Genetically determined heterogeneity in hemoglobin scavenging and susceptibility to diabetic cardiovascular disease.
A major function of haptoglobin (Hp) is to bind hemoglobin (Hb) to form a stable Hp-Hb complex and thereby prevent Hb-induced oxidative tissue damage. Clearance of the Hp-Hb complex can be mediated by the monocyte/macrophage scavenger receptor CD163. We recently demonstrated that diabetic individuals homozygous for the Hp 2 allele (Hp 2-2) were at 500% greater risk of cardiovascular disease (CVD) compared with diabetic individuals homozygous for the Hp 1 allele (Hp 1-1). No differences in risk by Hp type were seen in individuals without diabetes. To understand the relationship between the Hp polymorphism and diabetic CVD, we sought to identify differences in antioxidant and scavenging functions between the Hp types and to determine how these functions were modified in diabetes. The scavenging function of Hp was assessed using rhodamine-tagged and 125I-Hp in cell lines stably transfected with CD163 and in macrophages expressing endogenous CD163. We found that the rate of clearance of Hp 1-1-Hb by CD163 is markedly greater than that of Hp 2-2-Hb. Diabetes is associated with an increase in the nonenzymatic glycosylation of serum proteins, including Hb. The antioxidant function of Hp was assessed with glycosylated and nonglycosylated Hb. We identified a severe impairment in the ability of Hp to prevent oxidation mediated by glycosylated Hb. We propose that the specific interaction between diabetes, CVD, and Hp genotype is the result of the heightened urgency of rapidly clearing glycosylated Hb-Hp complexes from the subendothelial space before they can oxidatively modify low-density lipoprotein to atherogenic oxidized low-density lipoprotein.
Technion Faculty of Medicine, echnion-Israel Institute of Technology and Rambam Medical Center, POB 9649, Haifa, Israel.
Rabea
R
Asleh
Stuart
S
Marsh
Mark
M
Shilkrut
Ofer
O
Binah
Julia
J
Guetta
Flavio
F
Lejbkowicz
Ben
B
Enav
Naim
N
Shehadeh
Yoram
Y
Kanter
Orit
O
Lache
Osher
O
Cohen
Nina S
NS
Levy
Andrew P
AP
Levy
D000818:Animals; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism*; D000975:Antioxidants / Q000378:metabolism; D016466:CHO Cells; D002460:Cell Line; D006224:Cricetinae; D003925:Diabetic Angiopathies / Q000235:genetics / Q000378:metabolism*; D004705:Endocytosis; D020022:Genetic Predisposition to Disease; D006031:Glycosylation; D006242:Haptoglobins / Q000235:genetics* / Q000378:metabolism*; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008264:Macrophages / Q000378:metabolism; D009000:Monocytes / Q000378:metabolism; D011110:Polymorphism, Genetic; D011956:Receptors, Cell Surface / Q000378:metabolism*; D000098902:CD163 Antigen
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D000975:Antioxidants; D000098902:CD163 Antigen; D006242:Haptoglobins; D006454:Hemoglobins; D011956:Receptors, Cell Surface; C035492:haptoglobin-hemoglobin complex