Lipoprotein-X - Pathogenesis


The pathogenesis of lipoprotein-X in cholestasis is not totally resolved. Normally, the liver excretes lipoprotein complexes into the bile showing phospholipid and unesterified cholesterol concentrations similar to Lipoprotein-X. The in vitro incubation of these bile lipoproteins with serum or albumin leads to the appearance of Lp-X–like particles. These findings suggest that the reflux of bile into the plasma compartment causes the formation of lipoprotein-X in cholestasis as a result of a physicochemical, nonmetabolic process. On the other hand, lipoprotein-X particles found in familial LCAT deficiency are identical to those in cholestasis regarding ultrastructure and biochemical composition. It has been supposed that reduced LCAT activities, common in patients with hepatocellular disease, cause, alone or in combination with other factors, the formation of Lipoprotein-X in cholestasis. Lipoprotein-X is mainly removed by the reticuloendothelial system of the liver and the spleen, as shown by studies using radioactively labeled lipoprotein-X in rats. Other organs, such as the kidney, also actively clear Lipoprotein-X from the plasma.

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The pathogenesis of a disease is the mechanism by which the disease is caused. The term can also be used to describe the origin and development of the disease and whether it is acute, chronic or recurrent. The word comes from the Greek pathos, "disease", and genesis, "creation".

Types of pathogenesis include microbial infection, inflammation, malignancy and tissue breakdown.

Most diseases are caused by multiple pathogenetical processes together. For example, certain cancers arise from dysfunction of the immune system (skin tumors and lymphoma after a renal transplant, which requires immunosuppression).

Often, a potential etiology is identified by epidemiological observations before a pathological link can be drawn between the cause and the disease.