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Blood, 1 March 2002, Vol. 99, No. 5, pp. 1802-1810
PHAGOCYTES
Defects in leukocyte-mediated initiation of lipid peroxidation in
plasma as studied in myeloperoxidase-deficient subjects: systematic
identification of multiple endogenous diffusible substrates for
myeloperoxidase in plasma
Renliang Zhang,
Zhongzhou Shen,
William M. Nauseef, and
Stanley L. Hazen
From the Department of Cell Biology, the Department of
Cardiology, and the Center for Cardiovascular Diagnostics, Preventive
Cardiology Section, Cleveland Clinic Foundation, OH; the Chemistry
Department, Cleveland State University, OH; and the Inflammation
Program and Department of Medicine, University of Iowa and Veterans
Administration Medical Center, Iowa City.
 |
Abstract |
More than a decade ago it was demonstrated that neutrophil
activation in plasma results in the time-dependent formation of lipid
hydroperoxides through an unknown, ascorbate-sensitive pathway. It is
now shown that the mechanism involves myeloperoxidase
(MPO)-dependent use of multiple low-molecular-weight substrates
in plasma, generating diffusible oxidant species. Addition of activated
human neutrophils (from healthy subjects) to plasma (50%, vol/vol)
resulted in the peroxidation of endogenous plasma lipids by catalase-,
heme poison-, and ascorbate-sensitive pathways, as assessed
by high-performance liquid chromatography (HPLC) with on-line
electrospray ionization tandem mass spectrometric analysis of
free and lipid-bound 9-HETE and 9-HODE. In marked contrast, neutrophils
isolated from multiple subjects with MPO deficiency failed to initiate
peroxidation of plasma lipids, but they did so after
supplementation with isolated human MPO. MPO-dependent use of a
low-molecular-weight substrate(s) in plasma for initiating lipid
peroxidation was illustrated by demonstrating that the filtrate of
plasma (10-kd MWt cutoff) could supply components required for
low-density lipoprotein lipid peroxidation in the presence of MPO and
H2O2. Subsequent HPLC fractionation of plasma
filtrate (10-kd MWt cutoff) by sequential column chromatography identified nitrite, tyrosine, and thiocyanate as major endogenous substrates and 17 -estradiol as a novel minor endogenous substrate in
plasma for MPO in promoting peroxidation of plasma lipids. These
results strongly suggest that the MPO-H2O2
system of human leukocytes serves as a physiological mechanism for
initiating lipid peroxidation in vivo.
(Blood. 2002;99:1802-1810)
© 2002 by The American Society of Hematology.
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Introduction |
The peroxidation of lipids and the consequent
generation of bioactive lipid oxidation products are believed to play
important roles in the pathogenesis of atherosclerosis and other
inflammatory processes.1-5 Lipoxygenase, cyclooxygenase,
and cytochrome P450 are considered the primary enzymatic participants
in these events.6-10 These enzymes are expressed in
leukocytes and catalyze the direct insertion of molecular oxygen
(O2) into polyenoic fatty acids, forming hydroperoxides and
other advanced oxidation products.8 Whether alternative
chemical pathways contribute to the oxidation of lipoproteins and
lipids in complex biologic matrices, such as plasma, has not yet been
fully defined.
We and others have proposed that another potential pathway for
initiating lipid peroxidation in vivo may involve myeloperoxidase (MPO), a heme protein present in neutrophils, monocytes, and certain subpopulations of tissue macrophages.11-13 On phagocyte
activation in peripheral tissues and fluids, MPO is secreted into the
extracellular milieu and into the phagolysosome, where it uses hydrogen
peroxide (H2O2) generated during a respiratory
burst as a cosubstrate. Activated intermediates, Compounds 1 and 2, are
sequentially formed that generate reactive oxidants and diffusible
radical species through 2- and 1-electron oxidation reactions,
respectively.5,14 At plasma levels of halides, chloride
(Cl ) is a major cosubstrate for MPO and the cytotoxic
oxidant hypochlorous acid (HOCl) is produced.15 In
addition to halides16 and the pseudohalide thiocyanate
(SCN ),17,18 various organic and inorganic
components found in plasma have been suggested to potentially serve as
naturally occurring substrates for MPO. These include, but are not
limited to, estrogens,19 catecholamines,20
tyrosine,21 nitrite
(NO ),22 ascorbate,23
NADPH,24 serotonin,25 and nitric oxide
(nitrogen monoxide, NO).26 The relative
contribution of peroxidation of these substrates to the overall
activity of MPO in vivo is unknown. The products they form and the
reactions they initiate may serve significant biologic functions. For
example, NO , a major end-product of NO metabolism,
and tyrosine undergo MPO-catalyzed 1-electron oxidation reactions
generating nitrogen dioxide
( NO2)22,27 and
tyrosyl radical,21 respectively. These diffusible oxidant
species have been shown to initiate lipid peroxidation in model systems
using isolated lipoproteins or lipid vesicles as
targets.11-13 Moreover, protein oxidation products that
can be formed by MPO-generated tyrosyl radical or
NO2, such as dityrosine28
and nitrotyrosine,22,29,30 have been observed in human
atherosclerotic lesions31-33 and other inflammatory sites
at which lipid peroxidation products and MPO are also
found.34-36 Although in vitro studies examining individual
potential substrates for MPO in isolation have suggested their
potential role in promoting lipid oxidation, the actual substrates used
by MPO in complex biologic tissues and fluids in vivo have not yet been
determined. Indeed, a role for MPO in the oxidation of low-density
lipoprotein (LDL) and in the initiation of lipid peroxidation has
recently been questioned by several investigators. Noguchi et
al37 examined the capacity of leukocytes isolated from
wild-type and MPO knockout mice to promote the oxidation of LDL in
model systems ex vivo and observed only modest differences in the
parameters of lipid oxidation monitored.37 It has also
recently been suggested that MPO-catalyzed oxidation of LDL is
inhibited, rather than promoted, by the presence of
NO , particularly when focusing on protein oxidation
products.38 Moreover, an anti-oxidant rather than a
pro-oxidant function for MPO-generated tyrosine oxidation products and
LDL oxidation has been proposed.39,40 It has also been
suggested by some investigators that HOCl generated by MPO can promote
the oxidation of lipoprotein lipids and the formation of
hydroperoxides,41 whereas other studies have not supported
these observations.11,30 Finally, recent studies have
noted species differences between murine and human leukocytes with
respect to MPO and the generation of reactive oxidant
species.42-45
In the current study we sought to definitively establish whether human
leukocytes use MPO for catalyzing the oxidation of lipids in complex
biologic matrices, such as in plasma, where numerous competing
cosubstrates for the enzyme are present. We also sought to identify
chemically the component(s) in plasma that serve as preferred
substrates for the MPO-H2O2 system of leukocytes for the initiation of lipid peroxidation. In studies using
leukocytes isolated from healthy and MPO-deficient subjects, in
combination with HPLC with on-line electrospray ionization tandem mass spectrometry (LC/ESI/MS/MS), we now show that human neutrophils use MPO to initiate lipid peroxidation in whole plasma through multiple distinct diffusible substrates.
 |
Materials and methods |
Chemicals and reagents
Hanks balanced salt solution (HBSS) was purchased from Gibco BRL
(Grand Island, NY). Free fatty acids were purchased from Cayman
Chemical (Ann Arbor, MI). Organic solvents were obtained from Fisher
Scientific (Pittsburgh, PA). All other reagents were purchased from
Sigma Chemical (St Louis, MO) unless otherwise indicated.
General procedures
All buffers were passed over a Chelex-100 resin column (Bio-Rad,
Hercules, CA) and were supplemented with diethylenetriamine pentaacetic
acid (DTPA) to remove potential contaminant transition metal ions that
might catalyze LDL oxidation during incubation. Protein content was
determined by the Markwell-modified Lowry protein assay with bovine
serum albumin as standard.46 The concentration of reagent
H2O2 was assayed spectrophotometrically
( 240 = 39.4 M 1cm 1).47 Production of
H2O2 by glucose and glucose oxidase (GO, EC
1.1.3.4) was determined by the oxidation of Fe(II) and the formation of
an Fe(III)-thiocyanate complex.22 Peroxidase activity in
isolated leukocytes was evaluated by determining the rate of guaiacol
oxidation.48 HOCl production was quantified by the taurine
chloramine method.49 Superoxide
(O2 ) production by activated
human neutrophils was measured as the superoxide dismutase
(SOD)-inhibitable reduction of ferricytochrome c.50 In
situ staining of native gels for peroxidase activity was performed as
described.51 All protocols were in accordance with
institutional guidelines on research involving human subjects of either
the Cleveland Clinic Foundation or the University of Iowa and were
approved by their respective institutional review boards.
Informed consent was provided according to the Declaration of Helsinki.
Data are presented as mean ± SD. Comparisons between control and
tested groups were made using nonparametric analysis, and P < .05 was considered significant between 2 groups.
MPO and lipoprotein isolation
MPO (donor: hydrogen peroxide, oxidoreductase, EC 1.11.1.7) was
isolated and characterized as described.28,51 Purity of
isolated MPO was established by demonstrating R/Z 0.85
(A430/A280), sodium dodecyl
sulfate-polyacrylamide gel electrophoresis analysis with Coomassie
blue staining, and in-gel tetramethylbenzidine peroxidase staining to
confirm no eosinophil peroxidase contamination.51 Purified
MPO was stored in 50% glycerol at 20°C. Enzyme concentration was
determined spectrophotometrically ( 430 = 170 000
M 1cm 1).52 LDL was isolated
from fresh plasma by sequential ultracentrifugation as a
1.019 < d < 1.063 g/mL fraction, and dialysis was performed in
sealed jars under argon atmosphere.53 Final preparations were kept in 50 mM sodium phosphate (pH 7.0), 100 µM DTPA, and were
stored under N2 until use. LDL concentrations are expressed per milligram LDL protein.
Human neutrophil preparations
Human neutrophils were isolated from whole blood obtained from
healthy and MPO-deficient subjects, as described.54
Neutrophil preparations were suspended in HBSS (Mg2+-,
Ca2+-, phenol-, and bicarbonate-free, pH 7.0) and were used
immediately for experiments. Molecular characterization of 2 of the
MPO-deficient subjects have been reported in previous
publications.55,56
Lipid peroxidation reaction
Isolated human neutrophils (106/mL) were incubated
at 37°C with either 50% (vol/vol) normal human plasma or isolated
human LDL (0.2 mg/mL) under air in HBSS supplemented with 100 µM
DTPA. Neutrophils were activated by adding 200 nM phorbol myristate acetate (PMA) and were maintained in suspension by gentle mixing every
5 minutes. After 2 hours, reactions were stopped by immersion in ice or
water bath, centrifugation at 4°C, and immediate addition of 50 µM
butylated hydroxytoluene (BHT) and 300 nM catalase to the supernatant.
Lipid peroxidation products in the supernatant were then rapidly
assayed as described below.
Reactions with isolated MPO were typically performed at 37°C in
sodium phosphate buffer (20 mM, pH 7.0) supplemented with 100 µM DTPA
using 30 nM MPO, 1 mM glucose (G), and 20 ng/mL GO. Under this
condition, a constant flux of H2O2 (0.18 µM/min) was generated by the glucose-glucose oxidase (G/GO)
system. Unless otherwise stated, reactions were terminated by immersion
in ice or water bath and the addition of 50 µM BHT and 300 nM
catalase to the reaction mixture.
Lipid extraction and sample preparation
Lipids were extracted and prepared for mass spectrometry
analysis under argon or nitrogen atmosphere at all steps. First, hydroperoxides in the reaction mixture were reduced to their
corresponding hydroxides by adding SnCl2 (1 mM final). A
known amount of deuterated internal standard, 12-HETE-d8 (Cayman
Chemical), was added to the sample, and plasma lipids were extracted by
adding a mixture of 1 M acetic acid-2-isopropanol-hexane
(2/20/30, vol/vol/vol) at a ratio of 5 mL organic solvent mix:1 mL
plasma. After vortexing and centrifugation, lipids were extracted to
the hexane layer. Plasma was re-extracted by the addition of an equal
volume of hexane, followed by vortexing and centrifugation.
Cholesteryl ester hydroperoxides (CE-H(P)ODEs) were analyzed as their
stable SnCl2- reduced hydroxide forms by drying of the
combined hexane extracts under N2, reconstituting samples
with 200 µL 2-isopropanol-acetonitrile-water (44/54/2,
vol/vol/vol) and storage at 80°C under argon until analysis. For
the assay of free fatty acids and their oxidation products, total
lipids (phospholipids, cholesterol esters, triglycerides) were dried
under N2 and resuspended in 1.5 mL 2-isopropanol, and fatty
acids were released by base hydrolysis with 1.5 mL 1 M NaOH at 60°C
for 30 minutes under argon. Hydrolyzed samples were acidified to pH 3.0 with 2 M HCl, and fatty acids were extracted twice with 5 mL hexane.
The combined hexane layers were dried under N2, resuspended in 100 µL methanol, and stored under argon at 80°C until analysis by LC/ESI/MS/MS, as described below.
HPLC fractionation of plasma filtrate
To study the role played by low-molecular-weight compounds in
plasma as substrates for MPO in the promotion of lipid peroxidation, whole plasma from healthy donors was filtered through a 10-kd MWt
cutoff filter (Centriprep YM-10; Millipore, Bedford, MA) by centrifugation. The filtrate of plasma was used either directly or
after fractionation by HPLC. Reverse-phase HPLC fractionation was
performed using a Beckman C-18 column (4.6 × 250 mm, 5 µm OD; Beckman Instruments, Fullerton, CA). Separation of
low-molecular-weight compounds in plasma filtrate (0.5 mL) was carried
out at a 1.0 mL/min flow rate with 100% mobile phase A (water
containing 0.1% acetic acid) over 10 minutes, followed by a linear
gradient generated with 100% mobile phase B (methanol containing 0.1%
acetic acid) over 10 minutes, followed by 100% mobile phase B over 5 minutes. Effluent was collected as 1-mL fractions, dried under
N2, and resuspended in buffer (0.1 mL) for analysis.
Fractionation of plasma filtrate (0.5 mL) by strong anion exchange HPLC
(SAX-HPLC) was performed on a SPHERIS HPLC column (4.6 × 250 mm, 5 µm SAX; Phase Separations, Norwalk, CT). The separation of
low-molecular-weight compounds in plasma filtrate was carried out at
the flow rate of 0.9 mL/min under isocratic conditions using 45 mM
ammonium acetate buffer (pH 4.0) as mobile phase. Effluent was
collected as 1-mL fractions, dried under N2, and
resuspended in buffer (0.1 mL) for analysis.
Mass spectrometry
LC/ESI/MS/MS was used to quantify free radical-dependent
oxidation products of arachidonic acid 9-H(P)ETE and linoleic acid 9-H(P)ODE. Immediately before analysis, 1 vol H2O was added
to 5 vol methanol-suspended sample, which was then passed through a
0.22-µm filter (Millipore). Sample (20 µL) was injected onto a
Prodigy C-18 column (1 × 250 mm, 5 µm OD, 100 A; Phenomenex, Rancho Palos Verdes, CA) at a flow rate of 50 µL/min. Separation was
performed under isocratic conditions using 95% methanol in water as
the mobile phase. In each analysis, the entirety of the HPLC column
effluent was introduced onto a Quattro II triple quandrupole MS
(Micromass). Analyses were performed using electrospray
ionization in negative-ion mode with multiple reaction monitoring of
parent and characteristic daughter ions specific for the isomers
monitored. Transitions monitored were mass-to-charge ratio (m/z)
295 171 for 9-HODE, m/z 319 151 for 9-HETE, and m/z 327 184 for
12-HETE-d8. N2 was used as the curtain gas in the
electrospray interface. Internal standard 12-HETE-d8 was used
to calculate extraction efficiencies (greater than 80% for all
analyses). External calibration curves constructed with authentic
standards were used to quantify 9-HETE and 9-HODE.
Reverse-phase HPLC quantification of CE-H(P)ODEs
Samples (100 µL) reconstituted in methanol (without base
hydrolysis) were injected onto a Beckman C-18 column (4.6 × 250 mm, 5 µm OD; Beckman Instruments). Lipids were separated using an isocratic solvent system composed of 2-isopropanol-acetonitrile-water (44/54/2, vol/vol/vol) at a flow rate of 1.5 mL/min. CE-H(P)ODEs were
quantified as their stable hydroxide forms by UV detection at 234 nm
using CE-9-HODE (Cayman Chemical) for generation of an external
calibration curve.
 |
Results |
Neutrophils isolated from MPO-deficient subjects fail to initiate
lipid peroxidation in plasma but do so after the addition of
isolated MPO
More than a decade ago, Frei et al57 made the seminal
observation that neutrophil activation in plasma results in the
time-dependent formation of lipid hydroperoxides. The precise mechanism
involved was not identified but was characterized by its sensitivity to ascorbate, which had to be depleted before lipid oxidation products were formed.57 To test the hypothesis that MPO might serve
as the enzymatic catalyst for leukocyte-dependent peroxidation of plasma lipids, we compared neutrophils from healthy and
MPO-deficient subjects. Lack of functional MPO activity was confirmed
by the absence of HOCl production after leukocyte activation (Table
1) and the absence of an MPO activity
band within native gels of leukocyte detergent extracts after in-gel
tetramethylbenzidine peroxidase staining (data not shown).
MPO-deficient neutrophils displayed enhanced agonist-dependent
O2 generation relative to comparably
treated normal neutrophils (Table 1), as previously
reported.58-60 Neutrophils isolated from healthy and
MPO-deficient subjects failed to generate detectable levels of NO or
NO in a 2-hour period.
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Table 1.
Characterization of reactive oxidant species generated by
neutrophils isolated from healthy and MPO-deficient subjects
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To determine the role of MPO in promoting lipid oxidation in plasma
exposed to activated neutrophils, we next incubated cells with whole
plasma (50%, vol/vol) and physiological levels of Cl
(100 mM final). Phagocytes were activated with PMA, and the formation of 9-H(P)ODE and 9-H(P)ETE, specific oxidation products of linoleic and
arachidonic acids, respectively, was determined by LC/ESI/MS/MS. Normal
neutrophils generated significant levels of 9-H(P)ODE and 9-(H)PETE in
plasma after cell activation by PMA (Figure
1). In stark contrast, MPO-deficient
neutrophils failed to generate significant levels of lipid peroxidation
products after stimulation with PMA, despite their enhanced capacity to
produce O2 . Addition of catalytic
amounts of MPO restored the capacity of MPO-deficient neutrophils to
initiate the peroxidation of endogenous plasma lipids (Figure 1).

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| Figure 1.
MPO-deficient neutrophils fail to initiate lipid
peroxidation in plasma.
Neutrophils (1 × 106/mL) isolated from healthy and
MPO-deficient subjects were incubated at 37°C in HBSS supplemented
with DTPA (100 µM, pH 7.0) and fresh human plasma (50%, vol/vol).
Cells were activated by the addition of phorbol myristate acetate (PMA,
200 nM) and incubated for 2 hours (Complete System). The contents of
9-H(P)ODE and 9-H(P)ETE formed within endogenous plasma lipids were
then determined by LC/ESI/MS/MS as described in "Materials and
methods." Where indicated, human MPO (30 nM) was added to reaction
mixtures. Data represent the mean ± SD of triplicate
determinations. Each bar within a cluster for a given condition
represents results obtained from independent experiments performed with
neutrophil preparations from a distinct donor. PMN(MPO+), neutrophils
isolated from healthy subjects; PMN(MPO ), neutrophils isolated from
MPO-deficient subjects.
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Characterization and reaction requirements for peroxidation of
endogenous plasma lipids by activated human neutrophils and
isolated human MPO
Addition of catalase, but not heat-inactivated catalase, to cell
mixtures resulted in the near complete ablation of lipid peroxidation
in plasma, strongly suggesting a critical role for H2O2 in the cell-dependent reaction (Figure
2). Incubation of reaction mixtures with
SOD failed to attenuate the oxidation of plasma lipids (Figure 2). In
contrast, addition of heme poisons (eg, azide, cyanide) and
water-soluble antioxidant ascorbate resulted in complete inhibition of
neutrophil-dependent peroxidation of plasma lipids. Finally, addition
of HOCl scavengers, such as dithiothreitol and the thioether
methionine, failed to attenuate neutrophil-dependent peroxidation of
endogenous plasma lipids, assessed by quantification of 9-H(P)ODE and
9-H(P)ETE (Figure 2).

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| Figure 2.
Characterization of neutrophil-dependent initiation of
lipid peroxidation of endogenous plasma lipids.
Neutrophils (1 × 106/mL) isolated from healthy subjects
(PMN) were incubated at 37°C in HBSS supplemented with DTPA (100 µM, pH 7.0) and fresh human plasma (50%, vol/vol). Cells were
activated by the addition of phorbol myristate acetate (200 nM) and
then incubated for 2 hours (Complete System). The contents of 9-H(P)ODE
and 9-H(P)ETE formed within endogenous plasma lipids were then
determined by LC/ESI/MS/MS as described in "Materials and methods."
Additions or deletions to the Complete System were as indicated. Final
concentrations of additions to the Complete System were 30 nM human
MPO, 1 mM NaN3, 300 nM catalase, 300 nM heat-inactivated
catalase, 100 µM methionine, 100 µM ascorbate, and 10 µg/mL SOD.
Data represent the mean ± SD of 3 independent experiments.
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Results thus far presented strongly suggest that neutrophils use the
MPO-H2O2 system to generate reactive species
distinct from chlorinating intermediates as the primary oxidants for
initiation of lipid peroxidation in plasma. To confirm a physiological
role for MPO, we next added purified human MPO and an
H2O2-generating system (G/GO) to plasma and
monitored the formation of specific oxidation products by LC/ESI/MS/MS
analysis. Formation of 9-H(P)ODE and 9-H(P)ETE occurred readily and had
an absolute requirement for the presence of MPO and the
H2O2-generating system (Figure 3). Lipid oxidation was again inhibited
by catalase, azide, or ascorbate but was not affected by the addition
of SOD or methionine (Figure 3). Collectively, these results strongly
support a pivotal role for the MPO-H2O2 system
of leukocytes as a primary mechanism for initiating lipid peroxidation
in complex biologic tissues and fluids such as plasma.

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| Figure 3.
Characterization of MPO-dependent initiation of lipid
peroxidation of endogenous plasma lipids.
Fresh human plasma (50%, vol/vol) was incubated with isolated human
MPO (30 nM) at 37°C in HBSS supplemented with DTPA (100 µM, pH 7.0)
and an H2O2-generating system composed of G/GO
for 12 hours (Complete System). Under this condition, a continuous flux
of H2O2 is formed at 10 µM/h. The contents of
9-H(P)ODE and 9-H(P)ETE formed within endogenous plasma lipids were
then determined by LC/ESI/MS/MS as described in "Materials and
methods." Additions or deletions to the Complete System were as
indicated. Final concentrations of additions to the Complete System
were 1 mM NaN3, 300 nM catalase, 300 nM heat-inactivated
catalase, 200 nM SOD, 100 µM methionine, and 100 µM ascorbate. Data
represent the mean ± SD of 3 independent experiments.
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Endogenous low-molecular-weight substances in plasma serve as
cosubstrates for the MPO-catalyzed initiation of lipid peroxidation
in whole plasma
The active site of MPO sits at the base of a deep and narrow heme
pocket inaccessible to compounds significantly larger than a
dipeptide.61 Thus, the ability of isolated MPO and of an
H2O2-generating system to initiate lipid
peroxidation in plasma is consistent with low-molecular-weight
compounds in plasma serving as cosubstrates for MPO to generate
diffusible species capable of conveying oxidizing equivalents from the
heme group to distant targets, such as plasma lipoproteins. To test
this hypothesis, isolated human LDL was incubated with MPO and an
H2O2-generating system to generate a physiological flux of H2O2. In the absence of
other cosubstrates, no significant oxidation of lipoprotein lipids was
observed (Figure 4). In contrast, the
addition of low-molecular-weight constituents recovered from plasma
that had been filtered through a 10-kd MWt cutoff filter reconstituted
the capacity of the MPO-H2O2 system to promote
lipid peroxidation (Figure 4, left). In a parallel set of experiments,
either plasma or dialyzed plasma was exposed to the
MPO-H2O2 system, and the extent of lipid
peroxidation was determined. Lipid peroxidation occurred in plasma, but
not in dialyzed plasma, exposed to the
MPO-H2O2 system (Figure 4, right), suggesting
that MPO used low-molecular-weight substrates within plasma to
initiate peroxidation of plasma lipids. Consistent with this
observation, the subsequent addition of plasma filtrate to reaction
mixtures using dialyzed plasma as the target for oxidation restored the
ability of the MPO-H2O2 system to promote
lipid peroxidation (Figure 4, right).

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| Figure 4.
MPO uses endogenous low-molecular-weight/dialyzable
substrates in plasma to initiate lipid peroxidation.
(left) LDL (0.2 mg/mL) was incubated with isolated human MPO (30 nM)
and an H2O2-generating system composed of G/GO
for 12 hours at 37°C in HBSS supplemented with DTPA (100 µM, pH
7.0) as in Figure 3. Where indicated, the filtrate of plasma (Fp), the
low-molecular-weight constituents derived from plasma filtered through
a 10-kd MWt cutoff filter, was added (50%, vol/vol) to the MPO-LDL
reaction mixtures. Isolated MPO, an
H2O2-generating system (G/GO) and LDL were
added to Fp (Complete System). The content of 9-H(P)ETE formed within
endogenous plasma lipids was then determined by LC/ESI/MS/MS as
described in "Materials and methods." (right) Plasma (P) or
dialyzed plasma (DP) was incubated with isolated MPO and an
H2O2-generating system (G/GO) under conditions
similar to those described above. The content of 9-H(P)ETE formed
within endogenous plasma lipids was then determined by LC/ESI/MS/MS as
described in "Materials and methods." Where indicated, DP and P
were added.
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HPLC fractionation and identification of low-molecular-weight
substrates in plasma used by MPO for initiation of lipid
peroxidation
To identify the component(s) within the filtrate of plasma that
served as physiological cosubstrates for MPO and that promoted peroxidation of plasma lipids, plasma filtrate was fractionated on a
reverse-phase HPLC column, and the ability of each fraction to provide
substrates for MPO-dependent oxidation of LDL surface and core lipids
was determined (Figure 5). Comparisons
with the retention times for potential candidate substrates for MPO
suggested that the early eluting substrate(s) in fraction 3 comigrated
with low-molecular-weight organic anions and SCN ,
fraction 4 with NO , fraction 8 with tyrosine and
fraction 26 with estradiol (Figure 5). HPLC with on-line
electrospray ionization tandem mass spectrometry analysis (positive ion mode) demonstrated that fraction 8 was composed almost
exclusively of an analyte with m/z 182.08 the m/z anticipated for the
molecular cation of tyrosine (data not shown). The high salt content of
fractions 3 and 4 prevented analysis by LC/ESI/MS/MS.

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| Figure 5.
Reverse-phase HPLC fractionation and identification of
low-molecular-weight components in plasma used by MPO to initiate
lipid peroxidation.
Plasma was filtered through a 10-kd MWt cutoff filter. The filtrate of
plasma containing the low-molecular-weight components was then
fractionated by reverse-phase HPLC as described in "Materials and
methods." Each column fraction was dried under N2,
reconstituted in 50 mM sodium phosphate buffer (pH 7.0), and incubated
with a lipid source (LDL, 0.2 mg/mL), isolated human MPO (30 nM), and
an H2O2-generating system (G/GO) (10 µM/h
flux of H2O2). After incubation at 37°C for
12 hours, the contents of 9-HETE, 9-HODE, and CE-HODEs were then
determined as described in "Materials and methods." Retention times
of some compounds described as MPO substrates in vitro include:
Cl and Br , fraction 2 (F2);
SCN , F3; NO , F4; ascorbic acid, F5;
tyrosine, F8; 6-hydroxy-dopamine, F19; serotonin, F20; catecholamines,
F18-23; estradiols, F26.
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To further identify and confirm the cosubstrates of MPO in plasma that
support the initiation of lipid peroxidation by the enzyme, plasma
filtrate was fractionated by alternative column chromatographies (ion
exchange, straight phase). Under every chromatography system examined,
4 compounds (tyrosine, NO , SCN , and
17 -estradiol) comigrated with fractions that reconstituted the
capacity of MPO-H2O2 systems to initiate lipid
peroxidation. Results of fractionation on a strong anion exchange
column are shown in Figure 6. Consistent
with prior results using reverse-phase HPLC (Figure 5),
17 -estradiol, tyrosine, NO , and SCN
coeluted with the major fractions that supported MPO-dependent initiation of lipid peroxidation (Figure 6).

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| Figure 6.
Strong anion exchange HPLC fractionation and
identification of low-molecular-weight components in plasma used by
MPO to initiate lipid peroxidation.
Plasma was filtered through a 10-kd MWt cutoff filter. The filtrate
containing the low-molecular-weight components was then fractionated
by HPLC using a strong anion exchange column as described in
"Materials and methods." Each fraction was then assessed for its
capacity to provide cosubstrate for the
MPO-H2O2 system and initiate LDL lipid
peroxidation as in Figure 5. Retention times of some compounds
described as MPO substrates in vitro include: serotonin, estradiols,
Cl , fraction 3 (F3); tyrosine, F4; ascorbic acid, F5;
NO , F6; SCN , F7.
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Confirmation that MPO uses physiologically relevant levels of
nitrite, SCN , and tyrosine as cosubstrates to promote
peroxidation of lipids in plasma and demonstration that 17 -estradiol
can be used by MPO to initiate LDL lipid oxidation under certain
conditions
Levels of NO in the plasma of healthy human
subjects measure approximately 3.6 to 5 µM, but they may reach 50 µM at sites of inflammation.22 The concentration of free
tyrosine in plasma typically varies between 44 µM and 72 µM in
healthy fasting subjects.62 Each has been previously shown
to be used by MPO as substrate to initiate lipid oxidation in simple
model systems,11,13 but neither has been reported to
initiate MPO-dependent oxidation of endogenous lipids in plasma. To
assess a potential role for NO and tyrosine
as cosubstrates involved in lipid oxidation by the MPO-H2O2 system, we incubated physiologically
relevant levels of each with dialyzed plasma as a lipid source (50%,
vol/vol) and plasma levels of Cl (100 mM). As shown in
Figure 7, even in the presence of the
competing cosubstrate Cl , biologically relevant
concentrations of NO and tyrosine were effectively
used by the MPO-H2O2 system to promote peroxidation of endogenous plasma lipids. Similar dose-dependent effects of NO and tyrosine as substrates were noted
for MPO-mediated peroxidation of core LDL lipids in buffer containing
plasma levels of halides (Figure 8,
left). Addition of both NO and tyrosine resulted in lipid peroxidation, but at a level lower than that observed with either
substrate alone (not shown).

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| Figure 7.
MPO uses NO and tyrosine as
substrates to promote peroxidation of endogenous plasma lipids under
physiologically relevant conditions.
Isolated MPO (30 nM) and an H2O2-generating
system (G/GO) (10 µM/h flux of H2O2) were
incubated with dialyzed plasma (50%, vol/vol) and the indicated
concentrations of NO and tyrosine in 50 mM sodium
phosphate buffer (pH 7.0), supplemented with 100 µM DTPA and 100 mM
NaCl. After incubation at 37°C for 12 hours, the contents of
9-H(P)ODE and 9-H(P)ETE were then determined as described in
"Materials and methods."
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| Figure 8.
MPO-initiated oxidation of LDL lipids in the presence of multiple
competing cosubstrates.
(left) Isolated MPO (30 nM) and an
H2O2-generating system (G/GO) (10 µM/h flux
of H2O2) were incubated with LDL (0.2 mg/mL)
and the indicated concentrations of either SCN ,
17 -estradiol, NO , or tyrosine in 50 mM sodium
phosphate buffer (pH 7.0), supplemented with 100 µM DTPA and 100 mM
NaCl. After incubation at 37°C for 12 hours, the content of
CE-H(P)ODE was then determined as described in "Materials and
methods." (right) Isolated MPO (30 nM), an
H2O2-generating system (G/GO) (10 µM/h flux
of H2O2), and physiological levels of
Cl (100 mM), Br (100 µM),
NO (5 µM), tyrosine (100 µM), and LDL (0.2 mg/mL) were collectively incubated with the indicated concentrations of
SCN and 17 -estradiol in 50 mM sodium phosphate buffer
(pH 7.0), supplemented with 100 µM DTPA. After incubation at 37°C
for 12 hours, the content of CE-H(P)ODE was then determined as
described in "Materials and methods."
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Although studies have shown that SCN and 17 -estradiol
may serve as reducing substrates for peroxidases in vitro, the capacity of MPO to use either compound for initiating lipid oxidation has not
yet been reported. SCN levels in plasma from a healthy
subject range from 17 to 69 µM and may reach more than 200 µM in
the plasma of smokers.62 Normal levels of total estrogens
in serum are reported to be 37 to 184 pM in men and 18 to 1266 pM in
women, and they can reach significantly higher levels with
supplementation and pregnancy.62 When 17 -estradiol or
SCN was incubated with MPO, an
H2O2-generating system and LDL in media
containing plasma levels of Cl lipid peroxidation was
initiated in a dose-dependent fashion (Figure 8, left). When all
cosubstrates were present at physiological levels, tyrosine and
NO augmented MPO-H2O2-dependent initiation of lipid
oxidation under all conditions examined (data not shown). With
physiologically relevant concentrations, SCN , but not
17 -estradiol, was able to further promote lipid peroxidation in the
presence of multiple competing cosubstrates for MPO, including Cl , Br , NO , and tyrosine
(Figure 8, right).
 |
Discussion |
MPO is the single most abundant protein in neutrophils, but the
precise substrates used and the biochemical reactions mediated by this
enzyme in vivo are still not fully defined. MPO uses Cl
in vivo to generate microbicidal and chlorinating oxidants, as confirmed by the detection of chlorinated products at sites of inflammation in mice45 and humans.63
Furthermore, selective defects in host defenses (eg, against fungal and
yeast pathogens) are noted in mice and humans deficient in MPO
activity.45,64,65 However, a complex array of potential
reactions in addition to those involving halogenating oxidants have
been identified for MPO in model systems.14-30 Numerous
low-molecular-weight organic and inorganic substances found in
biologic matrices may serve as cosubstrates for MPO catalysis in
isolation in vitro, generating reactive oxidants and diffusible radical
species (reviewed in Podrez et al5 and Kettle and
Winterbourn14). The relative importance of these species
and their contributions to reactions that occur in vivo is uncertain.
Although lipid peroxidation and lipid-derived signaling molecule
formation are believed to be critical in atherosclerosis and other
inflammatory disorders, the pathways responsible for these processes in
vivo are not fully established. Leukocyte activation in whole plasma
has long been appreciated as a physiological mechanism for promoting
peroxidation of endogenous plasma lipids.57 However, the
enzymatic participant(s) and the reactive intermediates involved in
leukocyte-mediated lipid oxidation within complex matrices such as
plasma have not been directly defined. Results of the current study
definitively identify MPO as a major enzymatic catalyst for promoting
lipid oxidation by activated human neutrophils in plasma. Furthermore,
the MPO-H2O2 system uses low-molecular-weight components in plasma distinct from Cl for initiating
lipid peroxidation at sites of inflammation, including tyrosine,
NO , SCN , and perhaps 17 -estradiol.
Recent studies using leukocytes isolated from wild-type and MPO
knockout mice report modest differences in their capacity to promote
lipoprotein lipid oxidation and inhibition in lipid oxidation by the
addition of SOD.37 Two major species differences between
murine and human neutrophils include the significant generation of NO
by mouse but not human neutrophils and the 6- to 10-fold decrease in
MPO content found in murine neutrophils compared with that observed in
humans.30,42,43 Moreover, mixed leukocyte preparations
rather than isolated neutrophils were used in the studies with MPO
knockout mice.37 Whether these factors contributed to the
limited role reported for MPO by the elicited murine leukocytes and the
sensitivity to SOD remains to be established. Neutrophils from multiple
unrelated MPO-deficient humans all failed to promote peroxidation of
endogenous lipids in plasma unless supplemented with catalytic levels
of purified MPO. Catalase, peroxidase inhibitors, and ascorbate, but
not SOD, inhibited leukocyte-dependent peroxidation of plasma lipids,
consistent with the MPO-H2O2 system as the
responsible mechanism. The current results thus strongly support a
major physiological role for MPO in initiating lipid peroxidation by
activated human leukocytes and suggest that a function of the enzyme at
sites of inflammation may be to generate lipid oxidation products with biologic activity.
Four compounds in human plasma could support MPO-dependent peroxidation
of LDL lipids in the presence of physiological levels of
Cl : NO , tyrosine, SCN ,
and 17 -estradiol. Tyrosine and NO have been
implicated in the modification of lipoproteins by the MPO system of
leukocytes in prior studies.11-13 However, as far as we
are aware, a role for either SCN or 17 -estradiol in
the initiation of lipid oxidation by peroxidases has not yet been
reported. The addition of tyrosine and NO to the
MPO-H2O2 system modestly inhibited
MPO-dependent lipid oxidation compared with that observed with either
NO or tyrosine alone, potentially reflecting the
loss of intermediates ( NO2 and
tyrosyl radical) that promote lipid peroxidation through radical-radical coupling reactions, generating
nitrotyrosine.66
Cigarette smoking is a risk factor for cardiovascular disease, and
plasma levels of SCN in smokers may be increased 2 to 3 times more than that observed in nonsmokers.67,68 A
positive correlation between serum SCN levels and the
formation of advanced atherosclerotic plaques within coronary arteries
has been noted.67,69 The current discovery of
SCN as a physiological reducing substrate for MPO that
promotes LDL lipid oxidation suggests a potential mechanism for this
correlation. In recent studies, hypothiocyanate was identified as a
proximate oxidant that accumulates in buffer during oxidation of
SCN by eosinophil peroxidase, a related leukocyte
peroxidase.70 It is unclear how this 2 e
oxidation product of SCN would initiate lipid oxidation.
Indeed, the current studies suggest that MPO also generates the
1-electron oxidation product, thiocyanyl radical
( SCN), or that the addition of SCN to
MPO-H2O2 systems promotes the formation of a
protein radical species on MPO that is accessible to lipid targets. It
is interesting that van Dalen and Kettle71 recently
demonstrated the formation of a radical species after MPO-catalyzed
oxidation of SCN . Further examination of the mechanisms
of how SCN oxidation by MPO leads to the initiation of
lipid oxidation are warranted because it is tempting to speculate that
this pathway potentially contributes to the enhanced risk for
cardiovascular disease noted in smokers.
Identification of 17 -estradiol as a potential substrate for MPO in
plasma that can initiate lipid oxidation was unanticipated. The current
studies suggest, however, that 17 -estradiol does not likely play a
significant role in lipid oxidation mediated by MPO in vivo unless
localized consumption of alternative competing cosubstrates, such as
tyrosine, SCN , and NO has occurred,
and supraphysiological levels are achieved, such as through
supplementation. It is nonetheless interesting that elevated levels of
17 -estradiol in serum have been reported in subjects with acute
myocardial infarction and septic shock.72,73 Although many
studies have suggested that estrogens may serve as antioxidant
cardioprotectants,74 recent studies involving more than
3000 women demonstrated that estrogen replacement did not reduce, but
possibly enhanced, the overall rate of coronary events in women with
established coronary artery disease.74-76
Taken together, our results highlight the probable contribution of MPO
in promoting lipid oxidation at sites of inflammation. The development
of peroxidase inhibitors as novel anti-inflammatory agents thus merits
consideration. The sensitivity of leukocyte- and MPO-dependent
oxidation of plasma lipids to ascorbate also has implications for the
choice of anti-oxidant regimen one considers. In studies using
whole plasma, small unilamellar vesicles, or LDL as targets, ascorbate
inhibits MPO-mediated peroxidation of lipids far more effectively than
that observed with -tocopherol (R.Z. and S.L.H., unpublished
results, January 2000). Finally, the capacity of the
MPO-H2O2 system of leukocytes to form
bioactive lipid oxidation products in plasma suggests that MPO plays a
broad role in inflammation biology and host defenses. Indeed, we
recently demonstrated that exposure of LDL to the
MPO-H2O2 system of activated monocytes in
media containing NO converts the lipoprotein to a
high uptake form capable of promoting cholesterol accumulation and foam
cell formation.12 Oxidized lipid(s) were shown to serve as
major constituent(s) that facilitated recognition of the modified
lipoprotein by the macrophage scavenger receptor CD36.12,77 This receptor has recently been implicated in
foam cell formation and atherosclerosis.77,78 Thus,
MPO-dependent peroxidation of cell membranes and lipoproteins may serve
as a physiological mechanism to promote the uptake of modified and senescent cellular cons |