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. 1994 Jul;94(1):155–164. doi: 10.1172/JCI117301

Inhibition of hypercholesterolemia-induced atherosclerosis in the nonhuman primate by probucol. I. Is the extent of atherosclerosis related to resistance of LDL to oxidation?

M Sasahara 1, E W Raines 1, A Chait 1, T E Carew 1, D Steinberg 1, P W Wahl 1, R Ross 1
PMCID: PMC296293  PMID: 8040256

Abstract

Lipoprotein oxidation is believed to play an important role in atherogenesis. To investigate whether inhibition of oxidation of low density lipoprotein (LDL) would alter atherogenesis in the nonhuman primate, we administered probucol, a potent antioxidant, to Macaca nemestrina fed a high-fat, high-cholesterol diet. Probucol was administered to half of the 16 monkeys 14 wk after starting the hypercholesterolemic diet, and was given daily until they were sacrificed after 11 mos. To evaluate the antioxidant effect of probucol, the resistance of isolated plasma LDL to in vitro oxidation was evaluated. Probucol significantly increased the resistance of LDL to oxidative modification, as shown by an increase in the lag time required for conjugated diene formation. Lesions in the probucol-treated animals appeared less mature, and increased accumulation of lipid was observed in smooth muscle cells. Comparison of all control and probucol-treated monkeys demonstrated that intimal lesion areas in the thoracic aortas of the probucol-treated monkeys were reduced by 43% (P < 0.0001), but no significant difference in lesion area was found in the abdominal aortas or in the iliac arteries. However, the lag phase of conjugated diene formation was not prolonged in 2 of the 8 probucol-treated animals. A plot of intimal lesion size versus lag phase of all 16 animals showed a trend that lesion size was inversely related to oxidation resistance for all anatomic sites. The strong inverse relationship between intimal lesion size and resistance of LDL to oxidation supports a role for lipoprotein oxidation in the development and progression of lesions of atherosclerosis. The possibility that some of the effect is due to other biological properties of probucol cannot be ruled out.

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Selected References

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  1. Barth J. D., Arntzenius A. C. Progression and regression of atherosclerosis, what roles for LDL-cholesterol and HDL-cholesterol: a perspective. Eur Heart J. 1991 Aug;12(8):952–957. doi: 10.1093/eurheartj/12.8.952. [DOI] [PubMed] [Google Scholar]
  2. Björkhem I., Henriksson-Freyschuss A., Breuer O., Diczfalusy U., Berglund L., Henriksson P. The antioxidant butylated hydroxytoluene protects against atherosclerosis. Arterioscler Thromb. 1991 Jan-Feb;11(1):15–22. doi: 10.1161/01.atv.11.1.15. [DOI] [PubMed] [Google Scholar]
  3. Brown M. S., Goldstein J. L. Lipoprotein metabolism in the macrophage: implications for cholesterol deposition in atherosclerosis. Annu Rev Biochem. 1983;52:223–261. doi: 10.1146/annurev.bi.52.070183.001255. [DOI] [PubMed] [Google Scholar]
  4. Buckley M. M., Goa K. L., Price A. H., Brogden R. N. Probucol. A reappraisal of its pharmacological properties and therapeutic use in hypercholesterolaemia. Drugs. 1989 Jun;37(6):761–800. doi: 10.2165/00003495-198937060-00002. [DOI] [PubMed] [Google Scholar]
  5. Carew T. E., Schwenke D. C., Steinberg D. Antiatherogenic effect of probucol unrelated to its hypocholesterolemic effect: evidence that antioxidants in vivo can selectively inhibit low density lipoprotein degradation in macrophage-rich fatty streaks and slow the progression of atherosclerosis in the Watanabe heritable hyperlipidemic rabbit. Proc Natl Acad Sci U S A. 1987 Nov;84(21):7725–7729. doi: 10.1073/pnas.84.21.7725. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Chait A., Brazg R. L., Tribble D. L., Krauss R. M. Susceptibility of small, dense, low-density lipoproteins to oxidative modification in subjects with the atherogenic lipoprotein phenotype, pattern B. Am J Med. 1993 Apr;94(4):350–356. doi: 10.1016/0002-9343(93)90144-e. [DOI] [PubMed] [Google Scholar]
  7. Chung B. H., Wilkinson T., Geer J. C., Segrest J. P. Preparative and quantitative isolation of plasma lipoproteins: rapid, single discontinuous density gradient ultracentrifugation in a vertical rotor. J Lipid Res. 1980 Mar;21(3):284–291. [PubMed] [Google Scholar]
  8. Daugherty A., Zweifel B. S., Schonfeld G. Probucol attenuates the development of aortic atherosclerosis in cholesterol-fed rabbits. Br J Pharmacol. 1989 Oct;98(2):612–618. doi: 10.1111/j.1476-5381.1989.tb12635.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Esterbauer H., Striegl G., Puhl H., Rotheneder M. Continuous monitoring of in vitro oxidation of human low density lipoprotein. Free Radic Res Commun. 1989;6(1):67–75. doi: 10.3109/10715768909073429. [DOI] [PubMed] [Google Scholar]
  10. Faggiotto A., Ross R., Harker L. Studies of hypercholesterolemia in the nonhuman primate. I. Changes that lead to fatty streak formation. Arteriosclerosis. 1984 Jul-Aug;4(4):323–340. doi: 10.1161/01.atv.4.4.323. [DOI] [PubMed] [Google Scholar]
  11. Faggiotto A., Ross R. Studies of hypercholesterolemia in the nonhuman primate. II. Fatty streak conversion to fibrous plaque. Arteriosclerosis. 1984 Jul-Aug;4(4):341–356. doi: 10.1161/01.atv.4.4.341. [DOI] [PubMed] [Google Scholar]
  12. HAVEL R. J., EDER H. A., BRAGDON J. H. The distribution and chemical composition of ultracentrifugally separated lipoproteins in human serum. J Clin Invest. 1955 Sep;34(9):1345–1353. doi: 10.1172/JCI103182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Heinecke J. W., Rosen H., Suzuki L. A., Chait A. The role of sulfur-containing amino acids in superoxide production and modification of low density lipoprotein by arterial smooth muscle cells. J Biol Chem. 1987 Jul 25;262(21):10098–10103. [PubMed] [Google Scholar]
  14. Henriksen T., Mahoney E. M., Steinberg D. Enhanced macrophage degradation of biologically modified low density lipoprotein. Arteriosclerosis. 1983 Mar-Apr;3(2):149–159. doi: 10.1161/01.atv.3.2.149. [DOI] [PubMed] [Google Scholar]
  15. Kita T., Nagano Y., Yokode M., Ishii K., Kume N., Ooshima A., Yoshida H., Kawai C. Probucol prevents the progression of atherosclerosis in Watanabe heritable hyperlipidemic rabbit, an animal model for familial hypercholesterolemia. Proc Natl Acad Sci U S A. 1987 Aug;84(16):5928–5931. doi: 10.1073/pnas.84.16.5928. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Kodama T., Freeman M., Rohrer L., Zabrecky J., Matsudaira P., Krieger M. Type I macrophage scavenger receptor contains alpha-helical and collagen-like coiled coils. Nature. 1990 Feb 8;343(6258):531–535. doi: 10.1038/343531a0. [DOI] [PubMed] [Google Scholar]
  17. Ku G., Doherty N. S., Wolos J. A., Jackson R. L. Inhibition by probucol of interleukin 1 secretion and its implication in atherosclerosis. Am J Cardiol. 1988 Jul 25;62(3):77B–81B. doi: 10.1016/s0002-9149(88)80057-2. [DOI] [PubMed] [Google Scholar]
  18. Lock D. R., Kuisk I., Gonen B., Patsch W., Schonfeld G. Effect of probucol on the composition of lipoproteins and on VLDL apoprotein B turnover. Atherosclerosis. 1983 Jun;47(3):271–278. doi: 10.1016/0021-9150(83)90058-8. [DOI] [PubMed] [Google Scholar]
  19. Marcel Y. L., McPherson R., Hogue M., Czarnecka H., Zawadzki Z., Weech P. K., Whitlock M. E., Tall A. R., Milne R. W. Distribution and concentration of cholesteryl ester transfer protein in plasma of normolipemic subjects. J Clin Invest. 1990 Jan;85(1):10–17. doi: 10.1172/JCI114397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Masuda J., Ross R. Atherogenesis during low level hypercholesterolemia in the nonhuman primate. I. Fatty streak formation. Arteriosclerosis. 1990 Mar-Apr;10(2):164–177. doi: 10.1161/01.atv.10.2.164. [DOI] [PubMed] [Google Scholar]
  21. Masuda J., Ross R. Atherogenesis during low level hypercholesterolemia in the nonhuman primate. II. Fatty streak conversion to fibrous plaque. Arteriosclerosis. 1990 Mar-Apr;10(2):178–187. doi: 10.1161/01.atv.10.2.178. [DOI] [PubMed] [Google Scholar]
  22. Morel D. W., DiCorleto P. E., Chisolm G. M. Modulation of endotoxin-induced endothelial cell toxicity by low density lipoprotein. Lab Invest. 1986 Oct;55(4):419–426. [PubMed] [Google Scholar]
  23. Nagano Y., Nakamura T., Matsuzawa Y., Cho M., Ueda Y., Kita T. Probucol and atherosclerosis in the Watanabe heritable hyperlipidemic rabbit--long-term antiatherogenic effect and effects on established plaques. Atherosclerosis. 1992 Feb;92(2-3):131–140. doi: 10.1016/0021-9150(92)90272-i. [DOI] [PubMed] [Google Scholar]
  24. Nakamura T., Ueyama Y., Funahashi T., Yamashita S., Takemura K. K., Kubo M., Yamada K., Matsuzawa Y. Non-macrophage-related accumulation of cholesterol during probucol treatment in familial hypercholesterolemia: report of two cases. Atherosclerosis. 1992 Feb;92(2-3):193–202. doi: 10.1016/0021-9150(92)90278-o. [DOI] [PubMed] [Google Scholar]
  25. O'Brien K., Nagano Y., Gown A., Kita T., Chait A. Probucol treatment affects the cellular composition but not anti-oxidized low density lipoprotein immunoreactivity of plaques from Watanabe heritable hyperlipidemic rabbits. Arterioscler Thromb. 1991 May-Jun;11(3):751–759. doi: 10.1161/01.atv.11.3.751. [DOI] [PubMed] [Google Scholar]
  26. Parthasarathy S. Evidence for an additional intracellular site of action of probucol in the prevention of oxidative modification of low density lipoprotein. Use of a new water-soluble probucol derivative. J Clin Invest. 1992 May;89(5):1618–1621. doi: 10.1172/JCI115757. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Parthasarathy S., Young S. G., Witztum J. L., Pittman R. C., Steinberg D. Probucol inhibits oxidative modification of low density lipoprotein. J Clin Invest. 1986 Feb;77(2):641–644. doi: 10.1172/JCI112349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Pittman R. C., Carew T. E., Glass C. K., Green S. R., Taylor C. A., Jr, Attie A. D. A radioiodinated, intracellularly trapped ligand for determining the sites of plasma protein degradation in vivo. Biochem J. 1983 Jun 15;212(3):791–800. doi: 10.1042/bj2120791. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Pittman R. C., Taylor C. A., Jr Methods for assessment of tissue sites of lipoprotein degradation. Methods Enzymol. 1986;129:612–628. doi: 10.1016/0076-6879(86)29094-1. [DOI] [PubMed] [Google Scholar]
  30. Quinn M. T., Parthasarathy S., Fong L. G., Steinberg D. Oxidatively modified low density lipoproteins: a potential role in recruitment and retention of monocyte/macrophages during atherogenesis. Proc Natl Acad Sci U S A. 1987 May;84(9):2995–2998. doi: 10.1073/pnas.84.9.2995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Reaven P. D., Parthasarathy S., Beltz W. F., Witztum J. L. Effect of probucol dosage on plasma lipid and lipoprotein levels and on protection of low density lipoprotein against in vitro oxidation in humans. Arterioscler Thromb. 1992 Mar;12(3):318–324. doi: 10.1161/01.atv.12.3.318. [DOI] [PubMed] [Google Scholar]
  32. Regnström J., Walldius G., Carlson L. A., Nilsson J. Effect of probucol treatment on the susceptibility of low density lipoprotein isolated from hypercholesterolemic patients to become oxidatively modified in vitro. Atherosclerosis. 1990 May;82(1-2):43–51. doi: 10.1016/0021-9150(90)90142-6. [DOI] [PubMed] [Google Scholar]
  33. Ross R. The pathogenesis of atherosclerosis--an update. N Engl J Med. 1986 Feb 20;314(8):488–500. doi: 10.1056/NEJM198602203140806. [DOI] [PubMed] [Google Scholar]
  34. Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature. 1993 Apr 29;362(6423):801–809. doi: 10.1038/362801a0. [DOI] [PubMed] [Google Scholar]
  35. Schwenke D. C., Carew T. E. Initiation of atherosclerotic lesions in cholesterol-fed rabbits. I. Focal increases in arterial LDL concentration precede development of fatty streak lesions. Arteriosclerosis. 1989 Nov-Dec;9(6):895–907. doi: 10.1161/01.atv.9.6.895. [DOI] [PubMed] [Google Scholar]
  36. Sirtori C. R., Sirtori M., Calabresi L., Franceschini G. Changes in high-density lipoprotein subfraction distribution and increased cholesteryl ester transfer after probucol. Am J Cardiol. 1988 Jul 25;62(3):73B–76B. doi: 10.1016/s0002-9149(88)80056-0. [DOI] [PubMed] [Google Scholar]
  37. Sparrow C. P., Doebber T. W., Olszewski J., Wu M. S., Ventre J., Stevens K. A., Chao Y. S. Low density lipoprotein is protected from oxidation and the progression of atherosclerosis is slowed in cholesterol-fed rabbits by the antioxidant N,N'-diphenyl-phenylenediamine. J Clin Invest. 1992 Jun;89(6):1885–1891. doi: 10.1172/JCI115793. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Stein Y., Stein O., Delplanque B., Fesmire J. D., Lee D. M., Alaupovic P. Lack of effect of probucol on atheroma formation in cholesterol-fed rabbits kept at comparable plasma cholesterol levels. Atherosclerosis. 1989 Feb;75(2-3):145–155. doi: 10.1016/0021-9150(89)90171-8. [DOI] [PubMed] [Google Scholar]
  39. Steinberg D., Parthasarathy S., Carew T. E., Khoo J. C., Witztum J. L. Beyond cholesterol. Modifications of low-density lipoprotein that increase its atherogenicity. N Engl J Med. 1989 Apr 6;320(14):915–924. doi: 10.1056/NEJM198904063201407. [DOI] [PubMed] [Google Scholar]
  40. Steinbrecher U. P., Parthasarathy S., Leake D. S., Witztum J. L., Steinberg D. Modification of low density lipoprotein by endothelial cells involves lipid peroxidation and degradation of low density lipoprotein phospholipids. Proc Natl Acad Sci U S A. 1984 Jun;81(12):3883–3887. doi: 10.1073/pnas.81.12.3883. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Verlangieri A. J., Bush M. J. Effects of d-alpha-tocopherol supplementation on experimentally induced primate atherosclerosis. J Am Coll Nutr. 1992 Apr;11(2):131–138. [PubMed] [Google Scholar]
  42. Warnick G. R. Enzymatic methods for quantification of lipoprotein lipids. Methods Enzymol. 1986;129:101–123. doi: 10.1016/0076-6879(86)29064-3. [DOI] [PubMed] [Google Scholar]
  43. Wetterau J. R., Combs K. A., Albers H. W., Lamkin G., Stein E. A., Barnhart R. L., Chi E. M., Jackson R. L., Harmony J. A. Effects of probucol on plasma lipids, lipoproteins and parameters of high density lipoprotein metabolism. Horm Metab Res. 1992 Jun;24(6):289–296. doi: 10.1055/s-2007-1003315. [DOI] [PubMed] [Google Scholar]
  44. Wissler R. W., Vesselinovitch D. Combined effects of cholestyramine and probucol on regression of atherosclerosis in rhesus monkey aortas. Appl Pathol. 1983;1(2):89–96. [PubMed] [Google Scholar]
  45. Witztum J. L., Steinberg D. Role of oxidized low density lipoprotein in atherogenesis. J Clin Invest. 1991 Dec;88(6):1785–1792. doi: 10.1172/JCI115499. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Ylä-Herttuala S., Rosenfeld M. E., Parthasarathy S., Sigal E., Särkioja T., Witztum J. L., Steinberg D. Gene expression in macrophage-rich human atherosclerotic lesions. 15-lipoxygenase and acetyl low density lipoprotein receptor messenger RNA colocalize with oxidation specific lipid-protein adducts. J Clin Invest. 1991 Apr;87(4):1146–1152. doi: 10.1172/JCI115111. [DOI] [PMC free article] [PubMed] [Google Scholar]

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