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Journal of Lipid Research, Vol. 49, 1364-1371, June 2008
Lipoprotein separation in a novel iodixanol density gradient, for composition, density, and phenotype analysis
Section of Endocrinology and Metabolic Medicine, Faculty of Medicine, Imperial College London, St Mary's Hospital, London W2 1NY, United Kingdom This research was supported by a grant from GlaxoSmithKline. Published, JLR Papers in Press, March 12, 2008.
1 To whom correspondence should be addressed. e-mail: m.yee{at}imperial.ac.uk
Separation of lipoproteins by traditional sequential salt density floatation is a prolonged process ( 72 h) with variable recovery, whereas iodixanol-based, self-generating density gradients provide a rapid ( 4 h) alternative. A novel, three-layered iodixanol gradient was evaluated for its ability to separate lipoprotein fractions in 63 subjects with varying degrees of dyslipidemia. Lipoprotein cholesterol, triglycerides, and apolipoproteins were measured in 21 successive iodixanol density fractions. Iodixanol fractionation was compared with sequential floatation ultracentrifugation. Iodixanol gradient formation showed a coefficient of variation of 0.29% and total lipid recovery from the gradient of 95.4% for cholesterol and 84.7% for triglyceride. Recoveries for VLDL-, LDL-, and HDL-cholesterol, triglycerides, and apolipoproteins were approximately 10% higher with iodixanol compared with sequential floatation. The iodixanol gradient effectively discriminated classic lipoproteins and their subfractions, and there was evidence for improved resolution of lipoproteins with the iodixanol gradient. LDL particles subfractionated by the gradient showed good correlation between density and particle size with small, dense LDL (<25.5 nm) separated in fractions with density >1.028 g/dl. The new iodixanol density gradient enabled rapid separation with improved resolution and recovery of all lipoproteins and their subfractions, providing important information with regard to LDL phenotype from a single centrifugation step with minimal in-vitro modification of lipoproteins.
Supplementary key words ultracentrifugation apolipoprotein B very low density lipoprotein low density lipoprotein high density lipoprotein lipoprotein (a) Abbreviations: ApoA-I, apolipoprotein A-I; HMW, high molecular weight; IDGU, iodixanol density gradient ultracentrifugation; SFU, sequential floatation ultracentrifugation; TBE, Tris borate EDTA
The use of iodixanol for density gradient ultracentrifugation for isolation of lipoproteins was first described by Dr. John Graham (1–3). Iodixanol density gradient ultracentrifugation (IDGU) is a rapid method of separating lipoproteins and, unlike conventional sequential floatation ultracentrifugation (SFU) (4) or salt gradient systems (5), does not require prolonged ultracentrifugation time, salt density adjustment, or dialysis. We have developed a new three-layered gradient using iodixanol, which can be used for preparative and analytical work and, when compared with published two-layered iodixanol gradients, has the advantages of improved resolution of lipoproteins and their separation from plasma proteins as well as ability to subfractionate individual lipoprotein density classes. We describe the separation of plasma using both the IDGU and SFU methods and demonstrate the ability of the iodixanol gradient technique to provide additional useful information about lipoprotein distribution and composition and hence phenotype from a single ultracentrifugation step.
Materials Sixty percent iodixanol solution (OptiprepTM) was supplied by Axis-Shield (Oslo, Kimbolton, UK). The 13 g x 89 mm Luer lock syringe-filling cannula was from Holborn Surgical and Medical Instruments, Ltd (Margate, UK). Cholesterol H (L-type), triglyceride (L-type), phospholipid B, free cholesterol C, apolipoprotein A1-HA, and apolipoprotein B-HA assays, and lipid calibrator, triglyceride, and free cholesterol and phospholipids standards were supplied by Wako (Alpha Laboratories, Neuss, Germany). Lp(a), albumin, and total protein were measured routinely by the Chemical Pathology Department of St Mary's Hospital on the Beckman Immage system (High Wycombe, UK), using the respective assay kits. Optiseal polyallomer tubes (362181), 11.2 ml capacity; (361621), 4.7 ml capacity; and Thinwall Ultra-Clear (344088), 6.5 ml capacity ultracentrifuge tubes were supplied by Beckman Coulter (High Wycombe, UK). Spectra/Por membranes (MWCO 6-8000) were supplied by Spectrum Laboratories (Breda, Netherlands). Fluorinert FC-40 was supplied by Sigma-Aldrich (Poole, UK). Precast nondenaturing polyacrylamide gels (LPE-Gel 2/16) were supplied by CBS Scientific (Magna Park, UK). Tris borate EDTA (TBE) electrophoresis buffer (T-3913) was from Sigma-Aldrich. High-molecular-weight (HMW) protein standards were from Amersham Bioscience (Little Chalfont, UK). Polystyrene carboxylate (0.04 µm) modified (4% solid) beads (W004CA) were from Duke Scientific (Hatton, UK). Magnesium chloride hexahydrate and dextran sulfate (Dextralip 50) were from Sigma-Aldrich.
Blood samples
Preparation of iodixanol gradients and separation of plasma lipoprotein subfractions The initial three-step gradient was prepared by careful under-layering using a 10 ml disposable syringe with a long, wide, bore metal cannula. Three milliliters of the 9% solution was placed in the Optiseal polyallomer centrifugation tube (11.2 ml); this was then under-layered with 3 ml of the 12% solution and then with a final 3 ml of the 20% iodixanol/plasma solution. The tube was then carefully filled to the top with HEPES-buffered saline. To distribute the plasma lipoproteins in a continuous iodixanol gradient, the tube was capped and placed in an NVTi 65 rotor (Beckman Coulter) and centrifuged at 65,000 rpm (342,000 g) for 4 h at 4°C in an Optima XL-100K ultracentrifuge (Beckman Coulter) set at slow acceleration and deceleration. Samples were fractionated within 1 h of centrifugation.
Fraction collection
Fraction analysis
The density gradient profile and its reproducibility
SFU
Dialysis of lipoprotein fractions
LDL particle-sizing gradient gel electrophoresis
HDL-cholesterol measurement
Reproducibility and recovery Recovery data for the samples were calculated from the sum of the mass of each lipid and apolipoprotein in each fraction expressed as percentage of the mass in the original samples. The overall recovery of plasma lipids in the IDGU method was calculated from eight tubes and for the SFU method from six tubes. The lipid and apolipoprotein mass of the supranatant and the infranatant was used to estimate the recovery for each ultracentrifugation step of the SFU method. The lipoprotein recovery in the SFU method was calculated from whole plasma and each subsequent ultracentrifugation step, whereas in the IDGU method, recovery was calculated from each isolated lipoprotein formed in the gradient. Recovery for VLDL, LDL, HDL2, and HDL3 in the IDGU method was run in duplicate by substituting the lipoprotein samples for plasma in the iodixanol density gradient preparation.
Statistical analysis
Iodixanol density gradient The density profile generated by the iodixanol gradient is shown in Fig. 1 . The gradient from fractions 1–16 (density 0.997–1.063 g/ml) was linear, giving good resolution of the lipoprotein particles, and from fractions 17–21 (density 1.076–1.217 g/ml) of the tube, the density increased sharply in a curvilinear fashion, separating the plasma proteins from all lipoproteins except HDL. The coefficient of variation in each fraction ranged from 0.09–1.13%, with a mean of 0.29%. Using the distribution of plasma albumin as a marker, plasma proteins were seen to be predominantly confined within the bottom four fractions of the tube. The total cholesterol profile of plasma is shown, illustrating the distribution of lipoproteins in the iodixanol density gradient and their separation from plasma proteins.
Separation of lipoprotein fractions in iodixanol We determined the location and distribution of the conventional VLDL, LDL, HDL2, and HDL3 isolated by SFU in the iodixanol density gradient in duplicate (Fig. 2A –D). The lipoproteins show distinct distributions in the gradient. VLDL was recovered in fractions 1–4 (density <1.007); LDL in fractions 7–13 (density 1.016–1.043); HDL2 in fractions 13–17 (density 1.043–1.076), and HDL3 in fractions 14–19 (density1.049–1.119). For the purposes of analysis, HDL in the iodixanol density gradient was taken as fractions 14–19. Figure 3A shows the plasma lipid and apolipoprotein profile of a normal subject from which the conventional lipoproteins in Fig. 2 were derived. In comparison, Fig. 3B shows the plasma profile of a dyslipidemic type 2 diabetic subject. Figure 3C shows a subject with a significant amount of apo[a], which forms a distinct shouldering or peak between LDL and HDL, as illustrated.
The density ranges for the lipoproteins in iodixanol were typically lower than those derived from salt gradients, as previously described by others (1, 3). This phenomenon is believed to be to the result of the dehydration of the lipoprotein particles by the hyperosmolar salt solutions used in the salt gradients (3). To investigate this further, we compared the peak distribution of the lipoprotein fractions of the same plasma separated by the two different methods. We isolated lipoproteins using the conventional SFU method and then separated the harvested fractions by the IDGU method and compared them to the lipoproteins in whole plasma separated by the IDGU method alone. A shift in the peak concentration of LDL apoB-100 toward increased density, from 1.029 to 1.034 g/ml, was seen in samples that had undergone SFU with high salt concentrations, compared with the lipoprotein distribution of the same plasma that had not undergone SFU. A similar shift in the distribution of the peak concentration of apoA-I, from 1.063 to 1.076 g/ml, was noted in the HDL3 from SFU, compared with apoA-I in HDL that had not undergone SFU. The contribution of HDL2 to the total pool of apoA-I in HDL, in this sample, was less than 20%.
Recoveries from the IDGU
Comparison of HDL-cholesterol measurements We compared the HDL-cholesterol measurements from the IDGU method with those from the CDC HDL-cholesterol reference method. Figure 4A shows a scatterplot comparing the results. Analyzing the results with Pearson's correlation gave r = 0.91 with a P < 0.0001. A bias plot comparing the results in Fig. 4B showed a bias of –0.032 mmol/l, and the 95% limits of agreement were –0.327 and 0.263 mmol/l.
LDL subtypes and LDL particle size The high resolving power of this iodixanol density gradient can be exploited to analyze LDL subfractions and LDL particle size. Figure 5 shows the apoB-100 distribution and cumulative percentage in LDL2 and LDL3 in successive iodixanol density fractions (reference samples kindly provided by Dr. Muriel Caslake). Unfortunately, the LDL1 sample was not suitable for analysis, because the total cholesterol concentration was 0.3 mmol/l and the apoB-100 concentration was 9 mg/dl, too low for accurate measurement after fractionation. The smaller and denser LDL subfractions showed a shift in the apoB-100 distribution toward the right (higher density), which was also apparent when total cholesterol was measured (data not shown). Therefore, depending on the position and shape of the LDL distribution in the lipid profile of the plasma separation, the predominant LDL subfraction and proportion in the plasma can be readily identified.
In addition to information regarding the density distribution of the lipoprotein subclasses, their particle size profile can also be readily determined in the iodixanol density fractions. Figure 5 shows the size of the LDL particles in each density fraction as assessed on polyacrylamide gradient gel electrophoresis. As illustrated, LDL particles from successive increasing-density fractions show a decrease in size corresponding to smaller, denser LDL particles. Taking the LDL particle size of 25.5 nm as the cutoff between LDL phenotypes A and B (9), LDL particles in fractions 7–9 are classified as LDL1 and LDL2, and those from fractions 10–13 are LDL3. This is illustrated in Fig. 5, which shows the apoB-100 profile of LDL2, with 27.5% of the particles having a density >1.028 g/ml and a particle size of <25.5 nm, in contrast to LDL3 with 72.1%.
Comparison of the lipoprotein fractions from patients using IDGU and SFU
Our objectives in developing this new three-layered iso-osmotic density gradient procedure with iodixanol were to achieve rapid separation and preparative subfractionation of all three major lipoprotein density classes in a single run. Compared with SFU, the standard preparative method of lipoproteins, we have demonstrated improved fractionation and recovery of lipoproteins, although there was contamination of some subfractions of HDL3 with albumin, which is a common drawback of gradient ultracentrifugation methods. To completely remove albumin, a further ultracentrifugation step, use of albumin binding columns or gel electrophoresis, is required. Compared with the reported iodixanol density gradient from Davies, Graham, and Griffin (1), which effectively discriminates LDL from HDL but with poor separation of LDL from VLDL, or from Sawle et al. (3), which discriminates LDL from VLDL but with poor separation from HDL, our new gradient was able to give better fractionation of all three lipoproteins and separation from plasma proteins and was able to subfractionate LDL, enabling phenotyping of individuals in terms of cardiovascular risk. The study was performed using a three-layered self-generating continuous density gradient. This gradient was linear over the range of densities corresponding to the lipoprotein particles and was highly reproducible (coefficient of variation, 0.29%). Consequently, a complete lipoprotein profile was obtained from a single 4 h ultracentrifugation step. Assuming that the lipoprotein particles come close to their isopycnic density following ultracentrifugation in the density gradient, the ability of the system to resolve and subfractionate lipoprotein density classes will be determined by the slope of the density gradient over the requisite range and the number/volume of fractions collected. The steeper the slope of the density gradient, the smaller will be the subfraction volumes required to achieve adequate resolution in a given density range. This will compromise the preparative capacity of the procedure and limit the volumes available for compositional analysis. Our iodixanol gradient achieves a low linear density gradient slope over a wide density range to enable good resolution of adjacent density classes and their preparative subfractionation in 0.5 ml fraction volumes. Although our gradient has slightly less power to resolve LDL subfractions, compared with the method of Davies, Graham, and Griffin (1), we are able to resolve all major lipoprotein species in one centrifugation step. The HDL-cholesterol results from IDGU were comparable to the CDC reference method for measuring HDL-cholesterol used to standardize routine laboratory measurements, and the VLDL-cholesterol and triglyceride results were comparable to the traditional SFU method. Differences in LDL and HDL between IDGU and SFU methods were largely due to the difference in recoveries between the two methods, because correlations between the methods were strong, although recoveries were significantly different. However, lipoprotein recoveries from the SFU method are known to be highly variable, with reported recoveries from 88% in a single step to 36% involving multiple steps. Our recoveries are consistent with those from other published groups (2, 10). Recovery of VLDL was comparable between the methods, but recoveries for LDL and HDL were significantly better using the IDGU method due to minimal handling of samples and a methodology that is less likely to cause alteration to the lipoprotein particle. Recovery of HDL2 was lower in IDGU due to low concentrations, with cholesterol of 0.4 mmol/l and triglyceride of 0.01 mmol/l; when fractionated, the limits of the enzymatic assay were reached. Resolution of the lipoproteins isolated by IDGU was similar if not better than that of SFU when assessed by apolipoprotein content. IDGU gave a result comparable to traditional single-step SFU but was superior when multiple steps were involved. Lipoproteins isolated using IDGU were more representative of lipoproteins in vivo and unaltered physiologically, because the ultracentrifugation time was reduced from 72 h to 4 h, which reduced the risk of oxidation and enzymatic alteration of the lipoprotein particles, as well as potential changes associated with prolonged exposure to high g forces (11–14). In addition, because iodixanol is iso-osmotic to plasma up to solutions containing 40% of iodixanol (data from manufacturer's information leaflet), lipoproteins are less likely to be affected by osmotic shifts associated with methods requiring the high salt concentrations and high osmotic pressures needed to achieve the densities required to separate lipoproteins and the subsequent need for dialysis. We have demonstrated increased density of lipoproteins following exposure to the high salt concentrations with SFU that are not corrected following dialysis of the lipoprotein particles. In addition to the advantages stated, the IDGU also gave important information with regard to the density and particle size of the lipoproteins. The previous methodology for the subfractionation of LDL was performed using salt gradients (15). Lipid profiles derived from salt gradients require long centrifugation times and dialysis of samples that lead to the changes discussed earlier; in addition, salt gradients involved complicated procedures for preparation, often requiring the use of gradient-making equipment. This is avoided when using iodixanol, because the gradient formed is self-generating during centrifugation.
In all patients studied, three separate lipoprotein fractions were obtained, corresponding to VLDL, LDL, and HDL. Additional information was also obtained with regard to the subfraction distribution of the lipoproteins, because the position and shape of the lipoprotein profile gives information concerning the relative proportions of small, dense particles and larger, less-dense forms. Differences in the profile of normal and dyslipidemic plasma (as defined by the International Diabetes Federation, with plasma triglyceride To summarize, we have presented a new iodixanol density gradient with improved resolution and recovery of all lipoproteins and able to subfractionate lipoprotein particles, giving important information with regard to LDL phenotype from a single centrifugation step. Lipoprotein samples recovered are more representative of the physiological state, because of the reduced time and handling of samples.
The authors thank John Graham for his advice on iodixanol gradient formation, Muriel Caslake for the LDL subfractions, and Priscilla Ryder for recruitment. Manuscript received December 17, 2007 and in revised form March 4, 2008.
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