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Blood, 15 May 2004, Vol. 103, No. 10, pp. 3777-3782.
Prepublished online as a Blood First Edition Paper on January 22, 2004February 5, 2004; DOI 10.1182/blood-2003-11-4051.

Submitted December 1, 2003
Accepted January 12, 2004
Hepatic Low-Density Lipoprotein Receptor-Related Protein Deficiency in Mice Increases Atherosclerosis Independent of Plasma Cholesterol
Sonia M Espirito Santo, Nuno M Pires, Lianne S Boesten, Gery Gerritsen, Niels Bovenschen, Ko Willems van Dijk, J W Jukema, Hans M Princen, Andre Bensadoun, Wei-Ping Li, Joachim Herz, Louis M Havekes, and Bart J van Vlijmen*
Biomedical Research, TNO-Prevention and Health, Leiden, The Netherlands; Cardiology, Leiden University Medical Center, Leiden, The Netherlands
Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
Biomedical Research, TNO-Prevention and Health, Leiden, The Netherlands; Plasma proteins, Sanquin Research at CLB, Amsterdam, The Netherlands
Human Genetics, Leiden University Medical Center, Leiden, The Netherlands; General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
Cardiology, Leiden University Medical Center, Leiden, The Netherlands
Biomedical Research, TNO-Prevention and Health, Leiden, The Netherlands
Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX, USA
Biomedical Research, TNO-Prevention and Health, Leiden, The Netherlands; Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Plasma proteins, Sanquin Research at CLB, Amsterdam, The Netherlands
* Corresponding author; email: bjm.vanvlijmen{at}pg.tno.nl.
The low-density lipoprotein (LDL) receptor-related protein (LRP) has a well-established role in the hepatic removal of atherogenic apolipoprotein (APO) E-rich remnant lipoproteins from plasma. In addition, LRP recognizes multiple distinct pro- and anti-atherogenic ligands in vitro. Here, we investigated the role of hepatic LRP in atherogenesis independent of its role in removal of APOE-rich remnant lipoproteins. Mice that allow inducible inactivation of hepatic LRP were combined with LDL receptor and APOE double deficient mice (MX1Cre+LRPflox/floxLDLR-/-APOE-/-). On a LDLR-/-APOE-/- background, hepatic LRP deficiency resulted in decreased plasma cholesterol and triglycerides (cholesterol: 17.1±5.2 vs. 23.4±6.3 mM, P=0.025; triglycerides: 1.1±0.5 vs. 2.2±0.8 mM, P=0.002; for MX1Cre+LRPflox/floxLDLR-/-APOE-/- and control LRPflox/floxLDLR-/-APOE-/- mice, respectively). Lower plasma cholesterol in MX1Cre+LRPflox/floxLDLR-/-APOE-/- mice coincided with increased plasma lipoprotein lipase (71.2±7.5 vs. 19.1±2.4 ng/ml, P=0.002), coagulation factor VIII (4.4±1.1 vs. 1.9±0.5 U/mL, P=0.001), von Willebrand factor (2.8±0.6 vs. 1.4±0.3 U/mL, P=0.001), and tissue-type plasminogen activator (1.7±0.7 vs. 0.9±0.5 ng/ml, P=0.008) as compared to controls. Strikingly, MX1Cre+LRPflox/floxLDLR-/-APOE-/- mice showed a 2-fold higher atherosclerotic lesion area as compared to controls (408.5±115.1 vs. 219.1±86.0 103µm2, P=0.003). Our data indicate that hepatic LRP plays a clear protective role in atherogenesis independent of plasma cholesterol, possibly due to maintaining low levels of its pro-atherogenic ligands.

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