Angiopoietin-like protein 3 governs LDL-cholesterol levels through endothelial lipase-dependent VLDL clearance

Rene C. Adam, Ivory J. Mintah, Corey A. Alexa-Braun, Lisa M. Shihanian, Joseph S. Lee, Poulabi Banerjee, Sara C. Hamon, Hye In Kim, Jonathan C. Cohen, Helen H. Hobbs, Cristopher Van Hout, Jesper Gromada, Andrew J. Murphy, George D. Yancopoulos, Mark W. Sleeman, Viktoria Gusarova

Research output: Contribution to journalArticlepeer-review

118 Scopus citations


Angiopoietin-like protein (ANGPTL)3 regulates plasma lipids by inhibiting LPL and endothelial lipase (EL). ANGPTL3 inactivation lowers LDL-C independently of the classical LDLR-mediated pathway and represents a promising therapeutic approach for individuals with homozygous familial hypercholesterolemia due to LDLR mutations. Yet, how ANGPTL3 regulates LDL-C levels is unknown. Here, we demonstrate in hyperlipidemic humans and mice that ANGPTL3 controls VLDL catabolism upstream of LDL. Using kinetic, lipidomic, and biophysical studies, we show that ANGPTL3 inhibition reduces VLDL-lipid content and size, generating remnant particles that are efficiently removed from the circulation. This suggests that ANGPTL3 inhibition lowers LDL-C by limiting LDL particle production. Mechanistically, we discovered that EL is a key mediator of ANGPTL3's novel pathway. Our experiments revealed that, although dispensable in the presence of LDLR, EL-mediated processing of VLDL becomes critical for LDLR-independent particle clearance. In the absence of EL and LDLR, ANGPTL3 inhibition perturbed VLDL catabolism, promoted accumulation of atypical remnants, and failed to reduce LDL-C. Taken together, we uncover ANGPTL3 at the helm of a novel EL-dependent pathway that lowers LDL-C in the absence of LDLR.

Original languageEnglish (US)
Pages (from-to)1271-1286
Number of pages16
JournalJournal of lipid research
Issue number9
StatePublished - Sep 2020


  • Atherosclerosis
  • Cardiovascular disease
  • Familial hypercholesterolemia
  • Lipidomics
  • Low density lipoprotein receptor
  • Low density lipoprotein-cholesterol
  • Very low density lipoprotein

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology
  • Cell Biology


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