J. Lipid Res.
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A more recent version of this article appeared on August 1, 2004

Papers In Press, published online ahead of print May 16, 2004
J. Lipid Res., doi:10.1194/jlr.R400004-JLR200
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Submitted on April 8, 2004
Revised on May 6, 2004
Accepted on May 9, 2004

Cholesterol metabolism in the central nervous system during early development and in the mature animal

John M. Dietschy and Stephen D. Turley

Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-8887

Corresponding Author: john.dietschy{at}utsouthwestern.edu

Unesterified cholesterol is an essential structural component of the plasma membrane of every cell. During evolution, this membrane came to play an additional, highly specialized role in the central nervous system (CNS) as the major architectural component of compact myelin. As a consequence, in the human the mean concentration of unesterified cholesterol in the CNS is higher than in any other tissue (~23 mg/g). Furthermore, even though the CNS accounts for only 2.1% of body weight, it contains 23% of the sterol present in the whole body pool. In all animals, most growth and differentiation of the CNS occurs in the first few weeks or years after birth, and the cholesterol required for this growth apparently comes exclusively from de novo synthesis. Currently, there is no evidence for net transfer of sterol from the blood into the brain or spinal cord. In adults, the rate of synthesis exceeds the need for new structural sterol so that net movement of cholesterol out of the CNS must take place. At least two pathways are used for this excretory process, one of which involves the formation of 24(S)-hydroxycholesterol. Whether or not changes in the plasma cholesterol concentration alter sterol metabolism in the CNS or whether such changes affect cognitive function in the brain or the incidence of dementia remains uncertain at this time.


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