Lipoprotein X Causes Renal Disease in LCAT Deficiency.

Human familial lecithin:cholesterol acyltransferase (LCAT) deficiency (FLD) is characterized by low HDL, accumulation of an abnormal cholesterol-rich multilamellar particle called lipoprotein-X (LpX) in plasma, and renal disease. The aim of our study was to determine if LpX is nephrotoxic and to gai...

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Main Authors: Alice Ossoli, Edward B Neufeld, Seth G Thacker, Boris Vaisman, Milton Pryor, Lita A Freeman, Christine A Brantner, Irina Baranova, Nicolás O Francone, Stephen J Demosky, Cecilia Vitali, Monica Locatelli, Mauro Abbate, Carlamaria Zoja, Guido Franceschini, Laura Calabresi, Alan T Remaley
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0150083
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author Alice Ossoli
Edward B Neufeld
Seth G Thacker
Boris Vaisman
Milton Pryor
Lita A Freeman
Christine A Brantner
Irina Baranova
Nicolás O Francone
Stephen J Demosky
Cecilia Vitali
Monica Locatelli
Mauro Abbate
Carlamaria Zoja
Guido Franceschini
Laura Calabresi
Alan T Remaley
author_facet Alice Ossoli
Edward B Neufeld
Seth G Thacker
Boris Vaisman
Milton Pryor
Lita A Freeman
Christine A Brantner
Irina Baranova
Nicolás O Francone
Stephen J Demosky
Cecilia Vitali
Monica Locatelli
Mauro Abbate
Carlamaria Zoja
Guido Franceschini
Laura Calabresi
Alan T Remaley
author_sort Alice Ossoli
collection DOAJ
description Human familial lecithin:cholesterol acyltransferase (LCAT) deficiency (FLD) is characterized by low HDL, accumulation of an abnormal cholesterol-rich multilamellar particle called lipoprotein-X (LpX) in plasma, and renal disease. The aim of our study was to determine if LpX is nephrotoxic and to gain insight into the pathogenesis of FLD renal disease. We administered a synthetic LpX, nearly identical to endogenous LpX in its physical, chemical and biologic characteristics, to wild-type and Lcat-/- mice. Our in vitro and in vivo studies demonstrated an apoA-I and LCAT-dependent pathway for LpX conversion to HDL-like particles, which likely mediates normal plasma clearance of LpX. Plasma clearance of exogenous LpX was markedly delayed in Lcat-/- mice, which have low HDL, but only minimal amounts of endogenous LpX and do not spontaneously develop renal disease. Chronically administered exogenous LpX deposited in all renal glomerular cellular and matrical compartments of Lcat-/- mice, and induced proteinuria and nephrotoxic gene changes, as well as all of the hallmarks of FLD renal disease as assessed by histological, TEM, and SEM analyses. Extensive in vivo EM studies revealed LpX uptake by macropinocytosis into mouse glomerular endothelial cells, podocytes, and mesangial cells and delivery to lysosomes where it was degraded. Endocytosed LpX appeared to be degraded by both human podocyte and mesangial cell lysosomal PLA2 and induced podocyte secretion of pro-inflammatory IL-6 in vitro and renal Cxl10 expression in Lcat-/- mice. In conclusion, LpX is a nephrotoxic particle that in the absence of Lcat induces all of the histological and functional hallmarks of FLD and hence may serve as a biomarker for monitoring recombinant LCAT therapy. In addition, our studies suggest that LpX-induced loss of endothelial barrier function and release of cytokines by renal glomerular cells likely plays a role in the initiation and progression of FLD nephrosis.
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spelling doaj-art-924d5b398dcb4f228c32af616b5ce0812025-08-20T03:10:08ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01112e015008310.1371/journal.pone.0150083Lipoprotein X Causes Renal Disease in LCAT Deficiency.Alice OssoliEdward B NeufeldSeth G ThackerBoris VaismanMilton PryorLita A FreemanChristine A BrantnerIrina BaranovaNicolás O FranconeStephen J DemoskyCecilia VitaliMonica LocatelliMauro AbbateCarlamaria ZojaGuido FranceschiniLaura CalabresiAlan T RemaleyHuman familial lecithin:cholesterol acyltransferase (LCAT) deficiency (FLD) is characterized by low HDL, accumulation of an abnormal cholesterol-rich multilamellar particle called lipoprotein-X (LpX) in plasma, and renal disease. The aim of our study was to determine if LpX is nephrotoxic and to gain insight into the pathogenesis of FLD renal disease. We administered a synthetic LpX, nearly identical to endogenous LpX in its physical, chemical and biologic characteristics, to wild-type and Lcat-/- mice. Our in vitro and in vivo studies demonstrated an apoA-I and LCAT-dependent pathway for LpX conversion to HDL-like particles, which likely mediates normal plasma clearance of LpX. Plasma clearance of exogenous LpX was markedly delayed in Lcat-/- mice, which have low HDL, but only minimal amounts of endogenous LpX and do not spontaneously develop renal disease. Chronically administered exogenous LpX deposited in all renal glomerular cellular and matrical compartments of Lcat-/- mice, and induced proteinuria and nephrotoxic gene changes, as well as all of the hallmarks of FLD renal disease as assessed by histological, TEM, and SEM analyses. Extensive in vivo EM studies revealed LpX uptake by macropinocytosis into mouse glomerular endothelial cells, podocytes, and mesangial cells and delivery to lysosomes where it was degraded. Endocytosed LpX appeared to be degraded by both human podocyte and mesangial cell lysosomal PLA2 and induced podocyte secretion of pro-inflammatory IL-6 in vitro and renal Cxl10 expression in Lcat-/- mice. In conclusion, LpX is a nephrotoxic particle that in the absence of Lcat induces all of the histological and functional hallmarks of FLD and hence may serve as a biomarker for monitoring recombinant LCAT therapy. In addition, our studies suggest that LpX-induced loss of endothelial barrier function and release of cytokines by renal glomerular cells likely plays a role in the initiation and progression of FLD nephrosis.https://doi.org/10.1371/journal.pone.0150083
spellingShingle Alice Ossoli
Edward B Neufeld
Seth G Thacker
Boris Vaisman
Milton Pryor
Lita A Freeman
Christine A Brantner
Irina Baranova
Nicolás O Francone
Stephen J Demosky
Cecilia Vitali
Monica Locatelli
Mauro Abbate
Carlamaria Zoja
Guido Franceschini
Laura Calabresi
Alan T Remaley
Lipoprotein X Causes Renal Disease in LCAT Deficiency.
PLoS ONE
title Lipoprotein X Causes Renal Disease in LCAT Deficiency.
title_full Lipoprotein X Causes Renal Disease in LCAT Deficiency.
title_fullStr Lipoprotein X Causes Renal Disease in LCAT Deficiency.
title_full_unstemmed Lipoprotein X Causes Renal Disease in LCAT Deficiency.
title_short Lipoprotein X Causes Renal Disease in LCAT Deficiency.
title_sort lipoprotein x causes renal disease in lcat deficiency
url https://doi.org/10.1371/journal.pone.0150083
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