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Konaklieva MI, Plotkin BJ. Targeting host-specific metabolic pathways-opportunities and challenges for anti-infective therapy. Front Mol Biosci 2024; 11:1338567. [PMID: 38455763 PMCID: PMC10918472 DOI: 10.3389/fmolb.2024.1338567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/24/2024] [Indexed: 03/09/2024] Open
Abstract
Microorganisms can takeover critical metabolic pathways in host cells to fuel their replication. This interaction provides an opportunity to target host metabolic pathways, in addition to the pathogen-specific ones, in the development of antimicrobials. Host-directed therapy (HDT) is an emerging strategy of anti-infective therapy, which targets host cell metabolism utilized by facultative and obligate intracellular pathogens for entry, replication, egress or persistence of infected host cells. This review provides an overview of the host lipid metabolism and links it to the challenges in the development of HDTs for viral and bacterial infections, where pathogens are using important for the host lipid enzymes, or producing their own analogous of lecithin-cholesterol acyltransferase (LCAT) and lipoprotein lipase (LPL) thus interfering with the human host's lipid metabolism.
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Affiliation(s)
| | - Balbina J. Plotkin
- Department of Microbiology and Immunology, Midwestern University, Downers Grove, IL, United States
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2
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Ciro Acosta S, Díaz-Ordóñez L, Gutierrez-Medina JD, Silva-Cuero YK, Arango-Vélez LG, García-Trujillo AO, Pachajoa H. Familial LCAT Deficiency and Low HDL-C Levels: In silico Characterization of Two Rare LCAT Missense Mutations. Appl Clin Genet 2024; 17:23-32. [PMID: 38404612 PMCID: PMC10893891 DOI: 10.2147/tacg.s438135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/16/2023] [Indexed: 02/27/2024] Open
Abstract
Mutations in the lecithin-cholesterol acyltransferase (LCAT) gene, which catalyzes the esterification of cholesterol, result in two types of autosomal recessive disorders: Familial LCAT deficiency (FLD) and Fish Eye Disease (FED). While both phenotypes are characterized by corneal opacities and different forms of dyslipidemia, such as low levels of high-density lipoprotein-cholesterol (HDL-C), FLD exhibits more severe clinical manifestations like splenomegaly, anemia, and renal failure. We describe the first clinically and genetically confirmed case of FLD in Colombia which corresponds to a 46-year-old woman with corneal opacity, hypothyroidism, and dyslipidemia, who does not have any manifestations of renal failure, with two pathogenic heterozygous missense variants in the LCAT gene: LCAT (NM_000229.2):c.803G>A (p.Arg268His) and LCAT (NM_000229.2):c.368G>C (p.Arg123Pro). In silico analysis of the mutations predicted the physicochemical properties of the mutated protein, causing instability and potentially decreased LCAT function. These compound mutations highlight the clinical heterogeneity of the phenotypes associated with LCAT gene mutations.
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Affiliation(s)
- Sebastian Ciro Acosta
- Centro de Investigaciones en Anomalias Congenitas y Enfermedades Raras (CIACER), Universidad Icesi, Cali, Colombia
| | - Lorena Díaz-Ordóñez
- Centro de Investigaciones en Anomalias Congenitas y Enfermedades Raras (CIACER), Universidad Icesi, Cali, Colombia
- Departamento de Ciencias Basicas Medicas, Facultad de Salud, Universidad Icesi, Cali, Colombia
| | - Juan David Gutierrez-Medina
- Centro de Investigaciones en Anomalias Congenitas y Enfermedades Raras (CIACER), Universidad Icesi, Cali, Colombia
- Centro de Investigaciones Clinicas, Fundacion Valle del Lili, Cali, Colombia
| | - Yisther Katherine Silva-Cuero
- Centro de Investigaciones en Anomalias Congenitas y Enfermedades Raras (CIACER), Universidad Icesi, Cali, Colombia
- Departamento de Ciencias Basicas Medicas, Facultad de Salud, Universidad Icesi, Cali, Colombia
| | - Luis Guillermo Arango-Vélez
- Servicio de Endocrinologia, Fundacion Valle del Lili, Cali, Colombia
- Departamento de Medicina interna, Seccion de Endocrinologia, Universidad Icesi, Cali, Colombia
| | - Andrés Octavio García-Trujillo
- Servicio de Endocrinologia, Fundacion Valle del Lili, Cali, Colombia
- Departamento de Medicina interna, Seccion de Endocrinologia, Universidad Icesi, Cali, Colombia
| | - Harry Pachajoa
- Centro de Investigaciones en Anomalias Congenitas y Enfermedades Raras (CIACER), Universidad Icesi, Cali, Colombia
- Departamento de Ciencias Basicas Medicas, Facultad de Salud, Universidad Icesi, Cali, Colombia
- Genetic Division, Fundacion Valle del Lili, Cali, Colombia
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3
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de Serpa Brandão RMS, Britto FB, do Monte Neto JT, Lima MC, do Monte SJH, de Sousa Lima AV, Pereira EM, da Silva HJN, Oliveira DMTE, Coelho AGB, da Silva AS. Familial lecithin-cholesterol acyltransferase deficiency: If so rare, why so frequent in the state of Piauí, northeastern Brazil? Mol Genet Metab Rep 2022; 30:100840. [PMID: 35242572 PMCID: PMC8856911 DOI: 10.1016/j.ymgmr.2021.100840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 12/25/2021] [Indexed: 11/16/2022] Open
Abstract
Lecithin-cholesterol acyltransferase (LCAT), an enzyme that participates in lipoprotein metabolism, plays an important role in cholesterol homeostasis. Mutations in the LCAT gene can cause two rare genetic disorders: familial LCAT deficiency (FLD), which is characterized by corneal opacities, normocytic anemia, dyslipidemia, and proteinuria progressing to chronic renal failure, and fish-eye disease (FED), which causes dyslipidemia and progressive corneal opacities. Herein, we report six suspected cases of FLD in the backlands of Piauí, located in northeast Brazil. A genetic diagnosis was performed in index cases. Among these, a further investigation was performed to identify new cases in the families. In addition, molecular analyses were performed to verify the levels of consanguinity within families and the existence of a genetic relationship between them. All six index cases were confirmed as FLD with an identical mutation (c.803G > A, p.R268H). The genetic investigation confirmed another 7 new cases of FLD, 52 heterozygous and 6 individuals without mutations. The rate of consanguinity revealed that marriages within the family did not contribute to the high number of FLD cases within the restricted region. The elders of each family (patriarchs and matriarchs) were subjected to a kinship analysis and were more genetically related to each other than the control group. Bayesian analysis was implemented to confirm the hypothesis of connectivity among patriarchs and matriarchs and indicated that they were genetically more related to each other than would be randomly expected, thus suggesting the occurrence of a possible founder effect in these families.
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Affiliation(s)
- Rafael Melo Santos de Serpa Brandão
- Laboratory of Immunogenetics and Molecular Biology, Federal University of Piauí, Teresina, Brazil, Campus Ministro Petrônio Portella - SG 16. Bairro Ininga, Teresina, Piauí 64049-550, Brazil
- Corresponding author.
| | - Fábio Barros Britto
- Department of Biology, Federal University of Piauí, Teresina, Brazil, Campus Ministro Petrônio Portella - SG 01. Bairro Ininga, Teresina, Piauí 64049-550, Brazil
| | - José Tiburcio do Monte Neto
- Department of General Practice – Nephrology, Federal University of Piauí, Teresina, Brazil, Campus Ministro Petrônio Portella. Bairro Ininga, Teresina, Piauí 64049-550, Brazil
| | - Marcelo Cunha Lima
- Universitary Hospital (HU-UFPI/EBSERH), Federal University of Piauí, Teresina, Brazil, Campus Ministro Petrônio Portella. Bairro Ininga, Teresina, Piauí 64049-550, Brazil
| | - Semiramis Jamil Hadad do Monte
- Laboratory of Immunogenetics and Molecular Biology, Federal University of Piauí, Teresina, Brazil, Campus Ministro Petrônio Portella - SG 16. Bairro Ininga, Teresina, Piauí 64049-550, Brazil
| | - Antonio Vanildo de Sousa Lima
- Laboratory of Immunogenetics and Molecular Biology, Federal University of Piauí, Teresina, Brazil, Campus Ministro Petrônio Portella - SG 16. Bairro Ininga, Teresina, Piauí 64049-550, Brazil
| | - Ester Miranda Pereira
- Laboratory of Immunogenetics and Molecular Biology, Federal University of Piauí, Teresina, Brazil, Campus Ministro Petrônio Portella - SG 16. Bairro Ininga, Teresina, Piauí 64049-550, Brazil
| | - Higo José Neri da Silva
- Master's Program in Science and Health, Federal University of Piauí, Teresina, Brazil, Centro de Ciências da Saúde, Avenida Frei Serafim n° 2280. Bairro Centro, Teresina, Piauí 64001-020, Brazil
| | - Deylane Menezes Teles e Oliveira
- Graduate Program in Biotechnology - RENORBIO, Federal University of Piauí, Teresina, Brazil, Campus Ministro Petrônio Portella. Bairro Ininga, Teresina, Piauí 64049-550, Brazil
| | - Antonio Gilberto Borges Coelho
- Laboratory of Immunogenetics and Molecular Biology, Federal University of Piauí, Teresina, Brazil, Campus Ministro Petrônio Portella - SG 16. Bairro Ininga, Teresina, Piauí 64049-550, Brazil
| | - Adalberto Socorro da Silva
- Laboratory of Immunogenetics and Molecular Biology, Federal University of Piauí, Teresina, Brazil, Campus Ministro Petrônio Portella - SG 16. Bairro Ininga, Teresina, Piauí 64049-550, Brazil
- Department of Biology, Federal University of Piauí, Teresina, Brazil, Campus Ministro Petrônio Portella - SG 01. Bairro Ininga, Teresina, Piauí 64049-550, Brazil
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4
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Vitali C, Bajaj A, Nguyen C, Schnall J, Chen J, Stylianou K, Rader DJ, Cuchel M. A systematic review of the natural history and biomarkers of primary Lecithin:Cholesterol Acyltransferase (LCAT) deficiency. J Lipid Res 2022; 63:100169. [PMID: 35065092 PMCID: PMC8953693 DOI: 10.1016/j.jlr.2022.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/16/2021] [Accepted: 12/28/2021] [Indexed: 10/31/2022] Open
Abstract
Syndromes associated with LCAT deficiency, a rare autosomal recessive condition, include fish-eye disease (FED) and familial LCAT deficiency (FLD). FLD is more severe and characterized by early and progressive chronic kidney disease (CKD). No treatment is currently available for FLD, but novel therapeutics are under development. Furthermore, although biomarkers of LCAT deficiency have been identified, their suitability to monitor disease progression and therapeutic efficacy is unclear, as little data exist on the rate of progression of renal disease. Here, we systematically review observational studies of FLD, FED, and heterozygous subjects, which summarize available evidence on the natural history and biomarkers of LCAT deficiency, in order to guide the development of novel therapeutics. We identified 146 FLD and 53 FED patients from 219 publications, showing that both syndromes are characterized by early corneal opacity and markedly reduced HDL-C levels. Proteinuria/hematuria were the first signs of renal impairment in FLD, followed by rapid decline of renal function. Furthermore, LCAT activity toward endogenous substrates and the percentage of circulating esterified cholesterol (EC%) were the best discriminators between these two syndromes. In FLD, higher levels of total, non-HDL, and unesterified cholesterol were associated with severe CKD. We reveal a nonlinear association between LCAT activity and EC% levels, in which subnormal levels of LCAT activity were associated with normal EC%. This review provides the first step toward the identification of disease biomarkers to be used in clinical trials and suggests that restoring LCAT activity to subnormal levels may be sufficient to prevent renal disease progression.
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5
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Abstract
PURPOSE OF REVIEW Genetic LCAT deficiency is a rare metabolic disorder characterized by low-plasma HDL cholesterol levels. Clinical manifestations of the disease include corneal opacification, anemia, and renal disease, which represents the major cause of morbidity and mortality in carriers. RECENT FINDINGS Biochemical and clinical manifestations of the disease are very heterogeneous among carriers. The collection of large series of affected individuals is needed to answer various open questions on this rare disorder of lipid metabolism, such as the cause of renal damage in patients with complete LCAT deficiency and the cardiovascular risk in carriers of different LCAT gene mutations. SUMMARY Familial LCAT deficiency is a rare disease, with serious clinical manifestations, which can occur in the first decades of life, and presently with no cure. The timely diagnosis in carriers, together with the identification of disease biomarkers able to predict the evolution of clinical manifestations, would be of great help in the identification of carriers to address to future available therapies.
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Affiliation(s)
- Chiara Pavanello
- Centro Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
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6
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Di Taranto MD, Giacobbe C, Fortunato G. Familial hypercholesterolemia: A complex genetic disease with variable phenotypes. Eur J Med Genet 2020; 63:103831. [DOI: 10.1016/j.ejmg.2019.103831] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/01/2019] [Accepted: 12/21/2019] [Indexed: 12/21/2022]
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Manthei KA, Yang SM, Baljinnyam B, Chang L, Glukhova A, Yuan W, Freeman LA, Maloney DJ, Schwendeman A, Remaley AT, Jadhav A, Tesmer JJ. Molecular basis for activation of lecithin:cholesterol acyltransferase by a compound that increases HDL cholesterol. eLife 2018; 7:41604. [PMID: 30479275 PMCID: PMC6277198 DOI: 10.7554/elife.41604] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 11/06/2018] [Indexed: 01/29/2023] Open
Abstract
Lecithin:cholesterol acyltransferase (LCAT) and LCAT-activating compounds are being investigated as treatments for coronary heart disease (CHD) and familial LCAT deficiency (FLD). Herein we report the crystal structure of human LCAT in complex with a potent piperidinylpyrazolopyridine activator and an acyl intermediate-like inhibitor, revealing LCAT in an active conformation. Unlike other LCAT activators, the piperidinylpyrazolopyridine activator binds exclusively to the membrane-binding domain (MBD). Functional studies indicate that the compound does not modulate the affinity of LCAT for HDL, but instead stabilizes residues in the MBD and facilitates channeling of substrates into the active site. By demonstrating that these activators increase the activity of an FLD variant, we show that compounds targeting the MBD have therapeutic potential. Our data better define the substrate binding site of LCAT and pave the way for rational design of LCAT agonists and improved biotherapeutics for augmenting or restoring reverse cholesterol transport in CHD and FLD patients. Cholesterol is a fatty substance found throughout the body that is essential to our health. However, if too much cholesterol builds up in our blood vessels, it can cause blockages that lead to heart and kidney problems. The body removes excess cholesterol by sending out high-density lipoproteins (HDL) that capture the fatty molecules and carry them to the liver where they are eliminated. The first step in this process requires an enzyme called LCAT, which converts cholesterol into a form that HDL particles can efficiently pack and transport. The enzyme acts by interacting with HDL particles, and chemically joining cholesterol with another compound. Finding ways to make LCAT perform better and produce more HDL could improve treatments for heart disease. This could be particularly helpful to people with genetic changes that make LCAT defective. Several small molecules that ‘dial up’ the activity of LCAT have been identified, but how they act on the enzyme is not always well understood. Manthei et al. therefore set out to determine precisely how one such small activator promotes LCAT function. The experiments involved using a method known as crystallography to look at the structure of LCAT when it is attached to the small molecule. They also evaluated the activity of the enzyme and other aspects of the protein in the presence of the small molecule and HDL particles. Taken together, the results led Manthei et al. to suggest that the small molecule works by more efficiently bringing into LCAT the materials that this enzyme needs to create the transport-ready form of cholesterol. The small molecule also partially restored the activity of mutant LCAT found in human disease. This knowledge may help to design more drug-like chemicals to ‘boost’ the activity of LCAT and prevent heart and kidney disease, especially in people who carry a defective version of the enzyme.
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Affiliation(s)
- Kelly A Manthei
- Life Sciences Institute, University of Michigan, Ann Arbor, United States
| | - Shyh-Ming Yang
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, United States
| | - Bolormaa Baljinnyam
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, United States
| | - Louise Chang
- Life Sciences Institute, University of Michigan, Ann Arbor, United States
| | - Alisa Glukhova
- Life Sciences Institute, University of Michigan, Ann Arbor, United States
| | - Wenmin Yuan
- Department of Pharmaceutical Sciences and Biointerfaces Institute, University of Michigan, Ann Arbor, United States
| | - Lita A Freeman
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, United States
| | - David J Maloney
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, United States
| | - Anna Schwendeman
- Department of Pharmaceutical Sciences and Biointerfaces Institute, University of Michigan, Ann Arbor, United States
| | - Alan T Remaley
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, United States
| | - Ajit Jadhav
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, United States
| | - John Jg Tesmer
- Department of Biological Sciences, Purdue University, Indiana, United States
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Manthei KA, Ahn J, Glukhova A, Yuan W, Larkin C, Manett TD, Chang L, Shayman JA, Axley MJ, Schwendeman A, Tesmer JJG. A retractable lid in lecithin:cholesterol acyltransferase provides a structural mechanism for activation by apolipoprotein A-I. J Biol Chem 2017; 292:20313-20327. [PMID: 29030428 DOI: 10.1074/jbc.m117.802736] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 09/15/2017] [Indexed: 12/12/2022] Open
Abstract
Lecithin:cholesterol acyltransferase (LCAT) plays a key role in reverse cholesterol transport by transferring an acyl group from phosphatidylcholine to cholesterol, promoting the maturation of high-density lipoproteins (HDL) from discoidal to spherical particles. LCAT is activated through an unknown mechanism by apolipoprotein A-I (apoA-I) and other mimetic peptides that form a belt around HDL. Here, we report the crystal structure of LCAT with an extended lid that blocks access to the active site, consistent with an inactive conformation. Residues Thr-123 and Phe-382 in the catalytic domain form a latch-like interaction with hydrophobic residues in the lid. Because these residues are mutated in genetic disease, lid displacement was hypothesized to be an important feature of apoA-I activation. Functional studies of site-directed mutants revealed that loss of latch interactions or the entire lid enhanced activity against soluble ester substrates, and hydrogen-deuterium exchange (HDX) mass spectrometry revealed that the LCAT lid is extremely dynamic in solution. Upon addition of a covalent inhibitor that mimics one of the reaction intermediates, there is an overall decrease in HDX in the lid and adjacent regions of the protein, consistent with ordering. These data suggest a model wherein the active site of LCAT is shielded from soluble substrates by a dynamic lid until it interacts with HDL to allow transesterification to proceed.
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Affiliation(s)
- Kelly A Manthei
- Life Sciences Institute and the Departments of Pharmacology and Biological Chemistry, University of Michigan, Ann Arbor, Michigan 48109
| | - Joomi Ahn
- MedImmune, Gaithersburg, Maryland 20878
| | - Alisa Glukhova
- Life Sciences Institute and the Departments of Pharmacology and Biological Chemistry, University of Michigan, Ann Arbor, Michigan 48109
| | - Wenmin Yuan
- Department of Pharmaceutical Sciences and Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan 48109
| | | | - Taylor D Manett
- Life Sciences Institute and the Departments of Pharmacology and Biological Chemistry, University of Michigan, Ann Arbor, Michigan 48109
| | - Louise Chang
- Life Sciences Institute and the Departments of Pharmacology and Biological Chemistry, University of Michigan, Ann Arbor, Michigan 48109
| | - James A Shayman
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109
| | | | - Anna Schwendeman
- Department of Pharmaceutical Sciences and Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan 48109
| | - John J G Tesmer
- Life Sciences Institute and the Departments of Pharmacology and Biological Chemistry, University of Michigan, Ann Arbor, Michigan 48109.
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9
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Genetic lecithin:cholesterol acyltransferase deficiency and cardiovascular disease. Atherosclerosis 2012; 222:299-306. [DOI: 10.1016/j.atherosclerosis.2011.11.034] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 11/09/2011] [Accepted: 11/22/2011] [Indexed: 11/18/2022]
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Pisciotta L, Favari E, Magnolo L, Simonelli S, Adorni MP, Sallo R, Fancello T, Zavaroni I, Ardigò D, Bernini F, Calabresi L, Franceschini G, Tarugi P, Calandra S, Bertolini S. Characterization of Three Kindreds With Familial Combined Hypolipidemia Caused by Loss-of-Function Mutations of ANGPTL3. ACTA ACUST UNITED AC 2012; 5:42-50. [DOI: 10.1161/circgenetics.111.960674] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Angiopoietin-like protein 3 (ANGPTL3) affects lipid metabolism by inhibiting the activity of lipoprotein and endothelial lipases.
Angptl3
knockout mice have marked hypolipidemia, and heterozygous carriers of
ANGPLT3
, loss-of-function mutations were found among individuals in the lowest quartile of plasma triglycerides in population studies. Recently, 4 related individuals with primary hypolipidemia were found to be compound heterozygotes for
ANGPTL3
loss-of-function mutations.
Methods and Results—
We resequenced
ANGPTL3
in 4 members of 3 kindreds originally identified for very low levels of low-density lipoprotein cholesterol and high-density lipoprotein cholesterol (0.97±0.16 and 0.56±0.20 mmol/L, respectively) in whom no mutations of known candidate genes for monogenic hypobetalipoproteinemia and hypoalphalipoproteinemia had been detected. These subjects were found to be homozygous or compound heterozygous for
ANGPTL3
loss-of-function mutations (p.G400VfsX5, p.I19LfsX22/p.N147X) associated with the absence of ANGPTL3 in plasma. They had reduced plasma levels of triglyceride-containing lipoproteins and of HDL particles that contained only apolipoprotein A-I and pre-β–high-density lipoprotein. In addition, their apolipoprotein B–depleted sera had a reduced capacity to promote cell cholesterol efflux through the various pathways (ABCA1-, SR-BI–, and ABCG1-mediated efflux); however, these subjects had no clinical evidence of accelerated atherosclerosis. Heterozygous carriers of the
ANGPTL3
mutations had low plasma ANGPTL3 and moderately reduced low-density lipoprotein cholesterol (2.52±0.38 mmol/L) but normal plasma high-density lipoprotein cholesterol.
Conclusions—
Complete ANGPTL3 deficiency caused by loss-of-function mutations of
ANGPTL3
is associated with a recessive hypolipidemia characterized by a reduction of apolipoprotein B and apolipoprotein A-I–containing lipoproteins, changes in subclasses of high-density lipoprotein, and reduced cholesterol efflux potential of serum. Partial ANGPTL3 deficiency is associated only with a moderate reduction of low-density lipoprotein.
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Affiliation(s)
- Livia Pisciotta
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Elda Favari
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Lucia Magnolo
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Sara Simonelli
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Maria Pia Adorni
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Raffaella Sallo
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Tatiana Fancello
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Ivana Zavaroni
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Diego Ardigò
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Franco Bernini
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Laura Calabresi
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Guido Franceschini
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Patrizia Tarugi
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Sebastiano Calandra
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
| | - Stefano Bertolini
- From the Department of Internal Medicine (L.P., R.S., S.B.), University of Genoa, Genoa, Italy; Department of Pharmacological and Biological Sciences and Applied Chemistries (E.F., M.P.A., F.B.) and Department of Internal Medicine and Biomedical Sciences (I.Z., D.A.), University of Parma, Parma, Italy; Department of Biomedical Sciences (L.M., T.F., P.T., S.C.), University of Modena and Reggio Emilia, Modena, Italy; and Center E. Grossi Paoletti (S.S., L.C., G.F.), Department of Pharmacological
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11
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Pisciotta L, Fresa R, Bellocchio A, Pino E, Guido V, Cantafora A, Di Rocco M, Calandra S, Bertolini S. Cholesteryl Ester Storage Disease (CESD) due to novel mutations in the LIPA gene. Mol Genet Metab 2009; 97:143-8. [PMID: 19307143 DOI: 10.1016/j.ymgme.2009.02.007] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 02/17/2009] [Accepted: 02/17/2009] [Indexed: 02/07/2023]
Abstract
Cholesteryl Ester Storage Disease (CESD) is a rare recessive disorder due to mutations in LIPA gene encoding the lysosomal acidic lipase (LAL). CESD patients have liver disease associated with mixed hyperlipidemia and low plasma levels of high-density lipoproteins (HDL). The aim of this study was the molecular characterization of three patients with CESD. LAL activity was measured in blood leukocytes. In two patients (twin sisters) the clinical diagnosis of CESD was made at 9 years of age, following the fortuitous discovery of elevated serum liver enzymes in apparently healthy children. They had mixed hyperlipidemia, hepatosplenomegaly, reduced LAL activity (approximately 5% of control) and heteroalleic mutations in LIPA gene coding sequence: (i) the common c.894 G>A mutation and (ii) a novel nonsense mutation c.652 C>T (p.R218X). The other patient was an 80 year-old female who for several years had been treated with simvastatin because of severe hyperlipidemia associated with low plasma HDL. In this patient the sequence of major candidate genes for monogenic hypercholesterolemia and hypoalphalipoproteinemia was negative. She was found to be a compound heterozygote for two LIPA gene mutations resulting in 5% LAL activity: (i) c.894 G>A and (ii) a novel complex insertion/deletion leading to a premature termination codon at position 82. These findings suggest that, in view of the variable severity of its phenotypic expression, CESD may sometimes be difficult to diagnose, but it should be considered in patients with severe type IIb hyperlipidemia associated with low HDL, mildly elevated serum liver enzymes and hepatomegaly.
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Affiliation(s)
- Livia Pisciotta
- Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, I-16132 Genoa, Italy
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12
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A novel mutation of the apolipoprotein A-I gene in a family with familial combined hyperlipidemia. Atherosclerosis 2008; 198:145-51. [DOI: 10.1016/j.atherosclerosis.2007.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Revised: 09/01/2007] [Accepted: 09/06/2007] [Indexed: 11/21/2022]
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13
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Calabresi L, Pisciotta L, Costantin A, Frigerio I, Eberini I, Alessandrini P, Arca M, Bon GB, Boscutti G, Busnach G, Frascà G, Gesualdo L, Gigante M, Lupattelli G, Montali A, Pizzolitto S, Rabbone I, Rolleri M, Ruotolo G, Sampietro T, Sessa A, Vaudo G, Cantafora A, Veglia F, Calandra S, Bertolini S, Franceschini G. The Molecular Basis of Lecithin:Cholesterol Acyltransferase Deficiency Syndromes. Arterioscler Thromb Vasc Biol 2005; 25:1972-8. [PMID: 15994445 DOI: 10.1161/01.atv.0000175751.30616.13] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
To better understand the role of lecithin:cholesterol acyltransferase (LCAT) in lipoprotein metabolism through the genetic and biochemical characterization of families carrying mutations in the
LCAT
gene.
Methods and Results—
Thirteen families carrying 17 different mutations in the
LCAT
gene were identified by Lipid Clinics and Departments of Nephrology throughout Italy. DNA analysis of 82 family members identified 15 carriers of 2 mutant
LCAT
alleles, 11 with familial LCAT deficiency (FLD) and 4 with fish-eye disease (FED). Forty-four individuals carried 1 mutant
LCAT
allele, and 23 had a normal genotype. Plasma unesterified cholesterol, unesterified/total cholesterol ratio, triglycerides, very-low-density lipoprotein cholesterol, and pre-β high-density lipoprotein (LDL) were elevated, and high-density lipoprotein (HDL) cholesterol, apolipoprotein A-I, apolipoprotein A-II, apolipoprotein B, LpA-I, LpA-I:A-II, cholesterol esterification rate, LCAT activity and concentration, and LDL and HDL
3
particle size were reduced in a gene–dose-dependent manner in carriers of mutant
LCAT
alleles. No differences were found in the lipid/lipoprotein profile of FLD and FED cases, except for higher plasma unesterified cholesterol and unesterified/total cholesterol ratio in the former.
Conclusion—
In a large series of subjects carrying mutations in the
LCAT
gene, the inheritance of a mutated LCAT genotype causes a gene–dose-dependent alteration in the plasma lipid/lipoprotein profile, which is remarkably similar between subjects classified as FLD or FED.
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Affiliation(s)
- Laura Calabresi
- Center E. Grossi Paoletti, Department of Pharmacological Sciences, University of Milano, 20133 Milan, Italy
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