Severe hypercholesterolaemia leads to strong Th2 responses to an exogenous antigen.

Severe hypercholesterolaemia is associated with decreased levels of immunoglobulin G2a (IgG2a) antibodies [T-helper 1 (Th1) response] to modified malondialdehyde-modified low-density lipoprotein (MDA-LDL) and increased levels of Th2-dependent IgG1 antibodies in apolipoprotein E-deficient (apoE(-/-)) mice. To investigate whether this reflects a general pattern of metabolic regulation of the humoral immune response, apoE(-/-) mice were fed diets resulting in different degrees of hypercholesterolaemia and immunized with keyhole limpet haemocyanin (KLH) in aluminium hydroxide. Cholesterol levels for different treatment groups ranged from 14 to 77 mmol/l in serum and from 10 to 39 mmol/g in liver. Mice with severe hypercholesterolaemia had increased IgG1 antibodies to MDA-LDL and decreased IgG2a anti-MDA-LDL. Importantly, titres of IgG2a antibodies to KLH were also decreased, while IgE anti-KLH was increased, with a corresponding induction of interleukin-4 (IL-4) and IL-10 and a decrease in interferon-gamma (IFN-gamma) in KLH-stimulated spleen cells in vitro. Thus, hypercholesterolaemia clearly affects antibody production both to the autoantigen MDA-LDL and to the exogenous antigen KLH, favouring antibody isotypes (IgG1 and IgE) that are dependent on Th2 help to B cells. Nuclear receptors ligated by oxidized lipid derivatives modulate T-cell responses, and it is speculated that this mechanism may cause the switch to Th2 in severe hypercholesterolaemia.