Cholesterol in the liver

HMG-CoA-Reductase Inhibitors. Figure 1 Mechanism of action of statins - cholesterol synthesis pathway. The conversion of acetyl CoA to cholesterol in the liver. The step of cholesterol biosynthesis inhibited by HMG-CoA reductase inhibitors (statins) is shown. 

Although both LDL and HDL are primarily cholesterol particles, most of the cholesterol measured in the blood is assodated with LDL. The normal role of LDL is to deliver cholesterol to tissues for biosynthesis. When a cell is repairing membrane or dividing, the cholesterol is required for membrane synthesis. Bile acids and salts are made from cholesterol in the liver, and many other tissues require some cholesterol for steroid synthesis. As shown in Figure 1-15-6, about 80% of LDL are picked up by hepatocytes, the remainder by peripheral tissues. ApoB-100 is the only apoprotein on LDL, and endocytosis of LDL is mediated by apoB-100 receptors (LDL receptors) clustered in areas of cell membranes lined with the protdn clathrin. 

Orotic acid in the diet (usually at a concentration of 1 per cent) can induce a deficiency of adenine and pyridine nucleotides in rat liver (but not in mouse or chick liver). The consequence is to inhibit secretion of lipoprotein into the blood, followed by the depression of plasma lipids, then in the accumulation of triglycerides and cholesterol in the liver (fatty liver) [141 — 161], This effect is not prevented by folic acid, vitamin B12, choline, methionine or inositol [141, 144], but can be prevented or rapidly reversed by the addition of a small amount of adenine to the diets [146, 147, 149, 152, 162]. The action of orotic acid can also be inhibited by calcium lactate in combination with lactose [163]. It was originally believed that the adenine deficiency produced by orotic acid was caused by an inhibition of the reaction of PRPP with glutamine in the de novo purine synthesis, since large amounts of PRPP are utilized for the conversion of orotic acid to uridine-5 -phosphate. However, incorporation studies of glycine-1- C in livers of orotic acid-fed rats revealed that the inhibition is caused rather by a depletion of the PRPP available for reaction with glutamine than by an effect on the condensation itself [160]. 

Bile acids are synthesized from cholesterol in the liver (see p.314). Their structures can therefore be derived from that of cholesterol. Characteristic for the bile acids is a side chain shortened by three C atoms in which the last carbon atom is oxidized to a carboxyl group. The double bond in ring B is reduced and rings... 

Dextrothyroxine speeds up the decomposition of cholesterol and lipoproteins, thus activating catabolism of cholesterol in the liver, which results in cholesterol being more intensively transformed into bile salts. It lowers the level of low-density lipoproteins in the plasma and very low-density lipoproteins in fatty tissue. It is recommended for treating hyperlipoproteinemia. Synonyms of this drug are choloxin, lizolipin, natexin, travenon, and others. 

Bile salts secreted into the intestine are efficiently reabsorbed (greater than 95 percent) and reused. The mixture of primary and secondary bile acids and bile salts is absorbed primarily in the ileum. They are actively transported from the intestinal mucosal cells into the portal blood, and are efficiently removed by the liver parenchymal cells. [Note Bile acids are hydrophobic and require a carrier in the portal blood. Albumin carries them in a noncovalent complex, just as it transports fatty acids in blood (see p. 179).] The liver converts both primary and secondary bile acids into bile salts by conjugation with glycine or taurine, and secretes them into the bile. The continuous process of secretion of bile salts into the bile, their passage through the duodenum where some are converted to bile acids, and their subsequent return to the liver as a mixture of bile acids and salts is termed the enterohepatic circulation (see Figure 18.11). Between 15 and 30 g of bile salts are secreted from the liver into the duodenum each day, yet only about 0.5 g is lost daily in the feces. Approximately 0.5 g per day is synthesized from cholesterol in the liver to replace the lost bile acids. Bile acid sequestrants, such as cholestyramine,2 bind bile acids in the gut, prevent their reabsorption, and so promote their excretion. They are used in the treatment of hypercholesterolemia because the removal of bile acids relieves the inhibition on bile acid synthesis in the liver, thereby diverting additional cholesterol into that pathway. [Note Dietary fiber also binds bile acids and increases their excretion.]... 

Outline the functions of mitochondrial enzymes in the conversion of fructose into cholesterol in the liver. 

The C>4 bile acids arise from cholesterol in the liver after saturation of the steroid nucleus and reduction in length of the side chain to a 5-carbon add they may differ in the number of hydroxyl groups on the sterol nucleus. The four acids isolated from human bile include cholic acid (3,7,12-tiihydroxy), as shown in Fig. 1 deoxycholic acid (2,12-dihydroxy) chenodeoxycholic acid (3,7-dihydroxy) and lithocholic acid (3-hydroxy). The bile acids are not excreted into the bile as such, but are conjugated through the C24 carboxylic add with glycine or... 

A special consideration in the digestion of fats is that they are not water soluble and cannot be placed in aqueous solution along with the water-soluble lipase digestive enzymes. However, intimate contact is obtained by emulsification of fats through the action of bile salts from glycocholic and taurocholic acids produced from cholesterol in the liver ... 

The further degradation of cholesterol in the liver gives the bile acids ... 

Examples of HMG-CoA reductase inhibitors include lovastatin, simvastatin, and pravastatin the so-called statins. These drugs inhibit the rate-limiting enzyme in the synthesis of cholesterol in the liver. In addition, the reduction in the formation of hepatic cholesterol leads to a compensatory increase in the hepatic synthesis of LDL receptors on the surface of hepatocytes. These receptors bind plasma LDL leading to a reduction in plasma LDL—the bad cholesterol. 

Yeoh et al. (1995) demonstrated that chilli could protect humans against aspirin-induced gastroduodenal mucosal injury. A survey conducted by Kang et al. (1995) established the protective effect of chilli against peptic ulcer. Red pepper and natural and synthetic capsaicin in the diet significantly decreased cholesterol in the liver (Sambaiah and Satyanarayana, 1980). 

Insulin also exerts a stimulatory effect on the synthesis of cholesterol in the liver. In this tissue, HMG-CoA reductase is activated. HMG-CoA reductase, like hormone-sensitive lipase, can exist in two forms one is phosphorylated (inactive) and the other is dephosphorylated (active). Phosphorylation of the enzyme depends on an increase in the cellular concentration of cAMP and activation of protein kinase. The dephosphorylation (activation) is catalyzed by a phosphatase. In fat cells, a similar phosphatase dephosphorylates (inactivates) hormone-sensitive lipase. Insulin stimulates the activity of the phosphatase in both liver and fat cells. In this way, active HMG-CoA reductase predominates in the liver cell and directs HMG-CoA into cholesterol synthesis, and in the fat cell hormone-sensitive lipase is inactivated. 

Solubilisation (or emnlsification) of dietary lipids is accomplished by means of bile salts, which are synthesised from cholesterol in the liver and then stored in the gallbladder they are emptied into the gnt following the ingestion of fat. Emulsification of dietary fats renders them accessible... 

QIO, or simply CoQlO. It turns out that the very same enzyme needed to make cholesterol in the liver is necessary for the production of CoQlO. 

Cholesterol in the liver is reassembled into lipoproteins, or secreted in bile then recycled by absorption at the terminal ileum or excreted in the faeces. 

Colestyramine is an oral anion-exchange resin, which binds bile acids in the intestine. Bile acids are formed from cholesterol in the liver, pass into the gut in the bile and are largely reabsorbed at the terminal ileum. The total bile acid pool is only 3-5 g but, because such enterohepatic recycling takes place 5-10 times a day, on average 20-30 g of bile acid are delivered into the intestine every 24 hours. Bile acids bound to colestyramine are lost in the faeces and the depletion of the bile acid pool stimulates conversion of cholesterol to bile acid the result is a... 

Cholesterol is formed in the liver (85%) and intestine (12%) - this constitutes 97% of the body s cholesterol synthesis of 3.2 mmol/day (= 1.25 g/day). Serum cholesterol is esterized to an extent of 70-80% with fatty acids (ca. 53% linolic acid, ca 23% oleic acid, ca 12% palmitic acid). The cholesterol pool (distributed in the liver, plasma and erythrocytes) is 5.16 mmol/day (= 2.0 g/day). Homocysteine stimulates the production of cholesterol in the liver cells as well as its subsequent secretion. Cholesterol may be removed from the pool by being channelled into the bile or, as VLDL and HDL particles, into the plasma. The key enzyme in the synthesis of cholesterol is hydroxy-methyl-glutaryl-CoA reductase (HGM-CoA reductase), which has a half-life of only 3 hours. Cholesterol is produced via the intermediate stages of mevalonate, squalene and lanosterol. Cholesterol esters are formed in the plasma by the linking of a lecithin fatty acid to free cholesterol (by means of LCAT) with the simultaneous release of lysolecithin. (s. figs. 3.8, 3.9) (s. tab. 3.8)... 

An increased activity of ACAT provokes a decline in the concentration of free cholesterol in the liver cell. 

The mechanism of action of o-thyroxine appears to be stimulation of oxidative cataboli.sm of cholesterol in the liver through stimulation of 7-a-cholcstcrol hydroxylase, the rate-limiting enzyme in the conversion of cholesterol to bile acids. The bile acids arc conjugated with glycine or taurine and excreted by the biliary route into the feces. Although thyroxine docs not inhibit cholesterol bio.synthesis. it increases the number of LDL receptors, enhancing removal of LDL from plasma. 

Studies on the action of Benzyl N-Benzyl carbethoxyhydroxamate (W 398) (3) showed an accumulation of cholesterol in the liver with no effect on serum cholesterol levels. It is suggested that the drug Inhibits the transfer of cholesterol from the liver to the blood. 

Bile acids The major metabolites of cholesterol, which are synthesized in the liver and stored in the gallbladder for use as emulsifiers in the digestion of lipids. Primary bile acids are those synthesized directly from cholesterol in the liver Secondary bile acids are metabolites of primary bile acids produced by the action of intestinal bacteria. 

The bile acids cholic acid and chenodeoxycholic acid are synthesized from cholesterol in the liver (Dl, S3). Several structural modifications are necessary to convert cholesterol, with its 27 carbon atoms, C-5,6 double bond and 3p-hydroxyl group, to a 24-carbon atom, saturated, 3,7 and 12a-hydroxyl-ated bile acid. The major reactions in this transformation are shown in Figs. 3 and 4. The reactions are catalyzed by mitochondrial, microsomal, soluble, and possibly peroxisomal enzymes. 

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