Você está na página 1de 1

Chapter 26 / Gastrointestinal Secretion, Digestion, and Absorption ●

525

micelles diffuse across the unstirred water layer and deliver stream to low-density lipoprotein (LDL). Since cholesterol
lipid digestion products to the enterocytes for absorption. is carried by LDL, cholesterol content can be measured on
LDL particles. High levels of LDL particles can promote
Enterocytes secrete chylomicrons and medical problems and they are often referred to as bad cho-
very-low-density lipoproteins. lesterol particles (as opposed to HDL, which is often referred
After entering the enterocytes, the fatty acids and monoglyc- to as good cholesterol). One of the functions of LDL parti-
erides migrate to the smooth endoplasmic reticulum (SER). cles is the transport of cholesterol into the arterial wall where
A fatty acid-binding protein may be involved in the intracel- it is retained by arterial proteoglycans. Macrophages are
lular transport of fatty acids, but whether a protein carrier attracted to these sites and function to engulf the LDL parti-
is involved in the intracellular transport of monoglycerides cles. The process of engulfing LDL particles by macrophages
is still unclear. In the SER, monoglycerides and fatty acids initiates plaque formation in the arterial wall. Increased levels
are rapidly reconstituted to form triglycerides (Fig. 26.22). of plaque formation are linked to atherosclerosis. Over time,
Fatty acids are first activated to form acyl-coenzyme A (acyl- plaques become vulnerable to rupturing, which, in turn, acti-
CoA), which is then used to esterify monoglyceride to form vates blood clotting and leads to arterial stenosis.
diglyceride, which is transformed into triglyceride. The Apoproteins—apo A-I, apo A-IV, and apo B—are
lysolecithin absorbed by the enterocytes can be reesterified among the major proteins associated with the production
in the SER to form lecithin. of chylomicrons and VLDLs. Apo B is the only protein that
Cholesterol can be transported out of the enterocytes seems to be necessary for the normal formation of intesti-
as free cholesterol or as esterified cholesterol. The enzyme nal chylomicrons and VLDLs. This protein is made in the
responsible for the esterification of cholesterol to form cho- small intestine. It has a molecular weight of 250,000 and is
lesterol ester is acyl-CoA cholesterol acyltransferase. extremely hydrophobic. Apo A-I is involved in a reaction
The reassembled triglycerides, lecithin, cholesterol, and catalyzed by the plasma enzyme lecithin cholesterol acyl-
cholesterol esters are then packaged into lipoproteins and transferase (LCAT). Plasma LCAT is responsible for the
exported from the enterocytes. The intestine produces two esterification of cholesterol in the plasma to form cholesterol
major classes of lipoproteins: chylomicrons and very low- ester with the fatty acid derived from the 2-position of leci-
density lipoproteins (VLDLs). Both are triglyceride-rich thin. After the chylomicrons and VLDLs enter the plasma,
lipoproteins with densities <1.006 g/mL. The small intestine apo A-I is rapidly transferred from chylomicrons and VLDLs
exclusively makes chylomicrons, and their primary function to HDLs. Apo A-I is the major protein present in plasma
is to transport the large amount of dietary fat absorbed by the HDLs. The small intestine and the liver make Apo A-IV.
small intestine from the enterocytes to the lymph. Chylomi- Recently, it was shown that apo A-IV, secreted by the small
crons are large, spherical lipoproteins with diameters of 80 intestine, may be an important factor contributing to ano-
to 500 nm. They contain less protein and phospholipid than rexia after fat feeding.
VLDLs and are, therefore, less dense than VLDLs. The small Newly synthesized lipoproteins in the SER are trans-
intestine continuously makes VLDLs during both fasting and ferred to the Golgi apparatus, where they are packaged in
feeding, although the liver contributes significantly more vesicles. Chylomicrons and VLDLs are released into the
VLDLs to the circulation. VLDL is converted in the blood intercellular space by exocytosis. From there, they are trans-
ferred to the central lacteals (the beginnings of lymphatic
vessels) by a process that is not well understood. Experi-
Lumen Interstitial mental evidence seems to indicate that the transfer occurs
space
mostly by diffusion. Intestinal lipid absorption is associated
Monoglyceride Diglyceride Triglyceride with a marked increase in lymph flow called the lymphago-
gic effect of fat feeding. This increase in lymph flow plays an
Fatty acid Acyl-CoA important role in the transfer of lipoproteins from the inter-
Enterocyte cellular spaces to the central lacteal.
Lysolecithin Lecithin Fatty acids can also travel in the blood bound to albu-
min. Whereas most of the long-chain fatty acids are trans-
Cholesterol Cholesterol ester ported from the small intestine as triglycerides packaged in
chylomicrons and VLDLs, some are transported in the portal
Free cholesterol blood bound to serum albumin. Most of the medium-chain
Chylo- (8–12 carbons) and all of the short-chain fatty acids are
micron
transported via the hepatic portal route.

Altered lipase and bile secretion


Exocytosis significantly impair lipid digestion and
absorption.
● Figure 26.22 Endocytes form chylomicrons for lipid
transport. Chylomicrons are large lipoproteins and transport In several clinical conditions, lipid digestion and absorption
exogenous lipids to the liver and to adipose, cardiac, and skel- are impaired, resulting in the malabsorption of lipids and
etal tissue. Acyl-CoA, acyl-coenzyme A. other nutrients and fatty stools. Abnormal lipid absorption

Rhoades_Chap26.indd 525 11/12/2011 3:37:41 PM

Você também pode gostar