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New insights into how the intestine can regulate lipid homeostasis and impact vascular disease: frontiers for new pharmaceutical therapies to lower cardiovascular disease risk |
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| Authors: | Warnakula Samantha Hsieh Joanne Adeli Khosrow Hussain M Mahmood Tso Patrick Proctor Spencer D |
| Institution: | a Metabolic and Cardiovascular Diseases Laboratory, Alberta Institute for Human Nutrition, Mazankowski Alberta Heart Institute and the Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada b Molecular Structure and Function, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada c Department of Anatomy and Cell Biology, State University of New York Downstate Medical Center, Brooklyn, New York, USA d Department of Pathology and Laboratory Medicine, Genome Research Institute, University of Cincinnati, Ohio, USA |
| Abstract: | In recent years, evidence has emerged that the intestine is a significant regulator of systemic cholesterol homeostasis and can contribute to raised plasma cholesterol concentration. In this review we provide a context for the role the intestine may have in cardiovascular disease during conditions of chronic disease (insulin resistance, obesity). In particular, we highlight the physiological role of the intestine in lipid absorption, identify novel elements in enterocyte molecular biology, review the concept that chylomicrons and their remnants contribute to atherogenesis during chronic disease, and address new principles of chylomicron overproduction during conditions of insulin resistance including the associated hormonal control of the intestine during these conditions. Finally, we raise the issue of a growing need for novel lipid-lowering pharmaceutical therapies that target intestinal lipid metabolism. |
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