Deficient cholesterol side chain oxidation in patients without peroxisomes (Zellweger syndrome): evidence for the involvement of peroxisomes in bile acid synthesis in man.

The absence of peroxisomes in patients with the cerebro-hepato-renal (Zellweger) syndrome is accompanied by a number of biochemical abnormalities including the accumulation of the bile acid intermediates di- and trihydroxycoprostanoic acid. In this paper we show that there is a marked deficiency in the oxidative side chain cleavage of cholesterol in liver from Zellweger patients. These findings not only provide an explanation for the low levels of the major naturally occurring bile acids, cholic acid and chenodeoxycholic acid and the accumulation of di- and trihydroxycoprostanoic acid in Zellweger patients, but also suggest that peroxisomes are essential in bile acid synthesis in man.