1. Lipid Metabolism 3: Cholesterol biosynthesis, lipoprotein metabolism, steroid and eicosanoid synthesis Bioc 460 Spring 2008 - Lecture 37 (Miesfeld) Steroids are cholesterol derivatives that have been used as anabolic enhancers Mike Brown and Joe Goldstein shared the 1985 Nobel Prize for their work on cholesterol metabolism Cardiovascular disease is caused by fatty acid deposits that sequester cholesterol in plaques that can break off

2. Cholesterol is major component of membranes that is synthesized in liver cells from acetyl-CoA. Cholesterol metabolism is an important component of cardiovascular disease because of its association with the formation of atherosclerotic plaques. Steroid hormones are cholesterol derivatives that are important physiological ligands and pharmaceutical drugs. Eicosanoids are fatty acid derivatives that are precursors to prostaglandins, thromboxanes, and leukotrienes. Key Concepts in Lipid Metabolism

3. Cholesterol Biosynthesis Radioisotope labeling experiments have shown that all 27 carbon atoms of cholesterol are derived from acetyl-CoA.

4. Stage 1: Generation of mevalonate from acetyl-CoA In what turns out to be the rate-limiting step in the cholesterol biosynthetic pathway, the enzyme HMG- CoA reductase converts HMG-CoA to mevalonate in a reduction reaction that uses two molecules of NADPH and releases coenzyme A. This enzyme is the target of statin drugs. 2 C 2 1 C 6

5. Stage 2: Conversion of mevalonate to isopentenyl pyrophosphate and dimethylallyl pyrophosphate 1 C 5 isomerize or 1 C 6

6. Stages 3 and 4: formation of cholesterol (C 27 ) from six C 5 isoprenoids 1 C 5 1 C 10 + 1 C 15 +1 C 5 +1 C 15 1 C 30 1 C 27 1 C 30

7. Cholesterol synthesized in the liver has three metabolic fates; stored, exported, or converted to bile acid What would happen to cholesterol levels in the liver if bile acids were excreted rather than recycled back to the liver? Bile acid resin

8. Metabolism of dietary fats and cholesterol Triacylglycerols and cholesterol are transported through the circulatory system as components of plasma lipoprotein particles that consist of membrane-bound vesicles containing a hydrophobic core and one or more proteins on the surface called apolipoproteins.

9. Metabolism of dietary fats and cholesterol

10. Which class of lipoproteins are responsible for the gross blood plasma that appears within 1 hour of eating the triple burger?

11. Metabolism of dietary fats and cholesterol

12. "Why is LDL considered "bad cholesterol" and HDL "good cholesterol?"

14. Cardiovascular disease is due to the build-up of cholesterol-rich fibrous plaques in arteries

15. LDL receptor cycling and cholesterol homeostasis

16. Statin drugs inhibit cholesterol biosynthesis by blocking the activity of HMG-CoA reductase

17. 1 2 3 4 How do statin drugs lower serum LDL levels? Why would this decrease the risk of cardiovascular disease?

18. Ezetimibe (Zetia) blocks dietary cholesterol uptake

19. Surprisingly, recent clinical studies have shown that Vytorin, a Merck collaborative drug, is no more effective in reducing cardiovascular disease than statin drugs alone. It is not clear what these new results mean except that serum cholesterol levels alone may not be the best predictor of cardiovascular disease.

20. Steroid hormones are synthesized from cholesterol

22. Eicosanoids Biosynthesis

23. COX-2 Inhibitors