2.2.2. LDL and receptor mediated metabolism
LDL is the most abundant cholesterol-carrying lipoprotein in plasma. CE, located in the hydrophobic core of LDL, is the main form of cholesterol carried in LDL. CE is supposed to be too hydrophobic to pass through cell membranes. The question is how can esterified cholesterol be delivered into cells for their use? The delivery problem is solved by the LDL receptors. The LDL receptors bind LDL and CE packed into LDL particles is delivered into the cell by receptor-mediated endocytosis. The receptor-mediated removal of LDL cholesterol occurs mostly via classical LDL receptors that have been observed in all mammalian cells tested except erythrocytes (Brown and Goldstein 1986) (Fig. 1). The liver plays a crucial role in receptor mediated uptake of LDL: about 75% of the LDL particles removed from the circulation are mediated by the liver. Of these, 75% of the clearance is LDL receptor-mediated, the remainder is by a nonspecific, receptor-independent low affinity process (Pittman et al. 1982, Billheimer et al. 1984). Also SR-BI mediates LDL binding but only CE is selectively delivered to the cell especially in non-placental steroidogenic tissues (van Berkel et al. 1995).
Figure 1. Steps in the LDL pathway in cultured human fibroblasts.
The LDL receptor is a cell surface glycoprotein with a molecular weight of 164 kDa, with a coding gene on chromosome 19 (Francke et al. 1984). It is present on both hepatic and extrahepatic cells. The high binding interaction between LDL apoB and the LDL receptor is responsible for the receptor-mediated uptake and clearance of LDL from the circulation. The ApoE on apoE-containing lipoproteins (VLDL, IDL) is also capable of interacting with the LDL receptors and regulating the metabolism of these lipoproteins (Mahley 1990). Following the binding of LDL to its receptors, the lipoprotein is internalized and delivered into lysosomes where its CE is hydrolyzed. The liberated cholesterol is then used by the cell for the synthesis of plasma membranes, bile acids, and steroid hormones, or stored in the ester form. The increased intracellular cholesterol level will, in return, down regulate the LDL receptor activity, i.e., receptor synthesis. Subsequently, the number of the LDL receptors synthesized decreases when the cellular cholesterol content increases, and vice versa (Brown and Goldstein 1986). Therefore, cellular cholesterol content is the major LDL receptor regulator. ApoB-100, one of the largest monomeric proteins known, is the major protein component of LDL and acts as a ligand for the LDL receptor.
ApoB-100 is a large (513 kDa), single chain glycoprotein composed of 4536 amino acid residues with a coding gene residing on the short arm of chromosome 2 (Knott et al. 1986, Yang et al. 1986). There is only one apoB-100 molecule in each LDL particle (Tikkanen and Schonfeld 1985, Cladaras et al 1986). ApoB-100 also is not transfered between lipoprotein particles during the metabolic conversion of VLDL into LDL. It is presumed that the apoB-100 binding site resides in the carboxyterminal portion of the molecule. However, the region assumed to be involved in LDL binding is not yet clear. So far three apoB mutations, called familial defective apolipoprotein B-100 (FDB) (Arg3500®Gln, Arg3500®Trp, Arg3531®Cys) have been reported to be related to hypercholesterolemia (Soria et al. 1989, Gaffney et al. 1995, Pullinger et al. 1995). However, none of these mutations have been found in Finland (Hämäläinen et al. 1990).
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