LECITHIN-CHOLESTEROL ACYLTRANSFERASE (LCAT) DEFICIENCY

Scientifically reviewed | Last updated
For more information see our editorial policy

LCAT

Lecithin-cholesterol acyltransferase (LCAT) deficiency is a rare, autosomal recessive inherited enzyme defect of cholesterol metabolism. LCAT is secreted by the liver and is responsible for the esterification of free cholesterol in the blood. LCAT deficiency is associated with maturation or metabolization disorders of HDL particles, resulting in the accumulation of immature HDL precursors. In patients with LCAT deficiency, the activity of alpha-lcat (lcat activity, which esterifies cholesterol in HDL) and beta-lcat (lcat activity, which esterifies cholesterol in other lipoproteins) is absent. The fact that lcat has a key biochemical function in HDL metabolism has been confirmed in several studies in animals and humans. However, its role in the development of CHD and atherosclerosis remains unclear due to contradictory results of functional studies in various animal models.

 

Also called

LCAT deficiency

 

Symptoms

Clincal features of LCAT deficiency include

 

  • Hypoalphalipoproteinemia (HDL-C <10 mg/dl)
  • Corneal opacities (not to be confused with arcus lipoides)
  • Glomerulosclerosis caused by lipid deposits, which can lead to renal insufficiency requiring transplantation
  • Normochromic anemia caused by the reduced osmotic resistance of erythrocytes.

 

LCAT deficiency is associated with an increased risk of coronary heart disease.

A reduced proportion of cholesterol esters in total cholesterol (<60%) is characteristic and atypical lipoproteins (e.g. LpX) can be detected.

 

Causes

The molecular cause of LCAT deficiency is pathogenic variants in the LCAT gene. To date, more than 70 causative variants have been identified that are distributed across the entire gene.

 

Treatment

Enzyme replacement therapy with ACP-501, a recombinant human LCAT (rhLCAT), is currently being tested (phase 1).

 

Differential Diagnosis

Differential diagnoses include fish eye disease, which is based on a partial LCAT deficiency and is not associated with glomerulosclerosis and anemia. It must also be differentiated from apo-A-I and ABCA1 deficiency (Tangier disease), which are also associated with hypoalphalipoproteinemia but have a significantly higher coronary risk.

 

References

Shapiro M.D. 2018, Endotext [Internet] / Hooper et al. 2017, EJHG 25:e1 / Vitali et al. 2017, Curr. Caridol. Rep. 19:132 / Schaefer et al. 2016, Prog. Cardiovasc. Dis. 59:97 / Ramasamy I. 2016, Clin Chim Acta. 454:143 / Trajkovska K.T. et Topuzovska S. 2017, Anatol J Cardiol. 18:149 / Schaefer et al. 2016, Endotext [Internet] / Shamburek et al. 2016, J Clin Lipidol. 10:356

GENES
LCAT
HOW CAN YOU GET TESTED?
Step 1: Visit healthcare professional
Step 2: Sample collection (blood or buccal swab)
Step 3: Sequencing performed at our accredited laboratory
Step 4: Medical report
Step 5: Genetic counselling
FAQ

CONTACT US

Please get in touch with us for any questions, inquiries, feedback or with any comments you might have.

LATEST ARTICLES

Cystic fibrosis (CF) is a life-threatening, progressive, inherited condition that causes severe damage to the body, primarily affecting the organs of...

Read more

Down syndrome is a genetic condition caused by the presence of an extra copy of chromosome 21. It affects physical growth, facial features, and cogni...

Read more

Every year on April 25th, DNA Day celebrates the discovery of DNA’s double helix and the advances we’ve made in understanding genetics. D...

Read more

Neurodevelopmental disorders (NDDs) have diverse genetic origins, making diagnosis challenging. A new study analyzing over 1,100 pediatric patients f...

Read more

Colorectal cancer (CRC) remains one of the most prevalent and deadly cancers worldwide, with a significant number of cases presenting at an advanced ...

Read more

Carrier screening is a genetic test designed to identify whether an individual carries a gene with changes (mutations) associated with inherited diso...

Read more

Trisomy 13, also known as Patau syndrome, is a genetic condition in which cells in the body have three copies of chromosome 13 instead of two. The co...

Read more

The human brain develops through a complex series of events, with genes carefully regulating the formation of neurons and glial cells. A recent study...

Read more

Rare diseases affect between 300 and 400 million people worldwide – more than cancer and AIDS combined [1, 2], but despite this, many people face a...

Read more

Rosalind Elsie Franklin was a brilliant and meticulous research scientist whose interdisciplinary work made fundamental contributions to various area...

Read more