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August 30, 2005Circulation265 citationsOpen Access

Atorvastatin Inhibits Hypercholesterolemia-Induced Calcification in the Aortic Valves via the Lrp5 Receptor Pathway

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NRNalini M. RajamannanMSMalayannan SubramaniamFCFrank Caira

Key Result

Atorvastatin attenuated hypercholesterolemia-induced aortic valve calcification in Watanabe rabbits, mediated in part by reducing Lrp5/beta-catenin pathway expression and cellular proliferation.

Key Points

  • To determine whether Lrp5 receptor signaling contributes to hypercholesterolemia-induced aortic valve calcification and whether atorvastatin can inhibit this process.
  • Assigned 54 Watanabe rabbits to three groups (n=18 each): normal diet, 0.25% cholesterol diet, or 0.25% cholesterol diet with atorvastatin.
  • Evaluated valve calcification, cellular proliferation, and bone matrix markers using micro-computed tomography, calcein labeling, and osteopontin quantification.
  • Treated cultured aortic valve myofibroblasts in vitro with low-density lipoprotein with or without atorvastatin to analyze Lrp5/beta-catenin regulation.
  • A high-cholesterol diet promoted complex bone formation in aortic valves and upregulated Lrp5, osteopontin, and p42/44 expression.
  • Atorvastatin significantly attenuated bone formation, cellular proliferation, and Lrp5/beta-catenin protein levels in aortic valve tissue.
  • In vitro analyses confirmed that atorvastatin suppresses Lrp5/beta-catenin expression during low-density lipoprotein-mediated myofibroblast proliferation.

Structured PICO

Does atorvastatin reduce aortic valve calcification in hypercholesterolemic Watanabe rabbits?

P
Population
Watanabe rabbits (n=54) and in vitro aortic valve myofibroblasts
I
Intervention
0.25% (w/w) cholesterol diet with atorvastatin
C
Comparator
Normal diet (n=18) and 0.25% cholesterol diet without atorvastatin (n=18)
O
Outcome
Aortic valve calcification, bone formation, cellular proliferation, and Lrp5/beta-catenin protein levelssurrogate

Atorvastatin attenuates hypercholesterolemia-induced aortic valve calcification in a rabbit model, partially mediated by the Lrp5/beta-catenin pathway.

Abstract

BACKGROUND: Calcific aortic valve disease is the most common indication for surgical valve replacement in the United States. The cellular mechanisms of valve calcification are not well understood. We have previously shown that cellular proliferation and osteoblastogenesis are important in the development of valvular heart disease. Lrp5, a known low-density receptor-related protein, plays an essential role in cellular proliferation and osteoblastogenesis via the beta-catenin signaling pathway. We hypothesize that Lrp5 also plays a role in aortic valve (AV) calcification in experimental hypercholesterolemia. METHODS AND RESULTS: We examined the effects of cholesterol and atorvastatin in Watanabe rabbits (n=54). Group I (n=18) received a normal diet, group II (n=18) a 0.25% cholesterol diet, and group III (n=18) a 0.25% (w/w) cholesterol diet with atorvastatin for the development of calcification. The AVs were examined for cellular proliferation, Lrp5/beta-catenin, and bone matrix markers. Bone formation was assessed by micro-computed tomography, calcein injection, and osteopontin expression. Low-density lipoprotein with and without atorvastatin was also tested in AV myofibroblasts for cellular proliferation and regulation of the Lrp5/beta-catenin pathway. Our results demonstrate that the cholesterol diet induced complex bone formations in the calcified AVs with an increase in the Lrp5 receptors, osteopontin, and p42/44 expression. Atorvastatin reduced bone formation, cellular proliferation, and Lrp5/beta-catenin protein levels in the AVs. In vitro analysis confirmed the Lrp5/beta-catenin expression in myofibroblast cell proliferation. CONCLUSIONS: Hypercholesterolemic AV calcification is attenuated by atorvastatin and is mediated in part by the Lrp5/beta-catenin pathway. This developmental pathway may be important in the signaling pathway of this disease.

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Cite This Study

Rajamannan et al. (2005) studied Hypercholesterolemia-induced aortic valve calcification (n=54). Atorvastatin vs. 0.25% cholesterol diet without atorvastatin and normal diet was evaluated on Aortic valve calcification, cellular proliferation, Lrp5/beta-catenin, and bone matrix markers. Atorvastatin attenuated hypercholesterolemia-induced aortic valve calcification in Watanabe rabbits, mediated in part by reducing Lrp5/beta-catenin pathway expression and cellular proliferation.

synapsesocial.com/papers/6a0e0befea388c2a8d537528https://doi.org/10.1161/01.circulationaha.104.524306
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