In analytical studies, we developed and evaluated homogeneous assays for sequential testing of up to four lipid/lipoprotein constituents (HDL-cholesterol, apolipoprotein B, total cholesterol, and triglycerides) in a single tube. These new methods are particularly cost-effective in screening for subjects with high cardiovascular risk. In animal studies, we analyzed the laboratory and morphologic abnormalities in lecithin:cholesterol acyltransferase (LCAT) deficient mice. We showed that these animals develop serum lipoprotein X, glomerulosclerosis, and atherosclerosis and are a useful model of human LCAT deficiency. In a collaborative clinical studies we continued studying atherogenic plasma constituents and markers with respect to their analytical and diagnostic performance and overall clinical utility. In a series of studies, we investigated the effects of estrogen, vitamin E, and the selective estrogen receptor modulator raloxifen on vascular responsiveness, serum lipid profile, and inflammatory vascular markers in postmenopausal women. We observed divergent effects of estrogen hormone replacement therapy on serum markers of inflammation in postmenopausal women with coronary artery disease on appropriate medical management. In other studies dealing with the clinical significance of various viral (e.g., cytomegalovirus, herpes simplex viruses, hepatitis A virus) and bacterial infections (e.g., Helicobacter pylori, Chlamydia pneumoniae) and inflammatory processes in general, we observed that (a) total pathogen burden affects both coronary artery disease risk and serum C-reactive protein levels, and (b) the host response to cytomegalovirus infection is a determinant of susceptibility to coronary artery disease with gender-based differences in inflammation and type of immune response. Further, we found that antibodies to human heat-shock protein 60 are asssociated with the presence and severity of coronary artery disease, indicating an autoimmune component of atherogenesis.
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