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Plasma and cerebrospinal fluid cholesterol esterification is hampered in Alzheimer’s disease
Abstract
Objective: The purpose of this study was to evaluate cholesterol esterification and HDL subclasses in plasma and cerebrospinal fluid (CSF) of Alzheimer’s disease (AD) patients. Methods: The study enrolled 70 AD patients and 74 cognitively normal controls comparable for age and sex. Lipoprotein profile, cholesterol esterification, and cholesterol efflux capacity (CEC) were evaluated in plasma and CSF. Results: AD patients have normal plasma lipids but significantly reduced unesterified cholesterol and unesterified/total cholesterol ratio. Lecithin:cholesterol acyltransferase (LCAT) activity and cholesterol esterification rate (CER), two measures of the efficiency of the esterification process, were reduced by 29% and 16%, respectively, in the plasma of AD patients. Plasma HDL subclass distribution in AD patients was comparable to that of controls but the content of small discoidal preβ-HDL particles was significantly reduced. In agreement with the reduced preβ-HDL particles, cholesterol efflux capacity mediated by the transporters ABCA1 and ABCG1 was reduced in AD patients’ plasma. The CSF unesterified to total cholesterol ratio was increased in AD patients, and CSF CER and CEC from astrocytes were significantly reduced in AD patients. In the AD group, a significant positive correlation was observed between plasma unesterified cholesterol and unesterified/total cholesterol ratio with Aβ 1-42 CSF content. Conclusion: Taken together our data indicate that cholesterol esterification is hampered in plasma and CSF of AD patients and that plasma cholesterol esterification biomarkers (unesterified cholesterol and unesterified/total cholesterol ratio) are significantly associated to disease biomarkers (i.e., CSF Aβ 1-42).
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LCAT activity has been reported to be significantly reduced in the CSF of AD patients compared to control patients.
“Furthermore, LCAT activity has been reported to be significantly reduced in the CSF of AD patients compared to control patients [76, 77].”
From ApoE lipoproteins in the central nervous system under homeostasis and role in Alzheimer’s disease and related disorders (2026) · cites this paper as [77]
The altered gene expression and pathways revealed by MAPT R406W HNOs coincide with altered lipid metabolism and cholesterol regulation previously identified in FTLD and AD patients.
“The altered gene expression and pathways revealed by MAPT R406W HNOs coincide with altered lipid metabolism and cholesterol regulation, which has been previously identified in FTLD and AD patients6,67,68.”
From GRAMD1B is a regulator of lipid homeostasis, autophagic flux and phosphorylated tau (2025) · cites this paper as [68]
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Metadata
- Authors
- Turri, M., Conti, E., Pavanello, C., Gastoldi, F., Palumbo, M., Bernini, F., Aprea, V., Re, F., Barbiroli, A., Emide, D., Galimberti, D., Tremolizzo, L., Zimetti, F., Calabresi, L., AGAINST-AD Group, Andreoni, S., Appollonio, I., Da Re, F., Ferrarese, C., Karantzoulis, A., Negro, G., Pozzi, F. E., Remoli, G., Storti, B., & Zoia, C. P.
- Venue
- Alzheimer's Research & Therapy
- Published
- 2023-05-20
- Volume
- 15
- Issue
- 1
- ISSN
- 1758-9193
- PMC
- PMC10199596
- Cited by
- 27
- References
- 6
- Language
- en
- Funders
- Ministero dell'Università e della Ricerca (MNESYS (PE0000006), PRIN2017PFYK27)
- Università degli Studi di Milano
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