Metabolic pathway of LDL, HDL and TG, including diseases (Homo sapiens)

From WikiPathways

Jump to: navigation, search
62, 19, 22, 24, 27381611Cholesterol poolCellLiverIntestine5Chyclomicron43.2.1EndocytosisCholesterol is the precursor for steroid hormones.12, 20C-IILDLRAP1CETPAnnexin A2Cyclic fatty acidsNuclear hormone receptors(involved in sterol metabolism)CholesterolPCSK9MTPRemnant receptorHL Steroid Biosynthesis(general overview)LPLVit. D pathwayLPLLCATABCA1HLOxysterolsLDLRLDL-receptorSR-B131643.2.22617293743., 3343.6.223361843., 3043., 2543.4.32843.4.21, 3443.3.31043.1.432843.2.34, 843., 202143.1.335Cholesterol29CholesterolCholesterolClassical steroidogenesis(including diseases)Alternative steroidogenesis(including diseases)Bile AcidsB48EVLDLB100RemnantB48EHDL3A-IA-IIHDL2A-IIDLB100LDLB100C-IIEE43., 263838MTP2, 19, 22, 24, 27


This pathway shows genetic disorders related to lipoprotein metabolism. Two plasmalipoproteins, LDL and HDL, and one plasma lipid, triglyceride (TG), play an important role in this pathway. Hydrophobic lipids and fat-soluble vitamins are normally transported to the site of their uptake by transporters called lipoproteins, and any deregulation of the plasma concentrations of these proteins can cause dyslipidemias. Disorders resulting from an enzyme deficiency are highlighted in pink. More details on the composition of the various lipoproteins in this pathway are visualised in [1].

This pathway was inspired by Chapter 43 of the book of Blau (ISBN 3642403360 (978-3642403361)).

Quality Tags

Ontology Terms



View all...
  1. Frohlich J, Hon K, McLeod R; ''Detection of heterozygotes for familial lecithin: cholesterol acyltransferase (LCAT) deficiency.''; Am J Hum Genet, 1982 PubMed Europe PMC Scholia
  2. Khatun I, Walsh MT, Hussain MM; ''Loss of both phospholipid and triglyceride transfer activities of microsomal triglyceride transfer protein in abetalipoproteinemia.''; J Lipid Res, 2013 PubMed Europe PMC Scholia
  3. Griffiths WJ, Abdel-Khalik J, Hearn T, Yutuc E, Morgan AH, Wang Y; ''Current trends in oxysterol research.''; Biochem Soc Trans, 2016 PubMed Europe PMC Scholia
  4. Kathiresan S; ''A PCSK9 missense variant associated with a reduced risk of early-onset myocardial infarction.''; N Engl J Med, 2008 PubMed Europe PMC Scholia
  5. Hegele RA; ''Plasma lipoproteins: geneticinfluences and clinical implications.''; Nat Rev Genet, 2009 PubMed Europe PMC Scholia
  6. Blau Nenad, Duran Marinus, Gibson, K, Michael, Dionisi-Vici, Carlo; ''Physician's Guide to the Diagnosis, Treatment, and Follow-Up of Inherited Metabolic Diseases''; 9783642403361, 2014
  7. Auwerx JH, Babirak SP, Fujimoto WY, Iverius PH, Brunzell JD; ''Defective enzyme protein in lipoprotein lipase deficiency.''; Eur J Clin Invest, 1989 PubMed Europe PMC Scholia
  8. Abifadel M, Varret M, Rabès, Allard D, Ouguerram K, Devillers M, Cruaud C, Benjannet S, Wickham L, Erlich D, Derré A, Villéger L, Farnier M, Beucler I, Bruckert E, Chambaz J, Chanu B, Lecerf JM, Luc G, Moulin P, Weissenbach J, Prat A, Krempf M, Junien C, Seidah NG, Boileau C; ''Mutations in PCSK9 cause autosomal dominant hypercholesterolemia.''; Nat Genet, 2003 PubMed Europe PMC Scholia
  9. Brousseau ME, Schaefer EJ, Wolfe ML, Bloedon LT, Digenio AG, Clark RW, Mancuso JP, Rader DJ; ''Effects of an inhibitor of cholesteryl ester transfer protein on HDL cholesterol.''; N Engl J Med, 2004 PubMed Europe PMC Scholia
  10. Ajees AA, Anantharamaiah GM, Mishra VK, Hussain MM, Murthy HM; ''Crystal structure of human apolipoprotein A-I: insights into its protective effect against cardiovascular diseases.''; Proc Natl Acad Sci U S A, 2006 PubMed Europe PMC Scholia
  11. Eichmann TO, Kumari M, Haas JT, Farese RV Jr, Zimmermann R, Lass A, Zechner R; ''Studies on the substrate and stereo/regioselectivity of adipose triglyceride lipase, hormone-sensitive lipase, and diacylglycerol-O-acyltransferases.''; J Biol Chem, 2012 PubMed Europe PMC Scholia
  12. Lee J, Hegele RA; ''Abetalipoproteinemia and homozygous hypobetalipoproteinemia: a framework for diagnosis and management.''; J Inherit Metab Dis, 2014 PubMed Europe PMC Scholia
  13. Allen JM, Thompson GR, Myant NB, Steiner R, Oakley CM; ''Cadiovascular complications of homozygous familial hypercholesterolaemia.''; Br Heart J, 1980 PubMed Europe PMC Scholia
  14. Al-Kateb H, Bähring D, Hoffmann K, Strauch K, Busjahn A, Nürnberg G, Jouma M, Bautz EK, Dresel HA, Luft FC; ''Mutation in the ARH gene and a chromosome 13q locus influence cholesterol levels in a new form of digenic-recessive familial hypercholesterolemia.''; Circ Res, 2002 PubMed Europe PMC Scholia
  15. Assmann G, Herbert PN, Fredrickson DS, Forte T; ''Isolation and characterization of an abnormal high density lipoprotein in Tangier Diesase.''; J Clin Invest, 1977 PubMed Europe PMC Scholia
  16. Horton JD, Cohen JC, Hobbs HH; ''Molecular biology of PCSK9: its role in LDL metabolism.''; Trends Biochem Sci, 2007 PubMed Europe PMC Scholia
  17. Zanoni P, Khetarpal SA, Larach DB, Hancock-Cerutti WF, Millar JS, Cuchel M, DerOhannessian S, Kontush A, Surendran P, Saleheen D, Trompet S, Jukema JW, De Craen A, Deloukas P, Sattar N, Ford I, Packard C, Majumder Aa, Alam DS, Di Angelantonio E, Abecasis G, Chowdhury R, Erdmann J, Nordestgaard BG, Nielsen SF, Tybjærg-Hansen A, Schmidt RF, Kuulasmaa K, Liu DJ, Perola M, Blankenberg S, Salomaa V, Männistö S, Amouyel P, Arveiler D, Ferrieres J, Müller-Nurasyid M, Ferrario M, Kee F, Willer CJ, Samani N, Schunkert H, Butterworth AS, Howson JM, Peloso GM, Stitziel NO, Danesh J, Kathiresan S, Rader DJ; ''Rare variant in scavenger receptor BI raises HDL cholesterol and increases risk of coronary heart disease.''; Science, 2016 PubMed Europe PMC Scholia
  18. Haemmerle G, Zimmermann R, Hayn M, Theussl C, Waeg G, Wagner E, Sattler W, Magin TM, Wagner EF, Zechner R; ''Hormone-sensitive lipase deficiency in mice causes diglyceride accumulation in adipose tissue, muscle, and testis.''; J Biol Chem, 2002 PubMed Europe PMC Scholia
  19. Rehberg EF, Samson-Bouma ME, Kienzle B, Blinderman L, Jamil H, Wetterau JR, Aggerbeck LP, Gordon DA; ''A novel abetalipoproteinemia genotype. Identification of a missense mutation in the 97-kDa subunit of the microsomal triglyceride transfer protein that prevents complex formation with protein disulfide isomerase.''; J Biol Chem, 1996 PubMed Europe PMC Scholia
  20. Brunzell JD, Albers JJ, Chait A, Grundy SM, Groszek E, McDonald GB; ''Plasma lipoproteins in familial combined hyperlipidemia and monogenic familial hypertriglyceridemia.''; J Lipid Res, 1983 PubMed Europe PMC Scholia
  21. Higgins MJ, Lecamwasam DS, Galton DJ; ''A new type of familial hypercholesterolaemia.''; Lancet, 1975 PubMed Europe PMC Scholia
  22. Di Filippo M, Créhalet H, Samson-Bouma ME, Bonnet V, Aggerbeck LP, Rabès JP, Gottrand F, Luc G, Bozon D, Sassolas A; ''Molecular and functional analysis of two new MTTP gene mutations in an atypical case of abetalipoproteinemia.''; J Lipid Res, 2012 PubMed Europe PMC Scholia
  23. Baggio G, Manzato E, Gabelli C, Fellin R, Martini S, Enzi GB, Verlato F, Baiocchi MR, Sprecher DL, Kashyap ML; ''Apolipoprotein C-II deficiency syndrome. Clinical features, lipoprotein characterization, lipase activity, and correction of hypertriglyceridemia after apolipoprotein C-II administration in two affected patients.''; J Clin Invest, 1986 PubMed Europe PMC Scholia
  24. Walsh MT, Iqbal J, Josekutty J, Soh J, Di Leo E, Özaydin E, Gündüz M, Tarugi P, Hussain MM; ''Novel Abetalipoproteinemia Missense Mutation Highlights the Importance of the N-Terminal β-Barrel in Microsomal Triglyceride Transfer Protein Function.''; Circ Cardiovasc Genet, 2015 PubMed Europe PMC Scholia
  25. Assmann G, Smootz E, Adler K, Capurso A, Oette K; ''The lipoprotein abnormality in Tangier disease: quantitation of A apoproteins.''; J Clin Invest, 1977 PubMed Europe PMC Scholia
  26. Mishra SK, Keyel PA, Edeling MA, Dupin AL, Owen DJ, Traub LM; ''Functional dissection of an AP-2 beta2 appendage-binding sequence within the autosomal recessive hypercholesterolemia protein.''; J Biol Chem, 2005 PubMed Europe PMC Scholia
  27. Miller SA, Burnett JR, Leonis MA, McKnight CJ, van Bockxmeer FM, Hooper AJ; ''Novel missense MTTP gene mutations causing abetalipoproteinemia.''; Biochim Biophys Acta, 2014 PubMed Europe PMC Scholia
  28. Carlson LA, Holmquist L; ''Evidence for deficiency of high density lipoprotein lecithin: cholesterol acyltransferase activity (alpha-LCAT) in fish eye disease.''; Acta Med Scand, 1985 PubMed Europe PMC Scholia
  29. Ly K, Saavedra YG, Canuel M, Routhier S, Desjardins R, Hamelin J, Mayne J, Lazure C, Seidah NG, Day R; ''Annexin A2 reduces PCSK9 protein levels via a translational mechanism and interacts with the M1 and M2 domains of PCSK9.''; J Biol Chem, 2014 PubMed Europe PMC Scholia
  30. Glueck CJ, Fallat RW, Millett F, Steiner PM; ''Familial hyperalphalipoproteinemia.''; Arch Intern Med, 1975 PubMed Europe PMC Scholia
  31. Breckenridge WC, Little JA, Alaupovic P, Wang CS, Kuksis A, Kakis G, Lindgren F, Gardiner G; ''Lipoprotein abnormalities associated with a familial deficiency of hepatic lipase.''; Atherosclerosis, 1982 PubMed Europe PMC Scholia
  32. Brunham LR, Tietjen I, Bochem AE, Singaraja RR, Franchini PL, Radomski C, Mattice M, Legendre A, Hovingh GK, Kastelein JJ, Hayden MR; ''Novel mutations in scavenger receptor BI associated with high HDL cholesterol in humans.''; Clin Genet, 2011 PubMed Europe PMC Scholia
  33. Berger GM; ''An incomplete form of familial lipoprotein lipase deficiency presenting with type I hyperlipoproteinemia.''; Am J Clin Pathol, 1987 PubMed Europe PMC Scholia
  34. Albers JJ, Chen C, Adolphson JL; ''Familial lecithin-cholesterol acyltransferase: identification of heterozygotes with half-normal enzyme activity and mass.''; Hum Genet, 1981 PubMed Europe PMC Scholia
  35. Innerarity TL, Weisgraber KH, Arnold KS, Mahley RW, Krauss RM, Vega GL, Grundy SM; ''Familial defective apolipoprotein B-100: low density lipoproteins with abnormal receptor binding.''; Proc Natl Acad Sci U S A, 1987 PubMed Europe PMC Scholia
  36. Anchors JM, Gregg RE, Law SW, Brewer HB Jr; ''ApoE deficiency: markedly decreased levels of cellular ApoE mRNA.''; Biochem Biophys Res Commun, 1986 PubMed Europe PMC Scholia
  37. Dewey FE, Gusarova V, Dunbar RL, O'Dushlaine C, Schurmann C, Gottesman O, McCarthy S, Van Hout CV, Bruse S, Dansky HM, Leader JB, Murray MF, Ritchie MD, Kirchner HL, Habegger L, Lopez A, Penn J, Zhao A, Shao W, Stahl N, Murphy AJ, Hamon S, Bouzelmat A, Zhang R, Shumel B, Pordy R, Gipe D, Herman GA, Sheu WHH, Lee IT, Liang KW, Guo X, Rotter JI, Chen YI, Kraus WE, Shah SH, Damrauer S, Small A, Rader DJ, Wulff AB, Nordestgaard BG, Tybjærg-Hansen A, van den Hoek AM, Princen HMG, Ledbetter DH, Carey DJ, Overton JD, Reid JG, Sasiela WJ, Banerjee P, Shuldiner AR, Borecki IB, Teslovich TM, Yancopoulos GD, Mellis SJ, Gromada J, Baras A; ''Genetic and Pharmacologic Inactivation of ANGPTL3 and Cardiovascular Disease.''; N Engl J Med, 2017 PubMed Europe PMC Scholia
  38. Poirier S, Mayer G, Benjannet S, Bergeron E, Marcinkiewicz J, Nassoury N, Mayer H, Nimpf J, Prat A, Seidah NG; ''The proprotein convertase PCSK9 induces the degradation of low density lipoprotein receptor (LDLR) and its closest family members VLDLR and ApoER2.''; J Biol Chem, 2008 PubMed Europe PMC Scholia


View all...
124275view13:31, 6 October 2022DeSlAdded interpro ID and comment for remnant receptor
124274view13:28, 6 October 2022DeSlConverted arrows to textLabels to graphical lines
119310view13:13, 23 June 2021FinterlyAdded ISBN for book citation
117285view10:56, 20 May 2021DeSlUpdated PW nodes to single border again.
117269view10:44, 20 May 2021DeSlUpdated DataBase for Vit.D PW and Steroid BioSynthesis PW Nodes
117268view10:41, 20 May 2021DeSlTrying to update PW linkouts
117267view10:37, 20 May 2021DeSlUpdated PW Node visualisations
108085view11:52, 28 November 2019FehrhartOntology Term : 'disease pathway' added !
104036view17:48, 25 April 2019IreneHemelModified description
103489view13:52, 6 March 2019DeSlAdded linkout to oxysterols PW.
103448view16:40, 1 March 2019DeSlModified description
103447view16:39, 1 March 2019DeSlModified description
103446view16:28, 1 March 2019DeSlLast updates to diseases
103445view16:19, 1 March 2019DeSlChanged connectivity of PCSK9
103444view15:43, 1 March 2019DeSlReconnected diseases, added MTP protein
103443view15:18, 1 March 2019DeSlUpdated IDs in CM, remnant, HDL2/3, VDLD and IDL.
103442view15:10, 1 March 2019DeSlUpdated Ids for cyclomicrons and remnant.
103441view15:06, 1 March 2019DeSlAdded more IDs.
103440view14:51, 1 March 2019DeSlAdded IDs for VDLD, IDL and LDL.
103439view14:49, 1 March 2019DeSlAdded explanatory text to HDL, LDL and IDL.
103438view14:45, 1 March 2019DeSlUpdated layout
103437view14:42, 1 March 2019DeSlAdded more visualisations from Blau book.
103436view14:27, 1 March 2019DeSlStarted adding drawings from Blau book.
103429view12:39, 28 February 2019DeSlAdded some more info from book on cholesterol pool
103411view16:07, 27 February 2019DeSlAdded more PW linkouts
103408view12:08, 27 February 2019DeSlAdded more PW linkouts
103407view11:53, 27 February 2019DeSlAdded steroid PW links
103406view11:47, 27 February 2019DeSlUpdated LDL transport into cell.
103403view09:51, 27 February 2019DeSlRemoved weird signs in lit. ref; changed long OMIM linkouts to short ones
103399view17:45, 26 February 2019EgonwModified title
103392view19:14, 25 February 2019DeSlConnected diseases to anchors with enzymes, trying to fix test in Jenkins...
103384view11:22, 25 February 2019IngebudeOntology Term : 'altered lipoprotein metabolic pathway' added !
103383view11:22, 25 February 2019IngebudeOntology Term : 'familial combined hyperlipidemia' added !
103382view11:19, 25 February 2019IngebudeChanged identifiers of 2 geneproducts
103378view09:02, 25 February 2019Mkutmonfixed special characters in literature references
103375view18:36, 24 February 2019IngebudeChanged identifiers HDL
103266view09:03, 20 February 2019IngebudeChanged anchor
103265view08:51, 20 February 2019IngebudeSwitched around arrows
103252view14:42, 18 February 2019Ingebude
103245view10:17, 18 February 2019Ingebude
103243view10:10, 18 February 2019IngebudeAdded identifiers AHR LDL receptor and PCSK9 inhbitor
103233view09:05, 18 February 2019IngebudeChanged metabolites to geneproducts
103227view08:39, 18 February 2019IngebudeOntology Term : 'familial combined hyperlipidemia pathway' added !
103225view08:37, 18 February 2019IngebudeOntology Term : 'autosomal recessive hypercholesterolemia' added !
103224view08:37, 18 February 2019IngebudeOntology Term : 'Tangier disease' added !
103223view08:35, 18 February 2019IngebudeOntology Term : 'hypobetalipoproteinemia' added !
103222view08:33, 18 February 2019IngebudeChanged ref book by Blau
103219view08:21, 18 February 2019IngebudeModified description
103218view08:21, 18 February 2019IngebudeAdded missing disease
103212view13:53, 17 February 2019DeSlGrouped diseases, connected arrows again to group, changed arrow to graphical lines for diseases.

External references


View all...
NameTypeDatabase referenceComment
A-IIProteinP02652 (Uniprot-TrEMBL) AKA Apolipoprotein A-II
A-IProteinP02647 (Uniprot-TrEMBL) AKA Apo A-I; activator of lecithin-cholesterol acyl transferase (LCAT).
ABCA1GeneProductENSG00000165029 (Ensembl)
Alternative steroidogenesis (including diseases)PathwayWP4524 (WikiPathways)
Annexin A2ProteinH0YKN4 (Uniprot-TrEMBL)
B100ProteinP04114 (Uniprot-TrEMBL)
  • "Apoprotein B100 (ApoB-100) is embedded in the outer phospholipid layer of LDL particles." []
  • Synthesized in liver.
B48ProteinA8MUN2 (Uniprot-TrEMBL)
  • "Apolipoprotein B(apo B) occurs in the plasma in 2 main isoforms, ApoB48 and ApoB100. ApoB48 is generated when a stop codon (UAA) is created by RNA editing.

    As a result of the RNA editing, ApoB48 and ApoB100 share a common N-terminal sequence, but ApoB48 lacks ApoB100's C-terminal LDL receptor binding region. In fact, ApoB48 is so called because it constitutes 48% of the sequence for ApoB100.

    ApoB 48 is a unique protein to chylomicrons from the small intestine. After most of the lipids in the chylomicron have been absorbed, ApoB48 returns to the liver as part of the chylomicron remnant, where it is endocytosed and degraded." []
  • Synthesized in small intestine.
Bile AcidsPathwayWP4389 (WikiPathways)
C-IIProteinP02655 (Uniprot-TrEMBL) AKA Apolipoprotein C2; cofactor for lipoprotein lipase (LPL) enzyme.
CETPGeneProductENSG00000087237 (Ensembl)
CholesterolMetaboliteCHEBI:16113 (ChEBI)
Classical steroidogenesis (including diseases)PathwayWP4523 (WikiPathways)
Cyclic fatty acidsMetaboliteCHEBI:59238 (ChEBI)
EProteinP02649 (Uniprot-TrEMBL) AKA APo E, a ligand for receptor mediated endocytosis.
HL GeneProductP11150 (Uniprot-TrEMBL) EC
HLGeneProductQ9Y5X9 (Uniprot-TrEMBL) EC aka LIPC
IDLMetaboliteCHEBI:132933 (ChEBI) Itermediate-density lipoprotein (IDL), physiologically a short lived species, containd around equimolar amounts of cholesterol and Triglycerides (TG).
LCATGeneProductENSG00000213398 (Ensembl) AKA Lecithin-cholesterol acyl transferase
LDL-receptorProteinP01130 (Uniprot-TrEMBL)
LDLMetaboliteCHEBI:39026 (ChEBI) Low-density lipoprotein (LDL) is one of the two main cholesterol carrying lipoproteins, which are spheroidal macromolecular complexes responsible for transporting lipids through plasma.
LDLRAP1ProteinQ5SW96 (Uniprot-TrEMBL)
  • AKA Low density lipoprotein receptor adapter protein 1; ARH1
  • "Adapter protein (clathrin-associated sorting protein (CLASP)) required for efficient endocytosis of the LDL receptor (LDLR) in polarized cells such as hepatocytes and lymphocytes, but not in non-polarized cells (fibroblasts). May be required for LDL binding and internalization but not for receptor clustering in coated pits. May facilitate the endocytocis of LDLR and LDLR-LDL complexes from coated pits by stabilizing the interaction between the receptor and the structural components of the pits. May also be involved in the internalization of other LDLR family members." []
LDLRProteinENSG00000130164 (Ensembl)
LPLGeneProductENSG00000175445 (Ensembl)
MTPGeneProductP55157 (Uniprot-TrEMBL) "Catalyzes the transport of triglyceride, cholesteryl ester, and phospholipid between phospholipid surfaces. Required for the secretion of plasma lipoproteins that contain apolipoprotein B." []
Nuclear hormone receptors (involved in sterol metabolism)PathwayWP299 (WikiPathways)
OxysterolsPathwayWP4545 (WikiPathways)
  • "Oxysterols are oxygenated derivatives of cholesterol or its sterol precursors, e.g. 7-dehydrocholesterol (7-DHC) or desmosterol" [ PubMed 27068984].
  • See for mouse version (Human will be created at some point).
PCSK9GeneProductENSG00000169174 (Ensembl)
Remnant receptorProteinIPR038003 (InterPro) "The chylomicron remnant receptor accepts apoE as a ligand. Chylomicron remnants are removed from the circulation exclusively by the liver, probably because these large complexes can penetrate the unique sinusoidal vascular space. The multifunctional, α2-macroglobulin/LDL receptor-related protein (LRP) is the chylomicron remnant receptor" []
SR-B1ProteinQ8WTV0 (Uniprot-TrEMBL) AKA SCARB1; Receptor for HDL, mediating selective uptake of cholesteryl ether and HDL-dependent cholesterol efflux.
Steroid Biosynthesis (general overview)PathwayWP496 (WikiPathways)
VLDLMetaboliteCHEBI:39027 (ChEBI) Very low-density lipoprotein (VLDL) is one of the two main TG (triglyceride or triacylglycerol) carrying lipoproteins, which are spheroidal macromolecular complexes responsible for transporting lipids through plasma.
Vit. D pathwayPathwayWP1531 (WikiPathways)

Annotated Interactions

SourceTargetTypeDatabase referenceComment
HLmim-catalysisRHEA:38497 (Rhea)
mim-conversionRHEA:12046 (Rhea)
mim-conversionRHEA:38497 (Rhea)
Personal tools