J Clin Lipidol. 2026 Sep 25:S1933-2874(26)00529-5. doi: 10.1016/j.jacl.2026.09.018. Online ahead of print.
ABSTRACT
BACKGROUND: Lysosomal acid lipase deficiency (LAL-D) is characterized by severe dyslipidemia, including elevated low-density lipoprotein (LDL) cholesterol, despite activation of sterol-responsive pathways.
OBJECTIVE: We investigated whether altered receptor-mediated LDL catabolism may contribute to this phenotype.
METHODS: Epstein-Barr virus (EBV)-transformed lymphoblastoid cells from a patient with cholesteryl ester storage disease (CESD) homozygous for the LIPA Exon 8 Splice-Junction Mutation were compared with cells from heterozygous carriers, heterozygous familial hypercholesterolemia patients, and controls. LAL activity was measured using a fluorometric assay. LDL receptor (LDLR) surface expression and LDL internalization were assessed by flow cytometry.
RESULTS: CESD cells displayed markedly reduced LAL activity together with modest but significant reductions in LDLR surface expression and LDL internalization. Under low-serum conditions, LDLR gene expression was also significantly lower in CESD cells than in controls.
CONCLUSION: These findings suggest that impaired LDLR-mediated LDL uptake may contribute to dyslipidemia in LAL-D, alongside previously reported alterations in lipoprotein production. Confirmation in additional patients and disease-relevant cellular models is required.
PMID:42881040 | DOI:10.1016/j.jacl.2026.09.018