👤 Chaitra Marathe

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality worldwide despite intensive lipid-lowering therapy. Residual cardiovascular risk persists even in patients achieving optimal lipoprotein-cholesterol (LDL-C) levels, indicating that additional lipid mediators contribute to disease progression. Lysophosphatidylcholine (LPC), a bioactive lysophospholipid generated from phosphatidylcholine by cytosolic or lipoprotein-associated phospholipase A₂ (PLA₂), has emerged as a critical mediator linking dyslipidemia, inflammation, and vascular injury. LPC is highly enriched in oxidized LDL (oxLDL), electronegative LDL (LDL(-)), and lipoprotein(a) [Lp(a)], all of which represent highly atherogenic lipoprotein subclasses. This review delineates the metabolic origins of LPC, its transport via LDL, VLDL, and albumin, and its accumulation within atherosclerotic plaques. LPC promotes endothelial dysfunction, monocyte recruitment, foam-cell formation, and platelet activation, collectively driving plaque development and instability. Elevated LPC levels are consistently observed in metabolic disorders such as type 2 diabetes mellitus (T2DM) and non-alcoholic steatohepatitis (NASH), both of which exacerbate ASCVD risk. Although statins, ezetimibe, and PCSK9 inhibitors effectively lower LDL-C, they do not directly target LPC or its downstream inflammatory pathways. Clinical trials of lipoprotein-associated PLA₂ inhibitors (e.g., Darapladib) failed to reduce cardiovascular events, underscoring the complexity of LPC-related signaling. Future therapeutic approaches may involve enhancing lysophospholipase A Show less

Adults who test positive for a mutation associated with the development of hypertrophic cardiomyopathy (HCM) but who have not manifested left ventricular hypertrophy (LVH) at the time of that diagnosis are now commonly identified in the era of genetic testing. There are little published data, however, on the long-term outlook for these phenotypically normal gene carriers. Fifteen genotype positive/LVH negative patients with HCM were identified, seven of which were children when first diagnosed as gene carriers. Fourteen were followed up with clinical examinations, electrocardiography and echocardiography to determine if their clinical status had changed over time. Measurements included electrocardiographic changes, changes in wall thickness, diastolic function and global longitudinal stain. Ten participants were followed up for a total of 18 years, two for a total of 17 years, one for 11 years and one for 8 years. In addition, magnetic resonance imaging (MRI) studies were performed on 11 participants. Eleven participants carried a mutation for the MYBPC3 gene and three carried a mutation for the MYH7 gene. One patient, an adult at the time of initial investigation, developed phenotypic features of HCM on echocardiography and MRI, one an increase in wall thickness diagnostic for HCM only on MRI and another to be borderline for HCM on MRI. Hypertrophic cardiomyopathy can develop in adult life in carriers who may be negative for LVH at the time of gene diagnosis and warrants periodic supervision of carriers throughout their lives. Show less

Ligand activation of liver X receptors (LXRs) has been shown to impact both lipid metabolism and inflammation. One complicating factor in studies utilizing synthetic LXR agonists is the potential for pharmacologic and receptor-independent effects. Here, we describe an LXR gain-of-function system that does not depend on the addition of exogenous ligand. We generated transgenic mice expressing a constitutively active VP16-LXRα protein from the aP2 promoter. These mice exhibit increased LXR signaling selectively in adipose and macrophages. Analysis of gene expression in primary macrophages derived from two independent VP16-LXRα transgenic lines confirmed the ability of LXR to drive expression of genes involved in cholesterol efflux and fatty acid synthesis. Moreover, VP16-LXRα expression also suppressed the induction of inflammatory genes by lipopolysaccharide to a comparable degree as synthetic agonist. We further utilized VP16-LXRα-expressing macrophages to identify and validate new targets for LXRs, including the gene encoding ADP-ribosylation factor-like 7 (ARL7). ARL7 has previously been shown to transport cholesterol to the membrane for ABCA1-associated removal and thus may be integral to the LXR-dependent efflux pathway. We show that the ARL7 promoter contains a functional LXRE and can be transactivated by LXRs in a sequence-specific manner, indicating that ARL7 is a direct target of LXR. These findings provide further support for an important role of LXRs in the coordinated regulation of lipid metabolic and inflammatory gene programs in macrophages. Show less

The liver X receptors (LXRs) are a family of nuclear receptor transcription factors that are activated by oxysterols and have defined roles in both lipid metabolism and cholesterol regulation. LXRs also affect antimicrobial responses and have anti-inflammatory effects in macrophages. As mice lacking LXRs are more susceptible to infection by intracellular bacteria Listeria monocytogenes and Mycobacterium tuberculosis, we hypothesized that LXR might also influence macrophage responses to the intracellular protozoan parasite Leishmania chagasi/infantum, a causative agent of visceral leishmaniasis. Surprisingly, both LXRα knock-out and LXRα/LXRβ double-knock-out (DKO) mice were markedly resistant to systemic L. chagasi/infantum infection compared to wild-type mice. Parasite loads in the livers and spleens of these animals were significantly lower than in wild-type mice 28 days after challenge. Bone marrow-derived macrophages from LXR-DKO mice infected with L. chagasi/infantum in vitro in the presence of IFN-γ were able to kill parasites more efficiently than wild-type macrophages. This enhanced killing by LXR-deficient macrophages correlated with higher levels of nitric oxide produced, as well as increased gene expression of IL-1β. Additionally, LXR ligands abrogated nitric oxide production in wild-type macrophages in response to infection. These observations suggest that LXR-deficient mice and macrophages mount antimicrobial responses to Leishmania infection that are distinct from those mounted by wild-type mice and macrophages. Furthermore, comparison of these findings to other intracellular infection models suggests that LXR signaling pathways modulate host antimicrobial responses in a complex and pathogen-specific manner. The LXR pathway thus represents a potential therapeutic target for modulating immunity against Leishmania or other intracellular parasites. Show less