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Publication : Inhibition of ASGR1 decreases lipid levels by promoting cholesterol excretion.

First Author  Wang JQ Year  2022
Journal  Nature Volume  608
Issue  7922 Pages  413-420
PubMed ID  35922515 Mgi Jnum  J:363098
Mgi Id  MGI:7525116 Doi  10.1038/s41586-022-05006-3
Citation  Wang JQ, et al. (2022) Inhibition of ASGR1 decreases lipid levels by promoting cholesterol excretion. Nature 608(7922):413-420
abstractText  High cholesterol is a major risk factor for cardiovascular disease(1). Currently, no drug lowers cholesterol through directly promoting cholesterol excretion. Human genetic studies have identified that the loss-of-function Asialoglycoprotein receptor 1 (ASGR1) variants associate with low cholesterol and a reduced risk of cardiovascular disease(2). ASGR1 is exclusively expressed in liver and mediates internalization and lysosomal degradation of blood asialoglycoproteins(3). The mechanism by which ASGR1 affects cholesterol metabolism is unknown. Here, we find that Asgr1 deficiency decreases lipid levels in serum and liver by stabilizing LXRalpha. LXRalpha upregulates ABCA1 and ABCG5/G8, which promotes cholesterol transport to high-density lipoprotein and excretion to bile and faeces(4), respectively. ASGR1 deficiency blocks endocytosis and lysosomal degradation of glycoproteins, reduces amino-acid levels in lysosomes, and thereby inhibits mTORC1 and activates AMPK. On one hand, AMPK increases LXRalpha by decreasing its ubiquitin ligases BRCA1/BARD1. On the other hand, AMPK suppresses SREBP1 that controls lipogenesis. Anti-ASGR1 neutralizing antibody lowers lipid levels by increasing cholesterol excretion, and shows synergistic beneficial effects with atorvastatin or ezetimibe, two widely used hypocholesterolaemic drugs. In summary, this study demonstrates that targeting ASGR1 upregulates LXRalpha, ABCA1 and ABCG5/G8, inhibits SREBP1 and lipogenesis, and therefore promotes cholesterol excretion and decreases lipid levels.
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