Cholesterol Metabolism Southwestern Medical School Dallas, Texas.
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Transcript of Cholesterol Metabolism Southwestern Medical School Dallas, Texas.
Familial Hypercholesterolemia
• 1 in a million homozygous HO (both alleles)• 1 in 500 heterozygous HT (one defective allele)• HO serum cholesterol 650-1000 mg/100 ml• HT serum cholesterol 250-500 mg/100 ml• HO develop atherosclerosis, die before 20 yrs• HO death due to heart disease• HT enjoy normal life span but are at risk
What’s Wrong in FH?
• Suppressed by cholesterol
• 50-100 fold more active without cholesterol
• FH have high activity all the time
• Purified HMG-CoA reductase is inhibited
• Cholesterol not entering cell to suppress
• Receptor for cholesterol not present
• FH must lack a means of taking up the cholesterol from the plasma
HMG-CoA Reductase
What did Goldstein and Brown Accomplish?
• LDL has a specific membrane surface receptor• LDL receptors are needed to take up cholesterol• The binding of LDL to a receptor initiates
endocytosis, which brings LDL and its receptor inside the cell within an endosome
• The endosome fuses with a lysosome• LDL receptor escapes degradation• Cholesterol is free inside the cell• Receptor recycles to the cell surface
Cholesterol Uptake from LDL
Golgi
Endosome
Lysosome
Coated vesicleACAT
Coated Pit
LDL withapoB100
See p 263
LDL Particles
ApoB100
Cholesterol-rich, triglyceride-poor lipoprotein particles
LDL(180-260) Angstroms
Core of cholesterolesters
Membrane-like coat
Lipoprotein Metabolism I
• Liver and intestine are primary source of circulating lipids
• Chylomicrons carry triacylglycerols and cholesterol esters from intestine to tissues
• VLDL carry same from liver
• Lipoprotein lipases hydrolyze triacylglycerols
• VLDL IDL LDL
• LDL with apoB100 enters tissues
Lipoprotein Metabolism II
• HDL smallest LP
• Made in liver, released with no cholesterol
• Life span 5-6 days (longest LP)
• Receives cholesterol esters from LCAT
• Cholesterol ester transfer protein transfers ester to LDL and VLDL
• Most cholesterol esters are returned to liver
C
OH
HO
COO-
H3C
Mevalonate
R = H X = H Compactin
R = CH3 X = H Lovastatin (MevacorTM)
R = OH X = H Pravastatin (PravacholTM)
CH3
O
O
CH3
C COO-
OH
HO
R
X
R = CH3 X = CH3 Simvastatin (ZocorTM)
STATINS (Competitive inhibitors of HMG-CoA Reductase)
Summary
• LDL is required for cholesterol absorption
• LDL arises from VLDL by TG removal
• Lipoprotein lipase required to form LDL
• LDL has apoB100 to recognize receptor
• Receptor-mediated endocytosis
• HDL takes cholesterol from LDLvia LCAT
• HDL cholesterol goes back to the liver for oxidation, not deposition