Abstract
Apolipoprotein A-IMilano (apoA-IMilano) and apoA-IParis are rare cysteine variants of apoA-I that produce a HDL deficiency in the absence of cardiovascular disease in humans. This paradox provides the basis for the hypothesis that the cysteine variants possess a beneficial activity not associated with wild-type apoA-I (apoA-IWT). In this study, a unique antioxidant activity of apoA-IMilano and apoA-IParis is described. ApoA-IMilano was twice as effective as apoA-IParis in preventing lipoxygenase-mediated oxidation of phospholipids, whereas apoA-IWT was poorly active. Antioxidant activity was observed using the monomeric form of the variants and was equally effective before and after initiation of oxidative events. ApoA-IMilano protected phospholipid from reactive oxygen species (ROS) generated via xanthine/xanthine oxidase (X/Xo) but failed to inhibit X/Xo-induced reduction of cytochrome c. These results indicate that apoA-IMilano was unable to directly quench ROS in the aqueous phase. There were no differences between lipid-free apoA-IMilano, apoA-IParis, and apoA-IWT in mediating the efflux of cholesterol from macrophages, indicating that the cysteine variants interacted normally with the ABCA1 efflux pathway. The results indicate that incorporation of a free thiol within an amphipathic α helix of apoA-I confers an antioxidant activity distinct from that of apoA-IWT. These studies are the first to relate gain of function to rare cysteine mutations in the apoA-I primary sequence.

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