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    <title>Crom, M.P.G. de</title>
    <link>http://repub.eur.nl/res/aut/2632/</link>
    <description>List of Publications</description>
    <language>en</language>
    <image>
      <url>http://repub.eur.nl/static-eur/img/logo.png</url>
      <title>RePub, Erasmus University Rotterdam</title>
      <link>http://repub.eur.nl</link>
    </image>
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      <title>Endothelial nitric oxide synthase overexpression restores the efficiency of bone marrow mononuclear cell-based therapy (Article)</title>
      <link>http://repub.eur.nl/res/pub/23740/</link>
      <pubDate>2011-01-01T00:00:00Z</pubDate>
      <description>Bone marrow-derived mononuclear cells (BMMNCs) enhance postischemic neovascularization, and their therapeutic use is currently under clinical investigation. However, cardiovascular risk factors, including diabetes mellitus and hypercholesterolemia, lead to the abrogation of BMMNCs proangiogenic potential. NO has been shown to be critical for the proangiogenic function of BMMNCs, and increased endothelial NO synthase (eNOS) activity promotes vessel growth in ischemic conditions. We therefore hypothesized that eNOS overexpression could restore both the impaired neovascularization response and decreased proangiogenic function of BMMNCs in clinically relevant models of diabetes and hypercholesterolemia. Transgenic eNOS overexpression in diabetic, atherosclerotic, and wild-type mice induced a 1.5- to 2.3-fold increase in postischemic neovascularization compared with control. eNOS overexpression in diabetic or atherosclerotic BMMNCs restored their reduced proangiogenic potential in ischemic hind limb. This effect was associated with an increase in BMMNC ability to differentiate into cells with endothelial phenotype in vitro and in vivo and an increase in BMMNCs paracrine function, including vascular endothelial growth factor A release and NO-dependent vasodilation. Moreover, although wild-type BMMNCs treatment resulted in significant progression of atherosclerotic plaque in ischemic mice, eNOS transgenic atherosclerotic BMMNCs treatment even had antiatherogenic effects. Cell-based eNOS gene therapy has both proangiogenic and antiatherogenic effects and should be further investigated for the development of efficient therapeutic neovascularization designed to treat ischemic cardiovascular disease.</description>
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      <title>Microcalcifications in atherosclerotic lesion of apolipoprotein E-deficient mouse (Article)</title>
      <link>http://repub.eur.nl/res/pub/21903/</link>
      <pubDate>2010-12-01T00:00:00Z</pubDate>
      <description>Evidence is accumulating that calcium-rich microdeposits in the vascular wall might play a crucial role in the onset and progression of atherosclerosis. Here we investigated an atherosclerotic lesion of the carotid artery in an established murine model, i.e. the apolipoprotein E-deficient (APOE-/-) mouse to identify (i) the presence of microcalcifications, if any, (ii) the elemental composition of microcalcifications with special reference to calcium/phosphorus mass ratio and (iii) co-localization of increased concentrations of iron and zinc with microcalcifications. Atherosclerosis was induced by a flow-divider placed around the carotid artery resulting in low and high shear-stress regions. Element composition was assessed with a proton microprobe. Microcalcifications, predominantly present in the thickened intima of the low shear-stress region, were surrounded by areas with normal calcium levels, indicating that calcium-precipitation is a local event. The diameter of intimal microcalcifications varied from 6 to 70 μm. Calcium/phosphorus ratios of microcalcifications varied from 0.3 to 4.8, mainly corresponding to the ratio of amorphous calcium-phosphate. Increased iron and zinc concentrations commonly co-localized with microcalcifications. Our findings indicate that the atherosclerotic process in the murine carotid artery is associated with locally accumulated calcium, iron and zinc. The calcium-rich deposits resemble amorphous calcium phosphate rather than pure hydroxyapatite. We propose that the APOE-/- mouse, in which atherosclerosis was evoked by a flow-divider, offers a useful model to investigate the pathophysiological significance of accumulation of elements such as calcium, iron and zinc.</description>
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      <title>Ex vivo and in vivo regulation of arginase in response to wall shear stress (Article)</title>
      <link>http://repub.eur.nl/res/pub/28634/</link>
      <pubDate>2010-10-11T00:00:00Z</pubDate>
      <description>Background: Alterations of wall shear stress can predispose the endothelium to the development of atherosclerotic plaques. We evaluated the modulation of arginase by wall shear stress. Material and methods: We perfused isolated carotid arterial segments to either unidirectional high mean shear stress (HSS) or low mean and oscillating shear stress (OSS) for 3 days. Vascular function was analyzed by diameter measurement, arginase expression and localization by western blot and immunohistochemistry, respectively. These effects were also evaluated in right carotid artery of apolipoprotein E (apoE-/-) deficient mice, fed with high cholesterol diet, which was exposed to HSS, LSS and OSS flow conditions by the placement of a shear stress modifier for 9 weeks. ApoE-/- mice received either the arginase inhibitor nor-Noha (20mg/kg, 5 days/week) or placebo for 9 weeks. Plaque size and I/M ratio were determined by histology. Results: Our data from ex vivo perfusion showed that exposure of carotid segments to both low and oscillatory flow conditions significantly increase arginase II protein expression and activity as compared to high shear stress athero-protective flow condition. Long-term treatment with nor-Noha effectively decreased arginase activity at LSS and OSS regions, which in turn was accompanied by a decreased I/M ratio and the size of atherosclerotic lesion. In the lesion, inhibition of arginase decreased the number of CD68 positive cells at LSS and OSS zones. Exposure of carotid artery to OSS induced a more pronounced activation of arginase as compared to HSS. Conclusions: Arginase is modulated by patterns of wall shear stress. Long-term treatment of apoE- /- mice with arginase inhibitor decreased carotid I/M ratio and atherosclerotic lesion at LSS and OSS regions. Therefore, inhibition of arginase by nor-Noha may emerge as a distinct way to target atherosclerosis disease. </description>
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      <title>Three-dimensional registration of histology of human atherosclerotic carotid plaques to in-vivo imaging (Article)</title>
      <link>http://repub.eur.nl/res/pub/27303/</link>
      <pubDate>2010-08-01T00:00:00Z</pubDate>
      <description>An accurate spatial relationship between 3D in-vivo carotid plaque and lumen imaging and histological cross sections is required to study the relationship between biomechanical parameters and atherosclerotic plaque components. We present and evaluate a fully three-dimensional approach for this registration problem, which accounts for deformations that occur during the processing of the specimens. By using additional imaging steps during tissue processing and semi-automated non-linear registration techniques, a 3D-reconstruction of the histology is obtained.The methodology was evaluated on five specimens obtained from patients, operated for severe atherosclerosis in the carotid bifurcation. In more than 80% of the histology slices, the quality of the semi-automated registration with computed tomography angiography (CTA) was equal to or better than the manual registration. The inter-observer variability was between one and two in-vivo CT voxels and was equal to the manual inter-observer variability. Our technique showed that the angles between the normals of the registered histology slices and the in-vivo CTA scan direction ranged 6-56°, indicating that proper 3D-registration is crucial for establishing a correct spatial relation with in-vivo imaging modalities. This new 3D-reconstruction technique of atherosclerotic plaque tissue opens new avenues in the field of biomechanics as well as in the field of image processing, where it can be used for validation purposes of segmentation algorithms. </description>
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      <title>Beneficial effects of exercise training after myocardial infarction require full eNOS expression (Article)</title>
      <link>http://repub.eur.nl/res/pub/27440/</link>
      <pubDate>2010-03-18T00:00:00Z</pubDate>
      <description>Exercise training attenuates left ventricular (LV) dysfunction after myocardial infarction (MI). It could be speculated that these effects of exercise are mediated by increased endothelial NO synthase (eNOS) activity. In the present study we tested the hypothesis that eNOS plays a critical role in the exercise-induced amelioration of LV dysfunction after MI. MI or sham was induced in eNOS-/-, eNOS+/-and eNOS+/+mice. After 8 weeks of voluntary wheel running (∼ 7 km/day in all groups) or sedentary housing, global cardiac function was determined in vivo and (immuno)histochemistry was performed to assess cardiomyocyte size, fibrosis, capillary density and apoptosis in remote myocardium. At baseline eNOS-/-mice had higher mean aortic pressure compared to eNOS+/-and eNOS+/+mice, but had normal global cardiac function. MI resulted in marked LV remodeling, including cardiomyocyte hypertrophy and a reduction in capillary density, increased fibrosis and apoptosis, as well as LV systolic and diastolic dysfunction to the same extent in all genotypes. In eNOS+/+MI mice exercise abolished fibrosis and apoptosis in the remote myocardium, attenuated LV systolic dysfunction and ameliorated pulmonary congestion. These beneficial effects were lost in eNOS+/-and eNOS-/-mice, while LV systolic dysfunction and pulmonary congestion in eNOS+/-mice were exacerbated by exercise. In conclusion, the beneficial effects of exercise after MI on LV remodeling and dysfunction depend critically on endogenous eNOS. The observation that the lack of one eNOS allele is sufficient to negate all beneficial effects of exercise, strongly suggests that exercise depends on full eNOS expression. </description>
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      <title>Shear stress regulates angiotensin type 1 receptor expression in endothelial cells (Article)</title>
      <link>http://repub.eur.nl/res/pub/25283/</link>
      <pubDate>2009-10-23T00:00:00Z</pubDate>
      <description>Rationale: Shear stress (SS) has an established role in atherosclerotic plaque localization, but how it exerts its protective effect is not fully understood. Objective: To test the hypothesis that SS may downregulate angiotensin type 1 receptors (AT1,Rs). Angiotensin II has been shown to be proinflammatory and to promote atherosclerosis. Methods and Results: Using immunohistochemistry, we found a pronounced expression of AT1R in the inner, atheroprone regions of the aortic arch of C57BL/6 and endothelial NO synthase-deficient (eNOS-/-) mice but not eNOS-overexpressing mice. In human umbilical vein endothelial cells (HUVECs), laminar SS (15 dyn/cm2) induced a biphasic decrease in AT1R protein expression characterized by a first reduction at 1 hour (31 ±4% of static control, P&lt;0.01), partial recovery at 3 hours (65±9%), and a second more prolonged decline at 6,12, and 24 hours (48±9%, 36±9%, 33±5%, respectively, P&lt;0.05). One and 24 hours of SS significantly reduced fluorescent angiotensin binding compared to static HUVECs. Shear-induced downregulation of AT1R was abolished by treatment with protein kinase A and G inhibitors or A-nitro-L-arginine methyl ester (L-NAME). Fittingly, stimulating static HUVECs with an NO donor decreased AT1R protein levels. RT-PCR revealed a significant (P&lt;0.05) decrease of AT1R mRNA in HUVECs exposed to SS during 3 (6±2% of static control), 6 (4±1%), 12 (4±1%), and 24 hours (15±4%), suggesting a transcriptional downregulation of AT1R at length. Finally, angiotensin-induced vascular cell adhesion molecule was abated in HUVECs exposed to SS and in the outer aortic arch of mice. Conclusions: Our results demonstrate that SS may convey some of its atheroprotective effects through downregulation of AT1R in endothelial cells. </description>
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      <title>Novel roles of hepatic lipase and phospholipid transfer protein in VLDL as well as HDL metabolism (Article)</title>
      <link>http://repub.eur.nl/res/pub/17238/</link>
      <pubDate>2009-10-01T00:00:00Z</pubDate>
      <description>Objective: Elevated plasma phospholipid transfer protein (PLTP) expression may increase atherosclerosis in mice by reducing plasma HDL and increasing hepatic VLDL secretion. Hepatic lipase (HL) is a lipolytic enzyme involved in several aspects of the same pathways of lipoprotein metabolism. We investigated whether the effects of elevated PLTP activity are compromised by HL deficiency. Methods and results: HL deficient mice were crossbred with PLTP transgenic (PLTPtg) mice and studied in the fasted state. Plasma triglycerides were decreased in HL deficiency, explained by reduced hepatic triglyceride secretion. In PLTPtg mice, a redistribution of HL activity between plasma and tissue was evident and plasma triglycerides were also decreased. HL deficiency mitigated or even abolished the stimulatory effect of elevated PLTP activity on hepatic triglyceride secretion. HL deficiency had a modest incremental effect on plasma HDL, which remained present in PLTP transgenic/HL-/- mice, thereby partially compensating the decrease in HDL caused by elevation of PLTP activity. HDL decay experiments showed that the fractional turnover rate of HDL cholesteryl esters was delayed in HL deficient mice, increased in PLTPtg mice and intermediate in PLTPtg mice in an HL-/- background. Conclusions: HL affects hepatic VLDL. Elevated PLTP activity lowers plasma HDL-cholesterol by stimulating the plasma turnover and hepatic uptake of HDL cholesteryl esters. HL is not required for the increase in hepatic triglyceride secretion or for the lowering of HDL-cholesterol induced by PLTP overexpression.</description>
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      <title>Reduction of HDL levels lowers plasma PLTP and affects its distribution among lipoproteins in mice (Article)</title>
      <link>http://repub.eur.nl/res/pub/24286/</link>
      <pubDate>2009-08-01T00:00:00Z</pubDate>
      <description>Phospholipid transfer protein (PLTP) is associated with HDL particles in plasma, where it transfers phospholipids between lipoproteins and remodels HDL particles. Tangier disease patients, with a mutated ABCA1 transporter, have extremely low plasma HDL concentration and reduced PLTP activity levels, a phenotype that is also observed in mice lacking ABCA1. We investigated whether low HDL levels and low PLTP activity are mechanistically related. Firstly, we studied PLTP expression and distribution among lipoproteins in mice lacking ABCA1 (ABCA1-/-). Parallel to the strong reduction in PLTP activity in plasma of ABCA1-/-mice, decreased PLTP protein levels were observed. Neither PLTP synthesis in liver or macrophages nor the ability of the macrophages to secrete PLTP were impaired in ABCA1-/-mice. However, the PLTP activity level in the medium of cultured macrophages was determined by HDL levels in the medium. PLTP was associated with HDL particles in wild type mice, whereas in ABCA1-/-mice, PLTP was associated with VLDL and LDL particles. Secondly, we treated different mouse models with varying plasma HDL and PLTP levels (wild type, ABCA1-/-, apoE-/-and PLTPtg mice, overexpressing human PLTP) with a synthetic LXR ligand, and investigated the relationship between LXR-mediated PLTP induction and HDL levels in plasma. Plasma PLTP activity in wild type mice was induced 5.6-fold after LXR activation, whereas in ABCA1-/-, apoE-/-and PLTPtg mice, all having reduced HDL levels, induction of PLTP activity was 2.4-, 3.2- and 2.0-fold, respectively. The less pronounced PLTP induction in these mice compared to wild type mice was not caused by a decreased PLTP gene expression in the liver or macrophages. Our findings indicate that the extent of LXR-mediated PLTP induction depends on plasma HDL levels. In conclusion, we demonstrate that ABCA1 deficiency in mice affects plasma PLTP level and distribution through an indirect effect on HDL metabolism. In addition, we show that the extent of LXR-mediated PLTP induction is HDL-dependent. These findings indicate that plasma HDL level is an important regulator of plasma PLTP and might play a role in the stabilization of PLTP in plasma. </description>
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      <title>Elevation of systemic PLTP, but not macrophage-PLTP, impairs macrophage reverse cholesterol transport in transgenic mice (Article)</title>
      <link>http://repub.eur.nl/res/pub/24276/</link>
      <pubDate>2009-06-01T00:00:00Z</pubDate>
      <description>Phospholipid transfer protein (PLTP) is a multifunctional protein synthesized by various cell types and secreted into the plasma. Plasma PLTP is able to transfer phospholipids between lipoproteins and modulate HDL particles. Mice with overexpression of human PLTP have an increased ability to generate preβ-HDL, reduced total HDL levels and an increased susceptibility to atherosclerosis. As the macrophage is a key component of the atherosclerotic lesion and an important site of PLTP expression, we investigated the role of systemic and peripheral PLTP in macrophage cholesterol efflux and reverse cholesterol transport (RCT) in vivo. We used an assay in which3H-labelled cholesterol-loaded macrophages were injected intraperitoneally into recipient mice, and radioactivity was quantified in plasma, liver and faeces. Firstly, wild type macrophages were injected into wild type, PLTP transgenic (PLTPtg) and apoAI transgenic (apoAItg) mice. While plasma3H-tracer levels in apoAItg mice were increased compared with wild type mice, they were reduced in PLTPtg mice. Moreover, overexpression of PLTP significantly decreased faecal3H-tracer levels compared with wild type and apoAItg mice. Secondly, wild type mice were injected with peritoneal macrophages derived from PLTPtg or wild type mice. No significant difference in the amount of3H-tracer in plasma, liver or faeces was found between the two groups of mice. Our findings demonstrate that macrophage cholesterol efflux and RCT to faeces is impaired in PLTP transgenic mice, and that elevation of macrophage-PLTP does not affect RCT, indicating that higher systemic PLTP levels may promote atherosclerosis development by decreasing the rate of macrophage RCT. </description>
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      <title>Activation of MMP8 and MMP13 by angiotensin II correlates to severe intra-plaque hemorrhages and collagen breakdown in atherosclerotic lesions with a vulnerable phenotype (Article)</title>
      <link>http://repub.eur.nl/res/pub/15592/</link>
      <pubDate>2009-05-01T00:00:00Z</pubDate>
      <description>Angiotensin II (ATII)-mediated hypertension increases the risk for acute coronary events, which may be caused by augmented collagen degradation. Interstitial fibers of collagen type I in the plaque can be degraded by MMP8 and MMP13 specifically. Indeed high MMP8 levels have been correlated with ruptured plaques in patients. To study the contribution of ATII in plaque rupture, we evaluated its effect on MMP8 and MMP13 activity on the vulnerable lesions using an extravascular device that induces regions of pro-atherogenic shear stress in the carotid arteries of ApoE KO mice. This triggers the growth of lesions with a "vulnerable" macrophage-rich phenotype (referred to as upstream lesions) and lesions with a "stable" fibrotic phenotype (referred to as downstream lesions). ATII administration increased mean blood pressure, and increased the incidence of intra-plaque hemorrhages (IPH) from 30% to 73% of the animals in the upstream segments. The area of IPH was also increased by 5-fold. No IPHs were observed in the downstream lesions of the control group or the ATII group. In addition, ATII treatment doubled the size of upstream and downstream lesions. Upstream lesions in the ATII group were decreased in collagen content by 3-fold, contained 2-fold higher MMP8 and MMP13 levels, with a 2- and 3-fold increase in collagen type I degradation by MMP8 and MMP13 respectively compared to the upstream lesions in the control group. Gene expression analysis showed general increase in procollagens and TIMPs expression in response to ATII. However, ATII also decreased procollagen 5α3 expression in downstream lesions and decreased TIMP4 expression in upstream lesions. These data show that ATII promotes a "stable" fibrotic phenotype by inducing severe intra-plaque hemorrhages, characterized by increased degradation of interstitial collagen I via an MMP-mediated (MMP8 and MMP13) mechanism.</description>
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      <title>Detrimental effect of combined exercise training and eNOS overexpression on cardiac function after myocardial infarction (Article)</title>
      <link>http://repub.eur.nl/res/pub/16530/</link>
      <pubDate>2009-05-01T00:00:00Z</pubDate>
      <description>It has been reported that exercise after myocardial infarction (MI) attenuates left ventricular (LV) pump dysfunction by normalization of myofilament function. This benefit could be due to an exercise-induced upregulation of endothelial nitric oxide synthase (eNOS) expression and activity. Consequently, we first tested the hypothesis that the effects of exercise after MI can be mimicked by elevated eNOS expression using transgenic mice with overexpression of human eNOS (eNOSTg). Both exercise and eNOSTg attenuated LV remodeling and dysfunction after MI in mice and improved cardiomyocyte maximal force development (Fmax). However, only exercise training restored myofilament Ca2+-sensitivity and sarco(endo)plasmic reticulum Ca2+-ATPase (SERCA)2a protein levels and improved the first derivative of LV pressure at 30 mmHg. Conversely, only eNOSTg improved survival. In view of these partly complementary actions, we subsequently tested the hypothesis that combining exercise and eNOSTg would provide additional protection against LV remodeling and dysfunction after MI. Unexpectedly, the combination of exercise and eNOSTg abolished the beneficial effects on LV remodeling and dysfunction of either treatment alone. The latter was likely due to perturbations in Ca2+ homeostasis, as myofilament Fmax actually increased despite marked reductions in the phosphorylation status of several myofilament proteins, whereas the exercise-induced increases in SERCA2a protein levels were lost in eNOSTg mice. Antioxidant treatment with N-acetylcysteine or supplementation of tetrahydrobiopterin and L-arginine prevented these detrimental effects on LV function while partly restoring the phosphorylation status of myofilament proteins and further enhancing myofilament Fmax. In conclusion, the combination of exercise and elevated eNOS expression abolished the cardioprotective effects of either treatment alone after MI, which appeared to be, at least in part, the result of increased oxidative stress secondary to eNOS "uncoupling."</description>
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      <title>Large variations in absolute wall shear stress levels within one species and between species (Article)</title>
      <link>http://repub.eur.nl/res/pub/26978/</link>
      <pubDate>2009-05-01T00:00:00Z</pubDate>
      <description></description>
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      <title>Plasma phospholipid transfer activity is essential for increased atherogenesis in PLTP transgenic mice: A mutation-inactivation study (Article)</title>
      <link>http://repub.eur.nl/res/pub/28854/</link>
      <pubDate>2008-12-01T00:00:00Z</pubDate>
      <description>Plasma phospholipid transfer protein (PLTP) interacts with HDL particles and facilitates the transfer of phospholipids from triglyceride (TG)-rich lipoproteins to HDL. Overexpressing human PLTP in mice increases the susceptibility to atherosclerosis. In human plasma, high-active and low-active forms of PLTP exist. To elucidate the contribution of phospholipid transfer activity to changes in lipoprotein metabolism and atherogenesis, we developed mice expressing mutant PLTP, still able to associate with HDL but lacking phospholipid transfer activity. In mice heterozygous for the LDL receptor, effects of the mutant and normal human PLTP transgene (mutPLTP tg and PLTP tg, respectively) were compared. In PLTP tg mice, plasma PLTP activity was increased 2.9-fold, resulting in markedly reduced HDL lipid levels. In contrast, in mutPLTP tg mice, lipid levels were not different from controls. Furthermore, hepatic VLDL-TG secretion was stimulated in PLTP tg mice, but not in mutPLTP tg mice. When mice were fed a cholesterol-enriched diet, atherosclerotic lesion size in PLTP tg mice was increased more than 2-fold compared with control mice, whereas in mutPLTP tg mice, there was no change. Our findings demonstrate that PLTP transfer activity is essential for the development of atherosclerosis in PLTP transgenic mice, identifying PLTP activity as a possible target to prevent atherogenesis, independent of plasma PLTP concentration. Copyright </description>
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      <title>Acute elevation of plasma PLTP activity strongly increases pre-existing atherosclerosis (Article)</title>
      <link>http://repub.eur.nl/res/pub/30083/</link>
      <pubDate>2008-07-01T00:00:00Z</pubDate>
      <description>Objective - A transgenic mouse model was generated that allows conditional expression of human PLTP, based on the tetracycline-responsive gene system, to study the effects of an acute increase in plasma PLTP activity as may occur in inflammation. Methods and Results - The effects of an acute elevation of plasma PLTP activity on the metabolism of apolipoprotein B-containing lipoproteins and on diet-induced pre-existing atherosclerosis were determined in mice displaying a humanized lipoprotein profile (low-density lipoprotein receptor knockout background). Induced expression of PLTP strongly increases plasma VLDL levels in LDL receptor knockout mice, whereas VLDL secretion is not affected. The elevation in plasma triglyceride levels is explained by a PLTP-dependent inhibition of VLDL catabolism, which is caused, at least partly, by a decreased lipoprotein lipase activity. Together with the decreased plasma HDL levels, the acutely increased PLTP expression results in a highly atherogenic lipoprotein profile. Induction of PLTP expression leads to a further increase in size of pre-existing atherosclerotic lesions, even on a chow diet. In addition, the lesions contain more macrophages and less collagen relative to controls, suggesting a less stable lesion phenotype. Conclusion - In conclusion, acute elevation of PLTP activity destabilizes atherosclerotic lesions and aggravates pre-existing atherosclerosis. </description>
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      <title>Elevated expression of phospholipid transfer protein in bone marrow derived cells causes atherosclerosis (Article)</title>
      <link>http://repub.eur.nl/res/pub/30547/</link>
      <pubDate>2008-05-28T00:00:00Z</pubDate>
      <description>Background: Phospholipid transfer protein (PLTP) is expressed by various cell types. In plasma, it is associated with high density lipoproteins (HDL). Elevated levels of PLTP in transgenic mice result in decreased HDL and increased atherosclerosis. PLTP is present in human atherosclerosis lesions, where it seems to be macrophage derived. The aim of the present study is to evaluate the atherogenic potential of macrophage derived PLTP. Methods and Findings: Here we show that macrophages from human PLTP transgenic mice secrete active PLTP. Subsequently, we performed bone marrow transplantations using either wild type mice (PLTPwt/wt), hemizygous PLTP transgenic mice (huPLTPtg/wt) or homozygous PLTP transgenic mice (huPLTPtg/tg) as donors and low density lipoprotein receptor deficient mice (LDLR-/-) as acceptors, in order to establish the role of PLTP expressed by bone marrow derived cells in diet-induced atherogenesis. Atherosclerosis was increased in the huPLTPtg/wt → LDLR-/ - mice (2.3-fold) and even further in the huPLTPtg/tg→LDLR-/ - mice (4.5-fold) compared with the control PLTPwt/wt→LDLR-/- mice (both P&lt;0.001). Plasma PLTP activity levels and non-HDL cholesterol were increased and HDL cholesterol decreased compared with controls (all P&lt;0.01). PLTP was present in atherosclerotic plaques in the mice as demonstrated by immunohistochemistry and appears to co-localize with macrophages. Isolated macrophages from PLTP transgenic mice do not show differences in cholesterol efflux or in cytokine production. Lipopolysaccharide activation of macrophages results in increased production of PLTP. This effect was strongly amplified in PLTP transgenic macrophages. Conclusions: We conclude that PLTP expression by bone marrow derived cells results in atherogenic effects on plasma lipids, increased PLTP activity, high local PLTP protein levels in the atherosclerotic lesions and increased atherosclerotic lesion size. </description>
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      <title>Rapamycin modulates the eNOS vs. shear stress relationship (Article)</title>
      <link>http://repub.eur.nl/res/pub/28957/</link>
      <pubDate>2008-04-01T00:00:00Z</pubDate>
      <description>Aims: Studies in animals and patients indicate that rapamycin affects vasodilatation differently in outer and inner curvatures of blood vessels. We evaluated in this study whether rapamycin affects endothelial nitric oxide synthase (eNOS) responsiveness to shear stress under normo- and hypercholesteraemic conditions to explain these findings. Methods and results: Shear stress levels were varied over a large range of values in carotid arteries of transgenic mice expressing human eNOS fused to enhanced green fluorescence protein. The mice were divided into control, low-dose rapamycin (3 μg/kg/day), and high-dose rapamycin (3 mg/kg/day) groups and into normocholesteraemic and hypercholesteraemic (ApoE-/- on high cholesterol diet for 3-4 weeks) groups. The effect of rapamycin treatment on eNOS was evaluated by quantification of eNOS expression and of intracellular protein levels by en face confocal microscopy. A sigmoid curve fit was used to described these data. The efficacy of treatment was confirmed by measurement of rapamycin serum levels (2.0 ± 0.5 ng/mL), and of p27kip1expression in vascular tissue (increased by 2.4 ± 0.5-fold). In control carotid arteries, eNOS expression increased by 1.8 ± 0.3-fold in response to rapamycin. In the treated vessels, rapamycin reduced maximal eNOS expression at high shear stress levels (&gt;5 Pa) in a dose-dependent way and shifted the sigmoid curve to the right. Hypercholesteraemia had a tendency to increase the leftward shift and the reduction in maximal eNOS expression (P = 0.07). Conclusion: Rapamycin is associated with high eNOS in low shear regions, i.e. in atherogenic regions, protecting these regions against atherosclerosis, and is associated with a reduction of eNOS at high shear stress affecting vasomotion in these regions. </description>
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      <title>Endothelial primary cilia in areas of disturbed flow are at the base of atherosclerosis (Article)</title>
      <link>http://repub.eur.nl/res/pub/29209/</link>
      <pubDate>2008-02-01T00:00:00Z</pubDate>
      <description>Atherosclerosis develops in the arterial system at sites of low as well as low and oscillating shear stress. Previously, we demonstrated a shear-related distribution of ciliated endothelial cells in the embryonic cardiovascular system and postulated that the primary cilium is a component of the shear stress sensor, functioning as a signal amplifier. This shear-related distribution is reminiscent of the atherosclerotic predilection sites. Thus, we determined whether a link exists between location and frequency of endothelial primary cilia and atherogenesis. We analyzed endothelial ciliation of the adult aortic arch and common carotid arteries of wild type C57BL/6 and apolipoprotein-E-deficient mice. Primary cilia are located at the atherosclerotic predilection sites, where flow is disturbed, in wild type mice and they occur on and around atherosclerotic lesions in apolipoprotein-E-deficient mice, which have significantly more primary cilia in the aortic arch than wild type mice. In addition, common carotid arteries were challenged for shear stress by application of a restrictive cast, resulting in the presence of primary cilia only at sites of induced low and disturbed shear. In conclusion, these data relate the presence of endothelial primary cilia to regions of atherogenesis, where they increase in number under hyperlipidemia-induced lesion formation. Experimentally induced flow disturbance leads to induction of primary cilia, and subsequently to atherogenesis, which suggests a role for primary cilia in endothelial activation and dysfunction. </description>
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      <title>A novel model of cryoinjury-induced myocardial infarction in the mouse: a comparison with coronary artery ligation. (Article)</title>
      <link>http://repub.eur.nl/res/pub/13798/</link>
      <pubDate>2005-09-01T00:00:00Z</pubDate>
      <description>Mouse myocardial infarction (MI) models are frequently used research tools. The most commonly applied model is coronary artery ligation. However, coronary ligation often gives rise to apical aneurysmatic infarcts of variable size. Other infarct models include cryoinfarction, which produces reproducible infarcts of the anterior wall. Thus far, this model has not been extensively described in mice. Therefore, we developed a murine cryoinfarction model and compared it with coronary ligation. Studies were performed under isoflurane anesthesia with a follow-up of 4 and 8 wk. Cryoinfarction was induced using a 2- or 3-mm cryoprobe. Two-dimensional guided M-mode echocardiography was used to assess fractional shortening and left ventricular (LV) dimensions at baseline and end point. At end point, hemodynamics were assessed using a 1.4-Fr Millar catheter. Pressure-diameter relations were constructed by combining echocardiography and hemodynamic data. Histological and morphometric analyses of infarct and remote areas were performed. At 4 wk, 3-mm cryoinfarction resulted in decreased LV fractional shortening as well as decreased global LV contractility and relaxation, which was comparable with coronary ligation. No adverse remodeling was observed at this time point, in contrast with the ligation model. However, progressive LV remodeling occured between 4 and 8 wk after cryoinfarction with a further decline in hemodynamic parameters and LV pump function. Histologically, cryoinfarction resulted in highly reproducible, transmural, cone-shaped infarcts with reperfusion at the macrovascular level. These results indicate that the cryoinfarction model represents the anterior myocardial infarct with modest adverse remodeling and may thus be representative for infarcts encountered in clinical practice.</description>
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      <title>Elevation of plasma phospholipid transfer protein increases the risk of atherosclerosis despite lower apolipoprotein B-containing lipoproteins. (Article)</title>
      <link>http://repub.eur.nl/res/pub/13333/</link>
      <pubDate>2004-05-01T00:00:00Z</pubDate>
      <description>Plasma phospholipid transfer protein (PLTP) transfers phospholipids
      between lipoproteins and mediates HDL conversion. PLTP-overexpressing mice
      have increased atherosclerosis. However, mice do not express cholesteryl
      ester transfer protein (CETP), which is involved in the same metabolic
      pathways as PLTP. Therefore, we studied atherosclerosis in heterozygous
      LDL receptor-deficient (LDLR(+/-)) mice expressing both human CETP and
      human PLTP. We used two transgenic lines with moderately and highly
      elevated plasma PLTP activity. In LDLR(+/-)/huCETPtg mice, cholesterol is
      present in both LDL and HDL. Both are decreased in
      LDLR(+/-)/huCETPtg/huPLTPtg mice (&gt;50%). An atherogenic diet resulted in
      high levels of VLDL+LDL cholesterol. PLTP expression caused a strong PLTP
      dose-dependent decrease in VLDL and LDL cholesterol (-26% and -69%) and a
      decrease in HDL cholesterol (-70%). Surprisingly, atherosclerosis was
      increased in the two transgenic lines with moderately and highly elevated
      plasma PLTP activity (1.9-fold and 4.4-fold, respectively), indicating
      that the adverse effect of the reduction in plasma HDL outweighs the
      beneficial effect of the reduction in apolipoprotein B (apoB)-containing
      lipoproteins. The activities of the antiatherogenic enzymes paraoxonase
      and platelet-activating factor acetyl hydrolase were both PLTP
      dose-dependently reduced ( approximately -33% and -65%, respectively). We
      conclude that expression of PLTP in this animal model results in increased
      atherosclerosis in spite of reduced apoB-containing lipoproteins, by
      reduction of HDL and of HDL-associated antioxidant enzyme activities.</description>
    </item> <item>
      <title>Functional expression of endothelial nitric oxide synthase fused to green fluorescent protein in transgenic mice (Article)</title>
      <link>http://repub.eur.nl/res/pub/10227/</link>
      <pubDate>2003-01-01T00:00:00Z</pubDate>
      <description>The activity of endothelial nitric oxide synthase (eNOS) is subject to
      complex transcriptional and post-translational regulation including the
      association with several proteins and variations in subcellular
      distribution. In the present study we describe a transgenic mouse model
      expressing eNOS fused to green fluorescent protein (GFP), which allows the
      study of localization and regulation of eNOS expression. We tested the
      functionality of eNOS in the eNOS-GFP mice. Expression of eNOS was
      restricted to the endothelial lining of blood vessels in various tissues
      tested, without appreciable expression in non-endothelial cells. Activity
      of the enzyme was confirmed by assaying the conversion of L-arginine to
      L-citrulline. NO production in isolated vessels was increased in
      transgenic mice when compared to non-transgenic control animals (4.88 +/-
      0.59 and 2.48 +/- 0.47 micro mol/L NO, respectively, P &lt; 0.005). Both the
      mean aortic pressure and the pulmonary artery pressure were reduced in
      eNOS-GFP mice (both approximately 30%, P &lt; 0.05). Plasma cholesterol
      levels were also slightly reduced ( approximately 20%, P &lt; 0.05). In
      conclusion, eNOS-GFP mice express functional eNOS and provide a unique
      model to study regulation of eNOS activity or eNOS-mediated vascular
      events, including response to ischemia, response to differences in shear
      stress, angiogenesis and vasculogenesis, and to study the subcellular
      distribution in relation with functional responses to these events.</description>
    </item> <item>
      <title>Reduction of blood pressure, plasma cholesterol, and atherosclerosis by elevated endothelial nitric oxide. (Article)</title>
      <link>http://repub.eur.nl/res/pub/13106/</link>
      <pubDate>2002-12-13T00:00:00Z</pubDate>
      <description>In the vascular system, nitric oxide is generated by endothelial NO synthase (eNOS). NO has pleiotropic effects, most of which are believed to be atheroprotective. Therefore, it has been argued that patients suffering from cardiovascular disease could benefit from an increase in eNOS activity. However, increased NO production can cause oxidative damage, cell toxicity, and apoptosis and hence could be atherogenic rather than beneficial. To study the in vivo effects of increased eNOS activity, we created transgenic mice overexpressing human eNOS. Aortic blood pressure was approximately 20 mm Hg lower in the transgenic mice compared with control mice because of lower systemic vascular resistance. The effects of eNOS overexpression on diet-induced atherosclerosis were studied in apolipoprotein E-deficient mice. Elevation of eNOS activity decreased blood pressure ( approximately 20 mm Hg) and plasma levels of cholesterol (approximately 17%), resulting in a reduction in atherosclerotic lesions by 40%. We conclude that an increase in eNOS activity is beneficial and provides protection against atherosclerosis.</description>
    </item> <item>
      <title>Increased risk of atherosclerosis by elevated plasma levels of phospholipid transfer protein. (Article)</title>
      <link>http://repub.eur.nl/res/pub/13113/</link>
      <pubDate>2002-12-13T00:00:00Z</pubDate>
      <description>Plasma phospholipid transfer protein (PLTP) is thought to be involved in
      the remodeling of high density lipoproteins (HDL), which are
      atheroprotective. It is also involved in the metabolism of very low
      density lipoproteins (VLDL). Hence, PLTP is thought to be an important
      factor in lipoprotein metabolism and the development of atherosclerosis.
      We have overexpressed PLTP in mice heterozygous for the low density
      lipoprotein (LDL) receptor, a model for atherosclerosis. We show that
      increased PLTP activity results in a dose-dependent decrease in HDL, and a
      moderate stimulation of VLDL secretion (&lt;/=1.5-fold). The mice were given
      a high fat, high cholesterol diet, which resulted in hypercholesterolemia
      in all animals. HDL concentrations were dramatically reduced in
      PLTP-overexpressing animals when compared with LDL receptor controls,
      whereas VLDL + LDL cholesterol levels were identical. Susceptibility to
      atherosclerosis was increased in a PLTP dose-responsive manner. We
      conclude that PLTP increases susceptibility to atherosclerosis by lowering
      HDL concentrations, and therefore we suggest that an increase in PLTP is a
      novel, long term risk factor for atherosclerosis in humans.</description>
    </item> <item>
      <title>Elevation of plasma phospholipid transfer protein in transgenic mice increases VLDL secretion (Article)</title>
      <link>http://repub.eur.nl/res/pub/10002/</link>
      <pubDate>2002-01-01T00:00:00Z</pubDate>
      <description>Two lipid transfer proteins are active in human plasma, cholesteryl ester
      transfer protein (CETP), and phospholipid transfer protein (PLTP). Mice by
      nature do not express CETP. Additional inactivation of the PLTP gene
      resulted in reduced secretion of VLDL and subsequently in decreased
      susceptibility to diet-induced atherosclerosis. The aim of this study is
      to assess possible effects of differences in PLTP expression on VLDL
      secretion in mice that are proficient in CETP and PLTP. We compared human
      CETP transgenic (huCETPtg) mice with mice expressing both human lipid
      transfer proteins (huCETPtg/huPLTPtg). Plasma cholesterol in huCETPtg mice
      was 1.5-fold higher compared with huCETPtg/huPLTPtg mice (P &lt; 0.001). This
      difference was mostly due to a lower HDL level in the huCETPtg/huPLTPtg
      mice, which subsequently could lead to the somewhat decreased CETP
      activity and concentration that was found in huCETPtg/huPLTPtg mice (P &lt;
      0.05). PLTP activity was 2.8-fold increased in these animals (P &lt; 0.001).
      The human PLTP concentration was 5 microg/ml. Moderate overexpression of
      PLTP resulted in a 1.5-fold higher VLDL secretion compared with huCETPtg
      mice (P &lt; 0.05). The composition of nascent VLDL was similar in both
      strains. These results indicate that elevated PLTP activity in huCETPtg
      mice results in an increase in VLDL secretion. In addition, PLTP
      overexpression decreases plasma HDL cholesterol as well as CETP.</description>
    </item> <item>
      <title>Evaluation of phospholipid transfer protein and cholesteryl ester transfer protein as contributors to the generation of pre beta-high-density lipoproteins (Article)</title>
      <link>http://repub.eur.nl/res/pub/9795/</link>
      <pubDate>2001-01-01T00:00:00Z</pubDate>
      <description>High-density lipoproteins (HDLs) are considered anti-atherogenic because
      they mediate peripheral cell cholesterol transport to the liver for
      excretion and degradation. An important step in this reverse
      cholesterol-transport pathway is the uptake of cellular cholesterol by a
      specific subclass of small, lipid-poor apolipoprotein A-I particles
      designated pre beta-HDL. The two lipid-transfer proteins present in human
      plasma, cholesteryl ester transfer protein (CETP) and phospholipid
      transfer protein (PLTP), have both been implicated in the formation of pre
      beta-HDL. In order to investigate the relative contribution of each of
      these proteins, we used transgenic mouse models. Comparisons were made
      between human CETP transgenic mice (huCETPtg), human PLTP transgenic mice
      (huPLTPtg) and mice transgenic for both lipid-transfer proteins
      (huCETPtg/huPLTPtg). These animals showed elevated plasma levels of CETP
      activity, PLTP activity or both activities, respectively. We evaluated the
      generation of pre beta-HDL in mouse plasma by immunoblotting and crossed
      immuno-electrophoresis. Generation of pre beta-HDL was equal in huCETPtg
      and wild-type mice. In contrast, in huPLTPtg and huCETPtg/huPLTPtg mice,
      pre beta-HDL generation was 3-fold higher than in plasma from either
      wild-type or huCETPtg mice. Our findings demonstrate that, of the two
      plasma lipid-transfer proteins, PLTP rather than CETP is responsible for
      the generation of pre beta-HDL. These data support the hypothesis of a
      role for PLTP in the initial stage of reverse cholesterol transport.</description>
    </item> <item>
      <title>Human plasma phospholipid transfer protein increases the antiatherogenic potential of high density lipoproteins in transgenic mice (Article)</title>
      <link>http://repub.eur.nl/res/pub/9314/</link>
      <pubDate>2000-01-01T00:00:00Z</pubDate>
      <description>Plasma phospholipid transfer protein (PLTP) transfers phospholipids
          between lipoprotein particles and alters high density lipoprotein (HDL)
          subfraction patterns in vitro, but its physiological function is poorly
          understood. Transgenic mice that overexpress human PLTP were generated.
          Compared with wild-type mice, these mice show a 2.5- to 4.5-fold increase
          in PLTP activity in plasma. This results in a 30% to 40% decrease of
          plasma levels of HDL cholesterol. Incubation of plasma from transgenic
          animals at 37 degrees C reveals a 2- to 3-fold increase in the formation
          of pre-beta-HDL compared with plasma from wild-type mice. Although
          pre-beta-HDL is normally a minor subfraction of HDL, it is known to be a
          very efficient acceptor of peripheral cell cholesterol and a key mediator
          in reverse cholesterol transport. Further experiments show that plasma
          from transgenic animals is much more efficient in preventing the
          accumulation of intracellular cholesterol in macrophages than plasma from
          wild-type mice, despite lower total HDL concentrations. It is concluded
          that PLTP can act as an antiatherogenic factor preventing cellular
          cholesterol overload by generation of pre-beta-HDL.</description>
    </item> <item>
      <title>A Gp96/GRP94 is a putative high density lipoprotein-binding protein in liver. (Article)</title>
      <link>http://repub.eur.nl/res/pub/2588/</link>
      <pubDate>1999-03-25T00:00:00Z</pubDate>
      <description>We have previously shown that three high density lipoproteins (HDL)-binding proteins in liver, of 90, 110 and 180 kDa, are structurally related. In this study, these proteins are identified as gp96/GRP94. This protein is known to occur as a homodimer and has a dual subcellular localization: it is both an endoplasmic reticulum resident protein, where it is supposed to act as a chaperonin, and a plasma membrane protein, whose significance is unknown. In ultrastructural studies the plasma membrane localization of the homodimeric form was verified. The 90-kDa protein was abundantly present at the membranes of the endosomal/lysosomal vesicles as well as at the apical hepatocyte membranes, comprising the bile canaliculi. The monomeric protein is scarcely present at the basolateral membrane of the hepatocytes, but could be demonstrated in coated pits, suggesting involvement in receptor-mediated endocytosis. Labeling of the endoplasmic reticulum was virtually absent. Gp96/GRP94 was transiently expressed in COS-1 cells. However, the expressed protein was exclusively localized in the endoplasmic reticulum. Transfection with constructs in which the C-terminal KDEL sequence had been deleted, resulted in plasma membrane localized expression of protein, but only in an extremely low percentage of cells. In order to evaluate the HDL-binding capacities of this protein, stably transfected cells were generated, using several cell types. It appeared to be difficult to obtain a prolonged high level expression of gp96. In these cases, however, a marked increase of HDL-binding activity compared with the control cells could be observed.</description>
    </item> <item>
      <title>High Density Lipoprotein-Binding Proteins in Liver (Doctoral Thesis)</title>
      <link>http://repub.eur.nl/res/pub/18070/</link>
      <pubDate>1997-05-07T00:00:00Z</pubDate>
      <description>In one of the oldest civilizations we know, that of ancient Egypt, thoughts
about the heart reflected a certain duality. On the one hand, the heart was
associated with concepts like virtue, or soul. A central passage in the Book
of the Dead of the ancient Egyptians is the description and illustration of the
weighing of the soul (Fig. 1). The heart of the diseased was put on a pair of
scales and balanced against the hieroglyphic symbol of virtue, the feather
maat. If the ibis god of scribes, Thot, could register a favourable verdict, the
dead man or woman was presented to the god of the dead, Osiris, and was
allowed entrance into the world of the dead. If not, the heart was devoured
by a horrifying beast, which event was described as the Death of the Soul,
and meant total elimination of the individual [Rossiter, 1979J. On the other
hand, the Egyptians probably were aware of the physiological function of
the heart as a blood·pump and recognized a variety of heart conditior)s
[Ghalioungui, 1973J. People suffering from them would wear a small amulet
representing a heart [Howes, 1976J.</description>
    </item>
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