Titov V N
Klin Lab Diagn. 2015 Jun;60(6):4-14.
After more than half-century of different conceptions, the theory of general pathology was used to substantiate that all lipoproteins are bi-layer:lipid by their structure. The main function of high density lipoproteins as of all lipoproteins is transfer of fatty acids to cells and only in second turn taking away of spirit cholesterol from cells. At the stages of phylogenesis high density lipoproteins, low density lipoproteins and very low density lipoproteins began to function in a subsequent way. The fatty acids were transferred by low density lipoproteins in polar lipids at passive absorption by cells. Later on, lipoproteins transfer fatty acids in non-polar ethers with spirits glycerin and spirit cholesterol. The cells absorb them by receptor endocytosis. The hepatocytes secret in blood palmitic, oleic, linoleic and linoleic very low density lipoproteins. The palmitic and oleic very low density lipoproteins absorb physiologically insulin-dependent cells apoE/B-100 = endocytosis. The linoleic and linoleic very low density lipoproteins after transition of polyethers cholesterol from high density lipoproteins turn into low density lipoproteins. The cells absorb them by apoB-100 = endocytosis. The formation of chylomicrons occurs in blood and hepatocytes absorb them by the way of apoB/E-48 = endocytosis. The absorption of poly-unsaturated fatty acids by cells with apoB-100 = endocytosis form sensitivity of animals to exogenous hyper spirit cholesterol and absorption of poly-unsaturated fatty acids by apoE/A-I = receptors form corresponding resistance. The ApoE in lipoproteins form cooperative ligands--apoE/B-48 for chylomicrons, apoE/B-100 for very low density lipoproteins and apoE/A-I for high density lipoproteins. The chylomicrons in blood form apoB-48 from complexes of triglycerides secreted by enterocytes. These views change conceptions of pathogenesis and prevention of atherosclerosis, metabolic syndrome and resistance to insulin whose pathogenesis is unified by disorder of transfer in intercellular medium and absorption of fatty acids by cells.
经过半个多世纪的不同观点探讨,一般病理学理论被用于证实所有脂蛋白在结构上都是脂质双层的。高密度脂蛋白与所有脂蛋白的主要功能是将脂肪酸转运至细胞,其次才是从细胞中带走游离胆固醇。在系统发育阶段,高密度脂蛋白、低密度脂蛋白和极低密度脂蛋白开始按顺序发挥作用。低密度脂蛋白在细胞被动吸收时将脂肪酸转运至极性脂质中。后来,脂蛋白将脂肪酸转运至含甘油和游离胆固醇的非极性醚中。细胞通过受体介导的内吞作用吸收它们。肝细胞在血液中分泌棕榈酸、油酸、亚油酸和亚麻酸极低密度脂蛋白。棕榈酸和油酸极低密度脂蛋白被生理上依赖胰岛素的细胞通过apoE/B - 100 = 内吞作用吸收。亚油酸和亚麻酸极低密度脂蛋白在高密度脂蛋白中的多醚胆固醇转变后变成低密度脂蛋白。细胞通过apoB - 100 = 内吞作用吸收它们。乳糜微粒在血液中形成,肝细胞通过apoB/E - 48 = 内吞作用吸收它们。细胞通过apoB - 100 = 内吞作用吸收多不饱和脂肪酸导致动物对外源性高游离胆固醇敏感,而通过apoE/A - I = 受体吸收多不饱和脂肪酸则形成相应的抗性。脂蛋白中的载脂蛋白E形成协同配体——乳糜微粒的apoE/B - 48、极低密度脂蛋白的apoE/B - 100和高密度脂蛋白的apoE/A - I。血液中的乳糜微粒由肠上皮细胞分泌的甘油三酯复合物形成apoB - 48。这些观点改变了动脉粥样硬化、代谢综合征和胰岛素抵抗的发病机制及预防观念,其发病机制通过细胞间介质转运紊乱和细胞对脂肪酸的吸收而统一起来。