title: Release and capture of bioactive oxidized phospholipids and oxidized cholesteryl esters during percutaneous coronary and peripheral arterial interventions in humans.
abstract: OBJECTIVE
  This study sought to assess whether oxidized lipids are released downstream from obstructive plaques after percutaneous coronary and peripheral interventions using distal protection devices.
  
  
  BACKGROUND
  Oxidation of lipoproteins generates multiple bioactive oxidized lipids that affect atherothrombosis and endothelial function. Direct evidence of their role during therapeutic procedures, which may result in no-reflow phenomenon, myocardial infarction, and stroke, is lacking.
  
  
  METHODS
  The presence of specific oxidized lipids was assessed in embolized material captured by distal protection filter devices during uncomplicated saphenous vein graft, carotid, renal, and superficial femoral artery interventions. The presence of oxidized phospholipids (OxPL) and oxidized cholesteryl esters (OxCE) was evaluated in 24 filters using liquid chromatography, tandem mass spectrometry, enzyme-linked immunosorbent assays, and immunostaining.
  
  
  RESULTS
  Phosphatidylcholine-containing OxPL, including (1-palmitoyl-2-[9-oxo-nonanoyl] PC), representing a major phosphatidylcholine-OxPL molecule quantitated within plaque material, [1-palmitoyl-2-(5-oxo-valeroyl)-sn-glycero-3-phosphocholine], and 1-palmitoyl-2-glutaroyl-sn-glycero-3-phosphocholine, were identified in the extracted lipid portion from all vascular beds. Several species of OxCE, such as keto, hydroperoxide, hydroxy, and epoxy cholesteryl ester derivatives from cholesteryl linoleate and cholesteryl arachidonate, were also present. The presence of OxPL was confirmed using enzyme-linked immunoassays and immunohistochemistry of captured material.
  
  
  CONCLUSIONS
  This study documents the direct release and capture of OxPL and OxCE during percutaneous interventions from multiple arterial beds in humans. Entrance of bioactive oxidized lipids into the microcirculation may mediate adverse clinical outcomes during therapeutic procedures.
authors.affiliation: St. Boniface Hospital Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Medicine, University of California-San Diego, La Jolla, California.
authors.forename: Amir
authors.initials: A
authors.lastname: Ravandi
authors.affiliation: Department of Medicine, University of California-San Diego, La Jolla, California; University of Basel, Basel, Switzerland.
authors.forename: Gregor
authors.initials: G
authors.lastname: Leibundgut
authors.affiliation: Department of Medicine, University of California-San Diego, La Jolla, California; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Ming-Yow
authors.initials: MY
authors.lastname: Hung
authors.affiliation: Department of Medicine, University of California-San Diego, La Jolla, California.
authors.forename: Mitul
authors.initials: M
authors.lastname: Patel
authors.affiliation: Department of Pharmacology, University of Colorado Denver, Aurora, Colorado.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Hutchins
authors.affiliation: Department of Pharmacology, University of Colorado Denver, Aurora, Colorado.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Murphy
authors.affiliation: Department of Medicine, University of California-San Diego, La Jolla, California; Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Anand
authors.initials: A
authors.lastname: Prasad
authors.affiliation: Department of Medicine, University of California-San Diego, La Jolla, California.
authors.forename: Ehtisham
authors.initials: E
authors.lastname: Mahmud
authors.affiliation: Department of Medicine, University of California-San Diego, La Jolla, California.
authors.forename: Yury I
authors.initials: YI
authors.lastname: Miller
authors.affiliation: Department of Pharmacology and Chemistry and Biochemistry, University of California, La Jolla, California.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Dennis
authors.affiliation: Department of Medicine, University of California-San Diego, La Jolla, California.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Witztum
authors.affiliation: Department of Medicine, University of California-San Diego, La Jolla, California. Electronic address: stsimikas@ucsd.edu.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Tsimikas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000639:trends; D002788:Cholesterol Esters / Q000097:blood*; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000639:trends; D058729:Peripheral Arterial Disease / Q000097:blood / Q000601:surgery; D010713:Phosphatidylcholines / Q000097:blood; D010743:Phospholipids / Q000097:blood*; D053719:Tandem Mass Spectrometry / Q000379:methods
chemical_list: D002788:Cholesterol Esters; D010713:Phosphatidylcholines; D010743:Phospholipids
keywords: angioplasty; lipoproteins; oxidized cholesteryl esters; oxidized phospholipids