title: Markedly increased tissue concentrations of 7-dehydrocholesterol combined with low levels of cholesterol are characteristic of the Smith-Lemli-Opitz syndrome.
abstract: The Smith-Lemli-Opitz syndrome is an autosomal recessive birth defect (frequency 1:20,000-1:40,000) that results in profound mental retardation, physical deformities, and failure to thrive. It is characterized biochemically by low plasma cholesterol and greatly elevated levels of two dehydrocholesterols, one of which is the cholesterol precursor 7-dehydrocholesterol. To determine whether the block in cholesterol biosynthesis affects tissue sterols, we assayed several organs from two affected individuals, a female who died at 27 hours and a 20-week male fetus. Cholesterol concentrations in abdominal wall, adrenal gland, and kidney from two or three unaffected fetuses, who served as controls, averaged 2.0, 1.5, and 1.4 mg/g wet weight, compared to 0.08, 0.44, and 0.14, respectively, for the homozygous fetus. Cerebral cortex cholesterol concentrations were 2.2 mg/g for two 20-22-week fetal controls but only 0.21 and 0.09 mg/g, respectively, for the homozygous child and fetus. Similarly, tissue cholesterol levels were abnormally low in the homozygous child being less than 1 mg/g in liver, adipose, thymus, muscle, and adrenal and 6.2 mg/dl in plasma. Dehydrocholesterols could not be detected by conventional means in any controls but were elevated enough in tissues from affected individuals to make total sterol concentrations nearly normal. These results suggest that a defect in 3 beta-hydroxysterol delta 7-reductase leads to both a profound lack of cholesterol and its replacement by dehydrocholesterols. Such a combination may be lethal in the most severely affected individuals.
authors.affiliation: Research Service, Veterans Affairs Medical Center, East Orange, NJ.
authors.forename: G S
authors.initials: GS
authors.lastname: Tint
authors.forename: M
authors.initials: M
authors.lastname: Seller
authors.forename: R
authors.initials: R
authors.lastname: Hughes-Benzie
authors.forename: A K
authors.initials: AK
authors.lastname: Batta
authors.forename: S
authors.initials: S
authors.lastname: Shefer
authors.forename: D
authors.initials: D
authors.lastname: Genest
authors.forename: M
authors.initials: M
authors.lastname: Irons
authors.forename: E
authors.initials: E
authors.lastname: Elias
authors.forename: G
authors.initials: G
authors.lastname: Salen
mesh_terms: D000015:Abnormalities, Multiple; D000273:Adipose Tissue / Q000378:metabolism; D000311:Adrenal Glands / Q000378:metabolism; D002540:Cerebral Cortex / Q000378:metabolism; D002784:Cholesterol / Q000097:blood*; D003684:Dehydrocholesterols / Q000378:metabolism*; D005260:Female; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D007231:Infant, Newborn; D008607:Intellectual Disability; D008099:Liver / Q000378:metabolism; D008297:Male; D009132:Muscles / Q000378:metabolism; D010088:Oxidoreductases / Q000172:deficiency; D044925:Oxidoreductases Acting on CH-CH Group Donors; D013577:Syndrome; D013950:Thymus Gland / Q000378:metabolism
chemical_list: D003684:Dehydrocholesterols; D002784:Cholesterol; C016705:7-dehydrocholesterol; D010088:Oxidoreductases; D044925:Oxidoreductases Acting on CH-CH Group Donors; C019995:7-dehydrocholesterol reductase