Summary
Liver disease is associated with characteristic changes in the lipid composition of the surface coat of plasma lipoprotein particles. Cholesterol and lecithin molecules accumulate as hepatic secretion of lecithin-cholesterol acyltransferase decreases, and the arachidonate content, the precursor for eicosanoid production, is also reduced. By exchange and equilibration processes, such abnormal circulating lipoproteins should tend to induce corresponding changes in cell membrane lipid composition; studies in both human and experimental liver disease confirm that this does occur and that it is widespread. The correct functioning of membrane proteins, which serve as receptors or are responsible for enzymatic and transport processes, is most commonly dependent on the fluidity of their lipid bilayer matrix. Because cholesterol enrichment of biomembranes reduces bulk lipid fluidity, it can be predicted that extrahepatic membrane dysfunction might be a general feature of severe liver disease. This concept is supported by increasing experimental evidence and, as a consequence, it is proposed that many of the cellular disturbances and metabolic abnormalities accompanying hepatic disease result from, or are exacerbated by, lipoprotein-induced changes in membrane lipid composition and function. Importantly, this mechanism also suggests that drugs which can fluidise membranes, such as S-adenosyl-L-methionine (SAMe), might help ameliorate cellular dysfunction.
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References
Azzi A, Drahota Z, Papa S (Eds) In Molecular basis of membrane-associated diseases, Springer-Verlag, Berlin, 1989
Bergelson LD, Baruskov LI. Topological asymmetry of phospholipids in membranes. Science 197: 224–230, 1977
Bloom D, McGalden RA, Rosendorff C. Effects of jaundiced plasma on vascular sensitivity to noradrenaline. Kidney International 8: 149–157, 1975
Borochov H, Zahler P, Wilbrandt W, Shinitzky M. The effect of phosphatidylcholine to sphingomyelin mole ratio on the dynamic properties of sheep erythrocyte membrane. Biochimica et Biophysica Acta 470: 382–388, 1977
Brasitus TA, Dahiya R, Dudeja PK, Bissonnette BM. Cholesterol modulates alkaline phosphatase activity of rat intestinal microvillus membranes. Journal of Biological Chemistry 263: 8592–8597, 1988
Bruckdorfer KR, Graham J M. The exchange of cholesterol and phospholipids between cell membranes and lipoproteins. In Chapman & Wallach (Eds) Biological membranes, Vol. 3, pp. 103–151, Academic Press, New York, 1976
Cabre E, Periago JL, Abad-Lacruz A, Gil A, Gonzalez-Huix F, et al. Polyunsaturated fatty acid deficiency in liver cirrhosis: its relation to associated protein-energy malnutrition (preliminary report). American Journal of Gastroenterology 83: 712–717, 1988
Calandra S, Martin MJ, McIntyre N. Plasma lecithin-cholesterol acyltransferase activity in liver disease. European Journal of Clinical Investigation 1: 352–360, 1971
Chap HJ, Zwaal RFA, Van Deenen LLM. Action of highly purified phospholipases on blood platelets. Evidence for an asymmetric distribution of phospholipids in the surface membrane. Biochimica et Biophysica Acta 467: 146–164, 1977
Chapman D. Recent physical studies of phospholipids and natural membranes. In Chapman (Ed.) Biological membranes. Physical fact and function, pp. 125–202, Academic Press, London, 1968
Chauhan VPS, Sikka SC, Kalra VK. Phospholipid methylation of kidney cortex brush border membranes. Effect on fluidity and transport. Biochimica et Biophysica Acta 688: 357–368, 1982
Collins JR, Lacy WW, Stiel JN, Crofford OB. Glucose intolerance and insulin resistance in patients with liver disease. Archives of Internal Medicine 126: 608–614, 1970
Cooper RA. Anemia with spur cells: a red cell defect acquired in serum and modified in the circulation. Journal of Clinical Investigation 48: 1820–1831, 1969
Cooper RA. Lipids of human red cell membranes: normal composition and variability in disease. Seminars in Hematology 7: 296–321, 1970
Cooper RA. Abnormalities of cell membrane fluidity in the pathogenesis of disease. New England Journal of Medicine 297: 371–377, 1977
Cooper RA. Hemolytic syndromes and red cell membrane abnormalities in liver disease. Seminars in Hematology 17: 103–112, 1980
Cooper RA, Diloy-Puray M, Lando P, Greenberg MS. An analysis of lipoproteins, bile acids, and red cell membranes associated with target cells and spur cells in patients with liver disease. Journal of Clinical Investigation 51: 3182–3192, 1972
Day RC, Harry DS, McIntyre N. Plasma lipoproteins and the liver. In Wright et al. (Eds) Liver and biliary disease. Pathophysiology, diagnosis, management, pp. 63–82, Saunders, London, 1979
Dean RT. Lysosomes and membrane recycling. Biochemical Journal 168: 603–605, 1977
Filho MC, Gillett MPT. Changes in microsome lipid composition of rat tissues after bile duct ligation. Biochemical Society Transactions 14: 730–731, 1986
Floren C-H, Chen C-H, Franzen J, Albers JJ. Lecithin-cholesterol acyltransferase in liver disease. Scandinavian Journal of Laboratory and Clinical Investigation 47: 613–617, 1987
Ginsburg BH, Brown TJ, Ido S, Spector AA. Effect of the membrane lipid environment on the properties of insulin receptors. Diabetes 30: 773–780, 1981
Giraud F, Claret M, Garay R. Interactions of cholesterol with the Na pump in red blood cells. Nature 264: 646–648, 1976
Gjone E. Familial lecithin: cholesterol acyltransferase deficiency — a clinical survey. Scandinavian Journal of Clinical and Laboratory Investigation 33(Suppl. 73): 73–82, 1974
Glickman RM, Sabesin SM. Lipoprotein metabolism. In Arias et al. (Eds) The liver: biology and pathobiology, pp. 331–354, Raven Press, New York, 1988
Glomset JA. High density lipoproteins in human health and disease. Advances in Internal Medicine 25: 91–116, 1980
Gotto AM, Pownall HJ, Havel RJ. Introduction to the plasma lipoproteins. Methods in Enzymology 128: 3–41, 1986
Griffin GE, Pasternak CA. The cell surface and disease. Clinical Science 63: 1–9, 1982
Hagerman JS, Gould RG. The in vitro interchange of cholesterol between plasma and red cells. Proceedings of the Society for Experimental Biology and Medicine 78: 329–332, 1951
Hanahan DJ, Nelson DR. Phospholipids as dynamic participants in biological processes. Journal of Lipid Research 25: 1528–1535, 1984
Harris RA, Simon FR. What should hepatologists know about membrane fluidity? Hepatology 7: 177–180, 1987
Hashizume K, Koboyashi M, Ichikawa K. Guanosine 5′-triphosphate modulation of S-adenosyl-L-methionine-mediated methylation of phosphatidylethanolamine in rat liver plasma membrane. Biochemical and Biophysical Research Communications 114: 425–430, 1983
Heron DS, Shinitzky M, Hershkowitz M, Samuel D. Lipid fluidity markedly modulates the binding of serotonin to mouse brain membranes. Proceedings of the National Academy of Sciences 77: 7463–7467, 1980
Hirata F, Axelrod J. Enzymatic synthesis and rapid translocation of phosphatidylcholine by two methyltransferases in erythrocyte membranes. Proceedings of the National Academy of Sciences 75: 2348–2352, 1978a
Hirata F, Axelrod J. Ezymatic methylation of phosphatidylethanolamine increases erythrocyte membrane fluidity. Nature 275: 219–220, 1978b
Hope MJ, Bruckdorfer KR, Owen JS, Lucy JA. Chemically induced cell fusion in vitro of erythrocytes from patients with liver diseases. Biochemical Society Transactions 5: 1144–1146, 1977
Imai Y, Owen JS. Does cholesterol deposition in renal cortical brush-border membranes initiate Na retention in liver disease? Hepatology 10: 618, 1989
Jackson PA, Morgan DB. The relation between membrane cholesterol and phospholipid and sodium efflux in erythrocytes from healthy subjects and patients with chronic cholestasis. Clinical Science 62: 104–107, 1982a
Jackson PA, Morgan DB. The relation between the membrane cholesterol content and anion exchange in the erythrocytes of patients with cholestasis. Biochimica et Biophysica Acta 693: 99–104, 1982b
Jackson RL, Morrisett JD, Gotto AM. Lipoprotein structure and metabolism. Physiological Reviews 56: 259–316, 1976
Johnson SB, Gordon E, McClain C, Low G, Holman RT. Abnormal polyunsaturated fatty acid patterns of serum lipids in alcoholism and cirrhosis: arachidonic acid deficiency in cirrhosis. Proceedings of the National Academy of Sciences 82: 1815–1818, 1985
Kawata S, Chitranukroh A, Owen JS, McIntyre N. Membrane lipid changes in erythrocytes, liver and kidney in acute and chronic experimental liver disease in rats. Biochimica et Biophysica Acta 896: 26–34, 1987
Laffi G, Cominelli F, Ruggiero M, Fedi S, Chianigi VP, et al. Altered platelet function in cirrhosis of the liver: impairment of inositol lipid and arachidonic acid metabolism in response to agonists. Hepatology 8: 1620–1626, 1988
Laffi G, La Villa G, Pinzani M, Ciabattoni G, Patrignani P, et al. Altered renal and platelet arachidonic acid metabolism in cirrhosis. Gastroenterology 90: 274–282, 1986
Leat WMF. Man’s requirement for essential fatty acids. Trends in Biochemical Sciences 6: IX–X, 1981
Marcus AJ. The eicosanoids in biology and medicine. Journal of Lipid Research 25: 1511–1516, 1984
Mead JF. The non-eicosanoid functions of the essential fatty acids. Journal of Lipid Research 25: 1517–1521, 1984
Menashe M, Lichtenberg D, Gutierrez-Merino C, Biltonen RL. Relationship between the activity of pancreatic phospholipase A2 and the physical state of the phospholipid substrate. Journal of Biological Chemistry 256: 4541–4543, 1981
Molitoris BA. Membrane fluidity: measurement and relationship to solute transport. Seminars in Nephrology 7: 61–71, 1987
Neerhout RC. Abnormalities of erythrocyte stromal lipids in hepatic diseases. Journal of Laboratory and Clinical Medicine 71: 438–477, 1968
North P, Fleischer S. Alteration of synaptic membrane cholesterol/phospholipid ratio using a lipid transfer protein. Effect on γ-aminobutyric acid uptake. Journal of Biological Chemistry 258: 1242–1253, 1983
Nunez MT, Glass J. Reconstitution of the transferrin receptor in lipid vesicles. Effect of cholesterol on the binding of transferrin. Biochemistry 21: 4139–4143, 1982
Owen JS, Gillett MPT. Plasma lipids, lipoproteins and cell membranes. Biochemical Society Transactions 11: 336–340, 1983
Owen JS, McIntyre N. Erythrocyte lipid composition and sodium transport in human liver disease. Biochimica et Biophysica Acta 510: 168–176, 1978
Owen JS, Bruckdorfer KR, Day RC, McIntyre N. Decreased erythrocyte membrane fluidity and altered lipid composition in human liver disease. Journal of Lipid Research 23: 124–132, 1982
Owen JS, Hutton RA, Day RC, Bruckdorfer KR, McIntyre N. Platelet lipid composition and platelet aggregation in human liver disease. Journal of Lipid Research 22: 423–430, 1981
Owen JS, Hutton RA, Hope MJ, Harry DS, Bruckdorfer KR, et al. Lecithin: cholesterol acyltransferase deficiency and cell membrane lipids and function in human liver disease. Scandinavian Journal of Clinical and Laboratory Investigation 38(Suppl. 150): 228–232, 1978
Quinn PJ. The fluidity of cell membrane and its regulation. Progress in Biophysics and Molecular Biology 38: 1–104, 1981
Rafique S, Guardascione M, Burroughs AK, Owen JS. S-Adenosylmethionine (SAMe) reduces cholesterol deposition in erythrocyte membranes of cirrhotic patients. Journal of Hepatology 11(Suppl. 2): S51, 1990
Reed CF. Phospholipid exchange between plasma and erythrocytes in man and dog. Journal of Clinical Investigation 43: 1311–1321, 1968
Rothman JE, Lenard J. Membrane asymmetry. Science 195: 743–753, 1977
Schachter D. Fluidity and function of hepatocyte plasma membranes. Hepatology 4: 140–151, 1984
Schrier RW, Arroyo V, Bernardi M, Epstein M, Henriksen JH, et al. Peripheral arterial vasodilation hypothesis: a proposal for the initiation of renal sodium and water retention in cirrhosis. Hepatology 8: 1151–1157, 1988
Seidel D. Lipoproteins in liver disease. Journal of Clinical Chemistry and Clinical Biochemistry 25: 541–551, 1987
Shattil SJ, Anaya-Galindo R, Bennett J, Colman RW, Cooper RA. Platelet hypersensitivity induced by cholesterol incorporation. Journal of Clinical Investigation 55: 636–643, 1975
Shinitzky M, Henkart P. Fluidity of cell membranes: current concepts and trends. International Reviews of Cytology 60: 121–147, 1979
Simko V, Kelley RE, Dinscoy HP. Predicting severity of liver disease: twelve laboratory tests evaluated by multiple regression. Journal of International Medical Research 13: 249–254, 1985
Simon JB. Red cell lipids in liver disease: relationship to serum lipids and to lecithin-cholesterol acyltransferase. Journal of Laboratory and Clinical Medicine 77: 891–900, 1971
Sinclair HM. Essential fatty acids in perspective. Human Nutrition. Clinical Nutrition 38: 245–260, 1984
Singer SJ, Nicolson GL. The fluid mosaic model of the structure of cell membranes. Science 175: 720–731, 1972
Sloop CH, Dory L, Roheim PS. Interstitial fluid lipoproteins. Journal of Lipid Research 28: 225–237, 1987
Spector AA, Yorek MA. Membrane lipid composition and cellular function. Journal of Lipid Research 26: 1015–1035, 1985
Stenson WF, Seetharam B, Talkad V, Pickett W, Dudeja P, et al. Effects of dietary fish oil supplementation on membrane fluidity and enzyme activity in rat small intestine. Biochemical Journal 263: 41–45, 1989
Stramentinoli G. Modulation of membrane fluidity by S-adenosylmethionine treatment in different experimental conditions. In Mato (Ed.) 1st Conference on Biochemical, Pharmacological and Clinical Aspects of Transmethylation, pp. 97–104, Jarypo Editores, Madrid, 1986
Stuart MJ, Gerrard JM, White JG. Effect of cholesterol on production of thromboxane B2 by platelets in vitro. New England Journal of Medicine 302: 6–10, 1980
Stubbs CD. Membrane fluidity: structure and dynamics of membrane lipids. Essays in Biochemistry 19: 1–39, 1983
Sunnasy D, Cairns SR, Martin F, Slavin G, Peters TJ. Chronic alcoholic skeletal muscle myopathy: a clinical, histological and biochemical assessment of muscle lipid. Journal of Clinical Pathology 36: 778–784, 1983
Van Deenen LLM, De Gier J. Lipids of the red cell membrane. In Sturgenor (Ed.) The red blood cell, 2nd ed., pp. 148–214, Academic Press, New York, 1974
Ways P, Reed CF, Hanahan DJ. Red-cell and plasma lipids in acanthocytosis. Journal of Clinical Investigation 42: 1248–1260, 1963
Whetton AD, Gordon LM, Houslay MD. Elevated membrane cholesterol concentrations inhibit glucagon-stimulated adenylate cyclase. Biochemical Journal 210: 437–449, 1983
Willis AL. Nutritional and pharmacological factors in eicosanoid biology. Nutritional Reviews 39: 289–301, 1981
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Owen, J.S. Extrahepatic Cell Membrane Lipid Abnormalities and Cellular Dysfunction in Liver Disease. Drugs 40 (Suppl 3), 73–83 (1990). https://doi.org/10.2165/00003495-199000403-00008
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DOI: https://doi.org/10.2165/00003495-199000403-00008