Abstract

Acyl-CoA binding domain-containing 5 (ACBD5) is a peroxisomal protein that carries an acyl-CoA binding domain (ACBD) at its N-terminal region. The recent identification of a mutation in the ACBD5 gene in patients with a syndromic form of retinal dystrophy highlights the physiological importance of ACBD5 in humans. However, the underlying pathogenic mechanisms and the precise function of ACBD5 remain unclear. We herein report that ACBD5 is a peroxisomal tail-anchored membrane protein exposing its ACBD to the cytosol. Using patient-derived fibroblasts and ACBD5 knock-out HeLa cells generated via genome editing, we demonstrate that ACBD5 deficiency causes a moderate but significant defect in peroxisomal β-oxidation of very-long-chain fatty acids (VLCFAs) and elevates the level of cellular phospholipids containing VLCFAs without affecting peroxisome biogenesis, including the import of membrane and matrix proteins. Both the N-terminal ACBD and peroxisomal localization of ACBD5 are prerequisite for efficient VLCFA β-oxidation in peroxisomes. Furthermore, ACBD5 preferentially binds very-long-chain fatty acyl-CoAs (VLC-CoAs). Together, these results suggest a direct role of ACBD5 in peroxisomal VLCFA β-oxidation. Based on our findings, we propose that ACBD5 captures VLC-CoAs on the cytosolic side of the peroxisomal membrane so that the transport of VLC-CoAs into peroxisomes and subsequent β-oxidation thereof can proceed efficiently. Our study reclassifies ACBD5-related phenotype as a novel peroxisomal disorder.

Highlights

  • Uncertainty about the accuracy of triage blood pressure measurements was a prominent factor in the decision to not intensify antihypertensive therapy in ~ 50% of diabetic patients with elevated blood pressure readings

  • COMMENTARY Blood pressure control is the lynchpin of cardiovascular risk reduction

  • Copious research demonstrates that a high proportion of hypertensive patients do not achieve blood pressure control that conforms to current recommendations.[1,2]

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Summary

The Quandary of Improving Hypertension Control in Diabetes

STUDY Kerr EA, Zikmund-Fisher BJ, Klamerus ML, Subramanian U, Hogan MM, Hofer TP: The role of clinical uncertainty in treatment decisions for diabetic patients with uncontrolled blood pressure. A prospective cohort study examining what proportion of diabetic patients with a triage blood pressure > 140 mmHg systolic or 90 mmHg diastolic received a treatment change during a single routine visit and to what extent certain provider and patient factors influenced the likelihood of change. The study included 1,169 diabetic patients with elevated blood pressure treated by 92 primary care providers at nine Veterans Affairs facilities in three Midwestern states over 13 months. Patients were older (mean age 66 years) and were primarily male (97%) and white (80%). The mean systolic blood pressure was 154 mmHg (standard deviation: 113–228)

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