[PDF][PDF] Effects of infection and inflammation on lipid and lipoprotein metabolism: mechanisms and consequences to the host

W Khovidhunkit, MS Kim, RA Memon… - The Journal of …, 2004 - pdfs.semanticscholar.org
W Khovidhunkit, MS Kim, RA Memon, JK Shigenaga, AH Moser, KR Feingold, C Grunfeld
The Journal of Lipid Research, 2004pdfs.semanticscholar.org
Infection and inflammation induce the acutephase response (APR), leading to multiple
alterations in lipid and lipoprotein metabolism. Plasma triglyceride levels increase from
increased VLDL secretion as a result of adipose tissue lipolysis, increased de novo hepatic
fatty acid synthesis, and suppression of fatty acid oxidation. With more severe infection,
VLDL clearance decreases secondary to decreased lipoprotein lipase and apolipoprotein E
in VLDL. In rodents, hypercholesterolemia occurs attributable to increased hepatic …
Abstract
Infection and inflammation induce the acutephase response (APR), leading to multiple alterations in lipid and lipoprotein metabolism. Plasma triglyceride levels increase from increased VLDL secretion as a result of adipose tissue lipolysis, increased de novo hepatic fatty acid synthesis, and suppression of fatty acid oxidation. With more severe infection, VLDL clearance decreases secondary to decreased lipoprotein lipase and apolipoprotein E in VLDL. In rodents, hypercholesterolemia occurs attributable to increased hepatic cholesterol synthesis and decreased LDL clearance, conversion of cholesterol to bile acids, and secretion of cholesterol into the bile. Marked alterations in proteins important in HDL metabolism lead to decreased reverse cholesterol transport and increased cholesterol delivery to immune cells. Oxidation of LDL and VLDL increases, whereas HDL becomes a proinflammatory molecule. Lipoproteins become enriched in ceramide, glucosylceramide, and sphingomyelin, enhancing uptake by macrophages. Thus, many of the changes in lipoproteins are proatherogenic. The molecular mechanisms underlying the decrease in many of the proteins during the APR involve coordinated decreases in several nuclear hormone receptors, including peroxisome proliferatoractivated receptor, liver X receptor, farnesoid X receptor, and retinoid X receptor. APR-induced alterations initially protect the host from the harmful effects of bacteria, viruses, and parasites. However, if prolonged, these changes in the structure and function of lipoproteins will contribute to atherogenesis.—Khovidhunkit, W., MS. Kim, RA Memon, JK Shigenaga, AH Moser, KR Feingold, and C. Grunfeld. Effects of infection and inflammation on lipid and lipoprotein metabolism: mechanisms and consequences to the host. J. Lipid Res. 2004. 45: 1169–1196.
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