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Journal of Lipid Research, Vol. 43, 1275-1282, August 2002 PMA activation of macrophages alters macrophage metabolism of aggregated LDL
Section of Experimental Atherosclerosis, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10, Room 5N-113, 10 Center Drive MSC 1422, Bethesda, MD 20892 DOI 10.1194/jlr.M100436-JLR200
1 To whom correspondence should be addressed. e-mail: kruthh{at}nhlbi.nih.gov
Aggregation of LDL may contribute to its retention in atherosclerotic lesions. Previously, we showed that aggregated LDL induces and enters surface-connected compartments (SCCs) in human monocyte-derived macrophages by a process we have named patocytosis. Aggregated LDL was disaggregated and released from SCCs of macrophages when exposed to human lipoprotein-deficient serum. The serum factor that mediated aggregated LDL release and disaggregation was plasmin generated from plasminogen by macrophage urokinase plasminogen activator. We now show that activation of macrophages with PMA inhibits plasmin-mediated release of aggregated LDL from macrophages. With macrophage activation, plasminogen released about 60% less cholesterol and 63% less TCA-insoluble 125I-aggregated LDL than when macrophages were not activated. Electron microscopy showed that PMA did not cause SCCs to close, which could have trapped aggregated LDL within the SCCs and limited protease access to aggregated LDL. Rather, PMA decreased macrophage generation of plasmin by 61%, and stimulated lysosomal degradation of aggregated LDL by more than 2-fold. Degradation was mediated by protein kinase C, shown by the finding that degradation was inhibited by the protein kinase C inhibitor Gö6976. PMA-stimulated degradation of aggregated LDL was associated with a 3-fold increase in cholesterol esterification, consistent with hydrolysis and re-esterification of aggregated LDL-derived cholesteryl ester. In conclusion, macrophage activation with PMA causes more of the aggregated LDL that enters macrophage SCCs to be metabolized by lysosomes. This results in more cholesterol to be stored in macrophages and less aggregated LDL to be available for plasmin-mediated release from macrophage SCCs.
Abbreviations: AgLDL, aggregated LDL; DPBS, Dulbecco's phosphate-buffered saline; LPDS, lipoprotein-deficient serum; SCC, surface-connected compartment Supplementary key words acyl-CoA:cholesterol acyltransferase atherosclerosis cholesterol endocytosis plasmin low density lipoprotein surface-connected compartments phorbol myristate acetate protein kinase C trichloroacetic acid lysosomes patocytosis
Focal vessel wall retention of plasma-derived LDL contributes to cholesterol buildup in vessel plaques. This leads to atherosclerosis, a disease that represents the response of the vessel wall to retained LDL (1). Evidence suggests that aggregation of LDL may contribute to its retention in developing atherosclerotic lesions. LDL recovered from lesions shows an increased tendency to aggregate, and LDL aggregates have been demonstrated in early developing lesions (24). Many modifications to LDL cause LDL aggregation. These include oxidation of LDL and treatment of LDL with certain lipases that are present within lesions (e.g., sphingomyelinase, phospholipases A2 and C) (57). Simple vortexing of LDL is a convenient way to produce aggregated LDL (AgLDL) for experimental studies (8). Previously, we described an unusual endocytic pathway in macrophages through which AgLDL enters human monocyte-derived macrophages (9). In this pathway, which we call patocytosis, the AgLDL induces and enters surface-connected compartments (SCCs) where the AgLDL is stored. While some of the AgLDL undergoes lysosomal degradation in the macrophages, most of the AgLDL remains undegraded. In recent work, we showed that when macrophages are exposed to plasminogen, the macrophages release the stored AgLDL (10). This is the result of macrophage conversion of plasminogen to plasmin, mediated by macrophage urokinase plasminogen activator. The macrophage-generated plasmin disaggregates the AgLDL, allowing the unattached LDL particles to exit the open SCCs. Macrophage activation influences many aspects of macrophage function and metabolism. In this study, we examined whether activation of macrophages would influence the fate of AgLDL that had entered macrophages by patocytosis and accumulated in SCCs. One commonly used activator of macrophages is the phorbol ester, PMA. Here, we report that PMA activation of human monocyte-macrophages stimulates lysosomal degradation of AgLDL stored in SCCs. This promotes esterification of AgLDL cholesterol. At the same time, by removing AgLDL from SCCs, PMA activation of macrophages inhibits plasmin-mediated release of AgLDL from macrophage SCCs.
Materials Human LDL and human lipoprotein-deficient serum (LPDS) were obtained from Intracel; human 125I-LDL from Biomedical Technologies; [9,10-3H]oleic acid in ethanol from American Radiolabeled Chemicals; bovine lung aprotinin from ICN; human plasminogen and PMA from Calbiochem; human plasmin from American Diagnostica; D-Val-Leu-Lys-AFC plasmin substrate from Enzyme Systems Products; chloroquine, -amino-N-caproic acid, sodium oleate, and fatty acid-free BSA from Sigma; RPMI-1640 medium from Cellgro; pooled human AB, heat-inactivated serum from Pel-Freez; mouse monoclonal anti-cathepsin D (clone C5) from Biogenesis; mouse monoclonal anti-Aspergillus major glucose oxidase (clone DAK-G09) from Dako; Gö6976 and wortmannin from Biomol; polysilica acid gel-impregnated glass fiber sheets from Pall; Plastek C culture plates from MatTek; Lab-Tek chamber slides from Nalge-Nunc; and 20-nm BSA-gold from British Biocell.
Preparation of aggregated LDL
Assays of cell-association and degradation of 125I-AgLDL Cell-associated 125I-AgLDL was determined by rinsing macrophages five times with Dulbecco's phosphate-buffered saline (DPBS) containing Ca2+, Mg2+, and 0.2% BSA (three quick rinses and two 10-min incubations, all on ice). After a final rinse with DPBS plus Ca2+ and Mg2+, macrophages were dissolved overnight in 0.1 N NaOH. Aliquots of NaOH-solubilized cell samples were assayed for 125I radioactivity. Values were subtracted for 125I radioactivity determined for wells incubated with 125I-AgLDL but without macrophages. These values were <1% of the cell-associated 125I-AgLDL.
Assay of cholesterol and protein content of macrophages
Assay of macrophage plasmin activity
Assay of cholesteryl ester synthesis
Electron microscopic analysis of SCCs For assessment of lysosome-to-SCC transfer, macrophages were rinsed and incubated 24 h at 37°C with 250 µl of 20 nm BSA-coated gold particles (1012 particles/ml) to label macrophage lysosomes (18, 19). To prepare the gold particles, 1 ml of BSA-coated gold supplied in water by the manufacturer was dialyzed 16 h at 4°C against 1 l of RPMI-1640 medium. After incubation, macrophages were rinsed three times with RPMI-1640 medium to remove gold not taken up by the macrophages. Then, macrophages were incubated 5 h with 200 µg/ml AgLDL to induce AgLDL-containing SCCs. Macrophages were rinsed again, and incubated 24 h in RPMI-1640 medium plus 0.35% BSA without or with 0.1 µg/ml PMA. Following this incubation, the macrophage cultures were processed for electron microscopy as described above. In addition, immunolabeling of the lysosomal marker, cathepsin D, was carried out as described previously (17) to determine whether PMA stimulated transfer of this soluble lysosomal enzyme to SCCs. In this case, macrophages were incubated with AgLDL as described above but without the preincubation of macrophages with gold particles.
Statistical analysis
PMA inhibited plasminogen-mediated release of AgLDL from macrophages We recently showed that macrophage conversion of serum plasminogen to the active serine-protease, plasmin, causes release of AgLDL from macrophage SCCs (10). In addition, the released AgLDL is substantially disaggregated by the macrophage-generated plasmin. Here we examined what would happen if macrophages with SCCs containing AgLDL were exposed to serum plasminogen and at the same time were activated with PMA. As shown previously, plasminogen, either as a purified protein or as a natural component of LPDS, caused release of AgLDL cholesterol from macrophage SCCs (10). However, PMA treatment of macrophages decreased LPDS- and plasminogen-induced release of AgLDL cholesterol from macrophage SCCs by 57% and 60%, respectively (Fig. 1A) . PMA also reduced by 63% LPDS-induced release of TCA-insoluble 125I-AgLDL (i.e., undegraded 125I-AgLDL) (Fig. 1B).
The mechanism of the PMA decrease in plasminogen-induced release of AgLDL from macrophage SCCs was investigated. It is possible that PMA-activated macrophages generated less plasmin than did unstimulated macrophages. This was the case as PMA decreased by 61% the amount of plasmin associated with macrophage plasma membranes (566 ± 68 ng plasmin/mg cell protein without PMA and 222 ± 3 ng plasmin/mg cell protein with PMA). However, PMA inhibition of plasminogen-induced AgLDL release was not only due to a decrease in plasmin activity. This was shown by the observation that PMA also inhibited trypsin-induced release of AgLDL from macrophages. Immediately following a 1-h PMA treatment, trypsin-induced AgLDL cholesterol release from macrophages was reduced by 32% compared with AgLDL cholesterol release induced by trypsin without PMA treatment (Table 1). However, 24 h following PMA treatment, trypsin-induced release of AgLDL cholesterol was completely inhibited. Thus, after sufficient time, even an exogenously supplied active protease could not cause release of AgLDL from SCCs.
This finding suggested that protease no longer was accessible to the AgLDL within macrophages. This could have occurred by two mechanisms. First, PMA could have caused macrophage SCCs to close and lose their connection to the extracellular space. However, this was not the case. Electron microscopic analysis of SCCs in macrophages following incubation with PMA showed that PMA treatment did not significantly change the number of macrophages with SCCs (62 ± 5% of macrophages showed SCCs with PMA treatment and 52 ± 6% of macrophages showed SCCs without PMA treatment). Second, SCCs could have remained open but the AgLDL they contained could have been transferred from the open SCCs into the macrophage cytoplasm as discussed below.
PMA stimulated degradation of AgLDL
PMA-stimulated degradation of cell-associated 125I-AgLDL contributed to the decreased plasminogen-induced release of 125I-AgLDL from PMA-activated macrophages. Exposure of macrophages to LPDS or LPDS with PMA caused similar decreases in cell-associated 125I-AgLDL (70.5 ±1.8 µg/mg cell protein decreased to 11.4 ± 0.9 µg/mg cell protein with LPDS and to 12.4 ± 0.6 µg/mg cell protein with LPDS containing PMA). However, LPDS released 43.0 ± 3.7 µg/mg cell protein of TCA-insoluble 125I-AgLDL into the medium (i.e., undegraded 125I-AgLDL), while LPDS + PMA released only 27.5 ± 2.0 µg/mg cell protein of TCA-insoluble 125I-AgLDL into the medium. Simultaneously, addition of PMA to LPDS increased degradation of 125I-AgLDL (i.e., TCA-soluble 125I-AgLDL) by an amount equivalent to the amount that PMA decreased LPDS-induced release of TCA-insoluble 125I-AgLDL into the medium (Table 2).
PMA did not stimulate transfer of lysosomal contents into SCCs Given that PMA stimulated lysosomal-mediated degradation of AgLDL, we next sought to determine where this degradation occurred in SCCs or lysosomes. To investigate this point, we examined whether lysosomal contents were delivered to SCCs, and if so, whether PMA stimulated lysosome-to-SCC transfer. Previously, we showed the absence of cathepsin D, a soluble lysosomal enzyme, in SCCs (17). Here, we observed that PMA did not cause the appearance of this lysosomal marker in SCCs (data not shown). However, a soluble lysosomal enzyme transferred from lysosomes to SCCs might diffuse out of the open SCCs. Thus, we examined whether a much larger lysosomal marker, gold particles accumulated within lysosomes, showed evidence of transfer to SCCs. This was done by pre-loading macrophage lysosomes with gold, then inducing macrophage SCCs with AgLDL, and finally exposing macrophages to PMA. Although lysosomes were heavily labeled with gold, no gold transferred to SCCs during post-incubation of macrophages without or with PMA (Fig. 5) .
PMA stimulation of AgLDL degradation also stimulated cholesterol esterification Macrophages were incubated with 200 µg/ml AgLDL for 5 h, rinsed, and then incubated 24 h without and with PMA in the presence of [3H]oleate to determine the synthesis of cholesteryl [3H]oleate. PMA stimulated cholesteryl [3H]oleate synthesis 3.2-fold with 38 ± 6 nmoles cholesteryl [3H]oleate/mg cell protein synthesized without PMA and 122 ± 6 nmoles cholesteryl [3H]oleate/mg cell protein synthesized with PMA.
We have shown that macrophage activation with PMA affects how macrophages metabolize AgLDL. Macrophage activation causes an increase in degradation of AgLDL contained in macrophage SCCs. Previously, we showed that AgLDL in these SCCs could be released from the macrophage in a disaggregated state when macrophages were exposed to plasminogen (10). The macrophages convert plasminogen to the active serine protease plasmin, which is sufficient to cause the release and disaggregation of AgLDL through limited proteolysis of the AgLDL. Disaggregation of AgLDL may promote removal of LDL from atherosclerotic lesions, because efflux of lipoproteins from atherosclerotic lesions is inversely proportional to their size (20). However, the lipid core of atherosclerotic lesions is filled with cholesteryl ester-rich lipid particles that resemble the disaggregated lipid particles released from macrophages (21, 22). Thus, the rate of removal of these particles from the lipid core is not sufficient to prevent them from accumulating. PMA activation of macrophages inhibited plasminogen-stimulated release of aggregated LDL from macrophages in part by decreasing macrophage generation of plasmin. Simultaneously, PMA stimulated lysosomal degradation of AgLDL. Lysosomal degradation of LDL leads to storage of LDL cholesterol in lipid droplets (23), a process often considered to promote retention of cholesterol in atherosclerotic plaques. However, it is possible that storage of cholesterol within macrophages facilitates cholesterol removal from atherosclerotic plaques. This is because macrophages can excrete this cholesterol in discoidal particles produced by the macrophages when either macrophage-produced apolipoprotein E (apoE) or exogenously supplied amphipathic HDL apolipoproteins (e.g., apoA-I) complex with macrophage-derived phospholipid (11, 24, 25). In this regard, activation of protein kinase C stimulates cholesterol efflux from human skin fibroblasts, rat vascular smooth muscle cells, and mouse peritoneal macrophages induced by exogenously supplied apoA-I (2628), but does not stimulate cholesterol efflux from the human monocyte THP-1 cell line (29). Not only do macrophages repackage their stored cholesterol for excretion, macrophages also can directly transport their accumulated cholesterol out of plaques when macrophage foam cells emigrate from plaques (30). Thus, it is not clear whether it is better for macrophage processing of AgLDL to result in release of disaggregated LDL into the extracellular space, or retention of AgLDL-derived cholesterol within macrophages stored in lipid droplets. Besides variably affecting macrophage cholesterol efflux, PMA also variably affects other aspects of macrophage metabolism of lipoproteins and cholesterol, depending on the particular macrophage model being studied. For example, PMA decreases the number of cell-surface receptors for and uptake of acetyl-LDL by mouse resident peritoneal macrophages (31), but increases scavenger receptor concentration in U937 human macrophages (32). PMA increases cholesterol esterification in the presence of exogenously supplied oleic acid in IC-21 mouse macrophages (33), but does not stimulate cholesterol esterification in THP-1 human macrophages (34). In the current study, PMA stimulated cholesterol esterification, probably because of increased availability of cholesterol substrate for the ACAT enzyme secondary to the PMA-induced increase in AgLDL degradation. Chloroquine inhibition of PMA-stimulated AgLDL degradation suggests that degradation depended on lysosomal function. The increased degradation of AgLDL that had accumulated in macrophage SCCs could have occurred either in the SCCs following transfer of lysosomal enzymes to the SCCs, or after transfer of AgLDL from SCCs to lysosomes. We conclude that the latter occurred because no transfer of lysosomal contents (i.e., cathepsin D or gold particles) to SCCs occurred without or with PMA treatment of macrophages. Although we did not observe transfer of AgLDL to lysosomes by electron microscopy, wortmannin, a phosphoinositide 3-kinase inhibitor, decreased PMA-stimulated degradation of AgLDL. Wortmannin has been shown to inhibit both macropinocytosis and phagocytosis in macrophages, suggesting that transfer of AgLDL from SCCs to lysosomes may involve one of these two endocytic processes (35). Both processes mediate uptake of large particles through formation of vacuoles. If vacuoles form by pinching off from SCC membranes, they could accommodate the large size of AgLDL and transport the AgLDL to lysosomes. However, because vacuole formation was not observed by electron microscopy, possibly AgLDL transfers from SCCs to lysosomes during transient connection of these two compartments. Human monocyte-macrophages incubated with AgLDL have recently been shown to have an extensive array of tubules that show connections with spherical lysosomal-like structures (36). Although we observed that PMA stimulated accumulation of similar tubules in our experiments (unpublished data), a role for these tubules in transport of AgLDL to lysosomes remains to be shown. In conclusion, PMA activation of human monocyte-macrophages alters how they metabolize AgLDL. Without this activation, most AgLDL remains within macrophage SCCs, with only a small amount of AgLDL undergoing lysosomal degradation. In this case, the macrophages can disaggregate and release AgLDL from these compartments when the macrophages encounter plasminogen and convert this plasminogen to plasmin. On the other hand, PMA activation of macrophages increases lysosomal degradation of AgLDL. This releases cholesterol from the degraded AgLDL that is then available to be esterified and stored in macrophage lipid droplets. At the same time, lysosomal degradation of AgLDL that was previously stored in macrophage SCCs means that less AgLDL is available for disaggregation and release when macrophages are exposed to plasminogen. It remains to be determined whether it is better for AgLDL to be degraded, its cholesterol stored in macrophage lipid droplets, or to be disaggregated and its cholesterol released as partially degraded LDL particles into the extracellular space.
The authors thank Janet Chang and Rani Rao for help in carrying out experiments; Carol Kosh and Kim Sanders for help in preparation of the manuscript; and the Department of Transfusion Medicine, Clinical Center, National Institutes of Health, for carrying out monocytopheresis. Manuscript received December 21, 2001 and in revised form April 19, 2002 .
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