Monique de Fatima Mello Santana

Introduction Dyslipidemia is a common metabolic complication in patients with chronic kidney disease (CKD). Although the underlying mechanisms are not fully understood, oxidative stress, inflammation, and insulin resistance are thought to contribute to accelerated atherosclerosis. Peritoneal dialysis (PD) is a home-based therapy for patients with advanced CKD. In this modality, glucose is the predominant osmotic agent in the dialysate, leading to systemic metabolic effects., Patients undergoing PD tend to have a more atherogenic lipid profile than those receiving conservative treatment [...] Introduction Dyslipidemia is a common metabolic complication in patients with chronic kidney disease (CKD). Although the underlying mechanisms are not fully understood, oxidative stress, inflammation, and insulin resistance are thought to contribute to accelerated atherosclerosis. Peritoneal dialysis (PD) is a home-based therapy for patients with advanced CKD. In this modality, glucose is the predominant osmotic agent in the dialysate, leading to systemic metabolic effects., Patients undergoing PD tend to have a more atherogenic lipid profile than those receiving conservative treatment

Introdução A dislipidemia é uma complicação metabólica comum em pacientes com doença renal crônica (DRC). Embora os mecanismos subjacentes não sejam totalmente compreendidos, acredita-se que o estresse oxidativo, a inflamação e a resistência à insulina contribuam para a aterosclerose acelerada. A diálise peritoneal (DP) é uma terapia domiciliar para pacientes com DRC avançada. Nessa modalidade, a glicose é o principal agente osmótico na solução de diálise, levando a efeitos metabólicos sistêmicos., Pacientes submetidos à DP tendem a apresentar um perfil [...] Introdução A dislipidemia é uma complicação metabólica comum em pacientes com doença renal crônica (DRC). Embora os mecanismos subjacentes não sejam totalmente compreendidos, acredita-se que o estresse oxidativo, a inflamação e a resistência à insulina contribuam para a aterosclerose acelerada. A diálise peritoneal (DP) é uma terapia domiciliar para pacientes com DRC avançada. Nessa modalidade, a glicose é o principal agente osmótico na solução de diálise, levando a efeitos metabólicos sistêmicos., Pacientes submetidos à DP tendem a apresentar um perfil

Background: In individuals with Type 1 diabetes mellitus (T1D) who maintain good glycemic control and are free of chronic complications, lipid profiles are generally within normal ranges. However, impaired renal function or albuminuria alters this profile, contributing to the progression of diabetic kidney disease (DKD). This study hypothesized that, in urinary sediment cells from T1D individuals ( n = 87), the mRNA expression of genes related to free fatty acid (FFA) uptake ( CD36 , FABP1 , SCL27A1 , SLC27A2 , and SLC27A4 , which encode FATP1 , FATP2 , and FATP4 , respectively), albumin uptake ( LRP2 and CUBN ), inflammation ( IL1B and IL18 ), and fibrosis ( TGFB1 ) would vary depending on the degree of renal function decline and of urinary albumin excretion (UAE) and correlate with each other and with plasma lipid concentrations. Results: CD36 expression was higher in urinary sediment cells of individuals with relevant renal function decline compared to those without relevant decline. CD36 , IL1B , TGFB1 , and SLC27A4 (at the limit of statistical significance) expressions were higher in individuals with UAE > 11 mg/g versus UAE ≤ 11 mg/g creatinine (cohort median value). CD36 expression positively correlated with IL1B ( r = 0.46) and TGFB1 ( r = 0.45) expressions, and LRP2 expression positively correlated with IL18 ( r = 0.44) and TGFB1 ( r = 0.30). Expression of SLC27A genes also correlated with inflammatory and profibrotic genes. Plasma FFA concentrations positively correlated with CD36 ( r = 0.27) and IL1B ( r = 0.30) expressions, while plasma triglyceride (TG) concentrations positively correlated with CD36 ( r = 0.22) and negatively correlated with FABP1 ( r = −0.28) expressions. Urinary sediment gene expression was modulated by statin ( IL18 ) and angiotensin II receptor blockers ( LRP2 , CUBN , and FABP1 ) use. Conclusions: The expression of lipid metabolism–related genes in urinary sediment cells, correlated with proinflammatory and profibrotic genes, as well as with plasma FFA and TG, and associated with clinical indicators of renal function, provides indirect evidence for the involvement of lipids in the pathogenesis of DKD.

In rheumatoid arthritis (RA), the risk of cardiovascular death is 50% higher compared to the general population. This increased risk is partly due to the systemic inflammation characteristic of RA and changes in the lipoprotein profiles. This study investigated plasma lipid levels, lipid ratios, and the composition and functionality of high-density lipoprotein (HDL) in control individuals and RA subjects based on the disease’s inflammatory score (DAS28). This study included 50 control (CTR) individuals and 56 subjects with RA, divided into remission/low-activity disease (DAS28 < 3.2; n = 13) and active disease (DAS28 ≥ 3.2; n = 43). Plasma lipids (total cholesterol, TC; triglycerides, TG) and the HDL composition (TC; TG; phospholipids, PL) were determined using enzymatic methods; apolipoprotein B (apoB) and apoA-1 were measured by immunoturbidimetry. HDL-mediated cholesterol efflux and anti-inflammatory activity were assessed in bone marrow-derived macrophages. Comparisons were made using the Mann–Whitney test, and binary logistic regression was used to identify the predictors of active RA. A p-value < 0.05 was considered significant. TC, HDLc, and the TC/apoB ratio were higher in RA subjects compared to the CTR group. Subjects with active disease exhibited higher levels of TG and the TG/HDLc ratio and lower levels of HDLc, the TG/apoB ratio, TC, and apoA-1 in HDL particles compared to those with remission/low-activity RA. Increased levels of HDLc [odds ratio (OR) 0.931, 95% CI = 0.882–0.984], TC/apoB (OR 0.314, 95% CI = 0.126–0.78), HDL content in TC (OR 0.912, 95% CI = 0.853–0.976), PL (OR 0.973, 95% CI = 0.947–1.000), and apoA-1 (OR 0.932, 95% CI = 0.882–0.985) were associated with a decreased risk of active disease, but BMI (OR 1.169, 95% CI = 1.004–1.360) and TG (OR 1.031, 95% CI = 1.005–1.057) were positively associated with active disease. A reduction in HDL-mediated cholesterol efflux increased the OR for active RA by 26.2%. The plasma levels of HDLc, along with the composition and functionality of HDL, influence the inflammatory score in RA and may affect the development of cardiovascular disease.

The association between high-density lipoprotein (HDL) cholesterol and breast cancer (BC) remains controversial due to the high complexity of the HDL particle and its functionality. The HDL proteome was determined in newly diagnosed BC classified according to the molecular type [luminal A or B (LA or LB), HER2, and triple-negative (TN)] and clinical stage of the disease. Women (n = 141) aged between 18 and 80 years with BC, treatment-naïve, and healthy women [n = 103; control group (CT)], matched by age and body mass index, were included. Data-independent acquisition (DIA) proteomics was performed in isolated HDL (D = 1.063–1.21 g/mL). Results: Paraoxonase1, carnosine dipeptidase1, immunoglobulin mMu heavy chain constant region (IGHM), apoA-4, and transthyretin were reduced, and serum amyloid A2 and tetranectin were higher in BC compared to CT. In TNBC, apoA-1, apoA-2, apoC-2, and apoC-4 were reduced compared to LA, LB, and HER2, and apoA-4 compared to LA and HER2. ComplementC3, lambda immunoglobulin2/3, serpin3, IGHM, complement9, alpha2 lysine rich-glycoprotein1, and complement4B were higher in TNBC in comparison to all other types; complement factor B and vitamin D-binding protein were in contrast to LA and HER2, and plasminogen compared to LA and LB. In grouped stages III + IV, tetranectin and alpha2-macroglobulin were reduced, and haptoglobin-related protein; lecithin cholesterol acyltransferase, serum amyloid A1, and IGHM were increased compared to stages I + II. Conclusions: A differential proteomic profile of HDL in BC based on tumor molecular classification and the clinical stage of the disease may contribute to a better understanding of the association of HDL with BC pathophysiology, treatment, and outcomes.

Autoimmune rheumatic diseases (ARDs) exhibit an elevated incidence of cardiovascular disease (CVD). The elevation of inflammatory and immune stress accompanying ARDs contributes to atherosclerosis development and alterations in lipid metabolism and lipoprotein profile add to cardiovascular (CV) risk. The plasma concentration of high‐density lipoprotein cholesterol (HDLc) is inversely related to CVD and serves as a discriminator of CV risk. However, this association is not unequivocal, and changes in HDL functionality appear to emerge as a better indicator of CV risk, albeit difficult to measure and monitor clinically. The modulation of HDLc itself can bring benefits in controlling autoimmunity and reducing ARD activity. Understanding HDL function and each peculiarity involved in ARDs enables to seek means to prevent ischemic outcomes associated with CVD, in the face of the residual CV risk persisting even with controlled disease activity and classic risk factors. By comprehending HDL’s structural and functional nuances, it will be possible to develop more effective strategies to manage the evolution and outcomes of ARDs. It is also necessary to standardize diagnostic methods and establish different markers for each specific disease allowing the design of intervention strategies to restore HDL functionality, reduce residual CV, and prevent, alleviate, or even suppress ARD activity.

The expression of inflammation-related miRs bound to high-density lipoproteins (HDLs), the anti-inflammatory activity of HDLs isolated from individuals with breast cancer, and controls were determined. Forty newly diagnosed women with breast cancer naïve of treatment and 10 control participants were included. Cholesterol-loaded bone-marrow-derived macrophages were incubated with HDL from both groups and challenged with lipopolysaccharide (LPS). Interleukin 6 (IL6) and tumor necrosis factor (TNF) in the medium were quantified. The miRs in HDLs were determined by RT-qPCR. Age, body mass index, menopausal status, plasma lipids, and HDL composition were similar between groups. The ability of HDL to inhibit IL6 and TNF production was higher in breast cancer compared to controls, especially in advanced stages of the disease. The miR-223-3p and 375-3p were higher in the HDLs of breast cancer independent of the histological type of the tumor and had a high discriminatory power between breast cancer and controls. The miR-375-3p was greater in the advanced stages of the disease and was inversely correlated with the secretion of inflammatory cytokines. Inflammation-related miRs and the anti-inflammatory role of HDLs may have a significant impact on breast cancer pathophysiology.

Plasma cholesteryl ester transfer protein (CETP) activity diminishes HDL-cholesterol levels and thus may increase atherosclerosis risk. Experimental evidence suggests CETP may also exhibit anti-inflammatory properties, but local tissue-specific functions of CETP have not yet been clarified. Since oxidative stress and inflammation are major features of atherogenesis, we investigated whether CETP modulates macrophage oxidant production, inflammatory and metabolic profiles. Comparing macrophages from CETP-expressing transgenic mice and non-expressing littermates, we observed that CETP expression reduced mitochondrial superoxide anion production and H₂O₂ release, increased maximal mitochondrial respiration rates, and induced elongation of the mitochondrial network and expression of fusion-related genes (mitofusin-2 and OPA1). The expression of pro-inflammatory genes and phagocytic activity were diminished in CETP-expressing macrophages. In addition, CETP-expressing macrophages had less unesterified cholesterol under basal conditions and after exposure to oxidized LDL, as well as increased HDL-mediated cholesterol efflux. CETP knockdown in human THP1 cells increased unesterified cholesterol and abolished the effects on mitofusin-2 and TNFα. In summary, the expression of CETP in macrophages modulates mitochondrial structure and function to promote an intracellular antioxidant state and oxidative metabolism, attenuation of pro-inflammatory gene expression, reduced cholesterol accumulation, and phagocytosis. These localized functions of CETP may be relevant for the prevention of atherosclerosis and other inflammatory diseases.

Advanced glycated albumin (AGE-albumin) impairs cholesterol efflux and contributes to inflammation in macrophages. The current study evaluated: (1) the persistence of the deleterious effect of AGE-albumin in cholesterol efflux and in inflammation, and (2) how metabolic control in diabetes mellitus (DM) contributes to attenuate the deleterious role of AGE-albumin in macrophage cholesterol homeostasis. Methods: AGE-albumin was produced in vitro or isolated from uncontrolled DM subjects’ serum before (bGC) and after improved glycemic control (aGC). Albumin samples were incubated with bone marrow-derived macrophages and ¹⁴C-cholesterol efflux or LPS- induced cytokine secretion were determined immediately, or after cell resting in culture media alone. The ABCA-1 degradation rate was determined after cell incubation with cycloheximide, and ABCA1 protein level by immunoblot. Oil Red O staining was used to assess intracellular lipid accumulation. Results: A persistent effect of AGE-albumin was observed in macrophages in terms of the secretion of inflammatory cytokines and reduced cholesterol efflux. HDL-mediated ¹⁴C-cholesterol efflux was at least two times higher in macrophages treated with aCG-albumin as compared to bGC-albumin, and intracellular lipid content was significantly reduced in aGC-albumin-treated cells. As compared to bGC-albumin, the ABCA-1 protein content in whole cell bulk was 94% higher in aCG-albumin. A 20% increased ABCA-1 decay rate was observed in macrophages treated with albumin from poorly controlled DM. AGE-albumin has a persistent deleterious effect on macrophage lipid homeostasis and inflammation. The reduction of AGEs in albumin ameliorates cholesterol efflux.