Cellular membranes function as permeability barriers that separate cells from the external environment or partition cells into distinct compartments. These membranes are lipid bilayers composed o f g ly ce ro ph os ph olipids, sphingolipids and cholesterol, in which proteins are embedded. G l y ce r o ph o s ph olipids and sphingolipids freely move laterally, whereas t r a ns v e rse m o v em ent between lipid bilayers is limited. Phospholipids are asymmetrically distributed between membrane leaflets but change their location in biological processes, serving as signalling molecules or enzyme activators. Designated proteins -flippases and scramblases -mediate this lipid movement between the bilayers. Flippases mediate the confined localization of specific phospholipids (phosphatidylserine (PtdSer) and phosphatidylethanolamine) to the cytoplasmic leaflet. Scramblases randomly scramble phospholipids between leaflets and facilitate the exposure of PtdSer on the cell surface, which serves as an important signalling molecule and as an 'eat me' signal for phagocytes. Defects in flippases and scramblases cause various human diseases. We herein review the recent research on the structure of flippases and scramblases and their physiological roles. Although still poorly understood, we address the mechanisms by which they translocate phospholipids between lipid bilayers and how defects cause human diseases.
SectionsThe role of P4-type ATPases in lipid 'flipping' between the bilayer. P-type ATPases constitute a large protein family that transport cations and lipids across the membrane 24 . They are named 'P-type' because a conserved aspartic acid is transiently modified by phosphorylation during the reaction cycle. A phylogenic analysis divided the family into five subfamilies (P1-P5 types). Similar to other P-type ATPases, P4-ATPases are membrane proteins with cytoplasmic amino c Caspase-mediated PtdSer exposure Apoptotic bodies