 2 1 IB: CAT-1 PBS CAD CAD Membrane Cytosol PBS CAD

Cardiology, CardioVascular Center University Hospital Zurich Zurich, Switzerland

Cardiology, CardioVascular Center University Hospital Zurich Zurich, Switzerland Modification of by the lipoxidation product malondialdehyde leads to LOX-1 dependent activation of endothelial PKCbeta-2 and adverse endothelial effects of in patients with coronary artery disease Christian