[Cholesterol homeostasis and enterohepatic connection: new insights in cholesterol absorption].
The intestines have been proposed as the 'new player' in the field of atherosclerosis as a result of recent discoveries on intestinal cholesterol absorption and excretion. 'Niemann-Pick C1-like 1' is one of the most important transport proteins in the process of intestinal and biliary cholesterol absorption. Cholesterol is not only excreted via the hepato-biliary route but is also excreted directly into the intestinal lumen; this transintestinal cholesterol excretion is particularly important in mice. Other cholesterol transporters have also been identified, including the ABC transporters, which have been linked to rare disorders such as sitosterolemia. Inhibition of intestinal cholesterol absorption increases the hepatic synthesis of cholesterol and vis versa; several different genes and hormones play an important role in this process. When the effect of statins is insufficient or they cause too many side-effects, additional inhibition of intestinal cholesterol absorption is indicated.
Sint Franciscus Gasthuis, afd. Interne Geneeskunde, Rotterdam, the Netherlands. b.klop@sfg.nl
Boudewijn
B
Klop
Jan Willem F
JW
Elte
Manuel Castro
MC
Cabezas
D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D002784:Cholesterol / Q000378:metabolism*; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy* / Q000378:metabolism*; D007408:Intestinal Absorption / Q000187:drug effects / Q000502:physiology*; D008565:Membrane Proteins / Q000037:antagonists & inhibitors / Q000378:metabolism; D026901:Membrane Transport Proteins; D009542:Niemann-Pick Diseases / Q000188:drug therapy / Q000378:metabolism
D000924:Anticholesteremic Agents; D008565:Membrane Proteins; D026901:Membrane Transport Proteins; C410800:NPC1L1 protein, human; D002784:Cholesterol