Impact of Dietary Cholesterol on the Pathophysiology of Infectious and Autoimmune Disease

Abstract

Cellular cholesterol metabolism, lipid raft formation, and lipoprotein interactions contribute to the regulation of immune-mediated inflammation and response to pathogens. Lipid pathways have been implicated in the pathogenesis of bacterial and viral infections, whereas altered lipid metabolism may contribute to immune dysfunction in autoimmune diseases, such as systemic lupus erythematosus, multiple sclerosis, and rheumatoid arthritis. Interestingly, dietary cholesterol may exert protective or detrimental effects on risk, progression, and treatment of different infectious and autoimmune diseases, although current findings suggest that these effects are variable across populations and different diseases. Research evaluating the effects of dietary cholesterol, often provided by eggs or as a component of Western-style diets, demonstrates that cholesterol-rich dietary patterns affect markers of immune inflammation and cellular cholesterol metabolism, while additionally modulating lipoprotein profiles and functional properties of HDL. Further, cholesterol-rich diets appear to differentially impact immunomodulatory lipid pathways across human populations of variable metabolic status, suggesting that these complex mechanisms may underlie the relationship between dietary cholesterol and immunity. Given the Dietary Guidelines for Americans 2015–2020 revision to no longer include limitations on dietary cholesterol, evaluation of dietary cholesterol recommendations beyond the context of cardiovascular disease risk is particularly timely. This review provides a comprehensive and comparative analysis of significant and controversial studies on the role of dietary cholesterol and lipid metabolism in the pathophysiology of infectious disease and autoimmune disorders, highlighting the need for further investigation in this developing area of research.

Dysregulated serum lipid profile and its correlation to disease activity in young female adults diagnosed with systemic lupus erythematosus: a cross-sectional study

“…Recently, increasing studies have found that dyslipidemia in patients with SLE plays a key role in the development of atherosclerosis [7][8][9][10]18]. It seems that atherosclerosis frequently appears during the process of SLE.…”

“…Recent clinical studys showed that the patients with SLE had twofold higher risk of cardiovascular disease as compared to control, and SLE patients with lupus nephritis display significantly increased risk of myocardial infarction and cardiovascular disease mortality than SLE patients without lupus nephritis [5,6]. Additionally, SLE disease-related parameters could be taken into consideration when calculating cardiovascular disease risks, and most of the patients with SLE were diagnosed with dyslipidemia, suggesting that dyslipidemia could be a critical factor in the progression of cardiovascular disease in SLE [7][8][9][10]. The patients with SLE exhibited increased total cholesterol (TC), triglycerides (TG) and very lowdensity lipoprotein-cholesterol (VLDL-C), and decreased high-density lipoprotein-cholesterol (HDL-C) and apolipoprotein A (Apo A) compared with control [11].…”

Nutrient intake is a predictor of lung function in obese asthmatic adolescents undergoing interdisciplinary therapy

“…However, a recent systematic review (62) and meta-analysis (63) showed that only a consumption of high cholesterol can increase serum cholesterol by up to 5 %. Some studies have found it difficult to verify this result because of confounding factors, such as body mass, which has an influence on cholesterol metabolism (56,63) . Obese people appear to absorb more cholesterol compared with lean individuals (64) .…”

“…Thus, we believe that serum adipokine concentrations in the present study were not problematic, as these were below the values obtained in other studies with obese adolescents (27,53) . In addition, the fact that adipokine concentrations remain similar after interdisciplinary intervention suggests that other factors, besides fat percentage and BMI (53,55,56) , may be involved in the expression of adiponectin and leptin, such as sexual maturation (57) .…”

Atherosclerosis as Pathogenetic Substrate for Sars-Cov2 &lsquo;&lsquo;Cytokine Storm&rsquo;&rsquo;<strong> </strong>

“…Several studies suggest also an autoimmune response [43,44] in atherosclerosis with a switch in regulatory T cells from an initial protective phenotype (FoxP3+) into a pathogenic one (RORγt, T-bet, Bcl-6) [45].…”