Apolipoprotein E (
apoE) is a high affinity
ligand for several receptor systems in the liver, including the
low-density lipoprotein (
LDL) receptor, and non-
LDL receptor sites, like the
LDL receptor-related protein (LRP), the putative remnant receptor and/or
proteoglycans. Although the liver is the major source of
apoE synthesis,
apoE is also produced by a wide variety of other cell types, including macrophages. In the present study, the role of the
LDL receptor in the removal of
lipoprotein remnants, enriched with macrophage-derived
apoE from the circulation, was determined using the technique of
bone marrow transplantation (BMT). Reconstitution of macrophage
apoE production in
apoE-deficient mice resulted in a serum
apoE concentration of only 2% of the concentration in wild-type C57Bl/6 mice. This low level of
apoE nevertheless reduced VLDL and
LDL cholesterol 12-fold (P<0.001) and fourfold (P<0.001), respectively, thereby reducing serum
cholesterol levels and the susceptibility to
atherosclerosis. In contrast, reconstitution of macrophage
apoE synthesis in mice lacking both
apoE and the
LDL receptor induced only a twofold (P<0.001) reduction in
VLDL cholesterol and had no significant effect on atherosclerotic lesion development, although serum
apoE levels were 93% of the concentration in normal C57Bl/6 mice. In conclusion, a functional (hepatic)
LDL receptor is essential for the efficient removal of macrophage
apoE-enriched
lipoprotein remnants from the circulation and thus for normalization of serum
cholesterol levels and protection against atherosclerotic lesion development in
apoE-deficient mice.