Plasma squalene: lipoprotein distribution and kinetic analysis

Squalene: More than a Step toward Sterols

Squalene (SQ) is a natural triterpene widely distributed in nature. It is a metabolic intermediate of the sterol biosynthetic pathway and represents a possible target in different metabolic and oxidative stress-related disorders. Growing interest has been focused on SQ’s antioxidant properties, derived from its chemical structure. Strong evidence provided by ex vivo models underline its scavenging activity towards free radicals, whereas only a few studies have highlighted its effect in cellular models of oxidative stress. Given the role of unbalanced free radicals in both the onset and progression of several cardiovascular diseases, an in depth evaluation of SQ’s contribution to antioxidant defense mechanisms could represent a strategic approach in dealing with these pathological conditions. At present experimental results overall show a double-edged sword role of squalene in cardiovascular diseases and its function has to be better elucidated in order to establish intervention lines focused on its features. This review aims to summarize current knowledge about endogenous and exogenous sources of SQ and to point out the controversial role of SQ in cardiovascular physiology.

Biological importance and applications of squalene and squalane

Squalene is a polyunsaturated hydrocarbon with a formula of C₃₀H₅₀. Squalene can be found in certain fish oils, especially shark liver oil, in high amounts and some vegetable oils in relatively smaller amounts. Human sebum also contains 13% squalene as one of its major constituents. Squalane is a saturated derivative of squalene and also found in these sources. Interest in squalene has been raised after its characterization in shark liver oil which is used as a traditional medicine for decades. Several studies exhibited results that prove certain bioactivities for squalene and squalane. Up to date, anticancer, antioxidant, drug carrier, detoxifier, skin hydrating, and emollient activities of these substances have been reported both in animal models and in vitro environments. According to promising results from recent studies, squalene and squalane are considered important substances in practical and clinical uses with a huge potential in nutraceutical and pharmaceutical industries.

Squalene: A natural triterpene for use in disease management and therapy

Squalene is a natural lipid belonging to the terpenoid family and a precursor of cholesterol biosynthesis. It is synthesized in humans and also in a wide array of organisms and substances, from sharks to olives and even bran, among others. Because of its significant dietary benefits, biocompatibility, inertness, and other advantageous properties, squalene is extensively used as an excipient in pharmaceutical formulations for disease management and therapy. In addition, squalene acts as a protective agent and has been shown to decrease chemotherapy-induced side-effects. Moreover, squalene alone exhibits chemopreventive activity. Although it is a weak inhibitor of tumor cell proliferation, it contributes either directly or indirectly to the treatment of cancer due to its potentiation effect. In addition, squalene enhances the immune response to various associated antigens, and it is therefore being investigated for vaccine delivery applications. Since this triterpene is well absorbed orally, it has been used to improve the oral delivery of therapeutic molecules. All of these qualities have rendered squalene a potentially interesting excipient for pharmaceutical applications, especially for the delivery of vaccines, drugs, genes, and other biological substances. This paper is the first review of its kind and offers greater insight into squalene's direct or indirect contribution to disease management and therapy.

Visceral obesity is associated with high levels of serum squalene

OBJECTIVE

To investigate the impact of visceral obesity on cholesterol metabolism in normoglycemic offspring of patients with type 2 diabetes.

RESEARCH METHODS AND PROCEDURES

The proportion of intra-abdominal fat (IAF) was measured by abdominal computer tomography, and serum cholesterol synthesis and absorption markers were determined by gas-liquid chromatography in 109 normoglycemic offspring of patients with type 2 diabetes. Insulin action was measured with the hyperinsulinemic euglycemic clamp. The gene encoding squalene synthase (farnesyl-diphosphate farnesyltransferase 1) was screened with the single-strand conformation polymorphism analysis and direct sequencing.

RESULTS

Cholesterol synthesis markers correlated positively with IAF (r = 0.213 to 0.309, p < or = 0.027) and negatively with the rates of insulin-stimulated whole-body glucose uptake (r = -0.372 to -0.248, p < or = 0.010). However, serum squalene, the first measured precursor of cholesterol synthesis, showed a positive correlation with IAF (r = 0.309, p = 0.001) without any association with subcutaneous fat or insulin sensitivity. Variation in the farnesyl-diphosphate farnesyltransferase 1 gene did not explain elevated serum squalene levels in viscerally obese subjects. From the cholesterol absorption markers, cholestanol was associated negatively with IAF and positively with whole-body glucose uptake (p < 0.05).

DISCUSSION

High serum squalene levels are associated with visceral obesity but not with subcutaneous obesity. Whether this finding is causally connected to visceral obesity remains to be established.

Effects of plant stanol and sterol esters on serum phytosterols in a family with familial hypercholesterolemia including a homozygous subject

We studied the concentrations and ratios to cholesterol of noncholesterol sterols reflecting absorption (eg, campesterol) or synthesis (eg, lathosterol) of cholesterol off and on plant sterol and stanol ester spreads in serum and in different lipoproteins of a family with familial hypercholesterolemia, including heterozygous parents receiving no treatment and their homozygous offspring undergoing long-term treatment with statins and apheresis. Serum cholesterol levels were similar in the homozygous and heterozygous individuals, but the concentrations of sterols reflecting cholesterol absorption were as much as 10 times greater in the homozygous child than in the heterozygous parents, whereas the respective markers of cholesterol synthesis only tended to be higher. About 70% of squalene in the homozygous individual (60% in the heterozygous family members) and 85% to 90% of noncholesterol sterols (60%-80% in the heterozygous subjects) were transported by low-density lipoprotein. The ratios of absorption sterols to cholesterol were higher in high-density lipoprotein (HDL) than in very low-density lipoprotein (VLDL), whereas those of synthesis markers and plant stanols were highest in VLDL. The ratios of absorption sterols in serum were mostly lower than those in HDL but higher than in VLDL, whereas the ratios of synthesis sterols in serum were lower than they were in VLDL. Both spreads reduced serum total cholesterol by about 14% in the heterozygous family members and 9% in the homozygous individual. The sterol ester spread increased serum plant sterol concentrations (eg, campesterol in the homozygous family member increased from 5 to 9 mg/dL) and the ratios to cholesterol, but the stanol ester spread decreased them. Plant sterol esters seemed to similarly decrease serum cholesterol in this family with familial hypercholesterolemia, but the clinical role of increased plant sterol concentrations, almost doubled in the LDL of homozygous individuals, is not known.

Dietary squalene increases cholesterol synthesis measured with serum non-cholesterol sterols after a single oral dose in humans

Studies considering long-term squalene consumption have revealed no consistent effects on serum cholesterol levels but the immediate effect of dietary squalene on cholesterol synthesis has not been studied. Thus, the effect of a single dose of dietary squalene on postprandial lipid metabolism was studied in 16 male volunteeers aged 22-79 years. Two oral fat meals a week apart were administered to every subject, one without (control) and the other with 500 mg of squalene. Lipids, retinyl palmitate, squalene and non-cholesterol sterols were measured at baseline and after 3, 4, 6, 9, 12 and 24 h postprandially in plasma, chylomicron, VLDL and VLDL bottom and, in six randomly chosen subjects, also in IDL, LDL and HDL. In the fasting samples, squalene was mainly transported in LDL and HDL, whereas in squalene-supplemented postprandium most of squalene was carried in the triglyceride-rich lipoproteins. Postprandial squalene and retinyl palmitate curves closely resembled each other. After the squalene-enriched dietary fat load, squalene was significantly increased compared to control fat loads in plasma, chylomicrons, VLDL and IDL. Squalene addition increased significantly lathosterol/campesterol ratio in chylomicrons and VLDL at 12 h and in VLDL bottom at 9-12 h, and increased significantly VLDL lanosterol/campesterol ratio at 12 h, indicating enhanced cholesterol synthesis caused by squalene. Plasma plant sterol levels remained unchanged. In conclusion, a single oral dose of squalene representing a potential daily dietary amount increases cholesterol synthesis within 9-12 h detected in chylomicrons, VLDL and VLDL bottom.

Serum squalene in postmenopausal women without and with coronary artery disease

Squalene, found in earlier studies in human atherosclerotic plaques, was measured in the serum of postmenopausal women with coronary artery disease (CAD) (n = 25) and randomly chosen age-matched healthy controls (n = 30). The squalene concentrations of the whole population ranged from 37.5 to 115.5 microg/dl, and were higher in serum of the CAD than healthy women (91.4+/-2.6 versus 65.2+/-2.6 microg/dl, P = 0.000), a finding observed also in relation to cholesterol (43.8+/-1.8 versus 32.9+/-1.1 10(2)x mmol/mol of cholesterol, P = 0.000). The squalene concentration was also increased in chylomicrons, VLDL and d>1.006 g/ml lipoproteins, and the proportions to cholesterol in VLDL and d>1.006 g/ml lipoproteins. The respective squalene and cholesterol concentrations were related to each other in serum, VLDL and d>1.006 g/ml lipoproteins (r = 0.52, 0.85 and 0.55, respectively), whereas the correlation with triglycerides was seen only in VLDL (r = 0.84) over the whole population. Besides enhanced intestinal secretion, it remains to be shown whether higher serum squalene in postmenopausal coronary women is due to increased cholesterol synthesis or a defect in squalene conversion to lanosterol.

Postabsorptive metabolism of dietary squalene

Serum squalene, a non-steroid intermediate of cholesterol biosynthesis, originates mainly from endogenous cholesterol synthesis and partly from diet, especially in populations consuming a lot of olive oil rich in squalene. Its postabsorptive metabolism has not been studied in detail in humans. Its presence in chylomicrons and VLDL suggests that the removal of dietary squalene may reflect the metabolism of intestinal lipoproteins. Accordingly, we studied the postabsorptive metabolism of 1 g dietary squalene in 16 healthy subjects with apolipoprotein (apo) E 3/3 phenotype and in five type III hyperlipidemic apo E 2/2 homozygotes known to have a retarded chylomicron remnant removal, and compared the results with vitamin A fat load test. About 40% of the basal and 90% of the postabsorptive squalene was in lipoproteins < 1.019 g/ml. The peak concentrations of chylomicron squalene were at 6 h, and of triglyceride-rich nonchylo-fraction at 9-12 h in the controls. The peak values occurred later than those of vitamin A. At 24 h the levels still exceeded the basal ones. In type III dyslipoproteinemia, most of the basal and postabsorptive squalene was in lipoproteins of density less than 1.019 g/ml, the peak postabsorptive values occurred later than in the controls and the serum values remained above the control levels for up to 24 h. The squalene and vitamin A areas under the incremental response curves (AUC) were higher than in the control group. The AUCs of the two markers in chylomicron were correlated negatively and those in LDL+HDL were correlated positively with fasting HDL cholesterol levels, the respective correlations being opposite with fasting VLDL triglycerides. The postabsorptive profile of squalene levels resembled that of vitamin A in both groups, except that the squalene curves were shifted to a later time period. Thus, a delayed clearance of chylomicron remnants could be detected by analyzing serum squalene 6-24 h after the squalene-supplemented fat meal.

Radioprotection of mice by dietary squalene

Male C3H mice were fed a diet containing 2% squalene for 14 d prior to and 30 d subsequent to exposure to 6, 7 or 8 Gy of whole body gamma-irradiation (Cesium-137). After 14 d on squalene-supplemented diet, plasma and jejunal tissue squalene levels were 2X and 15X that of controls. Seven days after irradiation, total white cell counts and total lymphocyte counts were substantially depressed in a radiation dose-dependent manner. Although counts in the squalene group were consistently (18-119%) higher than those in the corresponding dietary control group, the differences between dietary groups at any single dose were not significant. Nuclear area of villus cells in the jejunum of both dietary groups was significantly reduced (20%) by day 11 post-irradiation but the nuclear area in squalene-fed mice was significantly greater (15%) than in controls, before and after irradiation. There were no differences in body weight as a function of either diet or radiation dose prior to the first observations of animal lethality. Animal survival was decreased from 100 to 0% at 30 d post-irradiation by radiation doses of 6-8 Gy, with the greatest difference between dietary groups being observed at 7 Gy (median survival times of 12 and 16 d for control and squalene groups, respectively). Overall, survival of squalene-fed mice was significantly prolonged compared with control-fed mice (P = 0.0054 by censored multiple regression analysis). It is concluded that squalene conferred some cellular and systemic radioprotection to mice receiving these lethal whole-body radiation doses.

High cholestanol and low campesterol-to-sitosterol ratio in serum of patients with primary biliary cirrhosis before liver transplantation

Serum levels of cholesterol precursors (squalene, delta 8-cholestanol, desmosterol and lathosterol), plant sterols (campesterol and sitosterol), cholestanol and cholestanol/noncholesterol sterol ratios were related to liver damage and liver transplantation indications in healthy controls (n = 26) and in 31 patients with primary biliary cirrhosis divided into group I (S-bilirubin less than 21 mumol/L; n = 14), group II (S-bilirubin 21 to 108 mumol/L; n = 7) and group III (elected for liver transplantation; S-bilirubin 109 to 520 mumol/L; n = 10). The mean serum respective lathosterol levels in controls and in group I were three and two times higher than those in groups II and III, respectively. The plant sterol contents were higher in group II than in groups I and III and the campesterol/sitosterol ratios were lowest in group III. The serum cholestanol levels were high even in group I (i.e., in patients without icterus) and increased progressively to group III, up to 6 and 13 times those in group I and the control group, respectively. The cholestanol/noncholesterol sterol ratios increased progressively from the controls to groups I, II and III. The serum cholestanol levels were positively related to serum bilirubin levels in all primary biliary cirrhosis patients (n = 31, r = 0.906) and to the plant sterol levels in the control group and group I, but significantly negatively in group III. The cholestanol vs. precursor sterol correlations were negative in most cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Increased amounts of cholesterol precursors in lipoproteins after ileal exclusion

Serum cholesterol precursor sterols reflect the activity of cholesterol synthesis. In this study, squalene, methyl sterol and lathosterol contents were studied in very low density lipoprotein (VLDL), low density lipoprotein (LDL) and high density lipoprotein (HDL) of heterozygous familial hypercholesterolemia patients without and with ileal bypass. The contents of lathosterol and all methyl sterols (lanosterol, delta 8,24-dimethylsterol, delta 8-dimethylsterol, delta 8-methostenol and methostenol), but not of squalene were increased in all lipoproteins by ileal bypass. The increase in the free methyl sterols was more marked than that in the esterified ones. The percentage esterification of the methyl sterols was highest in HDL and lowest in VLDL. Lipoprotein methyl sterol contents were positively correlated with each other and with cholesterol synthesis. The methyl sterols were slightly concentrated in LDL, and squalene strongly concentrated in VLDL. It is concluded that long-term stimulation of cholesterol synthesis increases the methyl sterols in all lipoproteins.

Biliary squalene levels in hepatobiliary disease

Following overnight fasting, biliary levels of squalene, bile salts, cholesterol and phospholipid were estimated using human bile obtained with a duodenal double lumen catheter after administration of caerulein. While the squalene level in B-bile was 6.86 microM in the control group, it fell significantly in patients with parenchymal liver diseases, especially liver cirrhosis. There was no significant change in the level in patients with cholelithiasis. Biliary squalene concentration showed a significant correlation with concentrations of bile salts, cholesterol and phospholipid. These results substantiate the possibility that the biliary squalene level reflects sterol metabolism in the liver.

Sterol and bile acid metabolism after short-term prednisolone treatment in patients with chronic active hepatitis

Serum levels of squalene, cholesterol and bile acid were measured before and after short-term prednisolone administration in patients with chronic active hepatitis. Comparison with normal controls indicated that serum bile acid levels were increased significantly (p less than 0.01) in patients with chronic active hepatitis, but serum levels of squalene and cholesterol did not differ significantly between the two groups. After short-term prednisolone treatment, serum levels of squalene and cholesterol were increased significantly (p less than 0.01) as compared with the pretreatment level. On the other hand, while serum fasting bile acid levels were found to be increased significantly (p less than 0.01), serum clearance after oral administration of ursodeoxycholic acid improved significantly (p less than 0.05) after treatment. These results indicated that short-term prednisolone treatment increases sterol metabolism in the liver in patients with chronic active hepatitis, resulting from an increase in hepatic clearance of bile acids.

Absorption and metabolic fate of dietary 3H-squalene in the rat

The absorption and metabolic fate of dietary squalene was investigated on the rat by administering a single oral dose of 3H-squalene and 14C-cholesterol. Experiments on rats with cannulated thoracic duct revealed that 3H-squalene was, like 14C-cholesterol, absorbed through the lymphatic vessels and that ca. 20% of absorbed 3H-squalene was cyclized to sterols during the transit through the intestinal wall. Feces contained 3H-sterols, indicating that newly synthesized mucosal sterols had been secreted into the gut lumen. In intact animals, 3H-squalene appeared in the circulation more rapidly than 14C-cholesterol and did not persist to any significant extent in the squalene-rich adipose and muscle tissues. The increase in dietary squalene load (8-48 mg) decreased the absorption percentage of 3H-squalene (45-26%) but did not affect the absorption of 14C-cholesterol (47%). Determination of fecal steroids revealed that during the first days absorbed 3H-squalene was eliminated to a significantly higher extent than 14C-cholesterol as fecal bile acids (34% vs 11%). The experiments indicate that the rat intestine has a marked capacity for absorbing dietary squalene and that the absorbed squalene is preferentially converted to bile acids in the liver.

Dietary squalene increases tissue sterols and fecal bile acids in the rat

Feeding 1% squalene increased markedly the concentrations of squalene and methyl sterols in each serum lipoprotein class, intestinal mucosa, liver and also in adipose tissue. It also increased cholesterol concentration of the liver and serum VLDL, and esterified cholesterol in serum LDL as well as fecal bile acids. The results suggest that absorbed dietary squalene contributes to some extent to the squalene content of adipose tissue, effectively increases the overall cholesterol synthesis and enhances cholesterol elimination preferentially as fecal bile acids.

Fate of intravenously administered squalene in the rat

To investigate the metabolism of serum squalene rats were given intravenously serum or isolated lipoprotein containing [3H]squalene and [14C]cholesterol. Labeled squalene disappeared multiexponentially from serum and the rate of disappearance was consistently faster than for [14C]cholesterol. [3H]Squalene given by injection did not accumulate in tissues, but was rapidly cyclized to sterols, resulting in the labeling of serum methyl sterols and cholesterol as well as biliary and fecal sterols and bile acids. Independent of the form of administration, the fractional conversion of squalene to serum cholesterol was less than one. This was caused by the fact that [3H]squalene was eliminated initially more rapidly than serum [14C]cholesterol in the feces and was converted to a greater extent than serum cholesterol to bile acids, whereas both labels were eliminated in parallel as neutral sterols. The results support the role of newly synthesized hepatic cholesterol as the preferred substrate of bile acid synthesis.