The
lipid aldehyde 4-oxo-2-nonenal (ONE) is a highly reactive
protein crosslinker derived from peroxidation of n-6
polyunsaturated fatty acids and generated together with
4-hydroxynonenal (HNE). Lipid peroxidation product-mediated crosslinking of
proteins in
high-density lipoprotein (HDL) causes HDL dysfunction and contributes to
atherogenesis. Although HNE is relatively well-studied, the role of ONE in
atherosclerosis and in modifying HDL is unknown. Here, we found that individuals with
familial hypercholesterolemia (FH) had significantly higher ONE-ketoamide (
lysine) adducts in HDL (54.6 ± 33.8 pmol/mg) than healthy controls (15.3 ± 5.6 pmol/mg). ONE crosslinked
apolipoprotein A-I (
apoA-I) on HDL at a concentration of > 3 mol ONE per 10 mol
apoA-I (0.3 eq), which was 100-fold lower than HNE, but comparable to the potent
protein crosslinker
isolevuglandin. ONE-modified HDL partially inhibited HDL's ability to protect against
lipopolysaccharide (LPS)-induced
tumor necrosis factor α (TNFα) and interleukin-1β (IL-1β) gene expression in murine macrophages. At 3 eq, ONE dramatically decreased
apoA-I exchange from HDL, from ∼46.5 to ∼18.4% (p < 0.001). Surprisingly, ONE modification of HDL or
apoA-I did not alter macrophage
cholesterol efflux capacity. LC-MS/MS analysis revealed that Lys-12, Lys-23, Lys-96, and Lys-226 in
apoA-I are modified by ONE ketoamide adducts. Compared with other dicarbonyl scavengers, pentylpyridoxamine (PPM) most efficaciously blocked ONE-induced
protein crosslinking in HDL and also prevented HDL dysfunction in an in vitro model of
inflammation. Our findings show that ONE-HDL adducts cause HDL dysfunction and are elevated in individuals with FH who have severe
hypercholesterolemia.