Objective-A functional acylation stimulating protein (ASP) receptor, C5L2, has been recently identified in ASPresponsive cells. Impaired ASP-mediated triglyceride synthesis has previously been described in a subset of hyperapolipoprotein B/familial combined hyperlipidemia subjects. Methods and Results-DNA sequencing of C5L2 coding region in 61 unrelated probands identified a heterozygous variant (G9683 T) in 1 subject, resulting in Ser3233 Ile substitution in the carboxyl terminal region. This variant was not detected in 2176 additional chromosomes by restriction fragment length polymorphism or fluorescence polarization genotyping. Eight family members of the proband were identified with one altered (ϩ/Ϫ)C5L2 allele. Nine other family members had the wild-type (ϩ/ϩ)C5L2 sequence. The abnormal allele was associated with increased plasma triglyceride, plasma cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein B and ASP. Of 23 subjects tested in cell-based ASP bioactivity assays, those with C5L2(ϩ/Ϫ) variant (nϭ2) had a 50% reduction in ASP-stimulated triglyceride synthesis, glucose transport and marked reduction in maximal binding (B max ). By contrast, a C5L2(ϩ/ϩ) family member responded normally, as did hyperapolipoprotein B normal ASP subjects compared with C5L2(ϩ/ϩ) controls (nϭ6). Key Words: acylation stimulating protein Ⅲ adipose Ⅲ C3adesArg Ⅲ gene defect Ⅲ G protein-coupled receptor Ⅲ hyperapolipoprotein B Ⅲ triglyceride synthesis I ncreased plasma apolipoprotein B (apoB) is a common dyslipoproteinemia associated with coronary artery disease 1 and is an excellent marker for diagnosis and treatment monitoring. 2 The hallmark is increased low-density lipoprotein (LDL) particles with overproduction of hepatic apoB 3 and increased small dense LDL particles. 4 Within this group, familial combined hyperlipidemia is considered to be the most frequent lipoprotein disorder in premature coronary artery disease (CAD). 5 The lipoprotein pattern varies in time and the level of penetrance may be incomplete, especially in premenopausal women. The pathogenesis of familial combined hyperlipidemia is complex and is very similar to that encountered in the metabolic syndrome. 6 This has hampered research in the cause of the disorder. Studies from Genest et al 7 and Castro-Cabezas et al 8 showed that hyperapolipoprotein B (hyperapoB) subjects have delayed triglyceride (TG) clearance and increased fatty acid after an oral fat load. 9 Peripheral resistance to fatty acid uptake in adipose tissue leads to increased hepatic flux, stimulating lipoprotein production. 10 We have proposed that, in a subset of patients, a defect in adipose tissue storage (particularly postprandially) might contribute to these abnormalities.
Conclusion-TheIn support of this hypothesis, acylation stimulating protein (ASP) is a potential candidate. ASP binds to adipocytes and preadipocytes, promotes triglyceride synthesis through stimulation of both glucose transport and fatty acid esterification, 11,12 indirectly enhancing the action ...