Effects of methylation and hydroxylation of sphingomyelins on their biophysical properties and interactions with cholesterol

Sfingomyeliner är viktiga sphingolipidmolekyler som finns i cellmembranets exoplastiska monolager. Sfingomyeliner är sällsynta i växter och mikroorganismer. Den enigmatiska sfingomelinmolekylen som Thudicum isolerade från hjärnvävnad i slutet på 1800-talet fick sitt namn på basen av det grekiska ordet”sfinx”. Sfingomyeliner återfinns speciallt rikligt i myelinskidorna i nervvävnad, var de sfingomyelinrika membranen bildar ett isolerande lager runt nervcellernas axoner. De polära sfingomyelinerna är viktiga beståndsdelar av ägg, mjölk och kött, och betraktas som viktiga näringsämnen speciellt för spädbarn. Det finns ett flertal sjukdomar uppstår på grund av defekter i sfingomyelinmetabolismen., t.ex. Niemann-Picks sjukdom, som är en obotlig ärftlig metabolisk sjukdom. Nyligen har det rapporterats att sfingomyelin tillsammans med kolesterol och specifika proteiner bildar funtionella domäner, s.k. membranflottar, i cellers membran. Membranflottar anses delta i många viktiga biologiska processer som t.ex. signalöverföring, lipid- och proteinsortering, apoptos, celladhesion, cellmigration och synapsers signalöverföring. Därför är det ytterst viktigt att förstå samverkan mellan sfingomyelin och kolesterol och hur denna samverkan påverkar bildandet membranflottar. I avhandlingen presenteras data från våra studier av sfingomyelin samverkan med kolesterol. För avhandlingen syntetiserade vi unika sfingomyelin molekyler genom att införa metyl- och hydroxylgrupper i olika positioner i sphingomyelinmolekylerna, med målet att lära oss mera om sphingomyelinets membranegenskaper och samverkan med kolesterol. Alla sfingomyelin molekyler som användes i avhandlingsarbetet är biologiskt relevanta. I studierna fann vi att hydroxyl- och amidgrupperna i sfingomyelin är viktiga i vätebindningar mellan sfingomyelinmolekyler samt mellan sfingomyelin och kolesterol. Vi upptäckte ytterligare att substition av metylgrupper i acylkedjan eller i interfasregionen hos sfingomyelinmolekyler signifikant destabiliserade sphingomyelin bilagret och försvagade/upphävde molekylernas samverkan med kolesterol. Hur sfingomyelinbilagrens stabilitet och sfingomyelinen-koleterol samverkan påverkades av hydroxylgrupper var beroende av hydrohygruppens position. Förekomst av en extra hydroxylgrupp i sfingomyelionmolekylens sfingoidbasen ökade stabilitetnen hos sfingomyelinbilagren samt stabiliserade sfingomyelinets samverkan med kolesterol.

Studies on membrane properties of cholesterol and 3-beta modified sterol analogs

Cholesterol (Chol) is an important lipid in cellular membranes functioning both as a membrane fluidity regulator, permeability regulator and co-factor for some membrane proteins, e.g. G-protein coupled receptors. It also participates in the formation of signaling platforms and gives the membrane more mechanical strenght to prevent osmotic lysis of the cell. The sterol structure is very conserved and already minor structural modifications can completely abolish its membrane functions. The right interaction with adjacent lipids and the preference of certain lipid structures over others are also key factors in determining the membrane properties of cholesterol. Because of the many important properties of cholesterol it is of value to understand the forces and structural properties that govern the membrane behavior of this sterol. In this thesis we have used established fluorescence spectroscopy methods to study the membrane behavior of both cholesterol and some of its 3β-modified analogs. Using several fluorescent probes we have established how the acyl chain order of the two main lipid species, sphingomyelin (SM) and phosphatidylcholine (PC) affect sterol partitioning as well as characterized the membrane properties of 3β-aminocholesterol and cholesteryl phosphocholine. We concluded that cholesterol prefers SM over PC at equal acyl chain order, indicating that other structural properties besides the acyl chain order are important for sphingomyelin-sterol interactions. A positive charge at the 3β position only caused minor changes in the sterol membrane behavior compared to cholesterol. A large phosphocholine head group caused a disruption in membrane packing together with other membrane lipids with large head groups, but was also able to form stable fluid bilayers together with ceramide and cholesterol. The Ability of the large head group sterol to form bilayers together with ceramide was further explored in the last paper where cholesteryl phosphocholine/ceramide (Chol-PC/Cer) complexes were successfully used to transfer ceramide into cultured cells.

Cholesterol, cardiovascular disease and statin use in older persons

Older age increases the risk of developing a chronic atherosclerotic cardiovascular disease (CVD), such as coronary heart disease. Complications of CVDs, myocardial infarction or stroke often lead to loss of functional capacity or premature death. Dyslipidemia, high serum levels of total or low-density lipoprotein cholesterol (LDL-c) and low levels of high-density lipoprotein cholesterol (HDL-c), is among the most important modifiable risk factors for CVDs; it can be treated with lifestyle modifications, and with lipid-lowering drugs, primarily statins. In older persons, however, the association of cholesterol levels with cardiovascular and all-cause mortality has been inconsistent in previous studies. Furthermore, the beneficial effects of statins in older persons without previous CVD are still somewhat unclear, and older persons are more prone to adverse effects from statins. This thesis presents a prospective cohort study (TUVA), exploring associations of cholesterol levels with mortality and the changes in cholesterol levels of a 70-year-old population in long-term follow-up. Further, prevalence of CVDs, risk factors and preventive medication use in the TUVA cohort is compared with respective prevalences in another age-matched cohort (UTUVA) 20 years later in order to examine the changes in cardiovascular risk over time. Additionally, to evaluate statin use patterns among older persons, an observational register study was conducted covering the total Finnish population aged 70 and older during 2000-2008. Based on individual-level data retrieved from national health registries, the population was classified into low, moderate and high risk groups according to estimated CVD risk. The prevalence, incidence and persistence of statin use among the risk groups was then evaluated based upon yearly statin purchases tracked from the Prescription Register. The prospective cohort study demonstrated that low total cholesterol, LDL-c and HDL-c were associated with higher mortality in a cohort of home-dwelling 70-year-olds. However, after adjusting for traditional cardiovascular risk factors and cancer this association disappeared. Further, low total cholesterol seemed to be protective, whereas low HDL-c strongly predicted increased risk of CVD death. Cholesterol levels of those elderly who remained available for follow-up and were still home-dwelling at the age of 85 seemed to improve with advancing age. Compared to the TUVA cohort, the later born UTUVA cohort had less CVDs and their risk factors were better controlled, which was reflected in the higher use of preventive medications such as statins and antihypertensives. The register studies confirmed that statin use has increased significantly during 2000-2008 among older persons, especially among the oldest (80+) age groups and among those at high risk for cardiovascular events. Two-thirds of new statin users persisted with their use during the four years of follow-up; the most discontinuations were made during the first year of use. In conclusion, statins are commonly used among older age groups in Finland. Most of the older statin users had a high cardiovascular event risk, indicating that the treatment is well directed towards those who are likely to benefit from it the most. No age-limits should be put on the screening and treatment of dyslipidemia in older persons, but the benefits and adverse effects of statin treatment should be carefully weighed based on an individual assessment of the person’s general health status and functional capacity. Physicians should pay more attention to medication adherence, especially when prescribing preventive medications.