1 Lipid metabolism II Phospholipids and glycolipids Eicosanoids. Synthesis and metabolism of cholesterol and bille acids Biochemistry I Lecture 9 2012 (E.T.) 2 Glycerophospholipids C H 2 C H O C O C H 2 O C O O P O O O X Phosphatidylcholine – PC Phosphatidylethanolamine – PE Phosphatidylserine – PS Phosphatidylinositol – PI Cardiolipin - CL 3 Biosynthesis of glycerophospholipids • located in all cells with exception of erytrocytes • the initial steps of synthesis are similar to those of triacylglycerol synthesis 4 Synthesis of triacylglycerols and glycerophospholipids – common aspects P i PI, cardiolipin P C H 2 O C O R C H O C O R C H 2 O R R C O S C oA H S C oA C H 2 O C O R C H O C O R C H 2 O C O R PC,PE,PS triacylglycerol hydrolase C H 2 O C O C H O C O R C H 2 O H diacylglycerol phosphatidate Addition of the head group 5 Location of phospholipids synthesis in the cell • Synthesis of phospholipids is located on membranes of ER •Enzymes are integral membrane proteins of the outer leaflet with active centers oriented on cytoplasma • Newly synthesised phospfolipids are built in the inner layer of the mebrane • By the action of flippases are transfered into the outer layer • De novo synthesized membranes are transported via a vesicle mechanism to the Golgi complex and from there to different organelles and the plasma membrane. ER membrane cytoplazma flipase > 6 Synthesis of phosphatidyl choline Choline must be activavated before the synthesis 1)Choline + ATP ® Choline-P + ADP 2)choline-P + CTP ® CDP-choline + PPi 3)CDP-choline + 1,2-DG ® fosfatidylcholine + CMP 4) 7 CH3 CH3 OH OH O N N O NH2 O– CH2 O– O O CH3–N–CH2–CH2–O–P–O–P–O– + CDP-choline CDP-choline plays a part formally similar to that of UDP-glucose in the synthesis of glycogen. 8 The biosynthesis of phosphatidyl ethanolamine (PE) is similar. Conversion of phosphatidyl ethanolamine to phosphatidyl choline CH3 CH3 CH3 N-methylation of phosphatidyl ethanolamine by SAM 9 Phosphatidyl ethanolamine + serine ® phosphatidyl serine + ethanolamine Biosynthesis of phosphatidyl serine (PS) Phosphatidyl serine can be also decarboxylated to form PE. CH2–CH–NH2 O– O P–O– R–CO–O–CH2 R–CO–O–CH CH2–O COOH O– O P–O–CH2–CH2–NH2 R–CO–O–CH2 R–CO–O–CH CH2–O Serine Ethanolamine CO2 10 1. Activation of phosphatidic acid CDP-diacylglycerol = activated phosphatidate 2 Synthesis of phosphatidyl inositol Phosphatidic acid + CTP ® CDP-diacylglycerol + PPi OH OH O N N O NH2 O– CH2 O– O O P–O–P–O– R–CO–O–CH2 R–CO–O–CH CH2–O 11 CDP-diacylglycerol + inositol ® CMP + phosphatidyl inositol (PI) 2. CDP-Diacylglycerol then reacts with free inositol to give phosphatidyl inositol (PI) 12 Plasmalogens modified glycerophospholipids (alkoxylipids or ether glycerophospholipids). Plasmalogens represent about 20 % of glycerophospholipids. O– O P–– CH2–O–CH=CH–R R–CO–O–CH CH2–O choline (in myocard) ethanolamine (in myelin) serine Alkenyl Ether bond Products of lipid remodelation 13 PAF (platelet activating factor) PAF induces aggregation of blood platelets and vasodilation and exhibits further biological effects, e.g. it is a major mediator in inflammation, allergic reaction and anaphylactic shock. Acyl reduced to alkyl Acetyl in place of the fatty acyl O– O P–O–CH2–CH2–N–CH3 CH2–O–CH2–CH2–R CH3–CO–O–CH CH2–O CH3 CH3 + 14 Transacylation reactions Exchange of acyls on the C-2 in phosholipids: diacylglycerols: oleic acid on the C-2 phospholipids: polyunsaturated FA (often arachidonic acid) on the C-2 15 Significance of glycerophospholipids • essential structural components of all biological membranes • essential components of lipoproteins in blood • supply polyunsaturated fatty acids for the synthesis of eicosanoids • act in anchoring of some (glyco)proteins to membranes, • serve as a component of lung surfactant • phosphatidyl inositols are precursors of second messengers (PIP2, DG) 16 Anchoring of proteins to membrane The linkage between the COOH-terminus of a protein and phosphatidylinositol fixed in the membrane lipidic bilayer exist in several ectoenzymes (alkaline phosphatase, acetylcholinesterase, some antigens). 17 Lung surfactant The major component is dipalmitoylphosphatidylcholine. It contributes to a reduction in the surface tension within the alveoli (air spaces) of the lung, preventing their collapse in expiration. Less pressure is needed to re-inflate lung alveoli when surfactant is present. The respiratory distress syndrome (RDS) of premature infants is caused, at least in part, by a deficiency in the synthesis of lung surfactant. 18 Baby with head turned to side showing airway and lungs. Closeup of airway and normal alveoli. Closeup of airway and collapsed alveoli. Respiratory distress syndrom Normally, alveoli stay open after each breath. RDS occurs when alveoli collapse after each breath. This means the baby has to work harder to breathe Treatment: Artificial surfactant is given 19 Enzymes catalysing hydrolysis of glycerophosholipids are called phospholipases. Phospholipases are present in cell membranes or in lysosomes. Different types (A1, A2, C, D) hydrolyse the substrates at specific ester bonds: O– O P–O–X (head group) R–CO–O–CH2 R–CO–O–CH CH2–O C A1 A2 D (only in brain and plants) Catabolism of glycerophospholipids 20 Sphingophospholipids Binding of phosphate Binding of choline 1 2 3 4 H O N H 2 O H Binding of FA sphingosine Components of membranes, signal transduction, myelin sheat FA – lignoceric 24:0 and nervonic 24:1(15) 21 • overall equation 16 C 1C 3 C 18 C oxosfinganine palmitate serine CO2 + + oxosfinganine sfinganine NADPH+H+ NADP FAD FADH2 sphingosine Biosynthesis of sphingosine 22 oxosfinganine Biosynthesis of sphingosine Palmitic acid serine CO2 23 C H 3 ( C H 2 ) 1 2 C H 2 C H 2 + C C H C H 2 O H O N H 3 C H 3 ( C H 2 ) 1 2 C H 2 C H 2 + C H C H C H 2 O H O H N H 3 C H 3 ( C H 2 ) 1 2 C H C H C H C H C H 2 O H O H N H 3 + NADPH + H+ NADP FAD FADH2 oxosfinganine sfinganine sfingosine 2. 3. 4. 24 24 18 1 2 3 4 H O N H 2 O H Biosynthesis of sphingomyeline 1.Attachment of fatty acid by amide bond = ceramide 2. Reaction with CDP-choline: Phosphocholine is attached to CH2OH = sphingomyelin Fatty acid phosphate sphingosine 25 Cerebrosides (monoglycosylceramides) galactosylceramide ceramide + UDP-galactose galactose O-glycosidic bond Glycosphingolipids N O O H H O O O H O H O H H O ceramide 26 Sulfoglycolipids are sulfated Sulfosphingolipids are formed by transfer of sulphate from 3´-phosphoadenosine-5´-phosphosulfate ( PAPS). 27 Ceramide–(1←1β)Glc-(4←1β)Gal-(4←1β)GlcNAc (3←2α) NeuAc Gangliosides Sialic acid is attached to oligosaccharide chain 28 Biosynthesis of glycosphingolipids Synthesis of cerebrosides: ceramid + UDP-gal ® ceramid -gal + UDP ……… + binding of other UDP-monosacharides Synthesis of sulfatides: Sulfatation of cerebrosides by PAPS Synthesis of gangliosides: ceramide + UDP -hexoses + CMP-NeuAc 29 Degradation of sphingolipids in lysosomes In lysosomes, a number of specific enzymes catalyse hydrolysis of ester and glycosidic linkages of sphingolipids. Sphingomyelins loose phosphocholine to give ceramide. Glycolipids due to the action of various specific glycosidases get rid of the saccharidic component to give ceramide. Ceramide is hydrolysed (ceramidase) to fatty acid and sphingosine. Sphingosine is decomposed in the pathway that looks nearly like the reversal of its biosynthesis from palmitoyl-CoA and serine. After phosphorylation, sphingosine is broken down to phosphoethanolamine (decarboxylated serine) and palmitaldehyde, that is oxidized to palmitate. 30 Phosphocholine FATTY ACID CERAMIDE (N-Acylsphingosine) SPHINGOSINE Sphingosine-1-P Phosphoethanolamine Palmitaldehyde PALMITIC ACID Ceramide Glc Gal GalNAc Gal NeuNAc Ceramide Gal Ceramide Glc Ceramide Gal–O-SO3– Ceramide–P–-choline SPHINGOMYELIN CEREBROSIDE SULPHATIDE GANGLIOSIDE GM1 ATP NAD+ Degradation of sphingolipids 31 Sphingolipidosis Lipid storage disorders Inherited defects in production of the enzymes that catabolize sphingolipids. They result in accumulation of their substrates in lysosomes, leading to lysosomal damage and to disruption of the cell as new lysosomes continue to be formed and their large number interferes with other cellular functions. In the sphingolipidosis mainly the cells of the central nervous system (including brain and retina) are affected. 32 Eicosanoids 33 Eicosanoids Local hormons Synthesis of eicosanoids: PG, TX (prostanoids) – cyclooxygenase pathway LT (Leukotriens) – lipoxygenase pathway The main types of eicosanoids: prostaglandins (PG) tromboxans (TX) leukotriens (LT) They are synthesized from polyunsatureted fatty acids with 20 carbons 34 signal molecule (adrenalin, trombin, bradykinin, angiotensin II) phospholipase A2 receptor 1. The release of C20 fatty acids from membrane phospholids arachidonic ac. EPE eicosatrienoic ac. cytoplasm Biosynthesis of eicosanoids 35 Inhibitors of phospholipase A2 Membrane phospholipids PUFA phospholipase A2 corticoids lipocortin Steroidal antiphlogistics (hydrocortisone, prednisone) stimulate the synthesis of protein lipocortin which inhibits phospholipase A2 and block the release of PUFA and eicosanoids formation. Principle of anti-inflammatory effect of glucocortikoids. They inhibit the two main products of inflammation, prostglandins and leukotrienes. ´ 36 Prostanoids: prostaglandins and prostacyclins • they are produced in nearly all cell types • endoplasmic reticulum • the site of their synthesis depends on expression of genes for the enzymes which take part in the synthetic pathways. • they have various effect (many types of receptors) 37 Involvement of prostanoids in physiological processes - examples TXA2 (tromboxane A2) It is produced in platelts, it stimulates vasoconstriction and and platelet agregation Duration of action ~ 30-60 s PGI2 (prostacycline A2) It is antagonist of TXA2, , it is produced by vascular endothelium, it inhibits platelet coagulation and has vasodilatation effects, half-life 3 min. Their equilibrated effects takes part in platelet coagulation and vasomotor and smooth muscle tone. 38 PGE2 is produced by mucose cells of the stomach and inhibits HCl secretion PGE2 and PGF2a are synthesized in endometrium and induce uterine contractions. Their concentration in amniotic fluid during pregnancy is low, it significantly increases during delivery. Together with oxytocin is involved in the induction of labor. It reduces the risk of peptic ulcer They can be used to induce abortion by inttravenous or intravaginal application 39 prostanoid Structural group Synthesized in The most remarkable effect PGE2 prostaglandin E nearly all cell types inflammatory reaction, vasodilation, inhibition of HCl secretion, secretion of mucine, increase of body temperature, increase of intensity and duration of pain, increase of vessel permeability PGF2α prostaglandin F nearly all cell types vasoconstriction increase of body temp. PGI2 prostacyclin endothelial cells, smooth muscle cells of blood vessels vasodilation, inhibition of platelet aggregation, increase of intensity and duration of pain, TXA2 thromboxane blood platelets platelet aggregation, vasoconstriction Examples of some biological effects of prostanoids 40 Synthesis of prostanoids (cycloxygenase pathway) Arachidonic acid PGG2 (two double bonds) PGH2 - precursor of all prostanoids of the 2-series cyklooxygenase (cyklooxygenase activity) cyklooxygenase (peroxidase activity) 2O2 The enzyme cyclooxygenase (COX) has two enzyme activities: 41 PGE synthase Prostaglandin H2 Thromboxane TXA2 Prostacyclin PGI2 Prostaglandin PGE2 Prostaglandin PGF2α PGE 9-keto reductase TXA synthase PGI synthase 42 The enzyme equipment of various tissues is different E.g., in the lung and the spleen, the enzyme equipment enables biosynthesis of all eicosanoid types. In blood platelets, only thromboxan synthase is present. The endothelial cells of blood vessels synthesize only prostacyclins. The catabolism of prostanoids is very rapid - Enzyme catalyzed ( t1/2 ~0,1-10 min) - non-enzymic hydrolysis (t1/2 sec-min) 43 COX-1: constitutive (still present) – involved into the synthesis of prostanoids at physiological conditions • COX-2: predomintly inducible – its synthesis is induced during inflammation (stimulation by cytokines, growth factors) Cyclooxygenase (COX) exists in two forms Prostanoids mediate, at least partly, the inflammatory response (they activate inflammatory response, production of pain, and fever) 44 Inhibitors of cyclooxygenase Because of importance of prostaglandins in mediating the inflammatory response, drugs that blocks prostaglandin production should provide relief from pain The main COX inhibitors are the nonsteroidal anti-inflammatory drugs (NSAIDs, analgetics-antipyretics): • acetylsalicylic acid (Aspirin) – irreversible inhibition • acetaminophen (Tylenol), ibuprofen – reversible inhibition • • They inhibit the both forms of COX 45 Inhibition of cyclooxygenase suppresses the effects of prostanoids … it has the positive effects (the anti-inflammatory effect, relief of pain, mitigation of fever. …) ….on the contrary, there may be some undesirable effects of blocked prostanoid production, e.g. decline in blood platelet aggregation, decreased protection of endothelial cells and of gastric mucosa. Therefore drugs are being developed which would act as selective inhibitors of COX-2 without the adverse gastrointestinal and anti-platelet side effects of non-specific inhibitors of COX. 46 COX-2 inhibitors They are proposed to act as potent anti-inflammatory agents by inhibiting COX-2 activity, without the gastrointestinal (stomach ulcer) and antiplatelet side effects associated with NSAIDs Examples: celecoxib, rofecoxib However further studies indicated that specific COX-2 inhibitors may have a negative effect on cardiovascular function. Coxibs were withdrawn from the market by its manufacturer because of negative patients study Nimesulid (AULIN, COXTRAL), meloxikam (ANTREND,LORMED,MELOBAX) – are still used, they inhibit more COX-2 than COX-1 and must be used with caution 47 Acetylsalicylic acid (Aspirin) salicylic acid acetylsalicylic acid ~ 500 mg analgetic, anti-pyretic actions ~ 50 mg anti-thrombotic action (prevention) It covalently acetylates the active site of cyclo-oxygenase, causing its irreversible inhibition 48 Low-doses of aspirin (ASA, 81-325 mg daily) has been shown to be effective in prevention of acute myocardial infarction. Aspirin blocks the production of TXA2. by inhibition of COX The principal effect of TXA2 is the stimulation of platelets aggregation. It may initiate the formation of trombus at sites of vascular injury or in the vicinity of ruptured atherosclerotic plaque. Such thrombi may cause sudden total occlusion of vascular lumen. By aspirin treatment the effect the effects of thromboxane are attenuated. Protective effect of acetylsalicylic acid 49 Lipoxygenase pathway Synthesis of leukotrienes Precursor of all leukotrienes of the 4-series 5-Lipoxygenase COO– OOH COO– O COO– Arachidonate 5-HydroperoxyETE Leukotriene LTA4 O2 all of them have three conjugated double bonds (trienes), the position of which may be different and the configuration either trans or cis.. 50 Leukotrienes are produced primarily in leukocytes and mast cells The classes of LTs are designated by letters A – E, the subscript denotes the total number of double bonds. COO– O LTA4 LTB4 OH S Cys®Gly LTD4 Slow-reacting substance of anaphylaxis (SRS-A) LTB4 12-Lipoxygenase GSH Glu 51 Example Structural group Synthesized in The most remarkable effect LTD4 leukotriene leukocytes, mast cells bronchoconstriction, vasoconstriction LXA4 lipoxin various cell types bronchoconstriction, vasodilation Eicosanoids 52 Cholesterol 53 Cholesterol HO 5-cholesten-3b-ol Essential component of membranes Source for synthesis of bile acids, steroids and vitamin D3 1 2 10 5 11 14 6 7 12 18 17 19 20 21 54 Biosynthesis of cholesterol • where: most of cells, mainly liver, adrenal cortex, red blood cells, reproductive tissues…. • where in the cell: cytoplasma, some enzymes located on ER • initial substrate: acetylCoA • balance of synthesis:18 acetylCoA, 36 ATP, 16 NADPH 55 3-hydroxy-3-methylglutarylCoA (HMG-CoA) acetylCoA acetoacetylCoA ER 1. phase of cholesterol synthesis - synthesis of 3-HMG-CoA Compare with the synthesis of keton bodies in mitochondrial matrix 56 3-HMG-CoA Mevalonic acid 2. phase - formation of mevalonate 3-HMG-CoA reductase + Double reduction of carboxylic group to primary alcohol group 57 Synthesis of mevalonate determines the overal rate of the cholesterol synthesis Enzyme 3-HMG-CoA reductase •bonded on the ER membrane • major control point of the synthesis • inhibited by some drugs 58 3-HMG-CoA reductase Kinds of metabolic control • control of enzyme synthesis by sterol level • control of enzyme proteolysis by sterol level • control of enzyme activity by covalent modification (phosphorylation) • competitive inhibition by drugs – statins (e.g.lovastatin, pravastatin, cerivastatin) 59 Control of 3-HMG-CoA reductase synthesis by cholesterol • affection of gene transcription by transcription factor SREBP (sterol regulatory element binding protein) • SREBP is activated at low level of cholesterol •SREBP binds DNA at sterol regulatory element (SRE) • the transcription is accelerated after SREBP binding • • 60 Regulation of HMG-CoA reductase proteolysis by sterols • Degradation of the enzyme is stimulated by cholesterol, mevalonate and farnesol. • Enzyme includes transmembrane sterol-sensitive region, that is resposible for ubiquitination of the enzyme at high level of sterols 61 Regulation of HMG-CoA reductase by covalent modification Forms of the enzyme phosphorylated dephosphorylated inactive active Glucagon, intracelular sterols (cholesterol, bill acids), glucocorticoids Insulin, thyroidal hormons Activation: kinase –AMP dependent phosphatase 62 Inhibition of HMG-CoA-reductase by drugs The statin drugs are reversible competitive inhibitors of HMG-CoA-reductase in liver. The synthesis of cholesterol in liver is decreased by their action. Statins – various structures part of their structure resembles to HMGCoA. Simvastatin (Zocor), Lovastatin (Mevacor), Pravastatin (Mevalotin), Pravastatin (Pravachol), Simvastatin (Lipovas), Fluvastatin (Lescol),… 63 64 mevalonyldiphosphate mevalonate Isopentenyl diphosphate Dimethylallyl diphosphate 5C 5C CO2 H2O 3.phase of cholesterol synthesis: formation of five carbon units O H - O O C - C H 2 - C - C H 2 - C H 2 O H C H 3 - O O C - C H 2 - C - C H 2 - C H 2 O P P O H C H 3 2ATP 2ADP C H 2 =C - C H 2 C H 2 O P P C H 3 ATP ADP + P i C H 3 C H 3 - C =C H C H 2 O P P 65 Dimethylallyldiphosphate isopentenyldiphosphate + PPi prenyltransferase geranyldiphosphate 66 Dimethylallyldiphosphate + isopentenyldiphosphate ® geranyldiphosphate 5 C 5 C 10 C 10 C 5 C 15 C farnesyl diphosphate 15 C 15 C 15 C 15 C + + 30 C squalene synthesis of dolichol and ubiquinon + Prenylation of proteins Prenylation of proteins geranyl diphosphate 67 dolichol coq2 Synthesis of oligosaccharide chains of glycoproteins Respiratory chain Dolichol diphosphate ubiquinon 68 Prenylation of proteins •Covalent modification of proteins • Binding farnesyl or geranyl-geranyl to SH- group of cystein •Mediates the interaction of proteins with membrane (anchoring) or protein –protein interaction or membrane –associated protein trafficking. • modifies some proteins affecting cell proliferation (GTP-binding proteins, eg. Ras, Rac, Rho) • inhibition of prenylation inhibits cell proliferation • inhibitors of prenylation – drugs at treatment of osteoporosis, cancer, cardiovascular diseases • farnprot 69 Squalene is linear molecul that can fold into a structure that closely resembles the steroid structure cholesterol squalen 70 Squalene (30 C) ® lanosterol (30 C) ® ® ® ® cholestadienol (27 C) ® cholesterol (27 C) Conversion of squalen to cholesterol is a process involving about 19 steps in ER : • cyclisation • shortening carbon chain from 30 to 27 C • movement of double bonds • reduction of double bond 71 Esterification of cholesterol Higher hydrophobicity Cholesterol + acylCoA ACAT Most often linoleic and linolenic acid acyl-CoA-cholesterol acyltransferase Located in ER 72 Transport of cholesterol in blood in form of lipoproteins From liver transported in form of VLDL Most of VLDL is converted to LDL after the utilization of main part of TG contained in them LDL transfers cholesterol into the periferal tissues Reverse transport of cholesterol to the liver - HDL 25-40% - esterified cholesterol 73 Cholesterol in blood Recommended value < 5 mmol/l When the total cholesterol level exceeds 5 mmol/l further investigation of lipid metabolism is necessary, especially the finding of the cholesterol distribution in the lipoprotein fractions LDL-cholesterol = „bad“ cholesterol HDL-cholesterol = „good“ cholesterol A high proportion of serum total cholesterol incorporated in HDL is considered as a sign of the satisfactory ability of an organism to eliminate undesirable excess cholesterol. On the contrary, an increased concentration of LDL-cholesterol represents the high coronary risk involved in hypercholesterolaemia. See Biochemistry II – 4.semestr 74 „Degradation of cholesterol“ • in higher animals steroid nucleus of cholesterol is neither decomposed to simple products nor oxidized to CO2 a H2O • only liver have ability to eliminate cholesterol • two ways of cholesterol elimination: conversion to bile acids and their excretion excretion of free cholesterol in bile • small amount is used for synthesis of steroid hormones and vitamin D • minimum amount of cholesterol is lost by sebum and ear-wax, in secluded enterocytes 75 Cholesterol balance per 24 h FOOD BIOSYNTHESIS 80-500 mg 800 – 1000 mg Steroid hormons, sebum and ear-wax, secluded enterocytes 200 mg Bile acids (primary) 500 mg Cholesterol (bile) 800 mg Cholesterol pool 1000-1500 mg/day is excreted 76 Cholesterol in the gut • cholesterol that enters gut lumen is mixed with dietary cholesterol • about 55% of this cholesterol is resorbed by enterocytes • remainig part is reduced by bacterial enzymes to coprostanol and excreted in feces Bacterial reductases 77 Structurally related to cholesterol; only the side chain on C-17 is changed b-sitosterol Consumption of phytosterols reduces the resorption of cholesterol. Recommended intake for people with increased level of cholesterol - 2g/day Phytosterols - sterols of plant origin Plant oils (corn, rapeseed, soya, sunflower, walnut) contain up to 0.9 % phytosterols. 78 How do phytosterols function? They penetrate into the mixed micelles that are in contact with intestine mucosa, they compete with cholesterol in resorption into the enterocytes. A:\micela.bmp 79 Synthesis of bile acids 7-α-hydroxylase NADPH, O2 cytP450 Located in ER (monooxygenase reaction) LIVER 7 rate-limiting step in the synthesis NADP+, H2O 80 In subsequent steps, the double bond in the B ring is reduced and additional hydroxylation may occur. Two different sets of compounds are produced. One set has a-hydroxylgroups at position 3,7, and 12, the second only at positions 3 and 7. Three carbons from the side chain are removed by an oxidation reaction. Primary bile acids chenodeoxycholate cholate LIVER 24 C pKA» 6 pKA» 6 12 81 Conjugation with glycine and taurine (ER) LIVER BILE INTESTINE deconjugation and partial reduction chenodeoxycholate cholate lithocholate deoxycholate feces enterohepatal circulation bacterias ABC-transporter 82 Conjugated bile acids taurocholic glycocholic Conjugation increase pKa values , increases detergent efficiency pKA» 2 pKA» 4 H O O H C O N H S O 3 - O H O H 83 lithocholate deoxycholate Secondary bile acids – do not have OH on C-7 Less soluble, excreted by feces 84 Enterohepatal circulation of bile acids Synthesis 0,2-0,6 g/den recyclation >95% Feces 0,2-0,6 g/den Digestion of lipids Reabsorption 12-32 g/den Efficiency >95% Including secondary bile acids Cholesterol®bile acids Gallbladder Intestine Liver