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Section XIV - Lipid Transport

Cholesterol is synthesized exclusively in the liver from acetyl-CoA. Very low density lipoproteins (VLDL) are produced by the liver and transport fatty acids and cholesterol to tissues. As VLDL loses fatty acids it becomes intermediate density lipoprotein (IDL) then low density lipoprotein (LDL), which delivers cholesterol to tissues. High density lipoprotein (HDL) removes cholesterol from tissues and transports it back to the liver for processing or excretion. Familial dyslipidemias result from genetic defects in apolipoproteins or proteins involved in lipid transport and can cause abnormal lipid levels and disease.

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193 views2 pages

Section XIV - Lipid Transport

Cholesterol is synthesized exclusively in the liver from acetyl-CoA. Very low density lipoproteins (VLDL) are produced by the liver and transport fatty acids and cholesterol to tissues. As VLDL loses fatty acids it becomes intermediate density lipoprotein (IDL) then low density lipoprotein (LDL), which delivers cholesterol to tissues. High density lipoprotein (HDL) removes cholesterol from tissues and transports it back to the liver for processing or excretion. Familial dyslipidemias result from genetic defects in apolipoproteins or proteins involved in lipid transport and can cause abnormal lipid levels and disease.

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Katharine Nerva
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124

Section XIV - Lipid Transport

I. Cholesterol synthesis occurs exclusively in the liver. a) Mnemonic: E = everything; rEmnant


A. Acetyl-CoA → cholesterol B. Very low-density lipoprotein (VLDL)

B. Rate limiting step is HMG-CoA reductase 1. Produced by the liver and transports fatty
acids and cholesterol to the tissues.
II. Because fat is not soluble in water, it must be 2. As VLDL loses fatty acids → IDL
transported in the blood by lipoproteins (lipid- 3. ApoB-100: necessary for hepatic secretion
protein complexes). of VLDL and facilitates binding of LDL
A. Chylomicrons to hepatic low-density lipoprotein (LDL)
receptors
1. Produced by enterocytes and transport fatty
acids and cholesterol to the tissues. 4. ApoC-II: cofactor for lipoprotein lipase
2. B-48: necessary for chylomicron secretion 5. ApoE: facilitates binding of chylomicrons,
from enterocytes VLDL, IDL, and HDL to the hepatic remnant
receptors
a) Mnemonic: He 8 cholesterol
C. LDL
3. ApoC-II: cofactor for lipoprotein lipase
a) Mnemonic: C = cofactor 1. Delivers cholesterol to periphery

4. ApoE: facilitates binding of chylomicrons, 2. Only contains ApoB-100


VLDL, intermediate-density lipoprotein
(IDL), and high-density lipoprotein (HDL) to
the hepatic remnant receptors

Figure 2.5.16 - Lipid transport


125

D. HDL removes cholesterol from the periphery IV. Familial dyslipidemias (Figure 2.5.17)
and delivers it to the liver.
1. Lecithin-cholesterol acyl transferase (LCAT)
converts cholesterol from the periphery into
esterified cholesterol → densely packed into
HDL core.
2. Cholesterol ester transfer protein (CETP)
transfers cholesterol esters to other
lipoproteins (i.e. VLDL, LDL, etc.).
3. HDL contains ApoE which facilitates hepatic
uptake of HDL.
4. Also contains ApoC-II and ApoA-I.

III. Measuring cholesterol Figure 2.5.17 - Familial dyslipidemias


A. Lipid panel: LDL, HDL, and VLDL
B. VLDL transports a high concentration of
triglycerides
C. VLDL used as a surrogate for triglycerides

Dyslipidemia Protein defect(s) Labs Findings


• Inability to synthesize
ApoB-100 (absence
• ↓ Chylomicrons Fat soluble
→ inability to secrete
• ↓ VLDL vitamin
Abetalipoproteinemia VLDL from liver) and
• ↓ IDL deficiency
ApoB-48 (necessary for
• ↓ LDL Acanthocytosis
chylomicron secretion
from enterocytes)
Familial • Apo C-II (a cofactor for • ↑ Triglycerides
Xanthomas
hyperchylomicronemia LPL) (chylomicrons
Pancreatitis
(type I) • LPL and VLDL)
• ApoB-100 defect
(allows VLDL and
Familial associated remnants Xanthomas
hypercholesterolemia to bind to the • ↑ LDL Coronary
(type II) LDL receptor on disease
hepatocytes)
• LDL receptor
• ApoE3 & ApoE4 (allows
Familial chylomicrons, VLDL, • ↑ Triglycerides Xanthomas
dysbetalipoproteinemia and IDL to bind to (chylomicrons, Coronary
(type III) hepatic lipoprotein VLDL, and IDL) disease
receptors)
Xanthomas
Familial (rare)
• Overproduction of • ↑ Triglycerides
hypertriglyceridemia Pancreatitis
VLDL (VLDL)
(type IV) Coronary
disease

Table 2.5.2 - Spur cell

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