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Figure 1.

Anion-exchange chromatography of low-density lipoprotein (LDL) from a hypercholesterolemic patient.

Chromatograms showing the L5 percentage before treatment (left), after 3 months of atorvastatin treatment (10 mg/day; center), and 3 months after the discontinuation of treatment (right) in hypercholesterolemic patient (baseline plasma LDL-cholesterol level, 226 mg/dL). Treatment with atorvastatin for 3 months reduced the level of L5, and discontinuation of treatment for 3 months resulted in the recurrence of elevated L5.

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Table 1.

Characteristics of Patients with Hypercholesterolemia and Healthy Control Subjects Before Atorvastatin Treatment.

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Table 2.

Characteristics of Patients with Hypercholesterolemia Before and After Atorvastatin Treatment.

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Figure 2.

Analysis of C-reactive protein (CRP) expression by using Western blot and enzyme-linked immunosorbent assay (ELISA).

(A, B) C-reactive protein expression in human aortic endothelial cells (HAECs) treated with L5 from 5 hypercholesterolemic patients (patients labeled as A–E). L5 increased endothelial CRP expression by up to 2.5-fold more than did L1. (C) L5 treatment (10–100 µg/mL) increased endothelial CRP expression in a dose-dependent manner. (D) ELISA analysis of CRP in the conditioned culture medium (CCM) of HAECs treated with phosphate-buffered saline (PBS), L1, or L5. For all experiments, n = 3, and bars shown in graphs represent standard deviation. *P<0.05, **P<0.01, ***P<0.001 vs. PBS or untreated control.

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Figure 3.

Detection of total reactive oxygen species (ROS) in human aortic endothelial cells (HAECs).

(A) L5 (50 µg/mL) from patients increased ROS production (green) in HAECs after 20 minutes (top and middle row) and after 24 hours (bottom row). Compared to the phosphate-buffered saline (PBS) control, L1 treatment had no effect. Staining with 4′,6-diamidino-2-phenylindole (DAPI) (blue) indicated HAEC apoptosis 24 hours after L5 (50 µg/mL) exposure. The pretreatment of cells with TS92 attenuated the L5-induced ROS increase after 20 minutes (middle row). (B) Blocking the production of ROS by adding ROS inhibitor N-acetyl cysteine (NAC) attenuated the L5-induced increase in CRP levels. For all experiments, n = 3, and bars shown in graphs represent standard deviation. *P<0.05, **P<0.01 vs. untreated control.

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Figure 4.

Effects of lectin-like oxidized LDL receptor-1 (LOX-1) inhibition in human aortic endothelial cells (HAECs).

(A) HAECs were pretreated with LOX-1 neutralizing antibody TS92 before the introduction of L1 or L5 into cell culture. (B) HAECs were pretreated with TS92 before the introduction of recombinant human CRP (5 or 50 µg/mL) into cell culture. For all experiments, n = 3, and bars shown in graphs represent standard deviation. *P<0.05 vs. untreated control.

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Figure 5.

Time-course analysis of L1 and L5 internalization by human aortic endothelial cells (HAECs) and L5-induced C-reactive protein (CRP) expression.

(A) Results of fluorescence microscopy showing that DiI-L1 and DiI-L5 (each red) were internalized by HAECs at different time points. The nuclei of HAECs were co-stained with 4′,6-diamidino-2-phenylindole (DAPI) (blue). (B) Western blot showing that L5 augmented endothelial CRP expression in a time-dependent manner. Time point 0 represents the phosphate-buffered saline (PBS) control. *P<0.05 vs. PBS-treated control. (C) L5 deprivation study showed that internalized L5 continued to induce CRP and lectin-like oxidized receptor-1 (LOX-1) expression 24 hours after replacing L5 conditioned culture media with fresh EGM2 media. L5 exposure times are shown. HAECs were incubated with recombinant CRP for 2 hours as a positive control. Time point 0 represents the PBS control. For all experiments, n = 3, and bars in graphs represent standard deviation. †P<0.05 vs. PBS-treated CRP control, *P<0.05 vs. PBS-treated LOX-1 control.

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