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Updated: Jul 16, 2026

LDL Cholesterol Uptake Assay Using Live Cell Imaging Analysis with Cell Health Monitoring
Published on: November 17, 2018
[After the LDL receptor and apolipoprotein B, autosomal dominant hypercholesterolemia reveals its third protagonist:
M Abifadel1, J-P Rabès, C Boileau
1Inserm, U781, Paris, France. abifadel@necker.fr
Insights
Proprotein Convertase Subtilin Kexin 9 (PCSK9) is the third gene linked to autosomal dominant hypercholesterolemia. PCSK9 mutations impact cholesterol levels, offering new therapeutic targets.
Area of Science:
- Genetics and Molecular Biology
- Cardiovascular Disease Research
Context:
- Autosomal dominant hypercholesterolemia was historically linked to two genes: the low-density lipoprotein receptor and apolipoprotein B.
- The discovery of PCSK9 (Proprotein Convertase Subtilin Kexin 9) in 2003 identified a third key gene involved in this condition.
Purpose:
- To highlight the identification and role of PCSK9 in hypercholesterolemia.
- To explore the impact of various PCSK9 mutations on cholesterol metabolism and cardiovascular health.
Summary:
- Gain-of-function mutations in PCSK9 lead to hypercholesterolemia by reducing LDL receptor levels.
- Loss-of-function mutations, such as p.Y142X and p.C679X, are associated with hypocholesterolemia and reduced cardiovascular risk, particularly in Black Americans.
- PCSK9 plays a significant role in cholesterol homeostasis, although its precise substrates and functions are still under investigation.
Impact:
- PCSK9 is a crucial factor in cholesterol homeostasis.
- PCSK9 inhibitors represent promising therapeutic targets for lowering LDL cholesterol and may work synergistically with statins.
Abstract:
The genes encoding the low-density lipoproteins receptor and its ligand apolipoprotein B, have been the only two genes classically implicated in autosomal dominant hypercholesterolemia. We have identified in 2003, the third gene implicated in this disease: PCSK9 (Proprotein Convertase Subtilin Kexin 9). Several mutations (p.S127R, p.F216L, p.D374Y...) of this gene have been reported to cause hypercholesterolemia by a gain of function leading to a reduction of LDL receptor levels. Other variations of PCSK9 are conversely associated with hypocholesterolemia particularly the non-sense p.Y142X and p.C679X mutations found in 2% of black Americans and associated with a decrease of LDL levels and coronary heart diseases. PCSK9 substrates and exact role have not been elucidated yet, but it seems that PCSK9 is definitely a major actor in cholesterol homeostasis. PCSK9 inhibitors might constitute new therapeutic targets that would decrease plasma LDL cholesterol levels and be synergistic with statin drugs.
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