Download MBBS Biochemistry PPT 72 Lipoprotein Metabolism Lecture Notes

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Lipoprotein Metabolism

Generation,Operation,Destruction

Formation,Functions,Utilization

Of

Lipoproteins

In

Health And Disease
In Human Body

How Transportation Of Lipids

Occur

Through Aqueous Media ?



What are Lipoproteins ?


? Lipoproteins are

complex

macromolecules

? Biosynthesized by

aggregation of

Lipids and

Apoproteins.

? Lipoproteins are compound

Lipids/Conjugated Proteins.

? Lipoproteins acquire charge and

made soluble in aqueous phase.
Why Lipoproteins are Biosynthesized?

Al types of Lipoproteins are

Biosynthesized In Human body


vNeutral Lipid

(Nonpolar)Biomolecules: Relatively

insoluble in water

vTherefore, Lipids are transported

in plasma and Lymph (aqueous

phase) as Lipoproteins

Hydrophobic lipids

Amphiphilic lipids


Structure Of Lipoprotein


Structure of lipoprotein



Hydrophobic lipids (TAG, CE) in Core

Amphiphilic lipids (C, PL) and proteins on

surface

Plasma Lipoproteins (Structure)

? Non-covalent

assemblies of lipids

and proteins

? LP core

? Triglycerides
? Cholesterol esters

? LP surface

? Phospholipids
? Proteins

Function as transport vehicles

? Cholesterol

for triacylglycerols and

cholesterol in the blood


Contents Of Lipoproteins Structure

?Non polar Lipids are at

center

?Polar Lipids and

Apoproteins are present

at periphery.

Function/Role Of Lipoproteins

Serves As Vehicles Of Lipid Transport

Through Aqueous Phase
?Lipoproteins function

as transport vehicles

?For transportation of

insoluble form of

Lipids in blood plasma.



? Lipoproteins deliver lipid

forms (Cholesterol and TAG

etc) from one tissue to

various other tissues for

their utilization.
? Various Lipoproteins formed within

body cells

? Serves in transportation of
? Exogenous (Dietary Source)
? Endogenous (Lipids biosynthesized)
? From one organ to another through

aqueous phase of Lymph and blood.

Role of Lipoproteins Components

?Substrates for Energy Metabolism (TAG)
?Provide Essential components for cell

structure (PL, Cholesterol)

?Precursors for Hormones (Cholesterol)
?Precursors for Bile acids and Bile salts (C)
?Carries Lipid soluble Vitamins
Types Of Lipoproteins

? There are different types of Lipoproteins

depending upon:

I. Site of Lipoprotein Biosynthesis
I . Lipid Content of LPL
I I. Apoprotein Type and Content
IV. Diameter /Size of LPL
V. Transport Destination
VI. Ultracentrifugation
VI .Electrophoretic Pattern
Lipoproteins

Site Of

Destination

Major

Biochemical

Synthesis

Lipids

Functions

Chylomicrons Intestine Liver

Exogenous

Deliver lipids of

Triacylglycerol

dietary origin to

Liver and

Adiposecytes

VLDLs

Liver

Extra Hepatic

Endogenous

Deliver

Tissues

Triacylglycerol

endogenously

produced Lipids

to

Extrahepatocytes

LDLs

Intravascular Extra hepatic

Cholesterol

Deliver

by removal of Tissues

endogenously

Triacylglycerol

produced

from VLDL

cholesterol to

Extrahepatocytes

HDLs

Liver and

Liver and steroid Phospholipid

Remove and

intestine

-hormone-

Cholesterol

degrade

producing glands

Cholesterol.


Chylomicrons

Very low density

Lipoprotein (VLDL)

Low density

Lipoprotein (LDL)

High density

Lipoprotein (HDL)
Lipoproteins

Lipoprotein Nomenclature, Composition and

Separation

CM

VLDL

LDL

HDL

Major ApoB 48 ApoB 100 ApoB 100 ApoA-I

Protein

Major TAG

TAG CE

PL

and CE

Lipid


Ultracentrifugation

of

Lipoproteins


Lipoprotein

Particles with distinct densities

1.Electrophoresis

2. Ultra centrifugation method

method:

CM (chylomicron )

CM (chylomicron)

Slow

very low density lipoprotein (

Slow

VLDL)

-Lipoprotein

low density lipoprotein ( LDL)

pre -Lipoprotein

high density lipoprotein (HDL)

Fast





High

- Lipoprotein


Lipoprotein Electrophoresis
Plasma Lipoproteins

For Triacylglycerol Transport (TAG-rich):

- Chylomicrons: TAG of dietary origin

- VLDL:TAG of Endogenous (hepatic)

synthesis

For Cholesterol transport (cholesterol-rich):

LDL: Mainly Free Cholesterol

HDL: Mainly esterified Cholesterol

Features Of Lipoprotein Metabolism
Important Organs Involved

In LPL Metabolism

? Intestine
? Liver
? Extra hepatocytes
? Adipose Cytes

Lipoprotein Metabolism

? Highly Complex
? Specific
? Highly Dynamic
? Regulated
? Wel Communicated, Coordinated


Lipoproteins In Health

Are In Dynamic State

? Biosynthesized at specific sites

? Components of Lipoproteins are responsible for its

metabolism

? Mobilized out from cel s /organs

? Modified in Blood circulation

? Interrelated with one another

? Uptake Specific dependent on specific receptor and

transporters

? Receptor mediated endocytosis

? Utilized and Assimilated to very great extent

? Highly Coordinated and Regulated
Important Enzymes and

Proteins

Involved in

Lipoprotein Metabolism

? Lipoprotein Lipase (LPL)
? Hepatic Lipase/HTGL
? LCAT
? CETP
? Apoproteins
? Transporters
? Receptors
Lipoprotein Lipase

OR

A Clearing Factor

Lipoprotein Lipase (LPL)

LPL is located in

?
endothelial lining of

blood vessels.
Lipoprotein Lipase (LPL)

? LPL is an extracel ular enzyme,

anchored by Heparan sulfate to

capil ary wal s of most tissues

? It is predominantly present in

Adipose tissue, Cardiac & Skeletal

muscle

? LPL requires Apo C-II for its activation

? LPL degrades TAG into Glycerol and free

fatty acids by its activity.

? Insulin stimulates its synthesis and

transfer to luminal surface of capil ary.
Lipoprotein Lipases

? Lipoprotein Lipases in capil aries of

adipose and muscle tissues hydrolyze

TAG in VLDLs.

? VLDLs become IDLs
? IDLs looses more TAG and become LDLs.
? LDLs are less in TAG and rich in

Cholesterol and Cholesterol-esters.

? Lipoprotein Lipase act upon TAG

of Lipoproteins and hydrolyze it

? LPL Transforms ?

?Chylomicron to Chylomicron

remnant

?VLDL to LDL


? Thus LPL clear circulating

Lipoproteins from blood

hence it is termed as

Clearing Factor.
? Type I Hypolipoproteinemia
? This is termed as Familial

Lipoprotein Lipase deficiency

? Caused due to:

?LPL defect
?Apo C-I defect

? LPL Hydrolyzes Triacylglycerol (TAG)

in core of CM and VLDL to free Fatty

acids and Glycerol.

? Released free fatty acids and Glycerol
? Then enter into the tissue, mainly

adipose, heart, and muscle (80%),

while about 20% goes indirectly to the

Liver.



LPL Mediates

Fatty Acid Uptake By Adiposecytes



Hepatic Lipase (HL)

Hepatic Triglyceride Lipase (HTGL)

? HL is bound to the surface of Liver

cells
? Hydrolyzes TAG to free fatty acids

and Glycerol
?HL is concerned with TAG hydrolysis

in Chylomicron remnants and HDL

coming to Liver.


LCAT

(Lecithin Cholesterol Acyltransferase)

Formation of Cholesterol Esters in Lipoproteins

? LCAT is associated with HDL

Lipoprotein.

? LCAT esterifies Cholesterol and

add to nascent HDL and form

mature HDL.


CETP

(Cholesteryl Ester Transfer Protein)

Cholesterol Ester Transfer Protein

CETP

? CETP is also termed as plasma

lipid transfer protein.

? CETP exchanges Lipids from

one Lipoprotein to another.


CETP Activity

? CETP is a Plasma Protein that

facilitates transfer/exchange of


? Cholesteryl Esters and

Triacylglycerol between two

Lipoproteins.
?By CETP activity

Cholesteryl Ester May be

transferred from HDL to:

? VLDL
? IDL
? LDL

? CETP transfers TAG from VLDL or LDL

to HDL

? In exchange of Cholesteryl Esters

from HDL to VLDL.
? HDL either transfers Cholesterol &

Cholesterol esters.

? To Liver and extrahepatocytes by means

of CETP activity.

CETP activity Responsible For

Sub fractions Of HDL

HDL2 and HDL3


CETP by its activity

Transforms HDL

HDL 3 to HDL 2



?Prior to CETP activity HDL is

smaller particle termed as

HDL3

? Post CETP activity HDL3

become larger TAG rich and

termed as HDL2

?HDL 3 is Cholesteryl

Ester rich biomolecule.

?HDL 2 is TAG and CE

containing.
? Receptors Scavenger Receptor

Class B1 (SR-B1/SCARB1)

present on Hepatocytes and

other organs are for HDL 2.

? HDL 2 is internalized in

hepatocytes and components of

it get metabolized.

Significance Of CETP Activity
CETP Activity

? Modifies HDL to its subtractions

? Exchange and Utilizes Lipoprotein components
to its best without waste.

? Regulates and Internalizes HDL

? Significance of CETP activity is to

transfer

? Valuable functional compound

Cholesterol from HDL to VLDL and get

transported to extrahepatocytes when

it is required for its use.

? Hence CETP activity is induced when

there is need of Cholesterol to Extra

hepatocytes.
?CETP activity reduces

content of Cholesteryl

Ester of HDL.



CETP and LCAT are Interrelated

? Low Cholesterol Ester content

of HDL after CETP activity


? Increases HDL associated LCAT

activity.


Inhibition Of CETP Activity

Causes High HDL levels In

Blood Circulation


? Effects of Inhibition of CETP



? CETP will not transfer the HDL Cholesteryl

Ester to VLDL, for use by extra hepatocytes.

? Not modify HDL3 to HDL2
? No internalization of HDL3 by Hepatocytes.
? This may elevate levels of HDL3 in blood.
? Defective Scavenging role of HDL
? Leading to its bad consequences of

Atherosclerosis.
? Inhibition of CETP increases HDL3

levels.

? But highly reduced CETP activity

accelerates very high HDL3 levels.

? This abnormal high levels of HDL3

evidenced showing development of

Atherosclerosis and Coronary Heart

Diseases.

?Recent Studies have

evidenced

?CETP inhibiting drugs
?Elevates levels of HDL3
?Increases mortality rate.
Failure of CETP Inhibitor Drugs

? Torcetrapib, failed in 2006 due to excess

deaths in Phase II clinical trials.

? Dalcetrapib, development halted in May 2012

when Phase II trials failed to show clinically

meaningful efficacy.

? Evacetrapib, development discontinued in

2015 due to insufficient efficacy.

? Obicetrapib (TA-8995, AMG-899), Phase II

results reported in 2015, discontinued in 2017

Apolipoproteins
Functions of

Apolipoproteins

? Apoproteins are protein parts of

Lipoprotein structure
? Apoproteins act as structural

components of Lipoproteins
?Apoproteins are polar moieties

which impart solubility to

Lipoprotein structure.
? Functions Of Apoproteins

? Recognizes Lipoprotein

receptors on cell membrane

surface as ligand.

? Which further facilitates

uptake of LP by specific tissues.

Apoproteins Activate /Inhibit

Enzymes Involved

in Lipoprotein Metabolism.
? Apo A I, C I, A-IV : Activators of LCAT

? Apo C-II: Activator of LPL

? Apo C-III: Inhibitor of LPL

? Apo AII: Inhibitor of Hepatic Lipase (HL)


? Chylomicrons contain ApoB-48.

? VLDLs, IDLs and LDLs has ApoB-100.
HDL transfers

Apo E & Apo CII

to

Chylomicrons & VLDL

Different Lipoprotein Metabolism






Chylomicron

Metabolism

Metabolism of Chylomicrons

Surface Monolayer

Phospholipids

Free Cholesterol

Protein

Hydrophobic Core

Triglyceride

Cholesteryl Esters


Chylomicron Metabolism

Chylomicron Transport and Uptake


Metabolic fate of chylomicrons. (A, apolipoprotein A; B-48, apolipoprotein B-48; , apolipoprotein C; E, apolipoprotein E;

HDL, high-density lipoprotein; TG, triacylglycerol; C, cholesterol and cholesteryl ester; P, phospholipid; HL, hepatic lipase; LRP,

LDL receptor-related protein.) Only the predominant lipids are shown.
Chylomicrons

? Assembled in intestinal mucosal

cel s

? Has lowest density
? It has largest size
? Highest % of lipids and lowest %

proteins

? Highest concentration of

Triacylglycerol (dietary origin)

? Chylomicrons carry dietary lipids

from intestine to Liver

? Responsible for physiological milky

appearance of plasma (up to 2

hours after meal)
? Chylomicron is a type of

Lipoprotein

? Formed in the intestinal

mucosal cells

? Due to aggregation of

dietary digested and

absorbed Lipids.

? The Chylomicrons has 99%

Lipids and 1% Proteins

? The predominant Lipid present

in Chylomicrons is

Triacylglycerol (TAG) of dietary

origin.
? The Apoprotein of Chylomicron is

B48

? Significant role of Chylomicron is

to transport dietary Lipids from

intestinal mucosal cell to Liver via

Lymph and Blood.

? Chylomicrons formed in

intestinal mucosal cells are

? First released in lymphatic

system

? Which then enters systemic

blood circulation via thoracic

duct.
? Chylomicrons in blood circulation are not

moved inertly

? But receives Apo C I and Apo E from the

circulating HDL and gets mature.

? Apo C I then stimulates the enzyme

Lipoprotein Lipase present in endothelial

lining of blood vessels of Adipose tissue

and Cardiac tissue.

? Activated Lipoprotein Lipase acts upon

TAG of Chylomicrons ,

? Hydrolyze it into free fatty acids and

Glycerol ,which then enters to

adjacent adiposecytes.

? Entered Free fatty acids TAG and

stored as reserve food material.
? The circulating Chylomicrons

are continuously acted upon by

Lipoprotein Lipase

? Most of the TAG is removed

from it and transformed to

Chylomicron remnant till they

reach Liver.

? The Liver has receptors for

Chylomicron remnant.

? Chylomicron remnant linked to

receptors of hepatocytes are

internalized and metabolized in

Liver.


? Chylomicrons transport dietary TAG

and Cholesterol from the intestine to

the peripheral tissues

? Lipoprotein lipase (LPL) is

activated by Apo C-II

? After most of the TG is removed,

Chylomicrons become

Chylomicron remnants. During

the process, CM give ApoC and

ApoA back to HDL
?CM remnants bind to specific

receptors on the surface of liver

cells through apo E and then the

complex is Endocytosed.

?Remnant receptor or ApoE

receptor or LRP (LDL receptor-

related protein)


? Chylomicron remnants deliver

dietary cholesterol and some

cellular cholesterol (via HDL)

to the liver.

? Half life of CM is short, less

than 1 hour.
Chylomicrons

Nascent Chylomicron are formed in the intestinal and

consists of rich in dietary TG + minimal amount of

dietary cholesterol + Apo (B-48)

Mature Chylomicron after Nascent chylomicron

passage to blood, addition of Apo C II and Apo E from

HDL

Lipoprotein lipase hydrolyzes TAG present in

Chylomicrons

Chylomicron remnant taken up by the liver through

endocytosis.

Apo C removed and returns back to HDL


Metabolism of VLDL and LDL

Formation and Fate Of VLDL


VLDL Metabolism

? The Lipoprotein Very Low

Density Lipoprotein (VLDL)

? Biosynthesized in

Hepatocytes and Intestinal

Mucosal Cells.
?The endogenously

biosynthesized Lipids are

aggregated

?Along with Apoprotein B-

100 to form VLDL.

? VLDL predominantly

contains Triacylglycerol of

endogenous origin.
Role Of VLDL

? VLDL facilitates in mobilizing out the

endogenously synthesized Lipids in

Hepatocytes and Intestinal mucosal cells.

? VLDL transports endogenous Lipids

from Liver to Extra Hepatocytes via

blood.

?Nascent VLDL accepts Apo

CII and Apo E from HDL

?This modify it to mature

VLDLs in blood.
? Nascent VLDL: contains Apo B-100
? Mature VLDL: Apo B-100 plus

Apo C-II and Apo E

(from HDL)

? Apo C-I is required for activation of

Lipoprotein lipase

? Lipoprotein lipase is required to

degrade VLDL TAG into Glycerol and

fatty acids
?Circulating VLDL on

action by Lipoprotein

Lipase hydrolyzes most

of its TAG.

?VLDL gets modified to

IDL and LDL.

? Thus intermediate product of

IDL and end product LDL are

formed from VLDL

? In blood circulation by action

of LPL on VLDL and removal of

TAG from it.
Normal VLDL Metabolism

Prevents the person

to

Suffer from Fatty Liver

? VLDL help in mobilizing out the

endogenously biosynthesized Lipids

of Hepatocytes.

? Normal Formation and mobilization

of VLDL prevents from accumulation

of excess Fat in the Liver and

develop Fatty Liver.


Modifications of Circulating VLDLs

VLDL IDL (returns Apo E to HDL) LDL

VLDL Metabolism


Dietary Carbohydrate Increases

VLDL Production

Plasma

Triglyceride

Dietary

(VLDL)

Carbohydrate

VLDL Remnants

IDL and LDL

? LDL results from loss of TAG in

VLDL

? LDL contains relatively more

Cholesterol esters

? LDL looses all Apo lipoproteins

except ApoB100.
Very Low Density Lipoprotein (VLDL)

Nascent VLDLare formed in the liver and consists of

endogenous TG + 17 % cholesterol + Apo (B-100)

Mature VLDL after Nascent VLDL passage to

blood, addition of ApoC II, ApoE and cholesterol

esters from HDL

Lipoprotein lipase (LPL) hydrolyzes TAG present

in VLDL

VLDL remnant containing less of TG and more of

cholesterol and taken up by the liver through

endocytosis.

Apo C removed and returns to HDL


LDL Metabolism

Most core lipid in LDL is Cholesterol ester.
ApoB100 is only Apolipoprotein in the surface.


Formation and Fate Of LDL
? Low Density Lipoprotein (LDL) is a

Lipoprotein formed from VLDL in

blood circulation.

? VLDL in blood circulation

receives Apo CII and Apo E from

the circulating HDL.

? Apo CI then stimulates the

Lipoprotein Lipase enzyme

present in the endothelial lining

of blood vessels.

? Lipoprotein Lipase then acts upon

TAG present in VLDL ,hydrolyze it

to Glycerol and free fatty acids
?LDL is the modified

form of VLDL formed

in blood circulation.

?LDL is remnant of

VLDL
?LDL is mostly associated

with Cholesterol and

Phospholipids with

minimal TAG

?Of endogenous origin

mobilized out from Liver.

? The major Apoproteins of LDL

is Apo B100

? Same as VLDL since LDL is

derived from VLDL
? Function of LDL is to transport

endogenously biosynthesized

Cholesterol from Liver to the

peripheral /extrahepatic tissues.

LDL Receptor

? Cell surface protein
? Recognizes Apolipoprotein B-100, present in VLDL,

IDL, LDL, and probably Apo-E

? LDL receptor is an integral membrane protein of

115 kDa,

? LDL receptor is highly regulated
? Intracellular cholesterol concentration increases,

the LDL receptor production is inhibited
LDL Receptor

?LDL receptor is also named

as ApoB100/ApoE

receptors

?Since ApoB-100 of LDL

binds to LDL receptor.

?The complexes of LDL and

receptor are taken into the

cells by endocytosis,

?Where LDL is degraded but

the receptors are recycled


? LDL receptors are found on cel

surface of many cel types of

extrahepatocytes.

? LDL is internalized by the tissues

when LDL get fixed to the LDL

receptors.

? LDL receptor mediates

delivery of Cholesterol

? By inducing endocytosis

and fusion with Lysosomes.

? Lysosomal lipases and

proteases degrade the LDL.


? Cholesterol then incorporates

into cell membranes or is

stored as cholesterol-esters of

extrahepatocytes.


LDL Receptor
LDL-Receptor-Related Protein-Associated

Protein (LRPAP1)

? Chaperone Protein which in humans is encoded

by LRPAP1 gene.

? Involved with trafficking of certain members of

LDL receptor family including LRP1 and LRP 2

? Acts to inhibit binding of all known ligands for

these receptors

? Prevent receptor aggregation and degradation in

endoplasmic reticulum, thereby acting as a

molecular chaperone.

Mutations and diseases related to

LRPAP1

? Abnormal ECM remodeling in neurons,

eye

?Dementia
?Myopia
?Marfans Syndrome
LDL Cholesterol levels

are

positively related to risk

of Cardiovascular

Disease.

?LDL values within

normal range is an

indication of healthy

status.

?But the high LDL levels

are abnormal .
? Cholesterol associated to this

high levels of LDL molecules

increases risk of

Atherosclerosis and CVD.


? Hence this LDL associated

Cholesterol is termed as "bad

Cholesterol"

Defect/Absence of

LDL Receptors

Leads to Accumulation of LDL

in Blood Circulation

Causing

Hypercholesteremia

and

Atherosclerosis
? Defect in LDL receptors on tissues

impairs LDL metabolism.

? Decreases LDL internalization

within the tissues.

? Increases abnormal levels of LDL in

blood (< 130 mg%).

? Increased LDL levels in

blood circulation due to

defect in LDL receptors is

termed as Type I a

Hyperlipoproteinemia.
? The major form of Lipid associated with LDL

is Cholesterol .

? Hence increased LDL levels is characterized

by Hypercholesterolemia.

? The Cholesterol associated with elevated

levels of LDL (more than its normal range) is

termed as bad Cholesterol,

? Since it increases the risk of Atherosclerosis

and its complications .

? Persons lacking the LDL

receptor suffer from Familial

Hypercholesteremia

? Due to result of a mutation in

a single autosomal gene

? Total plasma cholesterol and

LDL levels are elevated.
?Cholesterol Levels of:

?Healthy person = < 200 mg/dl

?Heterozygous individuals = 300 mg/dl



?Homozygous individuals = 680 mg/dl



High LDL levels can lead to

Cardiovascular Disease
Most Homozygous individuals

die of cardiovascular disease

in childhood

? LDL can be oxidized to form

oxidized LDL

? Oxidized LDL is taken up by

immune cells cal ed

macrophages.

? Macrophages become

engorged to form foam cells.


? Foam cel s become trapped in

the wal s of blood vessels and

contribute to the formation of

atherosclerotic plaques.

? Causes narrowing of the

arteries which can lead to

MI/heart attacks.
Familial hypercholesterolemia is due to a gene

defect in the LDL receptor

? Michael Palmer 2014

Role Of HDL

Reverse Transport Of

Cholesterol


? HDL is a high density

Lipoprotein.

? Nascent HDL is biosynthesized

in Liver.

? It is reservoir of Apoproteins



? HDL is the Lipoprotein, with highest

density.

? Since it is associated with 40-50% of

Apoproteins.

? The Apoproteins of HDL are Apo A I,

Apo A I , Apo C I,C I , Apo D and Apo E.

? HDL serves as a reservoir of

Apoprotein during its circulation.

? HDL gives it Apo CII and Apo E to

circulating nascent Chylomicrons

and VLDL .
? Nascent HDL of discoid shaped

(Empty Bag) biosynthesized in

Liver

? It is released in the blood

circulation for scavenging action.

The HDL has Scavenging Action

It serves as a

Scavenger For

Unwanted Body Lipids
? The Enzyme Lecithin Cholesterol Acyl

Transferase (LCAT) is associated with HDL

metabolism.

? Apo A I,A IV and CI stimulates the LCAT

activity of HDL.

? LCAT by its activity help in esterification of

free Cholesterol to Esterified

Cholesterol/Cholesterol Ester.

? HDL by its scavenging action collects the extra

non functional Cholesterol lying in blood

vessels and peripheral tissues.

? HDL esterifies Choleserol by its LCAT activity

and to HDL bag.

? The nascent HDL bags changes to spherical

shape .

? HDL is more associated with Phospholipids

and Cholesterol.
? The receptors for HDL are

present on Liver cells.

? HDL transports the excess,

unused Lipids from extra

hepatic tissues back to Liver for

its metabolism and excretion.

? The role of HDL is opposite to LDL.

? HDL transports Cholesterol From

extra hepatic tissues back to Liver.

? Thus the role of HDL is termed as

reverse transport of Cholesterol.
? Normal serum HDL levels are 30-60

mg%.

? The efficient activity of HDL is good

to the body

? As it prevents risk of Atherosclerosis

and their complications.

Reverse Cholesterol Transport (RCT)


High Density Lipoproteins (HDL ? Good)

? CETP by its activity modifies HDL 3

to HDL 2.

? HDL2 is then get internalized in

Hepatocytes for its final use.

? Cholesterol Ester carried by HDL to

hepatocytes is degraded to Bile

acids and Bile salts and get excreted

out.
Fate of HDL

HDL 2 binds SR-B1 receptor on Hepatocytes

And Other Cel s

Transfers Cholesterol &

Cholesterol ester to cell

Depleted HDL dissociates

& re-enters circulation

? HDL can bind to specific

hepatic receptors SR-B1

? But primary HDL clearance

occurs through uptake by

scavenger receptor SR-B1.
? SR-B1 can be upregulated in cells

when Cholesterol levels are low in

hepatic cells.

? SR-B1 is down regulated when

cholesterol levels are high in cells.

? Defect in low HDL synthesis in Liver

lowers the HDL activity and increases

the risk of Atherosclerosis.

? Defect in HDL receptors on Liver may

abnormally increase the HDL levels in

blood circulation and also increases the

risk of Atherosclerosis.
The Lecithin-Cholesterol Acyltransferase (LCAT)

reaction

Cholesterol esters can be stored inside lipoprotein

particles
HDL Interactions

with Other Particles

Tangier Disease: Disruption of Cholesterol

Transfer to HDL

? Michael Palmer 2014


HDL and Reverse Cholesterol Transport

Tangier Disease









LDL-R




LDL-R

50% of HDL C may

Return to the liver

On LDL via CETP

LDL/HDL Ratio and Cardiovascular Disease

? LDL/HDL ratios are used as a

diagnostic tool for signs of

Cardiovascular disease

? A good LDL/HDL ratio is 3.5
?LDL above normal range =
"Bad Cholesterol"

?HDL within normal range =
"Good Cholesterol"
-HDL above normal range =
"Bad Cholesterol"

? Protective role of HDL is not very

clear.

?An esterase that breaks down

oxidized lipids is associated with

HDL.

?It is possible (but not proven) that

this enzyme helps to destroy

oxidized LDL


Lipoproteins Facilitate Lipid

Transport
Effects Of Normal

Lipoprotein Metabolism

Normal LP Metabolism

? Maintains Normal levels of Lipoproteins

in the blood circulation by:

?Normal Formation of LP by specific tissues

?Normal Transformation and Transport of

LP in blood

?Normal Uptake of LP by specific tissues
? Normal Lipoprotein

Metabolism Reduces the risk

of:

?Atherosclerosis

?Myocardial Infarction

?Stroke

Lipoprotein Population Distributions

? Serum Lipoprotein

concentrations differ between

adult men and women.

? Primarily as a result of

differences in sex hormone

levels.


? Women having, on average, higher HDL

cholesterol levels and lower total

Cholesterol and TAG levels than men.

? The difference in total cholesterol,

however, disappears in post

menopause as Estrogen decreases and

use of Cholesterol is reduced.






PCSK9

Proprotein Convertase Subtilisin /Kexin type 9
PCSK9 - Mechanisms of Action

? PCSK9 is a Proprotein Convertase responsible for

? Degradation of low-density lipoprotein (LDL) receptors in

Liver.


? Mutations in PCSK9 gene cause familial

Hypercholesterolemia

? Due to reduced number of LDL receptors on surface of

hepatocytes.

? Decreases their ability to clear LDL cholesterol from plasma.

PCSK9 inhibitors ? Mechanisms of Action

? Conversely other PCSK9 mutations result in
? Unusually low concentrations of plasma LDL

cholesterol and a reduced risk of atherosclerotic

disease.

? Blocking activity of PCSK9 with monoclonal

antibodies reduces degradation of LDL receptors

? An injection of PCSK9-specific antibody

suppresses LDL-cholesterol concentrations.

? Increases clearance of LDL cholesterol


This post was last modified on 05 April 2022