Apolipoprotein M – Studies of Structure and Function

Apolipoprotein M (apoM), a 25 kDa plasma protein, is found in all major lipoprotein classes, although the majority is found in high density lipoproteins (HDL). ApoM has been suggested to be involved in the formation of and adding to the antiatherogenic functions of HDL, but its function is still not completely known. ApoM has been suggested to be a lipokalin. By studies in vitro using recombinant apoM we were able to show that apoM shares the ligand-binding abilities of lipokalins by being able to bind retinol and its two metabolites, all-trans retinoic acid and 9-cis retinoic acid. After successful crystallization trials we managed to determine the 3D structure of recombinant apoM expressed in E.coli. ApoM displays the typical lipocalin fold that was predicted, i.e. characterized by an 8-stranded antiparallel β-barrel enclosing an internal ligand-binding pocket, flanked by a α-helix. The ligand-binding pocket in apoM can be subdivided into a hydrophilic upper part, surrounded by several positively and negatively charged residues, and a hydrophobic lower part lined by numerous hydrophobic residues. ApoM was crystallized as a complex with either myristic acid or glycerol-1-myristate in the hydrophobic pocket showing that apoM can work as a fatty acid binding protein. We were also able to detect a binding of D-sphingosine and sphingosine-1-phosphate in ligand-binding studies. The physiological importance of the binding is not known. Mature apoM is circulating with a retained signal peptide. By constructing apoM with a cleavable signal peptide we were able to show that the signal peptide is necessary for the protein’s ability to associate to lipoproteins. We were also able to show that, in contrast to apoM with a cleavable signal peptide, full-length apoM was accumulated in stably transfected HEK293 cells, expressing apoM, unless serum was present. The addition of extra cellular HDL or co-expression of HDL was enough to completely restore the apoM expression. We have in a previous study found a marked positive correlation between plasma apoM and total cholesterol levels in healthy individuals. To investigate whether plasma apoM levels predict the risk of coronary heart disease, apoM was measured in plasma from subject later developing CHD and healthy controls from two prospective case-control studies, FINRISK ´92 and Copenhagen City Heart Study. In conditional logistic regression analyses, apoM was not a predictor of CHD events. We found positive correlations for apoM with both apoA-I and apoB

Mycolactone-dependent depletion of endothelial cell thrombomodulin is strongly associated with fibrin deposition in Buruli ulcer lesions

A well-known histopathological feature of diseased skin in Buruli ulcer (BU) is coagulative necrosis caused by the Mycobacterium ulcerans macrolide exotoxin mycolactone. Since the underlying mechanism is not known, we have investigated the effect of mycolactone on endothelial cells, focussing on the expression of surface anticoagulant molecules involved in the protein C anticoagulant pathway. Congenital deficiencies in this natural anticoagulant pathway are known to induce thrombotic complications such as purpura fulimans and spontaneous necrosis. Mycolactone profoundly decreased thrombomodulin (TM) expression on the surface of human dermal microvascular endothelial cells (HDMVEC) at doses as low as 2ng/ml and as early as 8hrs after exposure. TM activates protein C by altering thrombin's substrate specificity, and exposure of HDMVEC to mycolactone for 24 hours resulted in an almost complete loss of the cells' ability to produce activated protein C. Loss of TM was shown to be due to a previously described mechanism involving mycolactone-dependent blockade of Sec61 translocation that results in proteasome-dependent degradation of newly synthesised ER-transiting proteins. Indeed, depletion from cells determined by live-cell imaging of cells stably expressing a recombinant TM-GFP fusion protein occurred at the known turnover rate. In order to determine the relevance of these findings to BU disease, immunohistochemistry of punch biopsies from 40 BU lesions (31 ulcers, nine plaques) was performed. TM abundance was profoundly reduced in the subcutis of 78% of biopsies. Furthermore, it was confirmed that fibrin deposition is a common feature of BU lesions, particularly in the necrotic areas. These findings indicate that there is decreased ability to control thrombin generation in BU skin. Mycolactone's effects on normal endothelial cell function, including its ability to activate the protein C anticoagulant pathway are strongly associated with this. Fibrin-driven tisischemia could contribute to the development of the tissue necrosis seen in BU lesions

Apolipoprotein M associates to lipoproteins through its retained signal peptide.

Apolipoprotein M (apoM) is predominantly associated with HDL. In this study, it was investigated whether apoM's uncleaved signal peptide is necessary for the protein's ability to associate with lipoproteins. ApoM with a cleavable signal peptide, Q22A, was expressed, together with wild-type apoM, in HEK293 cells. On size-exclusion chromatography, the elution profile of wild-type apoM was similar to that of human HDL-associated plasma apoM. In contrast, the size of the Q22A mutant corresponded to free, unassociated apoM. This strongly indicates that the signal peptide is indeed necessary for apoM's ability to associate with lipid

HDL Stimulates apoM Secretion.

Apolipoprotein M (apoM) in human plasma is mainly associated with HDL. A retained signal peptide anchors apoM to the lipoproteins. To investigate the role of the signal peptide in the transfer of apoM from the synthesizing cell to the lipoproteins, wildtype apoM cDNA and the Q(22)A mutant, introducing a signal peptidase cleavage site, were used to stably transfect HEK293 cells, which intrinsically do not express apolipoproteins. When cultured under serum-free conditions, wildtype apoM was, in contrast to Q(22)A, poorly secreted. Addition of serum or purified HDL stimulated secretion of wildtype apoM, which was recovered in the medium incorporated in HDL. The liver cell line HepG2, which synthesizes HDL, was cultured under serum-free conditions and found to secrete apoM as part of an HDL-like particle. In conclusion, due to its retained signal peptide, apoM is poorly secreted unless HDL is either coexpressed or added to the culture medium

An ELISA for apolipoprotein M reveals a strong correlation to total cholesterol in human plasma

Apolipoprotein M (apoM) is a 188 amino acid, 25 kDa protein belonging to the lipocalin protein superfamily. Although predominantly associated with high density lipoprotein, apoM is found in all major lipoprotein classes. To facilitate clinical studies of apoM, we have developed a sandwich ELISA for the measurement of apoM in human plasma. This method has been used to investigate normal apoM variation and to establish reference values for healthy individuals through the measurement of 598 samples from the Nordic Reference Interval Project Bio-bank and Database ( NOBIDA) biobank. For women 18-49 years old, the reference interval for apoM was 0.58-1.18 mu mol/l, whereas for women 501 years and for men, the reference range was 0.61-1.30 mu mol/l. Correlation studies of apoM with 26 common clinical chemical analytes from the NOBIDA database revealed a marked positive correlation with plasma total cholesterol (r = 0.52) and LDL and HDL cholesterol ( r = 0.43 and 0.36, respectively). There was no statistically significant correlation with HDL/total cholesterol ratio or body mass index. In conclusion, a sandwich ELISA for the measurement of apoM in human plasma shows that apoM concentration is strongly correlated to total cholesterol in healthy individuals

Plasma concentrations of apolipoproteins A-I, B, and M in patients with critical limb ischemia.

OBJECTIVES: Apolipoproteins affect development of atherosclerosis, but their involvement in the pathogenesis of critical limb ischemia (CLI), a severe form of atherosclerosis, has not previously been examined. DESIGN AND METHODS: ApoA-I, apoB, and apoM were measured in plasma from 196 CLI subjects and 214 control individuals from the background population. RESULTS: Cases had lower levels of the apolipoproteins, as compared to controls; apoA-I, 1.23 vs. 2.08 g/L; apoB, 0.93 vs. 1.04 g/L; apoM, 0.75 vs. 0.91 mumol/L (p<0.0001 for all three). ApoA-I and apoM correlated negatively with inflammatory markers and positively to 1- and 3-year survival rates, whereas apoB did not. In multivariate analyses, apoA-I, but not apoB and apoM, was independently associated with CLI, the odds ratio being 0.015. CONCLUSIONS: In subjects with CLI, plasma concentrations of apoA-I, apoB and apoM were significantly lower than in control individuals, but only apoA-I was independently associated to CLI

A 6-year follow-up of dosing, coagulation factor levels and bleedings in relation to joint status in the prophylactic treatment of haemophilia

The primary aim of this study was to investigate the possible relationship between coagulation factor level and bleeding frequency during prophylactic treatment of haemophilia after stratification of the patients according to joint scores. The secondary aim was to obtain a systematic overview of the doses of coagulation factors prescribed for prophylaxis at the Malmo haemophilia treatment centre during a 6-year period. A retrospective survey of medical records for the years 1997-2002 and pharmacokinetic study results from the 1990s was complemented by collection of blood samples for coagulation factor assay when needed. Information on the dosing and plasma levels of factor VIII or factor IX, joint scores and incidence of bleedings (joint bleeds and 'other bleeds') was compiled. The patients were stratified by age (0-6, 7-12, 13-18, 19-36 and >36 years) and joint score (0, 1-6 and >6). Individual pharmacokinetic parameters of plasma coagulation factor activities (FVIII:C and FIX:C) were estimated. Trough levels during the treatment were calculated, as well as the number of hours per week of treatment during which plasma FVIII:C/FIX:C fell below a 1, 2 or 3% target level. Fifty-one patients with haemophilia A (two moderate, 49 severe) and 13 with haemophilia B (all severe) were included, yielding data for 364 patient-years of treatment. There was a wide range of dosing schedules, the most common ones being three times a week or every other day for FVIII and twice a week or every third day for FIX. The overall relationship between FVIII:C/FIX:C levels and incidence of joint bleeding was very weak, even after stratification of the patients according to joint score. There was no relationship between coagulation factor level and incidence of other bleeds. In this cohort of patients on high-dose prophylactic treatment, dosing was based more on clinical outcome in terms of bleeding frequency than on the aim to maintain a 1% target level of FVIII:C/FIX:C. Some patients did not bleed in spite of a trough level of 3%. The practical implication of our findings is that dosing in prophylactic treatment of haemophilia should be individualized. Thus, proposed standard regimens should be implemented only after careful clinical consideration, with a high readiness for re-assessment and individual dose tailoring

Hydrophobic ligand binding properties of the human lipocalin apolipoprotein M

Apolipoprotein M (apoM) is a plasma protein associated mainly with HDL. ApoM is suggested to be important for the formation of pre beta-HDL, but its mechanism of action is unknown. Homology modeling has suggested apoM to be a lipocalin. Lipocalins share a structurally conserved beta-barrel, which in many lipocalins bind hydrophobic ligands. The aim of this study was to test the ability of apoM to bind different hydrophobic substances. ApoM was produced both in Escherichia coli and in HEK 293 cells. Characterization of both variants with electrophoretic and immunological methods suggested apoM from E. coli to be correctly folded. Intrinsic tryptophan fluorescence of both apoM variants revealed that retinol, all-trans-retinoic acid, and 9-cis-retinoic acid bound ( dissociation constant 5 2-3 mu M), whereas other tested substances ( e.g., cholesterol, vitamin K, and arachidonic acid) did not. The intrinsic fluorescence of two apoM mutants carrying single tryptophans was quenched by retinol and retinoic acid to the same extent as wild-type apoM, indicating that the environment of both tryptophans was affected by the binding. In conclusion, the binding of retinol and retinoic acid supports the hypothesis that apoM is a lipocalin. The physiological relevance of this binding has yet to be elucidated