Liver cells fatty acid metabolism

These agents activate PPAR-y a nuclear transcription factor important in fat cell differentiation and fatty acid metabolism. PPAR-yagonists enhance insulin sensitivity in muscle, liver, and fat tissues indirectly. Insulin must be present in significant quantities for these actions to occur. 

The incidence of the severe form is between 1 in 20,000 and 1 in 40,000 in adults, although the incidence is much higher in children (1 in 5000). The fatty liver is a "visible" symptom of dysfunction, not necessarily a cause of liver failure, although it can be. Valproic acid is similar to a fatty acid and therefore can become incorporated into fatty acid metabolism. This involves formation of an acyl CoA derivative and also a carnitine derivative. However, this depletes both CoA from the intramitochondrial pool and carnitine and so compromises the mitochondria and reduces the ability of the cell to metabolize short-, medium-, and long-chain fatty acids via p-oxidation (Fig. 7.15). 

In animal cells, fatty acids are degraded both in mitochondria and peroxisomes, whereas in lower eukaryotes, P-oxidation is confined to peroxisomes. Mitochondrial P-oxidation provides energy for oxidative phosphorylation and generates acetyl-CoA for ketogenesis in liver. The oxidation of fatty acids with odd numbers of carbon atoms also yields propi-onyl-CoA that is metabolized to succinate. 

In the case of fatty acid metabolism, any problems of this sort are avoided because, even though both fatty acid oxidation and fatty acid synthesis can occur in the same cell (e.g. in liver cells), they are kept safely apart in different cellular compartments. With glucose metabolism, however, the enzymes for both glycolysis and gluconeogenesis are in the cytosol So do we bum up all our ATP ... 

An exciting area of research concerns the role of dietary n-6 PUFA in hypertension. Early human studies demonstrated a beneficial effect of a high dietary intake of an n-6 PUFA, i.e., LA, on BP (27-29). The mechanism of action would appear to be through the conversion to prostaglandins (PG), which in turn have been repeatedly shown to have effects on BP (30-34). Deficiencies of the long-chain n-6 PUFA, DGLA and AA, in cell membranes and tissues can contribute to diseases. Consistent alterations in tissue fatty acid metabolism exist during hypertension (35). Numerous membrane abnormalities have been reported in the spontaneously hypertensive rat (SHR), a commonly used animal model for human hypertension (36 1). Membrane abnormalities in kidney (42-44), thoracic aorta (45,46), and in the isolated liver cells (47) contribute to the altered membrane properties and functions and in part... 

Uptake of LCFAs across the lipid-bilayer of most mammalian cells occurs through both a passive diffusion of LCFAs and a protein-mediated LCFA uptake mechanism. At physiological LCFA concentrations (7.5 nM) the protein-mediated, saturable, substrate-specific, and hormonally regulated mechanism of fatty acids accounts for the majority (>90%) of fatty acid uptake by tissues with high LCFA metabolism and storage such as skeletal muscle, adipose tissue, liver,... 

FIGURE 9. Endogenous lipoprotein metabolism. In liver cells, cholesterol and triglycerides are packaged into VLDL particles and exported into blood where VLDL is converted to IDL. Intermediate-density lipoprotein can be either cleared by hepatic LDL receptors or further metabolized to LDL. LDL can be cleared by hepatic LDL receptors or can enter the arterial wall, contributing to atherosclerosis. Acetyl CoA, acetyl coenzyme A Apo, apolipoprotein C, cholesterol CE, cholesterol ester FA, fatty acid HL, hepatic lipase HMG CoA, 3-hydroxy-3-methyglutaryl coenzyme A IDL, intermediate-density lipoprotein LCAT, lecithin-cholesterol acyltransferase LDL, low-density lipoprotein LPL, lipoprotein lipase VLDL, very low-density lipoprotein. 

Insulin also plays a role in fat metabolism. In humans, most fatty acid synthesis takes place in the liver. The mechanism of action of insulin involves directing excess nutrient molecules toward metabolic pathways leading to fat synthesis. These fatty acids are then transported to storage sites, predominantly adipose tissue. Finally, insulin stimulates the uptake of amino acids into cells where they are incorporated into proteins. 

In the ebb phase, there is increased activity of the sympathetic nervous system and increased plasma levels of adrenaline and glucocorticoids but a decreased level of insulin. This results in mobilisation of glycogen in the liver and triacylglycerol in adipose tissue, so that the levels of two major fuels in the blood, glucose and long-chain fatty acids, are increased. This is, effectively, the stress response to trauma. These changes continue and are extended into the flow phase as the immune cells are activated and secrete the proinflammatory cytokines that further stimulate the mobilisation of fuel stores (Table 18.2). Thus the sequence is trauma increased endocrine hormone levels increased immune response increased levels of cytokines metabolic responses. 

Lipoprotein metabolism. Entero-cytes release absorbed lipids in the form of triglyceride-rich chylomicrons. Bypassing the liver, these enter the circulation mainly via the lymph and are hydrolyzed by extrahepatic endothelial lipoprotein lipases to liberate fatty acids. The remnant particles move on into liver cells and supply these with cholesterol of dietary origin. 

Cholesterol can be derived from two sources—food or endogenous synthesis from ace-tyl-CoA. A substantial percentage of endogenous cholesterol synthesis takes place in the liver. Some cholesterol is required for the synthesis of bile acids (see p. 314). In addition, it serves as a building block for cell membranes (see p. 216), or can be esterified with fatty acids and stored in lipid droplets. The rest is released together into the blood in the form of lipoprotein complexes (VLDLs) and supplies other tissues. The liver also contributes to the cholesterol metabolism by taking up from the blood and breaking down lipoproteins that contain cholesterol and cholesterol esters (HDLs, IDLs, LDLs see p.278). 

---