L36. Cholesterol Synthesis and Lipoprotein Transport Flashcards Preview

02. Cardiovascular > L36. Cholesterol Synthesis and Lipoprotein Transport > Flashcards

Flashcards in L36. Cholesterol Synthesis and Lipoprotein Transport Deck (29):

What is the definition of dyslipidaemia? What can it predispose to?

An abnormal Lipid Profile

To atherosclerosis, increased risk of MI and stroke


What is a lipid profile? What are four major types of abnormal lipid profiles?

The levels of LDL, HDL, and triaglycerides in the body. Particularly the ratio of these to one another.

Hypercholestrolaemia (total cholesterol increased >5mM)
Hyperticlyceridaemia (increased blood TAG)
Mixed hyperlipiademia
Low HDL cholesterol


What is the relationship between LDLs and the risk of developing coronary diseases and between HDLs and this risk?

The higher the LDLs the the higher the risk
The lower the HDLs the higher the risk


What kind of correlation exists between the total cholesterol: HDL ratio and the risk of developing coronary disease?

A very strong positive correlation: the higher the ratio (defined as > 5mM) the higher the risk of developing coronary disease


What is cholesterol?
What is it an important component of

Roughly translates to solid alcohol in bile
A 3-hydroxy-5-6-cholestene (a C27 polymer)

It is an important component of Lipoproteins (Chylomicrons, LDL, VLDL and HDL)


Cholesterol is a precursor to a number of important biological molecule, what are three of them?

1. Vitamin D
2. Steroid Hormones
3. Bile salts


Free cholesterol is an amphiphatic molecule. What is meant by this?

It has a hydrophobic part and a hydrophilic part


What is the main endogenous source of cholesterol production in the body?

Cholesterol is synthesised in the liver (de novo synthesis)


What are the four main fates of cholesterol (both endogenous and exogenous)?

1. Most is transported to the tissues for storage and use as energy: free cholesterol that is esterified in VLDL and chylomicrons and then taken up by the tissues
2. Storage in the gall bladder as bile salts
3. Used in the production of steroid hormones and vitamin D in the adrenal and gonad glands and the skin
4. Makes up membrane lipids providing steric hinderance


What are bile salts?

Detergent like molecules that are secreted on demand by the body to emulsify fats, taking up lipid from the diet


How does cholesterol provide the steric hinderance to the membranes?

The cholesterol intercalates in the lipid bilayer: within the kinks made by the fatty acyl chains and this reduces their fluidity.

There are membrane rafts that have high concentrations of cholesterol and are thus more rigid.


Describe the process of cholesterol synthesis in the liver

Acetyl CoA is made in the mitochondria
It is then converted into Hydromethyglutaryl-CoA (HMG-CoA)
HMG-CoA is converted into Mevalonic Acid by HMG-CoA reductase (an important enzyme)
Mevalonic Acid undergoes several sequences of metabolism into intermediates --> Squalene --> Cholesterol
Cholesterol negatively feeds back onto the enzyme HMG-CoA


What is the significance of the enzyme HMG-CoA for the cholesterol synthesis pathway?

It is the rate limiting step of the synthesis of the pathway
The activity of the reductase governs the relative amounts of cholesterol made in the liver
(Thus it is an important drug target)


What is important to note about the intermediate products made in the pathway?

Drug interference with the aim of altering cholesterol synthesis may have severe consequences as the intermediary components are also affected (this may lead to pathology)


Why is there a need for a specific mechanism for the body to transport cholesterol?

Cholesterol is a non-soluble, largely hydrophobic molecule which means that its ability to dissolve in the plasma is very low. (0.1mM compared to the 5mM present).

Free cholesterol is also able to alter the properties of membranes (problematic if delivered to the wrong site)


What is the mechanism of cholesterol transport?

Cholesterol (and triaglycerides) is esterified to make it more hydrophobic and then incorporated into small protein-lipid composits called CHYLOMICRONS


What are chylomicrons?

Small Protein-Lipid (amphiphatic) molecules with a core of cholestyl ester that carry cholesterol around in the plasma

Chylmicrons, LDL, VLDL and HDL


How is cholesterol obtained from the diet?

Triaglycerides (TAGs) and Cholesterol from the diet is absorbed in the small intestine and packaged into chylomicrons in the lymphatic system. This drains them into the blood stream towards the tissues. The tissues contain LIPOPROTEIN LIPASE which allows them to take up cholsterol from the chylomicrons


What is a triaglycerole?

An important form of dietary cholesterol: the main constituents of natural fats and oils.


Draw the synthesis, transport and use of cholesterol around the body

- TAG is packed into chylomicrons while cholesterol into VLDL
- These are taken to capillaries and tissues where Lipoprotein Lipases take out free fatty acids from it leaving VLDL remnants or Chylomicron remnants taken back to the liver
- VLDLs can be turned into LDLs which either go back to the liver or accumulate in extrahepatic tissues (like blood vessels)
- HDL precursors from the liver go through the plasma and enter extrahepatic tissue and take up cholesterol, becoming HDL going back to the liver.


What process if HDL important for?

Reverse Cholesterol Transport: Called the "Good" Cholesterol as it sequesters extra cholesterol from the tissues and takes it back to the liver.


What is Apolipoprotein?

A protein without its co-factors (without the lipid)


What is the significance of ApoE?

It is very important in taking up the cholesterol for carrying it around the body.

It is the major difference between VLDL and LDL is the loss of ApoE leading to LDL formation (when cholesterol > TAG it is LDL)


Compare and contrast the different lipoproteins from each other in descending size

Formed in the intestinal mucosa and carry TAG
Have apolipoproteins: ApoE (take up), B48 (structural) and APCII (activation of lipoprotein lipase)

Formed in the liver and carry cholesterol from there
ApoB100 (binds to SR-B1 receptor on the liver) - efficient take up by the liver

Derived from VLDL
Circulates to deliver cholesterol to the tissues
ApoB100 (binding to the liver)

Made in the liver and intestine
ApoA-1 (HDL formation and binding to the liver)


What are 3 important enzymes in the process of cholesterol transport and uptake in the body?

1. Lipoprotein Lipase into the tissue
2. ACAT in the liver helps the formation of VLDL
3. LCAT in the plasma helps HDLs scavenge cholesterol from membranes


What is the mechanism by which high LDL levels leads to an increased risk of cardiovascular disease?

LDL accumulation in the tissues gets oxidated and this oxLDL accumulates in the arterial walls leading increased expression of adhesion molecules by endothelial cells
Increase macrophages and increased inflammation = formation of FOAM cells
oxLDLs are toxic to the tissues
Formation of a fibrous tissue cap and a necrotic core: fibrous cap in atherosclerosis


What is controversial about dietary recommendations in terms of plasma cholesterol levels?

Dietary consumption may not be significant in determining blood level of cholesterol (the de novo liver synthesis may be the major contributor)


What is a statin?

A drug that are competitive inhibitors of the HMG-CoA reductase enzyme (by mimicking Mevalonic acid) - in attempt to reduce serum cholesterol levels


What is an adverse effect of statin use?

Q10 depletion (important to mitochondrial bioenergy transfer) and causes skeletal muscle and cardiac muscle complications.
How? Q10 is synthesised by activated isoprene - an intermediate of the cholesterol synthesis pathway. Statins reduce the production of isoprene.