Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter February 25, 2016

Reduced absorption and enhanced synthesis of cholesterol in patients with cystic fibrosis: a preliminary study of plasma sterols

  • Monica Gelzo , Concetta Sica , Ausilia Elce , Antonio Dello Russo , Paola Iacotucci , Vincenzo Carnovale , Valeria Raia , Donatello Salvatore , Gaetano Corso EMAIL logo and Giuseppe Castaldo

Abstract

Background:

Low cholesterol is typically observed in the plasma of patients with cystic fibrosis (CF) contrasting with the subcellular accumulation of cholesterol demonstrated in CF cells and in mice models. However, the homeostasis of cholesterol has not been well investigated in patients with CF.

Methods:

We studied the plasma of 26 patients with CF and 33 unaffected controls campesterol and β-sitosterol as markers of intestinal absorption and lathosterol as a marker of de novo cholesterol biosynthesis by gas chromatography (GC-FID and GC-MS).

Results:

Plasma campesterol and β-sitosterol results were significantly (p=0.01) lower while plasma lathosterol was significantly higher (p=0.001) in patients with CF as compared to control subjects. Plasma cholesterol results were significantly lower (p=0.01) in CF patients.

Conclusions:

Our data suggest that the impaired intestinal absorption of exogenous sterols in patients with CF stimulates the endogenous synthesis of cholesterol, but the levels of total cholesterol in plasma remain lower. This may be due to the CFTR dysfunction that reduces cholesterol blood excretion causing the accumulation of cholesterol in liver cells and in other tissues contributing to trigger CF chronic inflammation.


Corresponding author: Prof. Gaetano Corso, Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, Viale L. Pinto 1, 71122, Foggia, Italy, E-mail:

Acknowledgments

Grants from Regione Campania (DGRC 28/2/14) and by POR Campania (FSE 2007-13, project CREME) are gratefully acknowledged.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Ledder O, Haller W, Couper RT, Lewindon P, Oliver M. Cystic fibrosis: an update for clinicians. Part 2: hepatobiliary and pancreatic manifestations. J Gastroenterol Hepatol 2014;29:1954–62.10.1111/jgh.12785Search in Google Scholar

2. Gibson-Corley KN, Meyerholz DK, Engelhardt JF. Pancreatic pathophysiology in cystic fibrosis. J Pathol 2016;238:311–20.10.1002/path.4634Search in Google Scholar

3. Peretti N, Marcil V, Drouin E, Levy E. Mechanisms of lipid malabsorption in cystic fibrosis: the impact of essential fatty acids deficiency. Nutr Metab 2005;2:11.10.1186/1743-7075-2-11Search in Google Scholar

4. Cantin AM, Hartl D, Konstan MW, Chmiel JF. Inflammation in cystic fibrosis lung disease: pathogenesis and therapy. J Cyst Fibros 2015;14:419–30.10.1016/j.jcf.2015.03.003Search in Google Scholar

5. Figueroa V, Milla C, Parks EJ, Schwarzenberg SJ, Moran A. Abnormal lipid concentrations in cystic fibrosis. Am J Clin Nutr 2002;75:1005–11.10.1093/ajcn/75.6.1005Search in Google Scholar

6. White NM, Jiang D, Burgess JD, Bederman IR, Previs SF, Kelley TJ. Altered cholesterol homeostasis in cultured and in vivo models of cystic fibrosis. Am J Physiol Lung Cell Mol Physiol 2007;292:L476–86.10.1152/ajplung.00262.2006Search in Google Scholar

7. Fang D, West RH, Manson ME, Ruddy J, Jiang D, Previs SF, et al. Increased plasma membrane cholesterol in cystic fibrosis cells correlates with CFTR genotype and depends on de novo cholesterol synthesis. Respir Res 2010;11:61.10.1186/1465-9921-11-61Search in Google Scholar

8. Wu AH, Ruan W, Todd J, Lynch KL. Biological variation of β-sitosterol, campesterol, and lathosterol as cholesterol absorption and synthesis biomarkers. Clin Chim Acta 2014;430:43–7.10.1016/j.cca.2013.12.040Search in Google Scholar

9. Miettinen TA, Gylling H, Nissinen MJ. The role of serum non-cholesterol sterols as surrogate markers of absolute cholesterol synthesis and absorption. Nutr Metab Cardiovasc Dis 2011;21:765–9.10.1016/j.numecd.2011.05.005Search in Google Scholar

10. Rosenstein BJ, Cutting GR. The diagnosis of cystic fibrosis: a consensus statement. Cystic Fibrosis Foundation Consensus Panel. J Pediatr 1998;132:589–95.10.1016/S0022-3476(98)70344-0Search in Google Scholar

11. Sinaasappel M, Stern M, Littlewood J, Wolfe S, Steinkamp G, Hiejerman HG, et al. Nutrition in patients with cystic fibrosis: a European consensus. J Cyst Fibros 2002;1:51–75.10.1016/S1569-1993(02)00032-2Search in Google Scholar

12. Tomaiuolo R, Sangiuolo F, Bombieri C, Bonizzato A, Cardillo G, Raia V, et al. Epidemiology and a novel procedure for large scale analysis of CFTR rearrangements in classic and atypical CF patients: a multicentric Italian study. J Cyst Fibrosis 2008;7:347–51.10.1016/j.jcf.2007.12.004Search in Google Scholar

13. Amato F, Bellia C, Cardillo G, Castaldo G, Ciaccio M, Elce A, et al. Extensive molecular analysis of patients bearing CFTR-Related disorders. J Mol Diagn 2012;14:81–9.10.1016/j.jmoldx.2011.09.001Search in Google Scholar

14. Loser C, Mollgaard A, Folsch UR. Faecal elastase 1: a novel, highly sensitive, and specific tubeless pancreatic function test. Gut 1996;39:580–6.10.1136/gut.39.4.580Search in Google Scholar

15. Corso G, Gelzo M, Barone R, Clericuzio S, Pianese P, Nappi A, et al. Sterol profiles in plasma and erythrocyte membranes in patients with Smith-Lemli-Opitz syndrome: a six-year experience. Clin Chem Lab Med 2011;49:2039–46.10.1515/CCLM.2011.689Search in Google Scholar

16. Gelzo M, Clericuzio S, Barone R, D’Apolito O, Dello Russo A, Corso G. A routine method for cholesterol and 7-dehydrocholesterol analysis in dried blood spot by GC-FID to diagnose the Smith-Lemli-Opitz syndrome. J Chromatogr B Analyt Technol Biomed Life Sci 2012;907:154–8.10.1016/j.jchromb.2012.08.025Search in Google Scholar

17. Hrabovsky V, Zadak Z, Blaha V, Hyspler R, Karlik T, Martinek A, et al. Cholesterol metabolism in active Crohn’s disease. Wien Kin Wochenschr 2009;121:270–5.10.1007/s00508-009-1150-6Search in Google Scholar

18. Vuoristo M, Tilvis R, Miettinen TA. Serum plant sterols and lathosterol related to cholesterol absorption in coeliac disease. Clin Chim Acta 1988;174:213–24.10.1016/0009-8981(88)90388-9Search in Google Scholar

19. Wouthuyzen-Bakker M, Bodewes FA, Verkade HJ. Persistent fat malabsorption in cystic fibrosis; lessons from patients and mice. J Cyst Fibros 2011;10:150–8.10.1016/j.jcf.2011.03.008Search in Google Scholar PubMed

20. Oram JF, Vaughan AM. ABCA1-mediated transport of cellular cholesterol and phospholipids to HDL apolipoproteins. Curr Opin Lipidol 2000;11:253–60.10.1097/00041433-200006000-00005Search in Google Scholar PubMed

21. Manson ME, Corey DA, White NM, Kelley TJ. cAMP-mediated regulation of cholesterol accumulation in cystic fibrosis and Niemann-Pick type C cells. Am J Physiol Lung Cell Mol Physiol 2008;295:L809–19.10.1152/ajplung.90402.2008Search in Google Scholar PubMed PubMed Central

22. Kreiselmeier NE, Kraynack NC, Corey DA, Kelley TJ. Statin-mediated correction of STAT1 signaling and inducible nitric oxide synthase expression in cystic fibrosis epithelial cells. Am J Physiol Lung Cell Mol Physiol 2003;285:L1286–95.10.1152/ajplung.00127.2003Search in Google Scholar PubMed

23. White NM, Corey DA, Kelley TJ. Mechanistic similarities between cultured cell models of cystic fibrosis and Niemann-pick type C. Am J Respir Cell Mol Biol 2004;31:538–43.10.1165/rcmb.2004-0117OCSearch in Google Scholar PubMed

24. Jouneau S, Bonizec M, Belleguic C, Desrues B, Brinchault G, Galaine J, et al. Anti-inflammatory effect of fluvastatin on IL-8 production induced by Pseudomonas aeruginosa and Aspergillus fumigatus antigens in cystic fibrosis. PLoS One 2011;6:e22655.10.1371/journal.pone.0022655Search in Google Scholar PubMed PubMed Central

Received: 2015-11-25
Accepted: 2016-1-12
Published Online: 2016-2-25
Published in Print: 2016-9-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 19.5.2024 from https://www.degruyter.com/document/doi/10.1515/cclm-2015-1151/html
Scroll to top button