A deficiency in microsomal triglyceride transfer protein (MTP) causes the human lipoprotein deficiency syndrome abetalipoproteinemia. However, the role of MTP in the assembly and secretion of VLDL in the liver is not precisely understood. It is not clear, for instance, whether MTP is required to move the bulk of triglycerides into the lumen of the endoplasmic reticulum (ER) during the assembly of VLDL particles. To define MTP's role in hepatic lipoprotein assembly, we recently knocked out the mouse MTP gene (Mttp). Unfortunately, achieving our objective was thwarted by a lethal embryonic phenotype. In this study, we produced mice harboring a "floxed" Mttp allele and then used Cre-mediated recombination to generate liver-specific Mttp knockout mice. Inactivating the Mttp gene in the liver caused a striking reduction in VLDL triglycerides and large reductions in both VLDL/LDL and HDL cholesterol levels. The Mttp inactivation lowered apo B-100 levels in the plasma by >95% but reduced plasma apo B-48 levels by only ∼20%. Histologic studies in liver-specific knockout mice revealed moderate hepatic steatosis. Ultrastructural studies of wild-type mouse livers revealed numerous VLDL-sized lipid-staining particles within membrane-bound compartments of the secretory pathway (ER and Golgi apparatus) and few cytosolic lipid droplets. In contrast, VLDL-sized lipid-staining particles were not observed in MTPdeficient hepatocytes, either in the ER or in the Golgi apparatus, and there were numerous cytosolic fat droplets. We conclude that MTP is essential for transferring the bulk of triglycerides into the lumen of the ER for VLDL assembly and is required for the secretion of apo B-100 from the liver.J. Clin. Invest. 103:1287-1298(1999 to play an important role in this first "apo B lipidation" step (1,21,25). The existence of apo B in the rough ER of hepatocytes has been documented by immunoelectron microscopy (16). However, the lipidated apo B particles cannot be seen in the rough ER by routine electron microscopy, even when the thin sections are stained for lipids, because those particles are too small (< 150 Å in diameter) and lipid poor to be resolved by this technique. In a second step, the lipidated apo B molecule is thought to acquire the bulk of its core lipids by fusing with a large, VLDL-sized, apo B-free triglyceride particle (a "second-step" particle) (17,23). The existence of the secondstep triglyceride particles within a special compartment of the smooth ER has been supported by 2 different electron microscopic studies (16,23). Biochemical studies of VLDL assembly have also supported the concept that the bulk of neutral lipids are added to apo B in a second step after its translation is complete (1, 24).The role, if any, of MTP in the formation of second-step lipid particles is unclear. In fact, this issue has recently been highlighted as one of the fundamental problems in understanding MTP and lipoprotein assembly (15,26). In recent years, several groups have tried to address this issue by performing metabolic la...

The importance of cholesterol ester synthesis by acyl CoA:cholesterol acyltransferase (ACAT) enzymes in intestinal and hepatic cholesterol metabolism has been unclear. We now demonstrate that ACAT2 is the major ACAT in mouse small intestine and liver, and suggest that ACAT2 deficiency has profound effects on cholesterol metabolism in mice fed a cholesterol-rich diet, including complete resistance to diet-induced hypercholesterolemia and cholesterol gallstone formation. The underlying mechanism involves the lack of cholesterol ester synthesis in the intestine and a resultant reduced capacity to absorb cholesterol. Our results indicate that ACAT2 has an important role in the response to dietary cholesterol, and suggest that ACAT2 inhibition may be a useful strategy for treating hypercholesterolemia or cholesterol gallstones.

Abetalipoproteinemia, an inherited human disease characterized by a near-complete absence of the apolipoprotein (apo) B-containing lipoproteins in the plasma, is caused by mutations in the gene for microsomal triglyceride transfer protein (MTP). We used gene targeting to knock out the mouse MTP gene (Mttp). In heterozygous knockout mice (Mttp؉͞؊ ), the MTP mRNA, protein, and activity levels were reduced by 50%, in both liver and intestine. Compared with control mice (Mttp؉͞؉), chow-fed Mttp؉͞؊ mice had reduced plasma levels of low-density lipoprotein cholesterol and had a 28% reduction in plasma apoB100 levels. On a high-fat diet, the Mttp؉͞؊ mice exhibited a marked reduction in total plasma cholesterol levels, compared with those in Mttp؉͞؉ mice. Both the livers of adult Mttp؉͞؊ mice and the visceral endoderm of the yolk sacs from Mttp؉͞؊ embryos manifested an accumulation of cytosolic fat. All homozygous embryos (Mttp؊͞؊) died during embryonic development. In the visceral endoderm of Mttp؊͞؊ yolk sacs, lipoprotein synthesis was virtually absent, and there was a marked accumulation of cytosolic fat droplets. In summary, half-normal MTP levels do not support normal levels of lipoprotein synthesis and secretion, and a complete deficiency of MTP causes lethal developmental abnormalities, perhaps because of an impaired capacity of the yolk sac to export lipids to the developing embryo.Abetalipoproteinemia is an inherited human disease characterized by extremely low plasma levels of cholesterol and triglycerides and a virtual absence of the apolipoprotein (apo) B-containing lipoproteins [chylomicrons, very-low-density lipoproteins (VLDL), and low-density lipoproteins (LDL)] in the plasma (1, 2). Affected humans manifest intestinal fat malabsorption and frequently develop severe neurological problems as a result of deficient intestinal absorption of vitamin E, a fat-soluble vitamin (3). Abetalipoproteinemia is caused by mutations in the gene for the 97-kDa catalytic subunit of microsomal triglyceride transfer protein (MTP) (4-6). MTP is thought to transfer lipids to the apoB polypeptide chain as it is translated on the ribosome, allowing apoB to translocate into the lumen of the endoplasmic reticulum and assume the proper conformation for lipoprotein assembly (7,8). In abetalipoproteinemia, apoB is synthesized but cannot form lipoproteins and is degraded (9).Abetalipoproteinemia is considered to be an autosomal recessive syndrome, requiring two defective MTP alleles for disease expression. Parents of affected patients are said to have plasma lipid levels within the normal range (1). The normal plasma lipid levels in obligate heterozygotes have given rise to the concept that MTP normally is present in great excess within lipoprotein-secreting cells. That is, if MTP normally were present within microsomes in great excess, then halfnormal MTP levels in obligate heterozygotes would not be expected to affect lipoprotein secretion rates or plasma lipid levels. Against this concept, however, are recent in vitro data...

Dietary triacylglycerols are a major source of energy for animals. The absorption of dietary triacylglycerols involves their hydrolysis to free fatty acids and monoacylglycerols in the intestinal lumen, the uptake of these products into enterocytes, the resynthesis of triacylgylcerols, and the incorporation of newly synthesized triacylglycerols into nascent chylomicrons for secretion. In enterocytes, the final step in triacylglycerol synthesis is believed to be catalyzed primarily through the actions of acyl-CoA:diacylglycerol acyltransferase (DGAT) enzymes. In this study, we analyzed intestinal triacylglycerol absorption and chylomicron synthesis and secretion in DGAT1-deficient (Dgat1 ؊/؊ ) mice. Surprisingly, DGAT1 was not essential for quantitative dietary triacylglycerol absorption, even in mice fed a high fat diet, or for the synthesis of chylomicrons. However, Dgat1 ؊/؊ mice had reduced postabsorptive chylomicronemia (1 h after a high fat challenge) and accumulated neutrallipid droplets in the cytoplasm of enterocytes when chronically fed a high fat diet. These results suggest a reduced rate of triacylglycerol absorption in Dgat1 mice. Analysis of intestine from Dgat1؊/؊ mice revealed activity for two other enzymes, DGAT2 and diacylglycerol transacylase, that catalyze triacylglycerol synthesis and apparently help to compensate for the absence of DGAT1. Our findings indicate that multiple mechanisms for triacylglycerol synthesis in the intestine facilitate triacylglycerol absorption.The absorption of triacylglycerols by the intestine is highly efficient, and more than 95% of dietary triacylglycerols is absorbed, even if the diet is rich in fat. By comparison, only 30 -70% of dietary cholesterol is absorbed in most animals (1). The high efficiency of triacylglycerol absorption is likely due to an evolutionary pressure that maximized the ability to absorb rich sources of energy (such as fat) when food sources were scarce.Intestinal triacylglycerol absorption occurs by a series of steps in which dietary triacylglycerols are first hydrolyzed in the intestinal lumen and then resynthesized within enterocytes. In the lumen, dietary triacylglycerols are hydrolyzed by lipases to generate free fatty acids and monoacylglycerols. These molecules are taken up by enterocytes and then enter the triacylglycerol biosynthesis pathways. The triacylglycerol products are incorporated into nascent chylomicrons, which are subsequently secreted from enterocytes and enter the lymphatic system.Triacylglycerol biosynthesis in the intestine is believed to occur mainly through the monoacylglycerol pathway. In this pathway, monoacylglycerol and fatty acyl-CoA are covalently joined to form diacylglycerol in a reaction catalyzed by monoacylglycerol acyltransferase (MGAT) 1 (2). Diacylglycerol and fatty acyl-CoA are then used to synthesize triacylglycerol in a reaction catalyzed by acyl-CoA:diacylglycerol acyltransferase (DGAT) enzymes. High levels of DGAT activity are present in the small intestine (3-5), and both known DGAT genes, Dgat1...

Previous studies have demonstrated that lung-specific proteins are associated with surfactant lipids, particularly the highly surface active subfraction known as tubular myelin. We have isolated a surfactant-associated protein complex with molecular weight components of 36 000, 32 000, and 28 000 and reassembled it with protein-free lung surfactant lipids prepared as small unilamellar liposomes. The effects of divalent cations on the structure and surface activity of this protein-lipid mixture were investigated by following (1) the state of lipid dispersion by changes in turbidity and by electron microscopy and (2) the ability of the surfactant lipids to form a surface film from an aqueous subphase at 37 degrees C. The protein complex markedly increased the rate of Ca2+-induced surfactant-lipid aggregation. Electron microscopy demonstrated transformation of the small unilamellar liposomes (median diameter 440 A) into large aggregates. The threshold Ca2+ concentration required for rapid lipid aggregation was reduced from 13 to 0.5 mM by the protein complex. This protein-facilitated lipid aggregation did not occur if Mg2+ was the only divalent cation present. Similarly, 5 mM Ca2+ but not 5 mM Mg2+ improved the ability of the protein-lipid mixture to form a surface film at 37 degrees C. Extensive aggregation of the surfactant lipids without protein by 20 mM Ca2+ or 20 mM Mg2+ did not promote rapid surface film formation. These results add to the growing evidence that specific Ca2+-protein-lipid interactions are important in determining both the structure and function of extracellular lung surfactant fractions.