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Prepublished online as a Blood First Edition Paper on December 27, 2002; DOI 10.1182/blood-2002-08-2606.

Submitted August 26, 2002
Accepted December 17, 2002
Hyperhomocysteinemia accelerates atherosclerosis in cystathionine -synthase and apolipoprotein E double knockout mice with and without dietary perturbation
Hong Wang*, XiaoHua Jiang, Fan Yang, John W Gaubatz, Lang Ma, Mark J Magera, XiaoFeng Yang, Peter B Berger, William Durante, Henry J Pownall, and Andrew I Schafer
Department of Medicine, Baylor College of Medicine, Houston, TX, USA
Department of Pharmacology, Baylor College of Medicine, Houston, TX, USA
Department of Pathology, Baylor College of Medicine, Houston, TX, USA
VA Medical Center, Houston, TX, USA
Mayo Clinic, Rochester, MN, USA
* Corresponding author; email: hongw{at}bcm.tmc.edu.
Although hyperhomocysteinemia is as an independent risk factor for cardiovascular disease, a direct role for homocysteine (Hcy) in this disease remains to be shown. Whereas diet-induced hyperhomocysteinemia promotes atherosclerosis in animal models, the effects of Hcy on atherogenesis in the absence of dietary perturbations is not known. We have generated double knockout mice with targeted deletions of the genes for apolipoprotein E (apoE) and cystathionine -synthase (CBS), which converts Hcy to cystathionine. ApoE-/-/CBS-/- mice developed aortic lesions even in the absence of dietary manipulation; lesion area and lesion cholesteryl ester (CE) and triglyceride (TG) contents increased with animal age and plasma Hcy levels. Plasma total cholesterol was significantly increased, whereas, HDL-cholesterol and TG concentrations of apoE-/-/CBS-/- mice were decreased. Cholesterol esterification and activities of enzymes catalyzing CE or TG formation in the vessel wall and in peritoneal macrophages were not changed by hyperhomocysteinemia. However, uptake of human acetyl-LDL, but not native-LDL, by mouse peritoneal macrophages was higher in the presence of hyperhomocysteinemia. These results suggest that isolated hyperhomocysteinemia is atherogenic, and alters hepatic and macrophage lipoprotein metabolism, in part, by enhancing uptake of modified-LDL.

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