Abstract
Oxysterols are intermediates of cholesterol metabolism and are generated from cholesterol via either enzymatic or nonenzymatic pathways under oxidative stress conditions. Cholestan-3β,5α,6β-triol (C-triol) and 7-ketocholesterol (7-KC) have been proposed as new biomarkers for the diagnosis of Niemann-Pick type C (NP-C) disease, representing an alternative tool to the invasive and time-consuming method of fibroblast filipin test. To test the efficacy of plasma oxysterol determination for the diagnosis of NP-C, we systematically screened oxysterol levels in patients affected by different inherited disorders related with cholesterol metabolism, which included Niemann-Pick type B (NP-B) disease, lysosomal acid lipase (LAL) deficiency, Smith-Lemli-Opitz syndrome (SLOS), congenital familial hypercholesterolemia (FH), and sitosterolemia (SITO). As expected, NP-C patients showed significant increase of both C-triol and 7-KC. Strong increase of both oxysterols was observed in NP-B and less pronounced in LAL deficiency. In SLOS, only 7-KC was markedly increased, whereas in both FH and in SITO, oxysterol concentrations were normal. Interestingly, in NP-C alone, we observed that plasma oxysterols correlate negatively with patient's age and positively with serum total bilirubin, suggesting the potential relationship between oxysterol levels and hepatic disease status. Our results indicate that oxysterols are reliable and sensitive biomarkers of NP-C.
Highlights
Oxysterols are intermediates of cholesterol metabolism and are generated from cholesterol via either enzymatic or nonenzymatic pathways under oxidative stress conditions
The 16 Niemann-Pick type C (NP-C) patients showed a significant increase of both oxysterols: C-triol median value was 55.3 ng/ml, and the 7-KC median value was 86.0 ng/ml
In the two Niemann-Pick type B (NP-B) patients, we found the highest increase of both oxysterols observed in our cholesterol metabolism-related disorder (CMRD) series: C-triol median value 140 ng/ml and 7-KC median value 129 ng/ml (Table 1)
Summary
Oxysterols are intermediates of cholesterol metabolism and are generated from cholesterol via either enzymatic or nonenzymatic pathways under oxidative stress conditions. To test the efficacy of plasma oxysterol determination for the diagnosis of NP-C, we systematically screened oxysterol levels in patients affected by different inherited disorders related with cholesterol metabolism, which included Niemann-Pick type B (NP-B) disease, lysosomal acid lipase (LAL) deficiency, Smith-Lemli-Opitz syndrome (SLOS), congenital familial hypercholesterolemia (FH), and sitosterolemia (SITO). Recent studies show that the level and type of oxysterols generated under oxidative stress conditions are not related only to cholesterol availability or to reactive oxygen and nitrogen species, because the different oxysterols may reflect pathological processes in specific sites or organs [3]. In order to test the potential contribution of plasma oxysterol determination in the differential diagnosis of NP-C with other cholesterol metabolism-related disorders (CMRDs), we systematically tested plasma C-triol and 7-KC
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