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Androgen
Acetyl-CoA    Acetoacetyl-CoA                     Cholesterol pathways                                                    Estrogen
                                                                                                                          Mineralcorticoids
                                   Cholesterol                                                                            Glucocorticoids
  HMG-CoA synthase

      HMG-CoA
                                                                              pregnenolone
                                                                                                                        PXR
HMG-CoA reductase                                                                                   5β-pregnenolone-
                                                                                                    3,20dione

                        Neutral pathway                        Acidic pathway
                            CYP7A1                             CYP27A1




                                7α-deydrocholesterol
         Vitamin D3                                               27-hydrocholesterol

                                                                                                                        oxysterols
                           CYP27A1                           CYP7B1

 VDR                                     Primary BAs                                         Secondary BAs             LXR



      FXR                                              CDCA

                                                                                                     LCA

                                              CYP8B1




                                                                                                           DCA
                                                        CA



                                                                                                                             Figure 1
Bile acids




                         FXR   VDR




                                                                                            Systemic circulation
                                                                                   Mrp3
                          PXR CAR
                Ntcp
  Portal vein




                                                              Phase II
                Oatp-1         Phase I
                                                                                   Mrp4


                                                   Ugt2b4/7   Ugt1a1     Sult2a1
                               Cyp3a4
                                                                                   Ostα/β
                                 BA-OH              BA-GlcA   BA-GlcA    BA-SO




                                                       BSEP
                                         Mrp3                    Mrp2

                                                   Bile
                                                canalicular
                                                  efflux                           Renal BA
                                                                                   excretion


Figure 2                                         Fecal BA
                                                 excretion
Decrease
                                         LDL plasmatic LDLr
                                            levels expression CAR
                                                                          Cyp39A1
                           HMGCoA
                           reductase
                 FXR                                             PXR     Cholesterol
                          Cholesterol                                    catabolism
  ApoA1                   synthesis
                                                      ApoA1
              PCSK9                                                      SR-B1
                          SR-B1                       ABCA1
   HDL      LDLr
                       Increase HDL                    HDL             Decrese HDL
 synthesis activity
                         clearance                   synthesis          clearance

    Decrease                                         Decrease
LDL/HDL plasmatic                                  HDL plasmatic
                                        human         levels
     levels
          A                             mouse B




 Figure 3
FAS                                                      Triglyceride
                            activity                                                   synthesis
                                                                   CAR       PXR
              FXR          PPARα
                                                        Srebp-1c
                              β-Oxidation                          PPARα   CTP-1

                      ApoC III                                                      CD36
             VLDL                                         Fas
                      ApoA V                             Acc-1        β-Oxidation
           receptor
                      ApoC II                            Scd-1
 Syndecan-1                                 human
                                                        lipogenesis
               Increase LPL                 mouse
                  activity


A
    Increase VLDL and CM                            B
          clearance




Figure 4
hyperglicaemia
       FXR                                                              Insulin resistance

                                 GS                                                                    GLUT4
  G6Pase           PK
 PEPCK                     glycogen synthesis                                              Insulin
 F1,6bPase       glycolisis                                                                signaling
                 FAs synthesis                   Inflammatory
                                                 cytokines                                        SKELETAL MUSCLE
gluconegenesis
                                                 Glucose
                                                 production
                                                Glucose uptake
   LIVER




                                                                                                                appetite
                                                Insulin secretion
                     FXR
                           Adipocytes           β cells protection
                 GLUT4     differentiation
                 Lipid                                          GLP-1        GLP-1
                                                                                                   TGR5
                           Inflammatory
                 storage
                           cytokines                                                   AC
                                                                                                GDP
           WAT                                                                                         αβ
                                                                                                            γ
                                                                                       P
                                                        PANCREAS                  c-AM             GTP
                                                                                                        α
                     Figure 5                                                                                   GUT
Agonists


CAR
PXR
                 PGC-1α


      CREB       FoxO1    HNF4α

                                  PEPCK
                                  G6Pase

            gluconeogenesis




             Figure 6
Skeletal muscle

                                       TGR5                  AC            T4
                                                                                     TR
                                                                                 T3
                                                                        D2            1α
                                                                  C-AMP           PGC
                                                                                       2
                                             P α β       γ                          UCP
  FXR
                                          GD

                                                     P               CRE
                                               GT
                                                         α
        Rα                        PK
     PPA
                                                                                      Uncoupling
                    n                       FFA /
                atio                   TRIGLYCERIDES                                  B-oxidation
             xid
          Β-o                                                                         Oxidative phosphorylation

                                                 large
                                                 adipocyte




                                       TNF-α


                                          IR                                                             T4      TR
                                                                                           AC                 T3
                                                                      TGR5                           P
                                                                                                         D2      C1
                                                                                                               PG P1
                                                                                                                    α

                                                                                                c-AM             UC
     FXR                adiponectin                                                                                       P2
                                                                                                                             /3
                                                                                      γ                                 UC
                                                                                   αβ
                                                                                DP
                                                                             G                      CRE
adipocytes
differentiation
                         leptin
                                                                                        P
                                                                                      GT α
                                                                                                              CAR

                                                                                                          BAT
                          WAT
pre-adipocyte
                                        Figure 7

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Prof Stefano Fiorucci - Progress in lipid research

  • 1. Androgen Acetyl-CoA Acetoacetyl-CoA Cholesterol pathways Estrogen Mineralcorticoids Cholesterol Glucocorticoids HMG-CoA synthase HMG-CoA pregnenolone PXR HMG-CoA reductase 5β-pregnenolone- 3,20dione Neutral pathway Acidic pathway CYP7A1 CYP27A1 7α-deydrocholesterol Vitamin D3 27-hydrocholesterol oxysterols CYP27A1 CYP7B1 VDR Primary BAs Secondary BAs LXR FXR CDCA LCA CYP8B1 DCA CA Figure 1
  • 2. Bile acids FXR VDR Systemic circulation Mrp3 PXR CAR Ntcp Portal vein Phase II Oatp-1 Phase I Mrp4 Ugt2b4/7 Ugt1a1 Sult2a1 Cyp3a4 Ostα/β BA-OH BA-GlcA BA-GlcA BA-SO BSEP Mrp3 Mrp2 Bile canalicular efflux Renal BA excretion Figure 2 Fecal BA excretion
  • 3. Decrease LDL plasmatic LDLr levels expression CAR Cyp39A1 HMGCoA reductase FXR PXR Cholesterol Cholesterol catabolism ApoA1 synthesis ApoA1 PCSK9 SR-B1 SR-B1 ABCA1 HDL LDLr Increase HDL HDL Decrese HDL synthesis activity clearance synthesis clearance Decrease Decrease LDL/HDL plasmatic HDL plasmatic human levels levels A mouse B Figure 3
  • 4. FAS Triglyceride activity synthesis CAR PXR FXR PPARα Srebp-1c β-Oxidation PPARα CTP-1 ApoC III CD36 VLDL Fas ApoA V Acc-1 β-Oxidation receptor ApoC II Scd-1 Syndecan-1 human lipogenesis Increase LPL mouse activity A Increase VLDL and CM B clearance Figure 4
  • 5. hyperglicaemia FXR Insulin resistance GS GLUT4 G6Pase PK PEPCK glycogen synthesis Insulin F1,6bPase glycolisis signaling FAs synthesis Inflammatory cytokines SKELETAL MUSCLE gluconegenesis Glucose production Glucose uptake LIVER appetite Insulin secretion FXR Adipocytes β cells protection GLUT4 differentiation Lipid GLP-1 GLP-1 TGR5 Inflammatory storage cytokines AC GDP WAT αβ γ P PANCREAS c-AM GTP α Figure 5 GUT
  • 6. Agonists CAR PXR PGC-1α CREB FoxO1 HNF4α PEPCK G6Pase gluconeogenesis Figure 6
  • 7. Skeletal muscle TGR5 AC T4 TR T3 D2 1α C-AMP PGC 2 P α β γ UCP FXR GD P CRE GT α Rα PK PPA Uncoupling n FFA / atio TRIGLYCERIDES B-oxidation xid Β-o Oxidative phosphorylation large adipocyte TNF-α IR T4 TR AC T3 TGR5 P D2 C1 PG P1 α c-AM UC FXR adiponectin P2 /3 γ UC αβ DP G CRE adipocytes differentiation leptin P GT α CAR BAT WAT pre-adipocyte Figure 7